Minimally invasive surgery: a historical and legal perspective on technological transformation

Minimally Invasive Surgery (MIS) has experienced a significant evolution over the last 5,000 years, progressing from basic manual methods to sophisticated, robot-assisted approaches. The evolution of minimally invasive surgery (MIS) has been influenced by significant advancements in endoscopic visualization, electrosurgery, and laparoscopic tools, while recent innovations in artificial intelligence (AI) and robotic systems have further augmented surgical accuracy, minimized operative trauma, and enhanced patient outcomes. Notwithstanding its therapeutic advantages, minimally invasive surgery presents considerable medicolegal complications. The escalating intricacy of surgical technologies and procedures has resulted in an increased possibility of malpractice claims, presenting significant financial and professional hazards to healthcare providers. This requires the establishment of effective risk mitigation techniques, encompassing thorough surgical training, credentialing procedures, and compliance with established clinical standards. This review is divided into three sections: (1) the historical development and technological milestones of MIS; (2) the present landscape and future trajectories, emphasizing AI and robotic integration; and (3) the ethical and legal implications associated with MIS advancements, encompassing informed consent, surgeon liability, and patient safety concerns. The document underscores the pressing necessity for the advancement of legal and ethical frameworks to align with technological progress. Balancing innovation with ethical and legal safeguards is essential to ensure both progress and protection in modern surgical practice.