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Foreword
Theadoptionanddiffusionoflaparoscopicsurgeryhasbeenvariablearound
theworld.Costbarriersinlowandmiddle-incomecountriescontinuetobevery
signifcantissues,affectingpatientaccess.Forsomeprocedures,ithasrapidly
becomethepreferredapproach(e.g.cholecystectomyandappendicectomy),
whileforothers(e.g.pancreatoduodenectomyandrighthepatectomy)thishas
yettobeso.Aslevel1evidencebecomesavailabletosupportlaparoscopic
surgery,therearestillmanyunansweredquestionsrelatingtothefeasibilityand
advisabilityofdifferentlaparoscopicprocedures.
SirAlfCushieri,afatheroflaparoscopicgeneralsurgery,oncesaidthatthe(be-
neftsoflaparoscopicsurgeryarerelatedtotheinverseofthedepthoftheorgan
beingoperatedon’,meaningthatshowingthebeneftforsuperfcialtargets(e.g.
ventralhernia)ismorediffcultthanfordeeptargets(e.g.hiatushernia).Surge-
onpreferencesandsystemsfactorscanoftenexplainthisdifferenceinthedif-
fusionofaprocedure,buttherearealsotechnologicandergonomicfactorswhich
canbeimportant.Intherushtopromoteandpracticelaparoscopicsurgery,
thesehavenotalwaysreceivedsuffcientattention.Asascience,theyshould
underpintraininginlaparoscopicsurgery.Indeed,allsurgeons,surgicalassistants
andtheatrenurseswillfndthisbookofimmensevalue.Thehorizonsoflaparo-
scopicsurgerycontinuetoexpand,withtheadventof3Dimagingsystems,au-
gmentedrealityandroboticinstrumentation.Andwhilethiswillextendwhatis
possible,thefundamentalimportanceofpatientsafetyremainstheresponsibi-
lityofthelaparoscopicsurgeonandteam,nomatterwhattechnologyisavaila-
ble.Thisisnotthefrstbooktoaddressthetechnical,safetyandergonomic
elementsoflaparoscopicsurgery,butitdoessoinamostsystematic,practical
andelegantway.
JohnAWindsor
BScMBChBMDFRACSFACSFRSNZ
ProfessorofSurgeryandDirectorofResearch,UniversityofAuckland,NewZealand
HBP/UpperGISurgeon,AucklandCityHospital,Auckland,NewZealand
Founder,AdvancedClinicalSkillsCentre,Auckland,NewZealand
j.windsor@auckland.ac.nz
