Approaches of Surgery

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.

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.