Minimal Invasive Surgery
Over the last two decade, there has been rapid progress in the field of minimal invasive surgery (MIS). MIS is considered to be technically more demanding as compared to conventional open surgery. But the advancement in technology and advantages associated with MIS, more and more surgeons are getting attracted to MIS. In today’s era, there is no surgical procedure that cannot be done by MIS techniques. All what is required is hard work, patience and a good team effort.
eTEP (Extended view-Total Extra Peritoneal) repair of inguinal hernia
Compared to TEP, eTEP provides more working space and better visualisation of anatomical planes. It also obviates the need of blunt/blind dissection.
Suggested Reading
e TEP for direct inguinal hernia (Left)
Inadvertent peritoneal rents can be easily dealt in eTEP as it provides more working space as compared to TEP
Laparoscopic cystogastrostomy for pancreatic pseudocyst
Outcome is comparable to open method, but laparoscopic approach is associated with early recovery
Suggested reading
Guo Y, Hu S, Wang S, Li A, Cao F, Li F. Laparoscopic Intervention to Pancreatic Pseudocyst Confers Short-Term Benefits: A Meta-Analysis. Emerg Med Int 2021; 17:7586338.
Endoscopic enhanced-view totally extraperitoneal (eTEP) retrorectus approach for epigastric hernia
Offers better anatomical repair and is associated with less postoperative pain.
Suggested Reading
Laparoscopic Heller myotomy with Toupet fundoplication
Laparoscopic Heller myotomy with partial fundoplication (Toupet) provides best short and long term outcomes for achalasia cardia.
Suggested Reading
Aiolfi A, Tornese S, Bonitta et al. Dor versus Toupet fundoplication after Laparoscopic Heller Myotomy: Systematic review and Bayesian meta-analysis of randomized controlled trials. Asian J Surg 2020 ;43(1):20-28.
eTEP retro-rectus repair for para umblical hernia
More cost effective and provides better anatomical repair
Laparoscopic abdominoperineal resection
In terms of oncological clearance and long-time survival, results of laparoscopic approach are comparable to conventional open method
Suggested reading
Zhang X, Wu Q, Hu T et al. Laparoscopic Versus Conventional Open Abdominoperineal Resection for Rectal Cancer: An Updated Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A. 2018; 28:526-539.
Subcutaneous On-lay Laparoscopic Approach (SCOLA)
A safe and effective technique for repair of diastasis of the rectus abdominis muscles and associated small hernia of anterior abdominal wall.
Suggested reading
Right hemicolectomy by Initial Retrocolic Endoscopic Tunnel Approach (IRETA)
Learnt this technique from Prof C. Palanivelu and team during fellowship course in year 2018, at GEM Hospital Coimbatore- the mecca of laparoscopic surgery.
Not only safe, this technique also gives desired oncological results for right sided colonic cancers.
Suggested Reading
Transabdominal retromuscular repair
Left sided, L2-L3 (EHS) incisional hernia
eTEP for bilateral inguinal hernia (L>>R)
In obese, and in patients with narrow pelvis, eTEP should be preferred approach
Trans-abdominal pre peritoneal patch plasty (TAPP)
Compared to TEP, TAPP offers similar outcome. If performed properly, both techniques are safe and effective.
Laparoscopic appendectomy for mucocele of the appendix
In select cases, lap appendectomy is safe for mucocele of the appendix
Suggested Reading
Kim TK, Park JH, Kim JY et al. Safety and feasibility of laparoscopic surgery for appendiceal mucocele: a multicenter study. Surg Endosc. 2018 Nov;32(11):4408-4414.
Laparoscopic posterior mesh rectopexy
An effective treatment for complete rectal prolapse
Laparoscopic Choledochoduodenostomy
A simple, safe, and effective bilio-enteric anastomosis for benign biliary obstruction.
e TEP- Rives Stoppa for primary ventral hernia by three port technique
Suggested Reading
Ganesh et al. “Modified Three-Port Technique” of Extended Totally Extra Peritoneal-Rives Stoppa (eTEP-RS) Repair for Midline Ventral Hernias. Indian J Surg (2023)
Laparoscopic CBD exploration for difficult stones
Presented by Dr Ishan Bansal in AMASICON 2022, Guwahati
Laparoscopic cholecystectomy with incisional hernia repair
Transabdominal retromascular (TARM) with bilateral transversus abdominis release (TAR) for M2 (EHS) incisional hernia
Bochdalek hernia in an adult
A developmental defect in the postero-lateral diaphragm leading to herniation of abdominal contents into thoracic cavity. Commonly seen in paediatric age group but rarely in adults.
Feeding Jejunostomy
Laparoscopic FJ for entral access is associated with less post-operative pain and early recovery. It also helps in avoiding abdominal incisions in patients who are waiting for definitive surgery for upper gastrointestinal tract lesions.
Lap assisted lumbo peritoneal shunt
Safe and effective method of cerebrospinal fluid (CSF) diversion in patients with idiopathic intracranial hypertension (IIH)
Thoracoscopic lung biopsy
Associated with early recovery as compared to open biopsy
Sanjay Gupta 