OBJECTIVES: To assess the impact of six minimally invasive surgical technologies on worker absenteeism. METHODS: Using national health insurance claims data (Thomson-Reuters MarketScan Commercial Database) and matched data on workplace absence and short-term disability (MarketScan Health and Productivity Database), we identified 37,495 patients aged 18-64 with employer-sponsored health insurance who underwent either conventional or minimally invasive surgery during 2001-2008 for ischemic heart disease (n=18,184), uterine fibroids (n=12,795), prostate cancer (n=3,466), peripheral vascular disease (n=1,856), aortic aneurysms (n=245), or carotid disease (n=949).  Our primary endpoint was total days absent from work, measured as the patient-specific difference between days absent during the baseline period (-380 days to -15 days from procedure date) and the perioperative and post-operative periods (-14 days to + 352 days) to account for individual-specific illness burden and propensity to use medical care.  We studied the similarly-constructed secondary endpoint of the inflation-adjusted sum of (a) the dollar value of work absences (valued at $344/day for sick/vacation and $241/day for short-term disability based on prior studies) and (b) the dollar value of health plan expenditures for medical care.  Propensity scores were constructed using year of surgery, patient age, gender and Elixhauser comorbidities.  RESULTS: Minimally invasive surgery was associated with fewer unadjusted days of workplace absence, on average, for prostate cancer (-4.3 days), uterine fibroids (-11.4 days), peripheral vascular disease (-11.9 days), aortic aneurysms (-20.2 days), and ischemic heart disease (-26.0 days) (p<0.001 for all comparisons).  Absences were not significantly different by surgical approach for carotid disease.  The unadjusted sum of the dollar value of absences and medical care spending was lower for minimally invasive surgery for uterine fibroids (-$1,512, p=0.01), aortic aneurysms (-$18,876, p=0.06) and heart disease (-$33,746, p<0.001).  Results were comparable after propensity score adjustment.  CONCLUSIONS: Minimally invasive procedures frequently reduce worker absenteeism by substantial amounts.