Minimally Invasive Cardiac Surgery: Principle and Prospects
Minimally Invasive Cardiac Surgery: Principle and Prospects
复制标题
微创心脏手术：原理与前景
DOI：
10.1007/s005950050225
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发表时间：
1998
期刊：
影响因子：
2.5
通讯作者：
H. Matsuda
中科院分区：
文献类型：
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作者：
H. Matsuda
最近在外科领域取得的显著进展之一是微创手术或微创方法的引入。1自从在过去几年中在腹部手术中引入腹腔镜胆囊切除术以来，这一概念一直在发展。这种使用内窥镜支持的新方法现已广泛应用于包括其他外科亚专科在内的各个领域。在胃肠道手术中，方法和目标也扩展到胃肿瘤和肠道病变。1，2大多数外科医生最初的反应似乎是不情愿的，因为手术的经典概念是在直视下进行安全和一致的手术，而不考虑切口大小或侵入程度。外科临床实践的革命性变化的新时代必须离开允许外科医生使用他们想要的任何侵入性方法的传统态度。在胸外科领域，内窥镜手术（胸腔镜方法）在气胸、孤立性良性肺肿瘤和纵隔肿瘤切除术中也变得流行。3这种策略现在也已扩展到从动脉导管未闭结扎开始的心血管手术。4微创手术的概念也扩展到心内手术，如瓣膜病变、房间隔缺损（ASD）、和其他简单的先天性缺陷以及冠状动脉搭桥术。因此，巨大的变化
One of the most recent remarkable advances in the field of surgery is the introduction of less invasive surgery or a minimally invasive approach.1 This concept has been developing since the introduction of laparoscopic cholecystectomy in abdominal surgery over the last several years. This new approach using endoscopic support has now spread widely to various fields including other surgical subspecialities. In gastrointestinal surgery, the approach and targets have also been expanded to gastric tumors and intestinal lesions.1,2 The initial response by most of the surgeons appeared to be reluctance because the classic concept of surgery had been to perform safe and consistent procedures with direct vision without considering the size of the incision or the degree of invasiveness. The new era of revolutionary change in the clinical practice of surgery has to depart from the classic attitude that surgeons are allowed to use any invasive approach they desire. In the field of thoracic surgery, endoscopic procedures (the thoracosocopic method) have also become popular for pneumothorax, solitary benign pulmonary tumors, and mediastinal tumor resection.3 This strategy has now also been extended to cardiovascular surgery starting from ligation of patent ductus arteriosus.4 The concept of minimally invasive surgery is also spreading to intracardiac surgery such as for valvular lesions, atrial septal defect (ASD), and other simple congenital defects as well as for coronary bypass. Therefore, tremendous changes