Abstract
Minimally invasive general surgery (MIGS) encompasses a broad spectrum of contemporary operative techniques and technologies, including laparoscopy, robotic assistance, novel access approaches, advanced energy platforms, enhanced imaging, and emerging digital tools. This narrative review, conducted through a structured literature search of major medical databases, critically examines the evolution of these innovations and their impact on surgical practice, patient outcomes, and healthcare systems. Evidence from randomized controlled trials, meta-analyses, and large observational studies published over the past decade indicates that MIGS is generally associated with reduced postoperative morbidity, shorter hospital stay, reduced postoperative pain, faster functional recovery, improved cosmetic outcomes, and enhanced patient-reported quality of life compared with open surgery. However, important limitations persist, including heterogeneity in study design, limited long-term outcome data for emerging technologies, steep procedural learning curves, and disparities in global access. Particular emphasis is placed on the incorporation of artificial intelligence (AI), machine learning (ML), and simulation-based training, which hold the potential to enhance operative precision and accelerate skill acquisition but require rigorous validation and ethical oversight. Cost-effectiveness and international dissemination remain central concerns, underscoring the need for scalable innovations and standardized training models to achieve equitable adoption. Sustainable advancement in MIGS will depend on rigorous evidence generation, structured training pathways, cost-conscious implementation, and policies that promote equitable access across healthcare systems.