[Video-assisted transanal endoscopic microsurgery of rectal tumours - V-TEM]. / Videoassistierte transanale endoskopische Mikrochirurgie von Rektumtumoren - V-TEM.

BACKGROUND: Transanal endoscopic microsurgery (TEM) has become increasingly established as the method of choice for the local resection of endoscopically unresectable rectal adenomas and early-stage, low-risk rectal carcinomas. Multiple studies have shown that the single port-technique TEM results in significantly less trauma with comparable overall treatment outcome as compared to conventional radical surgical techniques. However, TEM is not widely used due to high initial set-up costs, the need for highly complex equipment and demanding surgical skill requirements. PATIENTS AND METHODS: To mitigate these challenges we have successfully developed a video-assisted TEM (V-TEM) method, which resulted in approximately 50 % lower initial set-up costs through the introduction of simplified original TEM surgical equipment. Between October 2003 and September 2011 we have completed 103 resections using the V-TEM method. RESULTS: The observed rates of complications and local recurrences are comparable to reported rates. CONCLUSIONS: We were able to mitigate the challenges of TEM through the establishment of the technically less demanding V-TEM method, which resulted in approximately 50 % lower initial set-up costs while maintaining overall treatment outcomes.

[Indications for laparoscopic pancreas operations: results of a consensus conference and the previous laparoscopic pancreas register]. / Indikation zur laparoskopischen Pankreasoperation: Ergebnisse einer Konsensuskonferenz und des bisherigen laparoskopischen Pankreasregisters.

Laparoscopic pancreatic surgery is not common practice in Germany and is only carried out in approximately 20 clinics but with an increasing trend. The reasons for this are manifold, such as the current selection of patients and both skills in laparoscopic and pancreatic surgery are necessary to perform this operation safely. In 2008 a registry called "Laparoscopic pancreatic surgery" was implemented to collect enough data in Germany to find out whether the resection is safe, feasible and beneficial for the patient.For further development of new laparoscopic techniques new data is needed. A group of experts performing laparoscopic pancreatic surgery in Germany supplied their data for the German registry for laparoscopic pancreatic resection and a consensus conference about the indications became necessary. This consensus conference discussed in particular the indications for laparoscopic pancreatic resection. A consensus was found by all members of the conference utilizing currently available evidence-based data.It was suggested that all data of laparoscopic pancreatic surgery should be evaluated in the German Registry. A consensus was made which diseases were either suitable for laparoscopic resection or not suitable or suitable in selected cases.