Minimally invasive procedures have become the standard of care for many surgeries. Whether you need a knee repaired, a stent to restore blood flow or a tumor removed, your highly skilled surgical team will work with advanced technology to maximize your results and ensure your safety. (The term “procedure” is preferred by the medical profession because “surgery” is more invasive, requiring making deeper cuts into the skin.)

Patients needing all of these care services have benefited from the availability of minimally invasive procedures: bariatrics, cancer, endocrine, heart and vascular, gastroenterology, general surgery, gynecology and orthopedics.

How minimally invasive surgeries work

Minimally invasive procedures use a long, flexible tube (an endoscope) with a tiny camera and light attached. The scope is inserted into the body through a small incision. An image is sent to a screen that the surgeon watches during the operation, providing greater accuracy for the procedure. The surgeon also makes other small incisions to insert necessary tools for the procedure. The number and size of the incisions depend on the operation.

Benefits of minimally invasive surgery

Compared with open surgery, minimally invasive procedures offer:

- Less pain and bleeding due to smaller incisions
- Shorter hospital stays
- Faster recovery time for an earlier return to normal activities
- Reduced risk of infection
- Decreased blood loss and need for transfusions
- Fewer and smaller scars

• Arthroscopic Procedures for Orthopedics
• Laparoscopic Procedures for Internal Organs
• Minimally Invasive Cancer Procedures

We use arthroscopic procedures to examine and treat the interior of a joint. Our surgeons at Goshen Orthopedics perform this minimally invasive procedure with an arthroscope, a type of endoscope that is inserted into the joint through a small incision.

In general, we use arthroscopic techniques to evaluate or treat orthopedic conditions, including torn or damaged cartilage. Arthroscopic procedures also give us less invasive ways to perform ACL reconstruction. (ACL stands for “anterior cruciate ligament.”)

Surgical instruments used in arthroscopic procedures are smaller than traditional instruments. Surgeons view the joint area on a video monitor to diagnose and repair torn joint tissue. Joints most commonly examined and treated by arthroscopy are knees, ankles, feet, hips, shoulders, elbows and wrists.

For procedures in the abdominal cavity, we often use laparoscopic procedures. Our surgeons use small incisions – usually less than half an inch – to place plastic tubes, called ports, for a video camera and several thin instruments.

The video camera becomes the surgeon’s eyes in this type of procedure. The camera projects an image of the body's organs onto a high-definition imaging screen.

Laparoscopic procedures are used by physicians in bariatrics, gynecology, oncology, intestinal and gall bladder, urology – to name a few.

Our surgical oncologists have extensive training and experience with minimally invasive procedures that may not be available at other cancer centers in the region.

• Robotic-assisted procedures – Robotic-assisted procedures are much more accurate traditional open surgeries. The 3-D view provided by a specially designed camera and the dexterity of the robotic hands allow the surgeon to maneuver through and around nerves and other vital structures. At Goshen Center for Cancer Care, we use the da Vinci robotic-assisted surgical system because it provides our surgeons with much greater visualization, precision and control. This helps remove cancerous tissue with less damage to surrounding healthy tissue.
• Endobronchial ultrasound and navigational bronchoscopy – These diagnostic tools facilitate less invasive diagnosis of lung tumors and other tumors of the chest. Endobronchial ultrasound uses a scope that has an attached ultrasound probe to look at tissues next to the airways and biopsy them. Navigational bronchoscopy uses a computer to map out the path to biopsy a lung lesion that could not otherwise be reached with the regular bronchoscope. This may mean earlier diagnosis for lesions that would otherwise be difficult to biopsy, and has lower risk of puncturing a lung compared to other biopsy techniques.
• Minimally invasive parathyroid procedures -The traditional surgical approach to parathyroid disease would be to look at all four glands, although the vast majority of parathyroid problems are caused by only one gland. At Goshen Center for Cancer Care, we often can localize the abnormal gland before the procedure and use a very small incision. We use blood tests to ensure that the parathyroid problem has been fixed prior to the patient leaving the operation.
• Laparoscopic procedures - With laparoscopic procedures, our surgical team can remove cancer with precision and accuracy through small incisions and better preserve healthy tissue. Patients recover more quickly from the procedures with less time in the hospital and fewer complications.
• Video-assisted thoracoscopic surgery (VATS) – Video-assisted thoracoscopic surgery is a minimally invasive procedure used to diagnose and treat a variety of conditions in the chest area, including lung and esophageal cancers. This procedure requires only small incisions, which can lead to a quicker and less painful recovery for the patient.