What is minimally invasive surgery

  There are three main methods of lung cancer surgery: 1) traditional “large incision” surgery, 2) “minimally invasive small incision” surgery, and 3) thoracoscopic surgery.  Traditional “large incision” surgery: It means cutting the skin of the back of the chest, from between the inner scapula and the spine, around the lower corner of the scapula, the lateral chest wall, to below the nipple of the anterior chest wall, forming an “S” shaped incision about 40-50 cm long; further cutting the latissimus dorsi muscle and other four major muscles of the chest back. The four major muscles of the thoracic back, including the latissimus dorsi muscle, are the most important muscles governing the activities of the upper limbs of the body and the most important muscles used in human labor and weight-bearing work.  During surgery, the operator’s hands, even the operator and a helper combined “two hands”, can be put into the thoracic cavity at the same time, the space is open, traumatic, is the longest incision, the largest, the largest damage, such as cranial, head and neck, abdominal, urological, orthopedic and other human surgical procedures, is the most cruel large incision in surgery It is the most brutal incision in surgery.  It is also translated as “standard posterior lateral incision”, which has been used for a long time as the “standard” incision for chest surgery, and is suitable for almost all open-heart surgeries. The disadvantages are self-explanatory.  Thoracoscopic surgery: With the help of a TV camera system, a thoracoscope equipped with a TV camera lens is inserted into the chest cavity and the image of the chest is projected on the TV screen. Outside the chest cavity, the surgeon operates the special surgical instruments that are inserted into the chest cavity to complete the surgical operation.  Compared with traditional surgery with a large incision, the incision for thoracoscopic surgery is significantly smaller, as long as the operating instruments can be inserted and the removed lung lobes can be removed. Depending on the size of the incision and whether or not the rib cage is opened, there are two types of surgery: “thoracoscopically assisted small incision surgery” and the so-called “full thoracoscopic surgery” in which the surgery is performed through several small incisions. The number of small incisions is divided into “thoracoscopically assisted small incision surgery” and “full thoracoscopic surgery”.  The total length of each small incision is about 10 cm, for example, one 3 cm, plus three 2 cm; even smaller. If the incision is too small, it will be difficult to remove the lobe after lobectomy, and even after the surgery is done, the incision has to be enlarged to take the lobe, then it is really a small incision for the sake of small incision.  Disadvantages: The surgery is expensive and requires special equipment, special and expensive disposable instruments; difficult lymph node dissection.  ”Minimally invasive small incision” surgery: It refers to the use of a small incision about 10 cm long in the lateral chest wall, which is free, protected, and does not cut the chest wall muscles such as the latissimus dorsi muscle, and does not need to cut the ribs, so that such a small surgical incision can complete the “traditional large incision surgery”. In other words, we can perform both lobectomy and mediastinal lymph node dissection, which is a minimally invasive surgery without the use of thoracoscope. Without the convenience of a large incision, the hand cannot reach into the chest cavity; without the convenience of television thoracoscopic illumination and magnification monitoring, all rely on the naked eye to complete the operation under a small incision, the difficulty of the operation obviously increased exponentially. However, it is obviously minimally invasive, with fast recovery and good recovery; and it can achieve the same degree of lymph node dissection as “large incision surgery”.  Disadvantage: the application of conventional surgical instruments makes the operation significantly more difficult.  In short, minimally invasive thoracic surgery includes thoracoscopic surgery and “minimally invasive small incision” surgery. The Lung Cancer Center carries out minimally invasive surgery, that is, “thoracoscopic” surgery, and on this basis, further carries out “minimally invasive surgery without thoracoscope”, that is, “minimally invasive small incision without muscle or rib, minimally invasive lung cancer radical surgery”. The procedure is a minimally invasive surgery without the use of a thoracoscope.