This document discusses the evolution of laparoscopic surgery and laparoscopic instruments from ancient times to modern times. It describes some of the early pioneers who developed early endoscopic instruments in the 18th-19th centuries like Philip Bozzini and Maximilian Nitze. It then discusses the development of modern laparoscopy in the early 20th century with pioneers like Jacobaeus coining the term "laparoscopy" and Veress developing pneumoperitoneum. The document highlights the crucial inventions of the rod lens system by Harold Hopkins in the 1950s and videolaparoscopy by Camran Nezhat in the 1980s that enabled complex laparoscopic surgery. It also discusses some of the challenges
What is MIS?
A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these struct uresIncludes laparoscopic, endoscopic, and other approaches.
Why MIS?
Decreased patient pain
Decreased patient recovery period
Possible decrease in inflammatory response in the patient which may prove to have a better outcome in oncologic operations.
Distant future
In the distant future, there will be a para- digm shift with the development of non-inva- sive surgical techniques in combination with nanotechnologies and a new era in the devel- opment of surgery, and subsequently in surgi- cal techniques, will be opened.
Nanotechnology is an umbrella term for materials and devices that operate at the nanoskill (1 billionth of a meter). In terms of scale, a nanometer is approximately one 1/8000 of a human hair or 10 times the diam- eter of a hydrogen atom. The size of the device can vary but starts from a ten thou- sand-logic element system that will occupy a cube of no more than one hundred nanome- ters. This is a volume slightly larger than 0.001 cubic microns. This would be sufficient to hold a small computer. For example, if red blood cells are approximately eight microns in diameter, the 100 nanomicroprocessor will be 80 times smaller than a red blood cell. Devices this size could easily fit into the circulatory system and could even conceivably enter indi- vidual cells.
Slideshow of Laparoscopic Surgery by Prof. R.K. Mishra Prof. R.K. Mishra has the distinction of being first Asian who is honoured as Professor of Minimal Access Surgery by legislated University of Govt. of India. He is is currently the most experienced professor of minimal surgery in the world who has alone as a single faculty trained more than 3000 surgeon and gynaecologists from 108 countries. http://www.laparoscopyhospital.com/drrkmishra.htm
This presentation of introduction of laparoscopic surgery made by Dr. R.K. Mishra Director and chief surgeon World Laparoscopy Hospital. Dr. Mishra in this presentation has explained present pas and future of laparoscopic surgery. Laparoscopy is a surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body, or to perform certain operations. World Laparoscopy Hospital is the center of excellence for laparoscopic and da vinci robotic surgery training and considered as one of the best institute in the world. For more detail about laparoscopic surgery please visit: http://www.laparoscopyhospital.com
What is MIS?
A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these struct uresIncludes laparoscopic, endoscopic, and other approaches.
Why MIS?
Decreased patient pain
Decreased patient recovery period
Possible decrease in inflammatory response in the patient which may prove to have a better outcome in oncologic operations.
Distant future
In the distant future, there will be a para- digm shift with the development of non-inva- sive surgical techniques in combination with nanotechnologies and a new era in the devel- opment of surgery, and subsequently in surgi- cal techniques, will be opened.
Nanotechnology is an umbrella term for materials and devices that operate at the nanoskill (1 billionth of a meter). In terms of scale, a nanometer is approximately one 1/8000 of a human hair or 10 times the diam- eter of a hydrogen atom. The size of the device can vary but starts from a ten thou- sand-logic element system that will occupy a cube of no more than one hundred nanome- ters. This is a volume slightly larger than 0.001 cubic microns. This would be sufficient to hold a small computer. For example, if red blood cells are approximately eight microns in diameter, the 100 nanomicroprocessor will be 80 times smaller than a red blood cell. Devices this size could easily fit into the circulatory system and could even conceivably enter indi- vidual cells.
Slideshow of Laparoscopic Surgery by Prof. R.K. Mishra Prof. R.K. Mishra has the distinction of being first Asian who is honoured as Professor of Minimal Access Surgery by legislated University of Govt. of India. He is is currently the most experienced professor of minimal surgery in the world who has alone as a single faculty trained more than 3000 surgeon and gynaecologists from 108 countries. http://www.laparoscopyhospital.com/drrkmishra.htm
This presentation of introduction of laparoscopic surgery made by Dr. R.K. Mishra Director and chief surgeon World Laparoscopy Hospital. Dr. Mishra in this presentation has explained present pas and future of laparoscopic surgery. Laparoscopy is a surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body, or to perform certain operations. World Laparoscopy Hospital is the center of excellence for laparoscopic and da vinci robotic surgery training and considered as one of the best institute in the world. For more detail about laparoscopic surgery please visit: http://www.laparoscopyhospital.com
LAPAROSCOPIC HAND INSTRUMENTS, ACCESSORIES AND ERGONOMICSsinghanubhav5
EXTENSIVE COVERAGE OF LAPAROSCOPIC INSTRUMENTS AND THEIR ERGONOMICS TO HELP SURGEONS TO KNOW HOW TO USE THEIR LAP INSTRUMENTS IN MOST APPROPRIATE WAY AND THEIR ERGONOMICS TO BE COMFERTABLE DURING SURGERY AND PATIENTS LIFE ALSO MORE SAFE.
This presentation will help u know with the history,present and coming up trends in laparoscopy .Also it is an acquaintance presentation regarding laparoscopy.
Basics of laproscopic surgery..
by dr navdeep s kamboj presented at sgrdumsar amritsar.
topics covered--
1 basics of laparoscopy
2 lap cholecystectomy
3 lap appendixcectomy
pneumoperitonem
merits and demerits of laproscopy
ligasure
endoscopy,
laparoscopic instruments
It has not changed the nature of disease
The basic principles of good surgery still apply,including appropriate case selection, excellent exposure,adequate retraction and a high level technical expertise
If a procedure makes no sense with conventional access, it will make no sense with a minimal access approach
The cleaner and gentler the act of operation, the less the patient suffers, the smoother and quicker his convalescence,the more exquisite his healed wound.
We actually do not know what is there stored for us, but we believe that laparoscopy is trending towards advancement and nano and robotic technology is going to replace in future.
3D cameras have come into existence and various newer technologies are being invented.
Chronological Advances in Minimal Access Surgery..pdfAmzadHosen3
World Laparoscopy Hospital provides learning by doing. It provides real-world laparoscopic surgery experience by allowing the trainee to get hands-on directly with whatever surgeons are learning and developing a sense of empowerment. After taking this laparoscopic training course, surgeons and gynecologists can perform laparoscopic surgery them self on their patients with confidence.
https://www.laparoscopyhospital.com/SERV01.HTM
LAPAROSCOPIC HAND INSTRUMENTS, ACCESSORIES AND ERGONOMICSsinghanubhav5
EXTENSIVE COVERAGE OF LAPAROSCOPIC INSTRUMENTS AND THEIR ERGONOMICS TO HELP SURGEONS TO KNOW HOW TO USE THEIR LAP INSTRUMENTS IN MOST APPROPRIATE WAY AND THEIR ERGONOMICS TO BE COMFERTABLE DURING SURGERY AND PATIENTS LIFE ALSO MORE SAFE.
This presentation will help u know with the history,present and coming up trends in laparoscopy .Also it is an acquaintance presentation regarding laparoscopy.
Basics of laproscopic surgery..
by dr navdeep s kamboj presented at sgrdumsar amritsar.
topics covered--
1 basics of laparoscopy
2 lap cholecystectomy
3 lap appendixcectomy
pneumoperitonem
merits and demerits of laproscopy
ligasure
endoscopy,
laparoscopic instruments
It has not changed the nature of disease
The basic principles of good surgery still apply,including appropriate case selection, excellent exposure,adequate retraction and a high level technical expertise
If a procedure makes no sense with conventional access, it will make no sense with a minimal access approach
The cleaner and gentler the act of operation, the less the patient suffers, the smoother and quicker his convalescence,the more exquisite his healed wound.
We actually do not know what is there stored for us, but we believe that laparoscopy is trending towards advancement and nano and robotic technology is going to replace in future.
3D cameras have come into existence and various newer technologies are being invented.
Chronological Advances in Minimal Access Surgery..pdfAmzadHosen3
World Laparoscopy Hospital provides learning by doing. It provides real-world laparoscopic surgery experience by allowing the trainee to get hands-on directly with whatever surgeons are learning and developing a sense of empowerment. After taking this laparoscopic training course, surgeons and gynecologists can perform laparoscopic surgery them self on their patients with confidence.
https://www.laparoscopyhospital.com/SERV01.HTM
Recent Human Anatomy: Regional and Clinical in three volumes is based on the Anatomy syllabus for MBBS-I course in India, as per the recommendation of the Medical Council of India (MCI) and All India Institute of Medical Sciences (AIIMS). It covers the entire range of prescribed topics in General Anatomy, Gross Anatomy, Embryology, Histology, Neuroanatomy, and Clinical Anatomy.
Features
• About 500 MCQs in each volume (with answers) to help prepare for objective tests, including NEET
• Over 500 clear, full-colour illustrations
• Comprehensive treatment of Clinical Anatomy, including clinical importance of Anatomy, clinical methods to examine a patient, and surgical procedures, to prepare students for further clinical studies
• Complete yet concise descriptions in Gross Anatomy with the use of tables
• Presentation of Histology of organs and their Histophysiology with illustrated diagrams
• Histology of tubular organs described from the inner to the outer side, for better comprehension
• An efficient approach to the study of Neuroanatomy, top downwards
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Evolution of laparoscopic surgery and laparoscopic instruments
1. Dr Aashish R. Chavan
Fellow In MAS
Dept. of Surgery
GMC,Nagpur
Evolution Of
Laparoscopic Surgery
And
Laparoscopic Instruments
2. Early pioneers of endoscopy who planted the seed
Finally the modern pioneers who pushed and expanded
these frontiers to give rise the birth of modern
laparoscopy.
3. The innate human curiosity to peer inside the body
cavities can be traced back to ancient times.
However, due to primitive technology and crude
instruments, many of these ambitions were not realized.
4. The first description dates to Hippocrates in Greece, for
use of a speculum to visualize the rectum (460–375
BC).
5. 1806: Philip Bozzini
(German)
Developed an instrument
“Lichtleiter “
Looked inside urinary
bladder.
A candIe as a light
source and consisted
of a light container,
mirrors, and tubes
through which the
light passed
6. 1853: Antoine Jean
Desormeaux used
Bozzini’s Lichtleiter
1867: Desormeaux used
an open tube to examine
the genitourinary tract
7. In 1867, a German dentist named Bruek
described the first internal light source.
He examined the mouth using illumination provided by a loop of
platinum wire
connected to an electrical current.
Because the wire generated intense heat, the loop was
cumbersome and dangerous to use;
8. Maximilian Nitze (1848 – 1906)
1St cystoscope
(Nitze-Leiter
cystoscope)
using an electrically
heated platinum wire
for illumination
cooled it by using a
continuous stream of
water through the
cystoscope.
9. During the 19th century, lenses, light sources, and
endoscopes evolved, and surgeons and internists
performed cystoscopy, proctoscopy, laryngoscopy,
and esophagogastroscopy.
In 19th century because internal visualization
remained relatively poor.
10. 1901 -Von Ott
- First inspection of abdominal cavity using a speculum
and candlelight.
In 1902, George Kelling (Germany)
visualized peritoneal cavity insufflated the abdomen of a
dog with filtered air.
used a Nitze cystoscope to look inside calling it
‘Celioscopy’.
11. Hans Christian Jacobaeus (1879 – 1937)
1910: Swedish internist; first thoracoscopic diagnosis with
a cystoscope in a human subject.
Jacobaeus in 1910, coined the term “ laparoscopy”
Treatment of a patient with tubercular intra-thoracic
adhesions.
The Possibilities for Performing Cystoscopy in Examinations of Serous Cavities. Münchner
Medizinischen Wochenschrift, 1911
12. The word laparoscopy is derived from a Greek word
lapara- “the soft part of the body between ribs and hip, flank, loin”
Skopein-“to look at or survey”.
Jacobaeus in 1910, coined the term “ laparoscopy
13. 1920: Zollikofer discovered the benefit of CO2 gas for insufflation
1938: Janos Veress developed a spring loaded needle for the induction
of pneumoperitoneum.
After World War II, the development of fiberoptics represented an
important step forward for endoscopy
14. Duration Of Complications And Rejection
During the mid-1950s to 1970s,
increase in complication rates due to bowel injuries
and cautery injuries for women undergoing laparoscopic sterilization.
Laparoscopic surgery was effectively banned in Germany from
1956 to 1961.
In the 1970s, similar concerns were raised in the United States,
large part related to the limitations of technology for good
vision.
15. British Physicist, Harold Hopkins in 1952
Made most crucial invention in operative
laparoscopy
Who developed the idea of the rod lens system.
18. British Physicist, Harold Hopkins in 1952
Conventional endoscopes In Hopkins system
were constructed on an optical system that
comprised relay and field lenses made from
glass with long intervening air spaces.
the roles of glass and air are interchanged
such that the optical system consists of air
lenses and long glass air spaces.
Disadvantage
1. Low refractive index and less capacity of
transmission of light
2. Small radius of aperture at viewing optic
so smaller image
Advantages
1. As the refractive index is now
predominantly that of glass, the light
transmission capacity of the endoscopes
is doubled.
2. “larger radius of clear aperture”
available at the viewing optic so larger
and broader image
19. 1974: Dr Harrith M Hasson,
MD working in Chicago, proposed a blunt mini-laparotomy which
permitted direct visualization of the trocar entrance into the peritoneal
cavity. It is popularly known today as Hasson‘s technique.
20. The 1970s and early 1980s were not the season for
change.
21. Kurt Semm (1927-2003)
To his struggle to establish the foundation of
minimally invasive surgery amongst his
contemporary surgeons
In 3o may 1980, Semm performed the first
laparoscopic appendectomy.
‘father of gynaecological laparoscopy’
He preferred the term ‘pelviscopy’ for operative
laparoscopy
Bhattacharya K. Kurt Semm: A laparoscopic crusader. Journal of Minimal Access
Surgery. 2007;3(1):35-36. doi:10.4103/0972-9941.30686.
22. Kurt Semm (1927-2003)
Semm's technique, however, was often criticized
Once, while making a slide presentation on ovarian cysts; suddenly the projector was
unplugged - with the explanation that “such unethical surgery should not be presented”
In 1970, after becoming the chairman of Ob/Gyn at the University of Kiel, his co-workers
demanded that he undergo a brain scan because, they said,
“only a person with brain damage would perform laparoscopic surgery”
In 1972, following Semm's presentation on laparoscopic ovarian cyst enucleation, a German
gynaecology professor remarked - ‘My young colleague, if you wish to advance in the
German academic world, do not pay any attention to Semm's non-sense.’
Between 1975 and 1980, his idea to perform laparoscopic cholecystectomy was rejected by
the general surgeons. The surgeons told him that they had enough work to do repairing the
intestinal damage, which occurred during extensive laparoscopic adhesinolysis
23. Kurt Semm (1927-2003)
In 3o may 1980, Semm performed the first laparoscopic
appendectomy.
Following his lecture on laparoscopic appendectomy, the
President of the German Surgical Society wrote to the Board
of Directors of the German Gynecological society suggesting
suspension of Semm from medical practice.
Subsequently, Semm submitted a paper on laparoscopic
appendectomy to the American Journal of Obstetrics and
Gynecology, which was rejected as unacceptable for publication
on the ground that the technique reported on was ‘unethical.’
24. Kurt Semm (1927-2003)
In 1981, Professor Jon Beerman, President of the
American Society of Reproductive Medicine, from Detroit,
Michigan, visited Kurt Semm to see the ‘magic surgery.’ In
the operation theatre, Beerman observed laparoscopic
adnexectomy.
He later commented ‘All I wanted to see was the reality of
this surgery. Now, I am ready to go on my planned hunting
trip.’
These comment in the US helped to make laparoscopic
surgery acceptable in that part of the globe.
25. Kurt Semm (1927-2003)
80 Inventions
his first inventions were to develop an
electronic CO2insufflator, a uterine
manipulator and a tubal patency
testing device.
In the 1970s, Semm developed
thermocoagulation, adapted the
Roeder loop, and further invented
extra- and intra-corporeal
endoscopic knotting to achieve
endoscopic hemostasis.
Brother and father owned a medical
instrument company which rapidly
produced instruments for him
He also developed a medical
instrument company Wisap in
Munich, Germany, which still
produces various endoscopic
instruments of high quality.
In 1985, he constructed the
pelvi-trainer = laparo-
trainer, a practical surgical
model whereby colleagues
could practice laparoscopic
techniques
26. Kurt Semm (1927-2003)
Finally in 2002, Semm received the ‘Pioneer in endoscopy’
award from the Board of Governors of the Society of
American Gastrointestinal Endoscopic Surgeons (SAGES).
Semm Displayed an ability to push his ideas through despite
skepticism and suspicion Without Semm, the laparoscopic
revolution may have been postponed by many years
At the age of 76, he died due to Parkinson's disease in 2003
27. Eric Muhe (In 1985)
Eric Muhe, of German origin, is interested in the gallbladder surgery,
laparoscopy designs where the tube is of greater caliber and indirect vision
and equipped with valves that prevent loss of pneumoperitoneum.
This author in 1985 performed the first laparoscopic cholecystectomy in
the world,
He presented his work at the 1986 Congress of the German Surgical
Society.
He, too, suffered skepticism and criticism and was ultimately
censored by the courts.
The season for change had not yet arrived
28. The single most important technological
advancement for complex laparoscopic surgery
would be the advent of video laparoscopy.
29. Biography of Camran Nezhat
Iran (Persia)
“an overnight surgical sensation that was 75 years in the making.”
founder “father” of operative video-laparoscopy.
During internship and residency at the State University of New York
Visualization difficulties from peering crouched over through the
endoscope with only one eye seemed the most crucial impediment
to overcome.
30. At the forefront and important
juncture of the discovery of the
advantages of operating on the
images (videolaparoscopy),
Camran performed endoscopic
surgery off the monitor starting in
1980s, using very heavy and
awkward video camera equipment
that had been produced for other
uses and which instead he
customized— rigged actually—for
use with the laparoscope
31. During the early to mid-1980s, videoscopic images were
applied to endoscopy and ultimately to the laparoscope.
The technology was now in place to support multiple
people working in concert by laparoscopy.
32. In 1987, French surgeon Phillip Mouret
performed the first videolaparoscopic
cholecystectomy
like Muhe, Semm, and Nezhat, was strongly
criticized.
In 1988,Francois Dubois, another Frenchman,
was the second surgeon to perform
videolaparoscopic cholecystectomy and was the first
to publish his early experience
33. American College of Surgeons annual
meeting in October 1989.
Laparoscopic cholecystectomy was introduced to the
general surgery world in the exhibit hall.
Patients were demanding the new surgery, and
instrument companies were supporting courses and
even paying tuitions for surgeons to be trained to use
their products.
34. Due to the poor intensity of light sources,
at times he used an extra laparoscope connected to the light source
only to bring “more light to the subject.”
35. Sensor is charged coupled device (CCD)
solid state chip sensor.
The foundation of the laparoscopic camera is the solid state chip sensor.
The CCD is composed of
small pieces of silicone called pixels, which are arranged in rows and columns
and are sensitive to light.
When light strikes a pixel, the silicon emits electricity, which is transmitted to
the monitor.
The electronic signals are then reconstructed on the monitor to give the video
image.
The resolution of the CCD is determined by number of the pixels on the sensor.
36.
37. Triple chip camera
Each chip devoted to only one color of the spectrum.
Since the major spectrum is derived from three colors i.e.
red, green and blue,
Modern three chip camera is able to reconstruct the image
consisted of these three primary colors.
Provide excellent resolution and color but they are
significantly more expensive.
38. Four types of lamp are used more
recently.
1. Quartz halogen.
2. Incandescent bulbs
3. Metal halide vapor arc lamp
4. Xenon.
5. LED Light
Fiber optic cables,
Light source & transmission
39. A normal light source (a light bulb) uses approximately
2 % in light and 98 % in heat.
This heat is mainly due to the infrared spectrum of light
and due to obstruction in the pathway of light.
A heat filter is introduced to filter this infrared to
travel in fiber optic cable.
A cool light source lowers this ratio by creating more
light, but does not reduce the heat produced to zero.
40. Halogen bulb.
Most common type of light source.
The electrodes are made up of Tungsten.
They utilize halogen gas that allows the bulb to burn
more intensely.
They have average life of 2000 hours.
These lamps are cheap
However, they lack in providing the natural white light
color.
41. Xenon lamp
The light emitted by xenon lamp is slightly bluish
More natural compared to halogen lamp.
A proper white balancing before start of the operation is a very good
practice for obtaining a natural color.
The white light is composed of the equal proportion of Red, Blue and Green
Color
At the time of white balancing the camera sets its digital coding for these
primary colours to equal proportion assuming that the target is white.
And if at the time of white balancing the telescope is not seeing a perfectly
white object then the setup of the camera will be very bad and the colour
perception will be very poor.
42. Laparoscopy in India – a personal
perspective
Father of laparoscopy in India.
A forceful, innovative and renowned teacher and surgeon,
Dr Udwadia was the first surgeon in India to start
Laparoscopy in surgery,
First to perform Laparoscopic Cholecystectomy in the
developing world in 1990.
Padma Shri National Award, New Delhi (2006)
Udwadia TE. Laparoscopy in India - A personal perspective.
J Min Access Surg 2005;1:51-2
Tehemton E. Udwadia
Emeritus Professor, Department of
Surgery,
Grant Medical College and JJ Hospital,
Consultant Surgeon, Head, Department
of Minimal Access Surgery, P.D.
Hinduja National Hospital, Consultant
Surgeon, Parsee General Hospital Breach
Candy Hospital, Mumbai, India
43. Dr. F.P. Antia, then Professor at the KEM Hospital/Nair Hospital, Mumbai
performed a diagnostic laparoscopy on a patient with cirrhosis using a
Nitze-type telescope and a feeble filament light bulb and atmospheric air
instilled with the help of a sigmoidoscope pump for induction of
pneumoperitoneum.
Dr Udwadia realised the importance of diagnostic laparoscopy for
surgeons.
In 1971 saw Dr. N.D. Motashaw, the Honorary Gynaecologist at the KEM
Hospital perform a diagnostic laparoscopy using a Storz laparoscope.
The first laparoscopic cholecystectomy in India was performed in 1990 at
the JJ Hospital, Mumbai, followed a few months later in Pune by Dr.
Jyotsna Kulkarni
44. FUTURE
Robotic Surgery,
Virtual Reality training
TeleSurgery are the areas to watch out.
Natural orifices transluminal endoscopic surgery
[NOTES]
Single incision laparoscopic surgery.[SILS]
The latter would make it possible for surgeons to
transmit their training, sense of touch, and
experience to injured patients on battlefields, at
disaster sites, perhaps even in outer space.
A candle and angled mirrors inside the device enabled the physician to see inside the cavity. It was originally thought to be most useful for examining the larynx, but the design later came to be adapted for urological and gynecological applications. The Lichtleiter was the forerunner of thousands of urologic endoscopes.