Influences on the introduction and use of minimally invasive therapies in Australia

Minimally invasive therapies (MIT), developed as alternatives to open surgery, offer the promise of reduction in morbidity and mortality, quicker return of patients to their normal activities and lower overall costs to society. However, minimally invasive therapies cause concern in that their comparative advantage over older methods may not always be well defined, their introduction may result in additional costs and reorganization for the institutions where they are used, and achieving adequate training of all who use them may not be easy. In this paper, the Australian experience in the introduction and assessment of some MIT is considered to illustrate a number of the issues facing those who use and fund such methods. Examples include both high capital cost technologies, such as shock wave lithotripsy and stereotactic radiosurgery, and less expensive techniques such as laparoscopic surgery.