Minimally Invasive Surgery for Cancer

For several decades, conventional or ‘open’ surgery had been used to treat cancer. Surgeons, surgically operated on the cancerous tissue and removed it. Alternatively, the afflicted part of the body would be treated by chemotherapy.The ill-effects of chemotherapy are well-documented, making it, an unpopular option.

• The disadvantages of open surgery are innumerable:
• It puts the patient at potential risk
• The incisions made are large
• Recovery time therefore involves longer convalescence periods
• During open surgery, the possibility of adjacent tissues and organs being accidentally affected, is possible
• Innumerable sutures are required to close the incision
• Unfortunately however, open surgery is still the only option in some cases.

For most cases, minimally invasive surgery (MIS) has emerged as a better option. In MIS, advanced incision techniques combined with sophisticated computer imaging (equipment and software)hasdone away with the need for the scalpel. Instead, tiny incisions or keyhole incisions are made in the body, to insert long, thin tubesthat are fitted with powerful, video cameras or scopes. As the scopeapproaches the cancerous tissue, the cameras project a real-time, real-size image. With the aid of the image guiding system,the surgeon makes a precise incision and draws out the tissue through one of the tubes that have been inserted, into the body. The procedure is done under general or local anesthesia depending on the case. MIS which is nearly three decades old has become popular with time and is replacing open surgery for a wide variety of cancers.

Benefits of minimally invasive surgery

• Smaller incisions – ‘keyhole’ openings
• Less damage to surrounding healthy tissue
• Less blood loss and need for transfusion
• Decreased post-operative pain and need for postoperative pain medication
• Less scarring and improved cosmetic appearance
• Earlier resumption of regular diet
• Quicker recovery and return to normal activities
• Fewer side effects
• Improved healing
• Shorter hospital stays
• Shorter recovery time

MIS types and Techniques

The enormous benefits and cost-effectiveness has made minimally invasive surgery, a more preferred surgical option. Diagnostic techniques keep improving in tandem with the research and advancement in technology.

Laparoscopic Surgery: Of all the techniques, Laparoscopy is the most versatile and effective. It is used to treat most of the cancers such as prostate, esophagus, bladder, lung, colon, liver, rectum, pancreas, bile-duct, gall-bladder and stomach. A laparoscope comprises of ‘trocars’, a pen-shaped device that is sharp at one end and encased within a tube. The trocars are inserted into “keyhole” incisions made. The surgeon views the inside of the organs with the help of a video camera, mounted on a thin metal tube that has been passed through one of the incisions. The surgeon with specialized instruments performs the surgery, with the help of the projected, magnified images on to computer screens.

• Da Vinci® Robotic Surgery:In this procedure, a robot's arms holds the surgical tools, while the surgeon controls them sitting ata console, looking at a three-dimensional view of the internal organs
• Transoral Laser Surgery: An endoscope is advanced through the mouth and laser energy is delivered through it, in order to break up and extract the timorous tissues
• Video-Assisted Thoracic Surgery (VATS): During this procedure, a laparoscope is inserted through a small cut made between the ribs, and tumors present in the lungs or esophagus are extracted
• High Intensity Focused Ultrasound (HIFU):High levels of ultrasound energy are focused onto narrow areas of the cancerous tissue, iteratively. This generates intense heat, which then destroys the tissue

Advanced and specialized treatment options are available with the quantum leaps made by medical technology, to treat many patients. Across medical centers today, multidisciplinary teams function to provide the best options to patients suffering from cancer. Cancer is curable and treatable when caught in the early stages, consequently periodic screening is advisable.