title: Laparoscopic surgery for benign and malign diseases of the digestive system: indications, limitations, and evidence.
abstract: The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient's condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today's indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.
authors.affiliation: Markus Alexander Küper, Department for General and Visceral Surgery, Bundeswehr Hospital Berlin, D-10115 Berlin, Germany.
authors.forename: Markus Alexander
authors.initials: MA
authors.lastname: Küper
authors.affiliation: Markus Alexander Küper, Department for General and Visceral Surgery, Bundeswehr Hospital Berlin, D-10115 Berlin, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Eisner
authors.affiliation: Markus Alexander Küper, Department for General and Visceral Surgery, Bundeswehr Hospital Berlin, D-10115 Berlin, Germany.
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.affiliation: Markus Alexander Küper, Department for General and Visceral Surgery, Bundeswehr Hospital Berlin, D-10115 Berlin, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Glatzle
mesh_terms: D004066:Digestive System Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004067:Digestive System Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cholecystectomy, Colorectal surgery; Esophagus; Gastrointestinal surgery; Laparoscopic resection of gastrointestinal; Laparoscopy; Liver resection; Pancreas resection; Stomach