Cuschieri A
Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Scotland.
World J Surg. 1992 Nov-Dec;16(6):1089-97. doi: 10.1007/BF02067066.
Laparoscopic procedures have begun to replace many conventional operations because of the avoidance of major surgery and the rapid recovery of the patient. The majority of these traditional operations will be performed laparoscopically in the future. For example, patients who suffer from achalasia will be able to undergo laparoscopic cardiomyotomy and patients with non-cardiac chest pain of esophageal origin will be able to undergo thoracoscopic myotomy. Likewise, a viable alternative to long-term medication with H2 blockers or omeprazole will be laparoscopic posterior vagotomy and anterior lesser curve seromyotomy. As methods are developed to deal with the extraction of large specimens, many ablative procedures will be undertaken by the laparoscopic route. Extraction techniques must not compromise the need for histopathological examination of the resected specimen in cancer resections. The ultimate spectrum of laparoscopic surgery will be determined by the progress in remote handling technology, overcoming the manipulative restrictions inherent in the current instrumentation. Research evaluating the efficacy of new methods will be essential.
由于避免了大手术且患者恢复迅速，腹腔镜手术已开始取代许多传统手术。未来，这些传统手术中的大多数将通过腹腔镜进行。例如，患有贲门失弛缓症的患者将能够接受腹腔镜贲门肌切开术，而患有食管源性非心源性胸痛的患者将能够接受胸腔镜肌切开术。同样，腹腔镜后迷走神经切断术和前小弯浆膜肌切开术将成为长期使用H2阻滞剂或奥美拉唑药物治疗的可行替代方案。随着处理大标本提取方法的发展，许多消融手术将通过腹腔镜途径进行。提取技术不得影响癌症切除术中对切除标本进行组织病理学检查的需求。腹腔镜手术的最终范围将取决于远程操作技术的进展，克服当前器械固有的操作限制。评估新方法疗效的研究至关重要。
