Laparoskopische Operationen in der Viszeralchirurgie - Welche Indikationen kann man minimalinvasiv behandeln?

Die Laparoskopie hat die Chirurgie revolutioniert indem sie das Prinzip des minimalinvasiven Zuganges etablierte. Insgesamt dauerte die Entwicklung fast 200 Jahre bis 1982 die erste Appendektomie und 1985 die erste Cholezystektomie laparoskopisch durchgeführt wurden. In der Zwischenzeit haben sich die Cholezystektomie, die Fundoplicatio, die Adrenalektomie und die Adipositaschirurgie als Standardindikationen des Verfahrens etabliert. Aber auch die Appendektomie erfolgt vielerorts bereits standardmäßig laparoskopisch. Noch nicht durchgesetzt hat sich das Verfahren in der Hernien-, Kolorektal-, Milz-, Leber- und Pankreaschirurgie, es wird aber zumindest bei Ersteren als echte Alternative diskutiert. Auch die wenigsten Malignome werden laparoskopisch operiert, obwohl die Laparoskopie beispielsweise im Fall von kolorektalen Karzinomen einem offenen Eingriff ebenbürtig ist.

Laparoscopy has basically changed surgery by implementing the minimally invasive access. The development lasted 200 years until the first appendectomy was performed laparoscopically in 1982 and the first cholecystectomy was performed in 1985. In the meantime, laparoscopy has become the standard for cholecystectomy, fundoplication, adrenalectomy, and bariatric surgery. Appendectomy is also carried out laparoscopically by many surgeons. For hernias, colorectal resections and splenectomy laparoscopy is a serious alternative but not the standard yet. The same is true for colorectal carcinomas.

Key words

laparoscopic surgery - benign diseases - oncologic diseases

Literatur

• 1 Ammori BJ, Baghdadi S.. Minimally invasive pancreatic surgery: the new frontier?.  Curr Gastroenterol. 2006;  8 132-142
• 2 Antolovic D, Kienle P, Knaebel HP. et al. . Totally laparoscopic versus conventional ileoanal pouch procedure - design of a single-centre, expertise based randomised controlled trial to compare the laparoscopic and conventional surgical approach in patients undergoing primary elective restorative proctocolectomy - LapConPouch-Trial.  BMC Surg. 2006;  6 13
• 3 Assalia A, Gagner M.. Laparoscopic adrenalectomy.  Br J Surg. 2004;  91 1259-1274
• 4 Braumann C, Jacobi CA, Menenakos C. et al. . Computer-assisted laparoscopic colon resection with the Da Vinci system: our first experiences.  Dis Colon Rectum. 2005;  48 1820-1827
• 5 Buchwald H, Avidor Y, Braunwald E. et al. . Bariatric surgery: a systematic review and meta-analysis.  JAMA. 2004;  292 1724-1737
• 6 Christian DJ, Buyske J.. Current status of antireflux surgery.  Surg Clin North Am. 2005;  85
• 7 Clinical Outcomes of Surgical Therapy Study Group. . A comparison of laparoscopically assisted and open colectomy for colon cancer.  N Engl J Med. 2004;  350 2050-2059
• 8 Eypasch E, Sauerland S, Lefering R, Neugebauer EA.. Laparoscopic versus open appendectomy: between evidence and common sense.  Dig Surg. 2002;  19 518-522
• 9 Feussner H, Hartl F.. Staginglaparoskopie in der Onkologie.  Chirurg. 2006;  77 971-980
• 10 Gagner M, Rogula T, Selzer D.. Laparoscopic liver resection: benefits and controversies. Surg Clin North Am 2004; 84 (2) 451-462
• 11 Gutt CN, Bintintan VV, Koninger J. et al. . Robotic-assisted transhiatal esophagectomy.  Langenbecks Arch Surg. 2006;  391 428-434
• 12 Himpens J, Dapri G, Cadiere GB.. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years.  Obes Surg. 2006;  16 1450-1456
• 13 Keus F, Broeders IA, van CJ. Laarhoven. Gallstone disease: Surgical aspects of symptomatic cholecystolithiasis and acute cholecystitis.  Best Pract Res Clin Gastroenterol. 2006;  20 1031-1051
• 14 Koninger J, Bottinger P, Redecke J, Butters M.. Laparoscopic repair of perforated gastroduodenal ulcer by running suture.  Langenbecks Arch Surg. 2004;  389 11-16
• 15 McNevin MS, Bax T, MacFarlane M. et al. . Outcomes of a laparoscopic approach for total abdominal colectomy and proctocolectomy.  Am J Surg. 2006;  191 673-676
• 16 Müller-Stich BP, Linke GR, Borovicka J. et al. .Laparoscopic mesh-augmented hiatoplasty as a treatment of gastroesophageal reflux disease and hiatal hernias - preliminary clinical and functional results of a prospective case series. Am J Surg (accepted)
• 17 Scheidbach H, Schneider C, Rose J. et al. . Laparoscopic approach to treatment of sigmoid diverticulitis: changes in the spectrum of indications and results of a prospective, multicenter study on 1545 patients.  Dis Colon Rectum. 2004;  47 1883-1888
• 18 Schmedt CG, Sauerland S, Bittner R.. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials.  Surg Endosc. 2005;  19 188-199
• 19 Schwenk W, Haase O, Neudecker J, Muller JM.. Short term benefits for laparoscopic colorectal resection.  Cochrane Database Syst Rev. 2005;  3 003145; 
• 20 Smithers BM, Gotley DC, Martin I, Thomas JM.. Comparison of the outcomes between open and minimally invasive esophagectomy.  Ann Surg. 2007;  245 232-240
• 21 Uranues S, Alimoglu O.. Laparoscopic surgery of the spleen.  Surg Clin North Am. 2005;  85

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