Page 36 - World Journal of Laparoscopic Surgery

WJOLS

Sanjiv P Haribhakti, Jitendra H Mistry 10.5005/jp-journals-10033-1235
My VieWPOint

Training in Advanced Laparoscopic Surgery in India

1 Sanjiv P Haribhakti, Jitendra H Mistry
2

ABSTRACT gap is that not many surgeons are trained in advanced
More and more evidence are supporting superiority or non- laparoscopic surgery and there are very few recognized
inferiority of laparoscopic surgery. It seems that laparoscopic options for the training is available in India. There is lot
surgery has a prominent future. In India, there are very few more to improve in training of advanced laparoscopic sur-
centers which provide advanced laparoscopic service to
patients. The reason for this is a lack of adequate training gery including the structure of the program in our country.
and training options in India. It is a high time to realize that
advanced laparoscopic surgery is a necessity for gastrointes- CuRRenT SCenARIo In IndIA:
tinal (GI) surgeons. It is important to compulsorily include the TRAInIng And PRACTICe
training of advanced laparoscopic surgery in the curriculum of
GI surgery training. There should be a structured program with Basic laparoscopic surgery is routinely performed by
well designed training module to improve healthcare caliber in
our country. majority of the general and GI surgeons. For advanced
Keywords: Laparoscopy, Training, advanced laparoscopic laparoscopic surgery; either surgeon needs to have
surgery, India. formal training of GI surgery or an extensive experience
How to cite this article: Haribhakti SP, Mistry JH. Training in of open GI surgery. Currently, some of the GI surgeons
advanced Laparoscopic Surgery in India. World J Lap Surg and very few general surgeons perform advanced
2014;7(3):136-137. laparoscopic surgeries. Without adequate exposure of
Source of support: Nil open surgery it is difficult to expand the field of advanced
Conflict of interest: None laparoscopic surgery for a particular surgeon especially
general surgeon. Currently, available recognized training
InTRoduCTIon options for GI surgery in India are Master of Chirurgical
5
(MCh) (total seats 32) and Diplomate of National Board
Laparoscopic surgery has become an integral part of (DNB) (total seats 31) in GI surgery. Majority of MCh
6
the armamentarium of general and gastrointestinal (GI) centers are government centers, most of these centers
surgeons. Some of the laparoscopic procedures have provide excellent exposure of open surgery with variable
become the standard of care now. Plenty of recent litera- exposure of advanced laparoscopic surgery. These
ture support either superiority or noninferiority of certain centers were started in an open era and have given some
advanced laparoscopic procedures; like laparoscopic of the best leaders of GI surgery to this country. But the
1-3
colorectal surgeries. Laparoscopic surgery may offer adaptation of advanced laparoscopic surgery has lagged
better cosmesis, lesser pain and wound complications, behind in these centers and is one of the reasons for
1,4
shorter hospital stay and other short-term benefits. The limited development of advanced laparoscopic surgery
era has now arrived where surgeon has to provide the best in India. Majority of DNB centers are private centers; few
option to the patient as patients have become well-aware of them provide good hands on training. Exposure of
and inquire for better available options. At present option open and laparoscopic surgery varies a lot from center
of hardcore advanced laparoscopic surgery is available to center. At either of these centers hands on training of
at very few centers in India. One of the reasons for this
advanced laparoscopic surgery is quite limited because
even for some of the consultants; advanced laparoscopic
surgery is in a learning phase. Fellowship program
1 Chairman, HPB and GI Surgeon
2
by National Board of Examination (FNB) in minimal
1 Department of Surgical Gastroenterology, Kaizen Hospital access surgery is a 2 year fellowship program provided by
Institute of Gastroenterology and Research Center, ahmedabad
Gujarat, India National Board of Examination. Few centers which confer
FNB are doing majority of laparoscopy work. So after
2 Department of HPB and GI Surgery, Baroda Laparoscopy
Hospital, Institute of Gastroenterology and Research Center MS in general surgery for a surgeon with inadequate
Vadodara, Gujarat, India exposure of open advanced GI surgery it is difficult to
Corresponding Author: Jitendra H Mistry, HPB and GI grasp advanced laparoscopy and majority of them adapt
Surgeon, Department of HPB and GI Surgery, 60, Sampat Rao basic laparoscopic surgery and some of the advanced
Colony, alkapuri, Vadodara-390007, Gujarat, India, Phone: procedures. They also have fear about their limitations of
9099903766, e-mail: jitlap@gmail.com
open conversion if requires or any complications. Certain
136