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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.
Children's Hospital Boston's Center for Minimally Invasive Surgery is known internationally for having pioneered or perfected many of the minimally invasive surgical procedures in use today.
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.
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 pediatric surgeries, and physicians at Children's are pioneers in the field.
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