Innovation in gastrointestinal surgery: the evolution of minimally invasive surgery—a narrative review

Frontiers in Surgery

Surgery

Josephine Walshaw¹  Ian Chetter¹  Safaa Dimashki²  Adam McClean²  Jing Yi Kwan³  James Tomlinson⁴  Chandra Shekhar Biyani⁵  Samantha Gajos⁶  Bright Huo⁷  Marina Yiasemidou⁸ 

[1] Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom;Department of General Surgery, Bradford Teaching Hospitals NHS Trust, Bradford, United Kingdom;Department of General Surgery, Bradford Teaching Hospitals NHS Trust, Bradford, United Kingdom;Department of Vascular Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom;Department of Spinal Surgery, Sheffield, Teaching Hospitals, Sheffield, United Kingdom;Department of Vascular Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom;Emergency Medicine Department, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, United Kingdom;Faculty of Medicine, Dalhousie University, Halifax, NS, Canada;NIHR Academic Clinical Lecturer General Surgery, University of Hull, Hull, United Kingdom;Hull York Medical School, University of York, York, United Kingdom;

关键词: laparoscopic;    robotic;    minimally invasive;    colorectal (colon) cancer;    rectal cancer;   

DOI  :  10.3389/fsurg.2023.1193486

 received in 2023-03-24, accepted in 2023-05-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundMinimally invasive (MI) surgery has revolutionised surgery, becoming the standard of care in many countries around the globe. Observed benefits over traditional open surgery include reduced pain, shorter hospital stay, and decreased recovery time. Gastrointestinal surgery in particular was an early adaptor to both laparoscopic and robotic surgery. Within this review, we provide a comprehensive overview of the evolution of minimally invasive gastrointestinal surgery and a critical outlook on the evidence surrounding its effectiveness and safety.MethodsA literature review was conducted to identify relevant articles for the topic of this review. The literature search was performed using Medical Subject Heading terms on PubMed. The methodology for evidence synthesis was in line with the four steps for narrative reviews outlined in current literature. The key words used were minimally invasive, robotic, laparoscopic colorectal, colon, rectal surgery.ConclusionThe introduction of minimally surgery has revolutionised patient care. Despite the evidence supporting this technique in gastrointestinal surgery, several controversies remain. Here we discuss some of them; the lack of high level evidence regarding the oncological outcomes of TaTME and lack of supporting evidence for robotic colorectalrectal surgery and upper GI surgery. These controversies open pathways for future research opportunities with RCTs focusing on comparing robotic to laparoscopic with different primary outcomes including ergonomics and surgeon comfort.

【 授权许可】

Unknown   
© 2023 Walshaw, Huo, McClean, Gajos, Kwan, Tomlinson, Biyani, Dimashki, Chetter and Yiasemidou.