Minimally Invasive Surgery (MIC)

  • Buttonhole surgery
  • Keyhole Surgery
  • MIC

What is Minimally Invasive Surgery

Minimally Invasive Surgery (MIS) is the umbrella term for surgical techniques in which a surgical intervention is performed in the area of the abdomen (laparoscopy) and the chest (thoracoscopy), the groin area or the joints (e.g. knee joint -> arthroscopy). Only the smallest skin incisions are used to perform the operation inside the body under video view with the video cameras, light sources and surgical instruments in the corresponding body cavity. This method of surgery is usually gentler and puts less strain on the body than conventional (“open”) surgery, as it does not require a wide opening of body cavities and joints.

Special features of the MIC surgical method

The technical and instrumental expenditure for the minimally invasive surgical procedures is extraordinarily high compared to conventional open surgical methods. Accordingly, the application of minimally invasive operations is very demanding. State-of-the-art surgical equipment and special instruments (video cameras, special optical probes, etc.) are required to view the surgical area. The MIS approach also requires special skills of the surgeons, especially spatial imagination, as well as special coordination skills between the video image and the surgical area.

Implementation of the MIC

Most minimally invasive procedures are performed with optics and thin instruments, which are inserted through the abdominal wall, chest wall or joint capsule. For this purpose trocars, sleeves as guides for camera optics and instruments, are inserted. In laparoscopic operations (laparoscopy), sterile gas (carbon dioxide) is introduced into the abdominal cavity (abdomen) to create a space (pneumo- or capnoperitoneum) that makes laparoscopy possible.

The magnification and targeted illumination of the surgical area then allows the surgical area to be displayed and evaluated. In the area of joints, water is used during arthroscopy to expand the joint space and to spare surrounding structures. The possibilities of minimally invasive surgery are relatively difficult to list, as they are constantly expanding and developing.

The experience of the individual surgeon also plays a major role. In general, it can be said that nowadays, due to the constant development of technology as well as devices and instruments, more and more operations can be performed minimally invasively. General and abdominal surgery: Chest surgery: Gynecology: Trauma surgery, Orthopedics: Minimally invasive surgery is still subject to rapid development.

Newer and newer techniques are being developed that allow further surgical treatments to be performed in a minimally invasive manner. Existing MIS techniques are being further developed. The laparoscopic removal of the gallbladder, for example, has become the undisputed standard in surgery today.

The development that this method has undergone is considerable. The first laparoscopic gall bladder removal in Germany took about 9 hours. Nowadays, in an uncomplicated case, this is possible in about 40-60 minutes.

The minimally invasive removal of a part of the colon was very controversial, especially in the case of tumors. Mainly because of the lack of tactile control by the surgeon, the method was partially rejected. However, progress has also been made in this field.

Today, for example, a hand of the surgeon can be inserted through a very small abdominal incision, which can then not only replace some instruments during the operation through coordinated finger movements, but can also and above all palpate. This enables further inspection of the diseased tissue. At the beginning of the MIC era, only operations in pre-existing body cavities were conceivable.

In the meantime, minimally invasive operations are performed in places that were initially considered unsuitable. For example, in a minimally invasive hernia operation, a mirror image of the abdominal wall is obtained by creating a space only for the mirror image to be created by means of air. The air is released after the operation, so that the normal anatomical conditions can be restored.

Some of the minimally invasive procedures are, as always at the beginning, only feasible in studies.Therefore, many methods are discussed among surgeons that are not yet widely used.

  • Gall bladder surgery (cholecystectomy)
  • Surgery for diaphragmatic hernia and reflux disease (fundoplication)
  • Gastric banding and gastric bypass surgery for pathological overweight
  • Colon and rectum operations (e.g. for diverticular disease or tumors)
  • Splenectomy
  • Removal of the appendix (appendectomy for appendicitis)
  • Loosening of adhesions in the abdomen (adhesiolysis)
  • Preparation of inguinal hernia
  • Scar and abdominal wall hernias, umbilical hernia
  • Diagnostic interventions in the abdominal cavity and targeted tissue removal (biopsy) of various organs (liver, lymph nodes, etc. )
  • Surgery on the thyroid and parathyroid glands
  • Sampling
  • Removal of superficial lung tumors
  • Removal of the pleura on the chest wall in case of spontaneous air entry into the gap between lung and chest wall (spontaneous pneumothorax)
  • Removal of ovarian cysts
  • Sampling
  • Diagnostics of the patency of the fallopian tubes
  • Diagnostic arthroscopy
  • Anterior cruciate ligament plastic surgery of the knee joint
  • Meniscus surgery
  • Cartilage smoothing
  • Carpal Tunnel Fission

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All articles in this series:

  1. Minimally Invasive Surgery (MIC)
  2. Advantages of the minimally invasive surgical method
  3. Summary