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  • Print publication year: 2008
  • Online publication date: December 2009

Appendix

Summary

A surgeon is required by law and bound by moral and ethical standards to explain a planned operation, its risks, and the expected outcome to the patient preoperatively. The purpose of this Appendix is to (1) provide a guide for discussing a proposed laparoscopic operation with the patient and (2) describe the informed consent as it relates to laparoscopy.

Diagnostic laparoscopy has gained widespread acceptance among gynecologic and general surgeons, but patients' expectations and the actual results from advanced operative laparoscopic procedures frequently do not coincide. For example, some patients believe that lasers are essential for a thorough operation, although most surgeons acknowledge that scissors and electrosurgical instruments are equally effective. Patients tend to consider laparoscopic procedures minor operations. This idea is reinforced by terms such as same-day surgery, Band-Aid surgery, minimal invasive surgery, and laser surgery. Patients and physicians underestimate the risks of complex operative endoscopy, which are potentially as serious as those associated with laparotomy.

The Informed Consent

Since 1914, surgeons have been required to obtain a patient's written consent before an operative procedure. This process allows the patient to participate in decisions with an understanding of the factors relevant to the proposed operation. The proper consent requires that the patient be informed of the diagnosis, the proposed treatment, the probability of success, alternative forms of therapy, and the risks of the planned operation.