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March 27, 2002

Laparoscopic Advances in General Surgery

Author Affiliations

Author Affiliations: Department of Surgery, Vanderbilt University Medical Center, Nashville, Tenn.

JAMA. 2002;287(12):1502-1505. doi:10.1001/jama.287.12.1502

Originally described in 1901, laparoscopy was used by gynecologists as a surgical approach throughout most of the 20th century. Its applicability to general surgery was popularized in 1987 when laparoscopic cholecystectomy was first performed.1 Subsequently, minimal-access approaches have been used by general surgeons for multiple intra-abdominal operations because of perceived reductions in patient discomfort and disability, shorter hospital stays, and more rapid return to work.2 Now the term minimally invasive surgery encompasses several variations on the purely laparoscopic approach. This general term can mean several different things including a pure laparoscopic approach (all incisions ≤1 cm), a hand-assisted approach in which access large enough to accommodate the surgeon's hand is made to facilitate the procedure (largest incision, 6-8 cm), or a laparoscopic-assisted procedure, some of which is performed in the traditional open fashion (largest incision >4 cm). The approach used is based upon the training, experience, and skills of the surgeon as well as the pathologic process being treated.

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