Minimally Invasive and Robotic Procedures

davinciDuring a minimally invasive procedure, surgeons make several small incisions in the skin — just a few millimeters, in some cases. A long, thin tube with a miniature camera attached at the end (called an endoscope) is passed through one of the incisions. Images from the endoscope are projected onto monitors in the operating room so surgeons can get a clear (and magnified) view of the surgical area. Special instruments are passed through the other openings. These instruments allow the surgeon to perform the surgery by exploring, removing, or repairing whatever's wrong inside the body.

Among the advantages to having a minimally invasive surgical procedure are:

  • reduced scarring,
  • reduced trauma to the body cavity,
  • less blood loss,
  • reduced chance of postoperative complications,
  • reduced pain and
  • depending on your condition, a shorter hospital stay and significantly faster recovery time.

In many cases, minimally invasive procedures are more effective in treating the condition and both short- and long-term prognosis is more favorable than traditional surgical techniques. 

Robot-assisted surgery is a special form of minimally invasive surgery. At UTMB Health, we use the da Vinci Surgical system, which was first approved by the US Food and Drug Administration (FDA) in 2000. In many applications, robot-assisted surgery has significant advantages over traditional minimally invasive surgery and open surgical techniques. The robotic system provides better visibility as a result of its 3D, high definition imaging capabilities.

In addition, hand-eye coordination is intuitive, in contrast to other minimally invasive (laparoscopic) systems, where the instruments’ movement on the monitor is opposite the direction of the surgeon’s hand. Robotic surgical systems have seven degrees of motion, just like a human wrist, whereas traditional minimally invasive surgical instruments are mostly restricted to four degrees of motion. 

The different types of minimally invasive surgery:

Robotic Surgery

Advanced, computer-enhanced technologies provide new alternatives to surgical procedures. Robot-assisted surgery is a special form of minimally invasive surgery (we use the da Vinci surgical system). Robot-assisted surgery is often associated with improved patient outcomes and less pain, blood loss, scarring and time to recuperate.

Endoscopic Surgery

Endoscopic surgery makes use of an endoscope, which is a thin tube with a small camera and light attached. As the doctor moves the endoscope through a body passageway (such as the gastrointestinal tract or respiratory tract) or opening (including from surgery), he or she can see inside the organ or tissue. Endoscopes are used for diagnosing conditions throughout the body. Advances in endoscopic medicine have led to the development of new endoscopic tools that enable physicians to see, diagnose and treat numerous conditions. The treatment of conditions with endoscopic tools is called therapeutic endoscopy.

Endovascular Surgery

Endovascular surgery is a minimally invasive procedure used to treat problems affecting the blood vessels. The surgeon will get access to the problem area, such as a clogged artery, through the femoral artery, for example. Sliding a long catheter through the artery, the clog will be treated with a self-adjusting stent or inflatable balloon. Unlike traditional vascular surgery, local anesthesia is typically used for endovascular surgery, and recovery time is reduced.

Laparoscopic Surgery

Laparoscopic surgery or laparoscopy is a form of minimally invasive surgery in which a small incision is made in the abdominal wall through which an instrument called a laparoscope is inserted. The laparoscope has a tiny video camera enabling the surgeon to see inside the abdomen without a large open surgical incision. The surgical area is magnified on a TV monitor.

The surgeon makes a few small incisions that are each about one-quarter to one-half inch long and inserts several small, thin instruments with which to operate. By carefully removing diseased tissue in small pieces, cancerous and damaged organs can be removed through laparoscopic techniques.

Video-assisted Thorascopic Surgery

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest.

During a video-assisted thoracoscopic surgery procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through several small incisions. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.

Surgeons use the video-assisted thoracoscopic surgery technique to perform a variety of operations, such as:

When compared with a traditional open operation (thoracotomy), video-assisted thoracoscopic surgery may result in less pain and shorten recovery time.

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