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Emerging Techniques in Minimally Invasive Surgery. Pros and Cons

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

New trends have emerged regarding the best minimally invasive access approaches to perform gastrointestinal surgery. However, these newer approaches are seen critically by those who demand a more strict assessment of outcomes and safety. An international panel of expert gathered at the 2014 American College of Surgeons Meeting with the goal of providing an evidence-based understanding of the real value of these approaches in gastrointestinal surgery. The panel has compared the efficacy and safety of most established approaches to gastrointestinal diseases to those of new treatment modalities: peroral esophageal myotomy vs. laparoscopic myotomy for achalasia, transgastric vs. transvaginal approach, and single-incision vs. multi-port access minimally invasive surgery. The panel found that (1) the outcome of these new approaches was not superior to that of established surgical procedures; (2) the new approaches are generally performed in few highly specialized centers; and (3) transgastric and transvaginal approaches might be safe and feasible in very experienced hands, but cost, training, operative time, and tools seem to limit their application for the treatment of common procedures such as cholecystectomy and appendectomy. Because the expected advantages of new approaches have yet to be proven in controlled trials, new approaches should be considered for adoption into practice only after thorough analyses of their efficacy and effectiveness and appropriate training.

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Authors and Affiliations

  1. Department of Surgery, Brigham and Women’s Hospital and Boston VA Healthcare System, Harvard Medical School, 1400 VFW Parkway, West Roxbury, Boston, MA, 02132, USA

    P. Marco Fisichella

  2. Department of Surgery, University of Southern California, Los Angeles, CA, USA

    Steven R. DeMeester

  3. Department of Surgery, Northwestern University, Chicago, IL, USA

    Eric Hungness & Nathaniel J. Soper

  4. IRCAD, Department of Digestive and Endocrine Surgery, University of Strasbourg, Strasbourg, France

    Silvana Perretta

  5. Department of Surgery, Florida Hospital, Tampa, FL, USA

    Alexander Rosemurgy

  6. Department of Surgery, Duke University, Durham, NC, USA

    Alfonso Torquati

  7. Division of Education, American College of Surgeons, Chicago, IL, USA

    Ajit K. Sachdeva

  8. Department of Surgery and Center for Esophageal Diseases, University of Chicago Pritzker School of Medicine, Chicago, IL, USA

    Marco G. Patti

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  1. P. Marco Fisichella
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  2. Steven R. DeMeester
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  9. Marco G. Patti
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Correspondence to P. Marco Fisichella.

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This paper is sponsored by the Division of Education, Committee on Emergent Surgical Technologies (CESTE), American College of Surgeons.

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Fisichella, P.M., DeMeester, S.R., Hungness, E. et al. Emerging Techniques in Minimally Invasive Surgery. Pros and Cons. J Gastrointest Surg 19, 1355–1362 (2015). https://doi.org/10.1007/s11605-015-2766-7

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