Minimally Invasive Surgery

Using current surgical techniques, it is often possible to do surgery with small incisions (about 1 to 3 cm) and less tissue disruption than occurs with traditional open surgery (surgery with larger incisions). To do minimally invasive surgery, surgeons insert tiny lights, cameras, and surgical instruments through small incisions. The surgeons can then do procedures using the images transmitted to video monitors as guides for manipulating the surgical instruments. In robotic surgery, the cameras provide surgeons with a 3-dimensional view and surgeons control surgical instruments from a computer.

Overall, minimally invasive surgery done with special instruments and a camera inserted through small incisions is called endoscopic surgery. Endoscopic surgery has various names depending on where it is done: laparoscopy in the abdomen, arthroscopy in joints, and thoracoscopy in the chest.

Because it causes less tissue damage than traditional surgery, endoscopic surgery has several advantages, including the following:

• A briefer hospital stay (in most cases)

• Often, less pain after the operation

• Lower risk of infection at the operative site

• Earlier return to work

• A tendency toward smaller scars

However, endoscopic surgery has some potential disadvantages:

• Because surgeons are using a video monitor, they are seeing only a 2-dimensional view of the site on which they are operating.

• Endoscopic surgery often takes longer than traditional surgery.

• Endoscopic surgery requires special equipment, which sometimes makes procedures more expensive.

People also should know that, although endoscopic surgery may cause less pain than traditional surgery, pain still occurs, often more than anticipated.

Because endoscopic surgery is technically difficult, people should do the following:

• Choose a highly experienced surgeon.

• Establish that surgery is necessary.

• Ask the surgeon and anesthesiologist how pain will be treated.