Re: Total colectomy/larproscopy

From: Howard McCollister (nospam_at_nospam.net)
Date: 08/19/04 

Date: 19 Aug 2004 07:22:19 -0500

"Griffin" <nospam@here.net> wrote in message
news:2004081718031916807%nospam@herenet...
> On 2004-08-17 08:09:12 -0400, "Howard McCollister" <nospam@nospam.net>
said:
>
> > This is technically difficult laparoscopically
> > and very prone to complications, the end result possibly being an
ileostomy
> > at a second operation.
>
> Ditto. Just because something *can* be done through the 'scope doesn't
> always mean it *should* be done through the 'scope. ;-)

Well, that's generally true, but it's a complex subject. Generally,
complication rates are higher for laparoscopic versions of what have
typically been open operations. This is in part because these operations are
harder to do laparoscopically, but also because the era of laparoendoscopic
surgery is only about 10 or 12 years old and we are still on the steep part
of the learning curve. There are many surgeons doing advanced laparoscopic
surgery that simply shouldn't be - their brains just aren't wired for
2D-->3D conversion. Additionally, the training in laparoendoscopic surgery
in surgery residencies is absymal. Minimally invasive fellowships are few
and far between - currently only about 80 accredited in the entire US.

So, the result is that undergoing a laparoscopic colon resection, or any
major laparoscopic operation, requires that the patient be very, very
careful about understanding the credentials and skills of the surgeon he or
she selects.

HMc

>

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