The historical impact of minimally invasive surgery

At first there is an idea which asks for more comfort for the patient and equal results compared to conventional procedures. This means less pain and fatigue, quicker convalescence and shorter hospital stay. The new procedures requests an entirely new operative skill and a new technique with new instruments. Those were early developed in Germany. The roads on which this was performed will be described. In another chapter the history of this development is shown, especially the German, French and US inventors with a special view on their personal experiences and disappointments like in the German surgeon M_he and the gynecologist Semm from Kiel, Germany. But they all remained enthusiastic as a common personal quality. The new technique (MIC) was translated "Mickey-Mouse-Surgery" and medicolegal consequences like in M_he were usual events. Another example of misunderstanding of the impact of the new technique: the first publication of Semm about the laoaroscopically removed appendix has been withheld so long in Germany until it was published in the USA in the Journal "Obstetrics and Gynecology". Besides this it is reported about the life cycle of this innovation pointing out to the final promising report, the professional adoption and public acceptance and the randomized controlled trials. The last stage is characterized by "jumping on another train". Pictures are shown of those pioneers who had the idea, who understood what they were doing and who took the responsibility. The final chapter will deal with the consequences for the future generation of surgeons and their training and the unanswered questions as to further fields. Doubtlessly, the pioneer period did not come to an end yet. A glance into the future may be allowed.