Societal and economical relevance of introducing optical techniques in surgery As outlined in Chapter 11 of this thesis, it is likely that by developing and ultimately implementing innovative optical techniques (either near‐infrared fluorescence imaging or diffuse reflectance spectroscopy) for intraoperative anatomical guidance, surgeons will benefit from improved (and perhaps even earlier) detection of vital anatomical structures. In this context a visionary passage from Koninckx et al.6, describing a crave for such tools, can be cited: “Consider that on a separate screen side by side, or even better on the same screen, the vascularization pattern or the fluorescence of a cancer and its metastasis or of the smaller endometriosis lesions would be clearly visible. Consider what would happen to nerve sparing surgery when camera intelligence will show the difference between fibrosis and a nerve. Ureters today can be visualized with illuminated stents, but this is cumbersome and expensive; consider that the camera would recognize the ureter”. At least two of these visions have come closer to becoming reality, with this thesis. The developments described in this thesis can (over time) facilitate critical decision‐making 196 during surgery, which can result in safer and more efficient surgical dissection. With these projected developments a positive impact on the society – in the first place the patients undergoing surgery – and the economy is foreseen. Improved safety of the patient, in terms of a reduced risk of iatrogenic tissue injury, is in that perspective very relevant. Enhanced intraoperative nerve detection (investigated in Chapter 9) could be beneficial for all kinds of surgical procedures. For example in abdominal surgical procedures preventing injury to autonomic pelvic nerves, improves functional outcome (decrease of the rate of sexual and urinary dysfunctions)7 and thereby the quality of life of the patient. When higher procedural safety and efficiency can be achieved, health‐care costs could be reduced by avoiding costly re‐operations and thereby re‐admission to or longer stay in the hospital, for e.g. repair of a ureteral injury or a common bile duct injury. For example, Andersson et al conducted a cost‐analysis regarding iatrogenic bile duct injury following cholecystectomy in a Scandinavian study population8. They conclude that the estimated overall costs for the society for the management of both minor and major bile duct injuries would be between 470,000 and 600,000 EURO per million inhabitants annually. When certain routine surgical procedures can be performed faster, as a consequence of earlier identification of vital anatomical structures (e.g. as shown by the feasibility study
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