digestive-diseases-2016_posters-accepted-abstracts

14 / 19

Volume 6, Issue 8(Suppl) J Gastrointest Dig Syst 2016
ISSN:2161-069X JGDS, an open access journal
Page 69
Digestive Diseases 2016
December 08-09, 2016
conferenceseries.com
Digestive Diseases
December 08-09, 2016 Dubai, UAE
International Conference on
J Gastrointest Dig Syst 2016, 6:8(Suppl)
Advanced laparoscopic surgical management of biliary and pancreatic disease: An overview
Premkumar Balachandran
Apollo Hospitals, India
Diseases of the biliary system and pancreas like all other organs range from simple to complex disorders and can be benign or
malignant. They could vary from a simple cyst to periampullary carcinoma and pancreatic head malignancies. Traditionally the
management of these disorders has been by conventional open surgery. The post operative morbidity has been reported to be high
and there is a significant mortality too. Certain disorders like infected pancreatic necrosis requiring necrosectomy usually have a
poor prognosis. The large incisions and blood loss and post operative pain add to the morbidity of the disease. The introduction of
laparoscopic surgery is a boon to the surgical field. The procedures which are performed by open surgery can be done as good if not
better by laparoscopy. The morbidity and mortality are greatly reduced. Procedures such as Puestows and Whipples done by open
surgery have a significant post operative morbidity. All these major pancreatic surgeries can nowadays be done by laparoscopic and
robotic surgery. The use of minimal access technique in the management of pancreatic and biliary diseases greatly reduces the post
operative morbidity and mortality. However significant expertise and experience is required for the performance of these procedures.
Single incision laparoscopic surgery: Principles and practices
Raj Palaniappan
Apollo Hospitals, India
Single Incision Laparoscopic Surgery (SILS) is a new age laparoscopic technique where laparoscopic surgery will be performed
through a single port rather than three or more ports as in conventional laparoscopy. Though it had initial popularity, it failed
to impress the surgical community due to its ergonomic difficulty. Feasibility of various procedures is tried in multiple centers and
the ergonomics are modified accordingly. Although results are similar to laparoscopy, SILS has its limitations like not possible for
all laparoscopic surgeries with the present available instruments, more time consuming, difficult traction techniques and ergonomic
limitations. However, early results are promising under technically strong hands and it is already proved beneficial in few procedures
like fundoplication, hysterectomy, splenectomy, sleeve gastrectomy, etc. Various ergonomic and instrument modifications are tried
and postulated for the same including numerous ports to enhance the performance. However, ergonomic modifications in line with
the principles of laparoscopy and instrumentation are mandatory for effective performance. With the recommendations of ergonomic
modifications and liver and organ transplantation techniques as per authors experience and research, even complex advancedminimal
access surgeries like gastrectomy, colectomy, gastric bypass, etc can be achieved by SILS technique. The recommendations include the
ideal SILS port, instruments, planes of instrumentation for dissection and manipulation during the procedures. With the possibility
of more new generation instruments to come, SILS is all set to replace laparoscopy in selected cases. However, long termmulti-centric
studies are required to prove the advantages over conventional laparoscopy.