Letters. (Opinion).

Editor's Note

Several readers expressed concern ver a photo we published of Dr. Harry Reich performing laparoscopic surgery without wearing a mask (Sept. 1, 2001, p. 1). We asked Dr. Reich to explain his rationale for not doing so, and his response follows. Let us know what you think about his position by writing to us at our editorial offices.

I am pleased that this practice hit a nerve with your readers. I liked the picture you published that was taken during my surgery with me operating without a mask. I did it to demonstrate the way I have operated for the past 10-plus years at Nesbitt Memorial Hospital in Kingston, Pa., and for over 100 surgical procedures while teaching abroad. This practice has been widely adopted in Europe.

Laparoscopic surgery has never been a sterile procedure when compared with the precautions associated with laparotomy, yet it is associated with a much lower infection rate.

I would estimate this rate as less than 0.5% if no intraoperative complications occur.

Most surgeons trained before 1988 operated while viewing the surgical field with their eye attached to the laparoscope. The laparoscope was held there by the surgeon's "sterile" gloved dominant hand. Although surgery using the ...