Minimally Invasive Surgery or minimally invasive surgery is the set of therapeutic techniques that minimize the aggression to perform the necessary surgical procedures for each pathology.
What does Minimally Invasive Surgery consist of?
There are different surgical techniques:
– Endoscopic
– Laparoscopic
– Robotic
– Surgery through natural orifices
According to experts in General Surgery, these techniques allow to improve the results with minimal injury to the tissues and the treated patient.
Minimally Invasive Surgery is part of the current history of surgery. Since the first laparoscopic cholecystectomy was performed in 1985 by Muhe in West Germany, minimally invasive surgery has grown exponentially. This technique has developed very rapidly, although it has no precedent in the history of surgery. However, the integration of these techniques has required a learning curve and the adaptation of each procedure to the tools available for such surgery. The engineering of surgical technology has developed in parallel, allowing the progressive realization of different interventions with less and less aggressive methods.
Minimally Invasive Surgery is a global concept that today encompasses almost all surgical disciplines (thoracic surgery, pediatric surgery, gynecology, urology, urology, traumatology, plastic surgery, orthopedic surgery, cardiac and vascular surgery, neurosurgery and ENT). Laparoscopy, being the best known surgical approach, is not the only possible approach for minimally invasive therapeutic procedures.
Types of Minimally Invasive Surgery
Minimally Invasive Surgery is classified according to the anatomical space where it is applied:
Endocavitary surgery
– Thoracoscopy (thoracic cavity).
– Laparoscopy (abdominal cavity).
– Arthroscopy (joints).
Endoluminal surgery
-ENT.
-Respiratory.
-Digestive.
-Urological.
-Gynecological.
-Vascular angioscopy.
-Pelvioscopy.
Other accesses
-Axillary.
-Mediastinum.
-Retroperitoneum.
-Preperitoneum.
-Perivascular.
Robotic surgery in minimally invasive surgery.
Robotic surgery is also related to minimally invasive surgery. Since the appearance of the first commercialized device such as Da Vinci®, and the first remote surgery project (Anubis), new surgical robots have been designed with the aim of progressively improving the application in modern surgery. Currently, the latest generations of the Da Vinci® line are already a reality applied in various surgical procedures, such as urological surgery, selected cases of digestive surgery, etc.
Prototypes are continually being developed that will continue to improve their performance, allowing their implementation and expanding their applicability to surgical practice.
Advantages of Minimally Invasive Surgery
Minimally Invasive Surgery presents different general advantages related to the technique and applicable to any procedure. In general, all procedures rely on the reduction of secondary postoperative morbidity and on the reduction of the physiological response to surgical aggression. The advantages of this type of surgery are:
– Reduced systemic inflammatory response associated with surgery and improved immune response.
– Decreased postoperative pain mainly due to the absence of major surgical incisions and reduced trauma to healthy tissues.
– Fewer surgical wound complications. The wounds have smaller diameters so they heal quickly and rarely present important complications. In addition, it is important to highlight the “esthetic” factor of these mini incisions.
– Reduction of the postoperative period and hospital stay. Consequently, the associated costs and waiting lists are significantly reduced.
In reference to patients, minimally invasive surgery allows:
– Less postoperative pain.
– It helps to avoid general anesthesia.
– Quicker labor insertion and return to normal life.
– Less distortion of work activity.
Impact of Minimally Invasive Surgery
Minimally Invasive Surgery is a new therapeutic alternative for the treatment of surgical conditions, competing with conventional surgery, the use of which has been reduced in interventions. Its development is having a major impact on hospitals, surgeons and patients.
The impact on health policy is noteworthy, since it is well known that in the West half of all hospitalizations are linked to possible complications and the postoperative convalescence period. The new mini-invasive techniques, with outpatient or short-stay treatments and outpatient follow-up, considerably decrease these figures. The effect is as follows:
– Lower costs per admission.
– Lower in-hospital infections.
– Shorter waiting lists.
– Reduced hospitalization and increased outpatient follow-up of patients.
Disadvantages of Minimally Invasive Surgery
The disadvantages that may arise in the application of these minimally invasive techniques are derived from the technical difficulty involved, the learning curve for the assimilation of the different techniques and the cost and development of the technology necessary to carry it out:
– It presents difficulties with spatial perception: due to the fact that the interventions are controlled by monitors, three-dimensional vision is lost in 2D monitors, however, thanks to technological advances three-dimensional vision is already a reality in full development phase.
– Loss of tactile perception, since there is no tissue palpation. The sensation and touch of conventional surgery is lost and it is necessary to learn to palpate with instruments.
– In case of surgical complications, the rapid response required by the surgeon must be adapted to the situation in the surgical field, where manual manipulation is impossible and must be replaced by surgical resources through the available instruments.
Regarding the impact on medical professionals, Minimally Invasive Surgery procedures are more demanding for surgeons and the medical profession in general, as they are more complex procedures than conventional ones. New generations of surgeons are adopting these techniques as the basis of their training.
Current status of minimally invasive surgery
Minimally Invasive Surgery is in a phase of evolution, progressively replacing conventional surgery and reducing the morbidity of the procedures and with an increasing percentage of therapeutic success. Many of the techniques of Minimally Invasive Surgery are being extended to different procedures and have become the reference technique in various pathologies: cholelithiasis, colon cancer, benign colonic disease, gastroesophageal reflux, morbid obesity, among others.
The rapid development of this technique has revolutionized the field of surgery and diagnostic techniques. This implementation is being accelerated by the diffusion it has received in the press and the enormous technological development undertaken by companies, which has allowed these standardized procedures to be developed in the space of ten years. However, according to published data, there are differences in the implementation of these techniques between Europe and the United States and according to the degree of development of different societies. Thus, the speed of implementation of this type of techniques depends on the resources available in each environment.
Our team
The surgical team of Laparoscopia Balear, with special dedication to minimally invasive surgery, has been a pioneer in the application and development of this type of techniques, collaborating in the dissemination and implementation of the same in various surgical procedures. The progressive specialization in this type of surgery allows us to offer the possibility of intervening the majority of surgical pathologies through a minimally invasive approach, individualizing each case according to the pathology and characteristics of the patient. On the other hand, we continue working to update and develop this surgical line and offer our patients the best therapeutic option available.