Minimally invasive surgery

Introduction Since the introduction of the laparoscopic cholecystectomy in the late 1980s, traditional open surgical methods have been gradually replaced with minimally invasive alternatives. Recently, laparoscopic procedures have been replacing even the most complicated open abdominal operations. Minimally invasive surgery is literally changing the complexion of the modern practice of surgery. The best example to illustrate recent emphasis of minimally invasive surgery is to review the changes in postgraduate surgical training over the past decade. Ten years ago there were only a few fellowships in minimally invasive surgery. Currently, there are 128 approved minimally invasive surgery fellowships in the United States for general surgery alone. The candidates who fill these new positions are those who would previously have applied for the other fellowship positions. This fact has significantly altered postgraduate surgical training because residents are choosing minimally invasive fellowships over the traditional surgical disciplines. In 2005, cardiothoracic and vascular surgery fellowship programs did not have enough applicants to fill the available positions. In comparison, minimally invasive fellowships had to turn away a surplus of applicants. Residents applying for fellowships are moving away from some of the more traditional disciplines towards minimally invasive surgery; over time this trend will change the make up of surgical specialists nationally. This paper reviews four major articles that were published between August 2005 and August 2006, and which had an impact on the field of minimally invasive surgery.