1. The ratio of the cut wound and the wound of the operation itself: the larger the ratio of the cut-off wound and the intrinsic wound, the greater the value of laparoscopic surgery, such as cholecystectomy, spermatic vein ligation, etc. surgery.
2. Selection of surgical types: Surgery can be roughly divided into simple resection, simple reconstruction and resection + reconstruction. Surgery for simple resection such as gallbladder, gastric vagus nerve resection, most gynaecological surgery, most urologic surgery; reconstructive surgery such as hernia repair, perforation of the digestive tract, fundoplication, biliary gut, and gastrointestinal short-circuit surgery . Choosing these two types of laparoscopic surgery due to traditional procedures such as large blockages and small operations will highlight its superiority. The third type of surgery requiring resection + reconstruction, such as partial resection of the stomach, colon resection, and pancreatoduodenectomy, is required to restore the continuity of the digestive tract, although people at home and abroad have explored such laparoscopic surgery, but It is difficult to expand and popularize due to the fact that the minimally invasive strengths are not prominent and the cost of surgery is high. In addition, the more traditional open surgery (such as pelvic cavity, dome surgery) that is difficult to expose in narrow cavities and difficult to operate, the more it can show the superiority of laparoscopic surgery, the extension of pictures, and the advantage of long rods for fine operation. .
3. Differentiation of surgical indications: Surgical treatment of the disease is nothing more than tumors, inflammation, wounds, deformation four categories. Laparoscopic surgery to treat patients with malignant tumors is the primary focus of debate. Most scholars think that early stage malignant tumors can still be explored, but the patients in the middle and advanced stages must first ensure their complete cure, just as the surgical maxims of the Chinese surgical surgeon and Professor Fazu's exhort their advisors, namely: the complete cure of malignant tumors such as the throne, any The improvement of the way is nothing more than a crown. Recent experimental studies indicate that pneumoperitoneum may promote the handling and dissemination of malignant tumors. Even those patients with benign diseases that meet laparoscopic guidelines should realistically select the customary force based on the surgeon’s laparoscopic skills. Surgical habits and contraindications are both relative patients and relative surgeons. Under the guidance of the general guidelines, each patient must be detailed. In detail, each surgeon can perform individualized medical treatment, just like a key. Open a lock of truth.
4. The decision to transfer open surgery: there are three main reasons for the transfer of open surgery: severe lesions, disordered conditions; poor equipment and equipment operations; laparoscopic surgeons have limited skill levels. It can also be divided into automatic transit and forced transit. The conversion of open surgery to surgery alone is a change from the first choice to the second, not the loss of surgery. Correctly knowing the problem of open surgery and being able to grasp the transit opportunity in a timely and decisive manner before the onset of severe complications is a hallmark of an experienced laparoscopic surgeon and a guarantee of safe and effective surgical treatment.
5. Patient Benefits and Social Economic Benefits Evaluation
(1) Benefits of the patient: There are several primary goals for measuring whether a patient can benefit from laparoscopic surgery: the time of surgery, the time of anesthesia, the rate of attack of intraoperative and postoperative complications, mortality, wound pain, and analgesics Use, recovery of organ function and daily activities, and return to work. The above goals should be fully compared with traditional open surgery. Balance the benefits of the patient.
(2) Social and economic benefits: The social benefits of evaluating laparoscopic surgery are mainly compared with open surgery in terms of operating costs, anesthesia fees, total hospital fees, post-operative rehabilitation operations, and bed turnover rate.