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What Is a Minimal Incision Procedure?

Surgeons removing a mass from a patient's body often make incisions that are from three-quarters to the full length of the mass. Minimal incision procedures are surgical procedures in which the incision made is just one-tenth the size of the mass of tissue that is to be removed. This less invasive surgical technique is used to remove growths or masses, such as cysts or lymphomas, in the body and to allow for a faster recovery time with less scarring than usually experienced with normal surgical incisions. Minimally invasive surgery that can be performed with minimal incision procedures include arthroscopic surgery, endovascular surgery and image-guided, or robotic, surgery.

In minimal incision procedures, a small incision is made that allows a surgeon to insert a laparoscope or endoscope through the skin or body cavity to an area of the body that requires surgery. Laparoscopic surgery or keyhole surgery is a technique for performing surgeries in the abdomen using a laparoscope. The laparoscope or endoscope consists of a telescopic rod lens or fiber-optic cable connected to a video camera. The abdomen is filled with air to lift it above the internal organs and make space for the laparoscope to fit inside the body. Small laparoscopic instruments are used to manipulate and remove tissue during a surgical procedure.

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Arthroscopy or arthroscopic surgery is performed by making a minimal incision near a joint, where an arthroscope — a type of endoscope — is inserted. The surgeon uses a video monitor to inspect the condition of the joint and look for signs of injury, such as torn cartilage. Irrigation fluid is added to the joint to distend it and create a space for the surgeon to work. Joints that commonly are subject to arthroscopic surgery include the knees, shoulders, wrists and hips.

Endovascular surgery uses minimal incision procedures to access the internal organs of the body by using the major blood vessels as a pathway. The femoral artery, a vein near the groin, often is used. A thin, flexible tube called a catheter with a special type of dye called radio-opaque dye is inserted into a major blood vessel in a leg artery. The tube is routed or threaded through the blood vessels, allowing a doctor to inspect them to diagnose atherosclerosis and aneurysms caused by ruptured blood vessels.

Image-guided, or robotic, surgery is used during some minimal incision procedures, such as heart surgery. Surgeons control the movements of a robot to make small, precise incisions on the body or drill into bone during joint, hip or knee replacement surgery. Once the patient's body has been mapped using X-rays, ultrasonographs and magnetic resonance imaging (MRI) scans, the surgeon plans a course of action and inputs the surgical pathway into the robot. The robot is positioned over the patient and monitored closely as it performs the actions that were plotted into its computer.

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