Minimal Access Surgeries in Orthopedics
Minimal access surgeries in orthopedics and sports medicine are a range of techniques designed to minimize tissue damage and speed up recovery. These include:
- Fluoroscopy-Guided Procedures: Utilize real-time X-ray imaging to guide surgical instruments during procedures. Commonly used for joint injections and spinal surgeries.
- Ultrasound-Guided Procedures: Employ ultrasound imaging to visualize muscles, tendons, and joints for accurate needle placement, commonly in joint injections and tendon repairs.
- Keyhole Surgeries: Small incisions are used to insert surgical instruments, often assisted by a camera. Popular in knee and shoulder surgeries like meniscus or rotator cuff repairs.
- Mini Arthroscopic Surgeries: Similar to keyhole surgeries, but specifically for joint-related issues, using a small arthroscope to diagnose and treat joint problems.
- Endoscopic Surgeries: Involves an endoscope to view internal structures, used in spinal and joint surgeries.
These surgeries are employed for various reasons
- Precision: Enhanced imaging provides better accuracy.
- Less Trauma to Tissues: Smaller incisions mean less damage to surrounding tissues.
- Reduced Pain and Scarring: Smaller incisions lead to less post-operative pain and smaller scars.
- Faster Recovery: Patients typically have quicker rehabilitation times.
- Lower Infection Risk: Smaller wounds reduce the risk of infections.
Specifically, they are used in
- Knee: For ACL reconstruction, meniscus repair.
- Shoulder: For rotator cuff repairs, shoulder stabilization.
- Spine: For discectomies, spinal decompressions.
Advantages over Open Surgeries
- Less Invasive: Smaller incisions reduce the trauma to the body.
- Quicker Recovery Time: Patients often return to normal activities faster.
- Less Pain and Scarring: Smaller incisions are less painful and heal with less visible scarring.
- Reduced Risk of Infection: Smaller wound surface area lowers infection chances.
- Better Cosmetic Results: Due to smaller scars.
Disadvantages and Shortcomings
- Limited Exposure: The smaller field of view can sometimes limit the surgeon’s ability to see and address all issues.
- Technical Difficulty: These procedures often require specialized training and expertise.
- Equipment Dependency: Reliance on specific, sometimes expensive, equipment.
- Not Suitable for All Cases: Some complex or extensive injuries might still require open surgery.
Conclusion
- Overall, minimal access surgeries offer significant benefits in suitable cases, particularly in terms of recovery and cosmesis, but they also require specialized skills and equipment and are not universally applicable.
