Читать книгу Small Animal Laparoscopy and Thoracoscopy онлайн

55 страница из 232

Understandably, a surgery team with extensive experience of open procedures may initially be reluctant to take on some of the challenges of MIS. This may be especially conspicuous in small animal laparoscopy, in which the conventional surgical approach provides easy access to all intraabdominal organs. A budding small animal laparoscopic surgeon may meet resistance from referring veterinarians and even staff members when converting open procedures to laparoscopic because costs and surgery time, at least initially, tend to be higher. Educating the referral base, clients, and staff in the advantages of laparoscopy may alleviate but not completely remove the initial resistance.

The surgeon's transition from open to MIS surgery can be greatly facilitated by skills pretraining. The basic laparoscopic skills of ambidexterity, optimizing instrument interaction; observing cues for depth perception; and precise, deliberate movements need to be achieved early in the skills development for the benefit of patient safety and surgeon's confidence in the operating room (OR). Furthermore, for the surgeon interested in advancement from basic to advanced procedures, simulation pretraining becomes a necessity, especially if aspirations include MIS suturing.