科研之友
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摘要
Suturing is a hallmark modality of surgery and is considered critical to many procedures, particularly in the gastroenterology field. The practice of surgery is evolving from open access to laparoscopic and now to endoscopic. Throughout this evolution, the ability to suture has remained the primary metric of complexity for each of these new domains. Intestinal tract closure has been particularly challenging for complex endoscopic surgeries during which inadvertent or intentional perforation of a normal hollow viscus commonly occurs. The American Society for Gastrointestinal Endoscopy (ASGE) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Working Group at the 2005 Natural Orifice Surgery Consortium for Assessment and Research meeting reported the consensus that successful closure of intentional lumen defects is an absolute necessity for natural orifice transluminal endoscopic surgery (NOTES) to progress and eventually replace other traditional surgical approaches.(1) Specifically, it can be said that endoscopic suturing may be the facilitating modality of future less-invasive approaches and certainly is necessary to handle a wide range of current clinical problems when standard technologies such as clips and staplers fail. The objective of this review is to identify the various means by which the challenge of endoscopic suturing has been addressed to date and to survey the clinical problems currently managed by the available technologies and techniques.
- 出版日期2015-2
