大腸外科治療の最前線

Frontiers of Colorectal Surgery

要旨●大腸外科治療において腹腔鏡手術を中心としたMIS（minimally invasive surgery）の概念が普及しているが，本邦が目指す「Society 5.0」ではdigital surgeryの時代が到来すると考えられており，今はその移行期にある．roboticsやenhanced visualization，ICT（information and communication technology）の活用による遠隔医療や人工知能（AI）によるビッグデータの解析と，これらすべての情報統合（connectivity）により実現するdigital surgeryは，従来の“population medicine”から，個人の遺伝素因・環境要因などに合わせた医療“precision medicine”を可能とするだろう．本稿では，腹腔鏡手術からdigital surgery時代への移行期におけるロボット支援下大腸手術，ICG（indocyanine green）を用いた近赤外光ガイド下手術，遠隔医療を中心に大腸外科治療の最前線について述べる．

　The concept of minimally invasive surgery centered on laparoscopy has become widespread in colorectal surgery, and we are currently in the transition phase of the digital surgery era, which is expected in Japan following the Society 5.0 initiative. Digital surgery, which will be realized through robotics, enhanced visualization, information and communication technology, big data analysis using artificial intelligence, and the connectivity of these methods, will enable “precision medicine,” a medical treatment tailored to individual genetic and environmental factors, rather than the conventional “population medicine.” This study describes the frontiers of colorectal surgery, focusing on robot-assisted colorectal surgery, indocyanine green fluorescence-guided surgery, and telemedicine in the transition from laparoscopy to the digital surgery era.