外科综合微创理论初探

Initial investigation of comprehensive minimally invasive surgery

影像介入、腹腔镜、内镜、医学机器人辅助等微创外科技术已成为目前微创外科技术的主流。然而,微创概念不清、评价标准缺乏,导致目前微创外科存在诸多弊端。笔者查阅国内外文献,结合临床现状,提出外科综合微创理论。该理论包含预防微创、诊断微创和随访微创等内容,并在外科综合微创的全体、全面和全程的“三全”原则基础上,设立评价外科综合微创的转归、并发症、时间和费用4级评价标准,从临床实践和理论层面为微创外科提供全面、切实、可行的理念和标准,旨在为规范微创操作,解决微创外科存在的问题作出尝试。

Surgical minimally invasive techniques such as image intervention,laparoscopy,endoscopy,and assisted medical robotics have become the mainstream of minimally inva⁃sive surgery(MIS).However,the vague concept,diverse mis⁃understanding,and the lack of standards have led to a lot of malpractice in current MIS.Based on the analysis of the clinical situation and the domestic and foreign literatures,the authors have put forward the theory of comprehensive minimally invasive surgery(CMIS),and established the concepts of minimally invasive prevention,minimally invasive diagnosis and minimally invasive follow⁃up in the view of hepatobiliary surgery.The authors have proposed“three⁃All”principles of all personnel,all aspects and all processes,and established a comprehensive four⁃level criteria of outcomes,complications,time and costs for CMIS,in an attempt to provide feasible and practical concepts and standards for MIS from a clinical practice and theoretical level,with a view to standardizing minimally invasive procedures and solving the problem of MIS.