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September 2009
The focus on this month's Kids Connection (minimally invasive robotic surgery and wound healing) certainly impresses us with current techniques for reducing the discomfort and complications of surgery, but even more so, it reminds us of the incredible impact that technology has on medical care. For some advances in technology, it becomes possible to do things that we simply could not do before. For instance, the advent of Magnetic Resonance Imaging (MRI) allows imaging of tissues that were not visible by any prior imaging technique. Thus, MRI allows for identification of neurological, skeletal and internal organ abnormalities that could only be identified by direct or microscopic observation before MRI. However, most advances in minimally invasive techniques just provide a less invasive or alternative technique for accomplishing a similar outcome. For example, in both adult and pediatric cardiology, many procedures have been moved from the operating room to the catheterization laboratory - coronary stents instead of bypass surgery, balloon dilation of valves instead of open heart repairs, and closure of a variety of defects with catheter delivered devices rather than surgical repair.
Dr. Hebra tells us about a variety of procedures that are now being performed using small scopes inserted through tiny incisions instead of instruments and hands used through a large skin opening. Since many of the movements required for complex surgery performed through a scope are very tiny and must be precisely performed, the addition of a "robot" to the procedure significantly expands the procedures which can be performed. These procedures lead to less injury and quicker healing, often critical for our smallest most fragile patients. As one who has undergone both traditional and laparoscopic hernia repair, I can testify that even for us "larger" patients, post-operative pain and discomfort are dramatically reduced by such procedures.
Also in this edition of Kids Connection, Dr. Gourdie discusses the future prospect of scar-free wound healing. It is somewhat of a paradox that the body's natural method of healing with a scar not only can produce aesthetic problems on the skin but more importantly, can lead to long term internal complications through scar contraction and adhesions to other tissues. In moving organs such as the lungs and heart, scars can severely limit the function of the organ or produce abnormal life-threatening electrical rhythms. So the notion of the healed area being made normal organ tissue rather than a scar holds tremendous promise for changing the nature of both accidental and surgical organ injury.
In conclusion, the small sampling of technological advances discussed in this issue make it clear that such advances in medicine have and continue to hold great promise for improving the lives of our most vulnerable patients. You can be assured that the MUSC Children's Hospital is dedicated to providing these latest technologies whenever they are likely to lead to such improvements.
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J. Philip Saul, MD
Medical Director
Director, Pediatric Cardiology |
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