Current technology on minimally invasive surgery and Interventional Techniques

Minimally invasive techniques (MIT) are used in interventions making use of long instruments inserted via natural openings or small incisions in the skin. There is a large role for technology in these interventions focusing on treating the patient with minimal damage to healthy tissue. Because of the interposition of these instruments, the degrees of movements are limited, visual feedback is indirect via use of endoscopic camera or imaging techniques, and haptic feedback is limited to force feedback to the human hand. Extensive training is needed to master the difficult minimally invasive methods. Traditionally, surgical training is performed on patients in the OR under supervision of an experienced surgeon/interventionist. Several training methods became available to train minimally invasive skills outside the operating room, e.g. box-trainers, VR-trainers, with and without a haptic feedback. In this paper, technology recently developed or under development for minimally invasive surgery, single port surgery, flexible endoscopy, NOTES (Natural Orifice Transluminal Endoscopic Surgery), needle and other type of interventions will be described, including recent developments in robotic systems. In addition, recent advancements in training systems development will be described and the advantages and disadvantages of the different training methods will be compared. Furthermore, the role of force feedback will be discussed.