If you had to undergo major surgery a decade ago, chances are you would have emerged from the operation with a long incision and an even longer recovery time. But nowadays that is no longer the case.

"Many major surgeries can now be done with the assistance of minimally invasive techniques," says George J. Childs, MD, FACS, a general surgeon at Manatee Memorial Hospital. "These medically advanced techniques have now become the standard of care for certain types of surgery."

A commonly used technique is laparoscopic surgery, sometimes called "keyhole surgery" because of the small incisions required. Gynecologic surgeons were among the first to use laparoscopic surgery, says Dr. Childs. Now many different types of physicians, including general surgeons, urologists, heart surgeons and orthopedic surgeons, use this minimally invasive technique to treat their patients.

How does it work?
A surgeon performs laparoscopic surgery by inserting a thin instrument with a video camera lens on one end into the patient's body through a small incision. The surgeon uses the camera to view the surgical area. Then, he or she performs the surgery using miniaturized operating tools inserted through other small incisions.

"Smaller incisions mean less time in the hospital after surgery and a shorter recovery time," says Dr. Childs. "In some cases, patients now can go home hours after having these procedures and return to work in just a few days.

"For example, an open cholecystectomy (gallbladder removal) used to mean a three- to four-day hospital stay. But now, with laparoscopic cholecystectomy, it's a one-day procedure," says Dr. Childs. Gallbladder removal is probably the most commonly performed minimally invasive abdominal procedure, he adds.

In addition to diseased gallbladders, surgeons now can remove spleens, kidneys, adrenal glands and ovaries, as well as sew the bowel together and repair hernias, all through incisions about the size of a keyhole.

George J. Childs, MD, FACS 250 2nd St. East Suite 4-F Bradenton, FL 34208 941-747-8404

Proceed with caution
According to Dr. Childs, some new surgical residents can do laparoscopy but are not trained in traditional open surgery, although a need still exists for the open procedure.

"For example, bypass surgery is still an open procedure," he says. "In an open procedure you have everything right in front of you, so you're less likely to miss something.

"Also, sometimes it takes longer to do a procedure through laparoscopy as opposed to open surgery. Then you worry about whether the patient will have complications from the anesthesia since he or she has to be under longer. So, it's not always a panacea."

Dr. Childs says a patient should ask his or her doctor which procedure is most commonly performed for the surgery he or she is anticipating. He adds that any type of surgery requires some recovery period, and patients should expect to experience some postoperative discomfort.

Surgical Robots Are on the Horizon
Dr. Childs looks forward to robotic technology in which surgeons guide a robot through minimally invasive procedures using a virtual reality program. Still in the experimental stages, this procedure is expected to give the surgeon greater precision in doing complex tasks.

For more information, visit www.manateememorial.com. Click on the Health Information link on the left side of the home page. Under Look It Up on the left side of the next page, click on Be Well Informed and scroll down to Deciding About Surgery.