Why the hype about minimally invasive surgery?

I commonly have been asked by family members and friends about minimally invasive techniques, as they are increasing advertised for a variety of different surgical procedures. The questions can best be summarized by “should I have my surgery done that way?”

The goals of minimally invasive surgery are much the same as for the traditional “open” surgeries of the past. The difference is that the incisions are smaller, and in general, there is less dissection, less bleeding, and less pain, and thereby quicker rehabilitation. But these less invasive procedures must be considered with caution, as the visualization during surgery is oftentimes decreased. Less invasive does not necessarily result in better outcomes, particularly when considered in the long term. And certain procedures, such as bunion surgery, have been shown to have worse results when performed in a less invasive manner.

One such type of minimally invasive surgery is arthroscopic surgery. Arthroscopy utilizes small portals (1 to 2 cm incisions) to pass cameras and instruments to perform the surgery. Saline water is used to fill the joint and to view the procedure. This type of surgery has become a standard of care for certain injuries such as anterior cruciate ligament (ACL) surgery, and has become more popular not only in the knee, but also in the shoulder, hip, and foot and ankle. Training programs in sports medicine traditionally have provided extensive training in arthroscopic procedures. The risk of infection is decreased because of the continuous use of water in arthroscopy.

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