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abdominal infection from post surgery
Discussion in 'All Categories' started by rahmawaty - Nov 23rd, 2011 10:31 pm.
if I got laparoscopic appendictomy and adhesiolysis, what kind of documentation or file result or what would the file look like shall I received as a patient?
re: abdominal infection from post surgery by Dr JS Chauhan - Nov 25th, 2011 12:34 am
Dr JS Chauhan
Dr JS Chauhan
Dear Rahmawaty

The best document your surgeon should give is DVD recording of your laparoscopic surgery. Your message sounds like you have developed some complication or you do not have believe on your surgeon. During the last Half a century progress in surgery was linked to the abandonment of major ablative and deforming procedures, and replacing all of them with simpler and safer non-invasive procedures. For example a radiologist can now drain abscesses and open blocked vessels in a mildly sedated patients where only 20 years ago the individual might have undergone major and risky procedures to complete exactly the same result.

Laparoscopic surgery was developed by gynecologists in the 1960s like a diagnostic tool. The procedure was gradually extended to allow minor surgical interventions, usually in fertility surgery, and usually on young healthy patients. In 1984 Reddick first applied the technique to laparoscopic cholecystectomy. The procedure became extremely popular among patients, mostly young and healthy, who have been in a position to return to work within few days following the procedure.

By 1991 a lot more than 10,000 laparoscopic cholecystectomy cases were reported. Within the last 5 years laparoscopic surgery has been extended to surgery of the appendix, colon , stomach , kidney ,and liver.

Of specific concern is the fact that the knowledge derived over time with laparoscopic surgery was obtained primarily in young healthy patients undergoing short and limited procedures. Extension of laparoscopic surgery technique to general surgery where patients are generally older and sicker ended only in the last decade and experience is thus limited.

The development of minimally invasive surgical procedures began in the animal lab and was carefully studied in select academic centers. It had been imported to the community hospitals only if its benefits and safety were established. In contrast the introduction of laparoscopic cholecystectomy was not made to enhance the safety from the procedure, but instead to reduce the discomfort linked to the surgical incision. The fierce economical competition in medicine fueled by the managed care movement, led to the rapid adoption of Laparoscopic Surgery among surgeons in community hospitals who were not formally trained in this method and acquired their knowledge by registering to short courses.

Laparoscopic surgical treatment is well-liked by patients and insurance providers. The absence of an incision is cosmetically appealing. The immediate post operative course is smoother, permitting early discharge in the hospital and early return to work. The procedure however is surgically demanding and introduces specific risks unique to the laparoscopic surgery that are not present throughout the performance of procedures like open cholecystectomy. While the goal of minimizing the immediate post operative morbidity is laudable, the patient, at the very least, should be entitled to exactly the same safety record associated with open procedures.

Alarmed with a series of severe and unusual complications reported after laparoscopic cholecystectomy. Many serious complications were identified comprising of major vessel laceration, hemorrhage, bile leak , and bowel perforation. In comparison only 23 such complication were identified following open cholecystectomy. The rate of damage towards the bile duct was 15 times higher when cholecystectomy was performed laparoscopically than if open cholecystectomy was performed.

The World Association of Laparoscopic Surgeon panel concluded that so long as complications from laparoscopic surgery exceed the complication rate of open procedures, laparoscopic surgery cannot be considered at the moment the state of the art. It is hoped that laparoscopic surgery performed by well trained surgeons will attain later on exactly the same safety record from the open procedure it attempts to replace.

With regards
JS Chowhan
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