Nathaniel J. Soper, MD, discussed the current state of laparoscopy, endolumenal procedures and natural orifice translumenal endoscopic surgery while delivering the Gliedman Oration at the Montefiore's 32nd annual Controversies, Problems & Techniques in Surgery conference, according to General Surgery News.
Dr. Soper is the chair of the Department of Surgery at Northwestern University's Feinberg School of Medicine in Chicago.
Here are six insights:
1. Robotics offers an advantageous new opportunity in laproscopic GI procedures, however there are some downsides. The robot helped improve dexterity, visualization and ergonomics for the surgeon. But the current time required and cost makes it hard to justify.
2. Dr. Soper stated that minimally invasive surgery may serve as a bridge to noninvasive surgery, and a key component of noninvasive surgery is endolumenal applications. Endolumenal applications can be used with endoscopic stapled sleeve resections and transanal endoscopic microsurgery
3. Natural orifice translumenal endoscopic surgery, or NOTES, an extension of endolumenal applications, which allows the surgeon to enter the body through a natural orifice with an endoscope and perform an extralumenal procedure.
4. However, according to Dr. Soper, the NOTES procedure will not be in widespread use any time soon as it can be costly and may increase time in the operating room
5. A similar procedure to NOTES, the per oral esophageal myotomy procedure, or POEM, can be used to treat achalasia safely and effectively.
6. Another area of opportunity in MIS GI procedures is gastroesophageal reflux operations done through the mouth rather than incisions.