Laparoscopic sutured anastomosis of the bowel.

Background: Even though the safety and efficacy of sutured anastomosis have been proved in open surgery, laparoscopic sutured anastomosis is rarely performed because it is difficult and time-consuming. We aim at description of a standardized technique for laparoscopic sutured anastomosis of the bowel and definition of its learning curve.

Methods: Fifty-six laparoscopic sutured anastomoses of cow small intestine were performed in a laparoscopic simulator.

The Tübingen balloon. A new method for adjusting the tension of the fundic wrap during laparoscopic Nissen fundoplication.

An adequate fundic wrap is fundamental to the success of conventional and laparoscopic Nissen fundoplications. Nevertheless, up to now there has been no standardized method for the surgeon to determine intraoperatively the width and tension of the fundic wrap according to objective criteria. With the support of Rüsch (Kernen, Germany), we developed a measurement balloon for use in laparoscopic Nissen fundoplication.

Indications and results of local treatment of rectal cancer.

Background: Local therapy of early rectal carcinoma has become an alternative to the classical radical operation which has a higher morbidity and mortality rate.

Methods: Rectal carcinoma was treated by transanal endoscopic microsurgery (TEM) in 113 patients. The indications for the procedure were pT1 low-risk tumour, advanced tumour in high-risk patients, and patients who refused more radical surgery based on oncological guidelines.

[Value of training courses in minimally invasive surgery].

The actual situation regarding the education für MIS requires the optimisation and standardisation of the training system. This paper presents the results of an inquiry about the evaluation of the course of operative laparoscopy. 80-90% of those interviewed made the comments "very good" and "good", with regard to the imparting of the theoretic foundation of the technique of endoscopic operations, for sufficient possibility of manual training and for the realistic setting of the animal organ model compared with the clinical operation.

Local therapy of rectal tumors.

Purpose: The aim of the study is to outline the rising importance of local treatment of rectal tumors and a changing strategy in therapy of early rectal cancer.

Methods: As the surgical procedure, transanal endoscopic microsurgery was used. Indications for the local procedure were pT1 low-risk tumors and tumors of higher stages in patients with severe risk factors and of those who refused the operation according to oncologic guidelines.