Thursday, August 2, 2018

This Type of Surgery Could Help You Heal Faster

By Carrie Vittitoe
Illustration by Silvia Cabib 
If a disease has progressed too far or pain has become intolerable, surgery might become a necessity, but that then means dealing with recovery. Over the past decade, there has been an uptick in the use of minimally invasive surgery, which often allows patients to return to regular activities sooner than traditional surgery. But how do you know if minimally invasive surgery is right for you?

What does “minimally invasive” actually mean?
The term minimally invasive generally means laparoscopic, which is when small incisions are made and trocars (small hollow tubes) are inserted into the incision. Surgeons then thread their surgical tools and a camera into the trocars to remove disease or make repairs without opening up the entire surgical area. The benefit of this type of surgery is that “rather than disrupting organs or the body cavity, it reduces the collateral involvement of tissue,” says Dr. Janet Chipman, a general surgeon with Baptist Health Surgical Group. This surgical approach often means less pain and a lowered risk of infection.

Qualifications for minimally invasive surgery
One of the most important determinants of whether a patient should have minimally invasive surgery as opposed to open surgery might surprise you because it doesn’t have anything to do with the patient. “Surgeons need to have high expertise in laparoscopy,” Dr. Chipman says. While a busy surgeon might be aggravating to a patient who is trying to get an appointment, it also likely means that the surgeon is well-practiced in laparoscopic techniques because she is performing it regularly.

Dr. Chipman adds that disease progression is also a determinant in whether a patient is a good candidate for minimally invasive surgery. For example, a cancer that is very large and bulky will require a bigger incision than what is used in laparoscopy.

Preparing for minimally invasive surgery
If a person is having surgery that requires the cleaning out of the bowels, Dr. Chipman says the purgative preparation is the same regardless of what type of surgery is being done.

Physicians who do both traditional and laparoscopic surgery often try to utilize the Enhanced Recovery After Surgery (ERAS) protocols. These protocols are intended to minimize the length of recovery regardless of surgery type. One aspect of ERAS is providing various types of pain control, including anti-inflammatories and acetaminophen, to reduce the use of narcotics. Another aspect of the protocol is the use of the medication Entereg to reduce the likelihood of postoperative ileus (nausea, vomiting, bloating, and decreased GI motility).

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