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  • Dr. Tarangini V

The Role of Technology in Minimally Invasive Surgery

What is minimally invasive surgery (MIS)?

In minimally invasive surgery, doctors use a variety of techniques to perform surgery with less damage to the body than open surgery. Minimally invasive surgery is generally associated with less pain, shorter hospital stays, and fewer complications.

Laparoscopy (surgery performed through one or more small incisions using a small tube and a small camera and surgical instruments) was one of the first types of minimally invasive surgery. Another type of minimally invasive surgery is robotic surgery. It provides a magnified 3D view of the surgical site, helping surgeons perform surgery with accuracy, flexibility, and control.

Image credits: istock



Various Types of minimally invasive surgeries include -

  • Adrenalectomy to remove one or both adrenal glands

  • Brain surgery

  • Colectomy to remove part of the affected colon

  • Gallbladder surgery to relieve gallstone pain (cholecystectomy)

  • Heart surgery

  • Hiatal hernia surgery to relieve gastroesophageal reflux disease (GERD) (sometimes called reflux prevention surgery)

  • Kidney transplant

  • Nephrectomy (nephrectomy)

  • Spine surgery

  • Splenectomy to remove the spleen

  • Minimally invasive surgery can also be used for more general surgery, including:

    • Cancer surgery, for example, to destroy a tumor

    • Colon and rectal surgery

    • Intravascular surgery to treat or repair an aneurysm

    • Gastrointestinal surgery, including gastric bypass

    • Gynecological surgery

    • Neurosurgery

    • Orthopedics

    • Otorhinolaryngology (Otorhinolaryngology) Head and neck surgery

    • Thoracic surgery


How has technology helped surgery?

Common to all is the use of information age technologies such as 3D visualization, robotics, teleoperation, and computer-assisted operations. These make it possible to transform the annoying movements of minimally invasive surgery from surgical workstations into natural hand movements.

Laparoscopic surgery is the first step into this information world, and dexterity-enhanced, computer-assisted, image-guided, or robotic surgery is the next step. In laparoscopic surgery, the surgeon looks at the video monitor—seeing the "information equivalent" of the actual organs and tissues. Although highly innovative new instruments are continuously being developed, laparoscopic surgery began with a grasping instrument that was first illustrated by Ambrose Paré in 1523.

Image credits:istock


Currently, the entire surgery is done electronically. In the world of information, it is performed by video images and electronic hand signals. Just as the surgeon can increase video images to improve visibility when operating from outside the body, it also enhances electronic hand movements, making the surgeon more dexterous and accurate than done by open surgery. Laparoscopic surgery can be seen as a transition to the world of information, enabling surgery far beyond the capabilities of bare hands, not only on a normal scale, but also on a microscopic, cellular, or nanoscale.

It is an additional bonus that the ability to enhance human capabilities through information technology also provides the ability to perform operations in remote areas. Patients and surgeons do not have to be in the same location to achieve improved surgical outcomes. Interventions can be performed over distance because hand movements are electronically transmitted to the tip of the device.


Innovations in the field of minimally invasive surgery (MIS)

Since its introduction in the early 1980s, the basic concepts haven't changed much, but there have been constant innovations to improve MIS. This includes innovations in instruments used such as laparoscopic instruments and sutures, surgical robotics, imaging systems, natural meat transluminal endoscopic surgery (NOTES), and single-port laparoscopy (SILS). The second stage of growth mentioned is related to surgical robots and imaging guidance. Their growth shows a gradual and exponential pattern from the mid-1990s to beyond 2000.



One of the greatest advances in MIS over the last decade is in the field of robotic surgery. Robotics was introduced for surgery in private hospitals in the early 1990s but were first used in military facilities during surgery in the 1970s. The combination of robotics and informatics can extend the surgeon's skills to achieve significantly improved accuracy and accuracy in complex surgery.

Robotic surgery

With the ever-advancing technology of optics and computing, virtual reality (VR) and three-dimensional (3D) have been introduced into the operating room. This enables the development of patient-specific models that allow complex surgery to be planned and performed on the VR platform prior to the actual surgery.



 

References

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