Role of Minimally Invasive Surgery in Gynecologic Cancers

01Aug08

Minimally invasive surgery continues to develop and become a suitable alternative in the surgical management of gynecologic malignancies. Intuitively, patient satisfaction has helped to drive the discipline of minimally invasive surgery. Smaller incisions, less postoperative pain, and shorter hospital stays are welcomed by women suffering from gynecologic cancers. More importantly, though, the science has kept up with innovative minimally invasive techniques [42].

Minimally invasive surgery has been shown to be safe and feasible while treating patients with the same efficacy as traditional open procedures. This, above all else, will help guarantee minimally invasive surgery as an acceptable approach in treating gynecologic malignancies.

For the entire article go to: http://theoncologist.alphamedpress.org/cgi/content/full/11/8/895
Alan C. Schlaerth, Nadeem R. Abu-Rustum
Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

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I personally believe laparoscopic surgery is perfect for today’s surgery. One of the problems with laparoscopic surgery though, or newer forms of surgery like robot and single port surgery and NOTES (Natural Orifice Translumenal Endoscopic Surgery) is that these cases in the beginning are time consuming. The physicians or better yet the persons with the buckets of gold do not want these procedures to be a ‘foreveroscopy’!

The ‘Nintendo generation’ physicians is easier convinced to use new minimal invasive procedural driven laparoscopic products, older generations have some bottlenecks.

For that reason the older generation of physicians and management choose traditional procedures and products to perform the surgery. Is there a difference in quality between hospitals because of the different approaches of surgery? The answer is obvious, however how can this be changed? In Europe there is so much difference in quality of surgery, safety and success, where do you start? The physicians are traveling more and more and learn in other countries what is possible. Take the gynecologic cancers, new products and training can make the surgery go more smooth, with more success for the patient and also the hospital. The problem is though, that when the physicians go home, they face financial problems, others are not convinced because of new techniques and they are back where they started. This can create a snowball effect, physicians leave the home country to perform surgery somewhere else.

I believe more and more work groups should be formed and more influence should be involved from a European level to train physicians in minimally invasive surgery in for instance East-Europa. By the way, one of the bottlenecks in these countries is the problems of disposable usage in comparison to re-usable. There are many pro’s and cons for both, I will get back to you on that.

Do you have any ideas how to spread the new techniques on a European level with a financial system, so that everybody can use the technology?

B.V.

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Tags: Disposables, Gynecologic cancers, laparoscopy, Minimally invasive surgery, NOTES, Reusable, Single Port Surgery