NOTES带给我们什么?——现实可行的技术还是微创外科新理念

What does NOTES bring us:a feasible technique or new conception of minimally invasive surgery

不断降低手术的创伤始终是外科医生不懈追求的目标,微创外科理念始终是推动外科手术技术不断创新和发展的指导思想和动力。进入21世纪,微创外科技术,包括腹腔镜和内镜技术都取得了巨大的成就。在此背景下,外科医生和内镜医生都在寻求更加微创的治疗手段,经自然腔道内镜外科技术(NOTES)应运而生。然而,受到伦理、器械等诸多因素制约,NOTES目前还不是一项现实可行的技术。即使将来能够取得突破性进展,也难以预见NOTES完全代替腔镜手术,更可能的情况是在相当长的一段时间内两者共存,各有其适应证。NOTES作为微创外科新的理念推动了微创外科技术进一步发展。

To reduce the surgical invasiveness is always the aim of the surgeons. The conception of minimally invasive persistently pushes the innovation and development of surgical technique. Since 21st century, significant achievements have occurred in minimally invasive field, including laparoscopy and endoscopy. Under this background, both of surgeons and endoscopists are seeking even minimally invasive methods, which evoke the NOTES. For the limitations of ethics and instruments, NOTES presently is not a feasible clinical technique. Even in the near future, technical breakthrough achieved, NOTES would not be totally instead of laparoscopic surgery. More reasonably, in a long time, laparoscopic surgery and NOTES will be coexistent and inter-complementary. As anew conception of minimally invasive surgery, NOTES promote the laparoscopic technique.