Dr. D.

Farquharson
General and Vascular Surgery
Princess Margaret Hospital
October 21, 2009
Introduction
A minimally invasive procedure is any procedure
(surgical or otherwise) that is less invasive than open
surgery used for the same purpose
Involves use of devices or instruments with indirect
observation of the surgical field
These procedures are carried out through the skin, a
body cavity or anatomical opening
Introduction
A minimally invasive procedure is distinct from a
non-invasive procedure, such as external imaging
There is minimal damage of biological tissues at the
point of entrance of instrument(s)
Introduction
Describes a field of surgery that crosses all discipline
Not really seen as a discipline unto itself but more a
philosophy of surgery
"Minimally invasive surgery focuses more on the
quality of life for the patient," says Mehmet Oz, MD,
director of the Cardiovascular Institute at the
Columbia University Medical Center in New York
Introduction
Minimal Incision Technique
A specialized surgical technique practiced by some
physicians/surgeons to remove masses or growths with
minimal scarring and less recovery time
The incision is usually about 1/10 the size of the
underlying mass
Past
MIS is not new, nor has it been fully explored or
discovered
1902 used in dogs; 1910 used in humans
Surgery 1987
Present
Cardiology Urological Surgery
General Surgery Ophthamology
Vascular Surgery Otorhinolargynology
Gynecology Trauma
Neurosurgery
Orthopedic Surgery
Thoracic Surgery
Present
Diagnostic Therapeutic
Benefits
Less operative trauma
Less expensive
Longer operative time but shorter hospital stay
Less painful and less scarring
Reduce incidence of post-op complications
Risks
Anaesthetic complications
Reaction to medications
Bleeding
Infection
Injury to surrounding structures
DVT/VTE
Hypercapnea
Death
Hypothermia
Future
Surgery without scars
Single Access Ports
NOTES
 ^ Lima, E; Rolanda C, Pêgo JM, Henriques-Coelho T, Silva D,
Carvalho JL, Correia-Pinto J. (2006). "
Transvesical endoscopic peritoneoscopy: a novel 5 mm port f
or intra-abdominal scarless surgery
". J Urol 176 (2): 802–5. doi:10.1016/j.juro.2006.03.075.
PMID 16813951.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16
813951&query_hl=3&itool=pubmed_docsum. Retrieved 2007-
04-18.
Future
 ^ Pai, RD; Pai RD, Fong DG, Bundga ME, Odze RD, Rattner
DW, Thompson CC (September 2006). "Transcolonic
endoscopic cholecystectomy: a NOTES survival study in a
porcine model".
 Transvaginal Cholecystectomy Called Pain Free
Summary
Minimally Invasive surgery is a exciting developing
field
It is here to stay
Beneficial for the patient in every way provided the
selection is proper
Future is bright for this field