内視鏡手技・腹腔鏡下手術がもたらす “低侵襲” の本態―R0切除・機能温存の重要性

Points to remember in “minimally invasive” endoscopic and laparoscopic cooperative surgery: balance between R0 resection and functional preservation

要旨

低侵襲手技の本態とは何であるか？　結果的に何を大切に手技の開発を進めるべきか？　命のピラミッドという言葉があり，治療を考えるうえで最も大切にすべきものは「命」であり，そして命を守ることができれば，次に機能を残すことを重視し，命と機能を守ることができれば，美容（傷の大きさ）を守ることが重要とされている。低侵襲手技の開発というのはこの点を遵守しつつ開発をしなければならない。LECSの開発経緯と，現在におけるさらなる低侵襲手技の開発における問題点などを記載した。

　What is the true essence of minimally invasive procedures? What should we consequently value in the development of minimally invasive techniques? The “pyramid of “life” is a phrase that states that the most important thing to consider in treatment is “life”, and if life can be preserved, then the next most important thing is to preserve function; if life and function can be preserved, then it is important to preserve cosmetics (wound size). The development of minimally invasive procedures must be developed in compliance with these points, and the history of the development of LECS and current issues in the development of further minimally invasive procedures are described.