MINIMAL INVASIVE SURGERY

A minimally invasive surgical procedure should be defined as one that is safe and is
associated with a lowerpostoperative patient morbidity compared with a conventional
approach for the same operation.1

In general surgery, minimally invasive surgery is synonymous with minimal access via ports
for the laparoscope and video assistance. Laparoscopic cholecystectomy revolutionized the
surgical approach to the abdomen. Not only did it replace conventional surgery, but it also
negated other nonsurgical alternatives such as dissolution therapy and extracorporeal
lithotripsy.1

In cardiac surgery, in contrast to general surgery, the goal should not necessarily be to
minimize pain since extracorporeal circulation, not mediastinotomy, is probably the major
cause of morbidity. Thus, we might consider minimally invasive cardiac surgery as largely
off-pump surgery. This is particularly true when minimally invasive surgery via a small
thoracotomy incision may still cause significant pain from spreading the ribs and at the same
time produces a more difficult and dangerous means of extracorporeal circulation with
limited exposure in a prolonged operative and anesthetic time. Therefore, in cardiac surgery,
we must resolve whether minimally invasive access is synonymous with minimal
invasiveness. It is likely that this is the case in some, but not all, minimal access methods.1

The role of minimal invasive surgery (MIS) in orthopaedics is substantial. The goal is to
decrease surgical trauma, bleeding, recovery duration and hospital length of stay and
postoperative morbidities. Scars are cosmetically more appealing without compromising
surgical objectives. MIS may offer expanded treatment options. We present a current
overview of MIS on fracture repair, spine surgery, joint replacement, and sports surgery.2

There are some advantages and disadvantages from minimally invasive surgery:3
Advantages:
1. Fewer scars on the outside and inside
2. Recovery is faster than conventional surgery
3. Less pain, less medication
Disadvantages:
1. Special training for surgeon
2. Special equipment

MIS has become an increasingly common alternative to open surgery for routine procedures,
and its use has been linked to numerous patient benefits. Data comparing total hospital costs
or total operative costs associated with MIS vs open surgery have generally placed MIS in a
favorable light. Despite these benefits, however, MIS remains underutilized in many US
regions and hospitals. Our study provides real-world outcomes showing that MIS has
statistically significant lower costs than open surgery for the 4 analyzed surgeries. 4

References
1. Ochsner JL. Minimally Invasive Surgical Procedures. 2000;2(3):135–6.
2. Langlotz F, Keeve E. Minimally invasive approaches in orthopaedic surgery.
2003;(March).
3. Minimally Invasive Surgery. 2008;(205):35216.
4. Fitch K, Engel T, Bochner A, Fitch K. Cost Differences Between Open and Minimally
Invasive Surgery. 2015;(September):40–8.