Advances And Novel Technologies In Surgical Instruments For The Treatment Of Cancer

In recent years, the field of oncology has witnessed a number of technological advances, including more precise radiation therapy and minimally invasive surgical techniques. Three-dimensional (3D), stereotactic, and proton-beam radiation therapy, as well as laparoscopy and robotic surgery, can enhance clinician's ability to treat conditions that were clinically challenging with conventional technologies, and may improve clinical outcomes or reduce treatment-related problems for some patients. Both patients and physicians seek access to these new technologies, which are rapidly being adopted into standard clinical practice. Such demand is often propelled by marketing that portrays the new technologies as the "latest and greatest" treatments available. However, evidence is often lacking to support these claims, and these novel technologies usually come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive, conventional treatment. The increased cost of novel treatments without adequate assessment of how they affect patient outcomes is a pressing concern given that inappropriate use of expensive technologies is one of the key factors that threaten the affordability of cancer care in the United States. To explore these issues further, the National Cancer Policy Forum (NCPF) of the Institute of Medicine organized a workshop in July 2015. This is the third NCPF workshop in a series examining the affordability of cancer care. Participants explored clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery and potential strategies to assess the value and promote optimal use of new technologies in cancer treatment. This report summarizes the presentations and discussions from the workshop.

Similar to the 1st edition, the 2nd edition of Minimally Invasive Surgical Techniques for Cancers of the Gastrointestinal Tract provides different approaches for various organs of the gastrointestinal tract. This book provides an updated resource of advanced minimally invasive surgical techniques for patients with GI cancers. It is primarily designed to provide a step-by-step approach of surgical techniques, highlighting key learning points and potential operative pitfalls. The text is largely focused on minimally invasive surgical techniques (laparoscopic and robotic), with new chapters on innovations in gastric cancer surgery including middle gastrectomy, pylorus preserving gastrectomy, and sentinel lymph node dissection. In addition, the text also includes new chapters on single incision surgery for cancers of the GI tract, on advanced instrumentation for trans-anal procedures, and on refined robotic approaches to total mesorectal excision. Chapters are written by experts with extensive experience in new techniques, and are accompanied by companion videos in almost every chapter. The 2nd edition of Minimally Invasive Surgical Techniques for Cancers of the Gastrointestinal Tract proves to be a valuable resource for surgeons at all levels of training that are interested in learning new techniques to improve patient satisfaction and cancer outcomes.

This book discusses the effects of emerging technologies on surgeons and surgical practice. The book opens with an overview of disruptive technologies, and their economic, scientific, ethical and social implications. Next comes a section describing how the Internet, virtual reality and simulation technology will change training and education. A section on Robotics covers computer-guided surgery, robotics and endoluminal therapies. Innovations in surgical instruments, including MEMS and Nanotechnology are outlined, as well. Next, the book reviews tissue engineering and artificial organs, genetic engineering, stem cells, emerging transplantation technologies and the brain-machine interface. A concluding section discusses ways of adapting to future technologies.

Pelvic Cancer Surgery: Modern Breakthroughs and Future Advances brings together the three main pelvic specialties (Urology, Gynecological Oncology and Colorectal Surgery) into one volume. Patients have been shown to benefit from a multidisciplinary approach since it allows surgeons of different specialties to learn from one another therefore enhancing the treatment for the patient. Pelvic cancer outcomes are poor in low volume centres. These centres account for 80% of the global centres dealing with these cancers. Pelvic Cancer Surgery: Modern Breakthroughs and Future Advances is a much needed book that can focus training and assist health professionals in their care of patients with pelvic dysfunction. Pelvic Cancer Surgery: Modern Breakthroughs and Future Advance is complete with full color illustrations and schematic diagrams and makes use of key points and stepwise figures for an enhanced learning experience.

The 20th century has finished, the century when surgery took huge steps forward thanks to progress in technology. Now we have entered the "century of biotechnologies", which will not only generate progress in surgery, but also lead to a real "cultural revolution" that will completely change approaches to solving different problems in medicine. The aim of this book is to bring surgeons closer to biotechnologies and to overcome the cultural gap dividing them from these new approaches. Biotechnologies are already proposed and used at different levels in surgical practice: in diagnostic technique, enabling practitioners to identify diseases at an early stage and follow their molecular modification over time; and in tissue engineering, where the use of "smart scaffolds" offers a possible answer to increasing demand for biocompatible tissues and organs in transplantation surgery. This volume focuses on the emerging field of stem cells, analyzing both their role as possible players in originating and perpetuating cancer – "cancer stem cells" – and, conversely, their extraordinary therapeutical potential. An additional section is dedicated to the evaluation and application of derived molecular factors that can enhance the physiological processes that are fundamentally important in surgery, such as hemostasis and wound healing. Surgeons have always been technologists, in the sense that since surgery began they have always needed technology, beginning with a scalpel and surgical instruments. They have always cooperated with technologists. However, in the new century, the first one of the millennium, a rapid increase in knowledge that is outside the realm of the surgeon’s traditional technological training is imposing itself – hence the aim of this book. It is now urgent to encourage surgeons to embrace this knowledge (biotechnology) with confidence. By its very nature, biotechnology is completely different from the technologies used so far, because it escapes the senses of sight and touch, which up to now have been the essence of the surgeon’s work. The cellular and molecular dimensions of biotechnologies are still far removed from most of the recent advances in modern surgical techniques. A common language between surgeons and biotechnologists will create further, revolutionary, progress in surgical sciences in the twenty-first century.

Cancers of the head and neck are among the most morbid of cancers. Convention al surgery and/or radiation therapy have a high cure rate for patients with early stage disease. However, despite optimal treatment with surgery and radiotherapy, patients with nodal spread or extensive local disease have a low cure rate. Even if a cancer is cured, a patient is often left with long-term debilities from the treatment and/or cancer. The major causes for decreased survival in patients with advanced head and neck cancer include local recurrence, distant metastases, and second primaries. All of these need to be addressed if one is to improve upon the curability of advanced disease. There are several new techniques, surgical and radiotherapeutic, designed to improve local control. Brachytherapy, or interstitial implantation, delivers a high dose of localized radiation with minimal normal tissue injury. This technique as discussed by Goffinet, may be even more efficacious when combined with hyperthermia. New, creative methods of radiation therapy delivery, such as the use of multiple fractions per day, as discussed by Parsons and Million, are also contributing to long-term local control. Laser therapy, discussed by Ossoff and Nemeroff, provides another tool for treatment of local disease.

The concern of this book is to give information only on surgical procedures; diagnosis management and post-operative care are mentioned only as required to round out the book's central purpose. A large portion of the book concerns breast cancer. Advances in the treatment of cancer by methods other than surgical over the last several years have brought relief to many without the need for surgery, even in a complementary role. In the treatment of breast cancer this has brought dispute and an all too ready dismissal of the role of the surgeon. There remain cases where surgery, usually as part of an overall treatment, is beneficial. Similarly surgery has a place in the treatment of cancers of the thyroid, parathyroid, adrenals, and spinal cord, again alongside newer methods. While newer, less invasive treatments have caught the attention, surgical procedures have developed new approaches and modern practice steadily improves. This book describes these less heralded, but important developments by explaining best practice.