Surgery Today

C omputer and video screens surround the operating table, their displays projecting larger-than-life sections of a patient's internal organs. Monitors beep and blip in the foreground as a surgical assistant quickly hands the surgeon his tools—two slender fiber-optic tubes, one equipped with telescopic lens, video camera and light source, the other fitted with a laser. The surgeon makes two tiny incisions in the patient's abdomen, each smaller than a dime, and then inserts the instruments. The telescopic lens and camera help the surgeon locate the organ. Watching his movements on the video screen, he uses the laser to first carefully cut away a lesion and then seal the organ where the cut was made. Even as the piece of tissue is being sent to the laboratory for biopsy, the patient's incisions have been stitched and covered with Band-Aids.

This scene is reenacted every day in hospitals across the country. New developments in techniques, instruments and knowledge have revolutionized the field of surgery, moving it into what once was considered only the realm of science fiction. Doctors routinely make microscopic incisions with beams of light, freeze cancerous cells with liquid nitrogen, and use computer-operated cameras to view the interior landscape of the body. While the range of surgical procedures remains vast, the procedures, themselves, have changed. For example, a patient undergoing surgery to remove his gall bladder previously faced an operation that sliced through the major muscles of the abdomen to reach the organ and then kept him in the hospital for a week with restricted physical activity for up to six weeks following the procedure. Today, the same patient would most likely undergo a laparoscopic cholecystectomy, a procedure in which surgeons make four tiny incisions in the abdomen and then insert delicate instruments and cameras that they manipulate from outside. In less than an hour, the diseased gall bladder is extricated through one of the incisions. After an overnight stay in the hospital followed by a week of rest, the patient is back to his normal activities.

Just when operations, such as open heart surgery, were becoming more and more complex, as well as risky, technological innovations simplified the field. Less invasive surgical techniques, new antibiotics and anesthesia, improved imaging techniques, and advances in preoperative management all have contributed to making the surgical experience of the average patient safer and less painful and his recovery time much quicker.

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