Chisari M G, Finocchiaro A, Lo Menzo E, Rosato V, Basile G
Istituto di Medicina Legale e delle Assicurazioni Università degli Studi di Catania, Italy.
Minerva Chir. 2004 Dec;59(6):589-96.
The laparoscopic technique introduced a new way of operating but inevitably causing new problems for the surgeon. After a comprehensive review of the history and the evolution of laparoscopic surgery from its beginning, the technical aspects of minimally invasive surgery and its fields of application are described. The close dependence on instruments and technology is emphasized. A detailed analysis of the advantages and limitations of laparoscopy is made with emphasis on the importance of a risk-benefit evaluation by the health care provider. Of key importance is to obtain a detailed and clear informed consent. The medico legal aspects of intraoperative complications and the liability of the surgical team in case of patients' injury or death are examined. However, it is always necessary to consider if the potential complications are predictable and/or preventable in accordance to the parameters of negligence, imprudence and lack of knowledge. The same criteria have to be applied to assure compliance with the preventive sanitary rules and that the conversion to laparotomy has been promptly carried out.
腹腔镜技术开创了一种新的手术方式，但不可避免地给外科医生带来了新问题。在全面回顾腹腔镜手术从起源至今的历史和发展历程后，本文描述了微创手术的技术层面及其应用领域。强调了对器械和技术的密切依赖。对腹腔镜手术的优缺点进行了详细分析，重点强调了医疗服务提供者进行风险效益评估的重要性。至关重要的是要获得详细、明确的知情同意。探讨了术中并发症的法医学问题以及手术团队在患者受伤或死亡情况下的责任。然而，始终有必要根据疏忽、轻率和知识欠缺等参数来考虑潜在并发症是否可预测和/或可预防。必须应用相同的标准来确保遵守预防性卫生规则，并确保及时进行开腹手术转换。
