Introduction

Journal of Family Practice, Nov, 2005 by Andre I. Brill

Whenever several courses of treatment are available, patients deserve to understand all of their options, and therefore be appropriately empowered to participate in selecting a therapy that suits their unique goals and sensibilities. Minimally invasive alternatives to a variety of conventional surgeries offer patients the now validated promises of accelerated recovery, better cosmesis, and less pain, with equivalent results or better in many circumstances. Beyond these and other endpoints typically used to benchmark surgical outcomes is the significant benefit of a faster return to normalcy, not just to work and the daily routine, but normalcy as a spouse, a parent, or an emotional and sexual partner. Such indirect costs of surgery are hard to measure and rarely studied but are essential in evaluating the relative value of a particular procedure. For all of these reasons, the minimally invasive procedures described here provide viable choices that family physicians can explore with patients who are weighing their treatment options.

Interestingly, while the rapid expansion of minimally invasive surgical procedures over the past decade is undoubtedly driven in part by the inquisitiveness of surgeons and their desire to provide patients with new possibilities, consumer interest has had a unique role in pushing this particular surgical agenda. The potential for rapid communication afforded by the advanced video technology used for imaging during laparoscopic surgery, has contributed to the rapid dissemination of compelling information about this approach to surgeons in traditional educational venues and to consumers who see these techniques demonstrated on the Internet and on television. Their curiosity piqued by the espousals of surgeons and captivating images of novel surgeries, patients increasingly are questioning primary care physicians about these options.

The following review of the minimally invasive options for 4 common procedures will facilitate such conversations with your patients. In each article, all of the authors have contributed information relative to their own areas of expertise. It is our hope that this will be of use to you in your practice and to your patients in making confident, informed decisions when surgery is required.