Good question! If you Google the term “minimally invasive” in relation to any medical treatment, it is likely that you will get a wide range of procedures that claim to fall under this category.
In the simplest terms (as defined by Dictionary.com) minimally invasive is a treatment that requires only a small incision or the insertion of an instrument into a body cavity involving minimal damage to body tissues.
Advances in medicine have caused the terminology to evolve. In a 2004 article in the journal Urology, minimally invasive treatments for patients with localized prostate cancer included:
- Laparoscopic radical prostatectomy - uses five small incisions on the abdomen with a laparoscope to visualize the prostate on a video monitor allowing the surgeon to remove the prostate and lymph nodes while sparing nerves.
- Robot-assisted radical prostatectomy – uses five small incisions on the abdomen; the surgeon manually operates robotic arms to manipulate the surgical instruments.
- Brachytherapy - involves needles to place bits of radioactive material called “seeds” in the prostate tissue surrounding the tumors.
- Cryotherapy - uses needles called cryoprobes that are inserted into the prostate around the tumor. Circulating argon gas is injected to freeze the tumor.
Since then, the following have been added to the list:
- Proton Beam Radiation - a type of conformal radiation therapy that delivers high doses of protons to a targeted area of the prostate.
- High Intensity Focused Ultrasound (HIFU) - an incision-free, radiation-free, outpatient procedure that uses an ultrasound probe to destroy targeted tissue within the prostate gland.
While each of these procedures can classify themselves as minimally invasive, they each have different qualifiers, and some of these procedures are less invasive than others.
Where does HIFU fall in the spectrum of minimally invasive?
A HIFU prostate ablation requires no piercing* of the skin and no damage to intervening tissue between the medical device and the targeted organ tissue. It seems too good to be true, but the medical instrument is simply inserted into a natural body cavity (the rectum) and energy is transmitted through the rectal wall and focused on targeted prostate tissue. The energy heats the precisely targeted prostate tissue until the temperature is too high for the cells to survive.
Because of the nature of the procedure, a minimally invasive prostate HIFU procedure offers the following benefits to patients:
- Single Visit
- Go home the same day - No hospital stay
- Little to no recovery time – Men can resume activities of daily living the next day, even return to work
- Reduced side-effect profile – The occurrence of erectile dysfunction or incontinence is less than both robotic prostatectomy or radiation
*a HIFU procedure may or may not utilize a suprapubic catheter. In this case, an incision would need to be made for the catheter, but no incisions are needed for the delivery of HIFU therapy.