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Home > Professional Reference > Minimally Invasive Surgery

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Minimally Invasive Surgery

This PatientPlus article is written for healthcare professionals so the language may be more technical than the condition leaflets. You may find the abbreviations list helpful.

Synonyms: keyhole surgery, laparoscopic surgery

This involves procedures performed by entering the skin via small incisions or by a body cavity, with two aims:

  • Produce the least possible damage to structures
  • At the same time, achieve the same result as if performed by open or more invasive surgery

Specialist equipment is required, including fibreoptics, camera and equipment with handles.

Background1

The use of light-containing probes to view internal cavities has a long history. Philip Bozzini (1771-1809) was the earliest deviser of such equipment which was called the 'Lichtleiter' and was primarily used to examine the vaginal cavity. This was then modified by John D. Fisher (1798-1850) and used for urological purposes. In 1929 Heinz Kalk, a German gastroenterologist,used laparoscopy to diagnose hepatobiliary disease. 30 years later the automatic insufflator was invented and used to perform an appendectomy as part of a gynaecological procedure. However, it was not until the early 1980s that laparoscopic procedures began to be performed on a regular basis in the United States of America and, subsequently, the United Kingdom, leading to regulation regarding procedure and training aspects.

Advantages and disadvantages of minimally invasive surgery

Advantages and disadvantages of minimally invasive surgery2
Advantages
Disadvantages
  • Less expensive
  • Shorter duration of hospital stay
  • Less trauma to patient
  • Less pain
  • Less blood loss
  • Smaller skin scars
  • Becoming more common for major surgical procedures, e.g. cardiac surgery
  • Requires special equipment
  • Specialist training required
  • Equipment is more expensive
  • Some procedures, especially latest ones, may take longer
  • Some complications can be masked, e.g. biliary peritonitis

Patient suitability

Not all patients will be suitable for minimally invasive procedures. For example, raised body mass index, previous abdominal surgery leading to adhesions or other underlying medical conditions may affect the decision on whether to proceed towards more invasive surgery.

Types of procedures performed using minimally invasive surgery

Types of procedures performed using minimally invasive surgery3,4
Body system
Procedures performed
CardiacClosing atrial septal defects
Coronary artery bypass graft ('off pump')
Repairing patent foramen ovale
Valve surgery5
GastrointestinalAppendicectomy
Adrenalectomy
Cholecystectomy
Lymph node biopsy
Splenectomy
Hiatus hernia, umbilical and inguinal hernia repairs
Colonic cancer
Diverticular disease
Inflammatory bowel disease
Rectal prolapse
Dividing adhesions
GynaecologicalPolypectomy
Sterilisation
Endometrial ablation
Fibroid removal
NeurologicalRemoval of pituitary tumours
Treatment of intracranial aneurysms
Carotid angioplasty
Radiosurgery for brain tumours
OrthopaedicArthroscopy of joints
Carpal tunnel release
Pelvic fracture repair
Rotator cuff repair
OtorhinolaryngologyRemoval of nasal/sinus tumours
Lymph node biopsy
Respiratory/ThoracicLung surgery
Recurrent pleural effusions
UrologyBiopsy
Remove kidney and ureteric calculi
Nephrectomy6
VascularStenting carotid and renal arteries
Repair of thoracic and abdominal aneurysms3
Varicose veins

Complications

Document references

  1. Historty of minimally invasive surgery; History of minimally invasive surgery - Minimally Invasive Surgery Center.
  2. Jaffray B; Minimally invasive surgery. Arch Dis Child. 2005 May;90(5):537-42. [abstract]
  3. Leaney B; What's new in vascular interventional radiology? Aortic stent grafting. Aust Fam Physician. 2006 May;35(5):294-7. [abstract]
  4. Mayo Clinic: Minimally invasive surgery at Mayo.
  5. Walther T, Falk V, Mohr FW; Minimally invasive mitral valve surgery. J Cardiovasc Surg (Torino). 2004 Oct;45(5):487-95. [abstract]
  6. Novick AC; Laparoscopic and partial nephrectomy. Clin Cancer Res. 2004 Sep 15;10(18 Pt 2):6322S-7S. [abstract]

Acknowledgements

EMIS is grateful to Dr Gurvinder Rull for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2010.
Document ID: 2457
Document Version: 22
Document Reference: bgp1999
Last Updated: 23 Mar 2010
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