Surgery is the art under the scalpel, and by nature, it is the removal of physical pain through acceptable trauma. In order to make this acceptable trauma smaller and smaller, surgeons have not stopped pursuing minimally invasive surgery since its inception. In modern conditions, every patient wants the most minimally invasive treatment. This places an objective demand on the surgeon. So what is minimally invasive? How can a surgeon be minimally invasive?
Minimally invasive is actually a relative concept. Simply put, it means to obtain the maximum benefit for the patient’s health with the minimum cost. For example, for a patient with a huge meningioma, without surgery, the surgeon will certainly not cause trauma to the patient, but the patient’s tumor will not be treated. This should not be in line with the minimally invasive concept. Then, it is also not in line with the minimally invasive concept to cut the occupancy completely, but let the patient’s neurological function be severely damaged or even pay the price of life. Minimally invasive means that the doctor is required to remove the tumor to the maximum extent possible according to the patient’s condition and actual situation, while trying to ensure the patient’s safety.
In order to be minimally invasive, the first objective requirement is for the doctor to have a very deep understanding of the disease the patient is suffering from. The same disease can be very different from patient to patient. Just like the same four-legged cat, but you would be hard pressed to find two cats that look exactly the same. It is also very difficult for you to meet two patients with the exact same condition for the same disease. Therefore, only with a deep understanding of the pathological nature of the disease is it possible to provide an individualized treatment plan for each individual patient and to minimize the trauma of treatment.
Secondly, a good doctor must have excellent skills. Modern minimally invasive neurosurgery is based on the development of microscopic neurosurgery. It is difficult to say that a neurosurgeon who does not know how to apply a microscope can make the surgery minimally invasive. And learning to apply the microscope is not as simple as just having a microscope, but only after rigorous training in operating under the microscope. Only through training can a surgeon become comfortable under the microscope. This also provides the technical assurance to achieve one’s ideal surgical operation.
Once again, the treatment process of the disease will involve many departments and many medical personnel. For example, the receiving physician, the treating physician, the main surgeon, the surgical assistant, the anesthesiologist, the supervising nurse and many other related auxiliary medical personnel, only when these people are organically integrated and collaborate, can various possible risk factors be eliminated in the bud, and the patient will be safe. Therefore, a united and collaborative team is a condition that cannot be ignored to ensure minimally invasive disease treatment. The above is to understand the requirements of minimally invasive treatment from the human point of view. From the physical point of view, there must be enough external conditions to support a good team to accomplish their ideal surgical treatment; bare hands will certainly not do the surgery. This is what the people often call the support of hardware and equipment. In fact, in addition to the above factors, the “Buddha’s heart” of the doctor is also the key to make “minimally invasive” the best!
The above is my superficial understanding of the modern concept of minimally invasive neurosurgery. I hope that through our efforts, neurosurgery will become more and more minimally invasive!