Quando si sente parlare di Bikini il pensiero vola subito a una spiaggia assolata con ragazze che si esibiscono a prendere il sole in costume a due pezzi.
In ortopedia invece il termine bikini fa riferimento a un tipo di accesso chirurgico mini-invasivo per l’operazione all’anca.
Il nome deriva proprio dall’idea di poter operare un paziente di protesi d’anca attraverso una cicatrice che possa scomparire sotto il costume.
Negli ultimi anni alla chirurgia tradizionale è andata via via sostituendosi la chirurgia mini-invasiva, una modalità di intervento che fa uso di piccole dissezioni del tessuto nelle quali vengono inseriti, con delle sonde, gli strumenti necessari all’intervento. L’obiettivo di questa procedura è quello di contenere i traumi a cui il paziente è sottoposto e agevolare un veloce decorso post operatorio.
La ricerca per una sempre minore invasività chirurgica (tissues sparing surgery
o risparmio dei tessuti) ha sviluppato in particolare le tecniche chirurgiche rivolte alle nostre strutture del movimento e della deambulazione.
Nello specifico, l’accesso chirurgico bikini è un’evoluzione dell’accesso anteriore mini-invasivo all’anca; da questo si differenzia solo per il tipo di taglio tissutale, in quanto non è un semplice taglio verticale ma è invece un taglio effettuato lungo la piega inguinale e permette di arrivare all’anca ‘aprendo i muscoli’ ed evitando il distacco dei tendini. Nessun trauma muscolare.
E’ una tecnica complessa ma dall’indiscutibile risultato.
Ha i vantaggi dell’accesso anteriore (vengono risparmiati i muscoli permettendo al paziente una rapida ripresa e una scarsa perdita ematica) e la cicatrice una volta guarita scompare.
La sua applicabilità va valutata in relazione al paziente, in quanto vanno valutati le sue caratteristiche morfologiche, peso corporeo, condizioni della cute e il tipo di alterazione che colpisce l’anca. Non tutte le patologie sono correggibili attraverso questa via chirurgica: la sicurezza e l’appropriatezza dell’intervento non devono mai essere sacrificate da una via chirurgica che non permette al chirurgo di muoversi con precisione.
Ho utilizzato l’accesso anteriore bikini anche durante i periodi di volontariato in Africa per eseguire correzioni di bacino nei bambini: tale procedura permette infatti di operare con una buona visibilità delle colonne del bacino.
E’ triste dover costatare come recentemente in Italia alcuni fatti di cronaca e intercettazioni abbiano reso negativamente famoso l’accesso bichini, facendo passare in secondo piano quelli che sono i reali benefici della conoscenza e dell’applicazione di questa procedura da parte di medici esperti.
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