Principles and Practice of Laparoscopic Surgery

Laparoscopy is a paradigm shift in abdominal surgery with the surgeon sacrificing wrist movement and tactile feedback for the benefits of precision and reduced trauma. This closed-cavity surgery technique of laparoscopy with complex gadgetry has been a notable advancement in surgical practice. The benefits include reduced post-operative pain, hospital stay, early return to work, and improved cosmesis. Surgeons are challenged to operate with a magnified visual field of the abdominal cavity on a video monitor using long slender instruments inserted through miniature skin with a peritoneal distension medium established for the workspace.

The overwhelming evidence in medical literature in favour of laparoscopic surgery has shifted from ‘Which procedure can?’ to ‘Which cannot?’. A wide application of laparoscopic surgery can be seen from specialty surgeons that operate within the abdominal cavity. Currently, this practice is well established in high-index countries but still budding in low-middle-income countries LMICs. Beyond open surgery skills, laparoscopic surgeons must be familiar with complex gadgetry, specialized instruments, pneumoperitoneum, and other unique aspects of laparoscopic surgery. This requires adequate training for optimal outcomes.

Competence in laparoscopic surgery is gained from simulation training and guided practice for beginners. This book is an adjunct to proctored training for laparoscopic surgery skills. It is crafted with in-depth discussion on the basic principles of laparoscopic surgery, numerous figure illustrations, easy-to-read text, and operative details of basic laparoscopic procedures. It highlights practices from regions of the world where this practice is yet to be entrenched. This book is designed for medical students, nurses, post-graduate surgical trainees, and beginner laparoscopic surgeons in the various subspecialties of surgery involved with the abdomen- General/ Hepaticopancreatobiliary/ Colorectal/ Pediatric Surgery, Urology, and Gynecology. It is our sincere hope that the book meets the desired objectives.

Emeka Ray-Offor MBBS(Nig) FWACS FMAS DMAS(Ind) FAC is a surgeon skilled in Endoscopy, Minimally Invasive Surgery (MIS), Colorectal and Hernia surgeries, with a Bachelor of Medicine, Bachelor of Surgery - MBBS from the University of Nigeria, Nsukka and postgraduate surgery training acquired in India, Europe, and US. He has a faculty position in the Department of Surgery, College of Health Sciences University of Port Harcourt Nigeria since 2011 and currently a Professor of Minimal Access Surgery in addition to being an Honorary Consultant Surgeon at the University of Port Harcourt Teaching Hospital Port Harcourt Rivers State Nigeria. He recently completed a 1- year Research Fellowship in the Colorectal Surgery department of Ellen Leifer and Steven Shulman Digestive Disease Center Cleveland Clinic Florida USA.

Professor Ray-Offor is a surgeon educator, has organized multiple workshops for training in Endoscopy/Minimal Access Surgery; a seasoned author with over 80 abstracts and peer-reviewed journal publications in addition being the editor of two books. He is a member of the Editorial Board of the Nigerian Journal of Gastroenterology and Hepatology, a reviewer of multiple scientific journals, and a member of several professional societies in Africa, Europe, Asia, and North America. These include the West African College of Surgeons WACS, the Society of Gastroenterology and Hepatology SOGHIN, Nigerian Society for Colorectal Disorders, European Association of Endoscopic Surgeons EAES, World Association of Laparoscopic Surgeons WALS, American College of Surgeons ACS, Society of American Gastrointestinal Endoscopic Surgeons SAGES, and American Society of Colon and Rectal Surgeons ASCRS. He is the founder of Oak Endoscopy Centre & Radiodiagnostics Port Harcourt Nigeria- a non-profit organization for advancing Endoscopy and MIS.

His main professional and scientific interests focus on gastrointestinal endoscopy, minimally invasive general/colorectal surgery, and colorectal cancer.

Raul J. Rosenthal MD FASMBS FACS is Regional Chair, Digestive Disease & Surgical Institute/Department Chair, Bariatric & Metabolic Surgery and General Surgery, Department of Bariatric and Metabolic Institute (BMI), at Cleveland Clinic Weston Hospital, Florida, USA. Dr Rosenthal is an industry leader, prolific author, medical researcher and attending surgeon at Cleveland Clinic Florida, where he has conducted well over 10,000 general surgery and bariatric procedures and trained more than 50 fellows in advanced gastrointestinal, minimally invasive and bariatric surgery.

In 2018 Dr Rosenthal received the LEAD Award from the American Society of Metabolic & Bariatric Surgery (ASMBS) Foundation in recognition of lifetime contributions to the field of bariatric surgery. Also in 2018, his breakthrough research into the use of indocyanine green fluorescence imaging in laparoscopic cholecystectomy was featured during the American College of Surgeons annual Clinical Congress.

Among his professional leadership roles, Dr Rosenthal served as president of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the SAGES Foundation; and as a past president of the executive committee of the American Society of Metabolic & Bariatric Surgery (ASMBS) and the ASMBS Foundation. He is the founding Clinical Editor of Bariatric Times and Associate Editor of SOARD and Obesity Surgery. He serves on the Editorial Board member of Annals of Surgery, Selected Readings in General Surgery Langenbeck’s Archives of Surgery, and Surgical Endoscopy. He is founding member and a past President of the Fellowship Council and also served as President of the South Florida Chapter of the American College of Surgeons and Governor of the American College of Surgeons.