دانلود کتاب جراحی قلب کودکان کم تهاجمی

Being a pediatric cardiac surgeon for 36 years, I have believed that reducing the invasion involving surgery to the living body, that is to say, minimizing invasion of surgery, was an essential duty for surgeons. Especially in neonatal open-heart surgery, the reason is that the success of postoperative ICU recovery does not only affect the final surgical outcome, but the future quality of life (QOL), including growth and psychomotor development, is affected more than the surgery itself. In addition, rapid recovery after surgery is a status of the hospital which indicates that team medical care is functioning very well. Until now, we have been taking measures against minimally invasive by learning from seniors and improving their ideas. However, if it was asked whether there was a measure that could be realized that there was a clear clinical effect, of course, it can be convinced that it is less invasive than before. But it must be answered honestly that it was unsure. There was only a strong vague feeling that it became minimally invasive before we knew. Since many factors are involved in the invasion of cardiac surgery, it may be difficult to produce a direct clinical effect from a single measure. Although minimally invasive is now a popular word, how should we interpret and practice it from now on? Since 2007, the patients’ condition in the postoperative ICU has gradually changed. In particular, diuretic drop and edema augmentation, which pediatric cardiac surgeons mostly dislike, have become increasingly visible. The postoperative quality which should be emphasized is clearly different from that before 2006. Sakakibara Heart Institute is proud to have developed world’s first new heart–lung machine devices and extracorporeal circulation management methods. As been reporting a lot of their minimal invasiveness and clinical effects so far, there is a little guilty conscience. What is the cause of this? Has minimally invasive extracorporeal circulation progressed? First of all, in this book, I would like to explain about extracorporeal circulation, which is the greatest invasion to living body, and how it became minimally invasive. There is one more thing to consider when discussing minimally invasive. It is not only the ability of the surgeon but also how to mature the overall capabilities of the surgical team. This is extremely important in the sense that it directly leads to minimal invasiveness of the patient. Surgery is performed by human hands. However, the evaluation of maturity is also difficult and vague and it cannot be measured numerically. However, if it can be quantified, would not time be the only one? As long as the surgery itself is invasive, shortening the time is the most fundamental for considering minimal invasiveness. Moreover, the fact that the time can be shortened means that minimally invasive is functioning. The author has made many proposals for minimally invasiveness from this point of view. Newcomers who became members of a team that performs many surgeries in a short time will grow further beyond that situation, and how to improve under this naturalness will also be necessary to establish new measures for less invasiveness in the future. In addition, if the surgery is completed early and the patient’s condition is stable, each team member can secure more private time. This is also a standard that indicates the good functionality of the surgical team and it will also mean minimally invasive for us healthcare providers. Currently, the training of surgeons is a pressing challenge. However, there are still only few reports on the efficiency of surgery and team development for minimizing invasiveness. Secondly, I would like to explain how to raise functional cardiac surgery teams, their strategies, and their minimally invasive nature. Research on minimally invasive surgery continues to advance, and many results have been reported. However, this book does not cover these general matters in textbooks. To the last, I would like to describe the contrivance and process of minimal invasiveness and the countermeasures from the reflection and raise future issues as one surgeon’s thought. It may be criticized for not being scientific or logical, but I hope that it will serve not only cardiac surgeons but also all young doctors, nurses, and clinical engineers.