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Minimally invasive surgery has become a common term in visceral as well as gynecologic surgery. It has almost evolved into its own surgical speciality over the past 20 years. Today, being firmly established in every subspeciality of visceral surgery, it is now no longer a distinct skillset, but a fixed part of the armamentarium of surgical options available. In every indication, the advantages of a minimally invasive approach include reduced intraoperative blood loss, less postoperative pain, and shorter rehabilitation times, as well as a marked reduction of overall and surgical postoperative morbidity. In the advent of modern oncologic treatment algorithms, these effects not only lower the immediate impact that an operation has on the patient, but also become important key steps in reducing the side-effects of surgery. Thus, they enable surgery to become a module in modern multi-disciplinary cancer treatment, which blends into multimodular treatment options at different times and prolongs and widens the possibilities available to cancer patients. In this quickly changing environment, the requirement to learn and refine not only open surgical but also different minimally invasive techniques on high levels deeply impact modern surgical training pathways. The use of modern elearning tools and new and praxis-based surgical training possibilities have been readily integrated into modern surgical education, which persists throughout the whole surgical career of modern gynecologic and visceral surgery specialists.
This survey explores both the established procedures and the frontiers of laparoscopic surgery, while examining several controversies that have evolved in recent years. Also addressed are topics such as two-handed surgical technique, intracorporeal suturing, intricate dissection, control of large vessels, the operating room of the future, cost considerations, and regulatory issues. June 1998 / 0-387-98338-4 / $150.00
Minimally invasive surgery has impacted the outcomes of surgery more than any technology since the development of sterile technique. The hard science has demonstrated that decrease in wound complications and recovery time has created the biggest gap with open approaches to surgery. The total economic benefit may be unfathomable when looked at comprehensively. Integral to the rise of minimal access and therapeutic techniques in surgery has been the growth of technological improvements over time. Beginning with insufflators, videoscopy, and energy devices, that evolution has continued into the development of tele-surgical devices that feature full articulation of instruments, high-resolution 3-D optics, and computer assisted movement. This has come with controversy – as the dominant manufacturer of robotic assisted devices, Intuitive Surgical, and their generations of da Vinci surgical platforms, holds enough market share to spur cries of monopoly and financial excess. However, with over 3000 world-wide systems in use, and over 6000 peer-reviewed research articles, the impact of robotic surgery cannot be ignored. The current state of data suggests equivalency in most procedures with regard to traditional outcome measures, equal or somewhat elevated costs, with specific areas of superiority. The first section of this textbook, Surgical Robots, covers the history, economics, training, and medico-legal aspects of robotic surgery that will be of interest to students, residents, fellows, surgical staff, and administrators or public health specialists who seek to gain a comprehensive background on robotic surgery, or justification for purchasing a robotic system for their institution. Surgeons will also find this background valuable to their practice, to give context to their procedures so they can better counsel their patients, help with advocating for robotic platform purchases, and proactively prepare themselves for medico-legal issues. The chapter on legal issues will have specific instances of robotic surgery-related lawsuits and their outcomes, a first for robotic surgery texts. The second section of this textbook, Robotic Procedures, will contain a comprehensive catalogue of procedures that have been performed robotically in general surgery, gynecology, urology, plastic surgery, cardiothoracic, and otolaryngology. Each author will cover the existing literature, preoperative planning, room and patient setup, steps of the procedure, and postoperative care. Standardized room maps and port placement will help the student, resident, fellow, surgeon or OR Staff to quickly reference these before cases. Each chapter will also cover the specific equipment needs and expected complexity of the procedures, allowing administrators to better gauge how to prepare for, or ration, use or their robotic resources. The final section, Future of Robotics, will give the entire scope of audience a look into what exciting advancements in the field are on the horizon. This textbook is a complete resource for robotic-assisted minimally invasive surgery, covering the history, current state, technical and clinical aspects, and future considerations that may be of interest to any who has a role, stake, or curiosity regarding robotic surgery.
Learn the nuances of successful minimally invasive pediatric surgery from international experts in this fast-changing field. Atlas of Pediatric Laparoscopy and Thoracoscopy, 2nd Edition, brings you up to date with the latest approaches, including gastrointestinal, intra-abdominal, and urologic procedures, as well as robotic operations and a variety of thoracoscopic procedures. Comprehensive, step-by-step instructions are highlighted with outstanding illustrations and more than 50 surgical videos that show you exactly how to proceed, making this an ideal resource for surgeons at all levels of experience. - Offers comprehensive instruction from global experts on the nuances of minimally invasive pediatric surgery, helping you successfully perform even the most challenging procedures. - Provides superb visual guidance with 350 full-color endoscopic views, 200 corresponding line drawings that illuminate every concept and highlight important anatomical details, and 55 high-quality procedural videos performed by the physicians who pioneered them. - Contains new chapters and updated information on laparoscopic intestinal operations in the neonate, laparoscopic fundoplication, endoscopic fundoplication, and minimally invasive pectus carinatum repair. - Focuses on minimizing recovery times and post-operative complications. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
A combination atlas and procedural guide for minimally invasive surgery Atlas of Minimally Invasive Surgical Operations delivers easy-to-follow, step-by-step procedural guidance accompanied by more than 800 high-quality illustrations designed to teach readers minimally invasive surgery techniques. Following the proven effective model of the acclaimed Zollinger’s Atlas of Surgical Operations, each procedure is fully explained with text and accompanying illustrations. The beautifully rendered line drawings depict every important action a surgeon must consider while performing the operation. The text includes consistently formatted coverage of indications, preoperative preparation, anesthesia, position, operative preparation, incision and exposure, procedure, closure, and postoperative care. · Illustrations were created by professors of medical illustration at Johns Hopkins University · Companion DVD shows the actual procedures in real time
This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.
This multidisciplinary textbook is designed to be the standard on the subject and is geared for use by physicians who are involved in the care and/or diagnosis of cancer patients. Comprehensive coverage is provided on all aspects of radioguided surgery. Practical information is readily accessible and throughout there is an emphasis on improved decision making. Tables present the indications, performance, and interpretation of procedures at a glance. A wealth of illustrations, including a full-color insert, enhances the application of new concepts.
Two of the most internationally renowned pancreatic surgeons have edited this definitive reference book on pancreatic surgery. Surgery of the Pancreas is directed at the operating surgeon, its primary emphasis being on anatomy, surgical technique, and clinical decision making. The book is extremely well illustrated both with line illustrations and with photographs.Fully updated throughout, this edition includes new chapters on - molecular biology and pancreatic disease - management of pseudocysts - cystic pancreatic neoplasms - consideration of radical/super radical operations - endoscopic and percutaneous stenting for pancreatic cancer Surgery of the Pancreas presents an unparallelled compendium of information, ranging from the historical aspectsof the organ and its diseases to the current status of such frontiers as transplantation and adjunctive therapies. The Editors have sought their contributors from 9 different countries and have recruited some of the most experienced and widely recognizedauthorities in the field. The definitive reference work: an in-depth text covering every aspect of pancreatic surgery Excellent line illustrations Cohesively written New topics such as molecular biology New interventional and diagnostic techniques included Completely up to date including ground breaking research in transplantation Shows all clinical options Helps the surgeon to avoid complications and hazards
Minimally invasive spine surgery, in some form or other, has historical roots dating back more than 100 years, and recent advances in technology now make it increasingly effective in treating suitable spine patients. While minimally invasive approaches have shown to reduce muscle damage, blood loss, and post-operative pain, to perform this t ype of surgery correctly, even highly skilled modern-day surgeons must prepare themselves for a demanding learning curve. For this reason, AOSpine proudly presents Minimally Invasive Spine Surgery: Techniques,Evidence, and Controversies, the most comprehensive book of its kind, which includes more than 500 pages of surgical techniques, illustrations, case images, tips and tricks, and research, providing an invaluable tool for spine surgeons around the world. Each technique is fully examined: The pros and cons of each is objectively reviewed Its spectrum of indications and contraindications is summarized Historical and modern day controversies relating to each technique are discussed Uniquely, chapters in the text are further supported by an evidence-based section summarizing research studies, analysis, and conclusions into each technique, from peer-reviewed journals The text covers more than just a range of interesting medical techniques. By including brief historical introductions on each technique and the surgeons that explored and founded its methods, their early (sometimes self-made) instrumentation, right through to todays current best-practice, this book provides an interesting, informative, and topical instruction on minimally invasive surgery and its increasingly encouraging results for spine-patient care.
Minimally Invasive Gynecologic Surgery provides a complete, practical and timely review of the minimally invasive surgical techniques used to treat gynaecologic diseases and conditions. Recent advances in technology and instrumentation, particularly the use of robot-assisted surgery, mean that minimally invasive approaches have become increasingly established as alternatives to traditional open surgeries. This book describes the full range of minimally invasive procedures in current gynaecologic practice, with discussion of the indications and contraindications and a summary of available evidence. The book opens with a section describing instrumentation, electrosurgery, how to avoid and manage complications and single port surgery. Subsequent sections cover procedures for benign and malignant conditions and relevant robotically assisted surgeries. Highly structured chapters provide practical guidance to key steps of each procedure, alternative management options; contraindications and available evidence Stellar contributors from leading centers in the USA, Brazil, Chile, Canada, France, Italy and Belgium ensure coverage reflects global best practice