The concept of minimally invasive medicine in general surgery?

  The concept of minimally invasive medicine is a medical idea that integrates the concept of minimally invasive and minimally invasive humanities. Minimally invasive surgery is guided by the concept of minimally invasive medicine, which has transformed from the concept of technology to the concept of service. It represents the humanistic concept of “people-oriented” and is the concrete embodiment of the new medical model of “biology-society-psychology”, the essence of which is to cure diseases or relieve pain with the smallest possible trauma. Compared with traditional surgical methods, MIS pays more attention to the protection of the lesion area and its surrounding tissues, avoids or minimizes systemic reactions, reduces the occurrence of complications, shortens the treatment time, and enables patients to recover as soon as possible. In short, MIS is to exchange the best treatment results for the least additional local and systemic damage.  From the biological point of view, open surgery is just more unavoidable incisional scars, but from the socio-psychological point of view, the psychological trauma caused by incisional scars is eternal. Minimally invasive surgery is not the same as small incisions, but most minimally invasive surgery is done with small incisions or even percutaneous puncture, which involves a conceptual change of surgical procedures. This involves a change in the concept of surgical procedures. The principle of “large incision and full exposure” emphasized in previous surgical procedures has been changed, not to mention that for some areas, such as retroperitoneum and subdiaphragm, it is difficult to clearly reveal the whole picture of the lesion even if the incision is large. The visualization technology based on modern endoscopic (flexible/rigid) equipment and image technology has solved the contradiction between the previous surgical incision and exposure, so that the surgeon can clearly see the lesion and its surrounding structures even if it is a “forbidden area”, thus achieving the surgical purpose safely, accurately and with ease.  Minimally invasive surgery includes: 1) endoscopic techniques; 2) lumpectomy techniques; 3) interventional techniques (both radiological and non-radiological); 4) other techniques (radiofrequency treatment of solid tumors). While related to general surgery is lumpectomy minimally invasive surgery, endoscopic minimally invasive surgery. Specifically, laparoscopic techniques, NOTES and NOTUS. Nowadays, laparoscopic cholecystectomy (LC) has become the gold standard for the treatment of gallbladder stones, and laparoscopic techniques are not only applied to general surgery diseases such as liver and gallbladder, spleen, gastrointestinal, pancreatic, thyroid (parathyroid) gland and hernia, but also rapidly extended to gynecology and urology. As far as general surgery is concerned, laparoscopic surgery has expanded into various fields. It has replaced the traditional surgical approach in the treatment of certain benign diseases. In the treatment of early-middle malignant tumors, a large number of animal experiments and clinical studies at home and abroad have shown that laparoscopic surgery does not increase the incidence of tumor dissemination, and at the same time can conform to the principle of radical tumor treatment and completely achieve the same efficacy as traditional surgical treatment, with no special impact on the postoperative survival time and disease prognosis of patients. And laparoscopic surgery has incomparable superiority in terms of less trauma, faster recovery and shorter hospitalization time than traditional surgery. Nowadays, laparoscopic colorectal tumor resection has been popularized worldwide, and laparoscopic techniques have been gradually applied in clinical practice for early to mid-stage gastric cancer, liver cancer and small intestine malignancy.