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I HAVE CANCER. CAN I HAVE A LAPAROSCOPIC OPERATION?

The answer is clear and unequivocal: YOU MOST CERTAINLY CAN.
There are, however, plenty of beliefs and claims from both patients and health professionals that create an impression by blurring the landscape. So we will prove the above answer by clarifying the myths from modern medical reality.

– “Open surgery “cleanses” cancer better”

FALSE. As popular as the above claim may seem, it is widely used mainly by the proponents of open surgery. But when we talk about resection of a cancerous tumor, we are referring to a scientific practice and not to magic devices that “cleanse”, “disappear”, “dissolve” or anything else for that matter. Surgery is a specific medical technique with explicit  principles, regardless of the means used, laparoscopic, or not. Therefore, the end result is the same, as long as the principles of surgical oncology are adhered to faithfully and without deviation, as set out in the global guidelines.

– “The oncological result is superior in the open resection”

FALSE. The oncological result is defined as the complete resection of a malignant tumor to a sufficient extent, including the involved vessels and lymph nodes. To achieve the above, the surgical technique has specific steps that the surgeon must follow without deviating from them. These determine the end result and not the access way, open or laparoscopic. The international medical literature, moreover, is full of studies proving the equal oncological effect between open and laparoscopic approaches.

– “The lymph nodes look better and are easier to remove in open surgery”

FALSE. The lymph nodes that need to be dissected for surgical staging of cancer are included in the preparation, provided that the principles of surgical oncology are followed faithfully. They are not removed one by one under sight and touch. It is therefore clear that open surgery offers absolutely nothing more in this area as well. Furthermore, if a matter of vision were raised, the laparoscopic technique would be superior by definition, due to the enlarged field of view it provides for.

– “Possible bleeding cannot be controlled laparoscopically”

FALSE. An oncological operation is performed on clear embryological vessels that lack vessels. However, if there are possible minor hemorrhages, they can be controlled very easily. In the case of bleeding from a larger vascular stem, the doctor trained in advanced laparoscopic surgery can also check it with increased vision, focused, without causing damage to neighboring structures. In cases of massive hemorrhage, it is possible to divert the surgery to an open one to ensure the patient’s health.

– “Special training is needed for laparoscopic oncological surgery”

TRUE. Although surgical oncology is an entity according to the above, laparoscopic cancer surgeries require special manipulations, great ease with laparoscopic tools, and training in advanced laparoscopic surgery.

– “Not all laparoscopic cancers can be operated on”

FALSE. With few exceptions, almost all malignancies related to general surgery can now be operated on laparoscopically, regardless of location, stage, or type. For colon, small intestine , and rectal cancers, laparoscopic access is the golden rule in all developed countries. The same goes for stomach cancer. Laparoscopic hepatectomy for malignancies has been around since 2000. Even pancreatic cancer can be treated in the same way, but currently only in specialized centers.

– “The laparoscopic technique that fills the abdomen with air, causes the spread and metastasis of cancer”

FALSE. The claim of peritoneal cancer cell implants during laparoscopy from the circulation of the administered gas has been refuted for many years by a number of publications. The same has happened with metastasis and tumor growth in the entry holes of laparoscopic instruments in the abdomen. They were the result of poor technique and insufficient oncological prophylaxis at the onset of laparoscopic surgery. Phenomena that are now completely eliminated.

– “Why should I prefer laparoscopic access?”

Because the incisions are much smaller, the stress on the body is minimal. Because the mobilizations, the manipulations, the injuries to the tissues, the bleeding are less. Because the patient experiences less pain, mobilizes and eats faster. Typically, the patient may drink fluids the day after surgery. Because recovery, return to home, and return to normal activity are faster. Because it is the technique that has been established in all developed countries for many years already.

“The patient is entitled to seek laparoscopic surgery”

TRUE. Although it is an inalienable right of every patient to choose their surgeon and the way they will be operated on, they have the right to request and choose laparoscopic surgery at the times we live. Not because it is something new and innovative, but already something old, which has even successfully passed the test in time for decades. In addition, he will benefit from all the advantages, making the surgery experience less unpleasant and painful.

It is proven that cancer is not a contraindication to the laparoscopic surgery. On the contrary, and as long as the oncology standards are being faithfully followed, it is considered the gold standard worldwide. For better or for worse, open surgery tends to be past, and claims of its superiority only confuse and misinform patients, artfully leading them to erroneous anachronistic choices and fear of having laparoscopic surgery. This should be eliminated because such tactics have dramatically delayed the modernization and the era of minimally invasive surgery in our country.