Laparoscopic Surgery Evaluation and Technical Base

 

Centers Approval

The well-being of patients with surgical conditions will depend on the quality of care provided. Although it is true that the concept of quality and the parameters to measure it are a currently debated topic as it implies multiple views of it. No one doubts the importance of quality assurance programs in the practice of surgery. Laparoscopic surgery is an inseparable part of general surgery and its indicators of morbidity and mortality should be evaluated with greater rigor and systematically because it is more complex. Simulations of laparoscopy is significant choice resembling Laparoscopic Needle Holder.

Only 3 years ago, Cushieri wrote about this: «while the incidence of important iatrogenic problems has been reduced, iatrogenesis is still present and causes the death of young patients still to take place as a result of laparoscopic surgery performed by processes benign. '

Quality of The Processes

There are published papers that show series of 5,000 or more patients operated by laparoscopic cholecystectomy with low rates of bile duct lesions. However, it must be taken into account that in our hospitals, these interventions have generally been performed by a small group of surgeons in the surgical services, who have achieved great experience and improvement of the technique.

However, due to the high frequency of gallbladder disorders in our environment and the increasing number of surgeons who can perform it electively and also in emergency services, then the complication rates may increase, if adequate measures are not taken to control the quality of the processes.

Evaluation of Laparoscopic Surgery

With the basic set of instruments, in addition to the cholecystectomy, other surgical interventions with this approach can be performed. Taking into account that level III hospitals already have this equipment and in the future a greater number of them may be increased, and where not all have the same conditions. It is necessary to create an accreditation system as to what type of interventions can be performed in each of the country's hospital centers, since as it is a more complex surgery than conventional surgery and its evaluation must be more rigorous.

The accreditation system of the centers, whose objective is to address the safety of the patients as much as possible, must take into account in the same way as in conventional surgery: the experience of the surgeons, the technological equipment available and the hospital infrastructure that it has.

It is understandable and we are all used to open surgery because in order to perform complex surgeries, the institution must be prepared to immediately guarantee any trans or postoperative complication that may arise, and it is essential that the institution has emergency diagnostic means, rooms of intensive care, availability of blood and blood products, as well as surgical guards and physical anesthesia 24 hours a day, among others.

Surgical Technique with Technological Base

As a surgical technique that is strongly supported by a technological base, which is otherwise constantly renewed and is extremely expensive, for a country like ours with not great resources, the progressive staging of technology will be, in my view, the fundamental basis for its development.

Complex advanced surgery cannot be performed with basic instruments and for it special instruments and equipment are essential that surely They will not be able to be acquired massage, as happened with basic laparoscopic surgery. Level hospitals, which were designed for this purpose, should be the first to have cutting-edge technologies and play a predominant role in the future, as centers for training and dissemination of this surgery, as they have been for many years in open surgery.

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