Minimal Disruption, Maximal Satisfaction
Surgical Techniques Put Surgeons on Cutting Edge
It would probably take longer for Robbie McClam to renew his driver’s license than it did to have his overactive parathyroid gland removed. “Minimally disruptive” is how he characterizes the surgery he had in 2004 at MCG Medical Center by surgeon Dr. David Terris, a specialist in thyroid and parathyroid disease. “Minimally invasive” is the technical term. Maximal satisfaction is generally the result.
“I
was amazed at how quickly I recovered from the surgery,” said the Columbia,
S.C., architect. “I was comfortable and at ease with minimal pain. I had the
surgery in the morning, and by noon, I was on the road heading back to Columbia.
I was on the job site the next day.”
In recent years, MCG Health System surgeons have developed and refined ever-expanding applications for minimally invasive procedures, resulting in shorter operative times, quicker recovery periods, less blood loss, minimal scarring and less pain.
“When I think about surgery today, I am reminded of the classic car commercials that said: ‘This isn’t your father’s Oldsmobile.’ Along those same lines, this isn’t your father’s OR,” said Dr. Terris, Porubsky Distinguished Professor and chair of the Department of Otolarnygology-Head and Neck Surgery.
Peep-Hole Surgery
Laparoscopic surgical procedures are minimally invasive techniques in which surgeons insert long, slim instruments into the body through dime-sized slits. A laparoscope is inserted to allow surgeons to see inside the body via a television monitor. A similar procedure is hand-assisted laparoscopy, using an incision large enough for the surgeon to insert his hand during surgery.
For years, these techniques have been used for certain surgeries such as abdominal or thyroid, but now are being used to treat urologic cancers, to perform hysterectomies and even to transplant kidneys.
“These are actually quite elegant procedures that usher in a new era of cancer management in our state,” said Dr. James Brown, an MCG Health System urologist who was one of the first in the state to perform laparoscopic prostate and kidney cancer surgery beginning in 2003.
“Academic medical centers across the country are moving toward this procedure as the norm,” said Dr. Sean Francis, director of urogynecology and the first physician in the Augusta area to offer laparoscopic hysterectomy in 2005. “We are doing everything we can to avoid opening the abdominal area. With the laparoscopic procedure, the largest scar is one centimeter in length while traditional abdominal incisions can be as long as 15 centimeters.” But cosmetic concerns aren’t the only consideration. “At least 25 percent less blood is lost during surgery using this technique.”
In
2004, MCG otolaryngologists and neurosurgeons teamed to endoscopically remove
benign tumors of the pituitary gland. In endoscopic procedures, a tool is
inserted through the nose, straight through the sinus area and into the
pituitary gland. “This new approach has significant benefits for patients,” said
Dr. Stil Kountakis, director of rhinology/sinus surgery. “Patients who have this
procedure experience less pain and a quicker recovery. And there is minimal
trauma to the nose.”
“We have the expertise to perform this procedure as well as the technology,” said neurosurgeon Dr. John Vender. “We use a specialized, powered endoscope holder that steadies the instrument with pinpoint precision, leaving the surgeon’s hands free to perform other aspects of the surgery. We also have a computer image-guided system to precisely localize the area where surgery is performed while preserving other structures.”
“Because of the patient-friendly nature of this procedure, there is a demand for it,” said neurosurgeon Dr. Dion Macomson. “Patients are shopping for it.”
Recovery Hums Along
In
2003, head and neck surgeon Dr. Christine Gourin pioneered a technique using a
harmonic
scalpel
to remove tumors of the parotid gland. “The harmonic scalpel is just as safe as
conventional surgical methods and is uniquely suited to surgeries where
protection of nerve function is important,” she said. “It results in less blood
loss, making it even easier to identify the facial nerve during surgery. The
harmonic scalpel greatly reduces operative time for the patient.”
Ultrasonic vibrations are produced by the expansion and contraction of piezoelectric crystals housed in the hand piece of the scalpel and transferred to the blade. The scalpel vibrates at a frequency of 55,000 Hz and cuts tissue bonds at temperatures between 60 to 80 degrees Celsius. The scalpel simultaneously cuts tissue and seals blood vessels, with low thermal transduction and no electric current.
Sophisticated Pediatric Care
The MCG Children’s Medical Center recently opened a new high-tech endosuite as part of the new Center for Minimally Invasive Surgery for Children.
“Minimally invasive surgery has become the standard of care for many thoracic and abdominal operations in children,” said Dr. Walt Pipkin, the center’s director. “As in adults, this technique allows children to heal faster with less pain, less scarring and less risk of infection. Parents and their children are able to get back to their lives more quickly.”
All equipment in the endosuite is ceiling-mounted and computer-controlled, including lights, cameras and insufflators. Specialized equipment includes tiny telescopes used to view the inside of the abdomen and chest that are connected to monitors, enabling surgeons to see interior structures at a larger and clearer size. No matter where the surgeons look, the number and orientation of the monitors give them a comfortable view to guide them easily and safely during surgery.
“We continually try to find new and different methods, technologies and treatments to achieve better outcomes for our patients,” Dr. Pipkin said.
Deborah Humphrey
[Top]