Endoscopy is a surgical technique that involves the use of an endoscope,a special viewing instrument that allows a surgeon to see images of the body’s internal structures through very small incisions.
Endoscopic surgery has been used for decades in a number of different procedures,including gallbladder removal, tubal ligation, and knee surgery. However, in the world of plastic surgery, endoscopic instruments have recently been introduced. Plastic surgeons believe the technique holds great promise, but further study is needed to establish its effectiveness, especially over the long-term. As important research continues, endoscopy is being used on a limited basis for both cosmetic and reconstructive procedures.
The endoscope consists of two basic parts: A tubular probe fitted with a tiny camera and bright light, which is inserted through a small incision; and a viewing screen, which magnifies the transmitted images of the body’s internal structures. During surgery, the surgeon watches the screen while moving the tube of the endoscope through the surgical area.
It’s important to understand that the endoscope functions as a viewing device only. To perform the surgery, a separate surgical instrument–such as a scalpel, scissors, or forceps–must be inserted through a different point of entry and manipulated within the tissue.
All surgery carries risks and every incision leaves a scar. However, with endoscopic surgery, your scars are likely to be hidden, much smaller and some of the after effects of surgery may be minimized. In a typical endoscopic procedure, only a few small incisions, each less than one inch long, are needed to insert the endoscope probe and other instruments.
For some procedures, such as breast augmentation, only two incisions may be necessary. For others, such as a forehead lift, three or more short incisions may be needed. The tiny eye of the endoscope’s camera allows a surgeon to view the surgical site almost clearly as if the skin were opened from a long incision.
Because the incisions are shorter with endoscopy, the risk of sensory loss from nerve damage is decreased. Also, bleeding, bruising and swelling may be significantly reduced. With the endoscopic approach, you may recover more quickly and return to work earlier than if you had undergone open surgery.
Endoscopic surgery may also allow you to avoid an overnight hospital stay. Many endoscopic procedures can be performed on an outpatient basis under local anesthesia with sedation.
Some procedures that may be assisted by endoscopy are:
Abdominoplasty (tummy tuck) — Endoscopy is sometimes used as an adjunct for selected patients who have lost abdominal muscle tone. Guided by the endoscope, the muscles that run vertically down the length of the abdomen may be tightened through several short incisions. Endoscopy is generally not used in patients who have a significant amount of loose abdominal skin.
Breast augmentation — Inserted through a small incision in the underarm or the navel, an endoscope can assist the surgeon in positioning breast implants within the chest wall. Endoscopy may also assist in the correction of capsular contracture (scar tissue that sometimes forms around an implant, causing it to feel firm), and in the evaluation of existing implants.
Facelift — Although the traditional facelift operation is still the best choice for most patients, especially those with a significant amount of excess skin, certain selected individuals may benefit from an endoscopically assisted procedure. When an endoscope is used, the customary incision along, or in the hairline is usually eliminated. Instead, small incisions may be strategically placed in areas where the most correction is needed. If the muscles and skin of the mid-face need to be smoothed and tightened, incisions may be hidden in the lower eyelid and in the upper gumline. To tighten the loose muscles of the neck, incisions may be concealed beneath the chin and behind the ears. The endoscope may also assist in the positioning of cheek and chin implants.
Forehead lift — Of all the cosmetic procedures that use endoscopy, forehead lift is the one which plastic surgeons more commonly perform. Instead of the usual ear-to-ear incision, three or more puncture-type incisions are made just at the hairline. The endoscope helps guide the surgeon, who removes the muscles that produce frown lines, and repositions the eyebrows at a higher level.
It’s important to keep in mind that the endoscopic approach has only recently been applied to plastic surgery procedures. There are some known risks, which vary in severity depending on the procedure being performed. These include infection, fluid accumulation beneath the skin (which must be drained), blood vessel damage, nerve damage or loss of feeling, internal perforation injury, and skin injury. Keep in mind that if a complication occurs at any time during the operation your surgeon may have to switch to an open procedure, which will result in a more extensive scar and a longer recovery period. However, to date, such complications are rare–estimated to occur in less that 5 percent of all endoscopy procedures.
If performed by an experienced, well-trained plastic surgeon, endoscopic procedures may provide the same results as open-method procedures, but with less scarring. In some cases, endoscopic surgery may require less recovery time than is usually required for open procedures. Patients who tend to be the best candidates for cosmetic endoscopic procedures are those who don’t have large amounts of loose hanging skin. Patients with loose facial or abdominal skin may benefit from a combination of classic and endoscopic techniques, in face or forehead lift, or abdominoplasty.
Please note that this information is offered freely to individuals considering cosmetic surgery. No rights are granted and it is not to be reprinted or copied without the prior written consent of Cosmetic Surgery Net – UK . Beware that although efforts have been made to assure accuracy, many of the issues discussed here are a matter of professional opinion. Consultation with a Qualified Plastic Surgeon should be obtained to answer more detailed questions and advise you based on your personal circumstances.