Once upon a time, when surgery was mentioned, a common image came to mind – shadowless lights, scalpels, doctors busy in the patient’s abdominal cavity ………… Traditional Open surgery has caused countless patients to be frightened and apprehensive. However, with the rapid development of minimally invasive surgery technology in the late 20th century, more and more minimally invasive techniques are being applied to clinical practice. As an important branch of minimally invasive surgery, the technology of minimally invasive urology and male surgery is also developing rapidly, bringing better options for male patients whose time is precious.
What are the advantages of minimally invasive urological and male surgery? How “minimally invasive” can “minimally invasive” be? What do patients who need minimally invasive surgery at …… need to pay attention to? Recently, I was fortunate enough to interview Liu Cundong, Director of the Department of Urology of the Third Affiliated Hospital of Southern Medical University, to introduce the application and status of minimally invasive technology in male surgery.
Why is minimally invasive prevalent?
Doctors and patients are faced with the dilemma that they want surgery to cure the disease, but they also want small incisions and fast recovery, but due to the disadvantages of traditional open surgery, they often choose to sacrifice incisions and recovery time in exchange for curing the disease. As a result, surgery has often become synonymous with large incisions, slow recovery time, and many infections, leaving many patients in a dilemma.
At the end of the 20th century, minimally invasive techniques, represented by the development of a series of lumpectomies, became increasingly mature, and minimally invasive surgery became more and more prevalent from the initial examination and diagnosis to the later treatment stage. So, what are the specific benefits of minimally invasive surgery?
Director Liu Cundong has detailed four advantages of minimally invasive surgery in clinical practice.
One, small incision
In surgery, especially male surgery, the size and location of the incision is directly related to the success or failure of the surgery and the healing time after the surgery because of the special location. The larger the incision, the greater the damage caused to the patient’s body and the slower the recovery. The large incision that cannot be avoided by open surgery can be well compensated by minimally invasive surgery.
Director Liu Cundong gave a simple example: for kidney stone removal surgery, a traditional open surgery requires a 15cm incision to cut the skin, fat, muscles and even nerves to reveal the kidney and cut open the renal pelvis or kidney to remove the stone, which may not be completely removed, while minimally invasive surgery can be performed with the help of advanced minimally invasive equipment, directly on the patient’s waist. With the help of advanced minimally invasive equipment, an incision of about 1cm is made directly in the patient’s lumbar region, and a catheter as thick as a pencil is inserted, through which the minimally invasive equipment can directly find the stone and break it up and remove it.
Second, fast recovery
Since minimally invasive surgery is less harmful to the human body. Therefore, the patient’s recovery time and hospitalization time are greatly shortened, and in the case of male surgery, it can basically be advanced by about a week. In this era when time is like gold, time is undoubtedly the most valuable asset.
Third, the application of a wide range of people
In addition to some patients who can normally bear open surgery can be converted to minimally invasive surgery, a considerable number of patients are unable to bear the trauma brought by open surgery due to other physical reasons, such as weaker constitution, high blood pressure coronary heart disease, diabetes, senior patients, etc. They have poor tolerance to surgery. However, the pain must be relieved by surgical means, so minimally invasive surgery can make a big difference.
Director Liu Cundong also gave us an example of an 86-year-old patient with prostatic hyperplasia who was still in the ward recently, suffering from dementia, hypertension coronary heart disease, poor heart function, long term catheter, recurrent urinary system infections and poor health. If open surgery is used to remove the diseased prostate lesion, the patient may not be able to withstand the blow of surgery at all, but after minimally invasive surgery, which removes the very large enlarged prostate without an incision just through the patient’s urethra, the patient recovers very well and urinates freely, avoiding a series of difficulties in recovery and infection.
The oldest patient to undergo minimally invasive surgery at this hospital is 97 years old and has recovered well. Therefore, it is undoubtedly a better choice for patients who are older, in poor health, unwilling or unable to adopt open surgery.
IV. Low comprehensive cost
According to the general concept, it seems to be an unbreakable truth that the cost of surgery is bound to rise when a new technology brings convenience. However, Director Liu Cundong explained that, according to the cost of individual surgery, the cost of minimally invasive surgery is definitely higher than that of open surgery because of the new technology and equipment required for minimally invasive surgery. Complications, blood transfusion, etc. The overall cost of minimally invasive surgery is definitely lower than that of traditional open surgery. Moreover, the pain suffered by the patient during the surgery is incomparable and decreases geometrically, so there is no need to worry about the fear of surgery at all.
Minimally invasive cannot cure all diseases
”At present, more than 90% of male surgeries can be completed with minimally invasive surgery”. Director Liu Cundong said that because of the rapid development of minimally invasive technology in recent years, and he himself is majoring in urology and minimally invasive male surgery, the proportion may be slightly higher. In actual clinical work, most male surgeries can be completed with minimally invasive surgery, and some minor surgeries can already be done instantly without affecting patients’ work and life.
In some aspects, such as adrenal and kidney tumors, urinary stones, and prostate hyperplasia, minimally invasive surgery has a unique advantage. For example, there is a very important gland called “adrenal gland” in the upper part of the kidney, which is very deep and it is not easy to expose the gland, especially for obese patients. The minimally invasive laparoscopic technique can not only display the adrenal gland clearly on the color screen, but also magnify the tumor on the gland several times to reveal it for the surgeon’s operation, which is not only a small incision with little trauma, but also allows the surgeon and the assistant to see the whole operation clearly through the screen, which greatly reduces the risk of the operation.
However, not all male surgeries need to be minimally invasive, and minimally invasive surgery has its own indications. Minimally invasive surgery is not necessary for some diseases of the scrotal area, for example, because it is not very invasive. However, many surgical procedures in these areas require great delicacy, and therefore microsurgical techniques are used extensively in these areas.
Likewise, some orthopedic surgeries of the genitalia likewise cannot be applied minimally invasive. The surgical purpose of orthopedic surgery fundamentally limits the use of minimally invasive surgery, and the use of minimally invasive surgery will instead increase the risk and difficulty of surgery. Therefore, new technologies should never be pursued blindly and reluctantly.
Minimally invasive does not mean non-invasive
Although minimally invasive technology is becoming more and more advanced, Director Liu Cundong needs to remind patients that the use of minimally invasive surgery does not mean that there is no trauma. Minimally invasive itself is less painful than open surgery, but it still exists. “Minimally invasive” is not synonymous with “non-invasive”. At the same time, minimally invasive surgery has its corresponding surgical indications, if not grasped properly, not only can it not achieve the purpose of minimally invasive, but also will bring more pain.
Minimally invasive surgery needs to pass the technical threshold
Director Liu Cundong said that although minimally invasive technology is more advanced than open surgery and has begun to replace open surgery in many aspects, the experience of open surgery is the necessary foundation for minimally invasive technology to be carried out. At the same time, minimally invasive surgical techniques must be practiced only after extensive and repeated training in minimally invasive operations. It is important for the surgeon who performs minimally invasive surgery to have solid basic medical knowledge and clinical experience, otherwise, minimally invasive surgery may become massively invasive if not handled properly.
Minimally invasive surgery is developed on the basis of open surgery, and the surgeon in charge must have rich clinical experience in open surgery. In the event of special circumstances or complications, such as bleeding, during surgery, the surgeon must immediately switch to open surgery. Only doctors with many years of experience in open surgery are able to perform the corresponding minimally invasive techniques.
In addition, minimally invasive surgery cannot be performed without the mutual cooperation of anesthesia, hospital technical equipment and medical staff. Therefore, a reliable team is necessary for minimally invasive surgery.
A few reminders for minimally invasive surgery
As a urological or male patient who needs minimally invasive surgery, how to choose a hospital? Director Liu Cundong briefly introduced several points of caution.
First, patients should have a basic understanding of their condition and whether this disease can be accomplished with minimally invasive surgery.
Secondly, it is very important to pick your surgeon because he is the key person who directly provides medical care to you. The success or failure of your pick determines the results of your surgery or the risks you take during the surgery. You can look at the reputation of that surgeon, the surgeries he has done before, and ideally, you can get first-hand information from patients who have undergone surgery with that surgeon.
Once again, the strength of the hospital’s facilities is also important. You can find out from the doctors who see you, your acquaintances, and you can even go directly to the ward of the department you are visiting to communicate directly with patients with the same disease to find out the real situation.