Posted: January 9th, 2024

Minimally Invasive Gastrointestinal Surgery

Minimally Invasive Gastrointestinal Surgery: A Review

Gastrointestinal surgery is a broad term that encompasses various procedures to treat disorders of the digestive system, such as ulcers, tumors, hernias, reflux, obesity, and cancer. Traditionally, these surgeries were performed through large incisions in the abdomen, which could result in significant pain, bleeding, infection, scarring, and prolonged recovery. However, with the advances in technology and surgical techniques, many gastrointestinal surgeries can now be performed in a minimally invasive way, using small incisions and specialized instruments.

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Minimally invasive gastrointestinal surgery (MIGS) is a type of surgery that uses fiber optics and a high-definition camera to project the surgical field onto a screen. The surgeon makes several small incisions in the abdomen to insert small ports or tubes, through which the camera and surgical tools are passed. The surgeon then operates on the affected organ or tissue using the images on the screen as a guide. The benefits of MIGS include:

- Less pain and discomfort
- Less blood loss and risk of infection
- Smaller scars and better cosmetic results
- Shorter hospital stay and faster recovery
- Lower cost and fewer complications

MIGS can be used to treat most gastrointestinal conditions that require surgery, such as:

- Bariatric weight-loss surgery: MIGS is the preferred method for reducing the size of the stomach or bypassing part of the small intestine to help patients lose weight and improve their health.
- Benign colorectal disease: MIGS can be used to remove polyps, diverticula, hemorrhoids, fistulas, or inflammatory bowel disease that affect the colon or rectum.
- Colorectal cancer: MIGS can be used to remove part or all of the colon or rectum that is affected by cancer, as well as nearby lymph nodes. MIGS has been shown to have similar or better outcomes than open surgery for colorectal cancer.
- Other gastrointestinal surgeries: MIGS can also be used to treat conditions such as appendicitis, gallstones, gastroesophageal reflux disease (GERD), hiatal hernia, stomach cancer, pancreatic cancer, liver cancer, and spleen disorders.

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MIGS is not suitable for everyone and depends on several factors, such as the type and stage of the disease, the patient's medical history and condition, and the surgeon's expertise and preference. Some potential risks and limitations of MIGS include:

- Conversion to open surgery: In some cases, the surgeon may encounter difficulties or complications during MIGS that require switching to a larger incision and open surgery. This may increase the risk of bleeding, infection, and recovery time.
- Injury to nearby organs: MIGS involves operating in a confined space with limited visibility and maneuverability. There is a possibility of injuring nearby organs or structures, such as the bladder, ureter, bowel, blood vessels, or nerves. This may require additional surgery or treatment.
- Gas-related complications: MIGS requires inflating the abdomen with carbon dioxide gas to create a working space for the surgeon. This gas may cause discomfort or pain in the shoulder or chest after surgery. It may also cause changes in blood pressure or heart rate during surgery. Rarely, it may enter the bloodstream and cause serious complications such as embolism or cardiac arrest.
- Recurrence of disease: MIGS does not guarantee a cure for the underlying condition and there is a chance of recurrence or progression of the disease after surgery. This may require further treatment or surgery.

MIGS is a safe and effective option for many patients who need gastrointestinal surgery. It offers several advantages over traditional open surgery and can improve the quality of life and outcomes for patients. However, it is not without risks and limitations and requires careful evaluation and discussion with a qualified surgeon.

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References:

1. Minimally Invasive Gastrointestinal Surgery - Yale Medicine [Internet]. Yalemedicine.org. 2023 [cited 9 January 2024]. Available from: https://www.yalemedicine.org/conditions/minimally-invasive-gastrointestinal-surgery
2. Minimally Invasive Gastrointestinal Surgery | Medscape [Internet]. Medscape.com. 2023 [cited 9 January 2024]. Available from: https://www.medscape.com/resource/mis
3. What Is Minimally Invasive Gastrointestinal Surgery? - iCliniq [Internet]. Icliniq.com. 2022 [cited 9 January 2024]. Available from: https://www.icliniq.com/articles/gastro-health/minimally-invasive-gastrointestinal-surgery
4. Gastrointestinal and Minimally Invasive Surgery | GlobeHealer [Internet]. Globehealer.com. 2021 [cited 9 January 2024]. Available from: https://www.globehealer.com/specialties/gastrointestinal-and-minimally-invasive-surgery/

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