For most patients who need gastrointestinal surgery, a minimally invasive approach is preferable to a traditional open procedure, which may require a long incision from sternum to navel. These less-invasive surgeries, such as laparoscopy, involve very small incisions, cause less pain and allow for faster recovery. Patients go home from the hospital sooner, have fewer complications such as infections, hernias, and adhesions and have less scarring inside and out. 

“Minimally invasive surgery is the gold standard approach to repair diaphragmatic hernias and anti-reflux procedures,” says Saber Ghiassi, MD, MPH, FACS, director of Bariatric and Metabolic Surgery at Bridgeport Hospital.

This approach can be used in the treatment of most gastrointestinal conditions which require surgery. Minimally invasive surgery is also the preferred technique for bariatric weight-loss surgeries, and for surgery to treat benign colorectal disease and cancer.

A minimally invasive gastrointestinal surgery typically uses fiber optics and a high-definition video camera to project the surgical field onto a screen in the operating room. “It allows for superior lighting and visualization of the organs we’re operating on and for more precise and safer surgery,” Dr. Ghiassi says. 

With the patient under general anesthesia, the surgeon makes several small incisions in the abdomen to place small ports or tubes that will accommodate the tools needed for the operation. Through one port, the surgeon pumps carbon dioxide into the abdominal cavity, creating a workspace, and then inserts the videoscope, which transmits images to a large high-definition screen. Once the surgeon completes the procedure, he or she removes the ports and allows the carbon dioxide to escape the cavity. Any gas that remains will be absorbed by the body and expelled through respiration.

Minimally invasive gastrointestinal surgeries are as effective as traditional open surgeries, and can, in some cases, have even better outcomes. While open surgeries often require an in-hospital recovery period of five to 10 days, minimally invasive surgery causes much less trauma to healthy tissue, lessening patients’ pain and accelerating their recovery. 

“Many of my patients don’t need any pain medication the day after surgery,” Dr. Ghiassi says. “They're often walking around and telling me that they're ready to go home because they feel great.” Minimally invasive surgery also drastically reduces the risks of wound complications, including infections, hernias and scar tissue formation.

Many appendectomies and gall bladder removals across the world are done laparoscopically, but many surgeons choose not to perform technically challenging procedures this way. At Yale Medicine, the gastrointestinal surgeons are specially trained and highly experienced in applying the minimally invasive approach to a broad spectrum of pathologies and problems in the gastrointestinal tract. 

“We have a high rate of success performing minimally invasive surgeries successfully with excellent outcomes,” says Dr. Ghiassi. Yale Medicine receives many referrals from other physicians and medical centers of patients with challenging conditions, or who need revisions of a previous surgery. “Any type of revision through minimally invasive surgery is more challenging,” Dr. Ghiassi says. “But we possess the skills and experience to help those patients. We are very patient-centric, providing patients with the best care possible."