الفهرس 
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Abstract
Change is part of surgery but it is never easy to accept. At the dawn of surgery, excellence was associated with big incisions: “Big scar, big surgeon.” Surgery with no scars was an impossible reverie. The introduction of the first laparoscopic cholecystectomy by Eric Muhe in 1985 was a corner-stone in the evolution of the surgical practice. Since that date, the concepts of surgery have changed and surgeons started to accept the idea of small incisions and role of laparoscopy in surgery.
Laparoscopy started to take the lead in many surgical practices driven by continuous developments and innovations in the equipments and instruments and creating novel techniques and approaches to perform various surgeries.
New techniques are arising and developing aiming at improving the outcomes of surgery and making the surgical procedures easier as much as possible.
Single Incision Laparoscopic Surgery (SILS) is gaining popularity nowadays as a surgical technique providing good and applicable surgical practice with the least unfavorable outcomes possible and minimal scaring in spite of its technical challenges regarding crowding of instruments and lack of triangulation.
Minilaproscopy is the natural evolutionary step in the history of laparoscopy concerning minimizing the incision size and decreasing the operative scars to the least possible. It is considered a transitional zone between conventional laparoscopy and advanced endoscopy. However, its advantages are still controversial.
Robotic Surgery is another technique which started to be accepted and practiced in many centers worldwide for multiple surgeries relying on its precision, comfortable atmosphere of work and excellent outcomes although it has some limiting factors mainly the high cost comparing to conventional and laparoscopic surgeries and the slow learning curve. Of course, Leaders of minimally-invasive surgeries will work to decrease such limitations and improve robotic surgical procedures.
Natural Orifice Translumenal Endoscopic Surgery (NOTES) is considered the novel revolution in minimally-invasive surgery. It represents the true “scarless” surgery. NOTES has been used and described by many surgeons in the recent years. However its technical difficulties concerning slow learning curve, lack of adequate experience and well developed instruments hinder its widespread and acceptance by the community. But as a new technique, it is expected that it will gain the targeted popularity in the upcoming years with the continuous innovations and improvements in the surgical field.
The last chapter in minimally-invasive surgery hasn’t been written yet. “Surgery is going digital”. “It’s no longer about blood and guts but bits and bytes. What might be a bit troubling, though is that the [first part] of the progress curve seems long and flat. But, that’s how it’s been with so many other big advances.” Thomas M. Krummel, chair of the Department of Surgery at Stanford University School of Medicine and a pioneer of robotic surgery.