Dr. Gary Frishman authors editorial in Journal of Minimally Invasive Gynecology

As school children, we were always taught to check and double-check our work. So it should come as no surprise that some of the best and brightest surgeons often perform a second-look surgery after a procedure or course of treatment to determine if their patient is free from adhesions (scar tissue). If adhesions are still found during a second-look laparoscopy (SLL), additional procedures may or may not be performed at that time. There are, however, risks to second-look surgery, as well as the cost associated with any surgery.

Gary N. Frishman, M.D., associate director of the Division of Reproductive Endocrinology and Infertility and Residency Program Director at Women and Infants Hospital of Rhode Island and the Warren Alpert Medical School of Brown University, where he is also a professor of obstetrics and gynecology, recently published an editorial entitled 'Is it time to take a second look at second-look laparoscopy?' in the Journal of Minimally Invasive Gynecology, a professional journal for which he is the deputy editor.

'Given both the costs and risks associated with second-look laparoscopy, AAGL (formerly the American Association of Gynecologic Laparoscopists) and our membership should strive to have SLL serve as a model for responsible health care,' said Dr. Frishman. 'This should include a prospective determination of who is the best and, ideally, most cost effective and low-risk candidate alongside capturing outcome data which can be periodically reviewed to confirm any emerging standard of care.'

Laparoscopy is a minimally invasive surgical procedure that involves several small cuts, each measuring less than ½ inch, which are made on the stomach. A tiny camera is put through one cut so the surgeon can see the internal organs on a video screen. The surgeon puts surgical instruments through the other cuts to operate. Laparoscopy gives the surgeon a view that is similar to an open stomach cut but decreases the pain and recovery time.

In discussing SLL, Dr. Frishman concludes that '... it is, indeed, time to take a second look at second-look laparoscopy' to ensure that the procedure is done in a way that balances the benefits to the patient with the costs and frequency of the procedure.

Dr. Frishman said, 'Women and Infants Hospital is fortunate to have many experts in minimally invasive gynecologic surgery such as laparoscopy, and our surgeons are recognized thought leaders on these procedures, the technology, and the best options for our patients.'

Provided by Care New England