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Surgery Lite: Understanding Endoscopic Surgery

When is minimally invasive surgery better than traditional surgery? What are the risks?

Marketing Minimally Invasive Surgery

Because of its popularity with patients, many hospitals - facing intense competition -- are aggressively advertising minimally invasive surgery.

"Minimally invasive surgery is a great marketing tool," says Oz. "Right now, every medical center wants to say that they can do it."

Argenziano agrees. "Minimally invasive surgery - especially robotic surgery -- can be a much bigger hit in the PR department than it is in the OR," he tells WebMD.

A few years ago when the da Vinci robot first came onto the market, some hospitals felt pressured to buy the machine in order to keep up with the competition, Argenziano says.

"It seemed like every hospital suddenly had a robotic surgery center, even if they didn't have a single robotic surgeon," says Argenziano. "These million dollar machines were just sitting in the hallway because no one knew how to use them."

There is a very real risk that surgeons will feel the pressure - both from patients and from hospitals -- to use cutting-edge but unproven techniques before they are ready.

"Surgeons are struggling to stay competitive," says Argenziano. "Some are embracing new technology not because they think it's the right thing to do, but because it gives them an edge over other surgeons."

Schwartz says that this is precisely what happened in the 1980s, when minimally invasive surgery was first used for operations like gallbladder removal.

Patients demanded the new technique, and some surgeons started performing endoscopic surgery after taking a short crash course. "It was a disaster," Schwartz tells WebMD. "Suddenly, you had people dying and suffering horrendous complications from gallbladder removals, an operation that had almost no risk with traditional techniques. It was a terrible beginning for this technology."

Obviously, the safety of many minimally invasive techniques has improved dramatically since then. But the same competitive pressures are still affecting surgeons and hospitals. Many minimally invasive procedures are safe and are often preferable to their open surgery equivalents. But Schwartz thinks that patients need to be more wary of the newest technology and techniques.

"For some of the new procedures, we just don't know how well they work," says Schwartz. "We don't know how safe they are. Patients need to know that, so that they can make an informed decision."

So you need to do some research into minimally invasive surgery. Being cautious with the latest surgical innovations is always a good idea. After all, your safety, or the safety of a loved one, is worth a lot more than a quicker recovery or a smaller scar.

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Reviewed on August 12, 2008

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