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Advanced Laparoscopic Surgery:Is it feasible?

Dr. Shahzad Alam ShahAssistant Professor Of Surgery

FJMC/Sir Ganga Ram Hospital Lahore

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What Is Advanced Laparoscopic

Surgery?

Dr Shahzad Alam ShahMid City Hospital Lahore Pakistan

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Current Scenario

Slow Progression

Grossly Deficient Training Doctors and Nurses ,paramedics

Individual Efforts

Do as I do policy

Advancement is driven by the multinationalcompanies

Disposables Dr Shahzad Alam ShahMid City Hospital Lahore Pakistan

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Establishment of centers for laparoscopicsurgery

Guidelines

Training Structured Program

Crash courses

Cost Containment

What needs to be done-

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Cost

Cost Containment

Improvisation and Innovations

Endosuturing

Reusable Instruments

Indigenous Resources

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SKILLS ACQUISITION IN ADVANCED LAPAROSCOPICOPERATIONS

2 handed dissection

technique Non dominant dexterity

Extra & Intra corporealknotting

Intracorporeal suturing.

Endotrainers

Animal Models

Apprenticeship

Training Courses

Clinical Program

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Skill Acquisition

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Improvisation and Innovations

Available, Affordable,Accessible, Acceptable

and Appropriate

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Improvisation and Innovations

TEP Hernia Repair

Dr Shahzad Alam ShahMid City Hospital Lahore Pakistan

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Extracorporeal Knoting and

Self made Endoloops

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Appendicectomy with Extracorporeal Knotting

Dr Shahzad Alam ShahMid City Hospital Lahore Pakistan

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Intracorporeal Knotting & Suturing

Dr Shahzad Alam Shah

Mid City Hospital Lahore Pakistan

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Re-usable Stapling and Intracorporeal

Suturing

Gastrojejunostomy

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Entro-entrotomy

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Tissue Approximation

Mesh Fixation Devices

TAPP Hernia Repair

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Conclusions

Every avenue of innovation and ingenuity

has to be explored to ensure that the optimalresult can be achieved at minimal cost

Equanimity, determination and commitmentto ones belief in the benefits of laparoscopic

surgery

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Laparoscopic surgery is a completely different fromconventional surgery. It, thus, demands specialized

training. Training has to be imparted as a crash course

Training for laparoscopic surgery

Dr Shahzad Alam ShahMid City Hospital Lahore Pakistan