COVID19 has brought about many changes in how we deliver health care and, in particular, how we practice surgery. We have learnt a significant amount about the actual coronavirus but also some of the weaknesses in our healthcare system, which we are now able to make more efficient. One example of this is the under-utilisation of minimally invasive surgery.

 

In the early days of the COVID19 pandemic, it became clear that intensive care resources and hospital bed space was at a premium and allocation of these precious resources could be better. This meant that to continue with elective surgery, patients needed to have a very streamlined and efficient pathway through the hospital. In short, patients should be brought into hospital and safely discharged as quickly as possible without the need of intensive care, where appropriate. Minimally invasive surgery often obviates the need for intensive care, allows for faster recovery and earlier discharge from surgery and it is associated with fewer complications – specifically that there is less likelihood of developing post-operative chest infection or pneumonia and that post-operative pain is considerably less. Surgery which involves smaller incisions using precise instruments and where the surgeon's hands are kept out of the abdominal cavity means that there is less surgical trauma during the operation and therefore a quicker recovery.

 

There is now no doubt in the many benefits of minimally invasive surgery whether that be laparoscopic or robotic surgery compared with traditional 'open' surgery involving a large incision through the abdominal wall. And whilst minimally invasive surgery has been the gold standard approach for many conditions prior to coronavirus, it advantages during a pandemic. All major surgical societies advocate the use of minimally invasive surgery where possible.

 

Offering laparoscopic or robotic surgery often comes down to technical expertise and availability of resources. In these circumstances, it may be important to get a second opinion regarding the possibility of minimally invasive surgery if it hasn't been offered from the outset.

 

We would be more than happy to discuss the appropriateness of a laparoscopic of robotic operation or offer you second opinion, if necessary, about the possibility of minimally invasive surgery and the many benefits compared to open surgery.

 

Take care,

Manish Chand

​

​