Percutaneous Endoscopy HT Gangal, MH Gangal, PH Gangal
Chapter Notes

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Origin of the Authors' Concept1

Visuals are better appreciated than other perceptions. Many clinical conditions require direct visual assessment for diagnosis, besides pinpointing the requisite surgery. The surgeon encounters many cases of abdominal ailments, which, with due clinical assessment, he or she tries to diagnose by available means, i.e. X-rays, ultrasound, CT scan studies, etc. The extent to which he or she can prove and confirm his or her assessment fixes his or her approach to the treatment. Problems specially faced by ladies alone add to the probabilities, thus, further influencing the appropriate line of treatment in women.
Despite all the advanced aids available for forming a learned assessment, on many occasions the surgeon has to venture into exploratory laparotomy, thoracotomy, etc. in order to confirm his or her diagnosis, and consequently the remedy, as emphasised by articles.1, 2 Otherwise, he or she may encounter an entirely unforseen problem, and find himself unprepared. Both the reports.1, 2 are probably an indication showing the situation even at these later years, and in probably well-equipped and manned institutions of highest academic background. However, for us since long towards such, the laparoscope and thoracoscope to some extent, have become additional tools where such situations can be eased. It has the fair benefit of laparotomy or thoracotomy to directly view the internal organs for the cause without its (laparotomy's or thoractomy's) disadvantages.
With this in mind, many surgeons world over have been now using the laparoscope to confirm or discount pathology, but are also embarking on this type of approach as a means of treatment in most branches of surgery.
There have been persistent efforts throughout the world, to develop safer and more acceptable procedures towards controlling the enormous population growth. Introduction of the Yoon-silastic ring band, in female sterilisation, has added considerable safety to the existing endoscopic practice, i.e. using clips, or unipolar or bipolar electrocoagulation. This development needs a few inexpensive supplementary equipment and faster techniques. 2There had been subsequently a considerable upsurge in the use of the laparoscope. The demand for this procedure had earlier been so great from rural and (ill-equipped) urban areas, that the pressure had led to the large-scale use of the laparoscope by inconsistent people.
It is to be realised that the risks and dangers associated with blind punctures of the abdominal wall (to create pneumoperitoneum, and to introduce cannulae/trocars and the laparoscope), have remained unchanged, even today.
  1. Edibam RD: Abstracts (09.A49) Laparoscopy, peritoneoscopy in the diagnosis of abdominal tuberculosis and malignancy. Jahangir Nursing Home: Pune IJG 10 (4) 1991.
  1. Gupte S, Pande GK, Sahni P et al abstracts (M3 A32) Minilaparotomy in diagnosis and treatment. IJG AIIMS:  New Delhi  10 (4) 1991.
  1. Menzies D, Ellis H: Intestinal obstruction from adhesions—how big is the problem. Ann R Coll Surg Engl 72 60–63, 1990.