What is Minimally Invasive Surgery (MIS)?
Minimally Invasive Surgery (MIS) commonly known as ‘keyhole surgery’ (laparoscopy or hysteroscopy) involves using small incision surgical techniques that are intended to achieve clinical outcomes akin to those of conventional open surgery but are associated with minimal discomfort, faster recovery time and shorter hospital stay.
MIS uses skilled surgical techniques and special equipment and instruments to successfully perform the surgery.
Benefits of Minimally Invasive Surgery
Compared to traditional open surgery, MIS has the following benefits for patients:
- Less discomfort
- Less blood loss
- Smaller and more aesthetically acceptable surgical scars
- Less need for pain medication
- Earlier discharge from hospital
- Earlier return to normal activities
Limitations of Minimally Invasive Surgery
The Minimally Invasive Surgery is not suitable for all patients. It has certain limitations which include:
- May take more time to perform as compared to open surgery
- May cost more due to specialized equipment used
- Requires expert training and more skill so it may not be offered in some centres
- As a result of intraoperative complications, unexpected findings or safety concerns the minimally invasive surgery be converted into open surgery.
Laparoscopic surgery incorporates the use of a thin tube-like instrument typically known as a laparoscope attached to a light source to visualize the area of concern inside the abdomen or plevis.
A laparoscope is passed into the abdomen through a tiny incision (cut) in the skin. Laparoscopy is performed in order to determine the cause of abdominal/ pelvic pain or distention It can confirm or refute abnormal radiological findings (ultrasound scan, CT scans MRI, X-rays).
Laparoscopic surgery can successfully remove endometriosis, pelvic adhesions, fibroids, uterus ovarian cysts and ectopic pregnancies.
How is it performed?
Laparoscopic surgery is performed under general anaesthesia. The skin over the abdomen is cleaned. The gynaecologist then makes a incision (cut) about 1-2 cm long into the navel (belly button).
The abdomen is distended with CO2 gas. This allows the gynaecologist to visualise the internal organs clearly with the laparoscope which is inserted through the incision into the abdominal cavity. The laparoscope is connected to a monitor to allow the gynaecologist and the rest of the surgical team to visualize and perform the entire operation.
Once the surgery is completed, the laparoscope and other instruments are removed. The incisions are closed and dressings are applied.
The recovery time varies depending on the type of surgery that was performed. The discomfort post-surgery is usually minimal when compared to open surgery.
Laparoscopy risk factors
In laparoscopic surgery, the risk of complications may increase, depending on the complexity of the operation performed.
In general, laparoscopic surgery is safe but as with all types of surgery, there are risk and complications involved.
- Excessive bleeding requiring blood transfusion
- Inadvertent damage to abdominal structures, such as the intestines, bladder, blood vessels and nerves. This risk is low but if it does unfortunately occur, these can be surgically repaired.
- General anaesthesia risks requiring ICU care
- Pelvic and wound infections requiring a course of antibiotics