Comments on: Minimally invasive surgery… pushing the frontiers further.

By: Bernard

Bernard — Fri, 27 Apr 2007 13:14:53 +0000

Gam, i don’t do bronchoscopy but it’s most commonly done to investigate for suspected lung cancer, and less commonly for suspected foreign body. Also, in patients in intensive care, it’s used to clear the airways from mucus and blood clots.

By: gam

gam — Fri, 27 Apr 2007 12:29:15 +0000

Thank you for the explanation. You are a great doctor. Just curious, in what cases of disease or sickness does one need bronchocopy? If I am not mistaken, the doctor told me that the wall of my husband’s lungs has thickened. He had bronchitis before.

By: Bernard

Bernard — Thu, 26 Apr 2007 01:04:32 +0000

FireHorse, i hear you. I don’t operate in that area, so I’d be making a guess. The report linked above mentions that Dr. Bessler, who operated, doesn’t expect the scarring doesn’t interfere with childbirth.

The vagina heals very quickly.

If it’s through the stomach or colon, scarring is not a problem. However, there’s a very important issue of contamination of the abdominal cavity with contents of the stomach and colon (which is not clean). That concern will have to be resolved first before this technique can be widely used.

Gam, gastroscopy is a subset of endoscopy. Endoscopy is any method of looking at a structure within the body using a scope.

Gastroscopy is endoscopy of the stomach. Other examples of endoscopy would be colonoscopy (colon), cystoscopy (bladder), laparoscopy (abdominal cavity), hysteroscopy (uterus), arthroscopy (joints), ventriculoscopy (brain ventricles), bronschoscopy (the airway to the lungs) etc.

I believe that the example you gave is probably cystoscopy, i.e. endoscopy into the bladder to remove the stone and NOT thru the vagina.

Jonzz, does that mean you prefer open surgery when it is required?

By: jonzz

jonzz — Thu, 26 Apr 2007 00:54:19 +0000

Gosh, all the four ‘openings’ you presented sounds so GELI! Mouth, anus, umbilicus, vagina!

Patient’s choice? Hmm, my choice would be ‘no way’, LOL

By: gam

gam — Thu, 26 Apr 2007 00:16:19 +0000

Dr. Bernard,
What is the difference between gastroscopy and endoscopy? Is gastroscopy done through the mouth and endoscopy through the anus or vagina? I know of a patient who had endoscopy(?) through her vagina to find out whether a stone is lodged inside her bladder after the IVP failed to show any images of any stone in her kidney.

By: Firehorse

Firehorse — Wed, 25 Apr 2007 23:34:00 +0000

Those choices that you presented to Jonzz dun sound all that exciting, especially going thru the vagina, wouldn’t that lead to scaring thus making it difficult for the woman to expand next time she wants to have a baby, just an ignorant guess here.

By: Bernard

Bernard — Wed, 25 Apr 2007 23:27:46 +0000

nyonya, LOL…

Seriously though, actually not true… an example is laparoscopic appendicectomy (LA) compared to open appendicectomy (OA). The cost of LA is not much more than OA but the patient’s overall recovery is faster and he goes back to work earlier. So the overall cost can actually be less than OA.

By: nyonyapenang

nyonyapenang — Wed, 25 Apr 2007 16:04:47 +0000

i guess if done at private hospitals…the cost will be high. the surgery may save him but the bill may ‘kill’ him.

By: Bernard

Bernard — Wed, 25 Apr 2007 11:58:21 +0000

yenjai, perhaps 10 years. The way that technology moves nowadays … and the way that surgeons embrace and assimilate technology, perhaps I dare say that 10 years would not be an over-estimate for it to become mainstream surgery if its benefits are proven. Prophetic or not… time will tell.

jonzz, well … the surgeon might present a menu… thru the mouth, anus, vagina or the umbilicus. It’s an era of patient’s choice.

By: jonzz

jonzz — Wed, 25 Apr 2007 06:09:20 +0000

Surgery through the vagina? If that doesn’t sound invasive, I don’t know what is, LOL…. Kidding kidding