Minimally Invasive Surgery

Minimally Invasive Surgery (MIC) is the term for surgical intervention with the smallest trauma (with the least injury of the skin and soft tissue).

It has always been the goal of the operative treatment to initiate a rapid recovery with minor complaints after the operation. At the beginning of the 1990s, laparoscopic surgery was initially used to surgically remove the gallbladder, and later to perform more complex surgeries.

Initially, the terms minimally invasive surgery and laparoscopic surgery were used almost synonymously. After the advantages of surgical technique with only small incisions in skin and other soft tissues became more and more evident with regard to the recovery of the patient, the development of so-called minimally invasive surgical procedures began in other fields. Examples include thoracoscopic surgery, endoscopic splitting of the retinaculum flexorum during carpal tunnel syndrome, minimally invasive access to hip replacement (endoprosthesis) (eg Yale technique), or bone stabilizing surgery. There are also tendencies to minimally invasive accesses in thyroid gland operations, which have not yet been established in the broad range. Another field of work for the MIC is in cosmetic surgery (eg forehead lift), since the advantage of the small scars comes into play here.

Smaller incisions and minor injuries of the soft parts during access usually lead to less pain after the operation, and usually also to a faster recovery and mobilization. On the other hand, there is often (but not always) the disadvantage of a clearer overview of the operating field, the mostly asymptomatic but still present major soft tissue injuries, the extended operating time, and the delayed accessibility in the case of a threatening complication such as, for example, This view, however, can be controversially discussed. An experienced laparoscopic surgeon will make the statement that he has a better overview and requires less time for the operation than during the corresponding open surgery.

In recent years, minimally invasive surgical techniques have become firmly established and have replaced many conventional surgical procedures (with a broader cut) that have been regarded as "gold standard" for decades.

To date, these specialized operations have mainly been carried out on a stationary basis. Only the knee joint mirroring was more frequent outpatient. Due to the lower postoperative pain and optimized technique, these procedures are increasingly being provided on an outpatient basis. In a few centers in Germany even the laparoscopic gallbladder removal and abdominal hernias are provided on an outpatient basis.

For example, arthroscopy has become widespread as a minimally invasive technique to examine joints and treat injuries. Laparoscopic or thoracoscopic surgical procedures also offer the possibility to carry out a more extensive inspection of the abdominal or thoracic cavity in the case of unclear findings than is otherwise possible with a conventional approach.

In part, laparoscopy is also performed before a complex and extended operation such as gastric removal, in order to carry out a status survey and to be able to plan further therapeutic, also operative procedures better. It is always discussed whether the laparoscopic operation of a malignant tumor, such as in colon cancer, can be carried out with the same necessary radicality as with conventional accesses. Overall, the choice of the surgical procedure (minimally invasive or conventional or open) must always be made individually.