The times when after the intervention procedure there was a huge scar left, and it was necessary to spend more than one week in the hospital bed, finally, devoting a lot of time to rehabilitation and returning to the daily routine – sinks into the past with a quick step. More and more areas of medicine are being conquered by minimally invasive operations, during which needle-sized punctures or extremely small incisions – up to 2 mm – are performed. After such procedures, the patient is put on his feet, his health is rapidly improving, and often he is allowed to return home even on the same day. It is important to note that until relatively recently, the first such operation was considered an object of ridicule, and today it is the gold standard in surgical treatment.
As the Head of the Interventional Radiology Department of the Republican Vilnius University Hospital, doctor interventional radiologist Andrei Afanasyev, tells us, the first operation of this type was not immediately recognized. The doctor innovator, who performed the first minimally invasive operation, received not praise, but a burst of skepticism. The medical community described this not as a breakthrough in medicine, but as a method of treatment that has no future.
“In the world, minimally invasive surgeries began to be applied at the end of the twentieth century. In 1983, a professor from Hamburg, Kurt Seemm, performed the first laparoscopic appendectomy – an operation to remove the appendage. The doctor who performed the successful innovative operation received a lot of ridicule at that time, the methods of low-invasive treatment were viewed with skepticism, believing that incisions of a few millimeters would never replace surgical operations,” says A. Afanasyev.
Fortunately, this unfounded criticism never came true. About seven years later, since the 1990s, minimally invasive surgeries began to spread around the world and quickly became popular. The innovation, which is rapidly conquering medical institutions, did not bypass Lithuania either: “The first low-invasive operation – removal of the appendage – was performed in Lithuania on 9 December 1992 by dr. Marius Purtokas. Today, low-invasive surgeries have spread to many areas of medicine and are considered the gold standard in medicine.”
“In interventional radiology, minimally invasive treatment methods, when needle-sized punctures or small incisions up to 2 mm are performed, are already applied to hundreds of different procedures. The range of these procedures is constantly expanding, improving, both diagnostic and therapeutic procedures are performed in real time observing the extremely accurate picture of the procedure. The deepest tissues or organs of the body are reached without an open incision, and the precisely controlled process of the procedure helps to ensure extremely accurate and effective treatment,” says A. Afanasyev.
One of the minimally invasive methods of treatment is embolization, during which the blood vessels that feed on the tumor, cyst, certain organ or tissue are blocked. Embolization, the doctor explains, is usually performed by radiologists or interventional radiologists using an X-ray or ultrasound to observe the procedure. “Through a small incision of a few millimeters, usually in the groin or in the wrist area, a catheter is introduced. A special substance is introduced into the catheter that blocks the blood vessel (microspheres, gel foam, special spirals). The catheter is directed through the blood vessels to the right place where embolization should be performed. After embolization, the catheter is removed, and the incision is closed. Depending on the complexity of the procedure and the general state of health of the patient, the patient can be observed for several hours or days, but most often patients are discharged home just outside the same day,” explains the interventional radiologist.
This method of treatment, he says, is often used in the treatment of cerebral aneurysms, pathological hemorrhages, uterine myomas, varicose veins, prostatic hyperplasia, the procedure is used to treat chronic pain, women who feel chronic pelvic pain, as well as to solve problems with urinary incontinence. “The rapid development of medical equipment and tools is influenced by innovative artificial intelligence solutions, and minimally invasive procedures are becoming an increasingly common method for treating various diseases and ailments. During minimally invasive procedures, it is possible not only to open clogged blood vessels – for example, in the presence of blockages in the arteries of the brain, intestines or limbs (with thrombectomy), but also to close them – for example, by stopping bleeding. In cases of uterine myomas, varicocele or arterial malformations, the blood vessels that feed the tumors or other formations are closed.
During minimally invasive procedures, it is possible to close even the blood vessels that cause inflammation and pain in the joints, and with the introduction of special electrodes – with the help of cold (cryoblation), heat (microwave or radiofrequency ablation) or electroimpuslus, even tumors can be destroyed. With the help of endovascular treatment, especially advanced technologies are applied in the treatment of cerebral aneurysms and complex aortic aneurysms,” says the interlocutor.
Minimally invasive methods of treatment not only cause less pain in patients, but thanks to them, the periods of hospitalization and rehabilitation are shortened, and the risk of complications becomes significantly lower. “Compared to traditional surgery, after which a full recovery occurs only after 6-8 weeks, after minimally invasive procedures, patients can return to the daily routine in a minimum period of 1-2 weeks. A shorter postoperative period in itself indicates that the treatment procedure applied to the patient is not so invasive – less harm to the body, less risk of complications, shorter postoperative period. Such procedures reduce not only the patient’s stress, but also make loved ones feel calmer, the patient can return to work faster, less bed days, less costs for medical institutions,” explains the doctor.
In addition, minimally invasive treatment methods also facilitate the work of doctors – the time of operations is reduced, and complex operations become simpler. “For doctors, minimally invasive methods allow them to carry out complex procedures faster and more efficiently, because modern surgery is developing at an extremely fast pace, every year a lot of new and improved means appear, the use of which becomes extremely effective. For example, some 8-hour brain surgeries in the world are becoming a thing of the past, since the methods applied in interventional radiology allow you to solve the same problem in just an hour. And this is not mysticism, these are real facts and stories from our work,” the doctor rejoices.
The doctor considers that these types of operations have the potential to spread even more and replace many surgical operations: “Medicine is improving, treatments are being sought that are focused on the patient’s health – they would work effectively, but would cause less damage to the human body, reduce the risk of complications and guarantee faster recovery. For example, in the surgical treatment of uterine myomas, hysterectomy is often performed in patients. During the hysterectomy operation, the uterus is removed, an incision of 10-15 cm in the lower abdomen is made, patients are subjected to general anesthesia, after the operation in the hospital it is still necessary to lie for 2 to 5 days, after full recovery is carried out only after 6-8 weeks. In the treatment of uterine myomas by embolization – local anesthesia is applied, it is enough to perform a small, a few millimeters of prick in the groin, and the patient is discharged home after just 1-2 days.”
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