The Newsroom    Published Tuesday, Dec. 8, 2009, 4:17 PM
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When it comes to surgery, small incisions are a big thing

Your Health
By Michael Warren

As times have changed, so has surgery. In the old days, surgeons operated through tiny incisions, because many believed that large incisions put the patient at greater risk. The mark of a good surgeon was to make as small an incision as possible, and surgeons prided themselves on having the smallest cut.

Then along came scientific advances that made surgery safe. Proper anesthetics, the recognition of the impact of infecting organisms, antibiotics, improved techniques and equipment; all made the size of the incision irrelevant.

More important than the length of the incision was the technique of the surgeon. The popular saying among surgeons, “incisions heal from side to side, not end to end,” meant the length of the incision had little impact on the outcome of the operation.

Modern surgeons have a new tool that helps them to perform these surgeries successfully.

Laparoscopic surgery employs sophisticated optical instruments, or periscope-type devices, inserted into the abdomen through a small incision, allowing the surgeon to view problems inside the body.

Moreover, by making a few additional small incisions, other instruments can be inserted and surgical procedures can be performed without ever having to make a large cut.

How should you, the patient, handle new developments like this? No one wants to be a “guinea pig” or the first person to have a new procedure performed.

Don’t worry about that. Surgeons are required to practice and even take additional training before performing new procedures on patients.

Even so, it is appropriate to question your surgeon and satisfy yourself that you are not his or her guinea pig.

Patients ask me all the time about my experience with certain procedures. I answer them frankly, explaining if a procedure is new to me. (Of course, the older I get the less often patients question my experience — I’m not sure whether to take that as a compliment.)

Don’t forget to ask about the complications, both short and long term. Find out what the expected results will be.

If your surgeon tells you this new procedure is replacing an old one, ask him or her to explain the differing results between the two methods. Make sure you are completely satisfied with the answers before undergoing the procedure.

Dr. Michael M. Warren is Ashbel Smith professor of surgery in the division of urology at the University of Texas Medical Branch at Galveston.

 

 




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