Minimally invasive surgery (MIS)

There are broadly 2 ways to perform any surgery. Surgery can be performed by a time tested open method (which requires a larger incision over the body) or a minimally invasive method (which requires 3-4 small 3-5 mm incisions). We have progressed so much in the last 10 years that we are able to do most surgeries by minimally invasive surgical methods.
MIS ensures less pain, faster recovery and better cosmesis than open surgery.

Types of MIS

Laparoscopy
This means performing surgery by putting a telescope and some long instruments into the abdominal cavity (tummy).

Thoracoscopy
This means performing surgery by putting a telescope and some long instruments into the thoracic cavity (chest).

Cystoscopy
This means entering into the urinary bladder via the urethra with a cystoscope either to diagnose a condition or to treat a condition.

Bronchoscopy
This means entering into the windpipe with a bronchoscope to diagnose a condition or to treat a condition or to collect some secretions for testing.

OesophagoGastroDuodenalScopy (OGD scopy)
This means entering into the foodpipe till the beginning of small intestine  with an esophagoscopeto diagnose a condition or to treat a condition or to take a biopsy .

Pediatric Endoscopy​

1. Upper GI endoscopy

Q. What is an upper GI endoscopy?
A. An upper GI endoscopy is a procedure where a doctor inserts a flexible tube with a lens and a light source, to look at the lining of the upper part of the gastrointestinal (GI) tract.
The upper part of the GI includes the oesophagus, the stomach, and the duodenum (first section of the small intestine).

Q. Why would my child need an upper endoscopy?
A. An upper endoscopy is used to look for inflammation (redness, irritation), bleeding, varices (enlarged veins), ulcers, strictures (narrowing) or polyps. It allows the doctor to perform procedures such as biopsy (tissue sampling), dilatation of the stricture, or stop bleeding. It also allows the doctor to remove foreign bodies within the upper gastrointestinal tract.

Q. How is it done?

  • Your child will need to be asleep for the procedure. This means that s/he will need a general anaesthetic. You will be informed about your child’s fasting (not eating or drinking) time before the procedure.
  • The endoscopy procedure normally takes between 10-20 minutes.
  • A mouth guard will be used to protect the teeth.
  • The endoscope will be passed through the mouth guard, gradually advanced into the oesophagus, stomach and duodenum.
  • During the procedure, the doctor will gently pump air and sterile water through the scope to get a better view.
  • Pictures will be taken with examination of each part of the upper gastrointestinal tract.
  • In most cases, tissue samples called biopsies are needed, and are taken with small forceps. This is not painful and should not cause pain afterwards.
  • Additional procedures such as dilatation, removal of polyps, treatment of bleeding, and removal of a foreign body may be performed. Your doctor will speak to you in detail both before and after the procedure

2. Colonoscopy

Q. What is a colonoscopy?
A. A colonoscopy is a procedure when a doctor inserts a flexible tube with a lens and a light source, to look at the lining of the lower part of the gastrointestinal (GI) tract. The lower part of the GI tract is called the colon or large intestine. A colonoscopy takes approximately 40-60 minutes.

Q. Why would my child need a colonoscopy?
A. A colonoscopy is used to look for inflammation (redness, irritation), bleeding, ulcers, and polyps. It also allows the doctor to perform procedures such as biopsy (tissue sampling) and polypectomy (removing polyps).

Q. Bowel preparation
A. A good bowel preparation is important for colonoscopy. Good preparation allows a good view of the entire colon and also reduces risks of procedure complications. Passing clear watery stool is a sign of good bowel preparation. It is also important that your child has plenty of additional clear fluid along with the bowel preparation. A specific bowel preparation instruction will be prescribed for your child.

Q. How is it done?

  • Your child will need to be asleep for the procedure. This means s/he will need a general anaesthetic.. You will be informed about your child’s fasting (not eating or drinking) time before the procedure.
  • The colonoscopy procedure normally takes between 30-60 minutes.
  • The colonoscope will be passed through the rectum, gradually advanced into the colon – sigmoid, descending, transverse, and ascending colon and caecum. It will also be advanced then to the end of the small bowel called terminal ileum.
  • During the procedure, the doctor will gently pump air and sterile water through the scope into the colon to inflate it. This will give the doctor a better view of the colon.
  • Pictures will be taken with examination of each part of the colon.
  • In most cases, tissue samples called biopsies are needed, and are taken with small forceps. This is not painful and should not cause pain afterwards. 
  • Additional procedure such as removal of polyps may be performed. Your doctor will speak to you in detail both before and after the procedure.

3. Bronchoscopy

A flexible or rigid telescope is inserted into the windpipe to visualise the inside of the tracheobronchial tree. Any blockages may be resolved, a sample may be taken for culture, a foreign body if present may be removed and any abnormalities diagnosed.

4. Laparoscopy

This entails performing abdominal surgery through very small 3-5 mm incisions using very slender instruments and a telescope. It leaves virtually invisible scars and is a cosmetic way of minimally invasive surgery

5. Thoracoscopy

This entails performing thoracic surgery through very small 3-5 mm incisions using very slender instruments and a telescope. It leaves virtually invisible scars and is a cosmetic way of minimally invasive surgery

6. Cystoscopy

A rigid telescope is inserted into the urethra to visualise the inside of the lower urinary system. Urological conditions can be diagnosed, conditions like posterior urethral valves may be treated, some njections can be given through this access.

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