Impact of body image on patients’ attitude towards conventional, minimal invasive, and natural orifice surgery

Lamadé, Wolfram; Friedrich, C.; Ulmer, Christoph; Basar, Tarkan; Weiβ, Heinz; Thon, Klaus‐Peter

doi:10.1007/s00423-010-0669-3

Cited by 18 publications

(14 citation statements)

References 17 publications

(20 reference statements)

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“…A variety of emerging factors are influencing the delivery of health care in the United States as well as the practical challenges faced by surgeons on a daily basis. These include strong popular interest in the newest minimally invasive techniques 1‐3 such as laparoscopic, 4 endoscopic, 5 and robotic approaches; 6 evidence that blood transfusions may have negative effects 7 on cost 8 as well as surgical morbidity 9 and mortality 10 particularly when extended‐storage banked blood is used; 11,12 emergence of several novel anticoagulation modalities such as direct thrombin or Factor Xa, inhibitors that do not require frequent monitoring, 13 but which are difficult to quickly reverse; 14 larger numbers of older patients now considered reasonable candidates for an increasing variety of operative procedures 15‐19 with a simultaneous increase in the proportion of the population considered elderly; 20 and finally, need for cost containment particularly in view of rapidly increasing health care expenses and restricted economic growth 21…”

Section: Introductionmentioning

confidence: 99%

Hemostats, sealants, and adhesives III: a new update as well as cost and regulatory considerations for components of the surgical toolbox

2012

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The hemostat, sealant, and adhesive components of the surgical toolbox continue to evolve and enter clinical practice at a rapid rate. The goal of this comprehensive, sequential review is to update these components to include those now available (February 2012) as well as to explore cost and regulatory factors that impact the development and use of these materials. A unique system of definitions for organizing these components based on group, category, and class is used as a means of improving the understanding and appropriate use of these materials. The system will be used here to present the most recent additions to the toolbox, which are evaluated based on safety, efficacy, usability, and cost. These new additions include pooled human plasma fibrinogen and thrombin embedded in an equine collagen patch for cardiac surgical hemostasis, polyethylene glycol (PEG) and human serum albumin for lung surgical pneumostasis, modified PEG and trilysine amine for spinal sealing, octyl and butyl lactoyl cyanoacrylate for vascular sealing, and a variety of octyl and butyl cyanoacrylates with or without dyes and/or polyester mesh for skin closure with the creation of a bacterial barrier. The system of definitions will also be used to clarify key strategies in the current health care environment for reducing costs and for increasing understanding of Food and Drug Administration regulatory decisions for these materials.

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Section: Introductionmentioning

confidence: 99%

Hemostats, sealants, and adhesives III: a new update as well as cost and regulatory considerations for components of the surgical toolbox

2012

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“…Application of scar-reducing or scarless operations seems to be a modern trend which is mostly preferred by young and educated patients (14,15). Moreover, patients with a negative body image tended to receive no scar surgery and were willing to accept increased surgical risks and higher costs to improve the cosmetic outcome (16). There is also evidence that less invasive surgery increases both the body image and cosmesis which was shown in a randomized controlled trial comparing laparoscopic single-port versus three-port appendectomy (17).…”

Section: Discussionmentioning

confidence: 99%

Transoral endoscopic mediastinal surgery (TOEMS)—results of a first clinical study for scarless mediastinal lymph node biopsies

et al. 2016

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Background: Video-assisted mediastinoscopy (VAM) represents the standard procedure for mediastinal lymph node biopsies. This operation results in a scar at prominent position at the anterior neck. Since there is a trend to less invasive procedures, natural orifice transluminal endoscopic surgery (NOTES) was introduced to different fields of surgery. Based on NOTES we developed a new approach for mediastinoscopy: transoral endoscopic mediastinal surgery (TOEMS). In previous studies using human cadavers and living pigs the feasibility of TOEMS was shown. It was unclear whether TOEMS could be safely applied in patients requiring mediastinal lymph node biopsies.Methods: We conducted a clinical phase I study recruiting ten patients with unclear mediastinal lymphadenopathy not resolved by prior bronchoscopy. All patients underwent TOEMS for mediastinal lymph node biopsy. The duration of the procedure and complications were monitored. In addition, all patients were examined for pain, swallowing dysfunction and sensation disturbance.Results: TOEMS was accomplished in eight patients. In two patients operation was converted to VAM due to technical problems. Mediastinal lymph nodes were dissected in all patients who finished with TOEMS. On average, two separate lymph stations were reached by TOEMS. Duration of the procedure was 159±22 min.Permanent palsy of the right recurrent laryngeal nerve was noticed in one patient postoperatively.Conclusions: This is the first report for a human application of NOTES in thoracic surgery. In fact, transoral endoscopic surgery seems to be a feasible approach for mediastinal lymph node biopsies.Further studies are needed to show whether this procedure has an advantage over VAM in terms of pain, complications and accessibility of mediastinal lymph node stations.

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“…Patient's preference on scarless concept may be influenced by age, gender, and surgical/endoscopic history at the cost of increased personal risk. A recent study [73] found that patients with "negative body image" favour scar less concept accepting increased operative risk [56]. Umbilicus hides the scar of surgical insult in SILS.…”

Section: Methodological Righteousness Sans Honestymentioning

confidence: 99%

Innovations in Endosurgery—Journey into the Past of the Future

Agarwal¹,

Chintamani

Ali³

et al. 2012

Indian J Surg

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Progress in surgical practice has paralleled the civilizational evolution. Surgery has progressed from being the last resort in saving life to being form and function preserver. Post-renaissance Industrial age gave an impetus to this march of surgery. The currently on going digital technological revolution has further catalysed this march. Having achieved the stabilized and acceptable clinical outcomes, the surgeon has embarked on a journey of improving patient reported outcomes (PRO). Improvement in PROs with the advent of laparoscopic surgery with the attendant emphasis on minimising invasion has led to debates about invasion being just parietal or holistic in physiological sense. There is a concern that parietal invasiveness shouldn't be a trade-off for compromised clinical outcomes. Single Incision Laparoscopic Surgery (SILS) in its current avatar with current instrumentation seems to be an enthusiastic bandwagon rolling on with the cosmetic benefits acting as veil to hide the potential clinical concerns. History of surgical innovations is riddled with tales of vindictiveness and vicissitude. Lest the same fate befalls SILS we would do better to examine the SILS bandwagon in its current form till the emerging technologies address the current concerns.

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Impact of body image on patients’ attitude towards conventional, minimal invasive, and natural orifice surgery

Abstract: Patients with an NBI tend towards scarless surgery and are willing to accept increased operative risk and to spend additional money for improved postoperative cosmesis.

Cited by 18 publications

References 17 publications

Hemostats, sealants, and adhesives III: a new update as well as cost and regulatory considerations for components of the surgical toolbox

Hemostats, sealants, and adhesives III: a new update as well as cost and regulatory considerations for components of the surgical toolbox

Transoral endoscopic mediastinal surgery (TOEMS)—results of a first clinical study for scarless mediastinal lymph node biopsies

Innovations in Endosurgery—Journey into the Past of the Future

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