By Jon C. Gould, W. Scott Melvin
The final healthcare professional was once first brought to laparoscopy approximately twenty years in the past. In those prior twenty years, there was an evolution within the symptoms, ways, and results for the surgery of many stipulations and illnesses. the controversy in regards to the optimum strategy keeps. regardless of the entire advances which were made through the 'evolution of the laparoscopic revolution', there's nonetheless development to be made. This factor will research the heritage of the minimally invasive surgical method of a number of stipulations, ongoing components of controversy, and destiny instructions.
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Additional info for Advances and Controversies in Minimally Invasive Surgery, An Issue of Surgical Clinics (The Clinics: Surgery)
The advent of minimally invasive techniques has revolutionized the approach to many surgical diseases and redeﬁned gold standards of care. These techniques nearly universally improve morbidity and mortality signiﬁcantly without degradation of eﬃcacy, addressing a concern surgeons had with open approaches. Transthoracic versus transabdominal In general, excellent results have been reported with both open approaches (Table 1). As expected, the debate often follows the lines of subspecialty. Published series in the thoracic surgery literature are published predominantly by thoracic groups, whereas general surgeons publish the majority of transabdominal series.
These studies have led some to redeﬁne their indications for repair . The original observations inherent to the previous surgical dictum have changed. Although elective surgery clearly has improved mortality rates CONTROVERSIES IN PARAESOPHAGEAL HERNIA REPAIR 963 over emergency surgery, outcomes have improved for emergent operations. This is likely because of better understanding and care of elderly, comorbid patients. Improved pharmacotherapy also oﬀers the opportunity for improved symptom control for minimally symptomatic patients.
53] Dunkin BJ, Martinez J, Bejarano PA, et al. Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device. Surg Endosc 2006;20:125–30.  Smith CD, Bejarano PA, Melvin WS, et al. Endoscopic ablation of intestinal metaplasia containing high-grade dysplasia in esophagectomy patients using a balloon-based ablation system. Surg Endosc 2007;21:560–9. Surg Clin N Am 88 (2008) 959–978 Current Controversies in Paraesophageal Hernia Repair S. Scott Davis, Jr, MD Emory Endosurgery Unit, Emory University, Emory Clinic Building A, 1365 Clifton Road, Suite H-124, Atlanta, GA 30322, USA The management of paraesophageal hernia (PEH) has become one of the most widely debated and controversial areas in surgery.