腹腔镜缝合术成为腹腔镜手术更广泛应用的障碍。
Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery.
作者信息
Lim Sangtaeck, Ghosh Sudip, Niklewski Paul, Roy Sanjoy
机构信息
Franchise Health Economics and Market Access, Ethicon, Inc., Somerville New Jersey, USA.
Cincinnati, Ohio, USA.
出版信息
JSLS. 2017 Jul-Sep;21(3). doi: 10.4293/JSLS.2017.00021.
BACKGROUND
Laparoscopic surgery is increasingly replacing the open procedure because of its many patient-related benefits that are well aligned with policies and programs that seek to optimize health system performance. However, widespread adoption of laparoscopic surgery has been slow, in part, because of the complexity of laparoscopic suturing. The objective of this study was to review the clinical and economic impacts of laparoscopic suturing in key procedures and to assess its role as a barrier to the broader adoption of laparoscopic surgery.
DATABASE
A medical literature search of MEDLINE, EMBASE, and BIOSIS from January 2010 through June 2016 identified 47 relevant articles.
CONCLUSION
Laparoscopic suturing and intracorporeal knot tying may result in extended surgical time, complications, and surgeon errors, while improving patient quality of life through improved cosmesis, diet toleration, and better bowel movements. Despite advancement in surgical techniques and the availability of newer surgical tools, the complexity of laparoscopic suturing continues to be a barrier to greater adoption of MIS. The results of the study underscore the need for development of proficiency in laparoscopic suturing, which may help improve patient outcomes and reduce healthcare costs.
背景
腹腔镜手术因其诸多与患者相关的益处，越来越多地取代开放手术，这些益处与旨在优化卫生系统绩效的政策和计划高度契合。然而，腹腔镜手术的广泛应用进展缓慢，部分原因是腹腔镜缝合操作复杂。本研究的目的是回顾腹腔镜缝合在关键手术中的临床和经济影响，并评估其作为腹腔镜手术更广泛应用的障碍所起的作用。
数据库
对2010年1月至2016年6月期间的MEDLINE、EMBASE和BIOSIS医学文献进行检索，共识别出47篇相关文章。
结论
腹腔镜缝合和体内打结可能会延长手术时间、引发并发症并导致外科医生失误，同时通过改善美观、饮食耐受性和排便情况提高患者生活质量。尽管手术技术有所进步且有更新的手术工具可供使用，但腹腔镜缝合的复杂性仍然是阻碍更广泛采用微创外科手术的一个因素。该研究结果强调了培养腹腔镜缝合熟练程度的必要性，这可能有助于改善患者预后并降低医疗成本。
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