Orthopaedic surgery has come a long way, and one of the most significant advancements in recent years is the widespread adoption of minimally invasive procedures, also known as “keyhole surgery". By using small incisions and specialised techniques, this method offers numerous advantages compared to traditional open surgery in eligible patients.
Advantages of Minimally Invasive Surgery
Reduced Tissue Trauma
Unlike traditional open surgery, minimally invasive procedures cause minimal disruption to the surrounding tissues. This results in less tissue trauma and a more comfortable recovery for patients. This has been especially beneficial for athletes, as it allows them to return to full function sooner.
Smaller Incisions
Minimally invasive procedures use smaller incisions, which not only contribute to reduced scarring but also result in a more aesthetically pleasing outcome thus addressing the cosmetic concerns of many patients.
Decreased Blood Loss
Minimally invasive techniques are associated with reduced blood loss during surgery. This decrease in blood loss not only lessens the need for blood transfusions but also diminishes the risk of developing anaemia, ensuring a safer and more comfortable recovery for patients.
Faster Recovery
Most minimally invasive procedures can take place as outpatient surgeries and patients can often return to their daily activities and work more quickly than with open surgery. This is especially beneficial for maintaining quality of life.
Lower Risk of Infection and Complications
Smaller incisions and minimised tissue exposure greatly reduce the risk of surgical site infections and complications, such as arthrofibrosis (excessive scar tissue formation). The decreased likelihood of these issues ensures a safer and smoother recovery.
Less Pain and Discomfort
The reduced tissue trauma associated with minimally invasive procedures translates to less postoperative pain. This diminished pain not only minimises the need for pain medication but also promotes a more comfortable and manageable recovery process, making it easier for patients to transition back to their daily routines.
Orthopaedic Conditions Treated
Minimally invasive procedures can treat a wide range of orthopaedic conditions, including:
Foot & Ankle
Shoulder
- Frozen Shoulder
- Rotator Cuff Tears
- Arthritis
- SLAP Tears
- Fractures
- Bursitis
Knee
- Fractures
- Dislocations
- Meniscus and Ligament Injuries
- Arthritis
Hip
- Labral Tears
- Femoral Acetabular Impingement (FAI)
- Fractures
- Cartilage Damage
- Arthritis
Potential Limitations and Considerations
While minimally invasive procedures offer several advantages over open surgery, there are some cases and considerations where they may not be suitable:
Complex Cases
Some complex or severe orthopaedic conditions may require open surgery. These cases often require a more extensive surgical approach to address thoroughly. Surgeons will evaluate the nature and severity of the condition to determine the most appropriate course of action.
Potential Risks and Complications
While minimally invasive surgery has reduced morbidity compared to open techniques, it is still an invasive procedure carrying inherent risks. These potential complications include bleeding, infection, and injury to organs. While these risks are generally less common than with open surgery, patients should discuss these possibilities with their orthopaedic surgeon.
Cost Considerations
The choice between minimally invasive and open surgery may also involve different cost considerations. Minimally invasive procedures may have varying cost implications depending on factors such as the specific procedure, the healthcare facility, and insurance coverage.
Patients ought to discuss the financial aspects of their surgical options with their healthcare providers, including any potential out-of-pocket expenses. Being well-informed about the cost considerations can help patients make the most suitable decision for their healthcare needs while being mindful of their financial situation.
Technological Advancements
Robotic-Assisted Surgery
Robotic surgery systems offer a precision and accuracy boost for complex procedures compared to traditional open surgery. Their integration is especially valuable for minimally invasive procedures, enabling smaller incisions and access to hard-to-reach areas. This helps to improve surgical outcomes on top of enhancing the advantages associated with minimally invasive procedures.
Advanced Imaging Techniques
Advanced imaging techniques allow surgeons to better visualise the surgical site and plan the procedure accordingly. This is especially important for minimally invasive procedures, where surgeons have limited access to and surface visibility of the surgical site. This enhanced visualisation not only contributes to the precision and success of the surgery but also reduces the likelihood of complications.
Modern Surgical Instruments and Tools
Ongoing innovations in surgical instruments and tools are continually enhancing safety and effectiveness. One notable challenge in these surgeries is the reduced sense of touch, which impacts a surgeon's ability to feel the texture and stiffness of tissues during the procedure. To overcome this hurdle, Smart Laparoscopic Forceps (SLF) has been in development. These specialised tools can measure the force applied and the angle at which tissue is grasped in real time. This provides surgeons with tactile feedback, enabling them to make better informed decisions during surgery.
The shift towards minimally invasive procedures among eligible patients has been a major leap forward in the field of orthopaedic surgery. While open surgery may still be necessary for complex cases, the continual advancements in technology enhance the safety and precision of minimally invasive techniques. This represents a step forward in orthopaedic care, providing patients with more comfortable and effective solutions to improve their quality of life.
References
- Barua, R., Bhowmik, S., Dey, A., & Mondal, J. (2022). Advances of the robotics technology in modern minimally invasive surgery. Design and Control Advances in Robotics, 91–104. https://doi.org/10.4018/978-1-6684-5381-0.ch006
- Minimally invasive surgery. Yale Medicine. (2022) https://www.yalemedicine.org/conditions/minimally-invasive-surgery
- Othman, W., Vandyck, K. E., Abril, C., Barajas-Gamboa, J. S., Pantoja, J. P., Kroh, M., & Qasaimeh, M. A. (2022). Stiffness assessment and lump detection in minimally invasive surgery using in-house developed smart laparoscopic forceps. IEEE Journal of Translational Engineering in Health and Medicine, 10, 2500410. https://doi.org/10.1109/JTEHM.2022.3180937
- Treuting R. (2000). Minimally Invasive Orthopedic Surgery: Arthroscopy. Ochsner journal, 2(3), 158–163.
- 5 benefits of minimally invasive surgery. Tuscaloosa Orthopedic & Joint Institute. https://www.tuscaloosaorthopedics.com/blog/5-benefits-of-minimally-invasive-surgery
- 5 advantages of minimally invasive procedures. Integrity Spine & Orthopedics. (2020). https://www.integrityspineortho.com/post/5-advantages-of-minimally-invasive-procedures
Dr Yung Shing Wai, Consultant Orthopaedic Surgeon: With his decades of specialist experience, Dr Yung is committed to providing not only high-quality, personalized and modern orthopaedic treatments; he also shares his knowledge by reviewing and contributing informative articles to provide patients with trustworthy and up-to-date orthopaedic insights.
