Neue Optionen für die Cholezystektomie: Single-Port-Zugang, Roboter, NOTES

Translated title of the contribution: New options for gallbladder removal: Single-port access, robots, NOTES

D. Wilhelm, D. Ostler, M. Kranzfelder, T. Vogel, S. Koller, H. Feußner

Research output: Contribution to journalReview articlepeer-review

Abstract

Today, laparoscopic cholecystectomy (CHE) is a highly standardized, less traumatic, and safe option for the treatment of gallstones. Nonetheless, the search for even better interventional options has continued. In the first step, the use of mechatronic support systems (“robots”) was evaluated: For active camera guidance or even for performing the complete procedure, active camera holders of the 1st or 2nd generation failed to be successful. However, “intelligent” devices of the 3rd generation may have the potential to reduce costs which could promote acceptance. Telemanipulation systems for CHE have not been justified due to additional expenses and lack of benefit for the patient. This could only change if less expensive but more effective “collaborative” systems are available to improve the surgical workflow and the safety level. Modifications of the laparoscopic approach were assessed in the form of “reduced port” or “mono-port” (≙ single-port) CHE. The additional expenses (instruments, operating room time, etc.) are (as well as for “mini-laparoscopy”) considerably higher, but a real benefit for the patient has not yet been shown. A real innovation seemed to arise about 10 years ago with the concept of natural orifice transluminal endoscopic surgery (NOTES) or scarless CHE. Today, it is obvious that this new approach (even in its variation of “rigid” NOTES CHE) was unable to achieve a breakthrough. However, many very promising technological advances of the last few years suggest that a convincing new option for CHE will soon be clinically available.

Translated title of the contributionNew options for gallbladder removal: Single-port access, robots, NOTES
Original languageGerman
Pages (from-to)51-58
Number of pages8
JournalGastroenterologe
Volume13
Issue number1
DOIs
StatePublished - 1 Feb 2018
Externally publishedYes

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