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Minerva Surgery 2021 May 04

DOI: 10.23736/S2724-5691.21.08638-X


language: English

Intraoperative and postoperative complications in colorectal procedures: the role of continuous updating in medicine

Antonello FORGIONE 1 , Salman Y. GURAYA 2, Michele DIANA 3, 4, 5, Jacques MARESCAUX 3

1 Advanced International Mininvasive Surgery (AIMS) Academy, Milan, Italy; 2 College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; 3 IRCAD, Research Institute against Digestive Cancer, Strasbourg, France; 4 Photonics for Health, ICube Lab, University of Strasbourg, Strasbourg, France; 5 Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg 1, Strasbourg, France


Accepting surgical complications, especially those related to the learning curve, as unavoidable events in colorectal procedures, is like accepting to fly onboard an aircraft with a 10 to 20% chance of not arriving at final destination. Under this condition, it is very likely that the aviation industry and the concurrent reshaping of the world and of our lives would have not been possible in the absence of high reliability and reproducibility of safe flights. It’s hard to imagine surgery without any intraoperative and/or postoperative complications. Nevertheless, there is a plenty of room for improvement by simply adopting what has been explicitly and scientifically demonstrated; training outside of the OR, usage of modern information technologies and application of evidence-based perioperative care protocols. Additionally, the possibility to objectively measure and monitor the technical and even non-technical skills and competencies of individual surgeons and even of OR teams through the application of structured and validated assessment tools can finally put an end to the self-referential, purely hierarchical, and indeed extremely unreliable process of being authorized or not to perform operations on patients. Last but not least, a wide range of new technologies spanning from augmented imaging modalities, virtual reality for intraoperative guidance, improved robotic manipulators, artificial intelligence to assist in preoperative patient specific risk assessment, and intraoperative decision-making has the potential to tackle several hidden roots of surgical complications.

KEY WORDS: Surgical education; Minimal invasive surgery; Colorectal surgery; Image guided surgery; Robotic surgery

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