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  • 1 I. sz. Sebészeti Klinika, Semmelweis Egyetem, 1082, Budapest, Üllői út 78.
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Absztrakt

2004-ben egy új technikával ismerkedett meg a világ, melyet természetes szájadékokon keresztüli endoscopos sebészetnek (NOTES) neveztek el. A módszerrel kapcsolatosan kérdések sora fogalmazódott meg, s bár számos problémára a mai napig nem sikerült megoldást találni, egyre újabb cikkek jelennek meg a módszer humánalkalmazásáról. A fennálló megoldatlan kérdések megkerülésére számos új műtéttechnikai megoldást fejlesztettek ki (hibrid NOTES, NOTUS, SPS, SLIS stb.), mely a problémákat ugyan nem küszöböli ki teljesen, egyes esetekben mégis reális megoldást jelenthet. Ismeretük és kritikus elemzésük fontos a kor sebészének. A módszerek bármelyikének alkalmazása a korábban lefektetett sebészeti és flexibilis endoscopos elvek felülvizsgálatát igényli. Bár ezeket sok esetben axiómaként kezelik, léteznek irodalmi adatok a tőlük eltérő kezelési elvekre is. A természetes szájadékokon keresztüli sebészet által felvetett szokásos kérdések (melyik behatolási kapu a legalkalmasabb, hogyan zárjuk a viscerotomiás nyílást, hogyan előzzük meg az infekciót, ki fogja végezni a NOTES-műtétet), kritikus elemzése csak a korábban “gold standard”-ként alkalmazott technikák okozta szövődmények (pl. laparoscopos műtétek utáni sebinfekció, sérv) tükrében érdemes. Humánadatok szerint a NOTES-műtét minimális fájdalommal jár, a betegek általában aznap elhagyhatják a kórházat. Elegendő-e ilyen rövid posztoperatív observatio, és elhagyható-e a cholecystectomia utáni drainage? A humáneredmények alkalmasak az új technikával kapcsolatos korai következetések levonására is. A laparoscopia fejlődése során felmerült problémák retrospektív elemzése lehetőséget teremthet a NOTES fejlődése során elkövethető hibák elkerülésére.

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Editor(s)-in-Chief: Oláh, Attila

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  • DR. BÁLINT ANDRÁS
  • DR. BEZSILLA JÁNOS
  • DR. BOROS MIHÁLY
  • DR. BURSICS ATTILA
  • DR. DAMJANOVICH LÁSZLÓ
  • DR. ENTZ LÁSZLÓ
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  • DR. VEREBÉLY TIBOR
  • DR. VERECZKEI ANDRÁS

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Magyar Sebészet
Language Hungarian
Size B5
Year of
Foundation
1947
Publication
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2021 Volume 74
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per Year
1
Issues
per Year
4
Founder Magyar Sebész Társaság -- Hungarian Surgical Society
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ISSN 0025-0295 (Print)
ISSN 1789-4301 (Online)

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