Schwartz's Surgery  Part I. Basic Considerations 

Chapter 13. Minimally-Invasive Surgery 

Copyright ©2007 The McGraw-Hill Companies 

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• Minimally-invasive surgery is a means of performing major operations through small incisions,

•  often using miniaturized,•  high-tech imaging systems, • to minimize the trauma of surgical exposure .

• small holes, big operations

Historical 

• Primitive laparoscopy, placing a cystoscope, was first performed by Kelling in 1901

•  In the late 1950s Hopkins described the rod lens, with no heat and little light loss

• 4 By the mid-1970s rigid and flexible endoscopes made a rapid transition from diagnostic instruments to therapeutic ones

• Fluoroscopic imaging allowed the adoption of percutaneous vascular procedures, the most revolutionary of which was balloon angioplasty

Laparoscopic surgery

Laparoscopic surgery

Laparoscopic surgery

• The unique feature of endoscopic surgery in the peritoneal cavity is the need to lift the abdominal wall from the abdominal organs. 

• used by most surgeons, is the induction of a pneumoperitoneum.

Laparoscopic surgery

Thoracoscopy

Without positive pressure, it is necessary to place a double-lumen endotracheal tube so that the ipsilateral lung can be deflated when the operation starts

Extracavitary Minimally-Invasive Surgery:

Access for Subcutaneous and Extraperitoneal Surgery

Hand-Assisted Laparoscopic Access

Robotic Assistance/ Robotic Surgery

ENDOSCOPY

Endoluminal Surgery

Endoluminal Surgery

Intraluminal Surgery

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