MIS techniques can be used for diagnostic purposes as well as for surgical procedures. These techniques include:
In endoscopy, a lighted tube, either flexible or rigid, is passed through a natural opening in the body (for example, the mouth or anus). A camera in the tube allows the surgeon to see and diagnose problems and conditions that may be difficult to see using other techniques.
Many useful surgical procedures are also performed with endoscopes, including the removal of growths and diseased tissue, insertion of stents and delivery of radiofrequency energy.
In laparoscopy, a flexible or rigid tube with a miniature video camera and light are passed through one or more small “keyhole” incisions in the body. Tiny surgical instruments of various kinds are guided through these small incisions as well. The surgeon operates while watching magnified images on an operating room monitor. Surgeons perform laparoscopic procedures for many common operations, including gallbladder removal, colectomy and bariatric (weight loss) surgery.
UC Irvine surgeons are pioneers in the use of these same approaches for more complex procedures, including esophagectomies, liver resections and partial nephrectomies, to name a few.
For certain procedures, surgeons use the da Vinci® Surgical System. This innovative robotic system provides unparalleled precision and three-dimensional real-time images during complex and delicate laparoscopic operations.
Other minimally invasive procedures include various forms of endovascular surgery, often used for cardiovascular problems. Miniature instruments and devices are threaded through blood vessels to open clogged arteries (angioplasty), reinforce weakened areas (stent grafting) and destroy unwanted tissue.
Advantages of endovascular procedures include smaller incisions, less discomfort, no need for general anesthesia, reduced stress on the heart, less need for blood products and faster recovery.
Our interventional cardiologists are among the first on the West Coast to use the vessels of the wrist as the main endovascular approach to the heart. This allows patients to heal even faster and with less post-procedure pain than traditional endovascular approaches through a vein in the groin.
Minimally invasive procedures used in back surgery include arthroscopic techniques to treat painful lumbar spinal stenosis. Through two small incisions, surgeons can perform a decompressive laminectomy (sometimes combined with a spinal fusion) to stabilize wobbly vertebrae that infringe on adjacent nerves—without the large incision and muscle trauma associated with traditional spine surgery.
UCI Health spine specialists also use a robotic guidance system to perform some of these procedures. The surgeon uses the SpineAssist® system to develop a three-dimensional blueprint for the procedure to within one millimeter, or 1/25th of an inch. A stabilizing guidance arm allows the surgeon to carry out the preoperative plan with precision.
UCI Health orthopaedic surgeons also perform minimally invasive arthroscopic surgery on all major joints, including the shoulder, knee, elbow, hip and ankle. Smaller versions of already miniaturized surgical tools have made it possible for surgeons to diagnose and repair many troublesome hand and wrist problems as well.
Recent technological advances have made it possible to treat many more diseases and conditions with heat or extreme cold. Such treatments are designed to destroy, or ablate, targeted tissues while leaving adjacent areas intact. Specialists perform the procedures with thin tubes—inserted through small incisions or directly through the skin (percutaneously).
Ablative therapies offer a high degree of accuracy, effectiveness and safety because they are performed with advanced imaging technologies. Patients experience small incisions, or none at all in some cases, as well as less pain and far faster recovery.
Ablation technologies include:
- Radiofrequency ablation (RFA)
- Microwave ablation
- Irreversible electroporation (non-thermal cell destruction)
At UCI Health, we have harnessed these therapies at our Ablative Oncology Center, the nation's first multidisciplinary university ablative oncology center. The center’s team of highly skilled surgeons, interventional radiologists and other medical specialists provide the most effective and least invasive cancer care available.