Minimally invasive surgical proceures avoid open invasive surgery in favor of closed or local surgery with less trauma. These procedures involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device, and are carried out through the skin or through a body cavity or anatomical opening. This may result in shorter hospital stays, or allow outpatient treatment. However, the safety and effectiveness of each procedure must be demonstrated with randomized controlled trials. The term was coined by John EA Wickham in 1984, who wrote of it in British Medical Journal in 1987.