Minimally Invasive Surgery (MIS) From Head to Toe
With advancements in medical technology, minimally invasive surgery is the new surgical technique that allows surgeons to perform safe, precise and less invasive surgical procedures. Bangkok Hospital, Bangkok Heart Hospital, and Wattanosoth Hospital are now offering minimally invasive surgery to patients with a wide range of surgical conditions.
Gynecologic conditions and minimally invasive surgery
With the advent of minimally invasive surgery, surgeons can now perform gynecologic surgery with cosmetically pleasing results. Minimally invasive surgery can be performed in patients with myoma, endometriosis, ovarian cyst, etc. Myoma uteri are a common condition in 30-40 year old women. 30% of the patients will need a surgery and it can also be treated by minimally invasive surgery.
Dr. YingChi Wang, a gynecologist at Bangkok Hospital, explained that with technological advancements, there is a new treatment option for endometriosis, ovarian cysts, and myoma known as advanced minimally invasive surgery. The surgical wound will be only 3-5 small cuts depending on the patient’s condition. A small camera will be inserted through a small hole allowing the doctor to see the relevant area enlarged on a digital screen. As internal tissues have reduced exposure, the need for invasive instruments is decreased. Patients also experience less blood loss, less pain, less scar tissue, and fewer complications post-surgery. Patients usually recover in 1-2 days and can perform normal activities within a week.
Orthopedic conditions and minimally invasive surgery
Dr. Pornthep Mamanee, an orthopedic surgeon at Bangkok Academy of Sports and Exercise Medicine (BASEM), FIFA Medical Centre of Excellence, said that usually joint injuries occur in the knees, ankles, wrists, shoulders and elbows. These joints can swell and suffer from inflammation and redness, making them immobile and limiting their range of motion. Joint injuries often occur as a result of bicycle accidents, falling in contact sports, and car accidents. The recovery time may take several months. The most common injury is anterior cruciate ligament injury. The injury most commonly occurs during sports that involves sudden stops, jumping or changes in direction like soccer, basketball, and skiing. Receiving a direct blow or collision to the knee, and non-contact injuries – caused by overstretched or weak muscles are possible causes.
Currently, arthroscopic surgery can be done instead of an open surgery for rotator cuff tear, anterior cruciate ligament tear, and meniscal tear. The advantages are smaller incision, less blood loss, and the patient is able to start rehabilitation within 1-2 days after surgery. In an athletic patient, the doctor will try to speed up the recovery time and get the patient back in the game as soon as possible.
Aortic aneurysm and minimally invasive surgery
Dr. Attapoom Susupaus, a cardiothoracic surgeon and assistant director of Bangkok Heart Hospital, explained that one of the most common cardiovascular condition is aortic aneurysm. The aorta is the largest blood vessel in the human body. However, some medical problems weaken the artery walls and can result in a weak aortic wall that bulges outward. This is called “aortic aneurysm”. In the worst cases, an aneurysm can burst or rupture. This causes bleeding and often leads to death within minutes to hours. Aneurysms can form in any section of the aorta, but they are most common in the abdomen and thorax. With recent advances, the surgical treatment of the condition greatly improves the patient’s safety.
There are two primary methods of aortic aneurysm repair: open repair and endovascular aneurysm repair (EVAR). Endovascular procedures aim to reduce the morbidity and mortality of treating aortic aneurysm. The endovascular aneurysm repair requires much smaller incisions and associates with reduced complications and better survival rate. After the surgery, patient should do moderate exercise and stop smoking as it may significantly reduce the mortality rate (4 times). The minimally invasive surgery technique can also be used in other cardiac surgeries such as aortic valve replacement.
Males who are 65 year and older has around 10-15% risk of developing aortic aneurysm. People who are in high risk groups should have a screening test in order to prevent the rupture and if they have any symptoms, they should consult a doctor right away.
Colorectal cancer and minimally invasive surgery
Dr. Wutthi Sumetchotimaytha, a surgical oncologist at Wattanosoth hospital, explained that colorectal cancer happens when cells grow and divide uncontrollably, without dying. Signs and symptoms of colorectal cancer include a change in bowel habits, such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days, and unexplained weight loss.
Treatment of colorectal cancer includes surgery, radiotherapy, and chemotherapy. In the past, the surgical treatment for colorectal cancer was open surgery. The surgical wound was around 6-12 inches or 15-30 centimeters depending on the size and location of the tumor. In the last two decades, laparoscopic surgery for colorectal cancer has undergone tremendous advancements. Only 4-5 small incisions (6-8 millimeters) are made to insert the surgical instruments. The largest surgical wound is around 4 centimeters and the size and number of surgical wounds depends on the size of the tumor.
The benefits of laparoscopic surgery are smaller incision, less blood loss, less recovery time, and fewer complications. The patient will recover faster and get back to normal life quicker. However, the treatment option the doctor recommends will depend on the patient’s condition and cancer stage.
Benefits of continual innovations in minimally invasive surgery
Minimally invasive surgery is a safe and effective technique to meet the surgical needs of many patients. In the last 20 years, many surgeons have come to prefer it over traditional open surgery, which requires larger incisions, and longer hospital stays. The benefits of minimally invasive surgery are less blood loss, less pain, shorter recovery time, and fewer post-operative complications. Continual innovations in minimally invasive surgery makes it beneficial for people with a wide range of conditions. Surgeons perform many minimally invasive surgeries, including: cancer surgery, orthopedic surgery, heart surgery, gastroenterologic surgery, gynecologic surgery, and urologic surgery.