Minimally invasive surgery: a concept already incorporated

Abstract

IIMinimally invasive procedures can be defined as those that can be performed by entering the body with the minimum damage to the entrance, which may be the skin, a body cavity or an anatomical opening. In contrast with the ancient aphorism "great surgeons, great incisions", the current trend regarding incisions is much closer to "the less, the better".The benefits from reducing injuries to the access route that are most advocated are the following: reduction of postoperative pain, reduction of bleeding, reduction of the inflammatory response to the trauma and a better esthetic result.1 However, the degree of proof of these benefits varies according to the specialty, and even between specific procedures.Examples of procedures that are said to be minimally invasive encompass a variety of fields, namely: in abdominal surgery, videolaparoscopy; in orthopedic surgery, arthroscopy;in thoracic surgery, videothoracoscopy; in cardiology, interventionist cardiology; in vascular surgery, interventionist vascular procedures; in radiology, radio-intervention; among others. This is without taking into account the advent of robotic surgery, which has gained space in all fields of surgery.However, all the new techniques developed within the sphere of minimally invasive surgery go beyond the basic concept of simply reducing the size of the incision. These advances and discoveries have unequivocally contributed towards accelerating the overall development of surgery, and even what is known as "conventional" or "open" surgery.Materials that were initially developed for video surgery are sometimes used in "open" cases to shorten the duration of the operation, thus providing a real benefit. Many "hybrid" procedures can also be cited as examples. Among these procedures, one that is well known is aor- In thoracic surgery, the tactic known as the fissureless technique 4 , which is used for accessing the pulmonary hilum to treat the fissure, is being incorporated by many thoracic surgeons, who perform videothorascopic lobectomy even when they operate on open cases.In surgical treatment for inguinal hernias, there have been interesting experiences using video surgery, with regard to the way in which the mesh is fixed. 5In relation to cardiovascular surgery, there has been an important discussion about diminishing not only the trauma of the incision but also the trauma caused by use of extracorporeal circulation. Along these lines, many myocardial revascularization procedures have been performed with the heart beating through the aid of special devices known as cardiac stabilizers, thereby suppressing the need for extracorporeal circulation. 6 Another trend in cardiac surgery without extracorporeal circulation consists of using transapical implantation of a valved endoprosthesis into the aortic position.

Surgical contraception of free‐ranging female capybaras: Description and comparison of open and minimally invasive techniques

“…However, it is always desirable that the handling and exposure of abdominal viscera be minimized in procedures performed in free‐ranging species in an out‐of‐hospital setting. An alternative in this direction would be the use of minimally invasive surgery (MIS), which may or may not involve the use of laparoscopic equipment 14,15 . A wide variety of techniques using 1, 2, or 3 laparoscopic portals have already been described for surgical contraception of wild animals 16–30 .…”

“…An alternative in this direction would be the use of minimally invasive surgery (MIS), which may or may not involve the use of laparoscopic equipment. 14,15 A wide variety of techniques using 1, 2, or 3 laparoscopic portals have already been described for surgical contraception of wild animals. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] In general, the results of these studies associate improved recovery and return to normal preoperative behaviors after laparoscopic interventions compared to a conventional laparotomy.…”

Minimally invasive cardiac surgery in patients with heart disease: Integrative review

“…As doenças cardiovasculares são consideradas como a principal causa de morte no mundo e a enfermidade mais comum na população mundial, segundo a Organização Mundial da Saúde (OMS), e atualmente, a esternotomia mediana total é o acesso cirúrgico de eleição para os procedimentos cardíacos em geral, permitindo amplo acesso ao cirurgião às cavidades cardíacas e vasos da base. Entretanto, é sabido que o trauma cirúrgico envolvido é grande, uma vez que há uma incisão extensa, juntamente com a necessidade de secção completa do esterno, o que resulta em baixa qualidade de vida do paciente no pós operatório, reflexo de desconforto e dor intensa em um tempo relativamente prolongado para a recuperação funcional, além da possibilidade de infecções graves (HUANG LÜ;HUANG, L;CHEN, L. 2022;MARIANI;PÊGO-FERNANDES, 2013).…”