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April 1995

Invited Commentary

Author Affiliations

Baltimore, Md

Arch Surg. 1995;130(4):409. doi:10.1001/archsurg.1995.01430040071015

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Avrahami et al describe an interesting variation on the limited or problem-oriented autopsy. Unlike these procedures, the laparoscopic approach offers several advantages: reduction of invasion of the body, easy application, and at least in the authors' hands with their cases, a rate of identification of lesions comparable to standard autopsy methods. The major limitation to the technique is that it is confined to examination of the abdomen. Since the most common types of disease in hospital deaths are cardiovascular, respiratory, and neurological problems, this is a serious restriction on widespread use of the procedure. Lack of ready access to the necessary equipment would be another difficulty for most hospital autopsy services. Nevertheless, in this era of declining autopsy rates with the consequent loss of valuable information for families, physicians, and trainees, any procedure that meets with greater acceptance by those who must request and those who must grant autopsy permission

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