Nezar A Almahfooz
Faruk Medical City, Sulaymania, Iraq
Scientific Tracks Abstracts: J Univer Surg
Background: Single incision laparoscopic surgery (SILS) is a natural evolution of minimally invasive surgery (MIS) era. The advent of SILS was in the field of gynecology 1969. SILS gain acceptance and has been introduced in general and bariatric surgery soon. Purpose was esthetic (scarless surgery), minimize parietal trauma, less pain and fast patient postoperative recovery. Despite these advantages, there is a concerned report of complications. Aiming to overcome the SILS complications, this novel technique; Single Incision Multiport Laparoscopic Surgery (SIMPLS) was innovated in Iraq. Method & Procedure: SIMPLS is a single surgeon prospective study conducted from Aug’ 2009- Dec’ 2017, in four hospitals in Iraq with the same laparoscopic platforms. Technique was tested in different laparoscopic operative procedures on 133 different cases. Results: Cholecystectomy (n=76), sleeve gastrectomy (n=20), appendectomy (n=9), diagnostic laparoscopy (n=8), hydatid cystectomy liver (n=4), fundoplication (n=4), ovarian cystectomy (n=3), renal cystectomy (n=3), Removal of gastric band (n=3), small bowel surgery (n=20), and combined sleeve gastrectomy and hiatal hernia repair (n=1). Time spend initiating ports ranging from 9-12 minutes. No much difficulty or struggle faced using standard laparoscopy instruments. No conversion was reported till today. The cosmetic outcome found to be extremely acceptable by surgeon and patients. Specific complications & difficulties: One case difficult intra-corporal liver retraction, gall bladder retraction in a severely inflamed gall bladder, bleeding at (angle of His), hematoma and ecchymosis, no port incision infection, and no incisional hernia Conclusion: SIMPLS technique is introduced by author as novel procedure in Iraq 2009 and is valid till today. Similar technique started few years before in other centers. Benefits of the procedure: technically feasible, reproducible for expert devoted surgeons, shorter time ports initiation, excellent esthetic results, lowest cost, not associated with incisional hernia. I advise wider practice, more trials to confirm these findings. I suggest it for interested experienced minimally invasive surgeons.
Nezar A Almahfooz is a Board degree certified general surgeon from the Council of Arab Board Surgery (CABS) 1992. He is Senior Consultant General, GIT, Bariatric and Metabolic surgeon in Faruk Medical City, Sulaymania, Leader and Director MIS surgery of Almowasat private hospital, Basrah-Iraq. He has pioneered the advanced laparoscopic and bariatric surgery in Iraq for the last 14 years. He has many international and regional memberships: Member Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Fellow of American College of Surgeons (FACS), Fellow of American Society for Metabolic and Bariatric Surgery (ASMBS), Member of the International Federation of Obesity Surgery (IFSO), Society of Laparoscopic Surgery (SLS), Egyptian and Arab societies of laparoscopic surgery (ESLS) and (ASLS), Establishing member of Iraqi Society of Metabolic and Bariatric Surgery (ISMBS). He has more than 21 published articles in general minimally invasive surgery, introduces many novel minimally invasive surgical techniques in Iraq.
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