Letters

Minimally invasive surgery More invasive than it looks

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6927.532b (Published 19 February 1994) Cite this as: BMJ 1994;308:532
  1. A C Skinner
  1. Warrington WA4 4AZ Department of Urology, University of Berne, Inselspital, 3010 Berne, Switzerland
  2. Department of Urology, Churchill Hospital, Oxford OX3 7LJ.

    EDITOR, - In the article on future developments in minimally invasive surgery J E A Wickham falls into the trap of confusing personal desire with accurate prediction and novelty with science.1 Most anaesthetists would query the term “minimally invasive.” Certainly such surgery entails “minimal access” but it remains to be seen how invasive minimal access surgery really is. Evidence is emerging, for example, that laparoscopic surgery is indeed quite a severe cardiovascular stress, and other “invasions” remain to be discovered.

    The suggestion that the “requirement for profound anaesthesia will decline” certainly does not apply to laparoscopic surgery - indeed, for laparoscopic herniorraphy the opposite is true. Sedoanalgesia is not, in any case, inherently better, safer, or preferred by patients, nor would its widespread application allow operator-sedationists to free themselves …

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