Editorial

Innovative direction in minimally invasive colorectal surgery platforms and techniques and quality control

  • ZHANG Mingguang ,
  • WANG Xishan
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  • Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Received date: 2024-04-07

  Online published: 2024-09-03

Abstract

The advancements in colorectal minimally invasive surgical techniques represent not merely technological innovation but also a significant leap in surgical philosophy. Over the past half-century, we have witnessed the historic transition from traditional open surgery to minimally invasive procedures, a change propelled by continuous innovations in surgical platforms and techniques. The innovations of platforms encompass developments in imaging platforms, energy platforms, instrumentation platforms. Furthermore, innovations in surgical techniques primarily focus on exploring variables within five key elements of surgical techniques: the approach, extent of bowel resection, lymph node dissection, reconstruction of the digestive tract, and specimen extraction. The progress in colorectal minimally invasive surgery has significantly reduced surgical trauma, and enhanced patients' postoperative quality of life and the overall safety of surgeries. This progress is underpinned by stringent quality control throughout the surgical process, ensuring standardized and homogeneous execution of procedures. Moving forward, the ongoing drive to innovate surgical techniques and philosophies will continue to improve the efficacy and safety of colorectal minimally invasive surgeries. This journey not only necessitates the relentless advancement of medical technologies, but also requires surgeons to continuously deepen and actively pursue surgical philosophies.

Cite this article

ZHANG Mingguang , WANG Xishan . Innovative direction in minimally invasive colorectal surgery platforms and techniques and quality control[J]. Journal of Surgery Concepts & Practice, 2024 , 29(03) : 192 -196 . DOI: 10.16139/j.1007-9610.2024.03.02

References

[1] SPANER S J, WARNOCK G L. A brief history of endoscopy, laparoscopy, and laparoscopic surgery[J]. J Laparoendosc Adv Surg Tech A, 1997, 7(6):369-373.
[2] LAU W Y, LEOW C K, LI A K. History of endoscopic and laparoscopic surgery[J]. World J Surg, 1997, 21(4):444-453.
[3] GASKIN T A, ISOBE J H, MATHEWS J L, et al. Laparoscopy and the general surgeon[J]. Surg Clin North Am, 1991, 71(5):1085-1097.
[4] 庄孟, 张筱倩, 王锡山. 结肠直肠微创手术平台的发展历程——冷兵器向热兵器的演变[J]. 外科理论与实践, 2021, 26(4):281-284.
  ZHUANG M, ZHANG X Q, WANG X S. Evolution of minimally invasive platforms for colorectal surgery: from cold weapons to hot weapons[J]. J Surg Concepts Pract, 2021, 26(4):281-284.
[5] 张明光, 王锡山. 结直肠外科术式的发展历程及挑战[J]. 中华医学杂志, 2021, 101(44):3620-3624.
  ZHANG M G, WANG X S. The development and challenge of colorectal surgery[J]. Natl Med J China, 2021, 101(44):3620-3624.
[6] 尹叶锋, 程璞, 王锡山. 结直肠外科术式历程——从经典到创新的演变[J]. 肿瘤防治研究, 2022, 49(10):989-995.
  YIN Y F, CHENG P, WANG X S. Evolution of colorectal surgery: from classic to innovation[J]. Cancer Res Prev Treat, 2022, 49(10):989-995.
[7] TSUKAMOTO S, FUJITA S, OTA M, et al. Long-term follow-up of the randomized trial of mesorectal excision with or without lateral lymph node dissection in rectal cancer (JCOG0212)[J]. Br J Surg, 2020, 107(5):586-594.
[8] 王锡山. 结肠直肠癌联合脏器切除若干问题思考[J]. 外科理论与实践, 2016, 21(06):461-463.
  WANG X S. Considerations on Multivisceral resection in colon and rectal cancer[J]. J Surg Concepts Pract, 2016, 21(6):461-463.
[9] 王锡山. 局部晚期结直肠癌联合脏器切除的适应证和治疗策略的选择[J]. 中国癌症杂志, 2015, 25(11):861-864.
  WANG X S. The indications and therapeutic strategies of multivisceral resection for locally advanced colorectal[J]. China Oncol, 2015, 25(11):861-864.
[10] 关旭, 焦帅, 黄海洋, 等. 中国经自然腔道取标本手术开展现状分析[J]. 中华结直肠疾病电子杂志, 2021, 10(2):122-131.
  GUAN X, JIAO S, HUANG H Y, et al. An investigation report on the current situation of natural orifice specimen extraction surgery in China[J]. Chin J Colorectal Dis(Electronic Edition), 2021, 10(02):122-131.
[11] 王锡山. 中国NOSES面临的挑战与展望[J]. 中华结直肠疾病电子杂志, 2018, 7(1):2-7.
  WANG X S. Current challenges and prospects of NOSES in China[J]. Chin J Colorectal Dis(Electronic Edition), 2018, 7(1):2-7.
[12] 王赫, 刘志鹏, 燕东, 等. 结直肠肿瘤经自然腔道取标本手术的研究进展[J]. 中华结直肠疾病电子杂志, 2020, 9(6):610-616.
  WANG H, LIU Z P, YAN D. The application progress of NOSES in surgery of colorectal cancer[J]. Chin J Colorectal Dis(Electronic Edition), 2020, 9(6):610-616.
[13] 李会晨, 付文政, 张锡朋. 经肛门全直肠系膜切除术治疗低位直肠癌[J]. 中华结直肠疾病电子杂志, 2014, 3(2):61-62.
  LI H C, FU W Z, ZHANG X P. Transanal total mesorectal excision for the treatment of low-rectal cancer[J]. Chin J Colorectal Dis(Electronic Edition), 2014, 3(2):61-62.
[14] HEALD R J, HUSBAND E M, RYALL R D. The mesorectum in rectal cancer surgery--the clue to pelvic recurrence?[J]. Br J Surg, 1982, 69(10):613-616.
[15] HOHENBERGER W, WEBER K, MATZEL K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome[J]. Colorectal Dis, 2009, 11(4):354-364;discussion 364-365.
[16] HE Z, YANG C, DIAO D, et al. Anatomic patterns and clinical significance of gastrocolic trunk of Henlé in laparoscopic right colectomy for colon cancer: results of the HeLaRC trial[J]. Int J Surg, 2022, 104:106718.
[17] CHEN J N, LIU Z, WANG Z J, et al. Low ligation has a lower anastomotic leakage rate after rectal cancer surgery[J]. World J Gastrointest Oncol, 2020, 12(6):632-641.
[18] 王玉柳明, 王贵玉. 《中国肿瘤整合诊治技术指南(CACA)·NOSES技术》要点介绍及解读[J]. 结直肠肛门外科, 2023, 29(5):417-422.
  WANG Y L M, WANG G Y. Key points and interpretation of the 'China oncology integrated diagnosis and treatment technology guidelines (CACA) ? NOSES technique'[J]. J Colorectal & Anal Surg, 2023, 29(5):417-422.
[19] 王锡山. 结直肠肿瘤NOSES术关键问题的思考与探索[J]. 中华结直肠疾病电子杂志, 2018, 7(4):315-319.
  WANG X S. Consideration and exploration of key issues in NOSES for colorectal cancer[J]. Chin J Colorectal Dis(Electronic Edition), 2018, 7(4):315-319.
[20] ARJONA-SáNCHEZ A, ESPINOSA-REDONDO E, GUTIéRREZ-CALVO A, et al. Efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy for locally advanced colon cancer: a phase 3 randomized clinical trial[J]. JAMA Surg, 2023, 158(7):683-691.
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