- Minimally invasive procedure
Minimally invasive surgical procedures avoid open invasive surgery in favor of closed or local surgery with less trauma. These procedures involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device, and are carried out through the
skinor through a body cavityor anatomical opening. This may result in shorter hospital stays, or allow outpatienttreatment. [ [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=mesh&list_uids=68019060 NCBI, National Center for Biotechnology Information, NCBI, MeSH, Medical SubHeadings, NLM, National Library of Medicine] ] However, the safety and effectiveness of each procedure must be demonstrated with randomized controlled trials. The term was coined by John EA Wickham in 1984, who wrote of it in " British Medical Journal" in 1987.
Many medical procedures are called minimally invasive, such as hypodermic injection, air-pressure injection,
subdermal implants, endoscopy, percutaneoussurgery, laparoscopic surgery, arthroscopic surgery, cryosurgery, microsurgery, keyhole surgery, endovascular surgery(such as angioplasty), coronary catheterization, permanent spinal and brain electrodes, stereotactic surgery, The Nuss Procedure, radioactivity-based medical imaging methods, such as gamma camera, Positron emission tomographyand SPECT(single photon emission tomography). Related procedures are image-guided surgery, robotic surgeryand interventional radiology.
surgeryshould have less operative trauma for the patient than an equivalent invasive procedure. It may be more or less expensive. Operative time is longer, but hospitalization time is shorter. It causes less painand scarring, speeds recovery, and reduces the incidence of post-surgical complications, such as adhesions. Some studies have compared heart surgery. [ [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11355122&query_hl=1 Intensive care after minimally invasive and conven... [Intensive Care Med. 2001 - PubMed Result ] ] However, minimally invasive surgery is not necessarily minor surgerythat only regional anesthesiais required. In fact, most of these procedures still requires general anesthesiato be administered beforehand.
Minimally invasive procedures are not completely safe, and some have complications ranging from infection to death. Risks and complications include the following:
*Anesthesia or medication reactions
*Internal organ injury
*Blood vessel injury
*Vein or lung blood clotting
*Death (rare) [ [http://www.mipinfo.com/dtcf/pages/RisksAndComplications.htm “Risks and Complications"] ]
Due to these advantages, surgeons are attempting to perform more procedures as minimally invasive procedures. Some procedures, such as gall bladder removal, can be done very effectively as minimally invasive surgery.Fact|date=March 2007 Other procedures, such as
endarterectomy, have a higher incidence of strokes in some studies.Fact|date=March 2007 The first successful minimally invasive aortic aneurysmsurgery was performed by Dr. Michael L. Marinat Mount Sinai Hospital, New York. [ [http://www.mountsinai.org/Who%20We%20Are/Newsroom/Press%20Releases?citype=News&ciid=04192006 Mount Sinai Hospital In the News] ]
medical equipmentmay be used, such as fiber opticcables, miniature video cameras and special surgical instrumentshandled via tubes inserted into the body through small openings in its surface. The images of the interior of the body are transmitted to an external video monitorand the surgeon has the possibility of making a diagnosis, visually identifying internal features and acting surgically on them.
ASA scoreor pre-operative physical fitness
* [http://www.nlm.nih.gov/medlineplus/ency/article/007012.htm Minimally invasive heart surgery] . Medical Encyclopedia, MedlinePlus.
* [http://www.ctsnet.org/sections/clinicalresources/adultcardiac/cosgrove.html Minimally invasive aortic valve surgery] . CTSNet article.
* [http://www.aaos.org/wordhtml/2003news/a8-9.htm Minimally invasive surgery yields benefits] . The American Academy of Orthopedic Surgeons. Febr. 2003.
* [http://www.sciencedaily.com/releases/2005/11/051128081619.htm Minimally invasive cancer treatments highlighted] . Science Daily. Nov. 2005.
* [http://www.endocrineweb.com/minimalpara.html Minimal Parathyroid Surgery] . The minimally invasive technique utilizing intraoperative nuclear mapping, slso called Minimally Invasive Radioguided Parathyroidectomy, or "MIRP". EndocrineWeb. June 20, 2005.
* Kilger E, Weis FC, Goetz AE, Frey L, Kesel K, Schutz A, Lamm P, Uberfuhr P, Knoll A, Felbinger TW, Peter K. Intensive care after minimally invasive and conventional coronary surgery: a prospective comparison. "Intensive Care Med." 2001 Mar;27(3):534-9. PMID 11355122
* [http://www.thieme.de/fz/min/ Journal of Minimally Invasive Neurosurgery] . Thiemme Verlag.
* [http://www.tandf.co.uk/journals/titles/13645706.asp Minimally Invasive Therapy and Allied Technologies] . A Taylor & Francis Journal.
* [http://www.elsevier.com/wps/find/journaldescription.cws_home/704371/description#description Journal of Minimally Invasive Gynecology] . Elsevier.
* [http://www.ismics.org/ International Society for Minimally Invasive Cardiothoracic Surgery]
* [http://www.mayoclinic.org/mininvasivesurgery-rst/ Minimally invasive surgery at Mayo Clinic in Rochester] . An useful and extensive list of endoscopic and other medical procedures performed at
* [http://www.med.nyu.edu/mininvasive/ NYU Minimally invasive solutions] . Very informative site of the
New York UniversityMedical Center.
* [http://www.back.com/articles-minimally.html?mastbox=yep Minimally invasive microsurgery] . Back.com
* [http://www.orthopaedics.com/knees.html#mis Minimally Invasive Surgery Video] .
* [http://www.columna.com.au/ Columna Homepage] Minimally invasive spinal disc replacement.
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