微创外科

微创外科

Minimally Invasive Surgery (MIS) is any procedure (surgical or otherwise) that is less invasive than open surgery for diagnostic and therapeutic purpose. It typically involves 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, a body cavity or anatomical opening.

微创外科是指用于诊断及治疗、创伤低于开放性手术的任何手术方法，它借助内窥镜或其他类似器械间接观察术野，运用腹腔镜等摇控操作手术器械，通过皮肤、体腔或其他解剖口完成手术。

In traditional open surgeries, a surgeon needs to make a large incision in order to operate. With MIS, the surgeon makes a few small holes--usually less than 1/2 an inch. The surgeon then inserts specially designed, thin instruments and sophisticated video equipment to perform the operation through the smaller opening.

在施行传统开放性手术时，外科医生所作的手术切口很大，而微创手术切口却不到1/2英寸。外科医生经由这些小切口将一些专门设计的细长器械和尖端视频设备插进手术部位，完成手术。

Benefits

优点

Minimally Invasive Surgery (MIS) techniques offer patients many benefits over traditional surgeries. They include:

与传统手术相比，微创外科好处较多，包括：

Less Pain

痛苦小

MIS procedures cause less post-operative pain and discomfort and require smaller doses of pain relievers than patients undergoing traditional surgeries.

微创外科引起的术后痛苦和不适较小，止痛药用量小于传统手术患者。

Shorter Hospital Stay

住院时间缩短

Patients who undergo MIS procedures are usually able to go home sooner. And, in many cases, the patient is able to return to normal activities and work more quickly.

一般情况下，MIS病人很快就可回家，且多数情况下，病人可更快地恢复正常活动和工作。

Less Scarring

手术疤痕少

MIS procedures require smaller incisions--which means smaller, less noticeable scars. The scars that do form as a result of MIS typically have a less jagged edge--giving them a more appealing look.

MIS手术切口小，也就是说，手术造成的疤痕更小更不显眼。即使有，也只是一点点锯齿线，外观更加美观。

Less Injury to Tissue

组织损伤小

Most traditional surgeries require a long incision. This incision usually has to be made through muscle. Muscle needs a significant time to heal after surgery. Because there are no long incisions in MIS, surgeons often do not have to cut through muscles to complete the procedure--leading to less tissue damage and quicker recovery.

多数传统手术切口都很长，且通常要穿透肌肉，肌肉的术后恢复所需时间长。MIS手术无长切口，作手术时外科医生也无需切断肌肉，因此，组织破坏少，恢复快。

Higher Accuracy Rate

精确度更高

Because MIS procedures use video-assisted equipment, the surgeon has better visualization and magnification of internal organs and structure. For patients, this translates into a more accurate and definitive procedure.

MIS采用视频辅助装置，通过放大，外科医生对内部器官及结构看得更清楚，对病人而言，这就意味着手术操作更加精确到位。

Disadvantages

缺点

On the other hand, there exist some important disadvantages for the surgeon, too. These include:

l          restricted vision

l          difficult handling of the instruments

l          very restricted mobility

l          difficult hand-eye coordination

l          no tactile perception

另一方面，微创外科对外科医生的限制也较多，主要有：

视野受限

器械操作难度增加

手眼协调难

无触摸感

Examples

举例

This is an example of minimally invasive surgery – laparoscopic cholecystectomy (gall bladder removal). The endoscopic camera is put in the abdomen through the navel, the instruments through small incisions with approximately 5-15 mm diameter. In the upper left corner, the endoscopic view is displayed.

下图为微创外科手术图例－腹腔镜胆囊切除术。内镜照相机经由脐部插入腹中，器械由几个约5-15 mm大小的切口插入。左上角显示的是内镜视图。