keyhole surgery

Term used to describe operations that do not involve cutting into the body in the traditional way. These procedures are performed either by means of endoscopy or by passing fine instruments through catheters inserted into the body by way of large blood vessels. Probably the best-known example is percutaneous transluminal coronary angioplasty (PTCA) to treat coronary artery disease. It involves passing a balloon-tipped catheter into a large artery in the groin and advancing it until the tip comes to rest in a narrowed coronary vessel; the balloon is then inflated to widen the diseased vessel. PTCA is performed in selected cases as an alternative to the conventional procedure of coronary artery bypass grafting (CABG).

Advocates of keyhole surgery claim it is safer and cheaper than conventional surgery, requiring a shorter hospital stay and less disruption to the patient's life. However, one or two such procedures have been called into question, either because they do not yield the long-term result of open surgery or because they are performed by people inexperienced in the technique. In roughly a third of cases treated by PTCA, for instance, the artery becomes blocked again within six months, requiring further surgery.