Minimal Invasive Conventional Surgery for GI Cancer: Review of 8 cases Dr.Qalander H.Abdulkareem Kasanzani, Consultant Surgeon. Dr. Taher Abdulla Hawrami ,CABS, Consultant Surgeon, Assistant Professor of Surgery, University of Sulaimany, College of Medicine, Head of department of Surgery. Dr. Muhamed Shekhani,M.B.Ch.B- C.A.B.M, Consultant physician, Assistant Professor of Medicine, University of Sulaimany, College of Medicine, Department of Medicine. From Kurdistan Ceneter for GIT & Hepatology, Sulaimani Teaching Hospital.
Abstract: <ul><li>Minimal invasive Surgery defined as that method of a surgical procedure which cause the least possible physical & mental trauma to the patient & achieving at least the same or better goal than conventional surgery. </li></ul><ul><li>Using the conventional method without advanced recent technology we can still do minimal trauma to the patient both physically & mentally. </li></ul><ul><li>Seven cases of GIT cancer has been presented as case review operated on by conventional method of minimal invasive surgery using no any new technology in the operative procedures. </li></ul>
Introduction: <ul><li>Minimal invasive surgery is a surgical innovation by using recent technology & doing different kind of surgical procedures which were not possible in past by our conventional method. </li></ul><ul><li>Doing a surgical procedure at remote site from the patient by new technology has very great advantage compared to conventional surgery. </li></ul><ul><li>Disadvantages : </li></ul><ul><li>It's not always available . </li></ul><ul><li>It's coasty & not all countries can manage . </li></ul><ul><li>It needs training, considerable time& maintenance of these equipments is as costly as the equipments itself . </li></ul><ul><li>Complication. </li></ul>
Introduction: <ul><li>We can in many cases use our skill rather than technology to achieve the goal of minimal invasive surgery without using expensive technology & avoiding the limitations described in the practice of minimal invasive surgery above . </li></ul>
Materials & methods: <ul><li>Eight cases of GI cancer and one case of benign distal gastric obstruction by corrosive agent has been reviewed with follow up of 3 years only . </li></ul><ul><li>Different modalities of treatment has been done for different patient varied from cure to palliation , specially in case of GIT cancer . </li></ul><ul><li>The new image technologies , had its great influence on our clinical setting& the modality of the remedies we choose for our cases in GIT center in Sulaimany . </li></ul><ul><li>Palliative surgery has been applied for advanced cases of GIT cancer by palliative resection in some cases , when clinical setting was in favor of that procedure . </li></ul><ul><li>In other cases more simple palliative procedure has been done like : bypass surgery . </li></ul>
Case 1: <ul><li>60 years old lady had dyspepsia for 4 months. </li></ul><ul><li>OGD had revealed small antral ulcer at greater curvature area. </li></ul><ul><li>Biopsy was well differentiated adenocarcinoma </li></ul><ul><li>All images modalities (contrast C.T. & US ) were in favor of no penetration of the wall , no L.N , no evidence of any metastasis . </li></ul><ul><li>Operated on by small incision at the area of the antrum& the lesion was not palpable during surgery. </li></ul><ul><li>Sub total gastrectomy has been done, the result was T1 (Mucosa & sub mucosa ) , No muscle layer invasion. </li></ul><ul><li>It has been reconstructed by Roux-en –Y , she had uneventful recovery . </li></ul><ul><li>Just follow up no further oncologic treatment has been advised . </li></ul>