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1

1. 1

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( Medline, Medlook)
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1990, .
,
,
,

.




, .

20
1901 elling,

.

1910
Jacobaeus ,
115 . 1922 Korbsch, 1923
eeling 1929 Steiner. 1929 Kalk

( 1951
2000 ). Fervers 1935
(CO2)
(50 ) Veress

.

2
,

Hopkins 1950.

1960
Kurt Semm
,
- . .

1970

.

, 1985
(mini-camera)
(video-camera -

(monitor).

1987 Lyons, Phillipe Mouret


,
. F. Dubois J.
Perissat, E. Reddick, D. Olsen G. Berci A.
Cuschieri.
.

,

.
,
.

1992
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(NIH)

3
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. [1]

4
2

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(
)

( 5-10mm)
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->
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. 1

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2. 1. 1



video.
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,

, (minimal invasive
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,
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. 2 Trocars

6
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. 4 

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56

1. Www. shios medical. go

2. . , ,
.

3. www. laparoscopy. org. gr

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7. www. iator. gr/sampalis/laparoskopisis. htm

8. , . . . . University Studio Press, 1


, , 2001

9. : . , ,
1992

10. . , : ,
University Studio Press, , 1991

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28. www. surgery. usc. edu

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31. . , , .
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37. , . . .
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2003
39. , . University
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-) - . 4,
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47. , . , .
, . , , 1998.

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, , 2001

49. . , ,
, 2002

50. . , 1998

60

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