Commentary

Where’s the data on minimally invasive cesarean?


 

To the editor:

I was greatly troubled by your publication of the article on “minimally invasive” cesarean by Drs. Marco A. Pelosi II and Marco A. Pelosi III (“Minimally invasive cesarean: Improving an innovative technique” July). The technique described is neither innovative nor improved. The authors describe standard cesarean technique with the addition of a disposable “surgical device” previously used for their so-called hand-assisted laparoscopy. They offer no proof of safety or efficacy and no proof that the technique improves fetal or maternal outcome.

I hope the fact that your journal is not peer-reviewed does not absolve you from any editorial control.

THOMAS I. JANICKI, MD
CLEVELAND, OHIO

Drs. Pelosi and Pelosi respond:

The confrontational nature of Dr. Janicki’s letter makes it obvious he has not seen or performed the cesarean procedure described and hasn’t bothered to read the article carefully or review the literature on the subject.

As for hand-assisted laparoscopy, we would like to remind Dr. Janicki that it has become the technique of choice for a large number of minimally invasive surgeons who use it to perform splenectomy, nephrectomy, bowel resection, and bariatric surgery. The peer-reviewed literature on hand-assisted laparoscopy, including ours, is quite extensive.

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