The second SAGES (Society of American Gastrointestinal Endoscopic S- geons) manual was intended to be a companion piece for the successful ?rst SAGES manual, edited by Carol Scott-Connor, that was published more than 4 years ago. Originally, the goal was to concentrate on tersely covered or often ignored aspects of the preoperative preparation of the patient and the operating room as well as the postoperative care of patients undergoing minimally in- sive operations. It was also our intention to include a section for each procedure where several different port placement schemes would be presented and brie?y discussed. Unique to this manual, the impact of the patient’s body habitus (short or long, narrow or wide) on port placement is also taken into account for many of the procedures. Also unique are chapters devoted to hypothermia, port wound closure, and the management of subcutaneous emphysema and abdominal wall hemorrhage caused by trocars. Naturally, the surgeon tends to focus on the technical aspects of the pro- dure, such as the operative tasks to be carried out, the order of operation, and the position of the surgeon and assistant. However, it is critical that the surgeon be aware that the CO pneumoperitoneum, far more so than laparotomy, results 2 in multiple physiologic alterations that, if not compensated for by the anest- siologist and surgeon, may endanger the patient or prevent the laparoscopic c- pletion of the procedure.
The perfect execution of a minimally invasive operative technique is only part of the equation for ensuring a favorable surgical outcome. It is also essential to have a complete understanding of the entire spectrum of perioperative care, including preoperative evaluation, technique selection, and postoperative management. Further, it is important to understand the physiologic impact of the C02 pneumoperitoneum. The SAGES Manual of Perioperative Care in Minimally Invasive Surgery provides strategies for successful patient management before, during and after laparoscopic surgery.
This easy-to-read manual includes comprehensive and authoritative coverage of perioperative concepts and strategies that not only optimize outcomes but also ensures quality patient care beyond the operating room:
guidelines for preoperative evaluation of healthy and complex patients
strategies for successful outcomes, including OR setup, patient positioning, anesthetic considerations, exposure technique, port closure method, and hernia prevention
multiple port arrangements for most operations and port placement schemes that take into account the B.M.I. of the patient
managing trocar placement-related bleeding, prophylaxis against DVT, prevention of intraoperative hypothermia and subcutaneous emphysema
when to convert to an open procedure
physiologic, immunologic, and oncologic implications of CO2 pneumoperitoneum, prevention of port-site tumors, minimizing the risk of gas embolism
postoperative considerations including fluid replacement, ambulation and early postoperative performance criteria
The SAGES Manual of Perioperative Care in Minimally Invasive Surgery is written by recognized experts and reflects the Society’s commitment to surgical education.
