[Present status of minimally invasive surgery in the Czech Republic]

The authors evaluate the contemporary state of miniinvasive surgery in the Czech Republic.

The authors made a questionnaire survey in surgical departments of the Czech Republic. Some 58% of the addressed departments (118 departments) replied. They evaluated the prevalence and use of miniinvasive techniques in 1997 in the following areas: flexible endoscopy, sonography, intervention radiology and endoscopic surgery.

40% of the surgical departments possess flexible endoscopes and 14% surgeons use endoscopy. Interdisciplinary collaboration is being enforced. In 54% departments endoscopy is ensured in collaboration by surgeons and gastroenterologists. Single-handed sonography was recorded among 3.2% surgeons, but 80% feel that surgeons should do sonography single-handed. Intervention radiology as an alternative to surgery is indicated by 88% surgeons. However only 1.2% surgeons participate actively in these examinations. The era of endoscopic surgery was started in the Czech Republic in 1991. At present these operations are made at all departments. The number of operations increases steadily. Thoracoscopy is used in 21% departments. In addition to cholecystectomy (100%) most frequently the following operations are made: appendenctomy--81%, inguinal hernia--67%, acute abdomen--55% and in a smaller number of departments (cca 10%) some more pretentious operations are made in the region of the oesophageal hiatus, intestinal resection etc.

Endoscopic surgery replaced in some areas classical surgery. The importance of flexible endoscopy and sonography induced an ever increasing numbers of surgeons to use these methods actively. Intervention radiology is also of increasing importance and in many cases it is the preferred alternative of classical operations.