Endoscopic surgery: what has passed the test?
The use of endoscopic surgery has increased in gastrointestinal surgery since the introduction of laparoscopic cholecystectomy. It was the aim of this study to investigate the impact of endoscopic procedures in 1998. Laparoscopic cholecystectomy, fundoplication, repair of perforated peptic ulcer, gastric banding procedure, sigmoid resection for diverticulitis, and ileal pouch-anal anastomosis were investigated using techniques of technology assessment. Feasibility, efficacy, and effectiveness were used to evaluate the different types of operation. The statements were graded by three categories of evidence. Laparoscopic cholecystectomy and fundoplication have passed the test. Laparoscopic repair of perforated duodenal ulcer, gastric banding for morbid obesity, and sigmoid resection for diverticulitis are feasible and efficient but not effective today. Laparoscopy-assisted ileal pouch-anal anastomosis has been shown to be feasible but is not yet efficient and effective.
2nd Department of Surgery, University of Cologne, Kliniken der Stadt Köln, Ostmerheimerstrasse 200, 51109 Cologne, Germany.
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Köhler
D019723:Endoscopes; D019317:Evidence-Based Medicine; D006801:Humans; D020706:Laparoscopes; D011183:Postoperative Complications / Q000209:etiology; D013525:Surgical Instruments; D013673:Technology Assessment, Biomedical