Minimal Access Surgery
Have we heard of Minimal Access Surgery? Well it is quite self explanatory actually, a surgical procedure performed via a small access. However in such diversified community, explaining the procedure actually can be quite comical. “Itu guna laserkah?”, ” teropong punya potongka”, “luka kecik-kecik potongka” or even ” guna camera potong ka” are some of the ways patients ask us about the above procedure. Patients, most of them, have actually heard quite a lot about this procedure and knows that this is advances in medicine and surgery and has its benefits.
Then I have older and even young surgeons asking what is so interesting in such a procedure. Isn’t the conventional open chop-chop more surgically interesting? More “fast & furious”? My answer ” True and False”.
Well, conventional surgery is what most or all of us are used to. Therefore, it becomes easier and safer but actually that too after some learning curve.So now it becomes exciting.
MAS is the way of the future. Benefits clearly outweighs the complications when a procedure becomes a norm such as laparoscopic appendectomy and laparoscopic cholecystectomy.
Yes, for the surgeon it can be tedious and frustrating in the begining but when the challenge and preserverance are conquered, and the patient recovers with a definite difference from conventional surgery — satisfaction guaranteed. Surgery is art.
A beginner in lapaoscopic surgery, should not have any restriction to convert to open method when he or she is having difficulty.
So what are the benefits:
1.Reduced post operative pain
2.Easier / Better recovery with shorter hospital stay
3.Early back to work
4. Good cosmesis
5. minimal adhesions and wound infections
And the disadvantages:
1.increased short term complications usually due to technical errors
Minimal access surgery requires totally different skills than conventional surgery. For instance, surgeons need to learn different hand-eye coordination (‘psychomotor’) skills in order to manipulate the imaging and surgical equipment; tissue appears significantly different when
viewed from inside the body; care must be taken to avoid accidental damage.
So why not laparoscopic surgery?






September 28th, 2006 at 2:31 pm
Aye for minimal access, I say. Got to go… will say more.
September 28th, 2006 at 2:33 pm
Thanks Bernard.
September 29th, 2006 at 9:33 am
George,
1. Cholecystectomy: no fight. Lap wins hands down.
2. Appendicectomy: a lot of advantages. Use in the appropriate setting.
“Lap” sounds better than “open” to patients too
September 30th, 2006 at 3:37 pm
Dear Doctor,
MAS is better than the opensurgery,Because MAS has more benefit than open surgery.Try your best to prove it &reveal to others. All the best.
October 1st, 2006 at 12:43 pm
Well thanks.
I do follow as far as possible the Cochrane Review for Lap Appendectomy. I am now into Lap TEP hernia repair. Lap ventral hernia repair has definite advantages except for very small hernias which can be repaired by Mayo’s technique.