Journey from basic to advanced laparoscopic surgery: our experience at UP Rural Institute of Medical Sciences and Research, Saifai, Uttar Pradesh, India

Abstract

Background: Laparoscopic surgery has completed twenty-five years since its inception. Almost all the surgical procedures are being done by laparoscopy. Primary goal of a laparoscopic procedure is to achieve good cosmetic outcome, reduced post-operative pain, early recovery and reduced hospital admission. The main objective of this study is to see the feasibility and benefit of performing advance laparoscopic surgery in a new rural institute where basic laparoscopic surgery is done and to share our experience. Methods: A retrospective study of case sheets and discharge summary from 1 st Jan 2012 till 1 st December 2015 was done. Altogether 400 patients underwent different advanced laparoscopic procedure. Cases done for the first time in the institute and those done by a single unit were only included. Technical feasibility, successful completion, operative time, duration of hospital stays and patients’ satisfaction regarding minimal scars were assessed. Results: All patients were aged between 13-75 years. Out of 400 patients, 270 were females and 130 were males. All procedures were technically feasible with basic laparoscopic instruments. Early ambulation and enteral feed was done within 24 hours in all and within 48 hours in patients who had bowel anastomosis. Postoperative hospital stay was 2-8 days. All appreciated cosmetic scar. Conclusions: Advanced laparoscopy is feasible, safe and effective in the hand of surgeons performing basic laparoscopic surgeries. Evaluation and monitoring in a systematic scientific manner will benefit the surgeon with a satisfactory learning curve that will ensure that patient welfare is not compromised. Persistence and perseverance is the key. Last but not the least; develop a team for better results.