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مركز جراحة الحدّ الأدنى

مركز جراحة الحدّ الأدنى

Generally speaking, a ‘surgery’ has been typically associated with operations such as opening up and sewing up skin. The surgical scar remaining after recovery and the post-operative pain were rather considered unavoidable with the previous surgery. Additionally, it took quite some time for the patient to return to their daily life after the surgery. These problems have been pointed out as the surgical demerits regardless of prognosis of the disease itself when performing a surgery for treatment of a disease. Thus, 'Minimally invasive surgery (MIS),' which is opening up skin partially with relatively less post-operative pain compared to the previous operation, has become a trend. Such a surgical method could be represented as a laparoscopic or endoscopic surgery in the area of surgery. For the merits of a laparoscopic surgery, it is known to have excellence in cosmetic perspective because of less surgical sounds compared to laparotomy, reduction in post-operative pain, reduction of hospitalization period, and early return to society. Furthermore, according to a recent report, it is known that there is a positive result in the prognosis with less reduction in immunity even while performing a radical operation identical to laparotomy in a surgery for cancer. In general, a device called 'endoscope' is divided into the laparoscope, thoracoscope, arthroscope, and hysteroscope according to the application site, and the surgery using these devices is commonly called an 'endoscopic surgery.'
Actually, there are several hospitals in which endoscopic surgeries are performed in Korea, but there are not many with the large-scale facilities at centers for endoscopic surgeries. Since the opening of CNUHH, under the slogan of advanced medical care, MIS has been performed at nearly all departments by establishing the MIS Center, with 3 rooms for laparoscopic/endoscopic surgery and 4 movable equipments within the operation room. At the Department of Surgery, a laparoscope is mostly used for Cholelithiasis and spleen surgery, adrenal gland surgery and acute appendicitis, and also for colon surgery, gastric surgery and thyroid surgery including colon cancer, where an endoscope and a laparoscope are used. An endoscope is also used in most gynecological and urological surgeries, and for most joint surgeries among orthopedic surgeries, an arthro endoscope is used.
Recently the high-tech robotic surgical system (da Vinci) was introduced to CNUHH, which enables to perform with perfection a more precise, minimally invasive surgery than endoscopic operations. It performs a surgery by remote control from an operator using the robotic arm, away from laparoscopic surgery in which an operator performs the surgery directly next to the patient. It is possible to perform a surgery without injuring the fine vessel or nerve of the tissue since it could reduce the operator’s hand tremor, and enlarge the operation view with the naked eye up to 10 times at maximum.
Then, it raises the question whether this endoscopic/laparoscopic surgery or robotic surgery could be safely performed even in the surgery for cancer patients. In the past, it was commonly believed that a large incision and definite elimination are necessary in the surgery for cancer. The answer to this question has already been confirmed in several books. In studies on a large number of patients, it is recorded that MIS like endoscopic/laparoscopic surgery on cancer patients have an equivalent or even superior record compared to the previous laparotomy and invasive surgery because it eliminates the tumor tissue more delicately and precisely than observing with the naked eye using the high-tech medical apparatus.
In conclusion, MIS has replaced the previous laparotomy in the surgery for cancer patients, and it is to be more widely used in theuture. Additionally, a robotic surgery in which the area of cancer is eliminated without an error by a robot after an order from a surgeon is to be in much more demand in the future instead of the previous platform in which a surgery is performed by a human.