微創手術（minimally invasive procedure）即一種較 A minimally invasive procedure is any procedure (surgical or otherwise) that is less invasive than open surgery used for the same purpose. A minimally invasive procedure 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 or through a body cavity or anatomical opening. This may result in shorter hospital stays, or allow outpatient treatment. However, the safety and effectiveness of each procedure must be demonstrated with randomized controlled trials. The term was coined by John EA Wickham in 1984, who wrote of it in British Medical Journal in 1987.
A minimally invasive procedure is distinct from a non-invasive procedure such as external imaging instead of exploratory surgery.
Many medical procedures are called minimally invasive, such as hypodermic injection, air-pressure injection, subdermal implants, endoscopy, percutaneous surgery, laparoscopic surgery, arthroscopic surgery, cryosurgery, microsurgery, keyhole surgery, endovascular surgery (such as angioplasty), coronary catheterization, permanent spinal and brain electrodes, stereotactic surgery, The Nuss Procedure, radioactivity-based medical imaging methods, such as gamma camera, Positron emission tomography and SPECT (single photon emission tomography). Related procedures are image-guided surgery, robotic surgery and interventional radiology.
Minimally invasive surgery should have less operative trauma for the patient than an equivalent invasive procedure. It may be more or less expensive. Operative time is longer, but hospitalization time is shorter. It causes less pain and scarring, speeds recovery, and reduces the incidence of post-surgical complications, such as adhesions. Some studies have compared heart surgery. However, minimally invasive surgery is not necessarily minor surgery that only regional anesthesia is required. In fact, most of these procedures still requires general anesthesia to be administered beforehand.
Minimally invasive procedures are not completely safe, and some have complications ranging from infection to death. Risks and complications include the following:
- Anesthesia or medication reactions
- Internal organ injury
- Blood vessel injury
- Vein or lung blood clotting
- Breathing problems
- Death (rare)
All of these risks are present also in open, more invasive surgery.
Due to these advantages, surgeons are attempting to perform more procedures as minimally invasive procedures. Some procedures, such as gall bladder removal, can be done very effectively as minimally invasive surgery.模板:Fact Other procedures, such as endarterectomy, have a higher incidence of strokes in some studies.模板:Fact The first successful minimally invasive aortic aneurysm surgery was performed by Dr. Michael L. Marin at Mount Sinai Hospital, New York.
"Lapraroscopic surgery has been around for a long time. We've been using laparoscopy for appendectomies, for taking out gall bladders and for removing cysts on the ovaries. But it's been in very limited use for hysterectomies." Dr. Warren Volker at Volker Health Care, Nevada. Laparoscopic hysterectomy, with incisions measuring less than 10 mm, is used for less than 10% of the roughly 800,000 hysterectomies annually performed in the United States, according to the American Association of Gynecological Laparoscopists (AAGL).
Special medical equipment may be used, such as fiber optic cables, miniature video cameras and special surgical instruments handled via tubes inserted into the body through small openings in its surface. The images of the interior of the body are transmitted to an external video monitor and the surgeon has the possibility of making a diagnosis, visually identifying internal features and acting surgically on them.
- Minimally invasive heart surgery. Medical Encyclopedia, MedlinePlus.
- Minimally invasive aortic valve surgery. CTSNet article.
- Minimally invasive surgery yields benefits. The American Academy of Orthopedic Surgeons. Febr. 2003.
- Minimally invasive cancer treatments highlighted. Science Daily. Nov. 2005.
- Minimal Parathyroid Surgery. The minimally invasive technique utilizing intraoperative nuclear mapping, slso called Minimally Invasive Radioguided Parathyroidectomy, or "MIRP". EndocrineWeb. June 20, 2005.
- Kilger E, Weis FC, Goetz AE, Frey L, Kesel K, Schutz A, Lamm P, Uberfuhr P, Knoll A, Felbinger TW, Peter K. Intensive care after minimally invasive and conventional coronary surgery: a prospective comparison. Intensive Care Med. 2001 Mar;27(3):534-9. PMID 11355122
- Journal of Minimally Invasive Neurosurgery. Thiemme Verlag.
- Minimally Invasive Therapy and Allied Technologies. A Taylor & Francis Journal.
- Journal of Minimally Invasive Gynecology. Elsevier.
- International Society for Minimally Invasive Cardiothoracic Surgery
- Minimally invasive surgery at Mayo Clinic in Rochester. An useful and extensive list of endoscopic and other medical procedures performed at Mayo Clinic.
- NYU Minimally invasive solutions. Very informative site of the New York University Medical Center.