"MINIMALLY" INVASIVE SURGERY
What does it mean?
Traditional surgery was performed without "magnification" (such as Loupes worn by the surgeon on eyeglasses, or better still, the operating Microscope).
The Creed "The bigger the surgeon (important), the bigger the incision" was
taught to budding surgeons well into the 1970's.
The reason for this statement had to do with visualization of tissues.
Operating lights placed a beam about the surgeons head on either side, to
illuminate the operating field. Therefore, the deeper the incision, the wider the wound.
The light could not go "through the Surgeon's head, only around." And we all know
how big a surgeon's head can get.
Enter the OPERATING MICROSCOPE.
Looking through a binocular microscope with fiberoptic illumination between the eyepieces, a surgeon could see directly into the wound. A TUBE Type incision could be used, so the top of the incision (skin) was the same size as the bottom (where the surgeons was doing the work). AND, the assistant had basically the same view from a binocular on the opposite side of the operating table!
Amazingly, some Neurosurgeons initially rebelled against this "New" technology. Arguments that it wasn't any better, or took longer to do a procedure, were made by those not inclined to believe, that a brighter operating field, magnification to see small anatomical parts, and less destruction of tissues, could not somehow produce better results.
Fiberoptic SCOPE (Endoscopy).
Using a fiberoptic narrow tube, physicians can see" indirectly" the tissues on a TV monitor through even smaller incisions. Early Problems: fiberoptic use on 1980 or 1990 TV monitors, was not High Def, the tip of the fiberoptic unit could get blood or other tissues on it, and then the "TV" (surgeon) went blind!
Progress
High Definition Monitors, better resolution cameras, techniques etc., now have made such procedures safer and routine.
So what then is "minimally" invasive surgery?
Surprisingly, it still can be quite invasive, just less so. At other times, it is what you might expect!
FOR INSTANCE:
A surgeon wishes to "FUSE" a spine using various techniques, such as screws
and/or device between the vertebrae. Rather than using a large incision, he uses
a "smaller" one with radiologic Guidance. STILL A LARGE PROCEDURE....Just less so.
In certain cases, it can be of significant benefit. In others, much less so.
JUST BECAUSE A SURGEON CAN DO SOMETHING SMALLER, doesn't mean it's always
best for the patient.
Alright, that seems counter intuitive, and certainly contradictory to what was said earlier.
Writing the bible on the head of a pin may be possible, but is it better?
In many cases, YES. In some, No!
Medical Specialties will differ in their use of a particular technique.
Some specialties find what's best in one field, doesn't apply so well to
theirs.
Also, Marketing (bad word), influences the public's decision on a particular technique. For instance, " Lasers" were used more frequently in Neurosurgery in the 1980s, and early 1990s than now. But patients still may believe this is what they need for a particular spine procedure.
SO, YOU CAN GUESS!
Your surgeon should be familiar with all the basic techniques, pros and cons!
And, be able to explain them to you.
MINIMIMALLY INVASIVE SURGERY therefore, is a term with some "wiggle room"....
unless your surgeon limits himself to "smaller" procedures on the spine.
Certainly, a fiberoptic "tube" approach, would seem to qualify But other's might
as well. And yes, sometimes a larger procedure may be still recommended
for reasons your surgeon should explain.
* * * * * * * * * * * *
FINALLY, AT TIMES, A "SIMPLE" RADIOLOGICALLY GUIDED OPERATION IS BEST.
Almost no incision is made ( large needle).
See " KYPHOPLASTY" on this site.
ALABAMA NEUROSURGEONS PC. HAS BEEN PERFORMING OUT PATIENT
SPINE OPERATIONS FOR MORE THAN 20 YEARS !
NOT ALL CASES ARE RECOMMENDED AS OUT PATIENT....DEPENDING ON THE OVERALL HEALTH OF THE PATIENT, AND NATURE OF THE PROCEDURE.
A SURGEON'S JUDGEMENT IS THE KEY.
BE INFORMED