Thursday, May 13, 2004
Tradition and the Hindering of Progress
According to this morning’s Boston Globe, today’s issue of the New England Journal of Medicine reports an extensive study showing that patients having laparoscopic surgery for colon cancer enjoy the same “success” rates as those having their bellies opened up for a full view. (Laparoscopic surgery, sometimes known as “keyhole” or “minimally invasive” has the surgeon operating by inserting instruments through small incisions and operating by looking at a TV monitor.) It seems that there has been a virtual moratorium on laparoscopic surgery for colon cancer since 1994, when spotty evidence was interpreted to show that colon tumors recurred much more often in patients treated with the minimally invasive technique.
Laparoscopic surgery for colon cancer is not appropriate in all cases, such as those in which the cancer has spread to surrounding tissue. But where it is appropriate, and considering its obvious advantages (smaller incisions, less pain, shorter hospitalization, quicker recovery), one would suppose that before many months have passed, it would be universal practice.
Not likely. Learning to do laparoscopic surgery requires intensive training – something not all surgeons will be anxious to undertake. On this point, the Globe article quoted Dr. Philip B. Paty, colorectal surgeon at Memorial Sloan-Kettering Cancer Center in New York as saying “I don’t see an immediate boom.”
What ought to be happening is that by this time a couple of months from now, hospital CEO’s across this land should have presented to their Boards of Trustees specific plans and schedules for implementing these new findings posthaste.
But, of course, that would be seen in most cases as interfering in the practice of medicine and, therefore, inappropriate. So a whole lot of patients will be getting less than the best care and costs will be higher, as well.
Tradition is a wonderful thing, but not when it hinders progress.
According to this morning’s Boston Globe, today’s issue of the New England Journal of Medicine reports an extensive study showing that patients having laparoscopic surgery for colon cancer enjoy the same “success” rates as those having their bellies opened up for a full view. (Laparoscopic surgery, sometimes known as “keyhole” or “minimally invasive” has the surgeon operating by inserting instruments through small incisions and operating by looking at a TV monitor.) It seems that there has been a virtual moratorium on laparoscopic surgery for colon cancer since 1994, when spotty evidence was interpreted to show that colon tumors recurred much more often in patients treated with the minimally invasive technique.
Laparoscopic surgery for colon cancer is not appropriate in all cases, such as those in which the cancer has spread to surrounding tissue. But where it is appropriate, and considering its obvious advantages (smaller incisions, less pain, shorter hospitalization, quicker recovery), one would suppose that before many months have passed, it would be universal practice.
Not likely. Learning to do laparoscopic surgery requires intensive training – something not all surgeons will be anxious to undertake. On this point, the Globe article quoted Dr. Philip B. Paty, colorectal surgeon at Memorial Sloan-Kettering Cancer Center in New York as saying “I don’t see an immediate boom.”
What ought to be happening is that by this time a couple of months from now, hospital CEO’s across this land should have presented to their Boards of Trustees specific plans and schedules for implementing these new findings posthaste.
But, of course, that would be seen in most cases as interfering in the practice of medicine and, therefore, inappropriate. So a whole lot of patients will be getting less than the best care and costs will be higher, as well.
Tradition is a wonderful thing, but not when it hinders progress.
