Arthroscopic Surgery

Arthroscopic Surgery the technique of visualizing, recording, diagnosing and if necessary performing surgery inside a joint using an Arthroscope with camera, monitor, video and related other instruments. Inserted through tiny port/s a pencil size Arthroscope allows visualizing almost all part of a joint which is not possible even by conventional opening procedure/s of wide incision/s. The procedure is doctor and patent friendly as it can be performed without or with short period of hospitalization; being minimally invasive it is less painful thus permits early recovery and return to work. Evolution of mini scopes side by side with standard sizes allowed Arthroscopy in large and small joints alike but knee is the ideal joint for Arthroscopy and the procedure is being most commonly practiced in the knee. It may be mentioned here that from Arthroscopic Surgery in France laparoscopic surgery was developed (1987). Subsequently application of the technique of Arthroscopy also extended to treat Slipped Disc of the vertebral column and Carpal Tunnel Syndrome of the hand.

Using an endoscope Kenji Takagi was credited to visualize first the inside of knee joint of a cadaver in Tokyo, Japan in 1918. The heat produced by its light source (bulb) was the most deterrent of that device. Introduction of optical fibre technique in seventies of last century resolved that problem. Such type of one scope with facility of direct vision using by placing observer's eye was brought by Dr AFM Ruhal Haque in Bangladesh on his return home from UK in 1982. In eighties of last century incorporation of camera, monitor, video, shaver and other hi tech instruments occurred. In 1994 birdem introduced Orthopaedic Surgery by appointing Dr MKI Quayyum Choudhury being trained and worked abroad, procured standard and mini scopes including all these accessories from Germany and became the first institute to introduce such operative treatment in Bangladesh. Subsequently other hospitals of the country also took steps to introduce this procedure. High cost, difficulty in achieving skill, over all easily accessible, less costly and non invasive MRI in diagnosing knee injuries etc. in subsequent years were the causes for which Arthroscopy particularly diagnostic one failed to achieve popularity in Bangladesh but its immense role of benefit and advantage still persists in knee surgery. [Shamsuddin Ahmed]