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Was bringt die Minimalisierung des Zugangstraumas für den Patienten

What is the value of minimizing access trauma for patients?

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Zusammenfassung

Ein wesentliches Anliegen der modernen Chirurgie ist die Reduktion des Zugangstraumas, um die operative Behandlung für den Patienten weniger belastend zu gestalten. Ohne Zweifel hat die minimal-invasive Chirurgie in den letzten 10 Jahren entscheidend zur Verbesserung der operativen Therapieergebnisse in der Viszeralchirurgie beigetragen und gilt daher als die dritte patientenfreundliche Revolution in der Chirurgie nach Einführung der Asepsis und der Anästhesie. Operationen, die vor einigen Jahren noch große Belastungen für den Patienten bedeuteten und der Gesellschaft erhebliche Kosten durch Arbeitsunfähigkeit und umfassende Rehabilitationsmaßnahmen verursachten, haben durch den minimal-invasiven Zugang viel von ihrem Schrecken verloren. Die körperliche Belastung ist ungleich niedriger, der kosmetische Effekt positiv und durch die wesentlich kürzere Rekonvaleszenz könnten die Kosten für die Gesellschaft deutlich reduziert werden.

Trotz der bekannten Vorteile, die inzwischen in zahlreichen Studien bestätigt werden konnten, ist die minimal-invasive Chirurgie durch die Einführung neuer Entgeltsysteme sowie strikter Budgetierung und begrenzter Ressourcen wieder vermehrt in die Diskussion geraten. Hier gilt es, realistische Kosten-Nutzen-Analysen aufzuzeigen sowie objektivierte Qualitätskontrollen zu etablieren, um innovative und patientenorientierte Ansätze in der Medizin auch in Zukunft durchführen zu können.

Abstract

Minimizing the access trauma of surgical interventions is becoming an essential task in modern surgery in order to make the treatment more comfortable for the patient. Minimally invasive surgery has had a major impact on the improvement of surgical results over the last decade. This is why such surgery is often named as the third patient friendly revolution in surgery after the introduction of asepsis and anesthesia. Operations that caused a huge strain on the patients in the past and led to immense costs for society because of the patient’s lost working time and extensive rehabilitation, have lost their fear thanks to this technique. The physical strain is lower, the cosmetic effect is considerable and the costs for society might be reduced due to the significantly shorter duration of convalescence.

Despite its known advantages, which have been reported in numerous studies, minimally invasive surgery has recently gained increased interest because of the installation of new accounting systems as well as strict budgeting and restricted resources.

Realistic cost-benefit analysis and objectified quality controls are needed in order to guarantee innovative and patient friendly basic approaches in medicine in the future.

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  1. Klinik für Chirurgie des Universitätsklinikums Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    P. Hildebrand, U.J. Roblick, R. Keller, M. Kleemann, L. Mirow & H.-P. Bruch

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  1. P. Hildebrand
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  2. U.J. Roblick
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  3. R. Keller
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  4. M. Kleemann
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  5. L. Mirow
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  6. H.-P. Bruch
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Correspondence to P. Hildebrand.

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Hildebrand, P., Roblick, U., Keller, R. et al. Was bringt die Minimalisierung des Zugangstraumas für den Patienten. Chirurg 78, 494–500 (2007). https://doi.org/10.1007/s00104-007-1348-y

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