Open Surgery
An "open" surgery is one in which the patient is cut open. A
typical open surgery involves the use of a scalpel (see
scalpel) to make an incision into the skin and cut through
the various layers of the dermis and sub-dermal layers and tissues
to get to the desired tissue or organ. Some open surgeries use
a laser to make the incision (see
laser).
Endoscopic Surgery
Endoscopy is a surgical technique that involves the
use of an endoscope, a special viewing instrument that
allows a surgeon to see images of the body's internal
structures through very small incisions.
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Endoscopic surgery has been used for decades in a number of
different procedures, including gallbladder removal, tubal ligation,
and knee surgery.
The endoscope
An endoscope consists of two basic parts: A tubular probe
fitted with a tiny camera and bright light, which is inserted
through a small incision; and a viewing screen, which magnifies
the transmitted images of the body's internal structures.
During surgery, the surgeon watches the screen while moving
the tube of the endoscope through the surgical area.
It's important to understand that the endoscope functions
as a viewing device only. To perform the surgery, a separate
surgical instrument--such as a scalpel, scissors, or forceps--must
be inserted through a different point of entry and manipulated
within the tissue.
Advantages of endoscopy
All surgery carries risks and every incision leaves a scar.
However, with endoscopic surgery, scars are likely to be much
smaller and some of the after effects of surgery may be minimized.
In a typical endoscopic procedure, only a few small incisions,
each less than one inch long, are needed to insert the endoscope
probe and other instruments. For some procedures, such as
breast augmentation, only two incisions may be necessary.
For others, such as a forehead lift, three or more short incisions
may be needed. The tiny "eye" of the endoscope's camera allows
a surgeon to view the surgical site almost as clearly as if
the skin were opened from a long incision.
Because the incisions are shorter with endoscopy, the risk
of sensory loss from nerve damage is decreased. Also, bleeding,
bruising and swelling may be significantly reduced. With the
endoscopic approach, recovery may be quicker than that of
an open surgery.
Endoscopic surgery may also allow you to avoid an overnight
hospital stay. Many endoscopic procedures can be performed
on an outpatient basis under local anesthesia with sedation.
Patients should discuss this possibility with their doctor.
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