ABSTRACT
PURPOSE: The informed consent is a legal requirement prior to surgery and should be based on an extensive preoperative interview. Multimedia productions can therefore be utilised as supporting tool. In a prospective randomised trial, we evaluated the impact of an extended education on patients undergoing cholecystectomy. MATERIALS AND METHODS: For extended patient information, a professionally built DVD was used. After randomisation to either the DVD or the control group, patients were informed with or without additional presentation of the DVD. The quality of education was evaluated using a purpose-built questionnaire. RESULTS: One hundred fourteen patients were included in the DVD and 98 in the control group. Patient characteristics did not differ significantly despite a higher educational level in the DVD group. The score of correctly answered questions was higher in the DVD group (19.88 vs. 17.58 points, p < 0.001). As subgroup analysis revealed, particular patient characteristics additionally impacted on results. CONCLUSION: Patients should be informed the most extensively prior to any surgical procedure. Multimedia productions therefore offer a suitable instrument. In the presented study, we could prove the positive impact of an information DVD on patients knowledge. Nevertheless, multimedia tools cannot replace personal interaction and should only be used to support daily work.
Subject(s)
Cholecystectomy, Laparoscopic , Informed Consent/legislation & jurisprudence , Multimedia , Patient Education as Topic/methods , Preoperative Care/methods , Videodisc Recording , Adult , Age Factors , Aged , Aged, 80 and over , Educational Status , Female , Germany , Humans , Male , Middle Aged , Patient Education as Topic/legislation & jurisprudence , Patient Satisfaction , Physician-Patient Relations , Surveys and QuestionnairesABSTRACT
Primary and secondary liver tumors may be treated with radiofrequency ablation (RFA) to improve tumor control and to increase patient survival. Lesions are punctured percutaneously or during open surgery. However, not all of the lesions are accessible percutaneously due to their localization: Adjacent structures could be endangered and/or the treatment would cause severe pain. Open surgery is an option in these cases but significantly more invasive. Laparoscopic RFA (LRFA) is an additional possibility in those cases: It offers a better access to difficult lesions than via the percutaneous route and is also less invasive than open surgery. The precision of targeting, however, in LRFA still has to be improved. In an in-vivo feasibility study we used a tumor mimic model in pigs to examine the applicability of laparoscopic RFA in combination with laparoscopic ultrasound using a set of dedicated new instruments to handle the RFA probe. To increase the ablation volume, the liver blood flow was reduced performing a Pringle maneuver. It is demonstrated that this set of specially designed instruments is indeed applicable and facilitates the targeting of liver lesions of any localization. Accordingly, it could significantly enlarge the applicability of LRFA.