Population perception of surgical safety and body image trauma: a plea for scarless surgery?

Bucher, Pascal Alain Robert; Pugin, François Louis; Ostermann, Sandrine; Ris, Frédéric; Chilcott, Michael; Morel, Philippe

doi:10.1007/s00464-010-1180-1

Cited by 71 publications

(72 citation statements)

References 21 publications

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“…This result is in line with other published surveys [7,8,21,22]. In a recent paper [23] on 420 subjects, the most important concern regarding surgical therapy was the fear of surgical complication, with 92% placing it first, whereas postoperative scars were the first concern for only 2% of the participants. Furthermore, analysing the relationship between surgical scars and the risk of complications, 86% of subjects would choose a larger scar but lower risk, whereas only 11% would choose a smaller scar but higher risk.…”

Section: Discussionsupporting

confidence: 88%

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

et al. 2011

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Much of the discussion pertaining to natural orifice transluminal endoscopic surgery (NOTES) focuses on technical issues, with little attention to women's perception and to their willingness to consent to this surgery, especially in the field of obesity. Aim of this study was to evaluate obese women's perception of NOTES and trans-vaginal access. Sixty two obese patients undergoing bariatric surgery were given a written description of NOTES with an anonymous questionnaire exploring their concerns and opinions regarding this technique. The risk of complications was the most important aspect with regard to surgical procedures for 87.1% of patients, while the aesthetic result counted only for 16.1%; none of the patients would accept an increased risk of surgical complications for a better aesthetic result, and 74.2% of them would prefer a standardized traditional surgical approach. Nulliparous women were more concerned about the potentially negative effects of NOTES on fertility than multiparous women and younger women were more worried about the effects on sexual function than older women. 83.9% of patients refusing NOTES stated that the main reason for their refusal was the lack of definitive data on the beneficial effects. Bariatric NOTES potentially offers obese women a scarless intervention, but only a few obese women expressed worries about the cosmetic/aesthetic effects of surgery, while most of them were worried about effects on future fertility and sexual life. Our study highlights a strong need for early reporting of outcome data to enlighten patients about this new approach to bariatric surgery.

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Section: Discussionsupporting

confidence: 88%

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

et al. 2011

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“…28,29 In the first one, participants were queried about their expectations for surgical treatment and their approach preference. 28 Again, the main concern of the survey responders was the risk of surgical complications (92%). When asked about the relative importance of different parameters, cure was placed first by 74%, safety by 33%, and cosmesis by only 3%.…”

Section: Notes Versus Less: Comparative Analysismentioning

confidence: 99%

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

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White

Gettman

et al. 2012

Urology

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Evidence relating to the perception and view of patients and physicians on natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) was scrutinized. A comprehensive literature search was performed through PubMed. A total of 18 studies were included in the analysis. Patients demonstrated interest in scarless surgery, with a preference for LESS over NOTES. Safety and efficacy remain the key factors in the decision-making process of patients. With more information about the safety and reproducibility of LESS and NOTES, and with improved educational efforts, patients and physicians alike may feel more comfortable in widespread application of scarless surgery. UROLOGY 80: 495-502, 2012.

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“…In contrast, all other invasive procedures for mediastinal lymph node biopsies produce apparent scars at the anterior neck. 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).…”

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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Population perception of surgical safety and body image trauma: a plea for scarless surgery?

Cited by 71 publications

References 21 publications

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

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

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