Minimally Invasive Surgery

Minimally invasive surgery is a type of surgery that causes less damage to the body compared to traditional open surgery. It usually means less pain, a shorter hospital stay, and fewer risks. One example is laparoscopy, where the surgeon makes small cuts and uses tiny tubes, cameras, and tools to do the surgery.

Laparoscopy was one of the first types of minimally invasive surgery. Another type is robotic surgery, which gives the surgeon a clear 3D view of the area, making it easier to control and perform the surgery precisely. Minimally invasive surgery is getting better and is a good choice for many people with different health problems. If you need surgery and think this method might be right for you, ask your doctor about it.

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.

Minimally Invasive Surgery is also Used 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 an organ is removed, 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 needs special tools and equipment, and the medical team must be specially trained to use them. Here are some of the tools used:

• 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: These are small tubes used inside the blood vessels. Surgeons guide them with X-rays to the area where surgery is needed.
• Trocars: These are tubes placed 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, instead of inflating the whole body cavity, a small balloon is used to make space only in the area needed for surgery. The balloon is put at the end of a tool and filled 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