Laparoscopic surgery also referred to as minimal access surgery describes the performance of surgical procedures with the assistance of a video camera attached with telescope and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.
It is difficult to credit one individual with the pioneering of laparoscopic approach. In 1902 Georg Kelling, of Dresden, Saxony, performed the first laparoscopic procedure in dogs and in 1910 Hans Christian Jacobaeus of Sweden reported the first laparoscopic operation in humans. In the ensuing several decades, numerous individuals refined and popularized the approach further for laparoscopy. The introduction of computer chip television camera was a seminal event in the field of laparoscopy.
Prof. R.K. Mishra doing laparoscopic surgery
This innovation in technology provided the means to project a magnified view of the operative field onto a monitor, and at the same time freed both the operating surgeon’s hands, thereby facilitating performance of complex laparoscopic procedures. Prior to its conception, laparoscopy was a surgical approach with very limited application and used mainly for purposes of diagnosis and performance of simple procedures in gynecologic applications.
According to Dr. Udwadia in developing countries the demands of laparoscopic surgery on the entire operating team are indeed heavy. Financial stringency imposes a burden which calls for reserves of equanimity, determination and commitment to one’s belief in the benefits of laparoscopic surgery. Every avenue of innovation and ingenuity has to be explored to ensure that the optimal result can be achieved at minimal cost.
The thrust of laparoscopic surgery has snowballed with almost blinding, incomprehensible speed and volume. Propelled by the aggressive enterpreneurship of instrument manufacturers, who found in laparoscopic surgery an el Dorado beyond their wildest dreams, forced by patient demand and advocated by pioneering surgeons with missionary if not fundamentalist zeal, there is no organ or tissue in the abdomen — both intra- and extra-peritoneal — which has not faced the impact of this surgery. The hurricane of laparoscopic surgery hit, gripped and convulsed the developing world with the same intensity as anywhere else.
The human hand performs many functions during surgery that are difficult to reproduce with laparoscopic instruments. The loss of the ability to place the hand into the abdomen during traditional laparoscopic surgery has limited the use of laparoscopy for complex abdominal surgery on the pancreas, liver and bile duct.
Laparoscopic surgery has replaced open surgery for many interventions over the years all over globe. Laparoscopy has been associated with less minor complications as well as shorter duration of hospital stay when compared to open surgery. In industrialised countries this is often the intervention of choice when surgery is needed. However, there is still a major gap in the implementation of modern surgical methods in under resourced settings, often due to restricted availability or access of the equipment and lack of training.
Laparoscopy Hospital, in collaboration with World Association of Laparoscopic Surgeons, has developed a programme for training and research in laparoscopic surgery, aiming to improve the use of laparoscopy in developing countries.
The Laparoscopic courses at Laparoscopy Hospital meet the guidelines established in the SAGES Framework for Post-Residency Surgical Education and Training. The University Diploma in Minimal Access Surgery (D.MAS) and Fellowship in Minimal Access Surgery (F.MAS) course designed and offered by Laparoscopy Hospital is endorsed by the Society of American Gastrointestinal Endoscopic Surgeons (SAGES). The “Hands On” training which is accepted globally by the Government of more than hundred countries is scientifically designed by academic council of World Association of Laparoscopic Surgeons and it ensures that the participants are able to do all the taught surgery themselves after training. Many thousand of surgeons and gynecologists from every corner of the globe have been trained for advanced laparoscopic skill at Laparoscopy Hospital within last eight years. There is hardly any country left in the world from where surgeons and gynecologist has not come to get laparoscopic training at Laparoscopy Hospital.
