Minimally Invasive Surgery
Using the latest technological advances in pediatric surgical care, the surgeons at Miller Children’s Hospital Long Beach are at the forefront in minimally invasive surgery. A number of procedures never thought possible are now performed minimally invasively such as thoracoscopic repair of congenital diaphragmatic hernia, esophagectomy and gastric pull-up, trachealesophageal fistula, lobectomy, wedge resection, decortication, removal of mediastinal tumors and repair of chest wall deformities.
Minimally invasive surgery is not limited to the torso and can be used in abdominal surgeries as well, such as fundoplication, spleenectomy, bowel resection, total colectomy and pull-through in ulcerative colitis, gallbladder, choledochal cyst, ovarian masses/tumors, undescended testicles, appendectomy and many others.
Benefits of Minimally Invasive Surgery
Traditionally, many surgical procedures were performed through large incisions using “open” incision techniques. Whenever possible, surgical procedures are now being done through tiny incisions less than an inch long using minimally invasive, or "keyhole" techniques. In most minimally invasive surgeries, a flexible camera and light-weight surgical instruments are introduced to the area requiring surgery through tiny incisions. Guided by greatly magnified images on a television monitor, surgeons are able to perform complex procedures less invasively.
The advantages of minimally invasive surgery are many including:
- Less pain
- Shorter/eliminate overnight hospital stay
- Improved recovery times
- Minimized scarring
It is anticipated that in the next decade, minimally invasive techniques will replace conventional open techniques for most surgical procedures, because the operations are less traumatic. The side effects are so minimal, that many of the minimally invasive procedures can be done in the outpatient setting.
Tiny incisions are made and a laparoscope, a tiny medical camera, is moved to various parts of the body to capture fiber optic images. These “pictures” are displayed on monitors to show surgeons what is happening inside. Laparoscopic surgery usually takes 30 to 90 minutes, depending on what type of procedure is done.
After the laparoscopy, the patient will go to the recovery room for two to four hours. Laparoscopic surgery does not require the abdominal muscles to be cut, resulting in less pain, quicker healing, improved cosmetic results and fewer complications such as infection and adhesions. Most children can usually go back to normal activities the next day, but can’t do any strenuous activity or exercise for a week. Common laparoscopic procedures are appendectomy (appendix removal), cholecystomy (gall bladder removal) and spleenectomy (spleen removal). Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in the chest. During this surgery, one or more small incisions are made in the chest. A tiny fiber-optic camera (called a thorascope) is inserted through one incision, and surgical instruments are inserted through this or other small incisions. The thorascope transmits images of the inside of the chest on a video monitor, guiding the surgeon in maneuvering the instruments to complete the procedure.
VATS can replace a traditional thoracotomy, which uses one larger incision to gain access to the chest. Common pediatric thoracoscopic procedures are esophageal injuries, pulmonary resection, repair to chest wall deformities, and thoracic cyst removals.
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