Integrated Advances in Minimally Invasive Surgery: Ergonomics, Visualization, and Artificial Intelligence in Modern Laparoscopy

Minimally invasive surgery has undergone significant transformation with the emergence of next-generation laparoscopy, characterized by the integration of ergonomic optimization, advanced visualization technologies, and intelligent assistance systems. This review aims to analyze the current state and future perspectives of laparoscopic surgery through these three core domains, emphasizing their combined impact on surgical performance, intraoperative safety, and clinical outcomes. A narrative review of high-impact literature published from 2020 onward was conducted, focusing on technological advancements and their application across diverse healthcare settings. The findings indicate that ergonomics remains a critical factor influencing surgeon performance and long-term sustainability, while innovations in visualization—such as three-dimensional imaging and fluorescence guidance—enhance spatial perception and operative precision. Additionally, the incorporation of artificial intelligence is redefining surgical workflows by enabling real-time analysis, safety assessment, and decision support. Despite these advances, disparities in access and implementation persist, particularly in middle-income regions such as Mexico, Colombia, and Ecuador. The evidence suggests that a progressive and context-adapted integration of these technologies is essential to ensure both innovation and accessibility. Ultimately, next-generation laparoscopy represents a shift toward a more integrated, data-driven, and human-centered surgical paradigm.