Traditional surgery in Orthopaedics and Spine surgery involves incising the skin, dissecting muscles, nerves and blood vessels, which can, unfortunately, give rise to postoperative pain and possible problems with wound healing. To minimise these issues, surgery through small incisions or keyholes developed a few decades ago and now popularised in select centres. Also, in certain situations, as in operations inside joints (arthroscopy), the visualisation of tissues could be better than traditional medicine. This type of surgery is called Minimally invasive surgery.
Minimally invasive surgery (MIS) can do through keyholes (small stab type incisions) as in the case of Arthroscopic surgery, which is surgery done inside joint spaces or Endoscopic spine surgery, which is done mainly for disc problems in the spine. MIS can also be done using small incisions in the needle as well as bones and joints. Examples in spine include microscopic spinal surgery done with the aid of microscope for disc problems and the minimally invasive spine surgery done for spinal trauma and fusion surgeries of the spine, where unique instruments are used to fix the needle through tiny incisions. Examples of this type of surgery in Orthopaedics include Minimally invasive trauma surgery and Minimally invasive Partial and Total joint replacements.
Here again, specialised instruments are used to perform these surgeries through tiny incisions.
So, the inevitable question arises. Can every Ortho and Spine surgery be done by this method?
It is standard practice in an advanced Ortho and Spine Center like ours, we try and do most surgeries through this approach as the benefits are apparent. Of course, not every surgery can be done by these methods as some operations do require broad exposure of tissues. Also, MIS surgeries need specific specialist training for the surgeon who is performing, as the orientation of tissues during surgery can be entirely different in minimally invasive surgery as compared to open surgery. The equipment required to complete these operations are also entirely different compared to traditional medicine, and often these equipment are expensive as they might have to import. So, only specialist centres can offer these surgeries for Ortho and Spine problems, and if MIS performed well, the immediate postoperative pain relief and long-term results could be superior and also minimise the risk of complications, compared to traditional surgery.
-Dr S S Kumar
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