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The development of surgery in recent decades has been rapid. From the first laparoscopic cholecystectomy in 1985 to Operation Anubis in 2007, scientific research has documented the advantages and benefits of the so-called minimally invasive surgery. Technology innovations have been catalytic, making the transition from laparoscopic, robotic and nowadays to hybrid surgery possible.

WHAT IS HYBRID SURGERY

Hybrid surgery is the use of multiple agents during operation, with the aim of a more detailed detection and a more precise resection of a pathological lesion.
These agents can be laparoscopic, robotic, endoscopic, computed tomography, ultrasound, energy sources, etc. in any combination and are available in the hybrid surgical room.
Hybrid surgery techniques have different names depending on the combination of the media used: Laparoscopic Intragastric Surgery, Laparoscopic Resection Endoscopic Assisted, Hybrid Image-guided Surgery.

WHAT ARE THE BENEFITS

The accurate intraoperative localization helps to resect a pathological lesion at narrower and more precise boundaries, resulting in the least possible damage to the surrounding healthy tissues. Extensive resections are eliminated, the risk of complications is reduced, and the possibility of the immediate control of the surgical outcome is offered. The recovery of the patient is rapid and the return to normal activity is immediate, even for operations that, if performed only laparoscopically, would require several days of hospitalization.

WHERE IS IT APPLIED

Many vascular, cardiac and neurosurgical procedures are already being hybridized.
In general surgery, the indications refer to pathologies that are not macroscopically visible and therefore impossible to detect only by laparoscopy. So they concern – up to date – wall or intravitreal tumors of the stomach, small intestine and colon. Large flat polyps, adenomas, stromal tumors, lipomas, leiomyomas are just a few examples.

CLINICAL EXAMPLE

Gastric stromal tumors (GISTs) are potentially benign tumors of the digestive tract and their treatment is complete resection.
The usual procedure involves the patient undergoing open surgery with a major abdominal resection and multi-day hospitalization. Laparoscopically, the incisions are minimized but there is great difficulty in locating the tumors, especially when they are small.
These problems are solved by hybrid surgery. Endoscopic intraoperative localization, helps tumor resection locally, damage to the remaining stomach is minimal and the patient receives a discharge in 2-3 days.