Minimally Invasive Surgery

Videoscopic surgery is one of the most innovative and sophisticated surgical techniques available today. Yet it also requires a very special kind of care.

For years, Middlesex Hospital's Advanced Telemedicine and Videoscopic Surgical Center has been at the forefront in both state-of-the-art technology and surgical excellence. Its specially constructed operating suite features the most advanced videoscopic technology available, including voice-activated robotics and real-time telemedicine capabilities.

The Center’s staff, including clinical nurse specialists, is highly trained in the various technologies involved in videoscopic surgery. This includes the use of advanced equipment and instrumentation, computer robotics, and telemedicine scheduling and implementation, with clinical pathways established to streamline patient care.

Specialties

With surgeons specially trained in basic and advanced videoscopic surgical techniques, the Center has revolutionized the way many basic surgical procedures are performed, including appendectomy, cholecystectomy, adhesiolysis, and inguinal and ventral herniorraphy. Center physicians also perform a number of advanced gastrointestinal, oncological, gynecological and arthroscopic procedures and, in conscious pain mapping, use videoscopy as a highly accurate diagnostic tool.

The results, to date, have been gratifying. For example, a recent study showed that patients who underwent a laparoscopic cholecystectomy at the Center had significantly lower total and technical complication rates than patients who had the same procedure done at thirty-five other Connecticut hospitals.

For additional information, or to make a referral to Middlesex Hospital's Advanced Telemedicine and Videoscopic Surgical Center, call (860)347-9167.

Common Procedures

At the Center, videoscopic surgery has had its most remarkable success in the treatment of gastroesophageal reflux disease (GERD). Once considered a “last resort” procedure, laparoscopic Nissen fundoplication has become a standard treatment for GERD because of the minimally invasive nature of videoscopic surgery. Studies have shown that more than 90% of patients who undergo the procedure are symptom-free after ten years.

Common to all videoscopic procedures is a dramatic reduction in patient pain, trauma and recovery time. At Middlesex Hospital, GERD patients usually stay between two or three days. In laparoscopic cholecystectomies, 95% of our patients are discharged on the day of surgery.

Laparoscopic Fundoplication

In this procedure a portion of the stomach is wrapped around the esophagus to create a new lower esophageal sphincter (LES).

The video monitor shows the surgeon closing the diaphragm muscle prior to the construction of the new LES.

Laparoscopic Preperitoneal Hernia Repair

In this procedure, a piece of plastic is placed between the peritoneum and abdominal wall to repair the hernia and prevent its return.

Advanced Shoulder Arthroscopy

Instead of making a large incision in the joint capsule, all manipulations are accomplished through tiny incisions under direct visual control.

Arthroscopic techniques offer the surgeon more diagnostic accuracy. In the photograph, the rotator cuff tendon is evaluated prior to surgical repair.

New Procedures

While the specially constructed operating suite at the Advanced Telemedicine and Videoscopic Surgical Center is designed for optimal use of the surgical space, the Center also offers two of the most advanced technologies available today: robotic scope positioning and complete telemedicine capabilities.

AESOP: Voice-activated Robotics

In traditional videoscopic surgeries, the laparoscope or endoscope was held by an assisting physician or nurse, often resulting in unsteady positioning. With the AESOP system, a robotic arm “hovers” over the patient and holds the scope, giving the physician a steady, clear picture of the surgical area. Since the system is computer-driven and voice-activated, the physician can have instant positioning on command and even “save the position” for later recall.

Telemedicine Capabilities

Middlesex Hospital is the only community hospital selected to participate in a national telemedicine network with Yale-New Haven Hospital and other nationally known hospitals.

Telemedicine capabilities enable consulting physicians within the network and from around the globe to view surgical procedures at the Center from up to three vantage points: an overall view of the suite, a close-up external view of the procedure and the internal view provided by the videoscope. Moreover, the consulting physician can communicate with the surgeon as the surgery is taking place. Using a Telestrator device, the consulting physician can, with a special mouse, draw instructions on the screen that can appear on a monitor screen in the surgery suite.

FAQs

What is videoscopy?

Videoscopic surgery allows physicians to see and work inside the body without making the large incisions required by traditional surgery. Instead, the surgeon uses small “ports” through which surgical instruments are passed. A videoscope – a tiny video camera connected to a television monitor – functions as a visual guide for the surgeon.

What kinds of procedures benefit from a videoscopic surgical option?

Center physicians perform a number of advanced gastrointestinal, oncological, gynecological and arthroscopic procedures and, in conscious pain mapping, use videoscopy as a highly accurate diagnostic tool.

How does videoscopic surgery affect recovery time?

Procedures using videoscopic surgery require shorter hospital stays, produce faster recovery periods and are more cost-effective than traditional surgery.

How are the outcomes vs. traditional surgical procedures?

Patients typically have a highly positive reaction to videoscopic surgery. They experience less pain and less scarring, and they are able to return to work and other normal activities in a much shorter time.

What is GERD?

For more than 9 million Americans, gastroesophageal reflux disease (GERD) is a chronic, painful and debilitating condition in which the stomach acids surge upwards from the stomach into the esophagus causing a harsh burning sensation. The condition occurs because the lower esophageal sphincter (LES) fails to close, allowing stomach acids to reflux back into the esophagus.

How is GERD treated?

Traditional treatment options include lifestyle changes and drug therapy. Because of advances in videoscopic surgery, the laparoscopic Nissen fundoplication has become the standard surgical treatment of GERD. In the procedure, videoscopic techniques are used to construct a new LES by wrapping the upper portion of the stomach around the lowest point of the esophagus. The new LES prevents reflux of stomach acids into the lower esophagus.

How successful is the treatment for GERD?

Studies have shown that more than 90% of patients who undergo the procedure are symptom-free after ten years. The traditional procedure required a hospital stay of up to ten days and a recuperation period of six weeks or more. With laparoscopy, the hospital stay is usually two or three days and most patients return to work within a week following the surgery.