Minimally Invasive Surgery

Minimally invasive surgery at a glance

• Minimally invasive surgery (MIS) is a surgical approach that reduces trauma to the body, primarily due to smaller incisions (or no incision) rather than the larger incisions used in open or traditional surgery.
• MIS is an excellent option for many urologic problems requiring surgery of the kidneys, prostate, bladder and other aspects of the urinary tract, such as a vasectomy.
• Minimally invasive surgeons use keyhole-size incisions, special instruments and video displays (from a tiny camera inserted through the incisions) to treat or diagnosis a urologic condition.
• MIS reduces surgical trauma to the body, resulting in shorter hospital stays, quicker recovery times, less scaring, pain, risk of infection and complications.
• Types of MIS Urology Associates performs are laparoscopy, no-scalpel vasectomy and robotic surgeries utilizing our da Vinci Surgical System.

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What is minimally invasive surgery?

Minimally invasive surgeries are techniques that give a surgeon access to internal organs and tissue without the need for a large incision. MIS also allows the surgeon to remotely view the area in question, often to confirm a condition or perform a biopsy, and then to correct the condition following confirmation.

Benefits of MIS

Patients often respond quite well to MIS, and the use of MIS has grown exponentially in the past two decades. This is primarily due to better health outcomes from MIS than traditional surgery, as well as less trauma for patients. MIS usually involves less discomfort, pain, bleeding, scarring, hospital stays, recovery times and absence from work. MIS can often involve less cost, though not always.

Types of minimally invasive urologic surgery

Laparoscopic surgery is the primary form of MIS and involves small incisions (smaller than one-half inch), through which a thin tube is inserted allowing a video camera and special surgical instruments passage into the body. The surgeon views the operating area on a color video monitor and utilizes the special instruments to perform the surgery.

For comparison, consider surgery to remove a kidney, called nephrectomy. Open surgery involves a large incision in the side, calling for a hospital stay of up to a week for it to heal and up to 12 weeks before the patient can resume normal daily activities. MIS nephrectomy involves small incisions for operation and removal, requiring much less hospital time and much faster return to normal activities.

Endoscopy is a minimally invasive procedure that allows the urologist to view internal organs and tissues using an endoscope, providing diagnostic evaluation of the kidneys (called cystoscopy), bladder and ureter. The endoscope is a flexible tube with a camera that returns an image to a video monitor. Rather than being inserted via MIS incisions, the endoscope enters the body through natural openings, such as the anus and urethra.

Robotic surgery is another form of MIS, and Urology Associates uses the da Vinci robotic surgery system. This system utilizes a surgical console in which a surgeon controls instruments attached to mechanized “arms.”

The urologist performing the surgery will discuss which form of MIS, laparoscopy or robotic, is appropriate for the patient – or if MIS is an option. Sometimes traditional, or open, surgery is still the best option.

Urologic procedures performed using MIS

Urology Associates physicians generally prefer MIS over traditional surgery. It has wide application for urologic conditions. Following are some of the MIS procedures we may use to treat urologic conditions or cancers.

• da Vinci prostatectomy for prostate cancer
• da Vinci and traditional laparoscopic nephrectomy for larger kidney cancers
• da Vinci robotic partial nephrectomy for small kidney cancers
• da Vinci sacrocolpopexy for vaginal prolapse
• Rezūm water vapor office treatment for BPH
• Greenlight laser ablation of the prostate for BPH
• Plasma button resection of the prostate for BPH
• No-scalpel vasectomy
• Laparoscopy for undescended testicles
• Percutaneous/Microscopic sperm extraction for infertility
• Interstim for refractory overactive bladder.

Whether a urologic surgeon uses MIS to treat such conditions depends on many factors, including the individual patient’s overall health, specifics of his or her condition and the physician’s assessment of the likely outcome.

Risks of minimally invasive surgery

All surgeries involve some risks, and MIS is no exception. However, one of the main benefits of MIS is the reduction in risks for the patient. Risks of any surgery include damage to organs or tissue, blood loss, pain, scarring and reaction to anesthesia.

MIS significantly reduces all these risks compared with traditional open surgery. Note also that some forms of MIS require little or no anesthesia.