EDITORIAL

he endoscopic method for performing operations appeared in surgery relatively recently, but fast enough it has become entrenched in all surgical specialties. Endoscopic techniques allow surgeons to perform radical interventions but with minimal trauma to the surrounding tissue and virtually bloodless. The advantages of endoscopic surgery are well known not only to doctors but also to patients. Equipment for such interventions in this country has ceased to be deficit. But at the same time the shortage of skilled surgeons able to implement such procedures competently and efficiently has become acute.

Currently, about a third of Russian surgeons have mastered endoscopic techniques. For this indicator, we are lagging far behind the developed countries. As yet, especially in the initial stages, there have been made lots of medical errors. There is an urgent need to train endoscopic surgeons and to create objective criteria for their permission to perform operations independently. It is important to define a set of competencies of the doctor mastering the endoscopic procedure in which it is obligatory to clearly define the place of traditional surgery. It is necessary to recognize as a fait accompli but nevertheless requiring interpretation and explanation the fact that now a whole generation of endoscopic surgeons are uncomfortable with traditional surgery.

The question of the limits of permissibility and appropriateness in endoscopic surgery is still relevant, particularly in cancer. The spectrum of operations performed using endoscopic techniques is extremely diverse. However, as most of them are absolutely logical, the need to perform some interventions is questionable. Here, by the way, lies another problem of modern endoscopic surgery – the mechanism of introducing new medical technologies. It is not a secret that under the guise of good intentions and by honest mistakes of some authors clearly dangerous and even harmful methods are sometimes pulled into practical surgery. It has not been clear yet who and how should resolve to adopt new technologies, where the line between innovation and commerce, what is the role of the Ministry of Health and public organizations in this issue.

There are many problems, but they are potentially solvable. We hope that our journal would help interested professionals to find answers to many of the previously raised questions.

Kossovich Mikhail A.

MD, Head of the Department of Surgery Emergency Conditions of Petrovsky National Research Centre of Surgery, Professor Department of Hospital Surgery # 1 of I.M. Sechenov First Moscow State Medical University