Keyhole Surgery

Last updated date: 05-Nov-2023

Originally Written in English

Keyhole Surgery

Surgery or any surgical procedure can be stressful but understanding what to expect before, during, and after the procedure can help you prepare. The methods and techniques used to diagnose or treat a given disease or injury determine what you feel and how each step affects you. In general, these distinct operations are carried out in one of three different ways: invasive, non-invasive, or minimally invasive.

Non-surgical medical procedures are referred to as non-invasive. Non-invasive procedures include diagnostic physical examinations and imaging investigations such as ultrasound, as well as rehabilitative treatments such as chiropractic manipulation. Put simply, they are non-invasive since they do not damage the skin as surgical procedures do.

Major open operations are highly invasive in terms of surgical procedures since they require doctors to make extensive incisions into the body.

However, because of significant technical advancements, a third option, a less invasive surgical procedure, has become accessible through keyhole surgery. The surgery is performed by a professional keyhole surgeon with minimal incisions. As an outcome, patients can expect reduced post-operative pain and a faster recovery.

 

What is Keyhole Surgery?

Keyhole Surgery Definition

Keyhole surgery, also known as minimally invasive surgery, is a type of surgery that allows doctors to access the inside of the body through a small incision rather than a large incision, eliminating the need for open surgery.

In a procedure known as laparoscopy, keyhole surgery is most typically done to gain access to the abdomen and female pelvic organs. The procedure is known as video-assisted thoracoscopic surgery when it is used to reach the thorax, which is the medical term for the chest. Arthroscopy is a keyhole surgery performed on a joint, such as the knee.

A slender rod containing a telescopic lens, light source, and the camera is pushed through a small incision in the skin during keyhole surgery, providing surgeons with a magnified picture of the inside of the body. An endoscope is a name for the rod. The incision can also be used to insert surgical equipment through it, permitting surgeons to operate.

Keyhole surgery can be used to diagnose and treat a range of medical diseases, as well as to conduct surgical procedures such as the removal of diseased or damaged organs or organ portions.

Keyhole surgery is a frequent method that offers several benefits over regular open surgery. These benefits include shorter post-surgery recovery durations and lower levels of discomfort, scar, and hemorrhage. Although the surgery is generally safe, there are certain risks.

 

Keyhole Surgery Indications

Keyhole Surgery Indications

A laparoscopy is a procedure that can be used to diagnose and treat a variety of problems.

It's most frequently used in:

  • Gastroenterology. To identify and treat digestive system disorders.
  • Gynecology. To identify and treat problems with the female reproductive system.
  • Urology. To identify and treat diseases of the urinary system.

 

Diagnostic Keyhole Surgery

If non-invasive diagnostic procedures such as ultrasonography or CT scans are inefficient or fail to give definitive results, keyhole surgery may be required. The use of keyhole surgery can confirm the diagnosis of a variety of medical conditions, including:

In a procedure known as a biopsy, keyhole surgery can also be utilized to obtain a tissue sample. This entails taking a small sample of tissue from the affected area and transferring it to a lab for analysis. Biopsy information can be used to identify and differentiate between different types of tumors, including malignant and non-cancerous tumors.

 

Therapeutic Keyhole Surgery

Treatment with keyhole surgery is also a choice. It's frequently used to:

  • Removal of appendix cases of appendicitis.
  • Removal of the gallbladder.
  • Removal of sections of the intestine.
  • Treat hernias, a condition in which an organ or a portion of an organ protrudes through a weak place in the abdominal wall.
  • Treat complicated stomach or duodenal ulcers.
  • Removal (partially or completely) of Cancer-affected organs, including the ovaries, kidneys, colon, liver, prostate, and bladder.
  • Ectopic pregnancy treatment.
  • Uterine leiomyoma are non-cancerous tumors that can grow in the uterus and should be removed.
  • Removal of the uterus in cases of pelvic inflammatory disease or endometriosis.

 

Keyhole Surgery Advantages

Keyhole Surgery Advantages

Keyhole surgery has a variety of advantages over standard open surgery.

  • Reduced physical impact. Using little incisions rather than big open wounds lowers the amount of blood lost as well as the degree of pain and discomfort experienced by the patient following surgery. Tissue injury is also reduced due to the small size of the devices utilized during the treatment. When compared to open surgery, this can lead to smaller scars on the outside of the body, resulting in better cosmetic effects.
  • Reduced complication risk. Following the treatment, the risk of health complications, hernia, and cellulitis, a bacterial infection of the skin and tissues beneath the skin, is lowered.
  • Reduced recovery time. The recovery time required after keyhole surgery is also shorter than that required after open surgery, lowering the risk of complications such as muscular atrophy, bone loss, and pneumonia associated with prolonged bed rest. Scarring is also greatly decreased due to the modest size of the incision.

It's worth noting that keyhole surgery has some disadvantages. The main disadvantage is that, because of its complexity, keyhole surgery takes longer to conduct than traditional surgery, necessitating more time under general anesthesia.

 

Keyhole Surgery Disadvantages

Keyhole Surgery Disadvantages

  • It is not appropriate for everyone. Those who have had previous open surgery in the upper or lower section of their belly, or women with severe medical conditions, are at higher risk for keyhole surgery. Other factors may have influenced the surgeon's decision to perform open surgery rather than keyhole surgery. Not all procedures can be performed using minimally invasive methods.
  • Special training and equipment are required. Before surgeons can do keyhole surgery, they must undergo particular training. Not all surgeons are certified to do these procedures, and not all facilities have the specialized equipment required to perform any or all of them.

 

Keyhole Surgery Preparation

A time of fasting is usually required before undergoing general anesthesia. This means no foods and drinks for six to twelve hours before the procedure, as well as no chewing gum or cigarette smoking. Surgeons will provide detailed directions on how to proceed, which must be strictly followed.

 

Keyhole Surgery Procedure

Keyhole Surgery Procedure

A general anesthetic is usually used for laparoscopy. This means that the person who is having surgery is sedated and then awakened when the procedure is completed.

The person's skin will be disinfected before a series of small incisions are made into the skin while they are under general anesthesia. When laparoscopy is performed solely for diagnostic purposes rather than to treat a specific disease, only one incision is usually required. Otherwise, many incisions will be required to allow for the use of various surgical equipment during the surgery. Single-port laparoscopy is a more recent technology that allows surgeons to do therapeutic operations with just one incision.

Gas is introduced via one of the incisions, commonly carbon dioxide or, less frequently, nitrous oxide, to inflate the belly and allow surgeons to see more clearly. The laparoscope will then be placed through an incision, allowing surgeons to view images from inside the cavity using the connected camera.

All instruments will be withdrawn after the procedure, and the wound will be closed and bandaged.

 

Keyhole Surgery Risks

Keyhole Surgery Risks

Laparoscopic surgery provides several advantages over traditional open surgery, including less pain and a lower chance of complications. However, problems can occur with any surgical operation, albeit infrequently. Minor difficulties are more frequent than serious complications, and doctors can usually deal with them promptly.

Minor complications that could arise include:

  • Vomiting or nausea
  • Bruising or hemorrhage around the incision.
  • Bacterial infection in the location of the incision
  • A hernia that is a bulge in the abdomen.
  • Crepitus is the sound of trapped air beneath the skin and joints, which causes popping or cracking sounds.

The following are examples of major complications that could occur:

  • Doctors are being compelled to perform traditional open surgery, which requires a wider incision through which to operate.
  • Deep vein thrombosis is a condition in which a thrombus forms in a deep vein in the body, which can result in pulmonary embolism.
  • Gas bubbles entering the bloodstream, for example, are complications connected with the use of carbon dioxide during the treatment.
  • Infection that extends beyond the incision and affects the entire abdominal wall or the lining of the abdominal cavity (peritonitis).
  • Increased heart pressure, which can be problematic for people who have heart disease or other cardiac conditions.
  • Port-site metastasis is the development of invasive cancer inside the abdominal wall following keyhole surgery to remove other cancers.
  • Organ damage that could lead to organ failure
  • Injury to blood vessels
  • Urinary tract injury
  • Nerve damage
  • Pneumothorax (collapsed lung).

 

Keyhole Surgery Recovery

Keyhole Surgery Recovery

People who have had keyhole surgery will be kept in the hospital for a few hours after the procedure and their vital signs will be checked. On the day of the laparoscopy, a person should be able to return home, but this will rely on a number of things, including the individual's health and the purpose of the procedure. A hysterectomy, for example, which removes all or part of the uterus, usually necessitates an overnight stay in the hospital.

A person may have the following symptoms in the hours and days after a laparoscopy:

  • Pain in the location where the incision was made, such as the lower abdomen, that ranges from mild to moderate.
  • There is sometimes soreness in the affected area due to administered gas.
  • Bloating is another symptom of gas.
  • Nausea as a result of the anesthetic and the gas.
  • Due to the tube used to support breathing during surgery, some patients have a sore throat.
  • A minor amount of vaginal bleeding is to be expected.

Doctors may prescribe pain relievers for stomach and shoulder pain. A painful throat might be relieved by taking lozenges or gargling saltwater. All of these symptoms should go away in a few days. If they don't go away, see a doctor for advice.

In the short period following the operation, it is common for individuals to feel more exhausted than usual. This is primarily due to the body's utilization of additional energy to repair itself. Taking naps on a regular basis may help with fatigue.

Regular activities can usually be resumed in less than a week after keyhole surgery has been used to diagnose a problem. Depending on the type of surgery performed, the recovery timeline might range from two to twelve weeks if utilized to treat a condition.

 

Other Types of Keyhole Surgery

An arthroscopy is keyhole surgery on a joint, such as the knee, while video-assisted thoracoscopic surgery is keyhole surgery on the chest.

Arthroscopy

Arthroscopy

An arthroscopy, like a laparoscopy, can be used to aid surgeons in diagnosing and treating specific disorders. The following are some of the most prevalent reasons for an arthroscopy:

  • Persistent inflammation
  • Tendon and cartilage tears
  • When little pieces of bone come loose from the joint.
  • Arthritis

Arthroscopies are most typically performed on the following regions of the body:

  • Meniscal cartilage tears and anterior cruciate ligament injuries, for example, are treated in the knee.
  • Shoulder joint, for example, rotator cuff tendon tears and recurrent dislocations.
  • Wrist, for example, in the case of carpal tunnel syndrome
  • Ankle joint
  • Elbow joint
  • Hip joint

After an arthroscopy, a person can normally resume normal activities within a few days. A lengthier sabbatical from any sporting or high-impact activities, on the other hand, will almost certainly be required.

 

Video-assisted Thoracoscopic Surgery (VATS)

VATS is a type of surgery that is used to treat diseases that affect the chest and lungs. Pleuroscopy is a term used when an operation is performed solely for diagnostic purposes.

VATS is similar to laparoscopy in that procedure involves the use of general anesthesia and the formation of small incisions through which an endoscope can be directed. The following are some of the reasons why surgeons could employ VATS:

  • Taking tiny samples of the lungs or their lining for examination in the lab.
  • Lymph node removal.
  • Surgically removing tumors or growths and determining whether they are malignant or not.
  • A complete organ removal such as lung 
  • Chest trauma treatment
  • Various lung disorders, such as pleural effusion, or water on the lungs, are treated.

After this type of procedure, a person is usually hospitalized for a few days, but this depends on a variety of things, including the precise cause of the operation.

 

Advanced Kinds of Keyhole Surgery

In some cases, the surgeon can insert the camera and surgical tool into the same skin incision. This means there will be less scarring. However, because the tools are so close together, it's more difficult for the surgeon.

In other circumstances, the surgeon will choose a device that allows them to reach in with his hand. The procedure is known as "hand assisted" laparoscopy. The skin incision must be greater than half an inch, but it can still be less than in open surgery. This has made keyhole surgery for the liver and other organs achievable.

 

What is Robotic Keyhole Surgery?

It is When mechanical arms are employed for keyhole surgery, they are operated by surgeons from an operating console. Presumably, this is more exact than a surgeon using only tools, lowering the chance of problems. The number of this equipment in hospitals around the world is growing, but they are still costly, and doctors who use them need special training.

 

When a Robot Helps?

robotic keyhole surgery

The medical team can use technology to help them be more accurate. The surgeon incises into the skin and inserts the camera as usual in the robotic form of keyhole surgery. Instead of grabbing the surgical equipment, they used the mechanical arms of a robot. They then proceed to an adjacent computer.

Many surgeons believe robotic keyhole surgery is particularly useful for operating on obese patients, in gynecologic and urologic procedures. Robots are used in the majority of prostate removal procedures.

The monitor shows the surgeon a three‐dimensional, high-resolution, magnified view inside the body during robotic surgery. They manipulate the robot and surgical equipment with hand controls while watching the screen. This allows the surgeon to be more precise, which can result in less trauma to the body and less blood loss. You may also have reduced discomfort following the procedure.

 

How Long Does it Take to Recover from Keyhole Surgery?

The recovery period for keyhole surgery varies from case to case, and is mostly determined by the cause for the procedure. A person who has had keyhole surgery to diagnose a problem should be able to recuperate in five to seven days. If keyhole surgery was performed to treat a problem, recovery can take anywhere from two to twelve weeks, depending on how minor or extensive the procedure was.

 

How Long Does Keyhole Surgery Last?

It could take anywhere from half an hour to four hours, or even longer if there are difficulties. The length of time varies greatly according to the cause for the surgery, as well as a number of other considerations.

 

When Should Contact a Doctor?

doctor and patient

If you have any of the following symptoms after a laparoscopy, you should see a doctor:

  • Fever or a fever of 38 degrees Celsius
  • Severe pain that continues to worsen
  • Any discomfort, redness, edema, discharge, or blood around the incision site.
  • Intense vomiting, such as vomit that occurs frequently and with little time between them
  • Feeling extremely cold for no obvious cause
  • Urinating with a burning sensation
  • After urination, the sensation that the bladder remains full.
  • A lot of vaginal bleeding or a lot of abnormal vaginal discharge
  • Swelling or pain in one of the legs

 

Conclusion

Keyhole surgery can be used to diagnose and cure problems throughout the body by surgeons. They employ laparoscopic equipment to observe the inside of the body and perform treatments, which they introduce through small incisions.

Long, thin rods with a camera and light at the end are known as laparoscopes. They transmit images from the inside of the body to a screen in the operating room, where the surgeon can see them. The surgeon can detect problems or conduct surgeries using these pictures by inserting other surgical instruments through keyhole incisions. The time it takes to recover from keyhole surgery is less than that of regular surgery. People are frequently able to return home the same day.

Keyhole surgery, like any other type of surgery, bears the potential for complications. Due to the small size of the incisions, it takes less time to recover than open surgery.