Benhidjeb T, Witzel K, Bärlehner E, Stark M
The New European Surgical Academy (NESA), Berlin-Buch.
Chirurg. 2007 Jun;78(6):537-42. doi: 10.1007/s00104-007-1346-0.
During the 20th Century, laparoscopic surgery achieved high standards and significantly reduced morbidity. In order to make surgery simpler and safer, a new concept, natural orifice surgery (NOS), has recently been introduced. The approach to the abdominal cavity may be transoral-transgastric, transvaginal-transdouglas or transanal-transrectal. This article describes the logic behind this approach and the expected challenges.
In order to realize this goal, we founded the first European based working group on NOS. This group concentrates on the development of transdouglas procedures in women by using the transdouglas endoscopic device (TED). This is a wide, multi-channel instrument, which will enable surgery to be performed via a single entry.
Simulation of various intra-abdominal operations, such as staging, cholecystectomy, appendectomy, myomectomy und ovarectomy, using TED has already been carried out. Practical studies are planned in the near future.
The feasibility of NOS has been demonstrated in various experimental studies. We believe that this technique will create a spectrum of innovative and high quality operations and will improve patient safety.
在20世纪，腹腔镜手术达到了很高的水平并显著降低了发病率。为了使手术更简单、更安全，最近引入了一种新的概念，即自然腔道手术（NOS）。进入腹腔的途径可以是经口-经胃、经阴道-经Douglas腔或经肛门-经直肠。本文描述了这种手术方法背后的逻辑以及预期的挑战。
为了实现这一目标，我们成立了首个基于欧洲的自然腔道手术工作组。该小组专注于通过使用经Douglas腔内镜设备（TED）来开展针对女性的经Douglas腔手术。这是一种宽大的多通道器械，它将能够通过单一入口进行手术。
已经使用TED对各种腹腔内手术进行了模拟，如分期手术、胆囊切除术、阑尾切除术、子宫肌瘤切除术和卵巢切除术。计划在不久的将来开展实际研究。
自然腔道手术的可行性已在各种实验研究中得到证实。我们相信这项技术将创造一系列创新且高质量的手术，并将提高患者安全性。
