For the convenience and comfort of patients in Southern Maryland, CalvertHealth Medical Center offers a broad range of minimally invasive procedures close to home. As these advanced surgical approaches have evolved, so has CHMC – while continually investing in the latest tools, technology and training.
For more than three decades, CalvertHealth Medical Center has been performing minimally invasive surgery starting with knee and shoulder arthroscopies in the 1980s. Today, about 40 percent of surgeries at CHMC are done minimally invasively from many urology and GYN procedures to more complex neurospine and vascular surgeries.
According to CalvertHealth Chief Nursing Officer Diane Couchman, MBA, BSN, RN, many general surgeries at Calvert such as appendectomies, gall bladder removals, hernia repairs and bowel resections are also done laparoscopically, when appropriate. “Our focus is on providing our patients with the safest and most effective treatment possible while improving quality outcomes.”
She went on to add, “The addition of high-resolution video camera systems and microscopes in our operating suites has positively impacted the growth of minimally invasive techniques here.”
At the same time, Couchman advises not all procedures can (or should) be done through minimally invasive methods. She stresses the importance of asking questions.
“Patients who are more informed help
improve their quality of care because
they have a better understanding
of what to expect before and after
surgery.”
Recently, we sat down with boardcertified
general surgeons Dr. Ervind
Bhogte and Dr. Razmi Alami to
answer frequently asked questions
about minimally invasive surgery.
Q. Is minimally invasive
surgery safe?
Absolutely. In fact, most surgeries
can now be performed in a minimally
invasive manner and in many cases,
it has become the standard of care to
offer minimally invasive options.
Q. How does minimally
invasive surgery
work?
Small incisions, sometimes called
keyhole incisions (about the width of
a finger), are made in the skin and
devices are placed into the abdominal
cavity of allow the surgeon to pass
instruments safely. The abdominal
cavity is inflated with gas to make
room for us to see and perform
surgery. A camera and instruments
are used to perform the necessary
surgery. Once surgery is complete, all
of the gas is evacuated, the devices
are removed and the incisions are
closed with sutures or glue. The
key thing to remember is that we
are doing the same operation as we
would be doing open.
Q. How would the
minimally invasive
surgical procedure differ?
In addition to the small incision, there
is usually less manipulation of the
surrounding organs and tissue which
makes it less traumatic. Sometimes,
but not in all cases, the minimally
invasive procedure also takes less
time than the open procedure.
Q. What types of
surgery are
minimally invasive?
Most surgeries can be performed
in a minimally invasive manner;
however, there are advantages
and disadvantages that must be
considered in each individual
case. Liver biopsy/partial removal,
gallbladder removal, appendix
removal, small bowel and colon
surgery, removal of adhesions/scar
tissue, stomach surgery, tissue
biopsies and spleen removal,
just to name a few, can all be
performed laparoscopically.
Q. What are the
advantages of
minimally invasive
surgery?
The minimally invasive surgical
technique translates to faster
recovery, much better pain control
and in most cases, a better
cosmetic outcome with scarring.
Due to the small incision size,
there are also typically fewer
excisional or wound complications.
Q. When is minimally
invasive surgery
not an option?
When the patient has had multiple
open abdominal surgeries, a
specific pathology or if there is an
emergency situation, minimally
invasive surgery may not be an
option. Each case is considered
individually, and each patient is
counseled about their individual
options. There are situations
in which you just have to say,
“This is not our safest option.”
Alternatively, if you are performing
a minimally invasive surgery, it
is very easy to switch gears and
convert to a traditional open
technique should you need to.