The future
Although there is no doubt that minimal access
surgery has changed the practice of surgeons, it has not changed the nature of
disease. The basic principles of good surgery still apply, including appropriate
case selection, excellent exposure, adequate retraction and a high level of
technical expertise. If a procedure makes no sense with conventional access,
it will make no sense with a minimal access approach.
Improvements
in instrumentation and the development of structured training programmes are the
key to the future of minimal access surgery. It is certain that there is much
that is new in minimal access surgery. Time will tell how much of what is new is
truly better.
The
cleaner and gentler the act of operation, the less the patient suffers, the
smoother and quicker his convalescence, the more exquisite his healed wound.
(Lord Moynihan of Leeds)