The first international Delphi consensus statement on Laparoscopic Gastrointestinal surgery.

Background: Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons.

Method for safe Verres needle entry at the umbilicus, with modification for first trocar entry to reduce the complication rate of first entry.

Background: Initial intraperitoneal access and first trocar entry are responsible for nearly half of all complications of laparoscopic surgery. The purpose of this article is to detail our method of initial intraperitoneal access with Veress needle and first trocar at the umbilicus used over the past 28 years.

Patients And Methods: Since 1990, a single surgeon performed laparoscopic surgery in 7600 patients.

Training for laparoscopic colorectal surgery creating an appropriate porcine model and curriculum for training.

Background: Laparoscopic colorectal surgery (LCRS) was first described in 1991, and its safety, efficacy and patient benefit were adequately documented in literature. However, its penetration and acceptability is poor in most countries, due to its long learning curve and lack of surgeons training and confidence. A Minimal Access Surgery (MAS) Training Center in Mumbai has over the last 7 years trained more than 8000 surgeons in various MAS specialities.

Robotic surgery is ready for prime time in India: Against the motion.

The use of Robotic Surgery as a purported adjunct and aid to Minimal Access Surgery (MAS) is growing in several areas. The acknowledged advantages as also the obvious and hidden disadvantages of Robotic Surgery are highlighted. Survey of literature shows that while Robotic Surgery is "feasible" and the results are "comparable" there is no convincing evidence that it is any better than MAS or even open surgery in most areas.

Prevention and management of complications of laparoscopic splenectomy.

Laparoscopic splenectomy (LS) has become a commonly performed minimal-access operation. With increasing experience, surgeons are undertaking LS for multiple pathologies and tackling spleens of diverse sizes. LS remains a challenging procedure to be performed by experienced laparoscopic surgeons, well supported by a team.

Ghee and honey dressing for infected wounds.

Ghee and honey has been advocated and used as dressing for infected wounds by Sushruta (600BC) and since 1991 in four Mumbai Hospitals. The gratifying results observed with the dressing have prompted this study which aims to establish its efficacy in five recalcitrant subset of chronic infected wounds over a three year period 2006-2009. A standardized ghee and honey dressing was used to treat: a) Eight cases of fungating malignant lesions.

Use of Nathanson retractor during laparoscopic splenectomy for supermassive spleens.

Background: Although feasibility of laparoscopic splenectomy for supermassive spleens has been described, obtaining uniform and uninterrupted retraction of a heavy spleen to ensure safe hilar dissection is challenging. We describe a technique of retraction of supermassive spleens using a Nathanson retractor.

Methods: This technique was used in 4 patients, and the demographic data as well as data related to the surgery were retrospectively collected.

Single-incision bilateral laparoscopic oophorectomy.

Although single-incision laparoscopic surgery made an appearance on the surgical scene only recently, it is being increasingly applied in the treatment of a variety of disorders. We report single-incision bilateral laparoscopic oophorectomy and salpingooophorectomy performed in two patients who had previously undergone breast conservation surgery for early breast cancer. Each procedure was undertaken using two 5-mm and one 3-mm ports inserted through a 2-cm transverse supraumbilical incision and standard laparoscopic instruments.

Single-incision laparoscopic cholecystectomy: How I do it?

Single-incision laparoscopic cholecystectomy (SILC) is a relatively new technique that is being increasingly used by surgeons around the world. Unlike the multi-port cholecystectomy, a standardised technique and detailed description of the operative steps of SILC is lacking in the literature. This article provides a stepwise account of the technique of SILC aimed at surgeons wishing to learn the procedure.

Laparoscopic splenectomy for tuberculous abscess of the spleen.

Abscess of the spleen is an uncommon clinical entity and a tuberculous abscess is particularly rare. Although image-guided aspiration has been reported, splenectomy is the preferred modality of treatment. We report a 32-year-old female diagnosed to have a large, multilocular splenic abscess during investigation of a pyrexial illness.

Surgical training in India.

Background: The quality of surgical training and competence defines the quality of patient care. The developed world evolved its surgical training over a long progressive period, whereas countries in the developing world, of which India is a reasonable example, were jettisoned into the waters, to hurriedly create their own training.

Method: Surgical training is but part of the picture of any countries medical education.

Navigating laparoscopic surgery into the next decade in developing countries - a personal perspective.

Introduction: Over 500 years ago, Vasco de Gama navigated from west to east, from Lisbon in Portugal to Calicut in India, in an epic voyage that lasted over 1 year (Fig. 1). This voyage was perhaps the greatest historic and, certainly, the greatest navigational achievement of the last millennium.

Laparoscopic surgery for inguinal hernia: Current status and controversies.

Repair of inguinal hernia is one of the commonest operations performed by surgeons around the world. The treatment of this common problem has seen an evolution from the pure tissue repairs to the prosthetic repairs and in the recent past to laparoscopic repair. The fact that so many hernia repairs are practiced is a testimony to the fact that probably none is distinctly superior to the other.