Literature DB >> 20490568

Patient preferences for surgical techniques: should we invest in new approaches?

Ahsan Rao1, James Kynaston, Euan R MacDonald, Irfan Ahmed.   

Abstract

BACKGROUND: The face of surgery has changed over the past two decades with the introduction of laparoscopic techniques. The majority of surgical specialties now perform minimally invasive procedures hence decreasing the scarring, pain, and infection historically associated with open surgery. To further reduce the invasiveness of surgery, new surgical techniques like Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Single-Port Surgery (SPS) are under development. Despite investment from the medical device industry and enthusiasm from medical professionals, we must analyse patient preferences and expectations of these novel techniques. This analysis will help us establish the demand for such techniques and guide future resource allocation.
METHODS: A questionnaire-based study was derived to identify whether the concepts of innovative techniques are acceptable to the general population. Their preferences between different available surgical options were recorded along with their choices for new innovative techniques. This study was carried out face-to-face and by using an online survey. It comprised four questions based upon a hypothetical scenario of an acute appendicitis. All the data were captured in a prospective database and analysed using statistical software.
RESULTS: A total of 750 participants from variable backgrounds took part in the study. NOTES or SPS without an established safety profile was accepted by 34.3% of patients. SPS was the most popular method followed by conventional laparoscopy. Open surgery and NOTES were the least preferred (ranked 1.78, 1.98, 2.94, and 3.27, respectively). Choosing between SPS and NOTES only, 80.6% opted for SPS, 11.8% NOTES, and 5.6% declined surgery. The most popular route of access for NOTES is oral (37.7%).
CONCLUSION: Single-port surgery was the most preferred method and NOTES was the least preferred technique. This shows general acceptance of the concept of virtually scarless surgery but without using the natural orifices.

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Year:  2010        PMID: 20490568     DOI: 10.1007/s00464-010-1078-y

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  22 in total

1.  Laparoscopic ovarian cystectomy using a single umbilical puncture method.

Authors:  T Kosumi; A Kubota; N Usui; K Yamauchi; M Yamasaki; H Oyanagi
Journal:  Surg Laparosc Endosc Percutan Tech       Date:  2001-02       Impact factor: 1.719

2.  Regarding ethics of rapid surgical technological advancement.

Authors:  S B Colvin; E A Grossi; A C Galloway
Journal:  Ann Thorac Surg       Date:  2000-11       Impact factor: 4.330

3.  In vitro comparison and evaluation of seven gastric closure modalities for natural orifice transluminal endoscopic surgery (NOTES).

Authors:  R P Voermans; A M Worm; M I van Berge Henegouwen; P Breedveld; W A Bemelman; P Fockens
Journal:  Endoscopy       Date:  2008-07       Impact factor: 10.093

4.  Comparison of transgastric access techniques for natural orifice transluminal endoscopic surgery.

Authors:  Stefan von Delius; Sonja Gillen; Emmanouil Doundoulakis; Armin Schneider; Dirk Wilhelm; Adam Fiolka; Stefan Wagenpfeil; Roland M Schmid; Hubertus Feussner; Alexander Meining
Journal:  Gastrointest Endosc       Date:  2008-06-17       Impact factor: 9.427

5.  Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy in Scotland.

Authors:  C M Lam; F E Murray; A Cuschieri
Journal:  Gut       Date:  1996-02       Impact factor: 23.059

6.  Women's positive perception of transvaginal NOTES surgery.

Authors:  Carrie Y Peterson; Sonia Ramamoorthy; Barbara Andrews; Santiago Horgan; Mark Talamini; Alana Chock
Journal:  Surg Endosc       Date:  2008-12-05       Impact factor: 4.584

7.  Patient attitudes and expectations regarding natural orifice translumenal endoscopic surgery.

Authors:  Lee L Swanstrom; Eric Volckmann; Eric Hungness; Nathaniel J Soper
Journal:  Surg Endosc       Date:  2009-04-03       Impact factor: 4.584

8.  Single-port laparoscopic surgery: initial experience in children for varicocelectomy.

Authors:  Jihad H Kaouk; Jeffrey S Palmer
Journal:  BJU Int       Date:  2008-03-05       Impact factor: 5.588

9.  Outcome after cholecystectomy for symptomatic gall stone disease and effect of surgical access: laparoscopic v open approach.

Authors:  G C Vander Velpen; S M Shimi; A Cuschieri
Journal:  Gut       Date:  1993-10       Impact factor: 23.059

10.  Natural orifice surgery: initial clinical experience.

Authors:  Santiago Horgan; John P Cullen; Mark A Talamini; Yoav Mintz; Alberto Ferreres; Garth R Jacobsen; Bryan Sandler; Julie Bosia; Thomas Savides; David W Easter; Michelle K Savu; Sonia L Ramamoorthy; Emily Whitcomb; Sanjay Agarwal; Emily Lukacz; Guillermo Dominguez; Pedro Ferraina
Journal:  Surg Endosc       Date:  2009-04-03       Impact factor: 4.584

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  25 in total

1.  Who should decide the best minimally invasive approach? Should we listen to our patients?

Authors:  Leandro Totti Cavazzola; Gustavo Lopes de Carvalho; José Sérgio Nascimento Silva
Journal:  Surg Endosc       Date:  2011-04       Impact factor: 4.584

2.  Magnetically anchored camera and percutaneous instruments maintain triangulation and improve cosmesis compared with single-site and conventional laparoscopic cholecystectomy.

Authors:  Nabeel A Arain; Luisangel Rondon; Deborah C Hogg; Jeffrey A Cadeddu; Richard Bergs; Raul Fernandez; Daniel J Scott
Journal:  Surg Endosc       Date:  2012-05-31       Impact factor: 4.584

Review 3.  Endoscopic surgery - exploring the modalities.

Authors:  Daniel Jin Keat Lee; Kok-Yang Tan
Journal:  World J Gastrointest Surg       Date:  2015-11-27

Review 4.  Consumer demand for surgical innovation: a systematic review of public perception of NOTES.

Authors:  Philip H Pucher; Mikael H Sodergren; Amy C Lord; Julian Teare; Guang-Zhong Yang; Ara Darzi
Journal:  Surg Endosc       Date:  2014-08-27       Impact factor: 4.584

5.  Learning lessons for the future: assessments of demand and benefit are required in addition to training in single incision laparoscopic surgery. Response letter to: Pucher PH, Sodergren MH, Singh P, Darzi A, Parakseva P. Have we learned from lessons of the past? A systematic review of training for single incision laparoscopic surgery. Surg Endosc (2013) 27:1478-1484.

Authors:  H Rehman; J E F Fitzgerald; I Ahmed
Journal:  Surg Endosc       Date:  2013-07-17       Impact factor: 4.584

6.  Magnetically anchored cautery dissector improves triangulation, depth perception, and workload during single-site laparoscopic cholecystectomy.

Authors:  Nabeel A Arain; Jeffrey A Cadeddu; Deborah C Hogg; Richard Bergs; Raul Fernandez; Daniel J Scott
Journal:  J Gastrointest Surg       Date:  2012-06-29       Impact factor: 3.452

7.  Training minimal invasive approaches in hepatopancreatobilliary fellowship: the current status.

Authors:  Gokulakkrishna Subhas; Vijay K Mittal
Journal:  HPB (Oxford)       Date:  2010-12-22       Impact factor: 3.647

8.  Single-port cholecystectomy versus multi-port cholecystectomy: a prospective cohort study with 222 patients.

Authors:  Markus J Wagner; Hans Kern; Alexander Hapfelmeier; Jan Mehler; Michael H Schoenberg
Journal:  World J Surg       Date:  2013-05       Impact factor: 3.352

Review 9.  Natural orifice transluminal endoscopy surgery: A review.

Authors:  João Moreira-Pinto; Estevão Lima; Jorge Correia-Pinto; Carla Rolanda
Journal:  World J Gastroenterol       Date:  2011-09-07       Impact factor: 5.742

10.  [Minimal access surgery: A survey among surgeons in Central Germany].

Authors:  A Weigt; F Rauchfuss; Y Dittmar; U Settmacher; H Scheuerlein
Journal:  Chirurg       Date:  2015-06       Impact factor: 0.955

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