Minimally invasive surgery (MIS) is surgery done through small incisions using miniturized surgical tools and cameras or telescopes. MIS usally results in less pain, less scarring, and a quicker recovery time.

A common form of MIS is laparoscopic surgery, where small instruments guided by a small telescope are passed through the body wall. The instruments are held and manipulated by the surgeon who controls their movements, while watching them on a video screen. This form of MIS has been used widely in adults and more recently in children. It usually involves operations in the abdomen including surgery of the stomach, gall bladder, intestines, kidneys and bladder.

Another form of MIS is Endosurgery (in Urology it is termed endourology). It involves operating on the internal structures of the urinary tract by passing small instruments with a light and telescope up the natural passages of the urinary tract, the urethra or through a small puncture in the bladder or kidney. This procedure is used mostly to diagnose and remove stones in the kidney, ureter or bladder. These methods can be used to deal with obstructions, but this has not been as successful as other methods. These methods include cystoscopy (looking inside the bladder), ureteroscopy (looking inside the ureter) and percutaneous nephroscopy (looking inside the kidney by way of a puncture through the skin).

Cystoscopy is used for vesicoureteral reflux to inject a biodegradable material under the ureter to correct the reflux. The success rate is about 75 to 80 percent, and more study is being carried out to determine the value of this approach.

An overview of laparoscopy
The word "laparoscopy" means to look inside the abdominal cavity with a special camera or "scope" (called a laparoscope). During laparoscopy, five or six small incisions are made in the abdomen. Then, the abdominal cavity is inflated with carbon dioxide to lift the abdominal wall away from the organs below and provide an operating space in the abdomen.

The laparoscope and surgical instruments are inserted through the incisions. The surgeon is guided by the laparoscope, which transmits a picture of the abdomen on a video monitor so the procedure can be performed.

  Positions of small incisions (5-10mm) for laparoscopic antireflux surgery
  Incision (6-inch) used in traditional antireflux surgery

Patients who have laparoscopic antireflux surgery generally experience less pain and scarring after surgery, have a quicker recovery, and less risk of infection than those who have traditional antireflux surgery. (See the chart below)

Laparoscopic antireflux  surgery

Traditional antireflux surgery

Five 5-10 mm incisions in the abdomen

Six-inch vertical incision from the sternum to the navel; frequently, surgical staples are used to hold the wound edges together

Length of hospital stay
2 days

Five to six days

Less bleeding and scarring after surgery
Less risk of infection after surgery

Potentially more bleeding and scarring after surgery
Greater risk of infection after surgery

No nasogastric tube needed

Nasogastric tube (tube that is placed through your nose and into your stomach to remove air and digestive juices from the stomach. It may also be used to place nutrients directly into the stomach when a patient cannot take food or drink by mouth.)

Robotic techniques for Urologic and Thoracic Surgery

Robotic Surgery is one of the most exciting and promising areas in the field of minimally invasive surgery. Advances in robotic technology make it ideally suited for use in a number of complex Urologic and Thoracic conditions.

Minimally invasive surgery offers the potential to perform operations with less pain and quicker recovery, but it is not appropriate for all surgeries. Your surgeon will be able to tell you in which cases it may be the best choice.

Surgeons who perform this type of surgery also know how to perform the same operations with alternative methods, if necessary. New technologies, such as robotic-assisted surgery, offers the potential for minimally invasive surgery to continue to improve and offer even more benefits to patients in the future.

Dr.’s Vince and Vance Moss are one of the very few board-certified specialists in the region who offer this state-of the art, increasingly popular surgical options to treat a variety of urologic/general and thoracic surgical conditions.

At MAMSURG, we are committed to our patients, thus, we utilize the latest technologies and techniques with both robotics and minimally invasive surgery to achieve terrific results.  Many patients have expressed to us that by simply visiting our office that they can  immediately see the difference.

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