52 外科手術的進展與革命 第一代手術-- 傳統開刀手術(Open Surgery) 第二代手術-- 微創手術(腹腔鏡手術) (Minimally Invasive Surgery; MIS)第三代手術-- 機器手臂手術 (Robotics Surgery)Slide #2 – Evolution or RevolutionWhen considering surgical trends and advancements in recent history, it is reasonable to conclude the natural evolution of surgical technique will continue to be increasingly less invasive while offering improved patient outcomes. This was not always the case. When minimally invasive surgery first surfaced in the form of the laparoscopic cholecystectomy, it was truly revolutionary. “Band-Aid” surgery incited different emotions throughout the surgical community. Some thought it promising, gimmicky, terrifying or just unnecessary. As more cases were completed, the lap chole became widely recognized as having enormous patient benefit. Less pain, a quicker recovery and improved cosmesis. However, these patient benefits came at a cost to much of the healthcare marketplace – at least initially. Suddenly there was new equipment that needed to be evaluated, purchased, maintained and understood. There were surgeons to train. There were insurance and billing quandaries. And there was a growing patient demand. With the MIS revolution came an adjustment period.From this perspective, the da Vinci™ is both an evolution and a revolution. An evolution because it is, at a minimum, propelling surgical technique in the direction in which it has been trending. However, the pace in which the da Vinci™ is impacting the surgical community is more aptly defined as revolutionary. The following clip underscores this robotic revolution.