PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 539004

[Risk and ethical problems in endoscopy].

F Renger
View original source ↗Export metadata ↓

Abstract

The explosive growth of natural-scientific knowledge and its utilization in medicine has enlarged the diagnostic and therapeutic possibilities. A change of the physician's work is connected with the laboratory and apparative-technical medicine. The simple methods of the anamnestic, at the same time psychoanalytic talk and the immediate examination of the patient are no more used according to their value. The immediate meeting between physician and patient is being forgotten. At the instance of the gastroenterological endoscopy the importance and methodology of the permanent collective judgment of examination techniques under management of a subspecialised team as well as the definition and control of risk and ratio expenses-use are described. For the testing of techniques as well as their use in routine work an informing talk with the patient is necessary as well his agreement, according to the directives of the WHO. Work and responsibility of the physician in Socialist Public Health is characterized by inclusion of state and society and the conscious participation of the citizens.

Explore related subjects

EndoscopyEthics, MedicalPhysician-Patient RelationsRiskEnglish AbstractJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

F Renger. 1979-08-15. [Risk and ethical problems in endoscopy].. https://pubmed.ncbi.nlm.nih.gov/539004/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Training with simulation improves residents' endovascular procedure skills.

BACKGROUND: Endovascular procedure simulators are now commercially available and in use for physician training. The purpose of this study was to evaluate the role of simulation-based training in vascular surgery residencies. METHODS: Residents from vascular surgery programs in a five-state area were invited to participate in a series of 2-day endovascular training programs that used a high-fidelity endovascular procedure simulator (SimSuite; Medical Simulation Corporation, Denver, Colo), didactic instruction, computer-based training, and tabletop procedure demonstrations. The curriculum covered arteriography and intervention for treatment of aortoiliac, renal, and carotid artery disease. Nine residents participated, with one to three per training session. Each completed an average of 9.5 simulated endovascular cases. Performance on a standardized TransAtlantic Inter-Society Consensus B iliac angioplasty/stenting case was used to assess endovascular skills and knowledge at the beginning of the training program, and this was repeated at the completion of the training. Performance metrics were measured by the simulator, faculty observed trainees' performance of simulated cases, and trainees provided their evaluations of the usefulness of the simulation experiences. RESULTS: Endovascular procedural skills on the standardized iliac intervention case improved after completion of the training program. Compared with performance early on day 1, performance improved (P < or = .05; paired t test): total procedure time decreased 54%, volume of contrast decreased 44%, and fluoroscopy time decreased 48% (mean change from baseline). Selection of angioplasty balloon catheters and stents was improved, and the average number of catheters used and stents deployed decreased, although this did not reach statistical significance. Faculty observation allowed identification of shortcomings of knowledge and skills, including common problems with selection of catheter, balloon, and stent sizes; correct positioning of the sheath; and intraprocedural monitoring. Postcourse evaluations indicated support for the use of simulation in vascular surgery residents' endovascular training. CONCLUSIONS: Training with a simulator, incorporated into an individual or small group learning session, offers a means to learn and realistically practice endovascular procedures without direct risk to patients, with measurable improvements in key performance metrics. How simulation training affects subsequent clinical performance has yet to be established.

Endoscopy↗
PubMed2007

Intraoperative surgical navigation for endoscopic sinus surgery: rationale and indications.

PURPOSE OF REVIEW: The present review discusses the rationale and indications for image-guided surgery through a critical discussion of registration concepts as well as clinical reports. RECENT FINDINGS: The surgical navigation accuracy achieved by commercially available image-guided surgery systems is best reported as target registration error. Clinically achievable target registration error is probably in the 1.5-2.0 mm range. Dry lab studies of registration serve to highlight the principles of registration, the process through which image-guided surgery systems calculate the one-to-one mapping relationship between the preoperative imaging data and the intraoperative surgical volume. Reports on image-guided surgery have highlighted its usefulness in primary and revision endoscopic sinus surgery, osteoplastic frontal sinusotomy, transsphenoidal hypophysectomy, endoscopic cerebrospinal fluid leak repair and endoscopic pterygomaxillary fossa biopsy. Both three-dimensional computed tomography angiography and computed tomography-magnetic resonance fusion images have been incorporated into IGS for advanced minimally invasive endoscopic skull base procedures. The American Academy of Otolaryngology-Head and Neck Surgery policy statement accurately summarizes the current consensus for image-guided surgery applications. SUMMARY: Image-guided surgery has emerged as an important technology, which both general otolaryngologists and subspecialty rhinologists can employ for a wide variety of procedures.

Endoscopy↗