Ask Dr. Wahlquist: What’s the difference between minimally invasive and minimal access surgery?
Dr. Wahlquist explains the distinction between “minimal access surgery” and “minimally invasive surgery.”
Surgical terms can be confusing. Surgeries are described as “minimal” or “minimally invasive,” but what do these terms actually mean? Orthopedic spine surgeon Dr. Trevor Wahlquist explains the difference between two surgery terms: minimally invasive surgery and minimal access surgery.
Dr. Wahlquist compares minimal surgical approaches to reconstructive approaches
“Confusion is understandable,” says Dr. Wahlquist. “Generally, it’s helpful to understand that there are two broad types of surgical approaches. Minimal procedures are performed through small incisions, and large reconstructive procedures require large incisions. Minimal procedures focus on minimizing the disruption of bone and soft tissues at the surgery site. Reconstructive procedures, like fusions from the thoracic to the lumbar spine, require large incisions and significant soft tissue trauma. For some medical conditions, large open procedures are necessary and important. But, thanks to technology advances, there are many basic degenerative spine conditions that can be treated minimally with much smaller incisions and less tissue disruption.”
Dr. Wahlquist distinguishes between two types of minimal surgical techniques
“Let’s talk about two categories of minimal surgical procedures,” says Dr. Wahlquist. “There are minimally invasive procedures and minimal access procedures. Both types of procedures strive to keep incisions small and minimize soft tissue disturbance. But technically, the term ‘minimally invasive’ has a specific connotation.”
Minimally invasive surgery
“’Minimally invasive’ is a term developed to describe surgeries handled via a tube and retractor system. A small incision is made and a tube is inserted through which instrumentation is guided,” Dr. Wahlquist explains. “The tubes direct the instrumentation to various focus spots on the spine where the surgery is performed. It’s a very important technique to treat a defined subset of problems.”
Minimal access surgery
“In contrast, minimal access is more of a philosophical approach than a technical term,” notes Dr. Wahlquist. “It’s not associated with specific technical tools. Rather, minimal access defines a surgical approach focused on using the smallest incisions possible and causing the least amount of trauma to the tissues as you perform the surgery. You may not use tubes and a retractor system. But you perform the surgery with a commitment to cause the least possible trauma to the skin, muscles, and ligaments surrounding the surgical site.”
Conditions appropriate for a minimal access approach
“A minimal access surgery approach comes into play for a number of conditions,” says Dr. Wahlquist. “These include disc herniation in the cervical or lumbar spine, sciatica, spinal stenosis, and spondylosis. All of these are conditions that can be addressed through a minimal access procedure when conservative treatments fail.
“These degenerative conditions are the focus of my own practice,” Dr. Wahlquist notes. “And I definitely take a minimal access surgery approach. Treating appropriate conditions with techniques that minimize soft tissue trauma can offer attractive patient benefits. Less trauma can mean less pain and faster rehabilitation, so patients get back to their activities sooner. Isn’t that what we all want when we need medical treatment? We want effective treatment with as little pain as possible and a rapid recovery so we can return to the life we enjoy.”
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