• Uterine Surgery: 2012 & Beyond -

  March 28-31, 2012
  Disney's Contemporary Resort Orlando, Florida

   

  ---

• FIGO Rome 2012

  ISGE Session on Hysteroscopy and Robotics

  ---

John Sciarra, MD - The Global Library of Women's Medicine

	The Global Library of Women's Medicine
	Australian Gynaecological Endoscopy Society
	Society of Laprascopic Surgeons
APAGE	Asia Pacific Association  for Gynecologic Endoscopy. www.apagemit.com
	Argentinian Society for Gynaecological Endoscopy
TSGE	Thai Society for Gynaecologic Endoscopists
	Mexican Federation of Gynecologic Endoscopy
	Croatian Society for Gynecological Endoscopy
SEEG	The Ecuadorian Society of Gynecologic Endoscopy
	The Peruvian Society of Gynecologic Endoscopy
	Indonesian Society for Gynaecological Endoscopy
	The Society of Cosmetogynecology www.iscgyn.com
	Association of Mexican Endoscopic Gynecology and Microsurgery
	Chinese Gynecologic Endoscopy Group.
IAGE	Indian Association of Gynaecological Endoscopists www.iageonline.com
TSMIG	Turkish Society of Minimal Invasive Gynecology www.mijid.org

"Laparoscopic surgery for the poorest of the poor"

by Daniel Kruschinski, MD and Michaela Katzer

The Preamble of the W.H.O. constitution:
"The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human without distinction of race, religion, political belief, economic or social condition"
But…
In rural areas 20 % of  surgeons are addressing the need of 80 % of the population without basic infrastructure power, water, sanitation, roads, and schools.
So …
With this dismal background of health care, can we hope to give quality surgical care to the poor?
Contradictory as it may sound, the answer is an emphatic YES.
I am confident that inspite of official apathy, or perhaps because of it, we are moving in the right direction.

The surgical care for the poor is an uphill and Herculean task, yet a task worthy of every ounce of our collective effort and energy. No one person, no one country can have the answers. It is vital all surgeons from all spheres of activity in the developing world from Professors to village doctors, as also those from all developed areas pool their concerns in this effort. If success is defined not by what one has attained but by the effort made in overcoming obstacles, just our sincere efforts in this cause would be by far the greatest triumph, the ultimate success story in the art and science of surgery - to ensure basic surgical care for all the poor.

For around 17 years lecturing about gasless Lift-Laparoscopy I have advocated, that for pragmatic progress in surgery in the developing world one must adhere to the concept of the 5 A's (acc. to Udwadia, 2003)
 Available, Affordable, Accessible, Acceptable and Appropriate
If CO2 cylinders have to be transported 200 kilometres over rough terrain to refill, the use of gasless laparoscopy would be available, accessible, acceptable, affordable, and hence appropriate.

The situation of laparoscopic surgery in many underdeveloped countries is fatal. Dr. John Ojokwu (the only laparoscopic surgeon in Nigeria) for example, who uses carbon dioxide said at our course in Ibadan that gasless Lift-laparoscopy is “a god send tool”.

The future of (laparoscopic) surgery as also of the surgical care of the poor in those countries lies in the proliferation, education, acknowledgement, recognition of the emerging genre of surgeons who by dint of courage, capability, innovation, improvisation, sacrifice have given a new dimension and aura to rural surgery

An example from India:
“Surgeons in India have innovated laparolift equipment out of towel clips, coat hangers, water pipes to permit the penetration of gasless laparoscopy to rural India and quality M.A.S. has been taken into small town rural India.”
Nande AG, 1997
Deshpande SV, 1997
Ramakrishna HK, 2003

To try to help establish laparoscopic surgery in underdeveloped countries, we conduct courses for Lift-laparoscopy, like our last course in the University of Ibadan, Nigeria last November, where we spent 14 days at the course:
“1st…

---

Please Login to read the rest of the article....

I have a question -- I just had a BSO at 47 years old for pelvic pain ovarian cyst, chocolate cyst, endometriosis, adhesions. I had a vaginal hysterectomy 8 years ago for heavy bleeding. My doctor says I cannot go on hormone replacement therapy for 2 months because of endometriosis regrowth. Reasonable treatment? or unnecessary?

I am consultant general and laproscopic surgery have MBBCH1987Alexandria -Egypt , Master in general surgery 1992 , Alex- Egypt, FRCS 1997 Glasg- UK, Fellowshep In MIS India 2007 and Diploma of Laproscopic surgery SSrsburg France. I would like to Jion an International Traning aid( be sponser for me)to learn& teaching Surgeons in Poor countaries

Thats great Dan,Peter Maher

Dear Dr Kruschinski and Ms Katzer, I was very pleased to read your article. This year, a book 'Pain Management in the low resource setting' sponsored by the Int Pain Society will be released by Dr Andreas Kopf (germany) and his Nigerian Colleague for free distribution in Africa/SE Asia. As a gynae Laparoscop surgeon, and contributer of chapter on Pelvic pain in the low resource setting would be happy to discuss further if helpful. Susan Evans sfe@internode.on.net

Join The Discussion:

Name: Email: Country: Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote Divoire Croatia (local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti Heard And Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic Peoples Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao Peoples Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (slovak Republic) Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province Of China Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (holy See) Venezuela Viet Nam Virgin Islands (british) Virgin Islands (u.s.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe
Express Yourself	of 350 Characters Allowed
Word Verification:
Enter the text in the image