Turkish surgeons’ experiences and perception about single-incision laparoscopic surgery

Abstract

Objective: We aimed to show Turkish surgeons' current status of experience and perception about single-incision laparoscopic surgery. Material and Methods:The experience and perception of general surgeons, who were members of the Turkish Surgical Association (3.5%, 116/3312), about single-incision laparoscopic surgery were analyzed according to demographic characteristics and a self-report questionnaire with the following four domains: surgeons' perception regarding the performance of single-incision laparoscopic surgery in their clinical practice; their experience of laparoscopic surgery; education, experience, and attitude for single-incision laparoscopic surgery; and the reason for performing/ not performing single-incision laparoscopic surgery in their practice.Results: There were no significant factors affecting Turkish surgeons' preference of surgical approach. Although, most surgeons performing single-incision laparoscopic surgery were educated (72.2%), the dominant factor driven them to perform this surgery seemed to be personal achievement and satisfaction (57%). Most surgeons who did not perform single-incision laparoscopic surgery were not interested to do so and considered it unnecessary (62.1%). In addition, the need for special equipment and training were dominant barriers (61%). Conclusion:It seems that Turkish surgeons' perception to perform single-incision laparoscopic surgery was more related to their personal achievement and satisfaction.Key Words: Perception, surgeon, single-incision laparoscopic surgery INTRODUCTIONEver since the advantage of minimal invasive surgery was proved in the era of surgery, a number of procedures have been performed laparoscopically. Beside the wide acceptance of laparoscopy as a primary approach for a number of surgical problems, for some procedures such as cholecystectomy, fundoplication, and adrenalectomy, it was accepted as "gold standard treatment. " In addition to wellknown advantages such as less blood loss, shorter hospital stay, enhanced recovery, and decreased complication rate, today, more complex oncological procedures are performed laparoscopically with a reliable level of efficacy and safety (1). The rapid development of minimal invasive surgery has led surgeons to advance its cosmetic benefits to the patients. Scarless surgery concept was developed from this point. For this purpose, reducing port number, applying mini-instruments, and using natural orifices were implemented for current surgical practices. Over time, application of natural orifice translumenal endoscopic surgery (NOTES) in humans remain limited, because of a lack of surgical ergonomics and the perception of patients and surgeons (2, 3). Laparoscopy with mini-instruments still being performed in some centers with the limitation of the need for special equipment. Today, the port reduction concept of advanced laparoscopic surgery is commonly accepted as single-incision laparoscopic surgery (SILS). With SILS, most of the expected benefits are successfully provided to patients. However, in...

Depletion and refertilization of the Tethyan oceanic upper mantle as revealed by the early Jurassic Refahiye ophiolite, NE Anatolia—Turkey

“…The lower Triassic-Campanian Munzur Limestone constitutes the eastern section of the Mesozoic 'Calcareous Axis' of the Tauride Platform (Ricou, 1980;Özgül, 1981), and consists mainly of neritic shelf carbonates. The late Cretaceous-Paleocene turbiditic sedimentary rocks resting unconformably over the ophiolite constrain its emplacement age as the late Cretaceous (Yılmaz, 1985;Yılmaz et al, 1990;Aktimur et al, 1995). Following its emplacement, the Refahiye ophiolite was thrust back onto the Permo-Triassic metamorphic rocks of the Sakarya Continent in the north as a result of continental collision between Eurasia and the Anatolide-Tauride platform (Fig.…”

“…The residues after high degrees of melting are commonly highly depleted in incompatible elements, compared to the low-degree melting residues, in both bulk and mineral chemistry. Aktimur et al, 1995;Özen et al, 2008;Sarifakioglu et al, 2009), showing the peridotite sample locations. Inset map displays the major tectonic belts (Dinter, 1998) and the distribution of major ophiolite complexes in Turkey (Dilek and Furnes, 2009).…”

“…Fig.1. Simplified geological map of the Refahiye area in NE Anatolia (modified fromAktimur et al, 1995;Özen et al, 2008;Sarifakioglu et al, 2009), showing the peridotite sample locations. Inset map displays the major tectonic belts(Dinter, 1998) and the distribution of major ophiolite complexes in Turkey(Dilek and Furnes, 2009).…”