Safety in Minimal Access Surgery EVIDENCE AND RECOMMENDATIONS
Safety in Minimal Access Surgery EVIDENCE AND RECOMMENDATIONS
Editors
Om Tantia
MS FRCS (Eng) FACS FICS FMAS FAIS FALS (Bariatric) IAGES
Medical Director and Head Department of Minimal Access and Bariatric Surgery Centre of Excellence Metabolic and Bariatric Surgery ILS Hospitals Kolkata, West Bengal, India
Tamonas Chaudhuri
MBBS MS FAIS FMAS FACS FACRSI (Hon)
Professor of Surgery Burdwan Medical College Senior Consultant Department of Minimal Access and Bariatric Surgery ILS Hospitals Kolkata, West Bengal, India
Forewords
C Palanivelu
Pradeep Chowbey
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Safety in Minimal Access Surgery: Evidence and Recommendations
First Edition: 2021
9789390595570
Printed at:
- Abhay Dalvi MS
- Professor
- Department of General Surgery
- In-Charge
- Minimal Access Surgery
- Seth GS Medical College and
- KEM Hospital, Mumbai
- Consultant
- Gleneagles Global Hospital
- Mumbai, Maharashtra, India
- Akshay Chitnis MS FIAGES FAMS
- Fellow
- Minimal Access Surgery
- Department of Minimal Access Surgery
- Hinduja Hospital
- Mumbai, Maharashtra, India
- Ankit Sahoo MS
- Senior Resident
- Department of General Surgery
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Anshuman Poddar MS
- Consultant
- Department of Minimal Access and Bariatric Surgery
- ILS Hospitals
- Kolkata, West Bengal, India
- Aparna Deshpande MS DNBE
- Professor
- Department of General Surgery
- Seth GS Medical College and
- KEM Hospital, Mumbai
- Consultant
- Laparoscopic, General and GI Surgeon
- BSES MG Global Hospital
- Mumbai, Maharashtra, India
- Aparna Govil Bhasker MBBS MS
- Bariatric and Laparoscopic Surgeon
- Apollo and Global Hospitals
- Mumbai, Maharashtra, India
- Aruna Tantia MS FMAS Dipl. in Pelvic Endoscopy (Germany)
- Director and Head
- Department of Obstetrics/Gynaecology and Minimal Invasive Gynaecology
- ILS Hospitals
- Kolkata, West Bengal, India
- Avinash N Supe MS DNB FICS FMAS FIAGES DHA DNB MHPE PGDME FCPS
- Emeritus Professor of
- Surgical Gastroenterology and
- Medical Education
- Seth GS Medical College and KEM Hospital
- Mumbai, Maharashtra, India
- Balasubramaniam Ramana MS DNB FRCS FIBC FACS FISA
- Head and Director
- Department of Minimal Access
- Bariatric, Hernia and GI Surgery
- Calcutta Medical Research Institute
- and Hospital
- Kolkata, West Bengal
- Visiting Consultant
- Institute of Minimal Access
- Metabolic and Bariatric Surgery
- Sir Gangaram Hospital
- New Delhi, India
- Founder President
- AWR Surgeons Community
- Chandragupta Ch MS FMAS
- Senior Consultant of Laparoscopic and Endoscopic Surgery
- Department of Surgery
- Shija Hospitals and Research Institute
- Imphal, Manipur, India
- Chetan Parmar MS DNB PGDHHM FRCS
- Consultant Bariatric/UGI and
- General Surgeon
- Honorary Associate Professor
- University College London, Medical School
- Clinical Lead
- The Whittington Hospital NHS Trust
- London, United Kingdom
- Daksh Sethi MS DMAS
- Clinical Associate
- Institute of Minimal Access
- Metabolic and Bariatric Surgery
- Sir Ganga Ram Hospital
- New Delhi, India
- Deep Goel FACS (USA) FRCS (England)
- Consultant Robotic Surgeon
- Senior Director
- Department of Surgical Gastro Onco, Bariatric and
- Advance Minimal Access Surgery
- BLK Super Specialty Hospital
- New Delhi, India
- Deepraj Bhandarkar MS FRCS FACS FICS MAMS FIAGES FALS FMAS Dipl. Lap Surgery (France)
- Consultant, Minimal Access Surgery
- Department of Minimal Access Surgery
- Hinduja Hospital
- Mumbai, Maharashtra, India
- Devendra Kh MS FMAS
- Head
- Department of Surgery
- Shija Hospitals and Research Institute
- Imphal West, Manipur, India
- Dilip Gode MS PhD FACS FICS FMAS
- Professor of Surgery and Dean
- Datta Meghe Medical College
- Nagpur, Maharashtra, India
- Eham Arora MS DNB FMAS FIAGES
- Assistant Professor
- Department of General Surgery
- Grant Medical College and
- Sir JJ Group of Hospitals
- Mumbai, Maharashtra, India
- Gaurav Kulkarni DNB MRCS (Edin) MD (USA) MBA FMAS
- Specialty Registrar in General Surgery
- Department of General Surgery
- Kettering General Hospital
- Kettering, Northamptonshire
- United Kingdom
- Jitender Singh Chauhan MS Fellowship Surgical Gastroenterology
- Fellow, Gastro Surgery
- Kaizen Hospital–Institute of Gastroenterology and
- Research Centre
- Ahmedabad, Gujarat, India
- Jugindra S MS FMAS
- Medical Superintendant and
- Consultant Surgeon
- Shija Hospitals and Research Institute
- Imphal West, Manipur, India
- Kalpesh Jani MS DNB FNB MNAMS FICS FACS
- Consultant Surgical Gastroenterology and Laparoscopic Surgeon
- VIGOS Hospital
- Vadodara, Gujarat, India
- Kamal Mahawar MS MSc FRCSEd
- Consultant Surgeon
- South Tyneside and Sunderland NHS Foundation Trust
- Sunderland
- Visiting Professor
- University of Sunderland
- Sunderland, United Kingdom
- Makhan Lal Saha MBBS MS FAIS FMAS FALS
- Professor and Head
- Department of General Surgery
- IPGME and R/SSKM Hospital
- Kolkata, West Bengal, India
- Manash Ranjan Sahoo MS
- Fellowship in Surgical Gastroenterology
- Professor and Head
- Department of Surgery
- All India Institute of Medical Sciences
- Bhubaneswar
- Chief Co-Ordinator
- Advanced Laparoscopic Surgery Training Centre
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Mathias Fobi MD FACS FICS FACN
- Clinical Professor of Surgery
- SAIMS JIO University, Indore
- Mohak Bariatric and Robotic
- Surgery Centre
- Indore, Madhya Pradesh, India
- Mayank Jain MS DNB FNB (MAS) FRCS FACS
- Consultant and Head
- Department of Minimal Access and Bariatric Surgery
- Synergyplus Hospital
- Agra, Uttar Pradesh, India
- Mohit Bhandari MBBS MS MMAS DMAS
- Founder, Director and Surgeon
- Mohak Bariatrics and Robotics
- Mohak Bariatric and Robotic Surgery Center
- Indore, Madhya Pradesh, India
- Namrata Biswas MD (Anaesthesia)
- Senior Consultant
- Department of Anaesthesiology
- ILS Hospitals, Kolkata
- Columbia-Asia, Kolkata
- BIRTH Clinic, Kolkata
- Neotia Hospital
- Kolkata, West Bengal, India
- Om Tantia MS FRCS (Eng) FACS FICS FMAS FAIS FALS (Bariatric) IAGES
- Medical Director and Head
- Department of Minimal Access and Bariatric Surgery
- Centre of Excellence Metabolic and Bariatric Surgery
- ILS Hospitals
- Kolkata, West Bengal, India
- P Senthilnathan MS DNB MRCS (Ed) DNB (GI Surg) FMAS FACS
- Consultant Surgical Gastroenterologist
- Division of HPB and Minimal Access Surgery
- GEM Hospital and Research Centre
- Chennai and Coimbatore, Tamil Nadu
- India
- Pankaj Kumar MS FIAGES
- Associate Professor
- Department of General Surgery
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Pinky Thapar MS DNB FICS
- Chief, Minimally Invasive
- Gastro-Intestinal and Endocrine Surgeon
- Jupiter Hospital
- Thane, Maharashtra, India
- Pradnya A Supe MS IBCLC
- Assistant Professor
- Department of Gynaecology and Obstetrics
- Lokmanya Tilak Medical College and Sion Hospital
- Mumbai, Maharashtra, India
- Prakash Kumar Sasmal MS FNB (MAS) FAIS FALS
- Additional Professor
- Department of General Surgery
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Pranav Mandovra MS FMAS
- Associate Consultant
- Department of Digestive Diseases
- Zen Multispeciality Hospital
- Mumbai, Maharashtra, India
- Pravin Rajendra Suryawanshi MBBS DNB Gen Surgery FMAS FAIS FIAGES FICS-GI Surgery
- Professor and Head
- Department of Surgery
- Dy Dean
- MGM Medical College
- Aurangabad, Maharashtra, India
- Priyanka Saha MBBS MS
- Assistant Professor
- Department of General Surgery
- Grant Government Medical College and
- Sir JJ Group Hospitals
- Mumbai, Maharashtra, India
- Ramanuj Mukherjee MBBS MS DNB MNAMS MRCS(England) FMAS
- Professor in Surgery
- Department of General Surgery
- RG Kar Medical College and Hospital
- Kolkata, West Bengal, India
- Ramesh Agarwalla MS FRCS (Edin) FAIS FIAGES FALS
- Director and Consultant
- Department of GI and Minimal
- Access Surgery
- Fortis Hospital, Kolkata
- Consultant of Kidney Institute
- Kolkata, West Bengal, India
- Rohan Kundu MBBS
- Department of General Surgery
- RG Kar Medical College and
- Hospital
- Kolkata, West Bengal, India
- Roy Patankar MS FRCS PhD FMAS
- Senior Consultant and Head
- Department of Digestive Diseases
- Zen Multispeciality Hospital
- Mumbai, Maharashtra, India
- Sameer Rege MS DNB FMAS FIAGES FALS
- Professor
- Department of Surgery
- Seth GS Medical College and
- KEM Hospital
- Mumbai, Maharashtra, India
- Sanjiv Haribhakti MS DNB MCh (GI)
- Chairman
- Department of Surgical Gastroenterology
- Kaizen Hospital–Institute of Gastroenterology and Research Centre
- Ahmedabad, Gujarat, India
- Shashi Khanna MBBS
- Consultant
- Department of Minimal Access and Bariatric Surgery
- ILS Hospitals
- Kolkata, West Bengal, India
- Shivanshu Misra MS FNB MRCS
- Bariatric and Laparoscopic Surgeon
- Shivani Hospital and IVF
- Kanpur, Uttar Pradesh, India
- Sudarshan Nagaonkar BE MTech IIT
- Director
- Precious Life Medical Technologies Private Limited
- Bengaluru, Karnataka, India
- Sunipa Chatterjee MS FMAS FICMCH
- Junior Consultant
- Department of Obstetrics/Gynaecology and Minimal Invasive Gynaecology
- ILS Hospitals
- Kolkata, West Bengal, India
- Suyash Bajoria MS FMAS FIAGES
- Laparoscopic Surgeon
- Post-Doctoral Fellow in Minimal Access Surgery
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Tamonas Chaudhuri MBBS MS FAIS FMAS FACS FACRSI (Hon)
- Professor of Surgery
- Burdwan Medical College
- Senior Consultant
- Department of Minimal Access and Bariatric Surgery
- ILS Hospitals
- Kolkata, West Bengal, India
- Ushasi Mukherjee DGO DNB
- Junior Consultant
- Department of Obstetrics/Gynaecology and Minimal Invasive Gynaecology
- ILS Hospitals
- Kolkata, West Bengal, India
- Vishakha Kalikar DNB FMAS
- Associate Consultant
- Department of Digestive Diseases
- Zen Multispeciality Hospital
- Mumbai, Maharashtra, India
- Vivek Bindal MS MRCS (Glasg) DNB FNB (MAS) FACS
- Vice-Chairman
- Institute of Minimal Access Metabolic
- and Bariatric Surgery
- Institute of Robotic Surgery
- Sir Ganga Ram Hospital
- New Delhi, India
Since the introduction of laparoscopic cholecystectomy in mid 80s, minimally invasive surgery (MIS) has shown superiority over conventional surgeries for majority of the diseases. With enhancement of imaging and better vision, surgeries are done accurately and evidences show that even complex operations are done with low morbidity and mortality. Quality-of-life is also better after minimally invasive surgeries.
Earlier, MIS was limited to few procedures and with higher complications. Over last 30 years, with improved technique and standardisation of procedures, majority of the surgeries are done by minimally invasive technique. Researches and evidence confirm that short-term results of MIS are superior to conventional surgeries.
Complex surgeries including cancers are done with improved long-term results. Dr. Om Tantia, an excellent minimal access surgeon and proficient teacher, practicing for more than 25 years, has edited books and published many original articles in the field of minimal access and bariatric surgery. I congratulate him for bringing a professional reference book with evidence and recommendations in various minimally invasive surgical procedures. Dr. Tamonas Chaudhuri, co-editor is also an excellent minimal access surgeon has played a key role in promoting minimally invasive surgery in this part of the continent.
The book has 27 chapters, highlighting safety aspects in minimal access surgery. It has been authored by renowned experts in their respective fields, written with illustrations, current evidences, recommendations.
The formats of the book permits learner to progress through the entire chapter on specific surgery. The best part of the book is critical comments and safety tips highlighting special nuances, error free situations and a guide to prevent errors.
Evidence-based statements and content in this book, including the descriptions of surgical techniques and illustrations would be of immense value to practicing surgeons, surgery residents and members of the surgical team.
I am delighted giving foreword to this book of exceptional superb educational value.
C Palanivelu
MS MCh FACS FRCS-ED PhD
Chairman
GEM Hospital and Research Centre
Professor and Director
Institute of Gastroenterology and Minimal Access Surgery
Managing Trustee
GEM Digestive Diseases Foundation—Charitable Trust
Lifetime Achievement Award International
Congress on Cancer 2016
FOREWORD
I am delighted to learn about the launch of the new book on Safety in Minimal Access Surgery: Evidence and Recommendations edited by Drs. Om Tantia and Tamonas Chaudhuri. Laparoscopy is being practiced for over 3 decades now throughout the world. The practice of minimal access surgery has ushered in a revolution in the practice of surgery. Minimal access surgical techniques have taken roots in almost all specialities of surgery such as General surgery, Urology, Cardiothoracic and vascular surgery, and Neurosurgery.
As with all therapeutic interventions, minimal access surgical interventions also are associated with the inevitable complications, adverse outcomes and undesirable sequelae. We are fortunate to have high volume centres of excellence in laparoscopy in our country. The experiences, expertise and outcomes from these centres of excellence are a source of great learning and training for our surgical fraternity.
Dr. Om Tantia today heads one of the foremost centres of excellence in laparoscopy and bariatric surgery in the country. He has been an erudite and passionate surgeon and teacher in his eminent career. It is with great delight that I look forward to his newest textbook on Safety in Minimal Access Surgery: Evidence and Recommendations. The book chapters have been carefully planned to include the work areas of most practicing surgeons today. Apart from a clear and lucid description in the text, the recommendations provided separately are the icing on the cake.
I wish to congratulate Drs. Om Tantia, Tamonas Chaudhuri and the numerous experts that have contributed to this publication. I know that this will be a useful and essential addition in the bookshelves of many practising surgeons today.
Pradeep Chowbey
MS MNAMS FRCS (London) FIMSA FAIS FICS FACS FIAGES FALS FAMS
Padmashri Awarded by The President of India
Chairman
Max Institute of Minimal Access Metabolic and Bariatric Surgery
Chairman
Surgery and Allied Surgical Specialities
Honorary Laparoscopic Surgeon to The President of India
Honorary Laparoscopic Surgeon to Armed Forces Medical Services (AFMS)
Doctor of Science (Honoris Causa)
Surgeon to His Holiness Dalai Lama
President
International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) 2012-2013
Asia Pacific Chapter of IFSO (IFSO-APC) 2011-2013
Asia Pacific Metabolic and Bariatric Surgery Society (APMBSS) 2010-2012
Obesity and Metabolic Surgery Society of India (OSSI) 2006-2009
Founder President
Asia Pacific Hernia Society (APHS) 2004
PREFACE
Safety in surgical practice is paramount to successful outcomes!
The technical details and principles of minimal access surgery are well-established. The objective of the current publication is to lay emphasis on “Safety in Minimal Access Surgery” based on three decades of experience in this field.
In our years of practicing surgery, we have been impressed by the frequent exasperation felt by those attempting to learn the field. The initial chapters of the book deals with the pre-surgical setup of the operating room, sterilisation techniques and recommendations based on thorough research and years of experience in safe practices.
The subsequent chapters touch upon planning specific surgeries for various conditions ensuring minimal complication rates and thus ensuring safe surgeries. Over the years various different modalities of approach to the patient have been spoken of with varying degrees of success and complication rates, and each novel technique addresses issues faced by the preceding ones. Volumes of books available on the subject are a testament to the fact that no technique is a universal answer to all patient presentations. Our aim is to make the reader familiar with the most practical approach to the patient and the inflection points where one needs to be more cautious. The journey from the initial techniques to the presently evolved state becomes important as ER Long states, “Nothing gives a better perspective of the subject than an appreciation of the steps by which it has reached its present state.” This book lays emphasis on analysis and deductive reasoning as it applies to approach various conditions and their presentations. The chapters in this book are assembled with evidences and recommendations from current world literature by various experts in the respective fields, with special emphasis on safety tips based on their vast experience.
As a reflection of the current struggle, a chapter has been specifically devoted to safety during the pandemic of COVID-19.
An attempt has been made to bring out the unique personal insight to the chapters with conscious effort to bind them together with unanimity of purpose, as reflected in the analytic approaches. Although the complexity of the subject may seem daunting at first, the approach outlined here should provide a user-friendly guide into this fascinating surgical field.
We ardently hope that the efforts that have gone into conceptualizing this book and articulating it into simple, coherent easy to understand language will be optimally utilized by the present surgical fraternity and the future embodiments of our profession.
This book is dedicated to our patients on whom we gained experience after years of unflinching hard work.
For Further Book information, please visit: https://www.ilshospitals.com/academia/smas/
ACKNOWLEDGEMENTS
It gives us great pleasure to acknowledge the efforts and contributions of the various persons involved in making this endeavour successful. First and foremost, we would like to thank Drs. C Palanivelu and Pradeep Chowbey for their support and kind words.
Our contributors, all respected surgeons and physicians in their fields, who have shared their knowledge most passionately and taken time out of their busy lives to give life to this work.
Our staff and team at ILS Hospitals and ILS academics, for their unparalleled support and cooperation. Special credit must be given to Mrs. Kajari our clinical research assistant, who has relentlessly worked, coordinated and compiled all the information and has been instrumental in completing this project. Our gratitude to Drs. GS Goyal, Senior Physician, ILS Hospitals for his constant inspiration and Rekha Singh Ganguli, Chief Operating Officer, ILS Hospitals for constant support.
We would also like to acknowledge Drs. Shashi Khanna, Anshuman Poddar, Sabyasachi Goswami and Mridul Tantia for sharing their valuable inputs, and their constant support.
Finally, we also like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Dr. Rajul Jain (Development Editor) and the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.