Commentary to “‘Open’ minimally invasive surgery in pediatric urology”

Abstract

I read with interest the article entitled ‘Open’ minimally invasive surgery in pediatric urology. The authors report and discuss their experience with, what they call, open minimally invasive surgery (MIS). Open MIS is defined as a surgical technique which uses small incisions and obviates the use of laparoscopic instruments. It is true that the term ‘minimally invasive surgery’ was, by tradition, understood to refer to laparoscopic or endoscopic surgery. This was probably already a lexical shortcut since, though the incisions might individually be smaller, the surgery itself is often not less invasive. The problem with new terms such as ‘open minimally invasive surgery’ is that these appellations are purely arbitrary, they relate solely to incision size, and in some cases the surgery itself seems more invasive than classic surgery. In this report, the authors refer to open MIS for renal surgery performed through small incisions (ranging from 1.3 to 2.5 cm in patients 10 years of age). What is the definition of small? Is it defined just as smaller than we used to perform? Or smaller than other surgeons do? Most of us try to use small incisions, but when do they become minimally