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Ⅰ. Subcutaneous emphysema Subcutaneous emphysema is the most common pneumoperitoneum complication, and the incidence of subcutaneous emphysema is as high as 2.7%. 1. Common reasons (1) Patient factors: patient weight and thickness of subcutaneous fat are closely related to the occurrence of subcutaneous emphysema, mainly due to the lack of subcutaneous adipose tissue in extremely emaciated patients, the weak blocking effect of adipose tissue on gas, and the rapid diffusion of gas along the subcutaneous to form subcutaneous emphysema. (2) Puncture technique, pneumoperitoneum needle is located in the extraperitoneal space: During the establishment of pneumoperitoneum needle blind penetration, the patient was obese and the abdominal wall was thick, the needle did not enter the abdominal cavity and injected gas, which directly formed subcutaneous emphysema. (3) Due to the complicated operation and long operation time, frequent replacement of instruments and removal of puncture apparatus increased the occurrence of subcutaneous emphysema. 2. Performance (1) In mild cases, the skin around the casing is swollen, and there is a feeling of twisting or holding snow when pressed: (2) In severe cases, the skin swelling is more obvious and extensive, spreading up and down along the chest and abdominal wall, reaching the neck, head and face, down the perineum and lower limbs (men can appear scrotal emphysema), which can lead to hypercapnia, acidosis, and even cardiopulmonary dysfunction; (3) The injection of little star gas but quickly reach high pressure or abdominal expansion is not uniform, percussion drum sound is not obvious should be highly suspected that the pneumoperitoneum needle is located in the extraperitoneum. 3. Prevention and treatment ① During the operation, the position of the pneumoperitoneum needle should be ensured correctly, and CO2 injection should be avoided in the extraperitoneal space after entering the abdominal cavity. When the pneumoperitoneum is initially connected, the pressure usually does not exceed 7~8mmHg, and a small pneumoperitoneum pressure should be applied during the operation to maintain the operating space. When the pneumoperitoneum was established, water injection test was performed with the syringe to confirm that the pneumoperitoneum needle really entered the abdominal cavity and then CO2 gas was filled. ② If the pneumoperitoneum needle is suspected to be extraperitoneal, it should be stopped immediately and re-punctured. ③ Tap each quadrant of the abdomen to determine the symmetrical drum sound; ④ After the pneumoperitoneum needle enters the abdominal cavity, the puncture needle is fixed to prevent external migration, and the change of flow rate of the pneumoperitoneum machine should be observed; ⑤ When suturing the fixed cannula, the muscle layer and fascia should be sutured simultaneously; ⑥ Try to shorten the operation time, especially in the elderly, the abdominal wall is relaxed, and the gas is easy to spill; ⑦ Normal cardiopulmonary function, mild subcutaneous emphysema more need not be treated, 24 to 48 hours self-absorption; ⑧ Severe subcutaneous emphysema, need to give hyperventilation, ventilator pressure oxygen, reduce the pneumoperitoneum pressure (10mmHg below), if necessary, temporarily suspend the operation Ⅱ. Hypercapnia and hypoxemia 1. Common reasons (1) Inappropriate artificial pneumoperitoneum pressure (too high abdominal pneumoperitoneum pressure (>15mmHg)) (2) Special positions of laparoscopic surgery, such as the use of low head and high foot during the operation (pelvic and gynecological operations, etc.), can elevate the diaphragm, restrict the movement of the bottom of the lung, and reduce lung compliance, affecting ventilation function, resulting in hypercapnia and hypoxemia in patients. It mainly occurs in patients with pre-existing lung dysfunction and in the case of longer operation time. 2. Prevention and treatment (1) During the operation, blood oxygen saturation and arterial blood gas analysis can be detected early. Once found, hyperventilation, inhalation of high concentration oxygen and intravenous infusion of 5% sodium carbonate should be given; (2) Strictly grasp the indications of laparoscopic surgery, and patients with poor cardiopulmonary function should be cautious during surgery; (3) pneumoperitoneum pressure should not be too high, 10~15mmHg can be; (4) Shorten the operation time as much as possible. For patients with more than 4 hours of operation, the blood gas analysis results should be dynamically detected during the operation, and the pneumoperitoneum should be temporarily interrupted if necessary to discharge CO2. Ⅲ. Pneumothorax and mediastinal emphysema Laparoscopic pneumoperitoneum is rare, but it is a very dangerous complication. 1. Common reasons (1) High pneumoperitoneum pressure and negative thoracic pressure allows gas in the abdominal cavity to enter the mediastinum and pleural cavity through the abdominal gap at the aorta or esophageal hiatus. (2) Congenital diaphragm defect or diaphragm injury during surgery, so that the gas in the abdominal cavity directly into the pleural cavity: (3) Congenital lung diseases, such as pulmonary bulla rupture during the operation; (4) pneumothorax can also be caused by injury of trachea by general anesthesia intubation, excessive positive pressure breathing pressure and failure of pressure control of pneumoperitoneum machine. 2. Suspicious performance ① unexplained decrease of blood oxygen saturation; ② The tidal volume decreases with the increase of gas resistance; ③ Unexplained hemodynamic changes; ④ If signs of pericardial tamponade appear, the possibility of pericardial aeration should be highly suspected. 3. Prevention and treatment In a small number of pneumothorax and mediastinal emphysema, breathing and SpO2 have not been affected, and can not be treated Pneumothorax occurring at the beginning of surgery or during operation should be immediately suspended and pneumoperitoneum should be removed, and closed thoracic drainage should be performed. After the patient's condition has improved, the pneumoperitoneum can be re-established, and if the vital signs are stable at this time, the surgery can be continued. If the pneumothorax occurs at the end of the operation, as long as the patient's vital signs are stable, the operation can be continued, and closed induction should be performed if necessary. Ⅳ. Gas embolism Gas embolism is a rare complication of pneumoperitoneum, but its consequences are very serious and mortality is high Common cause (1) The pneumoperitoneum needle strayed into the internal abdominal vein, and the gas directly rushed into the blood in a short time and entered the blood circulation; (2) During the operation, large veins (such as writing veins, inferior vena cava, etc.) were injured, and high pressure gas entered the blood wave circulation through the venous tear, resulting in gas embolism. 2. Performance (1) The end-tidal CO2 pressure increased sharply, the blood oxygen saturation suddenly decreased, and then the end-tidal CO2 pressure decreased significantly; (2) Blood pressure decreased, central venous pressure increased, pulmonary artery pressure increased, cardiac auscultation can appear grinding wheel murmur; (3) Precardiac ultrasonography and transesophageal ultrasonography can assist in diagnosis. 3. Prevention and treatment (1) Before aeration, it should be confirmed that the pneumoperitoneum needle has not penetrated the blood vessel; (2) If the vein rupture occurs during the operation, the tear should be clamped quickly, and repaired or ligation in time; (3) Intraoperative detection of central venous pressure and pulmonary artery pressure is helpful for early diagnosis; (4) Once a gas embolism occurs, it must be treated immediately. ① Suspend gas injection and relieve pneumoperitoneum to terminate the source of gas embolism; ② Inhale pure oxygen to reduce hypoxic damage to tissues and organs; ③ The left lying position ensures the blood supply of the left heart and systemic circulation; ④ The gas in the right atrium, right ventricle and pulmonary artery is aspirated by rapid central vein catheterization; ⑤ Air bubbles can be extracted by direct puncture of right atrium in emergency. Ⅴ. Pneumoperitoneal arrhythmia Pneumoperitoneum arrhythmia is not uncommon, but its exact cause is still unclear, in addition to the surgeon's own state, pneumoperitoneum should also be an important incentive. 1. Common reasons A Rapid aeration of the abdominal cavity results in peritoneal dilation stimulation, and abdominal stretch receptors excite the vagus nerve, causing arrhythmia. B. When the internal abdominal pressure increases, the inferior vena cava return is blocked, resulting in a decrease in the return blood volume and a change in cardiac systolic function, resulting in arrhythmia. Prevention and treatment Low flow gas injection first, and then gradually increase the gas injection speed after the body ADAPTS to it. Especially for the elderly, patients with cardiopulmonary diseases and other high-risk factors, the injection of heated CO2 gas can also be used to prevent the occurrence of pneumoabdominal arrhythmia. Pneumoperitoneal arrhythmias can usually be improved by stopping gas injection and releasing the pneumoperitoneum, and medical treatment is required in severe cases. Ⅵ. Postoperative shoulder pain Right shoulder pain is common and occurs 1-2 days after surgery. 1. Common reasons A. Continuous pneumoperitoneum leads to phrenic nerve tension. B. Residual CO2 is absorbed into the blood to form carbonic acid, which stimulates the phrenic nerve and produces shoulder reflex pain. 2. Prevention and treatment (1) pneumoperitoneum pressure was reduced during the operation. (2) After operation, CO2 and fluid in the abdominal cavity were absorbed; Hypophrenic warm saline irrigation; Pulmonary reexpansion. (3) Postoperative oxygen inhalation promoted O2 and CO2 exchange and accelerated CO2 discharge.

First, before the epidemic, many literatures reported that the aerosol produced by the smoke in the operating room contained many harmful components, which had certain adverse effects on the health of medical workers. In the epidemic period, the control of aerosol in the operating room is particularly important. The SAGES and EAES report highlights the following considerations for avoiding aerosol production during surgery: 1. Improve the awareness of protection: awareness determines behavior, and improving the awareness and prevention awareness of medical staff in the operating room is the primary condition. 2. The incision of laparoscopic surgery should be as small as possible to ensure the passage of trocar and avoid the phenomenon of air leakage caused by gaps; Maintain low and adequate pneumoperitoneum pressure levels; It is recommended to consider the laparoscopic gas smoke filtration and emission system. 3. Choose appropriate personal protection measures: Wear surgical masks correctly, but because the minimum filter particles of surgical masks are 5um, they cannot completely block smaller chemical particles or viral particles in surgical smoke, so they cannot be completely relied on. 4. Establish a good discharge system in the operating room. 5. Correct use of surgical electrical equipment. 6. Good attraction system. Two: In order to ensure the health and safety of medical personnel and patients, the effective protective measure is to set up reasonable smoke extraction facilities and prevent smoke inhalation. 1. Surgical smoke consists of 95% water or steam and 5% cell fragments in the form of particles. Particles contain harmful chemicals, biological particles, active cellular material or viruses, inactive particles, carbonized tissues, and bacteria. 2. Electrosurgical equipment can produce particles as small as 0.1μm, laser equipment can produce particles with an average diameter of 0.3μm, and ultrasonic knives will produce particles with an average diameter of 0.35μm~6.5μm. These tiny particles are inhaled by the human body, and then deposited directly in the alveoli, damaging human health. 3. Smoke produced by energy instruments used in surgery contains more than 600 kinds of organic compounds, most of which will cause certain harm to human health. Long-term inhalation or exposure to these contaminants can induce diseases of the respiratory, digestive, reproductive, nervous, blood, and immune systems. There may also be virus particles, cell active fragments, DNA fragments and other biologically active substances in surgical smoke. For example, studies have found that surgical smoke contains complete DNA fragments of bovine fibropapillomavirus (BPV) and human papillomavirus (HPV), while human immunodeficiency virus (HIV), human papillomavirus (HPV), human immunodeficiency virus (HIV) and human papillomavirus (HPV). Figure 1-2) can remain active in the smoke produced by the CO2 laser for 14 days and disappear completely after 28 days. In 1992, GattiBryant et al. collected smoke generated during breast plastic surgery and found that it induced mutations in Salmonella TA98 strain. At present, the number of HIV infections in China is more than 800,000, and the hepatitis B virus (HBV) infection rate of the population is more than 10%, which greatly increases the potential risk of HIV, HBV, HPV and other viruses. Three: Smoke extraction system should be set up to immediately eliminate surgical smoke, and personal protective measures should be taken: 1. Application of central smoke exhaust system: (1) In the operating room should be equipped with a high efficiency filtration system of surgical smoke extraction equipment, the exhaust rate must reach 30 to 45 meters/minute. (2) In order to effectively prevent hospital infection, the central smoke exhaust system needs to use a micro-particle filter with more than 99% efficiency. (3) The operating room can choose to install a fresh air system with physical mechanical ventilation and purification function, mobile air filtration purification smoke exhaust device and other methods to purify the air in the operating room. 2. Application of mobile smoke exhaust system: (1) Smoke evacuation equipment will not interfere with the surgical activities of the surgeon; (2) It has a large enough negative pressure attraction to ensure effective smoke removal; (3) There is enough filtration capacity to ensure the safety of the ambient air filtration system, of which the filtration system is particularly heaviest, it must be able to accommodate all the smoke generated, effectively remove harmful ingredients and odor, easy to operate. 3. Personal protection requirements (1) Pay attention to the protection of breathing, it is recommended to wear a high performance filter surgical mask, gloves and wear isolation clothes, which should be able to effectively filter particles of 0.01μm diameter. (2) Because surgical smoke may be adsorbed on the surface, studies have shown that contact lenses will adsorb more surgical smoke, so it is recommended to wear surgical protective glasses during surgery.

1. It has been found that laser instrument, ESU and ultrasonic knife can vaporize complete tissue cells and blood components. 2.the study confirmed that these vaporized cells are still active, the lower the energy used by the instrument, the shorter the time used each time, the greater the probability of the presence of active cells in the surgical smoke. 3. Studies have found that certain electric surgical tools can vaporize HIV-containing blood, and the smoke produced contains active HIV, which can infect cultured human T cells. HIV DNA can remain active in the smoke produced by CO2 laser for 14 days, and the activity completely disappears after 28 days. There have been reports that skin or eye contact with smoke may lead to HIV infection.

Laparoscopic instruments are used to do a variety of operations, which used to be called shrinkage surgery. The doctor only needs to open several keyhole-type holes around the surgical site of the patient. The operation can be performed visually in front of the computer screen without laparotomy. The operation time is short and the scar is small, which is actually called cosmetic holes. The advanced technology of less trauma, fewer complications, fast recovery, during the operation, the composition of the laparoscope and its various parts are the key to the operation, the establishment of pneumoperitoneum, the good or not of the cold light source, the integrity of the laparoscopic camera system, etc., are indispensable. The establishment of pneumoperitoneum is the basis of laparoscopic surgery. The normal operation of pneumoperitoneum is related to the patient's life safety, the successful completion of the operation and the occurrence of complications. The elevation of carbon dioxide pneumoperitoneum will increase the intrabitoneal pressure, and the diaphragm will move up, which will have a certain impact on the body's breathing, circulation and other systems. There are also complications, such as subcutaneous emphysema, hypercapnia, pneumothorax, mediastinal emphysema, postoperative neck and shoulder pain. Different Insufflators have such problems, and the reasons are closely related to the total volume of gas, Insufflators, ventilation pipes, puncture trocar, patient conditions, etc., which can directly affect the establishment of pneumoperitoneum, the exposure of operating field, and the progress of surgery. The cooperation of laparoscopic surgery fully proves that operating room nurses are required to be proficient in the working principle, operating process, parameter setting, common faults and handling ability of laparoscopic pneumoperitoneoscope, and prevent intraoperative faults to improve risk awareness, surgical quality and efficiency, so as to reduce the occurrence of hidden risks and complications.

1, large flow, up to 50L/min 2, excellent low pressure constant pressure stability technology 3, operation smoke filtration efficiency reached 99.99% 4. Achieved zero smoke emission in the operating room 5, one-click, intelligent pneumoperitoneum management 6, supporting the world's first concentric dual-channel trocar with valves 7, save carbon dioxide use, reduce medical costs 8, smaller equipment volume, lower noise

How to reduce the harm of operation smoke 1.Surgical incisions should be as small as possible to ensure the passage of trocar while avoiding slits to produce air leakage. Avoid any air leakage through the incision; 2.Keep the pneumoperitoneum at a low and adequate pressure level; 3.Before closing the pneumoperitoneum, removing the trocar, extracting the specimen, or converting it to an open incision, the gas should be safely evacuated through a filtration system. 4.Enhance personal protective measures for healthcare workers 5.Smoke filtration and emission systems is used under laparoscopy

1. The hospital can improve the quality of medical service, save medical costs and lessen air pollution in operating room. 2. Doctors can save workload, see clearly, and operate more smoothly. 3. Patients can shorten the operation time and reduce complications from unstable abdominal pressure.It also avoids the risk of smoke remained in the body. Summary: Yaoming smoke exhaust Insufflator benefits hospitals, doctors and patients.

1. Pneumoperitoneum instability Unstable pneumoperitoneum pressure causes instability in the pneumoperitoneum space, especially in narrow cavities (e.g. transanal surgery) High pneumoperitoneum pressure, patients with surgical pain. It can lead to common complications of pneumoperitoneum, such as subcutaneous emphysema, hypercapnia and acidosis, carbon dioxide gas embolism, and also pneumothorax or mediastinal emphysema, which can sometimes cause cardiac arrhythmia. 2. Surgical smoke obscuration and its hazards Smoke obscures the surgical field, which makes it difficult to see or see through. Smoke filled lens is easy to fog up, need to frequently wipe the mirror and suction and exhaust smoke, reduce the efficiency of the operation. Exhausted surgical smoke may contain active viruses and other hazardous substances, posing infection risks and long-term occupational hazards to healthcare workers. 3. The operation is not simple, need to connect multiple devices and pipelines, the operation is more cumbersome. 4. Small flow rate and can only output dry cold gas, which may cause postoperative pain and other damages to patients. 5. Large size, can not be placed in the trolley smoothly.

With the development of modern science, people's requirements for surgery are getting higher and higher, and laparoscopic surgery has been emphasized and popularized for its advantages of less trauma and faster recovery. In laparoscopic surgery, it is necessary to establish the surgical space, which needs to be filled with gas in order to have a good vision and operate with instruments.CO2 is the main gas commonly used to establish and maintain the pneumoperitoneum, Insufflator is indispensable to establish and maintain the pneumoperitoneum in the laparoscopic surgery, in a sense, it is precisely with the Insufflator that there is a real sense of the laparoscopic surgery. How to accurately control the cavity pressure of the Insufflator is the key technical point in the application of laparoscopic surgery, and the accuracy of the pressure control technology will directly affect the recovery of patients during and after laparoscopic surgery. However, the current Insufflator has the defects of unstable pneumoperitoneum and unclear surgical field, while the intelligent constant pressure smoke evacuation Insufflator introduced by Yaoming has solved these problems well.

Harmful Ingredients in Surgical Smoke Studies have shown that. 1. Surgical smoke contains more than 600 chemical components. Among them, the most abundant chemical components are hydrocarbons, nitriles, fatty acids, phenols, and so on. 2. The hazards of CO and acrylonitrile in the current smoke are of most concern, and the toxicity hazards to the human body are great. 3. Other chemical components that are of less concern but are also of great concern because they are highly toxic are hydrogen cyanide, formaldehyde and benzene. The hazards of surgical smoke are manifold 1. Smoke makes anatomical structures can not be clearly revealed, affecting the surgical field of vision, increasing the difficulty of surgery. 2. Smoke leads to multiple abortions of surgery, constant smoke evacuation and re-inflation, significantly lengthening surgical time. 3. Smoke increases the number of lens cleanings, accelerating depreciation and damage to the lens. 4. Smoke emissions are emitted in the operating room, and passive inhalation by the surgical staff over a prolonged period of time has the potential to cause serious physical harm. 5. When smoke from laparoscopic surgery is not discharged in a timely manner, it can lead to increased COHb concentration in the patient's blood, resulting in serious complications.

The main products of Yaoming are Intelligent Constant Pressure Smoke Evacuation Insufflator, and the consumables are filter tube set and trocar, our pneumoperitoneum machine has the following advantages: 1.Intelligent operation, bringing great convenience to the surgical process, different from traditional Insufflator, no need to manually control the flow, adding a number of self-researched advanced algorithms to accurately control the flow and pressure. 2.Breaking through the limitation of traditional pneumoperitoneum system, Yaoming Pneumoperitoneum System is able to operate stably at lower pressure to complete low-pressure laparoscopy. 3.With unique smoke exhaust mode, adsorbing harmful smoke, protecting the health of medical staff and patients, and returning a clean environment to the operating room. 4.The volume is one-third smaller than similar Insufflator, and the flow rate is enhanced to more than 40L per minute.

During laparoscopic surgery, it is necessary to establish the surgical space, which needs to be filled with gas in order to have a good vision and operate with instruments.CO2 is the main gas commonly used to establish and maintain the pneumoperitoneum, and the pneumoperitoneum equipment is indispensable to establish and maintain the pneumoperitoneum in the laparoscopic surgery, in a sense, it is precisely with the pneumoperitoneum equipment that there is the true meaning of the laparoscopic surgery. How to accurately control the cavity pressure of the pneumoperitoneum machine is the key technical point in the application of laparoscopic surgery, and the accuracy of the pressure control technology will directly affect the recovery of patients during and after laparoscopic surgery. Existing electronic pulse pneumoperitoneum machine, due to the defects of pressure control technology, there are potential surgical dangers in clinical application, therefore, it is necessary to recommend intelligent high-flow pneumoperitoneum machine with higher precision of pressure control. 1. Traditional insufflator have a small flow rate, imprecise control at low abdominal pressure, and manual pneumoperitoneum is prone to instability, while our CO2 Insufflator can reach a maximum of 50L per minute, and is small in size and simple to operate. 2. Traditional insufflator can only output dry cold gas, which is easy to cause postoperative pain and other damages to the patient, and also easy to cause carbon dioxide gas waste, not enough energy saving and environmental protection, while Yaoming Insufflator has adaptive heating technology to reduce the harm to the patient. 3. After the traditional insufflatotr is turned on, the operator needs to manually input the flow rate and pressure value required for operation according to his/her experience, and then input the gas into the abdominal cavity of the target patient to form the operating space, which leads to the low working efficiency and poor operation convenience of the traditional insufflator.Yaoming Insufflator has a clear and concise intelligent panel with one-button automatic and foolproof application, which is more suitable for Chinese doctors to use.

Why use insufflator Our products can be used in minimally invasive surgery, endovascular minimally invasive surgery has the advantages of less trauma, less pain for patients, quick postoperative recovery, etc., so in recent years, it has been rapidly popularized in hospitals at all levels in China. Insufflator is an important part of endoscopic surgery, and the function of Insufflator is to fill the cavity with carbon dioxide to establish a surgical space. Doctors can flexibly use various instruments in this space to perform surgery without damaging other organs. At the same time, the camera system can collect clear organ images and display them on the monitor in real time. Because carbon dioxide itself has the function of extinguishing fire, carbon dioxide gas is superior to other gases when using the electroknife in the cavity. Yaoming Insufflator system breaks through the limitations of traditional Insufflator system, and can perform stable operation under low pressure to complete low-pressure laparoscopy and surgery.

Cailianpress, July 5, Deputy Director of the State Food and Drug Administration Xu Jinghe pointed out at the "authoritative department talk opening" series theme press conference held by The State Council Information Office this morning, At present, 217 innovative high-end medical device products such as "brain pacemaker", carbon ion therapy system, proton therapy system, 5.0T magnetic resonance imaging system, comprehensive dynamic PET/CT, third-generation artificial heart, artificial blood vessel have been approved for market, and the launch of these products has achieved domestic breakthrough in high-end medical devices. It solves the situation that some products rely heavily on imports, most of which have been used in clinical diagnosis and treatment, and have achieved good results, which has improved the level of medical diagnosis and treatment in China. In recent years, the rapid development of China's medical device industry, the compound annual growth rate of the past five years is 10.54%, has become the world's second largest market for medical devices, industrial agglomeration, international competitiveness continues to improve.

Minimally invasive surgery, as the name implies, is surgery for "minor" wounds. With the continuous development of medical science and technology, the concept of "minimally invasive" has penetrated into every field of surgical treatment. However, because the development of minimally invasive techniques is relatively short compared to traditional surgery, there are some misunderstandings. Therefore, the popularization of minimally invasive knowledge is very important! The minimally invasive concept is based on curing diseases, reducing the damage caused by surgery, and reducing the impact of surgery on the body. It can be said that minimally invasive is to achieve the best healing purpose with minimal trauma. Minimally invasive generally includes the following points 1. Laparoscopic surgery The operation was performed with instruments outside the abdominal cavity through the abdominal wall puncture. Therefore, it is also called "keyhole" surgery, such as: laparoscopic hernia repair, laparoscopic cholecystectomy and so on. 2. Endoscopic surgery Its working principle is basically the same as that of laparoscopy, but the operation is performed through the natural cavity, such as gastroenteroscopic polypectomy, tracheoscopic surgery, electroscopic surgery, and sinus endoscopic surgery. 3. Luminal surgery The use of natural channels to perform surgery has the advantages of less trauma, quick recovery, no scar, such as vaginal hysterectomy, transrectal surgery, etc. 4. Vascular interventional surgery Through X-ray or CT-guided puncture interventional therapy technology, no knife incision, small damage, such as: vascular stent implantation, tumor drug implantation, etc. 5. Tumor ablation surgery Surgical procedures are performed by ultrasound or CT-guided puncture implantation of ablation needles, such as microwave ablation of thyroid nodules and ablation of liver and lung tumors. 6. Other surgeries Ultrasound focused treatment, radiation treatment and other technologies, the treatment of no wounds on the body surface. It is not difficult to see from this category that traditional open surgery is excluded from the modern minimally invasive concept, but how to rationally look at a variety of minimally invasive surgery, which requires "different people, different wisdom." The minimally invasive concept is summarized as "less trauma, less bleeding, less pain, and faster recovery" is correct, and so is the basic concept of surgery. If you want to truly achieve minimally invasive, the key is to choose a good surgical path and surgical method. For thoracic surgery, the same lesion can include: tracheoscopic surgery, thoracoscopic surgery, and traditional thoracotomy. If the treatment results are the same, of course, tracheoscopic surgery is the least invasive, followed by thoracoscopic surgery, and thoracotomy surgery is the least invasive. For example, gynecological surgery has three approaches: laparoscopic surgery, transvaginal surgery and traditional open surgery. For some diseases, all three approaches may be available, while for other diseases, it may not be appropriate. Therefore, rational treatment of surgical approaches is an important guarantee for achieving minimally invasive surgery. The choice of surgical approach is the first step of surgery, but also the most can reflect the concept of minimally invasive. Depending on the impact on the body, it can be removed through the vagina, without laparotomy, or even without laparoscopy. However, the technical principles that traditional surgery has always emphasized, such as keeping wet, keeping blood free, keeping clear, keeping gentle, etc., are also aimed at keeping minimally invasive. Therefore, these so-called traditional technology principles give minimally invasive a new concept, traditional does not mean backward and obsolete! Minimally invasive is a concept and principle, but it is difficult to define what is minimally invasive and what is huge. Minimally invasive indications are also composed of the following elements: patient, disease, surgeon, and surgery, and these four must be completely compatible to be the best choice. If the treatment of a disease is not suitable for this type of surgery, or even not suitable for the surgeon, the surgery should be changed, or it should be carried out by the surgeon who is more suitable for this type of surgery, and cannot be forced to do it. If the surgeon does not understand the operation of laparoscopic surgery, forced surgery will certainly not have good results, minimally invasive surgery may make huge trauma, so any surgery should be reasonable from the actual selection. A comprehensive consideration of minimally invasive surgery should be based on good recovery, with the following advantages: 1. Small wound Small wound or no cut, no scar, little impact on the body. Second, the pain is light The patient felt little pain and the operation was completed in a painless state. Three, fast recovery The damage to the organs and the interference to the function of other organs are greatly reduced, and the postoperative recovery time is shortened. 4. Less bleeding There was almost no bleeding during the operation. Clear vision, fine operation. 5. Short hospital stay Under normal circumstances, the operation recovery is fast and the cost is relatively low. To sum up, can the concept of minimally invasive surgery be summarized as follows: no treatment by the observer, no surgery for those who can be treated with drugs, no surgery for those who can be non-invasive, no minimally invasive, and no surgery for those who can be minimally invasive? The operation should abide by the principle of asepsis, follow the clinical approach, apply the appropriate technology, and choose the best treatment plan in order to ultimately achieve good treatment results.