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Role of Keyhole Surgery in Spinal Ailments

Keyhole surgery is relatively a new technique that involves the surgeon operating through really small (often not more than 5 mm) incisions. Read more here.

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When a person suffers from severe back or neck pain, the discs that connect the bones and ligaments comprising the spinal cord, get severely damaged. If the discs get herniated leading to neurological issues, the harniated part of this disc needs to be removed through the process of microdissection. This is where the role of keyhole surgery lies in case of spinal ailments. Keyhole surgery is an advanced form of surgery where a small hole is made instead of a larger incision like before, and  mircodissection of a harniated disc is performed to relive compression and pain in the spinal cord region. It is a safer variation of the spinal cord surgery and is also known as laparoscopic surgery. Keyhole surgery is relatively a new technique that involves the surgeon operating through really small (often not more than 5 mm) incisions. A telescope with a video camera is introduced through one incision and operating instruments are introduced through one or more other incisions. The operation is performed by the surgeon who watches the image on a television monitor. Laparoscopic surgery involves skills which not every surgeon has and there is a very definite learning curve involved for the surgeon.  Therefore, it is advisable to consider your surgeon's experience while taking a decision as to whether or not you should undergo the keyhole surgery. Advantages of Keyhole Surgery As the keyhole surgery is minimally invasive, there are a few advantages of it over the traditional spinal cord surgery. Listed below are the advantages of the keyhole surgery.
  1. Less pain
  2. Fast recovery
  3. Shorter hospital stay
  4. Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections.
  5. As the incisions made are tiny, the keyhole surgery is aesthetically better too.
Disadvantages of Keyhole Surgery In terms of patient outcomes, the keyhole surgery is certainly advantageous. However, the procedure is more difficult from the surgeon's perspective when compared to the traditional, open surgery. Listed below are the disadvantages of the keyhole surgery.
  1. The surgeon has restricted range of motion at the surgical site resulting in a loss of dexterity
  2. Poor depth perception
  3. Surgeons must use tools to interact with tissue rather than manipulate it directly with their hands. This may result in an inability to accurately judge how much force is being applied to tissue as well as a risk of damaging tissue by applying more force than necessary. This drawback also reduces tactile sensation, making it more difficult for the surgeon to feel tissue (sometimes an important diagnostic tool, such as when palpating for tumors) and making delicate operations such as tying sutures more difficult.
  4. The tool endpoints move in the opposite direction to the surgeon's hands due to the pivot point, making laparoscopic surgery (or keyhole surgery) a non-intuitive motor skill which can be difficult to learn.
Image source: resurgensspine