What is Minimally Invasive Surgery

There's a relatively new approach to surgery that's getting people out of the hospital sooner and back to their normal activites more quickly ­ with less pain and, in many cases, lower costs.

You may have heard about or read about it ...or you may even know someone who has had his or her gallbladder removed and was up an around in just a couple of days.

The approach, laparoscopy, is also known by several other names, including endoscopy and minimally invasive or less invasive surgery. No matter what term you use, the big advantage of this new technique is that there is no need to make a large incision. Instead, the surgeon operates through 3 or 4 tiny openings about the size of buttonholes, while viewing the patient's internal organs on a TV monitor.

This is really the most important difference between laparoscopy and traditional surgery. There is no large incision to heal, so patients have less pain and recover sooner.

Laparoscopy is literally setting new standards for patient care because it allows surgeons to perform many operations without the trauma and pain of a large incision. Thanks to both the skill of the surgeon and advances in technology, laparoscopic techniques are being applied to a growing number of procedures and someday will likely replace open surgical techniques in many areas.

Because there has been tremendous progress in a relatively short period of time, and because the technique has received so much attention in the popular press, most people are suprised to learn that laparoscopy itself is not new.



In fact, it actually dates back to as early as 400 B.C. - to the time of Hippocrates, the father of medicine.

Modern surgeons began perfecting its use in the early part of this century, but laparoscopy remained pretty much a diagnostic procedure until the 1970's when gynecologic surgeons began using laparoscopic techniques to perform female sterilizations, known as tubal ligations.

The real advantage in laparoscopy did not come until 1989, when doctors in Atlanta and Nashville began applying laparoscopic techniques to gallbladder operations.

Because so many people must undergo gallbladder surgery and face weeks of painful recovery, the doctors were looking for a less-invasive method to remove the diseased organ.

What they developed has become one of the most widely recognized surgical innovations since the introduction of anesthesia.

Rather than a 6- to 9- inch incision, the laparoscopic technique utilized only 4 tiny openings - all less than 1/2 inch in diameter

Instead of a 5- to 8-day hospital stay and 4 to 6 weeks of painful recovery at home, most patients now leave the hospital in a day or two and return to normal activites within a week.

When these benefits became widely recognized among patients and surgeons, the demand for the minimally invasive procedure exploded.

Today more than 95% of the 600,000 gallbladder operations performed each year in the U.S. are done laparoscopically.

You may be wondering if this approach, known as laparoscopic cholecystectomy, is as safe as the open procedure. Numerous medical studies have shown that the answer is YES.

The National Institutes of Health (NIH) had a panel of experts review all the available medical evidence. They compared the results of more than 100,000 laparoscopic cases with more than 200,000 cases of traditional gallbladder removal, and they found laparoscopic cholecystectomy to be as safe and effective as traditional open surgery.

The panel also found that the complication rate for laparoscopic cholecystectomy was actually lower than the complication rate for the open procedure.

The NIH concluded that the laparoscopic approach is the "procedure of choice."

Today, in addition to gallbladder surgery, surgeons are applying these techniques to a wide variety of gynecologic, general, thoracic and urologic procedures.

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