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With advancements in technology and surgical techniques, many orthopedic procedures can now be done with a minimally invasive approach to the operation. The benefits of minimally invasive surgery include less pain, faster recovery, and decreased risk of infection. Minimally invasive orthopedic surgery can be divided into several categories: Arthroscopic Surgery This involves the use of very small incisions and the percutaneous use of specialized video cameras and surgical instruments to perform surgery. Examples include shoulder surgery for rotator cuff repair or labral repair, elbow or wrist surgery for treatment of tendon, cartilage, and ligament injuries. Arthroscopic surgery is much less invasive than open surgery as there is no muscle dissection required to access the joint being operated on. This achieves all the goals of minimally invasive surgery: less pain, faster recovery and lower risk of infection. Endoscopic Surgery This typically involves a tiny incision and insertion of a camera equipped with a cutting device. Examples include endoscopic carpal tunnel release and endoscopic cubital tunnel release for the treatment of nerve compressions in the wrist and elbow, respectively. This approach typically causes less pain and gets patients back to work and leisurely activities faster than the traditional open surgery performed for these conditions. Traditional Open Surgery with Smaller Incisions or Muscle-Preserving Approach Some open procedures such as joint replacement surgery can be performed through smaller incisions. Newly developed surgical approaches and/or specialized retractors can help in performing hip, knee or shoulder surgery . Another element includes the use of a surgical approach that avoids releasing muscles and instead utilizes a muscle-spreading approach to get to the joint, as with anterior hip replacement surgery. The benefit is less pain and faster rehabilitation due to less dissection and preservation of the muscle attachments to bone. These procedures often involve a surgeon "learning curve" and those surgeons with more experience in these techniques can achieve better and more consistent results. I use minimally invasive surgical techniques whenever possible as I feel there is a huge benefit to the patient. Less pain and faster post-operative recovery are extremely valuable to the patient. Some of my shoulder replacement patients are candidates for outpatient surgery. Patient feedback has been extremely positive due to the fact that you can rest most comfortably in your own bed after surgery with a visiting nurse to help monitor and assist you. This also importantly comes along with a decreased risk of infection due to the avoidance of a hospital stay. Minimally invasive surgery is better for patients and will continue to be an important area of surgical advancement in orthopedics. Michael Cohn, M.D. Orthopedic Surgeon Shoulder to Hand Surgery Orthopedic Center of Palm Beach County 561-967-6500
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orthopedic surgery, minimally invasive, arthroscopic surgery, arthritis, rotator cuff, shoulder replacement,
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