What are the differences between an open and an endoscopic procedure?
Los Angeles, CA
Endoscopic scoliosis surgery utilizes cameras and instruments manipulated through multiple small incisions, sometimes referred to as portals, to correct and stabilize a spinal curve.
Glen Burnie, MD
An open procedure is typically done through a single incision that allows the surgeon to directly visualize the spine. This procedure has been traditionally used to correct scoliosis. It provides excellent exposure that is needed to successfully complete the operation. An endoscopic approach is performed through multiple small incisions. The surgery is performed using specialized instruments that are viewed on a monitor. The potential advantage of the endoscopic approach is a quicker recovery because it requires less muscle dissection. However, because of technical limitations, not all curves are best treated through an endoscopic approach.
The basic procedure is the same. The only difference is that portals are used in an endoscopic procedure instead of a standard incision.
The open procedure uses a large incision in the front which goes through the chest and allows for visualization of the spine. This incision is approximately 12-15 cm in length. The endoscopic procedure uses four or five small 1-2 cm incisions.
New York, NY
Open surgical procedures require larger incisions and may involve more blood loss than endoscopic procedures. On the other hand, endoscopic techniques are not optimally suited for many types of scoliosis and thus best results for some curvatures require an open technique. The size of the incision should certainly not be the primary concern when planning scoliosis correction. Overall, the optimal procedure requires careful planning by your surgeon and you should discuss advantages and disadvantages of different techniques in detail.
Both approaches attempt to accomplish the same surgical goals. Pain is more significant with open procedures than with endoscopic surgery. Another difference is the length of the scar.
New York, NY
An open procedure is done with a longer single incision allowing the surgeon to directly see the field of the operation. An endoscopic procedure is done using very small incisions that do not allow the surgeon to look through to the operative field. The "looking " is done using scopes that are introduced into these small incisions and using video monitors as the surgeon's eyes. The benefit of these small incisions is that muscle is not disrupted to the extent of an open procedure. The optics of the scopes used with endoscopic procedures allow for even better visualization of the operative field than with the naked eye.
The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.
It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.