Minimally Invasive Surgery

Overview

Minimally invasive surgery (MIS) represents a significant advancement in surgical techniques, designed to minimize bodily trauma, reduce recovery time, and lower the risk of complications. Unlike traditional open surgery, which involves large incisions, MIS utilizes small cuts, specialized tools, and innovative technologies like laparoscopes and robotic arms to perform operations with precision and minimal disruption to the body.

Common procedures performed with MIS techniques include laparoscopic, robotic, endoscopic, and endovascular surgeries, all of which can be used for a wide range of conditions across various medical specialties. From removing organs to repairing arteries, the versatility of MIS makes it an appealing option for many patients seeking a safer and faster recovery path.

What is Minimally Invasive Surgery?

Minimally invasive surgery (MIS) is a type of surgery where doctors make smaller cuts in your skin and tissues. They use special tools and methods to do the surgery with as little damage as possible. Because the cuts are smaller, it usually means less pain, fewer problems, and a quicker recovery. Today, many common surgeries are done this way.

Types of Minimally Invasive Surgery

Surgeons use minimally invasive surgery for various parts of the body, including:

• Adrenalectomy: Removal of one or both adrenal glands.
• Brain surgery: Surgical procedures on the brain.
• Colectomy: Removal of unhealthy parts of the colon.
• Gallbladder surgery (Cholecystectomy): Removal of the gallbladder to treat gallstones.
• Heart surgery: Surgical procedures involving the heart.
• Hiatal hernia repair: Surgery to relieve acid reflux or GERD.
• Kidney removal (Nephrectomy): Removal of a kidney.
• Kidney transplant: Transplanting a kidney from a donor.
• Spine surgery: Surgical procedures involving the spine.
• Splenectomy: Removal of the spleen.

Surgeons also use minimally invasive surgery for general surgeries, including:

• Cancer surgery: Removing or destroying a tumor.
• Colon and rectal surgery: Surgical treatments for conditions of the colon and rectum.
• Endovascular surgery: Treating or repairing an aneurysm inside blood vessels.
• Gastroenterologic surgery: Including gastric bypass surgery.
• Gynecologic surgery: Surgery related to women’s health.
• Neurosurgery: Surgery on the nervous system, including the brain and spinal cord.
• Orthopedic surgery: Surgery for bones, joints, and muscles.
• Otolaryngology (ENT)/Head and Neck Surgery: Surgery for ear, nose, throat, and head/neck conditions.
• Thoracic surgery: Surgery for conditions in the chest, including video-assisted thoracoscopic surgery (VATS).
• Urologic surgery: Surgery for the urinary system.

What are the Different Types of Minimally Invasive Surgery?

Minimally invasive surgery (MIS) refers to procedures performed through small incisions or natural body openings, offering less pain, quicker recovery, and reduced risks compared to traditional open surgery. Here are the main types of minimally invasive surgery:

Keyhole Surgery

• Minimally invasive surgeries often use tiny “keyhole” cuts, typically less than half an inch.
• These small incisions allow the insertion of special instruments.
• One incision is used for an endoscope, a small tube with a camera to display images of the inside of your body on a screen.
• Other cuts are used for long, narrow tools that perform the surgery.
• Different types of endoscopes are used for various body areas:
  • Laparoscope for the abdomen,
  • Thoracoscope for the chest,
  • Arthroscope for joints.
• This technique is called laparoscopic, thoracoscopic, or arthroscopic surgery, depending on the area being treated.

Robotic Surgery

• In robotic surgery, the surgeon uses robotic arms to perform surgery through small cuts.
• The surgeon controls the robotic arms from a console within the operating room.
• This method offers highly precise movements, especially in hard-to-reach areas.
• Some surgeries require only one small cut, but typically, multiple cuts are made.

Endovascular Surgery

• Endovascular surgery uses a small tube called a catheter to perform operations inside blood vessels.
• Only a tiny incision is made to insert the catheter, which can often be done with a needle, reducing bleeding.
• The surgeon guides the catheter through the blood vessels and passes surgical tools through it to complete the procedure.

Endoscopic Surgery

• In some cases, surgery is done without cutting the skin, using natural openings in the body like the nose or mouth.
• This is known as natural orifice endoscopic surgery.
• Surgeons use long, thin instruments passed through the endoscope to perform the procedure.
• There are two types of procedures:
  • Endoluminal surgery: performed within the walls of organs,
  • Transluminal surgery: involves cutting through an organ’s wall to reach the inside.

Who can Have Minimally Invasive Surgery?

Minimally invasive surgery is generally considered safer than traditional open surgery. In fact, some individuals who cannot undergo standard surgery might still be eligible for this less invasive option. However, this type of surgery may take longer and require more preparation, making it less suitable for emergencies or situations where the diagnosis is uncertain.

Additionally, people with certain heart or lung conditions might not be ideal candidates for laparoscopic surgery. This procedure involves inflating the abdomen with gas, which could potentially cause complications for individuals with heart or lung issues. Your doctor will assess whether this approach is appropriate for your specific condition.

What Happens During Minimally Invasive Surgery?

There are different steps for different types of surgery, but there are a few key differences between regular open surgery and minimally invasive surgery:

• Anesthesia: Open surgery usually needs general anesthesia (being fully asleep), but some minimally invasive surgeries only need local anesthesia (numbing the area) or mild sedation to help you relax. If you’re having endoscopic surgery, you might not need any anesthesia at all, just a numbing medicine in your throat.
• Incisions (cuts): The main feature of minimally invasive surgery is small cuts, usually about half an inch or smaller.If surgeons remove an organ, the cut may be a bit bigger but still smaller than in open surgery. These small cuts mean less pain, fewer risks, and a quicker recovery.
• Surgery time and recovery: Minimally invasive surgery can take longer because it involves more steps and tools. Robotic surgery, for example, can take extra time. However, recovery is faster. You may be able to go home the same day, and your small cuts will heal in weeks, not months.

What Tools are Used in Minimally Invasive Surgery?

Minimally invasive surgery requires special tools and equipment, and the medical team must undergo specialized training to use them. Some of the tools used include:

• Endoscopes: These are long, thin tubes with a camera and light at the end. They come in different sizes and can be rigid or flexible, depending on where the surgeon needs to look inside your body.
• Imaging equipment: Surgeons use screens to view the video from the endoscope. They may also use other tools like ultrasound or X-rays to see inside your body.
• Endovascular catheters: Surgeons use small tubes inside the blood vessels, guiding them with X-rays to the area where surgery is needed.
• Trocars: Surgeons place these tubes into the small cuts (ports) to allow other tools, like endoscopes, to pass through.
• Insufflators: These machines blow a small amount of carbon dioxide gas into your body to create space so the surgeon can see better.
• Balloons: Sometimes, surgeons use a small balloon instead of inflating the whole body cavity to create space only in the area needed for surgery. They place the balloon at the end of a tool and fill it with gas to make it bigger.
• Surgical instruments: These are long, narrow tools used for surgery through small cuts. Surgeons guide them through the trocars, endoscopes, or catheters.
• Da Vinci Surgical System: This is a robotic system used in robotic surgery. It includes a console for the surgeon to control the robot, a video screen to see inside the body, and robotic arms that hold the surgical tools.

What are the Benefits of Minimally Invasive Surgery?

Some of the benefits of minimally invasive surgery include:

• Less damage to the body
• Less blood loss
• Lower chance of complications during surgery
• Lower risk of infection
• Less scarring
• Shorter hospital stay
• Faster recovery time
• Less pain and less need for medication
• May not require being fully asleep (general anesthesia)
• May make surgery possible for people who couldn’t have it before

What are The Disadvantages of Minimally Invasive Surgery?

Some possible disadvantages of minimally invasive surgery are:

• It requires special training and equipment
• It may not be available in all areas
• It can be more expensive
• The surgery may take longer
• It may not be suitable in emergency situations
• The gas used during surgery can cause problems for some people’s heart and lungs

Frequently Asked Questions (FAQs)

1. What is minimally invasive surgery?

Minimally invasive surgery (MIS) uses small incisions and specialized tools like endoscopes and robotic arms to perform surgeries with less pain, quicker recovery, and fewer risks than traditional surgery.

2. What types of surgeries can be done with minimally invasive techniques?

MIS can be used for procedures like gallbladder removal, hernia repair, kidney surgery, cancer removal, and more, depending on the area being treated.

3. Who is a good candidate for minimally invasive surgery?

Most patients can undergo MIS, but those with certain heart or lung conditions may not be suitable. Your doctor will assess if it’s right for you.

4. What are the advantages of minimally invasive surgery?

Benefits include smaller incisions, less pain, faster recovery, shorter hospital stays, reduced risk of infection, and less scarring.

5. Are there any risks or disadvantages to minimally invasive surgery?

Risks include the need for specialized equipment, longer surgery times, higher costs, and it may not be suitable for emergency situations or all health conditions.