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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_605_Библиотеки_им_академика_М_И_Перельмана.pdf
BIOMEDICAL
ENGINEERING IN
GASTROINTESTINAL
SURGERY
BIOMEDICAL ENGINEERING IN GASTROINTESTINAL SURGERY
ARMIN SCHNEIDER
and
HUBERTUS FEUSSNER
Institute of Minimally Invasive Interdisciplinary Therapeutic
Interventions (MITI), Technische Universität München (TUM)
Academic Press is an imprint of Elsevier
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Copyright r 2017 Elsevier Inc. All rights reserved.
No par t of this publication may be reproduced or transmitted in any form or by any means, electronic or
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This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any infor mation, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom they
have a professional responsibility.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress
ISBN: 978-0-12-803230-5
For Infor mation on all Academic Press publications
visit our website at
https://www.elsevier.com/books-and-journals
Publisher: Mara Conner
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Editorial Project Manager: Ashlie Jackman
Production Project Manager : Nicky Carter
Cover Designer : Mark Rogers
Typeset by MPS Limited, Chennai, India
CONTENTS
v
m
c
s
-
FOREWORD
“Biomedical Engineering” (BME) is a rather young entity in the history
of interventional medicine, natural science, and engineering. It is an
impressive subject, which is considered by the public either with unlimited admiration since it promotes significant progress in health care or
with a deep concern since it favors inhuman “apparatus-based medicine.”
The discussion of the ethical aspects of BME will not be the subject
of this book, since the debate upon the ethical frame is more or less a
luxury problem. A discussion about active life support by means of artificial ventilation, dialysis, or mechanical circulation support, etc. may be
well justified or even necessary in individual cases but it became only possible as soon as the engineers were able to provide suitable devices and as
soon as physicians were ready to use them. Hundred years ago, philosophers, theologists, and the interested public were not troubled by this
dimension of medical care, simply because the problem did not exist at
all. The technical means were not given.
In fact, nobody would be inclined to avoid (ostensibly) difficult ethical
questions by terminating the development of even more effective support
systems. On the contrary, we need more innovative devices, procedures,
and systems to intensify the fight against diseases, injuries, and other
threats of health and well-being. Insofar, any research and development
activities in BME are, beyond a doubt, morally correct and of merit as
compared to other branches of technical R&D, just to mention in particular, military technology as an example.
If it is even a moral obligation to contribute to further progress in
BME, the question of how to do it has to be answered. All those who are
involved should possess a sound and comprehensive knowledge of the relevant medical problems and, simultaneously, of the available scientific and
technical potential to solve them.
However, no individual is able any longer to maintain more than a
superficial overview of all aspects of the numerous knowledge domains.
Surgeons, for example, are considered as a rather homogenous group of
professionals, but in reality, they are highly specialized and even subspecialized. An abdominal surgeon is today no longer an adequate counterpart
for an engineer who considers to design a new operating table for spine
surgery. Likewise, a cardiac surgeon would never be able to give an expert
insight into the special requirements of visceral surgery, etc.
ix
x Foreword
The same holds true for the large community of engineers or computer scientists. One engineer might be an expert in mechanical engineering, but he/she has only a marginal knowledge of electrical
engineering. The computer scientist is, perhaps, highly reputated in modern imaging procedures, but is by far less familiar with the special problems of state-of-the-art speech recognition.
Accordingly, it becomes more and more difficult to shape purposetailored teams of all the scientific and technical experts who are required
to solve a specific medical problem successfully. The authors of this book
aim at creating a comprehensive knowledge platform to bridge the different worlds of all partners involved, including the decision makers in the
BME industry. Necessarily, many compromises have, therefore, to be
made concerning the range of medical aspects and the informational
depth of the technical chapters. The result can only be an overview.
In this book, medicine is confined to surgery—and even more exclusively focused upon visceral surgery. We deliberately renounced to cover
all aspects of surgery, since the available frame and space of this book is
limited; the book is dedicated to visceral surgery, which still is neglected
as compared to the rather copious literature upon BME in bone-, neuro-,
and ENT surgery (due to the fact that BME, in general, can be more easily applied in rigid environments). Likewise, the readers should not expect
textbook-like chapters upon the basics of mechanical or electrical engineering or of computer science. We are unable to give more than an orientation about these knowledge domains. Insofar, the visceral surgeon
who expects some information upon new sophisticated details of visceral
surgery will certainly be disappointed when reading the medical aspects
of this book. On the other hand, he could be fascinated by the promising
and realistic options of intraoperative tissue differentiation. The specialist
in navigation technology will be bored by the description of various navigation technologies, but could be very much interested in the range of
potential clinical applications.
Last but not least, we strive to point out severe deficits and clinical
challenges which still exist in our currently available therapeutic armamentarium with the hope to stimulate the readers to take active part in a
continuous improvement of surgical care.
Textbooks of this kind are mostly compiled of specialized chapters
written by various experts in their field and put together by one or two
editors.