Innovation and evolution of gastric surgery

In the past half-century, the science of surgery has experienced rapid growth with new technologies impacting every area of the surgical experience. Humanity has demonstrated its capacity for innovation and resilience with developments, and expansion, and sophistication occurring in almost all surgical disciplines.

New and exciting developments in cameras, imaging, and improved diagnostics tools have led to dramatic shifts in the paradigm of how we approach disease. The major revolution of laparoscopy and minimally invasive surgery has impacted all disciplines in surgery leading to lower complications, less pain, and a shift to inpatient and outpatient surgery, improving the human experience of surgery and it was just the beginning.

Gastrointestinal surgery has advanced and improved the management of different disease processes from cancer to GERD but also, gastric surgery continues to explore other facets. For example, new developments in metabolic surgery permit gastric tissue manipulation to mitigate the overwhelming growth of obesity and related conditions. Surgical procedures can now interact with the microbiome and hormones to improve population health and well-being. Endoluminal interventions permit manipulation of the pylorus to treat and improve the quality of life in gastroparesis. As well, the increased interest in and usage of robotics represents a new path that has yet to be fully explored. The objectives to improve patient outcomes and minimize the physiologic impact of gastrointestinal interventions create a new axis for the evolution of robotics in gastric surgery.

In this issue of Digestive Medicine Research, we explore the latest technologies and techniques in gastric surgery, provide current data, and report adjuncts to introduce the reader to the future potentiality of gastric surgeries. This is a compilation of the latest innovations of minimally invasive gastric surgery. I had the honor of inviting world-renowned experts to provide their views on the most current and discuss their opinions and views on the future state of gastric interventions, and their potential impact within the gastric surgery field. New innovations, shifts in current practices, and the latest technologies have been reported and discussed to provide the reader with the newest data to improve their practices and have a better understanding of the direction of gastric surgery.

It would be amiss during this dark time in history to not note the overreaching impact COVID- 19 has impacted our lives and our work in gastric surgery. The worse health threat of our era impacted the health of millions of people arising in an unimaginable death toll and COVID-19 virus mutations continue to hinder our ability to progress. However, despite these new limitations and changes in how surgeons work and even if, when elective surgery was temporarily halted, I have had the honor to work alongside prominent surgeons who delivered outstanding reports understanding the importance of sharing their knowledge. This collaborative effort and understanding made this compilation a pleasure to help produce. We believe the following articles provide a better understanding of the evolution of gastric surgery and are an opportunity to learn.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Digestive Medicine Research for the series “Advanced Laparoscopic Gastric Surgery.” The article has undergone external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/dmr-21-62). The series “Advanced Laparoscopic Gastric Surgery” was commissioned by the editorial office without any funding or sponsorship. ADG served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Digestive Medicine Research from Dec 2019 to Nov 2021. ADG has received consulting fees for Levita, Teleflex, Phenomix and has received honoraria as a speaker for Gore and Medtronic outside the submitted work. The author has no other conflicts of interest to declare.

Ethical Statement: The author has accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Alfredo D. Guerron