Minimally invasive surgery (MIS; e.g., laparoscopic or thoracoscopic surgery) is a technique where operations are performed through small incisions (usually 0.5–1.5 cm) in the body. Trocars — hollow tubes that prevent air from escaping — are inserted into the abdomen or chest. Carbon dioxide is used to insufflate the abdomen and create a working space (this step is not needed in thoracoscopic surgery). Laparoscopic instruments are inserted through the trocars to gain access to internal anatomical structures. A laparoscope is a long, fiber optic video cable system that allows remote viewing of the affected area. The phases of dissection and resection discussed above can then be performed without the need for large incisions. Resected tissue is put into a retrieval bag and removed through one of the trocars or a slightly extended trocar incision.
MIS offers clinical and economic benefits.([FOOTNOTE=Fitch K, Engel T, Bochner A. Cost Differences Between Open and Minimally Invasive Surgery. Managed Care. 2015 Sep;24(9):40-8.],[ANCHOR=],[LINK=]),([FOOTNOTE=Tiwari MM, Reynoso JF, High R, Tsang AW, Oleynikov D. Safety, efficacy, and cost effectiveness of common laparoscopic procedures. Surg Endosc. 2011;25(4):1127-1135.],[ANCHOR=],[LINK=]),([FOOTNOTE=Roumm AR, Pizzi L, Goldfarb NI, Cohn H. Minimally invasive: minimally reimbursed? An examination of six laparoscopic surgical procedures. Surg Innovation.2005;12(3):261-287.],[ANCHOR=],[LINK=]) From a clinical perspective, MIS is associated with improved outcomes through reduced rates of complications such as infections, blood loss, incisional hernias, adhesions, and postoperative pain. Economic benefits include reduced length of hospital stay and readmissions, decreased recovery times, and lower costs across the episode of care. After hospital discharge, MIS patients typically are back to their daily routines faster than those who have had open surgery.