Laparoscopic surgery, also known as minimally invasive surgery (MIS), has revolutionized the field of gastrointestinal (GI) and hepatopancreatobiliary (HPB) surgeries in Nepal. This approach uses small incisions, specialized instruments, and a camera (laparoscope) to perform procedures that traditionally required large open incisions.
Figure 1. Laparoscopic surgery, a minimal invasive surgery.
Dr. Surendra Shah is a highly acclaimed super-specialized gastrointestinal and hepatopancreatobiliary (HPB) surgeon with an MCh degree, recognized for his exceptional expertise in advanced laparoscopic surgery after rigorous training and hands-on experience. He has performed thousands of laparoscopic surgeries and established himself as a leading laparoscopic surgeon. His journey from mastering basic laparoscopic procedures to highly complex laparoscopic surgeries (read below).
With a proven track record of success and a dedication to excellence, Dr. Surendra Shah is a trusted name in the field of laparoscopic surgery. For those seeking advanced laparoscopic surgical solutions, Dr. Shah stands as a beacon of expertise and reliability.
Fig. 1: Different laparoscopic surgeries
This procedure involves removal of the gallbladder, typically for gallstones or gallbladder inflammation which is one of the most common laparoscopic procedures.
Technical aspects: This surgery is performed with 3-4 small incisions (5 mm to 10mm), and gallbladder removed through the umbilical port in the bag. Patient is admitted on the day of surgery, oral feeding starts about 4 to 5 hours after surgery and discharged on the next day in more than 95% of cases.
Recovery: Majority of patient start their job 7 days after surgery. However, it may vary depending on the pain threshold of the patient and categories of work on the job.
Book your appointment →This is a Emergency Surgery performed for acute appendicitis on the same day of presenting to the Hospital.
Technical aspects: This surgery is performed with 3 small incisions (5 mm to 10mm), and appendix removed through the umbilical port in the bag. Oral feeding starts about 4 to 5 hours after surgery. Most of the patients are discharged on the next day.
Recovery: Majority of patient start their job 7 days after surgery. However, it may vary depending on the pain threshold of the patient and categories of work on the job.
Book your appointment →There are different types of hernia like:
Technical aspects: This surgery is performed with 3 to 4 small incisions (5 mm to 10 mm). Oral feeding starts about 4 to 5 hours after surgery. Most of the patients are discharged on the next day or the second day depending on the types of hernia.
Recovery: Majority of patient start their job 7 to 10 days after surgery depending on the type of hernia. However, it may vary depending on the pain threshold of the patient and categories of work on the job.
Book your appointment →This is performed mostly for colorectal cancer and sometimes for inflammatory bowel diseases like ulcerative colitis, diverticulitis and rectal prolapse.
Technical aspects: Your will be admitted at least one day before surgery. You will be prescribed purgative to clear bowel content (stool). This surgery is performed with 5 small incisions (5 mm to 12 mm), and resected bowel will mesentery and lymph nodes will be removed in the bag through about 4 to 5 cm small incision. Temporary stoma will be made in rectal surgery and sometime permanent stoma for lower rectal cancer. Oral liquid feeding starts in about 2 to 3 days after surgery. Most of the patients is discharge in 5 to 7 days after surgery in most of the cases. Doctor will discuss with you everything before surgery and clear all your queries
Recovery: Majority of patient start their job in 2 to 4 weeks after surgery. However, it may vary depending on the pain threshold of the patient and categories of work on the job.
Common Laparoscopic Colorectal Surgeries are:
Important Point: Oncologically, laparoscopic colorectal surgery has been proven to have equivalent cancer outcomes to open surgery with better short-term results and quality of life. This is particularly important for cancer patients in Nepal seeking modern treatment options.
Rectal Prolapse: This is condition where bowel prolapse from anus during defecation (movement of bowel)
This is performed mostly for Gastric (stomach) cancer and sometimes for gastric outlet obstruction due to either chronic peptic ulcer disease of advanced distal gastric cancer.
Technical aspects: Your will be admitted at least one day before surgery. This surgery is performed with 5 small incisions (5 mm to 12 mm), and resected bowel will omentum and lymph nodes will be removed in the bag through about 4 to 5 cm small incision. Oral liquid feeding starts in about 2 to 3 days after surgery. Most of the patients is discharge in 7 to 10 days after surgery in most of the cases. Doctor will discuss with you everything before surgery and clear all your queries
Recovery: Majority of patient start their job in 2 to 4 weeks after surgery. However, it may vary depending on the pain threshold of the patient and categories of work on the job.
Common Laparoscopic Gastric Surgeries are:
Important Point: Oncologically, laparoscopic colorectal surgery has been proven to have equivalent cancer outcomes to open surgery with better short-term results and quality of life. This is particularly important for cancer patients in Nepal seeking modern treatment options.
Increasingly used for diagnosis and treatment in acute abdominal conditions at major hospitals in Kathmandu and Lalitpur, including perforated ulcers, small bowel obstruction, and trauma.
Book your appointment →Important Point: Laparoscopic procedures offer significant advantages over traditional open surgery while maintaining equivalent clinical outcomes in most indications. These benefits are particularly important in the Nepali context, where faster recovery can mean quicker return to work and family responsibilities.
Laparoscopic procedures require only tiny cuts (0.5-1.2cm) compared to traditional open surgery, resulting in less scarring for patients.
Patients in Nepal experience significantly less post-operative pain, allowing for faster recovery and reduced need for pain medication.
Most laparoscopic patients in Kathmandu hospitals can return home within 24-48 hours, compared to 5-7 days for open procedures.
Nepali patients typically resume normal activities within 1-2 weeks versus 4-6 weeks with traditional surgery.
The minimally invasive nature results in decreased wound infection rates, important in Kathmandu's healthcare environment.
Reduced adhesion formation benefits long-term health outcomes for Nepali patients.
High-definition cameras provide surgeons with magnified views of anatomical structures.
Minimal bleeding during procedures creates safer surgical experiences in Nepal's medical facilities.
Nearly invisible scars are particularly valued by patients concerned about appearance.
Modern laparoscopic procedures available in Nepal match international standards of care.
While initial costs may be higher, Kathmandu patients save on shorter hospital stays and faster return to work.
Careful patient selection is crucial for successful laparoscopic GI and HPB procedures:
Important Point: The decision between open and laparoscopic approaches should be individualized based on patient factors, surgeon experience, and institutional capabilities. Conversion to open surgery should not be considered a complication but a prudent decision when necessary for patient safety.
Important Point: Patients should receive thorough preoperative counseling about the laparoscopic approach, including the possibility of conversion to open surgery and potential complications.
Dr. Surendra Shah is a renowned Laparoscopic Surgeon with extensive experience available in Kathmandu and Lalitpur, Nepal.
Disclaimer: The contents in this blog are meant to spread knowledge among the general public. We don't encourage readers to self-manage or treat others using this knowledge. We strongly suggest consulting a doctor for proper treatment.
