Wie beeinflusst die Technik die Entwicklung in der minimal invasiven Chirurgie?

Abstract

New technological developments affect the surgical disciplines in various ways. Very often a new operative technique is only possible, when new technologies have been developed before. Other developments lead to perfection of the operative procedure and, therefore, to better operative results and reduced complication rates. Furthermore, a new and very important field in the development is enabling surgeons to operate relaxed and ergonomic at the operating table so that they are able to work longer fully concentrated. New and better technology can also accelerate the operative procedure and, therefore, cut costs and time. The instrumental technology is crucial for successful endoscopic operations. The design of an instrument system for the so-called transanal endoscopic microsurgery allowed the local treatment of tumors in the lower third of the rectum. Eight years ago the development of the ‘full thickness resection device’ started, targeting a flexible device that should allowa full thickness resection in the colon descendens and the sigma using stapling technique. To improve the endoscopic vision we have been concerned with the development of a stereoscopic video system (3D-video). Later - as a more cost-efficient and more practical alternative — a telescope with optimized illumination, the ‘shadow telescope’, has been developed in cooperation with Endoskopische Geräte Berlin (MGB). To reduce the complexity of the management of the growing number of devices, the operating room system OREST has been constructed. Since OREST could not penetrate the market, there is still a lot of improvement necessary concerning ergonomics, that is addressed in systematic analyses of the operation business. In cooperation with the KernforschungszentrumKarlsruhe, the university of Tdbingen conceived and developed a remote controlled operation robot, aiming the handling of flexible and multifunctional instruments, including tactile sensory and force feedback. From these roots later more simple instrument holding and camera guidance systems arose, which assume boring and non-ergonomic static holding functions. Shortly the manipulator is available in a facilitated solely mechanical further development, the so-called RADIUS Surgical System, as a product of the recently founded company Tuebingen Scientific Surgical Products.