Implications of minimally invasive therapy.

Minimally invasive therapy (MIT) is a new approach to conditions that previously would have been treated by open surgery. It is made possible by developments in endoscopes, medical imaging and vascular catheters. Minimally invasive therapy has many implications for the health system, as it makes it possible to perform many procedures on an outpatient basis or with a short hospital stay. In addition, surgical training is not always necessary to carry out MIT procedures, which means that other specialties such as internal medicine and radiology have become involved in the field. Minimally invasive therapy has already led to conflicts between different specialties in some countries. It also is giving further stimulus to the reduction in numbers of hospital beds. On the other hand, full implementation of MIT requires attention to the system of out-of-hospital care, which generally is not prepared to monitor patients after discharge or to deal with complications that may arise. Quality of care in the out-of-hospital setting also needs attention.