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• W2010380016 abstract "I n years to come, the advent of laparoscopic cholecystectomy (LC) will be seen as a significant milestone in the history of surgery. Indeed, it is a momentous advance which has already had a momentous impact. Nonetheless, the early post-LC years witnessed an uncontrolled expansion of surgical endoscopic practice, at times not far short of abuse, which amounted to the biggest unaudited freefor-all in the history of surgery. The leaders of our profession lacked the foresight to grasp the implications of Wittmoser and Semm’s pioneering work in laparoscopic and thoracoscopic techniques,‘.2 and the majority of established surgical training departments were totally unprepared to deal with them. By default. then, the unprecedented expansion of minimal access surgery (MAS) was largely a peripheral phenomenon. Now that the dust has settled. it is important to analyze how MAS has altered surgical practice and training and how it will continue to do so in the future. The development of MAS has raised issues that extend beyond the technical aspects of operative patient care. First, it has given prominence to economic concerns that transcend the ongoing debate concerning the relative cost benefit of the new surgical approach versus conventional open surgery. Studies of cost efficacy, utility, and benefit, using objective parameters such as quality-of-life-adjusted years (QALYs), will assume increasing importance as future developments impose extra burdens on limited resources. Regrettably, in the economic area too, the reports on MAS have lacked scientific objectivity, producing wildly different conclusions on the basis of data that are often suspect. One major indirect benefit of MAS has been to emphasize. as never before, the importance of minimizing the trauma of surgical operative treatment-the raison d’&tre of endoscopic surgery." @default.
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• W2010380016 title "Whither minimal access surgery: tribulations and expectations" @default.
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• W2010380016 doi "https://doi.org/10.1016/s0002-9610(99)80104-4" @default.
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