Rudiman Reno
Digestive Surgeon, Division of Digestive Surgery, Department of General Surgery, School of Medicine, Padjadjaran University, Hasan Sadikin General Hospital, Bandung, Indonesia.
Ann Med Surg (Lond). 2021 Oct 8;71:102922. doi: 10.1016/j.amsu.2021.102922. eCollection 2021 Nov.
The improvement of the science and art of surgery began over 150 years ago. Surgical core tasks, "cutting and sewing" with hand and direct contact with the organs, have remained the same. However, in the 21st century, there has been a shifting paradigm in the methodology of surgery. The joint union between innovators, engineers, industry, and patient demands resulted in minimally invasive surgery (MIS). This method has influenced the techniques in every aspect of abdominal surgery, such as surgeons are not required to direct contact or see the structures on which they operate. Advances in the endoscope, imaging, and improved instrumentations convert the essential open surgery into the endoscopic method. Furthermore, computers and robotics show a promising future to facilitate complex procedures, enhance accuracy in microscale operations, and develop a simulation to improve the ability to face sophisticated approaches. MIS has been replacing open surgery due to improved survival, fewer complications, and rapid recoveries in recent years. Minimally invasive surgery's further research in diagnostic and therapeutic modalities is under investigation to achieve genuinely "noninvasive" surgery. Thus, MIS has gained interest in recent days and has been improving with promising outcomes.
外科学的科学与技术进步始于150多年前。外科手术的核心任务,即手工进行“切割与缝合”并直接接触器官,一直未变。然而,在21世纪,外科手术方法出现了范式转变。创新者、工程师、产业界和患者需求之间的联合促成了微创手术(MIS)。这种方法影响了腹部手术各个方面的技术,例如外科医生无需直接接触或看到他们所操作的结构。内窥镜、成像技术的进步以及器械的改进将基本的开放手术转变为内窥镜手术方法。此外,计算机和机器人技术在促进复杂手术、提高微观手术的准确性以及开发模拟以提升应对复杂手术方法的能力方面展现出广阔前景。近年来,由于生存率提高、并发症减少以及恢复迅速,微创手术一直在取代开放手术。目前正在对外科手术在诊断和治疗方式方面的进一步研究进行探索,以实现真正的“无创”手术。因此,近年来微创手术受到了关注,并取得了令人期待的进展。