Abstract
Laparoscopic surgery has been widely adopted and new technical innovation, procedures and evidence based knowledge are persistently emerging. This review documents recent major advancements in laparoscopic surgery. A PubMed search was made in order to identify recent advances in this field. We reviewed the recent data on randomized trials in this field as well as papers of systematic review. Laparoscopic cholecystectomy is the most frequently performed procedure, followed by laparoscopic bariatric surgery. Although bile duct injuries are relatively uncommon (0.15%-0.6%), intraoperative cholangiography still plays a role in reducing the cost of litigation. Laparoscopic bariatric surgery is the most commonly performed laparoscopic gastrointestinal surgery in the USA, and laparoscopic Nissen fundoplication is the treatment of choice for intractable gastroesophageal reflux disease. Recent randomized trials have demonstrated that laparoscopic gastric and colorectal cancer resection are safe and oncologically correct procedures. Laparoscopic surgery has also been widely developed in hepatic, pancreatic, gynecological and urological surgery. Recently, SILS and robotic surgery have penetrated all specialties of abdominal surgery. However, evidence-based medicine has failed to show major advantages in SILS, and the disadvantage of robotic surgery is the high costs related to purchase and maintenance of technology. Laparoscopic surgery has become well developed in recent decades and is the choice of treatment in abdominal surgery. Recently developed SILS techniques and robotic surgery are promising but their benefits remain to be determined.
Highlights
Introduction and Basic Aspects of MinimallyInvasive SurgeryIntroductory Chapter: Addressing the Challenges of Laparoscopic SurgeryFrancisco M
The uncontrolled manifold (UCM) provides a quantitative approach to analyze the influence of imposed constraints, e.g., workplace layout and instruments design on the postural strategy that surgeons choose to accomplish surgical tasks, and it allows to map the variance of three individual joint angles onto the head position variance
In the last few years, introduction and use of inertial sensors in the analysis and characterization of posture variability in the context of minimally invasive surgery has been a great advance in biomechanics methodology, as 3D photogrammetry requires a lot of time for digitation of images
Summary
The field of surgery has experienced a revolution in the present era with a dramatic shift from the traditional open surgery to minimally invasive surgery (MIS) This has been associated to numerous advantages over open surgery, mainly for patients, such as a reduction of tissue trauma and smaller postoperative scars, which in turn involves shorter hospital stays, reduction of the postoperative pain, and faster recovery. Despite the many advantages laparoscopic surgery offers to patients, laparoscopy entails a number of technical limitations for surgeons The performance of this surgical technique implies important restrictions on freedom of movement, mainly due to the use of rigid and long surgical instruments with poor ergonomic design, the location of the screens, the use of pedals to control the diathermy system, and by the fixed surgical ports for the instruments. Recently many other robotic systems are under development, including additional features such as enhanced portability and force feedback [22, 23]
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