The Laparoscopic Surgery Revolution: Finding a Capable Surgeon in a Rapidly Advancing Field

by David W. Page MD

Overview

More than 30 years ago, laparoscopic or "keyhole" surgery suddenly appeared as an operative technique. Laparoscopy quickly grew in the U.S. surgical field, where now more than two million operations annually use the technique. But is the training surgeons receive in laparoscopy sufficient to ensure patient safety? What are the specific situations where laparoscopy is beneficial and justified, and when is it ill-advised due to the additional complexity and risk factors? This is the first book written for general readers—avoiding medical jargon wherever possible—to expose the gritty history and downsides of "minimally invasive surgery." Additionally, it provides the perspective and insights of an esteemed surgeon who was working at the inception of laparoscopy and has a full understanding of this now widely popular procedure across its development and lifespan.

Readers will learn about the emergence of laparoscopic techniques in the 1990s, understand how minimally invasive surgery has been a boon to the business of surgery and to patient health and recovery overall, appreciate how the complexity involved in laparoscopic surgery has led to a higher incidence of surgeon "incompetence," and grasp the responsibility of a patient to take steps to assure that the surgeon is qualified before going into the operating room. Examination of eye-opening statistics on the outcomes of laparoscopic procedures documents the high level of capability of most surgeons, as well as the lack of appropriate ability with certain laparoscopic operations in the hands of some surgeons. The author also spells out how informed patients can be prepared to discuss and consider all aspects of an operation—and the surgeon's training and experience—to assure the best outcome for their health.

Product Details

ISBN-13:	9781440844782
Publisher:	ABC-CLIO, Incorporated
Publication date:	02/13/2017
Sold by:	Barnes & Noble
Format:	eBook
Pages:	284
File size:	7 MB

About the Author

David W. Page, MD, MFA, FACS, is a board-certified surgeon and professor of surgery at Tufts University School of Medicine and director of Undergraduate Programs in Surgery at Baystate Medical Center, Tufts University School of Medicine, Springfield, MA.

Table of Contents

Foreword Carol E. H. Scott-Conner, MD, PhD, MBA ix

Preface xi

Acknowledgments xxi

Abbreviations xxv

Part 1 The Third Great Revolution in Surgery: A Trail of Chaos from Heroic Scalpels to a World of Scopes 1

Chapter 1 "Dry Lab on Saturday, Pig Lab on Sunday, Grandma on Monday" 3

Chapter 2 The First Sounds of a Revolution 17

Chapter 3 Disorientation: My First Waltz with a Laparoscope 31

Part 2 Radical Surgery Reigns: The Calm before the Storm 49

Chapter 4 The Capable Surgeon: Surgical Competence and the Patient-Safety Movement 51

Chapter 5 Romancing the Stone: A Specialty in Decline and How General Surgeons Almost Lost the Gallbladder 67

Chapter 6 The Gallbladder's Tale: The Chaotic Birth of Laparoscopic General Surgery 79

Part 3 Telescopes Replace Scalpels: The Struggle to Maintain Surgical Competence Begins 97

Chapter 7 Innovative Surgeons, New Laparoscopic Operations, and the Dilemma of Patient Safety 99

Chapter 8 How Surgeons Discovered Learning Curves: Defining the Idea of a Capable Surgeon 113

Chapter 9 Surgeons without Scalpels: A Tipping Point Arrives Early for Surgical Laparoscopy 125

Part 4 Crisis in the Operating Room: Surgeons Face Self-Reflection under Bright Lights 141

Chapter 10 Big Egos, Small Incisions: The Surgical Personality Then and Now 143

Chapter 11 Resident Work-Hour Restrictions and the Destruction of the Culture of Surgery: A Crisis of Commitment, Fatigue, and the Sleep Lobby 159

Chapter 12 A Perfect Surgical Storm Is Brewing for General Surgeons 181

Part 5 The Modern Surgical Toolbox: General Surgery Is Changed Forever 193

Chapter 13 Surgical Education Today: Can We Still Train Capable General Surgeons? 195

Chapter 14 Surgical Competence: A New Definition for the Twenty-First Century 221

Notes 239

Glossary 269

Index 273

What People are Saying About This

Richard H. Bell

“Dr. David Page has carefully documented the unforeseen consequences of the introduction of 'band-aid' gallbladder surgery in the late 1980s. In the rush by surgeons and device makers to be able to offer the procedure, the traditional methods for training surgeons were ignored and many patients suffered the consequences. Surgical educators have looked hard at our system of training as a result and have found it wanting. Many good improvement efforts are underway, but the introduction of new technology in surgery is still a risky proposition. Surgeons and patients would be well advised to read Dr. Page’s account of this illuminating episode.”