Laparoscopy Hospital - Laparoscopic Research http://www.laparoscopyhospital.com/Research.htm Our mandate to excel in patient centered care, scholarly work and research en Thu, 18 Sep 2008 02:45:37 +0500 http://blogs.law.harvard.edu/tech/rss rkmishra@laparoscopyhospital.com admin@laparoscopyhospital.com Health 1440 RSSeditor v0.9.54 (http://www.rss-info.com) http://www.laparoscopyhospital.com/laparoscope1.jpg Laparoscopy Hospital - Laparoscopic Research http://www.laparoscopyhospital.com/Research.htm 100th Batch of Laparoscopic Training Program. Laparoscopy Hospital, New Delhi, India on 13th of September 2008 http://www.laparoscopyhospital.com/100thbatchoflaparoscopictrainingprogramme.htm contact@laparoscopyhospital.com Honorable Dr. Akhilesh Prasad Singh, Union Minister, Government of India as chief guest and Prof. Dr. P.R. Trivedi as Guest of Honour of certification ceremony of 100th batch of Laparoscopy Hospital on 13th of September 2008. Speech of Honourable Minister on the occasion of celebration of 100 th batch of Laparoscopic Training Programme of Laparoscopy Hospital on 13 th Evening at India Habitat Centre, Casurina Hall.

I am very happy to see the Galaxy of super specialist surgeons and gynaecologists who came here from different part of India and abroad Laparoscopic surgery is one of the fastest growing areas in surgery today. Combining advanced technology with patient care has allowed surgeons to do more advanced surgery with less trauma to patient. Patients are experiencing less pain, shorter hospital stays, and faster recovery times than were ever imaginable 20 years ago Laparoscopy was previously considered as surgery of rich people but in my opinion laparoscopic surgery should be available for every citizen of India specially the poor who earn their money by hard physical work and they need more rapid recovery then rich and affluent section of society - Dr.A.P.Singh. I am happy to know from Dr. R. K. Mishra that today Laparoscopy Hospital is celebrating the convocation of their 100 th batch of laparoscopic training course. Within last 8 year 2500 surgeons and gynaecologists has been trained in art and science of laparoscopic surgery by laparoscopy hospital. Among these 2500 surgeons 1150 surgeon are from overseas country - Dr.A.P.Singh. It is a hard fact that only rich and middle class people can afford Laparoscopic surgery. I am very happy to know that for the poor and needy, Laparoscopy Hospital provides once a month laparoscopic surgery completely free of cost. For these patients medicines are also dispensed absolutely free of charge. There is no charge attached to any service at our hospital for these categories of patients. This free service is provided to economically disadvantaged people irrespective of race , colour, language, class , creed, religion or region. Laparoscopy Hospital is providing these services in collaboration with World Association of Laparoscopic Surgeons. I wish all the surgeons and gynaecologist who are present here a great success in their professional life. Much work is being done by many organizations, particularly in private-public partnerships, to ensure that lives are saved and health improved worldwide and I request all the doctors present in this gathering also to serve the poor and needy with their advanced surgical skill - Dr.A.P.Singh"

]]> Laparoscopic Equipments detail http://www.laparoscopyhospital.com/laparoscopic_equipment_detail_1.htm contact@laparoscopyhospital.com Many surgeons says Laparoscopy is the by product of medical

engineering. Laparoscopy was initially criticized due to the cost of instruments and possible

complications due to these sharp long instruments and difficult hand eye co-ordination. Many senior

surgeons started saying Laparoscopy is conspiracy against common man. Minimal access surgery has

developed rapidly only after grand success of laparoscopic cholecystectomy. Recently computerized

designing of laparoscopic instrument is introduced and microprocessor controlled safety features

are added.

]]> Safety Considerations during Anesthesia in Laparoscopy http://www.laparoscopyhospital.com/Laparoscopic_anesthesia_special_consederation.htm contact@laparoscopyhospital.com Laparoscopy results in multiple post-operative benefits including

fewer traumas, less pain, less pulmonary dysfunction quicker recovery and shorter hospital stay.

These advantages are regularly emphasized and explained. With increasing success of laparoscopy, it

is now proposed for many surgical procedures. Intra operative cardio respiratory changes occur

during pneumoperitoneum Pa CO2 increases due to CO2 absorption form peritoneal cavity [6].in

addition theses procedures are associated with potential life threatening complications that are

not usually encountered with traditional open approach [7]. An understanding of the patho-

physiologic consequence of increased intra-abdominal pressure is important for anesthesiologist who

must prevent or when prevention is not possible adequately respond to these changes. Evaluate and

prepare the patient preoperative in the light of these disturbances. Therefore pathophysiologic

changes and complication of laparoscopy are first reviewed in compromised patients, cardio

respiratory disturbance aggravate this increase in PaCO<SUB>2. </SUB>Hemodynamic changes are

accentuated in high risk cardiac patient. Improved knowledge of hemodynamic changes in healthy

patient allows successful anesthetic management of cardiac patient. This paper is to find out all

the safety considerations during anesthesia in laparoscopy.

]]> Is Umbilicus Safe For Primary Port http://www.laparoscopyhospital.com/laparoscopic_research_at_laparoscopy_hospital.htm contact@laparoscopyhospital.com While laparoscopy has been an enormous advance from open surgery,recent development in microfibres and lenses have seen the creation of even tinier laparoscopes measuring two to four millimeters which are known as micro and mini laparoscopes, respectively. At the same time, small laparoscopic instruments have been produced and so the total laparoscopic procedure can be performed with incisions of two to four millimeters. Conventional laparoscopy uses a 10 mm umbilical incision for the laparoscope and 5 mm to 10 mm incisions elsewhere. Because of the small diameter of the micro and mini laparoscopes, under suitable circumstances surgeries may be performed without general anesthesia.

]]> Two Port Laparoscopic Repair of Ventral Hernia http://www.laparoscopyhospital.com/two_port_repair_of_ventral_hernia.htm contact@laparoscopyhospital.com This two port technique can be accomplished with the help of Anchor or

Protack or Tacker if patient can afford. Two port technique using PDS is safe and economical method of performing laparoscopic repair of ventral hernia. Although using strategically placed knot we have performed one port repair of ventral hernia also with the help of suture passer but if adhesions are present one port technique is not possible. Two port techniques should be included in

the practice of repair of ventral hernia surgery laparoscopically because in case of any difficulty the third port can be introduced any time without any difficulty.

]]> Two port Cholecystectomy http://www.laparoscopyhospital.com/two_port_cholecystectomy.htm contact@laparoscopyhospital.com Laparoscopic Cholecystectomy is the gold standard for the treatment ofgall stone disease. The operation is routinely performed using four or three ports of entry into the abdomen. At Laparoscopy Hospital we frequently perform Laparoscopic Cholecystectomy by Two Ports. We have developed a new technique of performing two port cholecystectomy with the help of modified extra corporeal Meltzer's knot. With this technique we can give traction over the gallbladder in any direction for proper exposure. This new innovative two-port method of gallbladder removal can be used only for simple uncomplicated cholelithiasis cases by experienced surgeon, but it has definite advantage over conventional four port cholecystectomy.

]]> Laparoscopic versus open repair of Duodenal Perforation http://www.laparoscopyhospital.com/dr_mohamad.htm contact@laparoscopyhospital.com Perforation is a life threatening complication of peptic ulcer disease. Duodenal Perforation is a common complication of duodenal ulcer15. The first clinical description of perforated Duodenal Perforation was made by Crisp in 18431. Laparoscopic treatment of perforated Duodenal Perforation was first reported by Mouret in 1989 followed soon after by Nathanson et al.The incidence of perforated Duodenal Perforation remains the same. Operative treatment of perforated duodenal ulcer consists of time honoured practice of omental patch closure but now this can be done by laparoscopic method. Laparoscopic approaches to closure of duodenal perforation are now being applied widely and may become the gold standard in the future especially in patient with &lt;10mm perforation size presented with in the first 24 hrs of onset of pain.

]]> Laparoscopic versus open repair of ventral hernia http://www.laparoscopyhospital.com/dr_fadhil_yaba_muhamed.htm contact@laparoscopyhospital.com Ventral hernia (VH) occur as a result of  weakness in the musculofacial layer of anterior abdominal wall, the most popular classifications are congenital, acquired, incisional & traumatic [1]. According to several medical literatures the successful series of laparoscopic repair for (VH) were done by LeBlanc in 1993. Since then it has been proved that to be accepted surgical technique. New standards have been noted for various indication, contraindication, light mesh in incisional hernia, which is considered as a common surgical complication with long term incidence of 10 - 20% and controversies in laparoscopic repair ,operative costs may be optimized with selection of mesh& optimal use of trans-abdominal suture & fixation device .This review article reveals the recent advances & progression in laparoscopic ventral hernia repair; technique even in patient with morbid obesity; old adult with incisional hernia.

]]> Laparoscopic versus open repair of inguinal hernia http://www.laparoscopyhospital.com/snehal.htm contact@laparoscopyhospital.com Background: Despite a large number of clinical studies in recent years no consensus has been achieved on the surgical technique of inguinal hernia repair for various reasons. Experts believe that their own prefered open methods have the lowest possible recurrence and complication rates. They tend to attribute any negative results, as shown by a number of regional quality studies, to other surgeons poor skill rather than to the technique itself. This review article aimed to compare laparoscopic versus open Laparoscopic hernia repair.

]]> Laparoscopic versus open appendectomy for the treatment of acute appendicitis. http://www.laparoscopyhospital.com/laparoscopic_versus_open_appendicectomy.htm contact@laparoscopyhospital.com Open appendectomy is the 'gold standard' for the treatment of acute appendicitis.  Laparoscopic appendectomy though widely practiced has not gained universal approval. Although it is a generally safe operation, postoperative complications occur in few patients.  Laparoscopic appendectomy was first described in 1983.  Reports of early studies were equivocal with few studies evaluating analgesic requirements and the length of hospital stay. This study was aimed to compare laparoscopic with open appendectomy and ascertain the therapeutic benefit, if any, in the overall management of acute appendicitis.

]]> Optimum shadow-casting illumination for endoscopic task performance http://www.laparoscopyhospital.com/Research.htm contact@laparoscopyhospital.com We hypothesize that task performance improves with the use of (i) balanced degree of shadow and illumination compared to no or maximum shadow contrast and (ii) shadow-casting illumination from above compared to the side of the operative field. The standard task entailed touching target points on an undulating surface using a surgical hook.  Each run consisted of 13 target points in a random sequence.  The end points for each run were the execution time and number of errors.  Five settings were investigated: no shadow, 22%, 42%, 65% shadow contrast created by above illumination and 22% shadow contrast produced with side illumination.  Ten surgeons participated in the study and each surgeon performed three runs with each setting in a random order. Shadow contrast settings had a lower number of errors compare to no shadow (p<0.0001).  Twenty-two percent shadow contrast had a lower number of errors with above illumination compared to the side (p<0.0001).  With the above illumination, 22% and 42% shadow contrast had a lower number of errors compared to maximum shadow contrast of 65% (p<0.005).  Optimum endoscopic task performance is obtained with above shadow-casting illumination and a balanced degree of illumination and shadow contrast.

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