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EVERYTHING YOU NEED TO KNOW ABOUT MINIMALLY INVASIVE SURGERY (MIS), AS TOLD BY DR. HASZ

In a world where health care is constantly evolving and progressing, as a patient it is hard to keep up with the latest procedures and treatment options. Lately, I have been receiving many inquiries and questions from patients surrounding around “minimally invasive surgery”. Through these recent dialogues it has become clear to me that Minimally Invasive Surgery (MIS) means different things to different people. This is how I break it down for my patients. MIS is not about the instruments used, but rather about surgery that protects healthy tissue and the normal supporting structures of the spine.

It has become a common perception by patients that minimally invasive surgery means performing surgery through small tubes, or by using microscopes, or using lasers or robots. These tubes and other retractors, microscopes, lasers, and robots are merely tools used to do surgery. They are not, by themselves, MIS. Please understand, just because a provider uses these tools does not make the surgery minimally invasive.

MIS  is performed with the least tissue manipulation necessary, while still accomplishing the goals of the surgery. With my patients I look to reduce trauma to the body and allow it to heal as fast as possible by carefully considering the most efficient and effective surgery for each patient.

For example, many years ago, knee surgeries required big incisions. Now many knee surgeries can be performed with small incisions and arthroscopes, which can actually show the pathology more precisely and with less collateral damage (and a shorter healing time). The same thing has been discovered with advances in gallbladder surgery. Now, most gallbladder surgery is done via endoscopic surgery.

Knowing the anatomy of the body is essential. Knowing where the blood supply is, protecting the nerves, and keeping muscles intact when possible, are all essential to MIS.  If spaces in between muscles and tissues can be separated as opposed to being cut, then there is less healing required.  If smaller incisions can be made, while still seeing what needs to be seen, and doing what needs to be done, then the body can heal faster.

The Society of Minimally Invasive Spine Surgery (SMISS) and other organizations to which I belong continue to advance the field of MIS. In our societies, we continue to teach the principles of MIS, as well as teach the actual techniques, to surgeons around the world.

To perform MIS, we use various tools–tubes, x-ray/flouroscopy, lasers, robots, endoscopes, microscopes, and cameras. But the principles of surgery are the same as traditional procedures. The body heals the same way as before, but with more direct approaches, there is less to heal, so we can get the job done, and get the patient up and moving faster, and with less discomfort. As an active participant in clinical trials and as a pioneer of artificial disc and other minimally-invasive procedure, I have found that the complexity of the case doesn’t necessarily mean that MISS is ruled out.

As spinal specialists, at the Virginia Spine Institute, it is part of our DNA to constantly seek better ways to improve our patients’ lives.

What is your perception of Minimally Invasive Surgery?

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