Catálogo de publicaciones - libros

We used robotic-assisted surgery and demonstrated the feasibility of having a standard robotic laparoscopic surgery without specific morbidity and within acceptable operative times. In its present configuration, the system seems to provide the greatest benefit for microsuturing within the abdomen or in very confined spaces. Improved ergonomic conditions and improved instrument dexterity at the level of the distal articulation appear to be of value in routine abdominal procedures. More research is needed for further improvement in tool design and optics arrangement. The robotic approach requires new operative strategies and modification of the pattern of trocar placement.

Gastroesophageal reflux disease (GERD) can be traced back to disorders of the gastroesophageal junction. But several psychological factors and psychiatric disorders interact through recognized psychophysiologic or behavioural mechanisms to affect the clinical presentation and treatment outcome. Even if many aspects are still unknown, the following is conceivable: that well defined personality factors moderate the effect of stress on the gastroesophageal junction, just as they can influence the perception and assessment of symptoms. Additionally, psychiatric disorders as comorbidities can also accompany GERD. For this reason, it is necessary to consider if an extension of hitherto psychological interventions could be helpful in patients with a subjective link between reflux and stress on an emotional personality related level, or in patients with attendant psychiatric disorders. This broadening relates both to the conservative use of antireflux medication and to surgical therapy, since a postoperative shift in symptoms can occur. The effectiveness of psychological interventions in several gastrointestinal patient groups could already be shown in the past. Whereas evidence for their effectiveness in patients suffering with GERD is partly still outstanding and should be investigated in the future especially as several individual promising starts have been made.