[The present and future status of "scarless" surgery]

The concept of scarless surgery aims at further minimization of diagnostic and therapeutic interventions. Based on the success of flexible gastroenterological endoscopy and laparoscopic surgery, it combines their advantageous approaches in a synergistic manner. Animal experiments have achieved encouraging results in respect to the feasibility of various types of interventions in the peritoneal and retroperitoneal cavity. Further studies and improvement of instruments will have to prove the practicality and superiority of this concept for medical outcome and efficiency compared to present standards of practice in the potential fields of application. The replacement of certain minimally invasive procedures with scarless intervention techniques seems reasonable, as do new fields of application. After further improvement of the methodology, adequate organization, infrastructure, and teaching structures will have to be developed. If they succeed, the concept of scarless surgery can expect a promising future.