Digital imaging, virtual and augmented reality.

The sensorial perception of what is captured is what we know as "image" and consists of a static component and a dynamic process. This continuous process of images capture is essential in surgery. The image is crucial for the surgeon, who requires it for the diagnosis, for the therapeutic process and for postoperative follow-up.

The economic impact of anastomotic leak after colorectal cancer surgery.

Objective: To determine the economic impact of the incremental consumption of resources for the diagnosis and treatment of anastomotic leak (AL) in patients after resection with anastomosis for colorectal cancer compared to patients without AL on the Spanish health system.

Method: This study included a literature review with parameters validated by experts and the development of a cost analysis model to estimate the incremental resource consumption of patients with AL versus those without. The patients were divided into three groups: 1) colon cancer (CC) with resection, anastomosis and AL; 2) rectal cancer (RC) with resection, anastomosis without protective stoma and AL; and 3) RC with resection, anastomosis with protective stoma and AL.

Multicenter clinical trial for the resection of rectal polyps using a new laparoendoscopic hybrid transanal access device.

Introduction: Complex polyps require the use of advanced endoscopic techniques or minimally invasive surgery for their approach. In rectal polyps it is of special relevance to reach a consensus on the best approach to avoid under- or overtreatment that increases unnecessary morbidity and mortality.

Methods: We describe a prospective, multicenter, pilot clinical trial with a first-in-human medical device.

Robotic-like suturing with FlexDex Surgical System® for difficult laparoscopic suture.

The field of laparoscopic surgery has experienced an exponential growth in recent years. Despite great progress in this field, standard laparoscopic tools have not been optimally developed and still has some deficiencies when it comes to mobility and ergonomics. Robotic surgery has attempted to solve these problems by improving the articulation of surgical instruments.

[Standardising sigmoidectomy by single umbilical incision].

The increase in single-incision endoscopic surgery has led to more and more procedures and surgical groups who perform them. Segmental resection is the procedure most likely to benefit from this approach since it achieves a significant minimisation in the parietal access; with umbilical mini-laparotomy the entrance ports are grouped together and extraction of the piece and preparation of the anastomosis can be performed. Among the colorectal procedures, sigmoidectomy seems to be the most appropriate area to start using these techniques by groups with laparoscopic colorectal experience.

[Duodenopancreatectomy in the elderly. Evaluation of results].

Introduction: With the increase in life expectancy, more and more resectable periampullary tumours are being diagnosed in the geriatric population. Despite the decrease in post-operative mortality, there continues to be a debate on the risk-benefit of cephalic duodenopancreatectomy (CPD) in the elderly.

Objective: To analyse the morbidity and mortality of CPD in patients over 70 years-old.

[Endoscopic transvaginal cholecystectomy].

Introduction: Transluminal endoscopic surgery through natural orifices (NOTES) allows intraperitoneal surgical procedures with minimal access to the abdominal wall. Currently it is not yet possible to perform these interventions without laparoscopic assistance, so these procedures are hybrids, fusion of minilaparoscopy and transluminal endoscopic surgery We present a prospective clinical series of patients undergoing surgery for gallstones, with hybrid NOTES transvaginal cholecystectomy with a nursing care plan adapted to this new approach.

Methods: Prospective clinical series of consecutive patients, nonrandomized, with transvaginal NOTES cholecystectomy.

[NOTES. History and current situation of natural orifice transluminal endoscopic surgery in Spain].

Natural orifice transluminal endoscopic surgery (NOTES), involves a group of new endoscopic approaches to the abdominal cavity, with potential advantages over conventional laparoscopic surgery. It is based on the possibility of performing intra-peritoneal surgical techniques through natural orifices by entering the peritoneal cavity through natural orifices perforating the organ that allows direct access to that cavity (stomach, vagina, rectum, bladder). The possibility of using this same route to access the retroperitoneum and mediastinum has subsequently been postulated.

[Single incision laparoscopic surgery].

One of the aims of the new technologies and techniques in minimally invasive surgery (MIS) is to achieve a surgery without or with minimal visible scars. Natural orifice transluminal endoscopic surgery (NOTES) might be considered to be a paradigm of this development but it has not yet been possible to implement this universally. Nevertheless, the resultant innovation of research into NOTES has enabled "bridge technologies" to be introduced that allow MIS to be developed with the required standards of efficiency and safety.