Minimally invasive surgery. Surgical oncology of the gastrointestinal tract

The general potential and current position of minimally invasive surgery fo r the surgical treatment of malignant tumours of the gastrointestinal tract are discussed. A reliable validation of these procedures for tumour surger y is still impossible due to the lack of longterm results, the selective ex perience, and the ongoing process of learning and development. However, it seems clear that minimally invasive procedures will have an important posit ion within surgical oncology. This is especially true with respect to impro ved staging of gastrointestinal tumours by laparoscopy and various palliati ve procedures that may be performed laparoscopically. Minimally invasive pr ocedures may suffice for the treatment of certain, highly selected cases of preneoplastic and early cancerous lesions. The definitive acceptance of mi nimally invasive procedures in the future will require further clinical, pr eferably randomised trials, comparing the advantages of the minimally invas ive access route to possible long-term disadvantages with regard to recurre nce-free and overall survival.