HISTORY OF LAPAROSCOPY BY DR SHASHWAT JANI

Dr Shashwat Jani
M.S. GYNEC .
DIPLOMA IN ENDOSCOPY.
Assist. Prof., Smt .N.H.L. Mun.Medical College,
Sheth V.S. General Hospital.
Ahmedabad.
Mobile : +91 99099 44160.
E-mail : drshashwatjani@gmail.com

The word ENDOSCOPY was
inherited from GREEK meaning…
‘To Examine Within’.
The term endoscopy was first used
between 980 and 1037 AD by
Aricenna.’
drshashwatjani@gmail.com 2

The first description dates
to Hippocrates in Greece,
for use of a speculum to
visualize the rectum
(460–375 BC).
Hippocrates also advised
injecting a large quantity of
air into the intestines
through the anus in the
case of intestinal
obstruction.

A three bladed speculum was found
in the ruins of Pompeii*
*A roman town buried by a volcano
eruption near modern Naples,
Italy - 79 AD).

In 1585, Aranzi was the first to use a light
source for an endoscopic procedure, focusing
sunlight through a flask of water and
projecting the light into the nasal cavity.
In 1806, Philip Bozzini, built an instrument
that could be introduced in the human body to
visualize the internal organs. He called this
instrument "LICHTLEITER". Bozzini used an
aluminium tube to visualize the genitourinary
tract. The tube, illuminated by a wax candle,
had fitted mirrors to reflect images.

In the 1865, the first
serviceable endoscope
was presented by
Desormeaux, nearly
50 years after Bazzini.

In 1869, Panteleoni of Ireland manage to
visualize the uterine cavity of a woman
using a cystoscope.

In 1879 , Max Nirze used lens to magnify the
area to be illuminated. This is the fore runner of
the optical system of the modern endoscopy.
Nirze is called
“The Father of Modern Endoscopy ”.
In 1887, he modified Edison`s light bulb and
created the first electrical light bulb for use
during urological procedures.

In 1901, George Kelling did the 1st
Experimental Laparoscopy. He insufflated
air into the abdomen of a dog and used
pneumoperitoneum and a cyctoscope on
dog.
In1910, Jacobaeus of Sweden was the first
to introduce the pneumoperitoneum and
adoption of Trendelenburg position, trocar
and cannula.

In 1911, H.C. Jacobaeus, again
coined the term
"laparothorakoskopie" after using the
procedure on the thorax and
abdomen.
He used to introduce the trocar inside
the body cavity directly without
employing a pneumoperitoneum.

In 1920, Zollikofer of Switzerland discovered
the benefit of CO2 gas to use for insufflation,
rather than filtered atmospheric air or
nitrogen.
In 1929, Kalk, a German physician,
introduced the forward oblique (135 degree)
view lens systems.
He advocated the use of a separate puncture
site for pneumoperitoneum.

In 1934, Ruddock need an air for peritoneum
and employed local anaesthesia. He designed
a Single puncture operating laparoscope and
its accompanying instruments with which
biopsies could be taken.

In 1936, Boesch of Switzerland is credited
for doing the first laparoscopic tubal
sterilization.
In 1938, Janos Veress of Hungary
developed a specially designed spring-loaded
needle.
Interestingly, Veress did not
promote the use of his Veress needle for
laparoscopy purposes. He used veress
needle for the induction of pneumothorax.

In 1947 , Roaul Palmer published his first 250
cases in which he used the lithotomy
Trendelenburg position and created a gaseous
distention. He also described using the uterine
cannula to elevate the uterus.

In 1953, The rigid rod lens system was
discovered by Professor Hopkins. The
credit of videoscopic surgery goes to this
surgeon who has revolutionized the
concept by making this instrument.
First Video Camera used by Dr Cameron
Nehzat.

In 1965, Kurt Semm introduced an automatic
insufflation device capable of monitoring intra-abdominal
pressures. This reduced the dangers
associated with insufflation of the abdomen and
allowed safer laparoscopy.

In 1966, Kurt Semm German Engineer and
Gynecologist , introduced thermocoagulation,
loop knots, irrigation device and performed
endoscopic appendectomy as part of a
gynecologic procedure.
In 1970, after becoming the chairman
of Ob/Gyn at the University of Kiel, his co-workers
demanded that he should undergo
a brain scan because, they said ,
“ Only a person with brain damage
would perform laparoscopic surgery ”

In 1968, Fragenheim noticed ovulation
through laparoscope.
In 1970 , Gynaecologists had embraced
laparoscopy and thoroughly incorporated
the technique into their practice…!!!
General surgeons, despite their exposure
to laparoscopy remained confined to
  
traditional open surgery…!!!

In 1972, H.Coutnay Clarke first time
showed laparoscopic suturing technique for
hemostasis.
In 1978, Hasson introduced an alternative
method of trocar placement. He proposed
a blunt mini-laparotomy which permits
direct visualization of trocar entrance into
the peritoneal cavity.

In 1978 , Laparoscopy
reached the zenith of glory
when refined techniques
described by Steptoe and
Edwards for ovum retrieval,
eventually resulted in
embryo transfer and birth of
a normal living child,
Louise Joy Brown.

In 1988, Harry Reich performed
laparoscopic lymphadenectomy for
treatment of ovarian cancer.
In 1989, Harry Reich described first
laparoscopic hysterectomy using
bipolar desiccation; later he
demonstrated staples and finally
sutures for laparoscopic
hysterectomy.

Semm was spectacularly productive in the late
1980s, introducing several new morcellators,
which could morcelate fist-sized myomas…!!!

In 1994, FDA approved Robotic surgical device
called AESOP (Automatic Endoscopic System for
Optimal Positioning. Computer motion, Inc.).
The da Vinci Robotic Surgical System and Zeus
Robotic Surgical System.

Many surgeons say…
"Laparoscopy is the by product of medical
engineering".
Laparoscopy was initially criticized due to
the cost of instruments and possible
complications due to these sharp long
instruments and difficult hand eye co-ordination.
Many senior surgeons started saying
"Laparoscopy is conspiracy against
common man".

By 1975 a huge heated debate had been
brewing about whether or not the removal of
ectopic pregnancies was indicated for
laparoscopy and also tubal ligation by
laparoscopy. Apparently there were some
unexpected complications rates with the
earliest procedures.
As a result, laparoscopy was the target of
intense scrutiny in the 1980s.
The 1980s represent what are arguably the
most controversial years in laparoscopy’s
entire history.

SAY NO
TO
LAPAROSCOPY…!!!???

Minimal access surgery has developed rapidly only
after Grand success of laparoscopic cholecystectomy
in 1987.
In 1989, The 2nd International conference for
endoscopic surgery, held in Atlanta, was described as
a boat-rocking success and represented the moment
in which,
finally, General Surgeons became
convinced of operative laparoscopy as the
future of surgery…!!!
Der aaye durust aaye …!!!


It took 5 years before Dr. Camran Nezhat was
able to present his laparoscopic treatment of
extensive endometriosis in 1985. This was at the
combined Canadian and American Fertility Society in
Toronto, Canada. His paper was finally published in
1986 in Fertility and Sterility. At that time he
reported laparoscopic treatment of Stage IV
Endometriosis… drshashwatjani@gmail.com 29

Before the introduction of laparoscopic
cholecystectomy, Gynecologists were
performing most of the advanced laparoscopic
procedures.
For example, in 1985, '86 and '89,
Dr. Camran Nezhat and his colleagues reported
laparoscopic treatment of Stage IV
Endometriosis involving the bowel, bladder
and ureters which he had been routinely
performing for years.

Nezhat and colleagues, in this country, and
Cainis in Clearmont, France, first reported
Radical hysterectomy in the late 1980s and
early 1990s.
M.A. Pelosi introduced novel laparoscopic
techniques of Single port laparoscopy.
GA Vilos advanced Hysteroscopic techniques.
Jacques Donnez and Hasson performed one of
the first laparoscopic Supracervical
hysterectomies.

Dazzling technological advances took center
stage during this era of 1990s…
The First Laparoscopic Robotic procedures
were performed by T. Falcone, J. Goldberg, A.
Garcia-Ruiz, H. Margossian, L. Stevens, a
procedure which was called,
“Full Robotic Assistance For Laparoscopic Tubal
Anastomosis.”
In 1996, the first live telecast of laparoscopic
surgery performed remotely via the internet
was achieved (Robotic Telesurgery).

Recently, Computerized designing of
laparoscopic instrument is introduced and
microprocessor controlled safety features
are added.
Now it is impossible to stop the speed
of growth of minimal access surgery
and every day new procedures are

added on its list…!!!
Rok sako to rok lo …!!!

Still, as laparoscopists, our advocacy work to perfect
and promote minimally invasive surgery is not done.
There are still too many patients who are enduring
needless open procedures.
For example, in 1997 66.8% of hysterectomies performed
in the U.S. were still done via laparotomy.
Statistics from 2004 estimate that more than 7 million
laparotomies (in all disciplines of surgery vs. 2.5 million
laparoscopies) are performed for benign conditions in the
US each year, with abdominal hysterectomies accounting
for 500,000 of those cases, and another 500,000
accounting for unspecified cases (excluding the 1 million
Cesarians).

Laparoscopy is a technologically dependent
surgery and before starting surgery every
surgeon should have reasonably good
knowledge of these instruments.
Please put a board in your Hospital :
“ Your Safety Is Our First Priority. “

THANK
YOU

HISTORY OF LAPAROSCOPY BY DR SHASHWAT JANI

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