Value of Minimally Invasive Surgery for Complex Procedures

According to a new study by Sean Harbison, M.D., F.A.C.S., associate professor of surgery at Temple University School of Medicine and Temple University Hospital, laparoscopy does not appear to spread gallbladder cancer, nor does it hinder future surgeries. “Laparoscopic techniques might actually help us diagnose gallbladder cancer earlier and should remain as a treatment option,” said Harbison.

Although rare, gallbladder cancer is particularly deadly because it is usually discovered at a very late stage. Both the location of the gallbladder and the lack of distinguishing symptoms make it difficult to diagnose early, when it’s more treatable. In fact, only 25 percent of gallbladder cancers are found early, and this is usually by chance, during a procedure for another condition—for instance, during surgery to remove gallstones.

In recent years, however, the growth of minimally invasive surgical techniques such as laparoscopy, has improved doctors’ ability to find gallbladder cancer earlier. Laparoscopy entails the insertion of narrow tubes with cameras attached through the navel or other small incisions. What has concerned surgeons, though, is whether laparoscopy hinders further surgical treatment for gallbladder cancer and whether laparoscopic surgery will spread the gallbladder cancer cells to other areas of the abdomen.

“We are hoping that advances in minimally invasive surgical techniques will continue to improve our ability to find gallbladder cancer at its earliest stage, because treatment is about 90-percent curative at that point,” he explained.

This study was presented at the International Hepato-Pancreatico-Biliary Association meeting in June 04.

Sutureless Technique is Effective for Delicate Thyroidectomy

An extremely delicate surgical procedure can be successfully performed using a sutureless surgical technique, according to a recent study conducted by Sean Harbison, M.D., F.A.C.S., associate professor of surgery at Temple University School of Medicine and a surgeon at Temple University Hospital.

Surgeons have been reluctant to remove the thyroid, usually as a treatment for thyroid cancer or thyroid disorders, using non-traditional surgical techniques. Because the gland is located near nerves and other critical organs, it is believed that the safest and most effective route is traditional open surgery. Harbison compared the benefits of a sutureless thyroidectomy using the harmonic scalpel, a device that enables surgeons to make smaller incisions, to the traditional open procedure.

“We found that there were no significant differences in outcomes, including length of hospital stay, between the two groups. The harmonic scalpel gives us a safe and efficient sutureless alternative to traditional thyroidectomy,” Harbison concluded.

This study was presented at the joint meeting of the New York Surgical Society and the Philadelphia Academy of Surgery in April 04.

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