Operative Techniques in Single Incision Laparoscopic Colorectal Surgery PDF
|Author||Daniel P. Geisler and Deborah S. Keller|
|File size||8.65 MB|
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Laparoscopic surgery has revolutionized the field of colorectal surgery. Since its introduction over 25 years ago, the patient benefits and financial value continue to develop. Despite the undeniable benefits, growth of laparoscopy has been slow. After the landmark Clinical Outcomes of Surgical Therapy (COST) trial demonstrated the oncological equivalence of laparoscopic to open colectomy in 2004, we expected the rates of laparoscopic colectomy to rise exponentially in the United States. However, since the trial, rates of laparoscopy for all colorectal disease have only risen to about two-thirds of eligible patients, with an estimated 50% application in colon cancer and 10% in rectal cancer cases. So why aren’t more surgeons practicing laparoscopic colorectal surgery? The largest barrier to widespread utilization is education.
Laparoscopic cases are technically demanding, and there is a significant learning curve and time investment for mastering the technology. For established surgeons, this creates a dilemma of taking the time out of practice to learn a new skill. For new graduates, laparoscopy is not adequately covered in surgical training, so dedication is needed to practice, and support is required to ascend the learning curve. However, the benefits for patients are worth the effort. We can also increase the number of minimally invasive options available. This is where reduced and single port laparoscopic surgery come in.
Single incision laparoscopic surgery – a hybrid of natural orifice transluminal endoscopic surgery (NOTES) and conventional laparoscopic surgery – has advanced the field of minimally invasive surgery, improving patient cosmesis, reducing postoperative pain, and further reducing length of stay compared to multiport laparoscopy. With all new technologies, there are technical challenges and a distinct learning curve. However, with experience and proper instruction, single incision laparoscopic surgery can be an integral part of your practice.
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