According to Dr. R.K. Mishra, Director, World Laparoscopy Hospital the mobile laparoscopic operating theatre is a fully equipped air conditioned and fully functional theatre to perform tubal sterilization in different parts of the rural India by qualified and skilled laparoscopic surgeons. This is innovative approach towards meeting the challenge of ever increasing population pressure on this planet. It provides optimal combination of high performance, functionality and mobility. The mobile operating theatre has all the required internal facilities to operate on its own. These facilities include but not limited to all electrical services, mechanical services such as operating theatre ventilation system to provide clean air, medical gas system, plumbing, operating table, operating light, surgical pendants and so forth. It also includes induction room, sterile preparation room, sterile store, scrub-up area and the OT itself. It is also fully equipped with surgical pendants, operating lights, operating table, etc. The OT has standard overall dimensions and the rooms are arranged in such a way as to conform fully to normal hospital requirements. One of the major causes of slow progress of our economy is population explosion. In countries where there is high rate of illiteracy the only successful control of population can be achieved by permanent method of sterilization because short and temporary methods of family planning is more expensive and often fail as it needs careful monitoring which is not possible by our underprivileged section of society. All over world laparoscopic sterilization is proved its effectiveness and is a permanent method of sterilization. In our District hospitals government has the family planning camps but the patients are reluctant to go outside their village due to many social, cultural and economic considerations. This problem has led us to think about am innovative model in which we provide the laparoscopic sterilization at door steps of our rural population.

World Association of Laparoscopic Surgeonâ€™s Mobile Laparoscopic Van will go to the door steps of the patient to provide services. A field survey of identified area, village(s), as the case may be, where to take the mobile operation theater, will be conducted with the participation of local community, Mahilaya Mandal, etc. Thereafter, paramedical team will conduct preoperative investigation of the willing persons of the area. The paramedical staff will interact with the local people including sarpanch / village head and explained to them the advantages of small family and to motivate the married couples who have completed their families. They will also educate the families about Maternal and Child Healthcare, and advantages of laparoscopic sterilization. The women and men would be made aware to know about their options and the real risks and benefits of any method or procedure they would like to choose. Necessary assistance will be given to enable them to make their choices/decisions. Adequate care should be taken that they do not need to be told what to do.

Thereafter, with the association of local community, the team will make a second visit to collect blood samples and other related tests of the persons who have shown their interest. All necessary tests will be conducted and documented properly. The willing persons will be registered. All the investigations will be revisited by a team of qualified laparoscopic surgeons and based on their investigations only the suitable fit cases for sterilization will be selected without any co-morbidity. Thereafter, date and place will be decided and conveyed to the registered persons for holding laparoscopic sterilization mobile camp at their door steps. Now when the date is finalized, the mobile operation theater will be completely sterilized, fully charged and properly tested and move towards the designated destination where sterilization is to be conducted. There will be 4-8 field visits per month to the identified areas in rural India. In one visit 25-30 laparoscopic sterilization can be performed safely by a team of 3-4 laparoscopic surgeons. Once the surgery is completed in the mobile camp, one qualified doctor and 2 nurses would be put on duty to stay overnight to watch and care operated patients. They will also educate the patients as to how to take care of their wound and take post operation medicines.

A proper list of names of the patients, and the surgeons who have performed the surgery will be kept. In case of any complication, the patient will directly consult the surgeons and if any emergency arises patient can be directly brought to World Laparoscopy Hospital, Cybercity, Gurgaon for further management, though such situations will rarely arise as laparoscopic sterilization is very safe and effective method of surgery where statistical data has shown that chances of complications are less that 0.1 percent. An appropriate technology for female sterilization by introducing several innovations in the technique of laparoscopic sterilization is in place. The technique is very simple and painless procedure performed under local anesthesia without sedation. Since the simplicity of the procedure allows resumption of normal routine the very next day it has become readily acceptable for the women from the rural and tribal areas. The method is highly cost effective, avoids sedation, and has been proven to be evidence based and robust in over two decades and in a vast geographic area of south India. Using doorstep laparoscopic sterilization World Laparoscopy Hospital is seeing the possibility of improved surgical outcomes in terms of less pain, faster recovery, early return to work and effective birth control. The preoperative, intra-operative and post-operative management of the laparoscopy sterilization will be ensured by team who is fully equipped for the purpose.

The patient is neither goes to the hospital nor incurs any expenses. The latest of the art facilities will be provided to the patients. Suitable incentives will also be arranged for every patient who undergoes sterilization. Post-operative follow up of patients will be provided who are operated by us. Free distribution of all the requisite medicines will be ensured. The vulnerable population of rural India will be benefitted in big way. This will go a long way in bring changes in the family planning and reproductive healthcare services in the demography of the nation. There is no denying the fact family planning has significantly contributed to improve maternal and child health, gender equity, economic development, and the demographic transition in many countries throughout the world. Standard of Living and Quality of life is improved after laparoscopic sterilization compared to standard conventional open techniques. Being a minimally invasive surgery laparoscopy also helps in conservation of environment. Laparoscopy is a day care procedure patient will be discharged on the same day. Patient does not need to take antibiotics, dressing of his wounds, antiseptic care of the wound, thus producing no biomedical waste, contrary to the open surgery where on an average one patient produces approximately 3 to 5 Kg of biomedical waste.

Besides consuming more medicine due to larger hospitalization, laparoscopy is more environmental friendly surgery as compare to conventional open surgery. One of the most important and effective method of conservation of environment can be achieved if the population is controlled. Each and every individual is consuming the natural resources and control of population by family planning will maintain the chain of ecosystem in which every life has equal opportunity. The strength of relationship between family planning and environment is very acute and if both are integrated the outcome would be very good. Family planning can benefit the environment in big way and mark the big step towards improving environment consciousness and saving earth from the onslaught of overcrowding population. There is a linkage between population and the environment degradation resulting in climate change, a global issue. Population initiatives on the other hand aim to balance a countryâ€™s population size, economic and social development needs, and resource availability, including natural resources. Family planning can be a cost-effective means of mitigating global warming. It has also been a means of helping vulnerable families adapt to the increasingly harsh local conditions anticipated as a consequence of global warming.

High fertility and unmet need for family planning besides stressing the environment causing immediate environmental problems such as resource depletion and poor water quality. Growing demands for resources are outstripping supply. Remote rural communities in India face the challenges of extreme poverty, poor health, and environmental degradation. And population growth often exacerbates these challenges. In communities that face environmental challenges along with high fertility and high maternal and child mortality, family planning can have great benefits for the health and well-being of women and families, with positive influences on the local environment. Meeting the reproductive health needs of women and ensuring environmental sustainability by connecting family planning with environment programs has proven to be a "win-win" strategy. Expanding family planning is a response to an existing need, and it gives women autonomy and equity. The context of family planning has shifted from population control decades ago to individual rights. It will help improving environmental sustainability, and to improve access to family planning in rural areas to give women more autonomy to limit their births and improve maternal and under-5 mortality. Women with access to family planning services will know how to space births, have the time to recover from childbirth, and have the strength to work in their own businesses or in agriculture, leading to more income. Working with local communities to help women gain access to family planning influences the local environment. Since mainly women collect wood and work in the fields, their health affects conservation activities. In these programs, local women participate in land management training and learn about family planning. As a result, women are healthier to participate in conservation activities, decreasing the population pressure on the environment. Through working with the local community to respond to their needs and ensuring access to reproductive health, new opportunities have opened up to work more closely together on conservation as well.