Minimally invasive procedures (also known as minimally invasive surgeries) encompass Surgery techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definition is invasive, and many operations requiring incisions of some size are referred to as open surgery. Incisions made during open surgery can sometimes leave large wounds that may be painful and take a long time to heal. Advancements in medical technologies have enabled the development and regular use of minimally invasive procedures. For example, endovascular aneurysm repair, a minimally invasive surgery, has become the most common method of repairing abdominal aortic aneurysms in the US as of 2003. The procedure involves much smaller incisions than the corresponding open surgery procedure of open aortic surgery.
Interventional radiologists were the forerunners of minimally invasive procedures. Using medical imaging techniques, radiologists were able to direct interventional instruments through the body by way of instead of the large incisions needed in traditional surgery. As a result, many conditions once requiring surgery can now be treated non-surgically.
Diagnostic techniques that do not involve incisions, puncturing the skin, or the introduction of foreign objects or materials into the body are known as non-invasive procedures.
Medical uses
Minimally invasive procedures were pioneered by interventional radiologists who had first introduced
angioplasty and the catheter-delivered
stent. Many other minimally invasive procedures have followed where images of all parts of the body can be obtained and used to direct interventional instruments by way of
(needles and fine tubes), so that many conditions once requiring open surgery can now be treated non-surgically.
A minimally invasive procedure typically involves the use of
arthroscopic (for joints and the spine) or laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an
endoscopy or large scale display panel, and is carried out through the
skin or through a
body cavity or anatomical opening. Interventional radiology now offers many techniques that avoid the need for surgery.
By use of a minimally invasive procedure, a patient may require only an adhesive bandage on the incision, rather than multiple stitches or staples to close a large incision. This usually results in less infection, a quicker recovery time and shorter hospital stays, or allow outpatient treatment.
Specific procedures
Many medical procedures are called minimally invasive; those that involve small incisions through which an endoscope is inserted, end in the suffix
-oscopy, such as
endoscopy,
laparoscopy, arthroscopy. Other examples of minimally invasive procedures include the use of
syringe, and air-pressure injection, subdermal implants, refractive surgery,
percutaneous surgery,
cryosurgery,
microsurgery,
keyhole surgery, endovascular surgery using interventional radiology (such as
angioplasty or embolization), coronary catheterization, permanent placement of
vertebral column and
brain electrodes, stereotactic surgery,
Nuss procedure,
radioactivity-based
medical imaging methods, such as
gamma camera, positron emission tomography and
SPECT (single photon emission tomography). Related procedures are image-guided surgery, and robot-assisted surgery.
Equipment
Special medical equipment may be used, such as
fiber optic cables, miniature
and special surgical instruments handled via tubes inserted into the body through small openings in its surface. The images of the interior of the body are transmitted to an external
video monitor and the surgeon has the possibility of making a diagnosis, visually identifying internal features and acting surgically on them.
Benefits
Minimally invasive
surgery should have less operative
Physical trauma, other complications and
adverse effects than an equivalent open surgery. It may be more or less expensive (for dental implants, a minimally invasive method reduces the cost of installed implants and shortens the implant-prosthetic rehabilitation time with four–six months
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pain and
, speeds recovery, and reduces the incidence of post-surgical complications, such as adhesions and
wound dehiscence. Some studies have compared
heart surgery.
Risks
Risks and complications of minimally invasive procedures are the same as for any other
surgery, among the risks are: death, bleeding,
infection, organ injury, and thromboembolic disease.
There may be an increased risk of hypothermia and peritoneal trauma due to increased exposure to cold, dry gases during insufflation. The use of surgical humidification therapy, which is the use of heated and humidified CO2 for insufflation, may reduce this risk.
Invasive procedures
Sometimes the use of non-invasive methods is not an option, so that the next level of minimally invasive techniques are looked to. These include the use of hypodermic injection (using the syringe), an
endoscopy,
percutaneous which involves needle puncture of the skin, laparoscopic surgery commonly called
keyhole surgery, a coronary catheter,
angioplasty and stereotactic surgery.
Open surgery
"Open surgery" is any surgical procedure where the incision made is enough to allow the surgery to take place. With tissues and structures exposed to the air, the procedure can be performed either with the unaided vision of the surgeon or with the use of
or
microscopes. Some examples of open surgery used are for herniated disc commonly called a "slipped disc", and most types of
cardiac surgery and
neurosurgery.
Associations
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for adults.
International Pediatric Endosurgery Group (IPEG) for pediatrics.
See also
Further reading
External links
