Laparoscopy or bandaid surgery, is a surgical technique where small incisions are performed usually in the region of the abdomen, opposed to open surgical procedures involving larger cuts and potentially further complications for the patients. What is mostly interesting within this dynamic field of medicine, is the introduction of robotics and technology to aid surgeons which enable visual magnification, stabilisation, and simulations to better approach these new, innovative, surgical practices.
In view of the spreading popularity of such new surgical techniques being performed by surgeons around the world, InTech kindly asked Dr. Mustaq Chalkoo, author of the research paper “Laparoscopic Management of Difficult Cholecystectomy“, to talk to us about the benefits of laparoscopy, its growing use among surgeons and the advancement of medicine towards less and less invasive surgeries we all should be informed of. The mentioned research paper is comprised in the book “Advances in Laparoscopic Surgery“, edited by Arshad M. Malik and available to read, share and download for free on InTech’s reading platform.
Introducing Dr. Chalkoo
Dr. Mustaq Chalkoo’s specialty is laparoscopy and minimal access surgery. He is currently employed for the Government Medical College Srinagar, Kashmir. He is also a Fellow of the Association of Minimal Access Surgeons of India and Fellow of the Indian Hernia Society, among other. He teaches mbbs (Bachelor of Medicine, Bachelor of Surgery) and postgraduates and is an active reviewer of many reputable international journals of medicine.
InTech: What is your specialty in medicine and your main interests as a researcher?
Dr. Chalkoo: My field of specialization is laparoscopy and I have been active in the field for the last ten years. I have more than 60 research papers published up-to-date in many national and international highly reputable journals.
My fields of interest are hepatobiliary, hernia and GI surgery. I have devised an innovation in minilap cholecystectomy which is internationally recognised as the “The Chalkoo technique’’ and published by the International Journal of Surgery. Also, I have introduced new concepts in total abdominal hysterectomy and bilateral salpingo oophrectomy which have been adopted by gynecologists all around the world and are commonly known as the Chalkoo concepts. My team and I have managed to contribute our pictures in laparoscopic appendicectomy to be incorporated in the text book of surgery read by undergraduates and postgraduates of surgery in Switzerland.
InTech: So far, how many papers have you published?
Dr. Chalkoo: We have published more than 60 papers and most of them can be found in national and international journals. Most of our published material is on laparoscopy.
InTech: Laparoscopic surgeries are modern, non-invasive surgeries. What are the benefits for patients undergoing laparoscopic surgery?
Dr. Chalkoo: One of the wonderful things that has happened for the benefit of our patients is the introduction of laparoscopy. Who knows what other wonderful new techniques the future holds for us. Laparoscopy is not only a minimal access approach but it also holds advantages in the metabolic response to surgery and the immune system. Laparoscopy enables the patients to heal much more quickly in comparison to recovering from open procedures. Also, it is cost effective and causes less disfigurement of the body. Patients have to spend less time in the hospital and can resume their work earlier. The possible delayed complications that used to be seen in conventional open surgery like incisional hernia or infections are seen a lot less with laparoscopy. One of the key things in laparoscopy is the possibility of self learning as surgeons have all their procedures recorded and can use to recordings to learn from their own mistakes. Moreover, the recorded material can be used for teaching young recruits in laparoscopy.
InTech: In what cases laparoscopic surgery can be performed?
Dr. Chalkoo: Laparoscopy can be performed in many cases when surgery is needed, for example when removing gallbladder stones, CBD stones, appendices, hernias, orchidectomy, orchedopexy, varicelectomy, liver cysts, upper ureteric stones, or GI malignancy. It can also be used in the pelvis region to tackle gynecological problems like ovarian cystectomy, serosal fibroids, hysterectomy and tubal patency tests, among other. Laparoscopy can also solve retroperitoneal problems like phaechromocytome and nephrectomies for non functional kidneys. Furthermore, lung resections and hydatid cysts of lung can be eased with laparoscopy. We call it thoracoscopy. Well, to be honest, the only procedure that can’t be performed laparoscopically is the caesarean section. But who knows what the future holds.
InTech: What are the risk factors?
Dr. Chalkoo: We all understand that no technique, strategy or modality of treatment is 100% risk-free. So is not laparoscopy. There are some possible risks. A common problem might be improper positioning or too much force used during scope insertion. Laparoscopy demands a lot of training before one can safely embark on a surgical procedure. Also, in some cases the performance of laparoscopy may sometimes result in injuries to internal organs. Air embolism is a dangerous possible complication but fortunately we do not come across much of these issues in surgical practice when using laparoscopy as the mode of treatment.
InTech: Can you expand on the subject of laparoscopy to treat cholecystectomy (removal of gold bladder). What are the advantages for the patients?
Dr. Chalkoo: In fact, laparoscopy is a gold standard for cholecystectomy. It is rather difficult to expand on laparoscopy as a mode of treatment for gallstone disease because I could talk to you about it for hours. I can describe it briefly: is needed to be done is to create a pnemoperitoneum and then create working ports (incisions) to perform the surgery video-guided. By now, lots of modifications have been introduced in the technique. For example, we started with four ports that got down to three ports, two ports, a single single port and finally we got to no-port laparoscopy called NOTES. Currently a robot is employed for the NOTES procedure. All the advantages for patients have already been mentioned.
InTech: What other common complications can be easily solved with laparoscopic techniques?
Dr. Chalkoo: Well, almost all complications that may occur during laparoscopy can be solved by laparoscopy. Some of them are portal bleeds, hemorrhaging during laparoscopy, liver tears, and the most dangerous complication is the occurrence of cbd (common bile duct) injuries.
InTech: What are the latest research developments in the field of applied laparoscopy?
Dr. Chalkoo: Laparoscopy is within a changing scenario. There are many developments being introduced in this field. No wonder we have turned to robotics and its appliances which are widely used in laparoscopy. The long debate whether laparoscopy is safe for G.I. (gastrointestinal) malignancies has been settled now. We have advanced towards single port laparoscopic surgeries, Notes, and now to robotic laparoscopy as well. There is a lot of work to do to further develop new robotics devices for this kind of surgeries in the near future.
InTech: What type of audiences will benefit the most from reading this book?
Dr. Chalkoo: I strongly believe that all types of audiences will benefit from this book. It is an invaluable source for all laparoscopic surgeons; in particular for gynaecologists and urologists who will find it most interesting.
InTech: What are your future plans and your next projects?
Dr. Chalkoo: Currently we are working on a new research project: the modification of three port laparoscopic cholecystectomy. Also, I am a reviewer for the following journals:
- International Journal of Surgery
- International Journal of Surgery-Case Reports
- Malaysian Journal of Surgery
- Webmed Central – U.K.
- North-American Journal of Medicine
- Surgical Science
- Journal of Pakistani Medical Students
I have already reviewed more than 35 international papers up-to-date.
InTech: What is your experience in publishing with an Open Access publisher?
Dr. Chalkoo: It was a very interesting experience to collaborate with InTech. I hope we can keep this collaboration ongoing for the betterment of each other, our patients and our society in general.
About Dr. Mushtaq Chalkoo
Dr. Chalkoo’s specialty is laparoscopy and minimal access surgery. Currently he is employed at the Government Medical College Srinagar, Kashmir, and SMHSand associated hospitals in Srinagar as a consultant. He is also a Fellow of Minimal Access Surgeons of India, Fellow of India Hernia Society, Fellow of the Society of Laparoscopic and Endoscopic Surgeons of India, Fellow of the Indian Association of Gastrointestinal and Endo Surgeons, and Fellow of the Associations of Surgeons of India. Dr. Chalkoo has written more than 60 research papers, introduced 2 innovations in the field of laparoscopy he is recognised for worldwide, and is a reviewer in many international medical journals.