檢視微創手術的原始碼

'''微創手術（minimally invasive procedure）'''即一種較
A '''minimally invasive procedure''' is any procedure ([[surgery|surgical]] or otherwise) that is less [[invasive (medical)|invasive]] than [[open surgery]] used for the same purpose. A minimally invasive procedure typically involves use of [[Laparoscopic surgery|laparoscopic]] devices and remote-control manipulation of instruments with indirect observation of the surgical field through an [[endoscopy|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.<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=mesh&list_uids=68019060 NCBI, National Center for Biotechnology Information,  NCBI, MeSH, Medical SubHeadings, NLM, National Library of Medicine]</ref> However, the safety and effectiveness of each procedure must be demonstrated with [[randomized controlled trial]]s. 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.

==Specific procedures==
Many medical procedures are called minimally invasive, such as [[syringe|hypodermic injection]], air-pressure injection, [[subdermal implant]]s, [[endoscopy]], [[percutaneous]] surgery, [[laparoscopic surgery]], [[arthroscopic surgery]], [[cryosurgery]], [[microsurgery]], [[keyhole surgery]], [[endovascular surgery]] (such as [[angioplasty]]), [[coronary catheterization]], permanent [[vertebral column|spinal]] and [[brain]] [[electrodes]], [[stereotactic surgery]], [[Nuss procedure|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]].

==Benefits==
Minimally invasive [[surgery]] should have less operative [[Physical trauma|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 [[scar]]ring, speeds recovery, and reduces the incidence of post-surgical complications, such as [[Adhesion (medicine)|adhesions]]. Some studies have compared [[heart surgery]].<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11355122&query_hl=1 Intensive care after minimally invasive and conven...[Intensive Care Med. 2001&#93; - PubMed Result<!-- Bot generated title -->]</ref> 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.

==Risks==
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 
*Bleeding 
*Infection 
*Internal organ injury 
*Blood vessel injury 
*Vein or lung blood clotting 
*Breathing problems 
*Death (rare)<ref>[http://www.mipinfo.com/dtcf/pages/RisksAndComplications.htm “Risks and Complications"]</ref>

All of these risks are present also in open, more invasive surgery.

==Prevalence==
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.{{Fact|date=March 2007}} Other procedures, such as [[endarterectomy]], have a higher incidence of strokes in some studies.{{Fact|date=March 2007}} The first successful minimally invasive [[aortic aneurysm]] surgery was performed by Dr. [[Michael L. Marin]] at [[Mount Sinai Hospital, New York]].<ref>[http://www.mountsinai.org/Who%20We%20Are/Newsroom/Press%20Releases?citype=News&ciid=04192006 Mount Sinai Hospital In the News]</ref>

"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]].<ref>[http://www.volkerhealthcare.com]</ref> 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).

==Equipment==
Special [[medical equipment]] may be used, such as [[fiber optic]] cables, miniature [[video camera]]s 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.

== See also ==
* [[Endoscopy]]
* [[Surgery]]
* [[Anesthesia]]
* [[ASA score]] or pre-operative physical fitness
* [[Medicine]]
* [[Traumatology]]

==References==
* [http://www.nlm.nih.gov/medlineplus/ency/article/007012.htm Minimally invasive heart  surgery]. Medical Encyclopedia, MedlinePlus.
* [http://www.ctsnet.org/sections/clinicalresources/adultcardiac/cosgrove.html Minimally invasive aortic valve surgery]. CTSNet article.
* [http://www.aaos.org/wordhtml/2003news/a8-9.htm Minimally invasive surgery yields benefits]. The American Academy of Orthopedic Surgeons. Febr. 2003.
* [http://www.sciencedaily.com/releases/2005/11/051128081619.htm Minimally invasive cancer treatments highlighted]. Science Daily. Nov. 2005.
* [http://www.endocrineweb.com/minimalpara.html 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

== Notes ==
{{Reflist}}

==External links==
* [http://www.thieme.de/fz/min/ Journal of Minimally Invasive Neurosurgery]. Thiemme Verlag.
* [http://www.tandf.co.uk/journals/titles/13645706.asp Minimally Invasive Therapy and Allied Technologies]. A Taylor & Francis Journal.
* [http://www.elsevier.com/wps/find/journaldescription.cws_home/704371/description#description Journal of Minimally Invasive Gynecology]. Elsevier.
* [http://www.ismics.org/ International Society for Minimally Invasive Cardiothoracic Surgery]
* [http://www.mayoclinic.org/mininvasivesurgery-rst/ Minimally invasive surgery at Mayo Clinic in Rochester]. An useful and extensive list of endoscopic and other medical procedures performed at [[Mayo Clinic]].
* [http://www.med.nyu.edu/mininvasive/ NYU Minimally invasive solutions]. Very informative site of the [[New York University]] Medical Center.

[[Category:Medical terms]]
[[Category:Surgery]]

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