Many aging processes may increase the risk of surgery. Whether this increased risk is acceptable depends on the nature of the problem prompting the surgery. If it is an acute, life-threatening circumstance for which there are few or no alternatives, a high degree of risk may be acceptable in solving the problem. If the problem is not urgent and involves an elective procedure, it may be more appropriate to delay surgery until control of complicating factors reduces the risks as low as possible.
There is no specific age for the development of unusual risks at the time of surgery. In addition to a chronologic age, everyone also has a physiologic age, that is, the degree to which the various aging processes have actually progressed. For example, if the aging process in one person has reached a particular point at his or her chronologic age of 65, and another person does not reach that same point of age-related changes until age 75, then although there is a difference of 10 years in their chronologic age, both have the same physiologic age. Problems and complications related to surgery vary with the physiologic age.
Most elderly patients, unless they have severe medical problems, can tolerate even major surgical procedures. The risk does increase, even in people of younger physiologic age, when two or more procedures must be done within a short time. If possible, it is better for there to be a long interval between surgical procedures to keep the risks of the surgeries as low as possible.
Surgical risks always seem to be higher for individuals who must undergo an emergency procedure than for those who choose the time of their procedure. However, the increased risk for an emergency procedure is probably related to the medical problems and complications causing the emergency rather than to the procedure itself. Without complicating diseases or other problems, emergency surgery may not be any greater risk than elective surgery.
Your physician can help you select from the various surgical options. For many problems, surgical procedures have now been developed that are simpler to perform and less traumatic for the patient.
Many kinds of surgery can now be performed using an instrument called a laparoscope. This instrument is inserted into the abdominal cavity through a small, half-inch, incision. The procedure may be done with minimal anesthetic. Other instruments may also be inserted through small incisions to perform the operation.
Operations that are commonly performed through the laparoscope include removal of the gallbladder, removal of the appendix, removal of a kidney, repair of a hernia, and treatment of reflux disease involving the esophagus (the swallowing tube). The laparoscope may also be used to look into the abdominal cavity when the diagnosis is uncertain. It is possible to biopsy (sample) the liver or other tissues through the laparoscope.
Although laparoscopic surgery is much less invasive than conventional surgery, it is not proper for all operations. In some cases where surgery can usually be done through the laparoscope, the surgeon may decide on the basis of what is seen that the operation needs to be converted to a conventional open surgery procedure. Often this occurs if there has been previous surgery that has left adhesions or scars that prevent proper vision through the laparoscope.
The recovery after laparoscopic surgery is often rapid, and patients may leave the hospital on the day of surgery or on the next day. There is still a period of recuperation at home. Because this kind of surgery is less invasive, it is often suggested for the elderly.