the same thing today they did in 1990," he says. "That was 25 years
ago. That would have been like doing the same thing in 1990 that they
did in 1965. That's a huge time warp."
Complacency aside, time didn't stand still between 1965 and 1990,
and it hasn't stood still since. We asked a panel of experts to talk about
the following 10 important innovations that are making a difference in
2015 — advances that weren't necessarily on the radar 2, 3 or 5 years
ago, let alone a quarter century past.
1
Laparo-endoscopic
single-site (LESS) surgery
The innovative single-port, through-the-navel approach known
as LESS surgery is a clean break from that 1990 time warp, says Dr.
Rosemurgy. It requires some training, but "going from open to
laparoscopy in 1990 was a much bigger step than going from
laparoscopy to single-incision laparoscopy today."
And the benefits? They couldn't be more obvious if they bit you, he
argues. "The navel is itself a scar," he points out. "So what we're
essentially doing is putting a scar in an already existing scar. That
way the surgery becomes scar-less. People have some expectation
that there should be some benefit beyond the obvious. But the fact
that the difference is so obvious is what points out the importance
of this."
Still, says Dr. Rosemurgy, a dismayingly large number of surgeons
seem not to want to embrace progress. "Some doctors find it difficult
to do," he says, "but they've not taken the time to learn it. It didn't
happen right away for them, so they're not going to learn it."
Are there other issues? "Some say it's more expensive, but I don't
think that's true," he says. Certain instruments — like multi-trocar sin-
gle ports and deflectable-tip laparoscopes — are needed, "but every-
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