Why the Hype about Minimally Invasive Surgery?

As a doctor, I am regularly asked by family members and friends about minimally invasive techniques, as they are increasingly advertised for a variety of different surgical procedures. The basic question that I am repeatedly asked is “Should I have my surgery done that way?” Minimally invasive techniques describe the approach used to perform a surgery, with the goals of surgical treatment remaining the same as the more traditional, and oftentimes more extensive, approaches.

How is Minimally Invasive Surgery Different?

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.

Yet 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.

An example: Arthroscopic Surgery

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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