The increasing complexity of Minimally Invasive Therapy and surgery re
quires the transformation and application of classic systems theory. T
he basic tools of systems analysis and design are essential to realize
technology that functions in a co-ordinated fashion to ensure a safe,
smooth and precise execution of interventions or operations on a huma
n being. The paper describes the basic classification of systems and o
utlines the speculative structure of an MIT Operating System (MITOS) f
rom the medico-technical point of view. Future developments such as re
mote handled telepresence surgery and CT/MR image-guided surgery are i
ncluded in the perspective.