What is Minimally Invasive Surgery (MIS)?
Minimally Invasive Surgery (MIS) is a modern surgical technique designed to perform complex operations through tiny incisions, rather than significant cuts made in traditional open surgery. Using advanced tools like laparoscopes, endoscopes, and robotic-assisted systems, surgeons can access internal organs with precision while minimising damage to surrounding tissues.
This approach offers several advantages, including more minor scars, reduced blood loss, less post-operative pain, shorter hospital stays, and quicker recovery times. MIS is widely used for various specialities, including gynaecology, urology, gastroenterology, orthopaedics, and general surgery.
Types of Minimally Invasive Surgery
Procedures include laparoscopic, robotic-assisted, endoscopic, and keyhole surgeries for various organs and conditions
- Laparoscopic Surgery: One of the most common forms of MIS, laparoscopic surgery, uses a thin tube with a camera (laparoscope) inserted through a small incision. It allows surgeons to view the inside of the abdomen or pelvis on a screen and perform precise procedures. It is often used for gallbladder removal, hernia repair, appendectomy, and gynaecological surgeries.
- Endoscopic Surgery: In this approach, a flexible tube with a light and camera (endoscope) is inserted through natural body openings, such as the mouth, nose, or rectum, rather than external cuts. Endoscopic surgery is often used to examine or treat conditions of the digestive tract, respiratory system, or urinary tract.
- Robotic-Assisted Surgery: Robotic surgery enhances the capabilities of minimally invasive techniques by giving surgeons superior precision and control. Using robotic arms controlled from a console, doctors can perform highly complex procedures with reduced tremors and greater accuracy. Common in urology, gynaecology, and cardiothoracic surgeries, robotic-assisted surgery offers excellent outcomes.
- Thoracoscopic Surgery: Also known as Video-Assisted Thoracoscopic Surgery (VATS), this technique is used for operations inside the chest, such as lung biopsies, tumour removal, or treating pleural conditions. Small incisions and specialised cameras provide access without the need for open chest surgery, making recovery much faster.
- Hysteroscopic Surgery: Focused on the uterus, hysteroscopic surgery uses a hysteroscope (a thin, lighted tube) inserted through the vagina and cervix to diagnose or treat uterine problems. It is commonly used for removing fibroids, polyps, or addressing abnormal bleeding without external incisions.
- Arthroscopic Surgery: This minimally invasive technique is used in orthopaedics for joint problems. Through a small incision, an arthroscope with a camera is inserted into the joint (such as the knee, shoulder, or ankle) to diagnose and treat issues like torn ligaments, cartilage damage, or arthritis.
1 to 3 Hours
Surgery Duration
General Anesthesia
Anesthesia Used
1 to 3 weeks
Full Recovery
When is Minimally Invasive Surgery Recommended?
Minimally invasive surgery is recommended when patients require surgical treatment but want to avoid the risks and prolonged recovery associated with traditional open surgery. Some of the key indications include:
- Gallbladder Disorders: Conditions like gallstones or gallbladder inflammation (cholecystitis) are often treated with laparoscopic cholecystectomy, which is safer and less painful than open surgery.
- Gastrointestinal Conditions: Patients with appendicitis, hernias, colorectal diseases, or acid reflux may be advised minimally invasive approaches such as laparoscopic appendectomy, hernia repair, or fundoplication.
- Gynecological Disorders: Women experiencing fibroids, endometriosis, ovarian cysts, or abnormal uterine bleeding can benefit from laparoscopic or hysteroscopic surgery, which preserves fertility and reduces recovery time.
- Urological Problems: Robotic or laparoscopic surgery is often used for kidney stones, prostate enlargement, or cancers of the bladder, kidneys, and prostate, offering precise outcomes with minimal complications.
- Thoracic & Cardiac Issues: Video-assisted thoracoscopic surgery (VATS) is used for lung nodules, pleural effusion, or tumours. Specific cardiac procedures, like valve repair or bypass, can also be performed with robotic-assisted minimally invasive techniques.
- Orthopedic Conditions: Arthroscopic surgery is ideal for joint injuries, ligament tears (like ACL), rotator cuff repairs, or early arthritis. It allows faster rehabilitation compared to traditional open joint surgery.
- Obesity & Bariatric Surgery: Patients undergoing weight-loss procedures, such as gastric bypass or sleeve gastrectomy, benefit from minimally invasive laparoscopic techniques that reduce hospital stay and improve recovery.
Preparing for a Minimally Invasive Surgery Procedure
Preparing for your Minimally Invasive Surgery is a key part of a smooth surgery and a fast recovery.
Medical Evaluation & Pre-Op Tests
Your physician will be examining your entire medical history, drugs, and allergies before surgery. To ensure you are fit to go under the anaesthetic scalpel, routine examinations like blood tests, chest X-rays, ECG or imaging (depending on the condition) are ordered. Any long term diseases such as diabetes, high blood pressure, and heart disease ought to be under control prior to the operation.
Lifestyle Adjustments & Health Habits
If you smoke, you'll be advised to quit at least 4-6 weeks before surgery, as smoking slows down healing and increases anaesthesia risks. Alcohol consumption should also be avoided for at least a week. Certain medications like aspirin, NSAIDs, vitamin E, or blood thinners may need to be stopped, as they can increase bleeding risks. Eating a balanced diet rich in protein and vitamins helps prepare your body for optimal recovery.
Pre-Surgery Instructions
Your surgery team will give you very specific guidelines, based on what kind of MIS you are having. In general, a preoperative fast is usually required to minimize the risks associated with anesthesia and to be 6-8 hours. You can be asked to take only necessary medications with a sip of water on the day of surgery.
Home & Support System Preparation
Arrange for a family member or friend to drive you home after the surgery, as you won't be able to drive immediately. Most minimally invasive procedures are day-care or short-stay surgeries, so preparing your home with essentials like comfortable clothes, easy-to-digest meals, water, and necessary medications will help you recover with ease.
Day of Surgery
On the surgery day, arrive at the hospital as per your scheduled time. Avoid wearing makeup, nail polish, jewellery, or contact lenses. Dress in loose, comfortable clothing, ideally with front buttons or zippers for easy change after surgery.
What Happens During Minimally Invasive Surgery?
During the procedure, small incisions are made, and specialized instruments and cameras are used to perform surgery with minimal trauma.
- Preparation & Anesthesia: On the day of surgery, you'll meet your surgical and anaesthesia team to go over the final details. Most minimally invasive surgeries are done under general anaesthesia, so you'll be completely asleep and pain-free during the procedure. In some cases, regional or local anaesthesia may be used depending on the type of surgery.
- Small Incisions & Access Ports: Instead of a large incision, the surgeon makes a few tiny cuts (usually 0.5-1 cm long). Through these, small tubes called trocars or access ports are placed. These allow the surgeon to insert a camera (endoscope or laparoscope) and specialised surgical instruments.
- Use of Camera & Visualisation: A miniature camera is passed through one of the ports, sending high-definition images to a monitor in the operating room. This gives the surgeon a magnified view of the internal organs and structures, ensuring precision and safety throughout the procedure.
- Performing the Surgery: With the help of long, thin instruments, the surgeon carefully performs the required steps, whether it's removing a diseased organ (like gallbladder or appendix), repairing tissues, treating gynaecological conditions, or performing joint surgeries. The surgeon's movements are highly controlled, often enhanced by robotic assistance in some advanced centres.
- Tissue Removal or Repair: If an organ or tissue needs to be removed, it is broken down into smaller pieces and extracted through one of the small incisions. In repair procedures, sutures, clips, or staples may be applied internally using the special instruments.
- Closing the Incisions: Once the surgery is complete, the instruments are withdrawn, and the tiny incisions are closed with dissolvable sutures or surgical tape. A small dressing is applied over the cuts, and in most cases, no stitches need to be removed later.
- Post-Surgery Recovery: After surgery, you'll be moved to a recovery room where your vitals will be monitored. Since the incisions are small, patients typically experience less pain, minimal scarring, and faster recovery compared to traditional open surgeries. Many are even discharged the same day or within 24-48 hours, depending on the procedure.
Who Performs the Minimally Invasive Surgery?
Minimally invasive surgery (MIS) is performed by specialists based on the condition:
- General Surgeons for Hernias, appendicitis.
- Gynecologists for Endometriosis, hysterectomies.
- Urologists for Kidney stones, prostate issues.
- Orthopedic Surgeons for Joint replacements.
- Cardiothoracic Surgeons for Heart surgeries.
- Gastroenterologists, Radiologists, Plastic and Bariatric Surgeons address digestive, vascular, cosmetic, and weight-loss concerns.
Recovery After a Minimally Invasive Surgery Procedure
Recovering from a Minimally Invasive Surgery is a step-by-step process, and genuine care makes all the difference.
First Few Days After Surgery
- Most patients go home the same day or within 24-48 hours. Expect mild pain, swelling, or discomfort near the incision sites.
- Gentle walking is encouraged soon after surgery to improve circulation and reduce the risk of blood clots.
- Avoid heavy lifting, bending, or sudden movements. Stick to light activities and allow your body to rest.
Doctor's Tip: "Even if you feel okay, give your body time. Pain medicine should be taken on schedule rather than waiting for pain to become severe."
Weeks 1 to 2
- By this time, incisions begin to heal and soreness decreases significantly. Most people can return to desk jobs and light activities within a week.
- Stitches are usually dissolvable, but if not, your doctor will remove them during a follow-up.
- You may be allowed to drive, provided you're not on strong pain medication.
- Doctor's Tip: "Listen to your body. If certain activities cause pain, it's your body's way of saying you need more rest."
Weeks 3 to 4
- Energy levels improve, and most patients resume everyday routines, including work, light exercise, and daily chores.
- Low-impact activities like walking, yoga, or light stretching may be introduced with your surgeon's approval.
- Continue to avoid strenuous workouts, heavy lifting, or core-focused exercises.
Doctor's Tip: "This is the time when patients often feel back to normal.' But healing continues under the surface, don't rush into intense activities yet."
6 Weeks and Beyond
- By 6 weeks, most patients are cleared for complete activities, including sports, weight training, and physically demanding work.
- Scars begin to fade and blend into the skin, with minimal visible marks compared to open surgery.
- Internal healing is complete, and you should feel fully back to your regular lifestyle.
Doctor's Tip: "Your incisions may look fine, but keep protecting them from sun exposure. Use sunscreen or cover them to prevent darkening."
Lifestyle Changes After Minimally Invasive Surgery
- Follow your surgeon's advice on diet, activity, and wound care.
- Avoid heavy lifting or strenuous activity until cleared by your doctor.
- Keep incision sites clean and dry to prevent infection.
- Attend all follow-up appointments to monitor healing.
Benefits of Minimally Invasive Surgery
Benefits include smaller scars, reduced pain, faster recovery, shorter hospital stays, and lower risk of complications
- Smaller Incisions, Minimal Scarring: Small keyhole incisions are used in place of large cuts and less noticeable scars and better cosmetic results are obtained. Faster Recovery and Reduced Hospital stay.
- Faster Recovery & Shorter Hospital Stay: Most patients go home within 1-2 days, compared to a week or more after traditional open surgery.
- Less Pain & Discomfort: Smaller incisions mean reduced tissue trauma, resulting in less post-surgical pain and a smoother recovery.
- Lower Risk of Infection & Complications: Since wounds are more minor, the chances of infection, excessive bleeding, or wound-related issues are significantly reduced.
- Quicker Return to Daily Life: Patients can usually resume everyday work, family, and social activities much sooner than with open surgery.
Risks of Minimally Invasive Surgery
Potential risks include bleeding, infection, organ injury, or conversion to open surgery if complications arise
- Anesthesia-Related Risks: As with any surgery, general anaesthesia carries potential complications like allergic reactions, breathing difficulties, or rare side effects.
- Bleeding or Infection (Though Rare): Even with minor cuts, there's still a slight chance of bleeding, infection, or poor wound healing.
- Organ or Vessel Injury: In rare cases, surgical instruments may cause accidental injury to nearby structures, requiring further repair.
- Conversion to Open Surgery: Sometimes, if visibility is limited or complications arise, the surgeon may need to switch from MIS to open surgery for safety.
- Not Suitable for Everyone: Patients with severe obesity, extensive scar tissue from prior surgeries, or certain medical conditions may not be ideal candidates.
What is the Cost of Minimally Invasive Surgery in India?
The cost of minimally invasive surgery can vary depending on the type of procedure, the technology used, and the patient's medical needs. On average, it ranges from Rs. 1,20,000 to Rs. 2,50,000. While it may seem higher than traditional surgery upfront, patients often save on hospital stay, medications, and recovery time, making it a cost-effective option in the long run.
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