Laparoscopic Hernia Repair: How to Learn at Ease R Padmakumar, D Madhukar Pai, Farish Shamsudeen
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FM1Laparoscopic Hernia Repair — How to Learn at EaseFM2
FM3Laparoscopic Hernia Repair — How to Learn at Ease
R Padmakumar DNB MNAMS FAIS Dip ALS FCLS FIMSA FRCS Senior Consultant General and Laparoscopic Surgeon, Department of General and Laparoscopic Surgery, Sunrise Group of Hospitals Kochi, Kerala, India D Madhukar Pai MS FCLS Consultant General and Laparoscopic Surgeon, Department of General and Laparoscopic Surgery, Sunrise Group of Hospitals Kochi, Kerala, India Farish Shamsudeen MS Consultant General and Laparoscopic Surgeon, Department of General and Laparoscopic Surgery, Sunrise Group of Hospitals Kochi, Kerala, India
FM4
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Laparoscopic Hernia Repair — How to Learn at Ease
First Edition: 2017
9789386150677
FM5FROM THE AUTHORS' DESK
Repair of simple and complex abdominal hernias by laparoscopic technique is now the method of choice in most centers. Laparoscopic repair offers outcomes equivalent to open repair with the additional benefits of greater patient satisfaction and reduced hospitalization. For some hernias, notably incisional hernia and hiatal hernia, the technique appears to be superior to conventional surgery.
Open hernia surgery is usually considered a basic surgical technique while laparoscopic hernia repair is considered an advanced procedure. The reason for this is that we study inguinal canal anatomy since our first year of undergraduate classes. But laparoscopic anatomy is not usually taught. It is our aim to make the procedure easy and learnable to young practicing surgeons. In this book, detailed description of laparoscopic anatomy is given. It also gives definite guidance to patient selection and operative techniques. Each procedure is illustrated with a series of high-quality photographs in a step-by-step manner, allowing the reader to follow the sequence of the operation. The recognition and management of complications are highlighted and postoperative management is also described. In the consecutive section, background information about hernia is detailed. This operative guide offers a complete analysis of each of the current technologies and is a valuable source of information for practitioners and trainee surgeons. In this book, we have included pediatric hernia repair and two-port repair.
R Padmakumar
DNB MNAMS FAIS Dip ALS FCLS FIMSA FRCS
Sr. Consultant General Lap and
Metabolic Surgeon
+91 9447230370; 9846320370
D Madhukar Pai
MS FCLS
Consultant General & Lap. Surgeon
+91 9847278663
Farish Shamsudeen
MS
Consultant General & Lap. Surgeon
+91 9656662003
Please log on to our websites:
FM6
FM7FOREWORD
Video of laparoscopic cholecystectomy (LC) was first time viewed by surgeons in 1989 with disbelief and excitement together at SAGES in USA. A German Surgeon Muhe performed first LC in 1986 and subsequently two French Surgeons, Mouret and Dubois introduced LC to the world. The procedure was adapted and accepted worldwide. Laparoscopic cholecystectomy spread like a wildfire across the globe despite higher incidence of common bile duct injury even today. Video-assisted Minimally Invasive Surgery has been termed as the unparallel surgical revolution and we entered the silver jubilee year of Minimally Invasive or Minimal Access Surgery in 2014.
After cholecystectomy, the next elective general surgical procedure, which is performed by every general surgeon, is groin hernia repair. Every general surgical trainee starts his or her surgical debut with an open hernia repair, apppendectomy and then gallbladder in that order. Therefore, it is not surprising that laparoscopic cholecystectomy has been the “Gold Standard” index procedure to be taught and learnt by all surgical trainees around the world by the sheer volume of the symptomatic and/or asymptomatic gallbladder disease over the last 25 years.
Although the number of open groin hernia repairs are also performed in large numbers (700,000/year in USA) but penetration of laparoscopic groin hernia repair has been limited and rather low, not only in India, China (< 4%) but even in USA, UK (around 20%) and Europe (up to 30%). As soon as we talk of laparoscopic groin hernia repair, it becomes an advanced laparoscopic procedure. There is a definite longer learning curve and rarely serious operative complications (vascular, bowel and urinary bladder), which have been unknown during open groin hernia repair. There are two standard laparoscopic techniques for the repair of groin hernia, i.e. Trans-Abdominal Pre-Peritoneal (TAPP) and Totally Extra-Peritoneal (TEP) repair over the last 25 years. There have been large number of laparoscopic groin hernia operations performed worldwide but there are extremely limited opportunities for surgeons to get exposure and training in the two techniques.
Live operative workshops in which expert surgeons perform these procedures for the benefit of the trainees and practcing surgeons have a limited role to the extent that trainees get to know the technique and get encouraged FM8to learn and develop into a laparoscopic hernia surgeon. I firmly believe that a surgeon, who labels himself or herself as a laparoscopic hernia surgeon, must be familiar with both the techniques, i.e. TAPP and TEP for the simple reason that in case of conversion from TEP, TAPP is a fall-back procedure. The best way to teach and learn laparoscopic hernia repair or, for that matter, any laparoscopic/endoscopic procedure is by preceptorship and proctorship model, which is quick, effective and safe way to teach and learn laparoscopic or open surgery.
This book shall help general surgeons acquire the basic knowledge about the anatomical basis and surgical techniques of repair of both groin and ventral/incisional hernia and also other hernias. I have focused on laparoscopic groin hernia repair because laparoscopic ventral/incisional hernia repair is less difficult to learn and perform. I am confident that this monograph will come handy for those surgeons, who would want to begin to learn the Art and Craft of laparoscopic repair of various abdominal wall defects. Going through the monograph, it seems that the most significant challenge was to have originality of illustrations, diagrams and operative pictures depicting anatomy and the steps of the procedure. I hope the authors have taken due care about the originality of their work and any of the work reporoduced has been duly acknowledged. I am delighted to write a “FOREWORD” for this work produced by Dr R Padmakumar, Dr D Madhukar Pai and Dr Farish Shams on “Laparoscopic hernia repair - how to learn at ease”.
Mahesh C Misra
MBBS MS FRCS (Glasg.) FACS FAMS FCLS Hon. FRCS
Director
Professor of Surgery
Department of Surgical Disciplines
Chief
JPN Apex Trauma Centre
All India Institute of Medical Sciences
New Delhi, India
Mobile: +91-9868397701
FM9FOREWORD
Team work, willingness to teach more than anything else, hard work in the right direction and persistence are the way to success. These are the things all of us have to learn from Dr Padmakumar and his team. If these qualities with in-depth knowledge can be translated to a bunch of papers, you can make out what can happen. It is not only the experience this team has, it is how they look at this large experience, which is seen in this book.
To put on paper what you do is not that easy. It always depends on the vision and the way you look at it. Dr Padmakumar's team has always looked at things way ahead of what others did and this book has their vision, a vision different from the usual.
Wishing all the success to Dr Padmakumar and his team.
Hafeez Rahman
MBBS MD DNB FCLS
Senior Consultant Gynecologist and Laparoscopic Surgeon
Chairman
Sunrise Group of Hospitals
Chairman
International Modern Hospital, Dubai
FM11ACKNOWLEDGMENTS
We express our gratitude to all the people who helped us in getting our dream materialized. First and foremost, we acknowledge the ever-supportive, encouraging Chairman Dr Hafeez Rahman, and Managing Director Mrs Parveen Hafeez.
We are thankful to Dr Kiran VR for contributing a chapter on pediatric hernia. We express our sincere thanks to Dr Kumar Abhishek for the drawings and pictures.
We are grateful to all our colleague doctors, especially Dr Mary Vargheese, Dr Sandeep Gupta, Anesthesiologist Dr PG Shaji and his team, theater nurses, floor staff and paramedical staff for all their efforts in taking care of our patients in an excellent manner.
We are obliged to Mrs Renu Reghunath, Mr Subin Thomas, Mrs Premna Subin and Mrs Sindhu S for editorial assistance.
We express our sincere thanks to Mr Sreenath for the drawings and pictures.
We express our gratitude to our teachers and family members, who always gave us their support.
We are grateful to all our trainees and our patients, who raised us to this level to make the project happen.
We place on record our sincere gratitude to the office bearers of India Hernia Society, especially Professor Dr MC Misra for the invaluable encouragement. Our heartfelt gratitude to the office bearers and members of the Association of Surgeons of India for the support in all over endeavors.