Malik A, Mellinger J D, Hazey J W, Dunkin B J, MacFadyen B V
Department of Surgery, Medical College of Georgia, Room BI 4074, 1120 15th St., Augusta, GA 30912, USA.
Surg Endosc. 2006 Aug;20(8):1179-92. doi: 10.1007/s00464-005-0711-7. Epub 2006 Jul 24.
The field of minimally invasive surgery has seen tremendous growth since the first laparoscopic cholecystectomy was performed in 1987. The key question is not how successful these techniques are currently, but rather where may they lead in the future? New technologies promise to usher in an era of even less invasive procedures. The terms being coined in the literature include "incisionless," "endoluminal," "transluminal," and "natural orifice" transluminal endoscopic surgery. These techniques certainly have the potential to become the next wave of minimally invasive procedures. A recent editorial in Surgical Endoscopy by Macfadyen and Cuschieri highlighted the ongoing developments in endoscopic surgery and stressed the critical importance of surgeons being involved in future applications and permutations of these techniques [1]. There are early signs of such involvement. The work of numerous investigators in the field was presented recently at the 2005 Digestive Disease Week. The American Society for Gastrointestinal Endoscopy and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), in collaboration with the American College of Surgeons, recently organized a postgraduate course in endoluminal therapy at the spring 2005 meeting held in Hollywood, Florida. The course is being offered again at the 2006 SAGES annual meeting. Similar courses are being offered at other regional and national meetings. This review attempts to highlight some of the available and evolving endoluminal therapies reviewed at that forum, including techniques for the management of gastroesophageal reflux disease, endoscopic mucosal resection, endoluminal bariatric surgery, transanal endoscopic microsurgery, and transgastric endoscopic surgery, as well as new technologies and possible future directions in luminal access surgery.
自1987年首次进行腹腔镜胆囊切除术以来，微创手术领域取得了巨大的发展。关键问题不在于这些技术目前有多成功，而在于它们未来可能会走向何方？新技术有望开创一个侵入性更小的手术时代。文献中创造的术语包括“无切口”“腔内”“经腔”和“自然腔道”经腔内镜手术。这些技术确实有可能成为下一波微创手术的浪潮。Macfadyen和Cuschieri在《外科内镜》杂志上最近发表的一篇社论强调了内镜手术的持续发展，并强调外科医生参与这些技术未来应用和改进的至关重要性[1]。已经有早期迹象表明这种参与。该领域众多研究人员的工作最近在2005年消化系统疾病周上进行了展示。美国胃肠内镜学会和美国胃肠与内镜外科医生学会（SAGES）与美国外科医师学会合作，最近在佛罗里达州好莱坞举行的2005年春季会议上组织了一次腔内治疗研究生课程。该课程将在2006年SAGES年会上再次提供。其他地区和全国性会议也在提供类似课程。本综述试图重点介绍在该论坛上讨论的一些现有的和不断发展的腔内治疗方法，包括胃食管反流病的治疗技术、内镜黏膜切除术、腔内减肥手术、经肛门内镜显微手术、经胃内镜手术，以及腔内入路手术的新技术和可能的未来发展方向。
