八、结论
现在,非常常规的腹腔镜手术早在1990年的时候是根本不可想象的。而且,在复杂的重建手术中,机器人辅助平台的应用提高了手术操作的准确性,改善了手术结局;更重要的是,非常多的泌尿外科医师能够去做许多非常高质量的腹腔镜手术。腹腔镜和机器人辅助下的腹腔镜手术的广泛应用强调了对显微外科基础(包括气腹的生理效应、入路的获悉、并发症的处理)详细而全面的掌握的重要性。随着以后机器人和可以弯曲内镜引导技术的进步,可以看到经自然通道内镜手术(natural orifice transluminal endoscopic surgery,NOTES)的应用,可以做无肉眼可见瘢痕的手术。其好处就是更多精通腹腔镜和机器人的外科医师可以做任何手术并且没有多年前的那种大切口所导致的任何并发症;除此,将对患者进行真正的小切口治疗。上面这些,应该是外科道路探索和评估的下一步。到那时,就会实现像奥斯勒20世纪所说的“给人类带来伤害的疾病需要比它伤害更小的方法来治疗(Diseases that harm require treatments that harm less)”那样。我们也正处于通往未来的道路上。
致谢
特别感谢Dr.Robert Sowerby对这一章的辛勤付出与大力支持。
参考文献
完整的参考文献列表通过www.expertconsult.com在线获取。
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(鲍一歌 编译 魏 强 审校)