minimally invasive surgery - mums.ac.ir · history y1901 ‐von ott‐first inspection of abdominal...
TRANSCRIPT
![Page 1: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/1.jpg)
Minimally invasive surgery
Dr. Ali J angjooAssociate professor of minimally invasive surgery
Mashhad University Of Medical SciencessAban 1392
![Page 2: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/2.jpg)
SynonymKey Hole SurgeryEndoscopic SurgeryButton Hole SurgeryMinimally Invasive SurgeryMinimal Access Surgery
LaparoscopyThoracoscopyCystoscopyHysteroscopy
![Page 3: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/3.jpg)
History1901 ‐ Von Ott ‐ First inspection of abdominal cavity using a speculum and candlelight.1983 ‐ First laparoscopic appendicectomy Semm, a German gynaecologist.1985 ‐ First Lap Chole Erich Muhe a German surgeon.1987 ‐ First laparoscopic repair of inguinal hernia by Ger.1989 ‐ First lap hysterectomy, Reich et al.1993 ‐ First Robotic Laparoscopic surgery (Robotic telesurgery) Dan Stoianovici.
![Page 4: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/4.jpg)
Frequently done proceduresAbdomen ‐ esophagectomy‐ hiatal hernia‐ achalasia‐ intestinal resection‐ cholecystectomy‐ appendectomy‐ hernia repair‐ splenectomy‐ adrenalectomy‐ sympathectomy‐ prolapse‐ spinal surgery‐ bariatric surgery ‐ trauma management
Chest ‐mediastinoscopy‐ thymectomy‐ pericardial window‐ hilar nodes‐ pleural lesions‐ lung biopsy‐ empyema‐ effusion‐ sympathectomyGynecology ‐ ovaries‐ uterus‐ ep‐ infertility
![Page 5: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/5.jpg)
Frequently done proceduresSpine ‐ abscess drainage‐ discectomy‐ biopsy‐ scoliosisNeck ‐ thyroid ‐ parathyroid‐ thymus
Urology ‐ nephrectomy‐ adrenalectomy‐ stone disease‐ prostate ‐ varicoceleAxilla & breast ‐ axiloscopy‐ subcutaneous mastectomyRobotic surgery
![Page 6: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/6.jpg)
Most commonly done MAS Diagnostic laparoscopyCholecystectomyAppendicectomyRepair of all types of HerniaHysterectomySplenectomyFundoplicationRepair of D.U. perforationProlapseNephrectomy
![Page 7: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/7.jpg)
AdvantagesImproved diagnosisLess tissue dissection & disruptionLess herniaLess wound infectionLess chance of adhesionsEarly return to workLess painLess complication(DVT, pneumonia)Less immunosuppressionBetter cosmesis
![Page 8: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/8.jpg)
DisadvantagesMore expensive
More operative time
Potential for major complications in inexperienced hands
Loss of tactile feedback
Difficult in complicated cases
![Page 9: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/9.jpg)
ContraindicationsSevere COPD or Cardiac diseasesGrade II or III ShockGeneralised peritonitisPrevious extensive abdominal surgeryPrevious generalized inflammatory disease or irradiationHyper & Hypo coagulable statesAdvanced stage of pregnancySuspected Carcinoma ?
![Page 10: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/10.jpg)
Diagnostic Laparoscopy
Electronic Eye Inside Abdomen
Kelling 1901
![Page 11: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/11.jpg)
Laparoscopic Cholecystectomy
Lap chole is now gold standard for the treatment of gallstone diseases.Most commonly performed Minimal Access Surgery by General surgeons worldwide. In Europe 97% of cholecystectomy is now done laparoscopically.
![Page 12: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/12.jpg)
Laparoscopic Appendicectomy
10 days Post OP
![Page 13: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/13.jpg)
Tubal Surgery
Sterilization * Ectopics * Cysts * Recanalization
![Page 14: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/14.jpg)
Uterine Surgery
![Page 15: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/15.jpg)
Laparoscopic splenectomy
![Page 16: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/16.jpg)
Splenectomy
![Page 17: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/17.jpg)
Ambiguous genitalia
![Page 18: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/18.jpg)
Pull Through for Hirschsprung’s Disease
![Page 19: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/19.jpg)
Phaeochromocytoma
![Page 20: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/20.jpg)
Obesity Surgery
![Page 21: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/21.jpg)
ThoracoscopyNo rib resection No sternotomyMinimal morbidity Need double lumen intubationNeed lateral position Advantages are more than laparoscopy
![Page 22: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/22.jpg)
Oesophageal atresia
Open
![Page 23: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/23.jpg)
NephrectomyLaparoscopic Living Donor Nephrectomy For Kidney Transplantation
The University of Maryland & Dundee has
the world’s largest experience with this
technique
![Page 24: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/24.jpg)
Axilloscopy
After
![Page 25: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/25.jpg)
HALS
![Page 26: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/26.jpg)
HALS
![Page 27: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/27.jpg)
HALS
![Page 28: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/28.jpg)
HALS
![Page 29: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/29.jpg)
Gasless Laparoscopic Surgery
Abdolift
No added advantage except if patient is at high risk to pneumoperitoneum
![Page 30: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/30.jpg)
Mini & Micro Laparoscopy
![Page 31: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/31.jpg)
Present status in world
Coronary bypass surgery on beating heartCardiac Valve SurgeryCardiac Tumor Surgery
Surgery without sternotomy
![Page 32: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/32.jpg)
Future of Laparoscopy
Now surgeons are operating exclusively
via a computer interface controlling a
master–slave manipulator through
Internet.
![Page 33: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/33.jpg)
Trans Atlantic MAS
Globalization of Surgery
![Page 34: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/34.jpg)
Robotic arm
ROBODOC®
CASPAR®daVinci
![Page 35: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/35.jpg)
Robotic console
ZEUS™ console
AESOP® console
![Page 36: Minimally invasive surgery - mums.ac.ir · History y1901 ‐Von Ott‐First inspection of abdominal cavity using a speculum and candlelight. y1983 ‐First laparoscopic appendicectomy](https://reader034.vdocuments.us/reader034/viewer/2022042319/5f08875c7e708231d4227593/html5/thumbnails/36.jpg)
Minimal Access Surgery
Be committed to provide our community this surgical procedure of new Millennium
THANK YOU !