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Das Konzept der narbenlosen Eingriffe („scarless surgery“): ein Weg in die Zukunft?

The present and future status of “scarless” surgery

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Zusammenfassung

Das Konzept der narbenlosen Eingriffe basiert auf der Vorstellung, die Invasivität diagnostischer und therapeutischer Eingriffe konsequent weiter zu minimieren. Sie baut auf den Erfolgen der flexiblen gastroenterologischen Endoskopie und der minimal-invasiven Chirurgie auf und versucht, deren Vorteile synergistisch zu kumulieren. Tierexperimente haben ermutigende Ergebnisse bezüglich der Machbarkeit vielfältiger Eingriffe im Peritoneal- und Retroperitonealraum gezeigt. Weitere Studien und instrumentelle Weiterentwicklungen müssen die Praktikabilität und Überlegenheit des Konzepts auf seinen potenziellen Anwendungsgebieten beweisen quo ad medizinischer Ergebnisqualität und Effizienz im Vergleich zu den heute gängigen Verfahren. Die Ablösung einzelner minimal-invasiv chirurgischer Verfahren durch das Konzept der narbenlosen Eingriffe ist ebenso denkbar wie die Erschließung neuer Indikationsgebiete. Neben den rein methodischen Weiterentwicklungen sind hierzu angemessene organisatorische, infrastrukurelle und ausbildungsrelevante Strukturen zu schaffen. Wenn dies gelingt, kann das Konzept der narbenlosen Eingriffe für zahlreiche Anwendungsfelder einen attraktiven Weg in die Zukunft weisen.

Abstract

The concept of scarless surgery aims at further minimization of diagnostic and therapeutic interventions. Based on the success of flexible gastroenterological endoscopy and laparoscopic surgery, it combines their advantageous approaches in a synergistic manner. Animal experiments have achieved encouraging results in respect to the feasibility of various types of interventions in the peritoneal and retroperitoneal cavity. Further studies and improvement of instruments will have to prove the practicality and superiority of this concept for medical outcome and efficiency compared to present standards of practice in the potential fields of application. The replacement of certain minimally invasive procedures with scarless intervention techniques seems reasonable, as do new fields of application. After further improvement of the methodology, adequate organization, infrastructure, and teaching structures will have to be developed. If they succeed, the concept of scarless surgery can expect a promising future.

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Authors and Affiliations

  1. Asklepios Klinik Altona, Paul-Ehrlich-Straße 1, 22763, Hamburg, Deutschland

    F. Hagenmüller

  2. Ethicon Endo Surgery Europe, Norderstedt, Deutschland

    M. Immenroth, T. Berg & S. Rasche

  3. Ethicon Endo Surgery Inc., Cincinnati, USA

    K. Bally

Authors
  1. F. Hagenmüller
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  2. M. Immenroth
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  3. T. Berg
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  4. K. Bally
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  5. S. Rasche
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Correspondence to F. Hagenmüller.

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Hagenmüller, F., Immenroth, M., Berg, T. et al. Das Konzept der narbenlosen Eingriffe („scarless surgery“): ein Weg in die Zukunft?. Chirurg 78, 525–530 (2007). https://doi.org/10.1007/s00104-007-1344-2

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