[Surgical therapy focusing mainly on endoscopic treatment]

Endoscopic surgery was popularized at the beginning of the 1990s in Japan, along with the development of video optical instruments, and it was soon applied to the treatment of solid cancers. Less invasive surgical techniques were sought using various approaches in various fields in the 2000s, and now in 2010 three approaches are notable: (1) single incision laparoscopic surgery using a one window method, which is attracting considerable interest because of its low invasiveness; (2) natural orifice translumenal endoscopic surgery (NOTES); and (3) robotic surgery, which is being pursued as a new modality. Further improvements in all these methods are anticipated as a result of the development of new instruments and the mastery of surgical techniques. However, an assurance of the safety of surgical procedures and a good prognosis are requisites for all these methods, and a level of quality equivalent to that of surgical techniques such as traditional thoracic and abdominal surgery must be maintained. Although these methods seem to represent difference paths, investigations of the various surgical techniques pursued by surgeons reveal that the various paths merge to reach the same goal. Therefore, extensive studies of new surgical techniques in various fields are needed to ensure that these new techniques hold up to the expectations of surgeons.