微创外科技术在胰腺外科中的应用与发展

The application and development of minimally invasive surgery in pancreatic surgery

微创外科是现代科技发展与外科创新结合而形成的一种新的医学理念,其目的是以最小的损伤达到最佳的外科治疗效果。随着现代医学的发展,人们对健康和美容提出了更高的要求。而医学和相关学科的相互融合和快速发展,尤其是内镜、腔镜和介入治疗等新技术的出现,更是推动了微创外科技术的广泛应用和不断发展。腹腔镜技术作为微创外科的一项重要技术,其应用和发展尤为迅速。自1987年首例腹腔镜胆囊切除术开展以来,腹腔镜手术在普外科的各个领域得到了广泛应用并取得良好的手术效果。然而由于胰腺解剖位置和毗邻关系的复杂性,腹腔镜胰腺手术的开展远远落后于胆道和胃肠等腹腔其他脏器的微创手术,其发展亦相对滞后。随着腹腔镜技术的不断提高和腔镜器械的不断改进,手术显像技术由平面二维显像技术发展为三维立体显像技术,腹腔镜手术的灵活性和清晰度大大提高,胰腺外科的大多数手术已均可在腹腔镜下完成,手术方式也逐渐由腹腔镜辅助手术发展为全腹腔镜手术。目前达芬奇机器人手术系统已开始应用于胰腺外科手术,手术操作也更趋向于精准化。经自然腔道的内镜手术的手术创伤更小,有望于胰腺外科开展应用。

Minimally invasive surgery is a new medical concept,which combines the development of modem science and technology and the innovation of surgery. The goal of invasive surgery is to achieve the best effect of surgery with minimal damage. With the development of modem medicine, people put forward higher requirements for health and beauty. The integration and rapid development of medicine and the related disciplines promote the wide application and continuous development of minimally invasive surgical techniques. Laparoscopic technique, as one of the most important techniques in minimally invasive surgery, is applied and developed rapidly. Since the first laparoscopic cholecystectomy was carried out in 1987, laparoscopic surgery has been widely used in various fields of abdominal surgery and achieved good results. However, due to the complexity of the pancreatic anatomic location and adjacent relationship, the development of laparoscopic pancreatic surgery is far behind the minimally invasive surgery of other abdominal organs such as the biliary tract and gastrointestinal tract. With the improving of laparoscopic surgery and endoscopic equipment, surgical imaging by a two dimension replaced by a three dimension imaging technology, the flexibility and clarity of laparoscopic surgery is greatly improved. And most of the pancreatic surgery has been Ifinished in laparoscopic surgery. Laparoscopic assisted surgeryis also gradually developing into total laparoscopic surgery. At present, Da Vinci robotic surgery system has been applied to pancreatic surgery, and the operation is more accurate. Endoscopic surgery with natural orifice is less invasive and is expected to be used in pancreatic surgery.