[The third wave of cardiac surgery]. / La tercera ola de la cirugía cardiaca.

A review of the history of cardiac surgery around the world is made divided into three stages, the first since the beginning of humanity until 300 years BC; the second moment shows how comes the platform that would give the anatomical and functional bases of the cardiovascular system. This historic moment includes: 1. the description and analysis of the function of blood and its components; 2. the description of the normal and abnormal Anatomy of the human heart and its vessels; 3. the anatomic and functional correlation: Foundation of the deductive thinking, and 4. the anatomic and functional integration with the clinic. Finally, the third wave, which is living today, is the stage of the technological explosion that begins with procedures as thoracoscopic surgery with the concept of reducing surgical trauma through minimum approach surgery. Also the use of robotics to solve some of the alterations in the CC, another is hybrid procedures and finally the use of fetal cardiac surgery.

Se hace una revisión de la historia de la cirugía cardiaca a nivel mundial dividida en tres etapas; la primera desde los inicios de la humanidad hasta 300 años a.C, El segundo momento muestra cómo surge la plataforma que daría las bases anatómicas y funcionales del sistema cardiovascular. Este momento histórico comprende: 1. La descripción y el análisis de la función sanguínea y sus componentes; 2. La descripción de la anatomía normal y anormal del corazón humano y sus vasos; 3. La correlación anatomo-funcional: fundamento del pensamiento deductivo, y 4. La integración anatomo-funcional con la clínica. Por último, la tercera ola, que es la que se vive en la actualidad, es la etapa de la explosión tecnológica que inicia con los procedimientos toracoscópicos, con el concepto de reducir el trauma quirúrgico mediante la cirugía de mínimo abordaje. También está el uso de la robótica para solucionar algunos de las alteraciones en las Cardiopatías Congénitas, otro son los procedimientos hibridos y finalmente la cirugía fetal.

[Review of the developmental history of robotic surgery].

The evolution of minimally invasive surgery has gradually lead to the stage of robotic surgery with unprecedented controllability and precision, little trauma, mild tenderness, rapid recovery, short hospitalization, cosmetic appearance, and prominent superiority. It is now extensively and gradually applied in general surgery, cardiac surgery, thoracic surgery, neurosurgery, urinary surgery, gynecology and obstetric surgery, orthopedic and ophthalmology surgery, etc. Since the introduction of surgical robots into China at the beginning of the 21(st) century, robotic surgery has been developing steadily.

Clubfoot: etiology and treatment Ignacio V. Ponseti, MD, 1914-.

This biographical sketch of Ignacio V. Ponseti, MD, corresponds to the historic text, The Classic: Congenital Club Foot: The Results of Treatment, available at DOI 10.1007/s11999-009-0720-2 and The Classic: Observations on Pathogenesis and Treatment of Congenital Clubfoot, available at DOI 10.1007/s11999-009-0721-1.

[The natural orifice surgery concept. Vision and rationale for a paradigm shift]. / "Natural-Orifice-Surgery- (NOS-)Konzept". Vision und Rationale für einen Paradigmenwechsel.

BACKGROUND: During the 20th Century, laparoscopic surgery achieved high standards and significantly reduced morbidity. In order to make surgery simpler and safer, a new concept, natural orifice surgery (NOS), has recently been introduced. The approach to the abdominal cavity may be transoral-transgastric, transvaginal-transdouglas or transanal-transrectal. This article describes the logic behind this approach and the expected challenges. METHODS: In order to realize this goal, we founded the first European based working group on NOS. This group concentrates on the development of transdouglas procedures in women by using the transdouglas endoscopic device (TED). This is a wide, multi-channel instrument, which will enable surgery to be performed via a single entry. RESULTS: Simulation of various intra-abdominal operations, such as staging, cholecystectomy, appendectomy, myomectomy und ovarectomy, using TED has already been carried out. Practical studies are planned in the near future. CONCLUSION: The feasibility of NOS has been demonstrated in various experimental studies. We believe that this technique will create a spectrum of innovative and high quality operations and will improve patient safety.

The progress in bariatric surgery.

Morbid obesity, caused by fat tissue accumulation, is a serial multi-factorial chronic disease, with rapidly increasing prevalence in most countries in the world including Poland. Conservative treatment of morbid obesity is almost always unsatisfactory and that is why several surgical methods have been developed. There are four kind of methods: malabsorbtive procedures; restrictive procedures; malabsorbtive/restrictive procedures and experimental procedures. The development of bariatric surgery goes back to 1952 and since that time it has been evolving dynamically. All the surgical methods have benefits and disadvantages. Presently the introduction of minimally invasive surgical techniques seems to be very safe, efficient and cost-effective in treatment for morbid obesity. New methods are also being evaluated, such as gastric myo-electrical stimulation. Bariatric surgery will still be developing until we understand all the factors responsible for it is origin.