Minimally invasive surgery: challenges, opportunities and new directions

Minimally invasive surgery creates a small incision or hole to access the body cavity of interest. This approach, most often used in abdominal surgery, translates into minimal scarring as surgeons make several small incisions versus one large cavity opening. Taking the example of a cholecystectomy, an open procedure may use incisions five to eight centimeters in length, while minimally invasive laparoscopic procedures use three to four small incisions, generally no more than five millimeters in length. Benefits include reduced peri-operative pain, anxiety and other morbidities, shorter post-operative recovery time (metabolic recovery time increases with the volume of exposed cavity) and shorter hospital stays (up to 50% reduction in hospital stays for some procedures1). In addition to this quicker path to the ambulatory stage for patients, healthcare providers experience faster patient turn-over and improved efficiency of healthcare delivery leading to more procedures per year and higher revenues. In some cases, the length of surgery is shortened 10 to 20 percent, benefiting surgeons by decreasing the considerable physical stress associated with open surgical procedures. For payers, a shorter hospital stay and reduced post-operative visits yields better compliance with medical instructions and lower costs per patient.