Innovations in minimally invasive surgery: lessons learned from translational animal models

Area of Science:

• Surgical Innovation
• Medical Research Methodology

Background:

• Animal models are indispensable for advancing surgical research and technique development.
• A diverse range of models, including inanimate objects, anatomical specimens, and live animals, are required to address challenges in surgical innovation.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES) serves as a prime example of a procedure necessitating such comprehensive modeling.

Purpose of the Study:

• To evaluate the utility of various experimental models in overcoming challenges associated with developing new surgical techniques.
• To establish a framework for the safe and reliable implementation of novel surgical procedures in clinical practice.

Main Methods:

• Over 400 experimental procedures were conducted using inanimate models, ex vivo tissues, and animals.
• These experiments focused on addressing key challenges in Natural Orifice Transluminal Endoscopic Surgery (NOTES), including peritoneal access, gastrotomy closure, exposure, retraction, and dissection.
• Training methodologies for initiating new procedures were also developed and tested.

Main Results:

• The systematic application of different models facilitated the identification of optimal solutions for each surgical problem.
• This approach enabled the precise definition of the safest and most effective methods for applying new techniques to patients.
• The study successfully led to the first safe transvaginal and transgastric cholecystectomies in human patients.

Conclusions:

• Animal experimentation remains vital, as current computational models cannot fully replicate complex biological interactions.
• Animal research is essential for validating new technologies and developing surgical training programs.
• Animal models serve as a critical precursor to human patient trials, enhancing surgeon preparedness and patient safety.