Minimally invasive surgery (MIS)
Minimally invasive surgery (MIS) refers to surgical techniques that limit the size and number of incisions, resulting in less trauma to the body, reduced recovery time, less postoperative pain, and lower risk of complications compared to traditional open surgery. MIS techniques are employed across various specialties and are increasingly becoming the standard of care for many procedures.Common Types of Minimally Invasive Surgery
Laparoscopic Surgery (Keyhole Surgery)
Laparoscopic surgery uses small incisions, a camera (laparoscope), and specialized instruments to perform operations within the abdomen or pelvis. It is widely used in gastrointestinal, gynecological, urological, and bariatric surgeries.
- Laparoscopic Cholecystectomy: Removal of the gallbladder, typically due to gallstones.
- Laparoscopic Appendectomy: Removal of the appendix in cases of appendicitis.
- Laparoscopic Hernia Repair: Repair of inguinal, umbilical, or incisional hernias.
- Laparoscopic Colorectal Surgery: Procedures for colorectal cancer, diverticulitis, or inflammatory bowel disease (IBD).
- Laparoscopic Gastrectomy: Partial or total removal of the stomach, often performed for gastric cancer.
- Laparoscopic Bariatric Surgery: Weight loss surgeries like gastric bypass and sleeve gastrectomy.
- Laparoscopic Ovarian Cystectomy: Removal of cysts or tumors from the ovaries.
- Laparoscopic Hysterectomy: Removal of the uterus with fewer and smaller incisions.
Endoscopic Surgery
Endoscopy involves the use of an endoscope (a flexible tube with a light and camera) inserted into body cavities, allowing for visualization and treatment of various conditions without large incisions. This technique can be applied to the gastrointestinal, respiratory, urological, and other systems.
- Upper GI Endoscopy (EGD): For diagnosing and treating issues in the esophagus, stomach, and duodenum, including ulcers, esophageal varices, and stomach cancer.
- Colonoscopy: Inspection of the colon and rectum, often for colorectal cancer screening or to investigate gastrointestinal symptoms. Polypectomy (removal of polyps) is commonly performed during colonoscopy.
- Bronchoscopy: Inspection of the airways (trachea, bronchi, lungs) to diagnose lung cancer, infections, or obstructions.
- Cystoscopy: Visual examination of the bladder and urethra, used to diagnose bladder cancer, urinary tract infections, or stones.
- Arthroscopy: A minimally invasive procedure used to examine and treat joint issues, such as those in the knee, shoulder, hip, or elbow. Common treatments include meniscus repairs and rotator cuff repairs.
- Sinus Endoscopy: Used to treat chronic sinusitis, nasal polyps, and other sinus conditions.
Percutaneous Surgery
Percutaneous procedures involve gaining access to the body through the skin (often with a needle or small incision), allowing for treatment without the need for larger incisions.
- Percutaneous Coronary Intervention (PCI): A procedure to treat coronary artery disease, often using angioplasty or stent placement.
- Percutaneous Kidney Stone Removal: A procedure to remove kidney stones through a small incision in the back, often with a laser.
- Percutaneous Vertebroplasty/Kyphoplasty: Minimally invasive procedures to treat spinal compression fractures caused by osteoporosis or trauma.
- Percutaneous Liver Biopsy: A needle is used to collect liver tissue for diagnostic purposes, such as assessing liver damage or liver cancer.
Minimally Invasive Spinal Surgery
Minimally invasive techniques for spinal surgery involve smaller incisions and specialized instruments for treating spinal issues like herniated discs, stenosis, or fractures.
- Minimally Invasive Discectomy: Removal of herniated disc material pressing on the spinal cord or nerves.
- Spinal Fusion: A procedure to join two or more vertebrae together, commonly used in cases of spinal instability, such as after a fracture or in conditions like spondylolisthesis.
- Minimally Invasive Spinal Decompression: Used to relieve pressure on the spinal cord or nerves, often due to spinal stenosis.
Minimally Invasive Cardiac Surgery
These procedures are used to treat heart conditions while minimizing the trauma of traditional open-heart surgery.
- Minimally Invasive Coronary Artery Bypass Surgery (MICS CABG): A smaller incision is used to bypass blocked coronary arteries, as opposed to the larger incision used in traditional open-heart surgery.
- Transcatheter Aortic Valve Replacement (TAVR): A non-surgical procedure to replace a narrowed aortic valve in patients who are at high risk for traditional open-heart surgery.
Minimally Invasive Urologic Surgery
Urology has benefited significantly from minimally invasive techniques for treating kidney, bladder, and prostate conditions.
- Laparoscopic Nephrectomy: Removal of the kidney (either partial or full) for conditions such as kidney cancer.
- Transurethral Resection of the Prostate (TURP): Removal of part of the prostate to treat benign prostatic hyperplasia (BPH).
- Laparoscopic or Robotic Prostatectomy: Removal of the prostate gland for prostate cancer.
- Percutaneous Nephrolithotomy: A procedure for the removal of large kidney stones using a small incision in the back.
- Minimally Invasive Kidney Stone Removal: Includes procedures like ureteroscopy or laser lithotripsy to treat kidney and urinary tract stones.
Minimally Invasive Gynecological Surgery
Minimally invasive techniques are widely used in gynecology to treat various conditions affecting the uterus, ovaries, and other reproductive organs.
- Laparoscopic Hysterectomy: Removal of the uterus through small incisions.
- Laparoscopic Myomectomy: Removal of uterine fibroids while preserving the uterus.
- Endometrial Ablation: A procedure to destroy the endometrial lining of the uterus to treat abnormal uterine bleeding.
- Laparoscopic Ovarian Cystectomy: Removal of cysts from the ovaries.
- Minimally Invasive Sterilization: Permanent birth control methods, such as Essure (a device inserted into the fallopian tubes).
Minimally Invasive Thoracic Surgery
Thoracic surgeons use minimally invasive techniques to treat lung, chest, and esophageal conditions.
- Minimally Invasive Esophagectomy: Removal of the esophagus using small incisions, often for esophageal cancer.
- Sympathectomy: Used to treat hyperhidrosis (excessive sweating) by cutting or removing parts of the sympathetic nerve chain.
Minimally Invasive Orthopedic Surgery
Orthopedic surgery has seen a major shift toward minimally invasive approaches, especially for joint-related problems.
- Arthroscopic Knee Surgery: A minimally invasive technique to treat conditions like meniscus tears, ligament injuries, and knee arthritis.
- Shoulder Arthroscopy: Used to repair torn rotator cuffs, remove damaged tissue, or treat shoulder impingement.
- Hip Arthroscopy: A minimally invasive procedure to diagnose and treat hip joint issues such as labral tears or femoroacetabular impingement (FAI).
- Minimally Invasive Spine Surgery: Treatment of conditions like herniated discs, spinal stenosis, and spinal fractures through small incisions.
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