Minimally invasive surgery is a marriage of modern technology and surgical innovation. It has resulted in many procedures that accomplish the age old goals of surgery (diagnosis, Cancer staging, removal and repair of disease states) with small incisions and decreased psychological trauma.

Incising the skin, fat and muscle tissues is a time honored necessity to gain access to the disease process. The incision is the primary source of pain, infection and psychologic stress, which often leads the patient to delay the performance of a needed operation. Such a delay in treatment may allow the disease to advance to a point where it is either incurable or the operation is made more difficult, resulting in an increased risk of complications or death. The ability to perform conventional operations through small ("keyhole") incisions is sufficiently enticing to many patients so that they are agreeable to undergo surgery earlier in the course of their disease when an operation will be potentially easier and more effective.

Originally popularized in 1988 as "Laser surgery for Gallstones," minimally invasive surgery has gained increasing momentum and acceptance by both the public and medical communities. Though lasers are rarely utilized in today's minimally invasive procedures, advanced technology has allowed surgeons to apply minimal access techniques to a wide variety of surgical procedures. The central focus of today's high technological operations is the videoscope. This scope, which ranges from 2-10 mm (25 mm = 1 inch) in diameter, can be inserted into body cavities such as the abdomen and allow the surgeon to visualize the organs to be operated upon. With the assistance of long instruments inserted though small puncture wounds, the surgeon and assistants can perform operations which previously required large incisions to allow for visualization and manipulation of the diseased organs.

The list of minimally invasive surgical procedures is increasing on a daily basis. Some of the more common procedures performed at the Duke Endosurgery Center include: cholecystectomy (gallbladder removal), appendectomies, anti-reflux procedures, hernia repairs, splenectomies, adrenalectomies, colon and small bowel resections, staging and diagnosis of cancers, and treatment for ulcer disease. Similarly several surgical specialties are increasing the utilization of minimally invasive techniques in their daily practices. Specialties which include Gynecology, Plastic, Thoracic, Urologic, Pediatric, and Orthopaedic surgery all now employ minimally invasive techniques where applicable.