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Hand-Healthy Hand Scrubs - December 2013 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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OSE_1213_part2_Layout 1 12/5/13 2:55 PM Page 91 SURGICAL TECHNOLOGY icant learning curve. One fundamental skill involves lining up the tools in use to prevent crowding and clashing at the surgical site inside, says Sharona B. Ross, MD, director of minimally invasive surgery and surgical endoscopy at Florida Hospital's Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery in Tampa. This can prove particularly challenging at the intersection of instrumentation and visualization. "We use 5mm deflectable tip laparoscopes," she says, which can be laid flat, yet still view another angle on demand. "Can you do singleincision with a rigid scope? Yes, you can, but then you can't move the other instruments out of the way." What could be better than a scope that circumvents traffic at the site? Well, three-dimensional imaging would be, and the past year has seen the introduction of a 3D laparoscope with a deflectable tip, but it's a 10mm scope, which is too wide of an instrument for single-incision operations. "If you need that and a stapler, there's not enough room in the port," says Dr. Ross. Safety in sight In the big picture, the surgeon who performs laparoscopic procedures through a single incision must remain focused on patient safety. It is not, after all, a shortcut procedure. "It's not how we get in that's most important," says Dr. Ponsky, "it's what we do when we get there. When we take out an organ, we want to do it safely." Paul Curcillo II, MD, FACS, agrees, noting that the single-incision method lends itself to clinical caution in trained hands. "One of the biggest improvements of single-port access has been that we've rerecognized the importance of the critical view," says the director of minimally invasive surgical initiatives and development at Fox Chase Cancer Center in Philadelphia. "You're maintaining safety, seeing what D E C E M B E R 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E 9 1

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