Keyhole takes the sting out of surgery
Dec 06, 2010
KEYHOLE surgery has changed the face of surgical procedures and reduced the fear associated with the theatre. <b>Dr. Moses Galukande</b> explains the concept and analyses why some hospitals have chosen keyhole surgery over open surgery.
KEYHOLE surgery has changed the face of surgical procedures and reduced the fear associated with the theatre. Dr. Moses Galukande explains the concept and analyses why some hospitals have chosen keyhole surgery over open surgery.
Keyhole surgery, or minimally invasive surgery as it is also known, is a method of carrying out an operation without having to make a large incision (cut). In fact the incisions made during a keyhole surgery are a centimeter or less.
Keyhole surgery has been referred to as the greatest surgical advancement since anaesthesia was introduced. Modern technology has provided for tiny cameras which can be inserted in the body, working alongside computers.
The good news is the technology is available in Uganda. In fact, it has been practised for at least five years. Currently some major private and public hospitals such as International Hospital Kampala and Mulago use the technology.
What keyhole surgery entails
Depending on the body area where the keyhole surgery is to be performed, tiny incisions are made and a special tube inserted. This is known as a ‘port’, through which a special viewing instrument is passed. It works like a telescopic camera projecting images from inside the body onto a TV monitor which the surgeon looks at to see what the problem is and what needs to be fixed.
The surgeon can also pass one or a series of tiny surgical instruments through the same port or a different port, depending on the procedure being carried out.
The surgeon can operate the equipment from outside the body while looking at the monitor. The ‘scopes’ vary in size and design depending upon the area of the body is being operated on.
What happens before the operation?
One is instructed on how to prepare for the operation. One should eat or drink anything beforehand for the amount of time specified. It is important to follow instructions; otherwise the operation is delayed or cancelled.
Before the day of operation, a surgeon should explain the procedure in detail and discuss any worries the patient may have. An anaesthetist (the officer who gets you to sleep) also explains in detail the process of getting one to sleep before surgery.
What procedures can be performed using keyhole surgery?
As technology becomes more sophisticated, keyhole surgery is increasingly adopted as the recognised procedure for a whole range of conditions which would have previously required one to be opened up with a traditional scalpel (knife).
This includes but is not limited to:
Hernia repairs
Gall bladder removal
Certain cases of hysterectomy (uterus removal)
Appendix removal (appendectomy)
Release of adhesions (where internal organs stick together and form bands of scar tissue)
Investigating infertility due to blocked tubes or internal scarring
Investigating undiagnosed chronic abdominal pains
How long does keyhole operation take?
The operation time may be longer than or take the same time as the conventional or open surgery.
What are the advantages of keyhole surgery?
One tends to recover faster after keyhole surgery and get fewer side effects. There is little scarring after keyhole surgery.
Compared to open surgery, adhesions have been proven to occur less often after keyhole surgery. Adhesions can be painful and cause obstruction.
What happens after the operation?
The extent of surgery determines how soon one is able to go home after the operation. However, for instance, in cases where a gall bladder removal would previously have required one to remain in hospital for a week or even longer; with keyhole surgery, it is normal to go home after an overnight stay or two days later at most.
With keyhole surgery, scarring is minimal and the tiny open wounds should heal quickly and the pain is less. A surgeon should be able to advise one and avail the necessary information that a patient may want to know.
What are the risks?
After surgery, one may feel sick, get a headache, sore throat or feel dizzy. But these effects are short-lived. Any surgery carries a small risk of infection or bleeding. Side effects are much less with keyhole surgery; it takes the sting out of surgery.
There is a small chance that keyhole surgery cannot be carried out. Sometimes the surgeon will not be able to carry out an operation using the keyhole method for technical reasons or because of unexpected findings. In this case, the surgeon instead carries out the operation using a larger incision.
What is the alternative?
All operations carried out as keyhole surgery can also be carried out using open surgery.
What you should/not do after the procedure?
You may need some pain relievers when you get home. They are normally provided after surgery.
You should not have a bath or shower for 48 hours after the operation so that the wounds are allowed time to heal.
With some operations, there is a small risk of infection, so you may need to take antibiotics for a while after the operation.
A doctor reviews you at a specified time to check on how you are progressing.
You should call the hospital if:
You are experiencing a lot of pain after taking pain relievers.
There is any substance oozing from the operation sites.
hat is the cost?
In Uganda, keyhole surgery costs between sh1.5m to sh6m in privately hospitals, depending on the procedure and other factors for instance if a patient has ailments like diabetes or heart disease. The cost of keyhole surgery in higher abroad.
In terms of resources necessary to carry out the surgery, it calls for a lot of capital investment for a hospital to be able to carry out keyhole surgery. The initial investment is not less than $50,000 (sh115m). Other requirements include biotechnical support, consumables and a surgeon who can operate the equipment
Doctors anticipate that in the near future, keyhole surgery will be readily available in most upscale health facilities in Uganda.
Keyhole surgery, or minimally invasive surgery as it is also known, is a method of carrying out an operation without having to make a large incision (cut). In fact the incisions made during a keyhole surgery are a centimeter or less.
Keyhole surgery has been referred to as the greatest surgical advancement since anaesthesia was introduced. Modern technology has provided for tiny cameras which can be inserted in the body, working alongside computers.
The good news is the technology is available in Uganda. In fact, it has been practised for at least five years. Currently some major private and public hospitals such as International Hospital Kampala and Mulago use the technology.
What keyhole surgery entails
Depending on the body area where the keyhole surgery is to be performed, tiny incisions are made and a special tube inserted. This is known as a ‘port’, through which a special viewing instrument is passed. It works like a telescopic camera projecting images from inside the body onto a TV monitor which the surgeon looks at to see what the problem is and what needs to be fixed.
The surgeon can also pass one or a series of tiny surgical instruments through the same port or a different port, depending on the procedure being carried out.
The surgeon can operate the equipment from outside the body while looking at the monitor. The ‘scopes’ vary in size and design depending upon the area of the body is being operated on.
What happens before the operation?
One is instructed on how to prepare for the operation. One should eat or drink anything beforehand for the amount of time specified. It is important to follow instructions; otherwise the operation is delayed or cancelled.
Before the day of operation, a surgeon should explain the procedure in detail and discuss any worries the patient may have. An anaesthetist (the officer who gets you to sleep) also explains in detail the process of getting one to sleep before surgery.
What procedures can be performed using keyhole surgery?
As technology becomes more sophisticated, keyhole surgery is increasingly adopted as the recognised procedure for a whole range of conditions which would have previously required one to be opened up with a traditional scalpel (knife).
This includes but is not limited to:
How long does keyhole operation take?
The operation time may be longer than or take the same time as the conventional or open surgery.
What are the advantages of keyhole surgery?
One tends to recover faster after keyhole surgery and get fewer side effects. There is little scarring after keyhole surgery.
Compared to open surgery, adhesions have been proven to occur less often after keyhole surgery. Adhesions can be painful and cause obstruction.
What happens after the operation?
The extent of surgery determines how soon one is able to go home after the operation. However, for instance, in cases where a gall bladder removal would previously have required one to remain in hospital for a week or even longer; with keyhole surgery, it is normal to go home after an overnight stay or two days later at most.
With keyhole surgery, scarring is minimal and the tiny open wounds should heal quickly and the pain is less. A surgeon should be able to advise one and avail the necessary information that a patient may want to know.
What are the risks?
After surgery, one may feel sick, get a headache, sore throat or feel dizzy. But these effects are short-lived. Any surgery carries a small risk of infection or bleeding. Side effects are much less with keyhole surgery; it takes the sting out of surgery.
There is a small chance that keyhole surgery cannot be carried out. Sometimes the surgeon will not be able to carry out an operation using the keyhole method for technical reasons or because of unexpected findings. In this case, the surgeon instead carries out the operation using a larger incision.
What is the alternative?
All operations carried out as keyhole surgery can also be carried out using open surgery.
What you should/not do after the procedure?
You should call the hospital if:
hat is the cost?
In Uganda, keyhole surgery costs between sh1.5m to sh6m in privately hospitals, depending on the procedure and other factors for instance if a patient has ailments like diabetes or heart disease. The cost of keyhole surgery in higher abroad.
In terms of resources necessary to carry out the surgery, it calls for a lot of capital investment for a hospital to be able to carry out keyhole surgery. The initial investment is not less than $50,000 (sh115m). Other requirements include biotechnical support, consumables and a surgeon who can operate the equipment
Doctors anticipate that in the near future, keyhole surgery will be readily available in most upscale health facilities in Uganda.