History of Laparoscopy

Minimally Invasive Surgery

The Pioneers 1

The great physician, Hippocrates of Ancient Greece( circa 460-377 BC) made the original reference to a speculum to examine the rectum.

The Pioneers 2

In the early 1800s, Philip Bozzini of Austria examined the urethra of a patient using a simple tube and candlelight. (Basic design of Lichtleiter was a instrument for future development of endoscopes)

Segalas in Paris, John Fisher in USA, Desormeaux in Paris developed their improved cystoscopes.

The Pioneers 3

Bruck, a dentist, developed a platinum wire cooled by water to illuminate the inside of the mouth.

Based on Bruck design, Nitze finally developed his first improved cystoscope in 1855 in which the light rays were gathered into his instrument via mirrors.

Thomas Edison invented the incandescnt light bulb.(1879) Newman of Glasgow miniaturzed Edison`s invention and

incorporated it into the Nitze`s cystoscope(first Laparoscop).

The Pioneers 4

Georg Kelling of Dresden performed the first cholecystectomy in living dog(COELIOSCOPIE -1902) / the first human laparoscopy with pneumoperitoneum using room air insufflation with Nitze cystoscope.

The Pioneers 5

Jacobaeus of Sweden presented his series of patients who had laparoscopy in 1910 (published a series of over 100 laparoscopy and thoracoscopy(LAPAROSCOPY).

The Pioneers 6

Dimitri von Ott from St.Petersburg examined the intraabdominal contents and the pelvis via an inscision in the vaginal vault to insert a speculum to examine the pelvis./Gynecologic laparoscopy/ (1901)

Laparoscopic Surgery

Diagnostic Lap.Surgery Advanced Lap.Surgery

Diagnostic tool

Laparoscopy has been used primarily as a diagnostic tool since its introduction by Kelling & Jacobaeus in the early 20th century.

Theraputic ToolIn the field of : General Surgery Gynaecological Surgery Colorectal Surgery Digestive Surgery Morbid Obesity Surgery Urological Surgery Endocrine Surgery Aortoiliac Surgery Pediateric Surgery Plastic Surgery

General Surgery Laparoscopic Billiary Surgery Cholecystectomy

Common bile duct surgery

Inguinal Hernia Repair

TAPP

TEP

Emergency Surgery

Appendectomy

Peritonitis(Perforated Ulcer,Diverticulitis)

Small bowel obstruction

Pediatric Surgery Appendectomy-Pyloromyotomy-Nissen Non Palpable testis-Varicocele Nephrectomy-Splenectomy Hypertrophic pyloric stenosis

Thoracoscopic Surgery

Pleural diseases Mediastinal & Parietal Pathologies Lung diseases Malignancies

Gastric Surgery Antireflux Procedures( Nissen-Toupet-Hill ) Giant hiatus hernia Achalasia

Morbid Obesity Surgery

Gastric Banding Gastric Bypass Vertical Band Gastroplasty Biliopancreatic Diversion Sleeve Gastrectomy

Colorectal Surgery Right Colectomy Left Colectomy Rectal resection for cancer(TME) Sigmoidectomy Rectal Prolapsus Procedures(Rectopexia) Transanal endoscopic Microsurgery(TEM)

Endocrine Surgery Thyroidectomy Parathyroidectomy Transabdominal Adrenalectomy

Urological Surgery Pyeloplasty Pyelotomy Uretrotomy-Uretrolyse- Uretroplasty Burch Cystotomy Radical & Partial Nephrectomy Aortic & Cava Lymphadenectomy Illio-obturator Lymphadenectomy Laparoscopic Radical Prostatectomy Laparoscopic Prostatocystectomy RPLND

Hepatic Surgery Hydatid cysts(Drainage/Resection) Biopsies Intraoperative Sonography

Pancreatic Surgery

Lap. Distal Pancreatectomy

Splenic Surgery Lap. Splenectomy

Cardiac Surgery Transthoracoscopic Ligation of patent ductus

arteriosus(PDA). Transthoracoscopic CABG.

Vascular Surgery

Aortoiliac Surgery Laparoscopic Transperitoneal abdominal

aortic replacement with L. renal artery direct reimplantation in pigs.

Laparoscopic Retroperitoneal replacement of abdominal Aorta in pigs.

Gynaecologic Surgery

Diagnostic Laparoscopies Ovarian Laparoscopies Laparoscopic Hysterectomy( LAVH / TALH ) Endometriosis Hysteroscopic Surgeries( Uterin

Malformations / Mayomas & Polips / Tubal sterilisation/ Endometrial ablations)

Robotic Surgery

Complications 1

Access related: 1-Veress needle

2-Trocar

3-Vascular injuries( grate vessels, Port site)

4-Gastrointestinal injuries

5-Urinary tract injuries

Complications 2

Surgery related Instrument related