Transition from anatomic to functional minimally invasive surgery

With the development of minimally invasive management,laparoscopic operation has become more and more prevalent.As a surgical procedure,a serial of events,such as psychological damage,fasting,bleeding,hypothermia,pain,introduce of cathartic,gastric tube,urinary catheter and aggressive resuscitation of crystal fluid,can produce stress and delay the rehabilitation. Evidence-based medicine has demonstrated that during the laparoscopic surgery,alleviating these events is associated with milder stress reaction and fast recovery.The focus of minimally invasive surgery should be shifted from the local injury to the stress of the whole body,from the wound size to the psychological,physiological and pathological changes of the whole body,from the technique of operation to the comprehensive management during perioperative period.In summary,the minimally invasive surgery focuses more and more on minimizing the stress influence on the whole body rather than merely on the minimal incision.It is reasonable to conclude that this kind of research will bring significant innovation in minimally invasive surgery in the future.