From Innovation to Routine,Laparoscopic Surgery-What is the Future?
Minimally invasive therapy (MIT) has captured the attention of patients as well as physicians in the whole world in the last decade.Since the first laparoscopic cholecystectomy was reported in 1985, surgery entered into a revolutionary era.Due to the rapidly evolving nature of this technology, once-considered innovative surgical procedures will soon become standard procedures, and the procedure will soon become out-of-date.As one of the best example, laparoscopic surgery has successfully replaced most open surgical procedures recently.In the future, the development of MIT will still be a formidable challenge to both novice and experienced laparoscopic surgeons.Laparoendoscopic surgery of single site (LESS) has been used successfully for many surgical procedures since 2004.Experimental natural orifice transluminal endoscopic surgery (NOTES) first described in 2003 has expanded significantly since the application of the technique within the human arena after 2008.Although the technology of LESS or NOTES may not be mature at the present, its application will expand rapidly as other MIT procedures.The robotic system initially conceived for use in cardiac surgery, has been adopted widely by urologists and other surgical specialties.The surgical outcomes of robotic procedure have been proved to be at least the same, if not better than, as traditional laparoscopic or open prostatectomy.With miniaturization and refinement in fiberoptic and endoscopic technology, imaging of myriad bodily viscera through a multitude of natural orifices will soon become routine.And almost every body cavity, including the brain, will be successfully accessible to endoscopic inspection and manipulation.A computer-controlled robotic platform will allow precise, controllable, complex, and reproducible maneuvers of flexible endoscopes inside hollow organs and three-dimensional anatomic spaces to further enhance the capabilities of endoscopy.The economic challenges have created a dilemma for many hospitals and physicians;it is hopeful that the price will decrease as competition evolves and the technology become more mature in the future.Since the first transatlantic telerobotic cholecystectomy, further development for this technology will expand to the delivery of healthcare.As telecommunications and robotic technology continues to advance, telesurgery is likely to play on a more prominent role in surgical practice.Further development on teleradiology and telepathology will also occur for future patient care.National Aeronautics and Space Administration (U.S.A.) is investigating extraterrestrial application of robotic surgery as continued space exploration provides the potential for astronauts in space needing emergent operation.The future development of MIT is really bright and the changing speed is unpredictable.However, no matter how surgical technology advances, no technology can replace you as a caring physician with love in the heart of your patients.
邱文祥
陽明大學醫學院
国内会议
香港
英文
13-18
2011-11-24（万方平台首次上网日期，不代表论文的发表时间）