Page 24 - Laparoscopic Surgery Online Journal

10.5005/jp-journals-10033-1198
Hana Alhomoud
ORIGINAL ARTICLE
Ethical Issues and Training in Laparoscopic Surgery

Hana Alhomoud

ABSTRACT bringing new and promising changes to surgical practice,
but correct performance of these procedures require previous
Teaching operative laparoscopic skills by taking into account
the basic principles of medical ethics in a recognized teaching training to acquire sufficient manual dexterity so that
hospital like the World Laparoscopic Hospital in India under avoidable harm is not caused to patients who are operated
the supervision of experienced laparoscopic surgeons is of 3
paramount importance to surgical training. on with these techniques.
Specifically, laparoscopic training can be carried out
Keywords: Ethics, Laparoscopy, World laparoscopic hospital.
using different modalities, such as the pelvitrainer,
How to cite this article: Alhomoud H. Ethical Issues and performance of laparoscopy in experimental animals or
Training in Laparoscopic Surgery. World J Lap Surg 2013;6(3):
cadavers, or using virtual reality simulators in specially
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equipped centers.
Source of support: Nil
World laparoscopic hospital (WLH) in India which is
Conflict of interest: None declared a well-recognized training laparoscopic center under the
supervision of an experienced laparoscopic surgeon
INTRODUCTION Professor Mishra. In the WLH you can find all the modalities
Ethics, also known as moral philosophy, is a branch of of laparoscopic training. Professor Mishra ensures that the
philosophy that involves systematizing, defending and trainee receives all the basic training in laparoscopy.
recommending concepts of right and wrong conduct. It Trainee spends a period of basic training in experimental
comes from the Greek word ethos, which means ‘character’. 1 animals, pigs. In this phase, the trainee can become
Each generation of surgeons inherits the moral and familiarized with the routes of surgical approach and
ethical foundations from the preceding generation and must placements of the trocars, and begin to acquire the
practice the art and science of surgery based on these necessary skills to perform endoscopic dissection and
principles. While the foundations remain unchanged, the tissue suturing. Thus it seems that the greater the skill
applications become more complex and the decisions more acquired through experimental surgery, the shorter the time
difficult as advancing technology provides greater required to transfer this skill to surgical practice in humans,
opportunities to save lives and relieve pain and suffering. with the subsequent technical assistance of experienced
Until the past 50 years, the technology did not exist to treat laparoscopic surgeons.
many diseases, surgery was relatively straightforward, and With these premises for training, it is attempted to
all a surgeon’s effort was directed at stopping the advance preserve the principal of beneficence, which, according to
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of a disease or correcting a congenital defect. Sometimes Gracia, is the ethical principle that obliges one not only to
social issues related to advanced surgical technology, such cause harm, but to do good.
as implementing an unproven technology or itinerant WLH ensures that the trainee will learn the basic
surgery, would arise. With each of the new dilemmas, the principal of medical ethics (beneficence, nonmaleficence,
foundations have continued to suffice, although the solutions autonomy and justice). 5 During the training program in
have become more complex. More importantly, the ethical WLH a qualified laparoscopic surgeons will guide the
dilemmas have dramatically increased in scope; rather than trainees how to assess the effectiveness and safety of a new
revolving only around an individual patient or the conduct laparoscopic surgical device before using it. Because human
of medical practice, the impact of technologies have driven dignity is the priority in WLH, Professor Mishra obliges
the ethical implications to the new dimensions of global himself to teach the trainees how to obtain informed consent
health, population imperatives, and impact of the evolution from patients in a manner that is comprehensible and in
of the human species per se. 2 accordance with the language, customs and culture of the
Since, laparoscopic was first introduced in surgical patient. Informing in this way of the advantages of
practice, there has been a progressive increase in the number laparoscopy as well as its limitations and the possibility of
of its potential applications in surgical specialties, including conversion to open surgery.
both complex oncologic extirpation surgeries and It can be concluded that correct training in laparoscopy
meticulous reconstructive techniques. This situation is in a well-recognized center like the WLH in India will
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