Week 6: Minimally Invasive Surgery

Question 1

What is minimally invasive surgery?

Answer 1

Surgeons use a variety of techniques to operate with less damage to the body than in open surgery; in general minimally invasive surgical techniques are associated with less pain, shorter length of hospital stay and fewer complications

Question 2

What are examples of MIS?

Answer 2

Laparoscopy: as recent as 1985 first laparoscopic cholecystectomy.
Arthroscopy
Thoracoscopy
Neuro endoscopy
MIS spine techniques

Question 3

Why are endoscopies not true MIS examples?

Answer 3

All involve natural orifice entry

Question 4

What are the benefits of MIS?

Answer 4

Shorter length of stay
Shorter rehabilitation time
Reduced operating time with experience

Question 5

What are the disadvantages of MIS?

Answer 5

Specialised training required
Gentle Learning curve
Technical difficulties
Potential for open conversion
Expense of specialised instrumentation & equipment
Disposable items – waste & expense

Question 6

What equipment is necessary for MIS?

Answer 6

Camera & camera heads
Light source & light leads
Insufflator
Monitor
Telescopes
Access ports & trocars

Question 7

What are laparoscopies used for?

Answer 7

Diagnosis & surgical repair or removal.
Gallstones – cholecystectomy
Appendicitis – appendicectomy
Hernia – hernia repair
Adhesions – division of adhesions
Perforated ulcer – closure of perforation
Hiatus hernia – hiatus hernia repair
Carcinoma – gastrectomy; hemicolectomy; anterior resection; oesophagogastrectomy

Question 8

Why is intra-umbilical entry used?

Answer 8

Fixed peritoneum
Thin
Least vascular
cosmetic

Question 9

What injuries can occur from primary port closed entry?

Answer 9

Bowel injury
Vascular injury
Retroperitoneal haemorrhage
Bladder injury
Injury to over inflated stomach

Question 10

What is arthroscopy used for?

Answer 10

Diagnosis & surgical repair or removal
Cartilage – menisectomy
Bone surface repair – chondroplasty
Ligament repair – reconstruction
Bony fragment – removal of foreign body

Question 11

What is a thoracoscopy used for?

Answer 11

Diagnosis & surgical repair or removal
Bullae –
Carcinoma – wedge resection; lobectomy;

Question 12

What is a neuro endoscopy used for?

Answer 12

Endoscopic third ventriculostomy
Aids flow of CSF
Preventing obstructive hydrocephalus