Names of our Departments

Minimal access surgery

Minimal invasive spinal surgery (MISS) was first performed in the 1980s, but has recently seen rapid advances. Technology has enabled spine surgeons to expand patient selection and treat an evolving array of spinal disorders, such as degenerative disc disease, herniated disc, fractures, tumors, infections etc using newr and minimal invasive approaches.

Minimal invasive spinal surgery (MISS) : What is it all about?

It is interesting to know the background of the development of minimal invasive surgery. One potential drawback of traditional low back surgery is the damage that occurs due to the long incision. Sometimes disruption of natural spinal anatomy is necessary to facilitate decompression of pinched nerves and the placement of screws and devices to stabilize the spine. This may lead to lengthy hospital stays , prolonged pain and recovery periods, significant operative blood loss, and risk of post-op infection.MISS developed to rectify the longstanding problems of conventional spinal surgery.

Why Minimal Invasive Surgery?

Minimal invasive spinal surgery(MISS) has been developed with the aim of reducing approach related morbidity or 'collateral damage' to surrounding tissues whilst obtaining the same clinical outcomes of traditional open procedures.

Minimal Invasive Spine Surgery have been used for various surgeries like:

a. Micro-discectomy

b.Endoscopic Discectomies

c. Interbody fusion

d. Thoracoscopic Spine Surgery

e. Pedicle screw fixation

f. Biopsy

Microdiscectomy :surgery for a herniated lumbar disc is traditionally performed through a two-inch incision. The muscle is peeled off of the surrounding bone to access the disc space. The use of microscope allowed better illumination and magnification as well as a relatively smaller incision.

Endoscopic discectomy:The overall goal of this technique is quite similar to that of an open microdiscectomy. The endoscopic discectomy procedure is performed through a small tube placed through a small puncture in the skin. A specialized micro video camera, or a microscope and specialized lighting, is used to visualize the nerves and disc. Removal of disc material is performed with specialized micro instruments. The benefit of this procedure lies in the reduction of local trauma. Specifically, this means that none of the muscles, ligaments, or other soft tissue structures have been cut or disrupted in anyway. This translates into very little pain after surgery and a greatly enhanced rate of recovery. Many patients can return to work in just a few days.

The benefits of MISS include:

1. Reduced blood loss

2. Reduced post-operative incisional pain

3. Minimised respiratory difficulties

4. Improved mobilization

5. Early discharge from hospital

6. Enhanced rehabilitation and early return to activities and work.

These advantages afford a clear reduction in direct and indirect health care costs when employing MISS or MASS techniques.

Dr.Shailesh Kelkar

M.S. M.Ch.( Neurosurgery ) ,Minimal Access Surgeon

Consultant - Neuro Surgeon