Richard Hodin, MD, is chief of Boston-based Massachusetts General Hospital’s Division of General and Gastrointestinal and the Division of Gastrointestinal and Oncologic Surgery. He spoke with Becker’s ASC Review about the trends in intraoperative gastrointestinal treatment.
Questions: What are trends in GI surgeries that gastroenterologists should know?
Dr. Richard Hodin: A major advance in terms of the GI surgery has been the development of minimally invasive techniques, starting with laparoscopic cholecystectomy in the early 1990s.
Laparoscopic approaches are now utilized in a wide array of GI surgical procedures. More recently, robotic technology has been applied to some areas of surgery, especially when there are hard-to-reach sites, like the deep pelvis for rectal surgery, the left upper quadrant for distal pancreatectomy and posterior to the liver for some hepatic resections.
The advantages of the robotic approach are still not well defined, and we have learned the hard way that some new approaches like this can be associated with increased complications, especially early on. Minimally invasive surgery has been carried forward to an even greater extent when it comes to a variety of endoluminal procedures that avoid an abdominal incision completely, e.g., peroral endoscopic myotomy, per oral endoscopic pyloromyotomy and advanced endoluminal resections of rectal tumors.
Something to keep an eye on in the future is the application of artificial intelligence to both teach young trainees how to do procedures, but, even more importantly, to make surgery safer. Think of when you are driving your car and mistakenly get too close to the lines in the road — the warning beeps and lights go off, and you quickly correct. This kind of early warning system is being developed to alert surgeons during an operation using AI technology.
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