Garey Carissa L, Laituri Carrie A, Ostlie Daniel J, St Peter Shawn D
Department of Pediatric Surgery, Center for Prospective Clinical Trials, Children's Mercy Hospital, Kansas City, Missouri, USA.
J Laparoendosc Adv Surg Tech A. 2010 Jun;20(5):503-6. doi: 10.1089/lap.2009.0394.
Laparoscopic surgery has become the standard approach for most thoracic, abdominal, and pelvic procedures in adults and children. We now know that laparoscopy has proven benefits; however, at its introduction, laparoscopy was adopted without appropriate clinical evidence to justify the approach as an alternative to open surgery. In continued efforts to increase the benefits of minimally invasive surgery to their patients, surgeons have innovated new techniques to further decrease the impact of the operation on patients. These innovations range from decreasing the size of ports and instruments to the current group of techniques termed "scarless" surgery. In the current era of evidence-based medicine, it is the surgeon's responsibility to prove that the benefits outweigh the risk before new techniques are widely applied to patients. This article seeks to review the history of laparoscopic surgery, apply lessons learned to the evolution of single-incision laparoscopic surgery, and make a statement urging for sound prospective evaluation.
腹腔镜手术已成为成人和儿童大多数胸、腹及盆腔手术的标准术式。我们现在知道腹腔镜手术已被证明具有诸多益处；然而，在其引入之时，腹腔镜手术是在缺乏恰当临床证据证明其可替代开放手术的情况下被采用的。为了持续提高微创手术给患者带来的益处，外科医生创新了新技术以进一步降低手术对患者的影响。这些创新涵盖从减小切口和器械尺寸到当前被称为“无瘢痕”手术的一系列技术。在当前循证医学时代，外科医生有责任在新技术广泛应用于患者之前证明其益处大于风险。本文旨在回顾腹腔镜手术的历史，将所吸取的经验应用于单切口腹腔镜手术的发展历程，并发表声明敦促进行合理的前瞻性评估。
