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Small Wonder - Minimally Invasive Surgery Videos

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The Basics

The CHOP MIS team defines what is meant by "minimally invasive surgery". (It’s much more than just little tiny incisions.) Also learn about the benefits of MIS to pediatric patients.

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Transcript: The Basics


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Alan Flake, MD: Minimally invasive surgery could be defined as surgery that's less invasive than the old large-incision open surgery.

Susan Scully, RN: It's surgery that you do through tiny little holes with specialized equipment.

Alan Flake, MD: Very, very small incisions that we put scopes and instruments through to do the large operations that we used to do through big incisions.

Thane Blinman, MD: It's had all kinds of different names during history--thoracolaparoscopy, general endoscopic surgery, Band-Aid surgery, keyhole surgery, scarless surgery -- all kinds of different names for it. We call it minimally invasive surgery.

Alan Flake, MD: The two main types of minimally invasive surgery are laparoscopy, and that's were we operate in the abdominal cavity.

Thane Blinman, MD: So laparoscopy is looking inside the abdomen with a telescope.

Alan Flake, MD: And the other is thoracoscopy.

Thane Blinman, MD: Thoracoscopy means looking into the thorax, the chest.

Alan Flake, MD: There have been many principles in open surgery that have been developed over the years that really allow it to be done safely.

Thane Blinman, MD: All these principles that we've used count even more in minimally invasive surgery.

Alan Flake, MD: How you achieve those goals is what's different about minimally invasive surgery.

Thane Blinman, MD: That means, not that we replicate every step exactly the same way, but that the mechanical result is at least as good-and in many circumstances the result is a lot better.

Alan Flake, MD: There are many benefits to having minimally invasive operations.

Thane Blinman, MD: The first advantage, of course, is that the incisions are a lot smaller.

Alan Flake, MD: So you have less pain immediately after the procedure. You don't have the amount of muscle that you've divided and the large incisions that used to be very painful.

Thane Blinman, MD: We can do our operation with a great deal of precision, and that's the next thing.

N. Scott Adzick, MD: The optics and the magnification are a huge advantage for minimally invasive approaches. Frequently, when we do open operations in kids or in babies, we wear magnifying loupes that magnify things by a factor of usually three and a half to four.

Thane Blinman, MD: Minimally invasive techniques give us 20 or 30 times magnification. We can see a lot more, and we're not just looking from the top. We can see from the side. We can look underneath. We can go around corners. We can see things we never saw before on the open cases, and that lets us operate with a great deal of precision.

N. Scott Adzick, MD: Plus you're leaving organs in their natural position. You're not manipulating them to bring them in or out of the abdomen or things of that sort. So the optics are fantastic.

Alan Flake, MD: Certainly, if you have three little 5-millimeter incisions, you recover much more quickly than if you have a 12-inch-long incision. Not only do you have less pain in your recovery, but your intestine begins to work more quickly. You're functionally recovered much more quickly than you are with large incisions.

Susan Scully, RN: The worst thing is to see your child in pain. So, if we can do a surgery that would have caused a week of pain, and now they're only going to be in pain for two days, that has to be one of the best things for a parent to hear.

Alex Maysonet, Father: My mind is going years ahead of me. You know, and it's like -- Wow. Is this going to be, like, a really big surgery? Is she going to have huge scars? Is this something that she's going to be affected with psychologically?

N. Scott Adzick, MD: Than cosmetic result, the appearance, is dramatically better than, say, a big cut with a big scar in the abdomen. There's just no comparison.

Alan Flake, MD: And so I think the cosmetic benefits are real. And I think they're important psychologically for people as well as, to some degree, functionally.

Alex Maysonet, Father: I think she's had bigger scratches now than --

Tammy Maysonet, Mother: Than her incisions.

Alex Maysonet, Father: -- than her incisions.

Susan Scully, RN: To be able to do what they do in such a small space with very little pain and very little healing time for kids, I think, is what we're here to do.
 

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