Minimal access surgery also commonly know as laparoscopic surgery, keyhole surgery, scarless surgery, natural orifice surgery or endoscopic surgery has almost gripped the entire surgical arena in various allied specialities of surgery. The 21st century “ Time bound Generation” needs more out of there surgical experiences and surgeons never hesitated to give them back with the best of the surgical outcomes and results.
The minimal access surgery developed in late nineteenth century with help of great surgeons who devoted there vision, energy and science to bring this field of surgery in common surgical practice around the world. The technologies, logistics and training that we see today were not available that time. In due progress,the healthcare industry realised the potential and advantages of minimal access surgery for the patients and society. In turn, the technical advancements, training programs, equipment and logistics, availability and development of science in various surgical disciplines took over last three decades.
As the name defines, the minimal access surgery is performed by creating small cuts in the body using specialised instruments, techniques and monitor system to visualise and perform the entire surgery. This surgery provides the advantages of less pain after surgery, less injury to internal tissues of the body, early recovery of the patients, minimal scar on the body and early return to the work and office.
The surgeons and hospitals mostly educate the patients regarding the benefits of surgery or educated patient demand minimal access surgery from the doctors. The usage of minimal surgery is not limited to abdominal cavity but is also commonly used to treat various cancers, kidney disease, urological disease, chest surgeries, nasal and throat endoscopic surgeries, gynaecological surgeries, neurological and spine surgeries, endoscopic gastrointestinal procedures and joint surgeries.
The advancements of the surgical instrumentation and surgeons enthusiasm globally to adventure with the advanced techniques for patients health has worked out very well. The early questions about the safe usage of laparoscopic surgeries and other minimal access surgeries were
answered by long term results and scientific data published across numerous guidelines in national and international journals.
The use of robotic surgeries which is advanced approach of minimal access surgery itself have been applied at various hospitals. The common myth associated with robotic surgery with patients is “ robot do the surgery”. Actually, it’s not the case as robot console is handled by surgeon as he guides and performs the surgery himself using robot as intermediate. The advantages comes with increased precision, movements as similar to conventional surgery and three dimensional vision to improve the accuracy.
However, these advantages comes with high cost of robotic system and high cost of robotic surgery. Moreover, application of robotic surgery in every arena of minimal access surgery is not applicable. Though, the scientific data is generally favouring robotic surgery, the long term results and efficacy of the surgery for many disease performed with robotic surgery are not yet proven without doubt. Hopefully, with progress of long term research we will able to get better picture of usage of robotic surgery.
The need of an hours lies with healthcare technology providing industry to make it feasible and available the usage of minimal access surgery to poor patients by working on there cost and logistics. The very same is applied to robotic system where the whopping costs itself restricts its widespread usage.
The usage of endoscopic robotic arms and single platform robotic systems a still very limited. We also need to stress upon robust training programs for surgeons as it lacks uniformity among institutes.
There is no doubt the present and the future of the surgery will remain minimal access surgery!
Dr Saurabh Bansal ( Surgeon)
Founder and Managing Director
Surgeons House Limited