Minimally invasive surgery (MIS) or laparoscopic surgery has offered the patients many benefits including, but not limited to, early recovery, less postoperative pain, cosmetic incisions and less incidence to incisional hernias.  Since the first laparoscopic cholecystectomy in 1985, laparoscopic surgery has expanded in leaps and bounds to become the standard procedure for many intra-abdominal surgeries. With traditional laparoscopy and multi-port da Vinci Robotic Surgery, surgeons operate through a few small incisions.

The quest for scar reduction beyond standard laparoscopy led to the experimentation with natural orifice surgery and single scar (incision) surgery. Single-port (incision) laparoscopy is not new. It had been around for more than 30 years. The gynaecologists were doing tubal ligation with a single-puncture laparoscope since the late 70s. This technique works well for gynaecological surgery as the uterus can be manipulated from below. These early instruments had offset eyepieces with a straight operating channel through which an applicator for the silicone ring to occlude the tubes, could be passed.

Single-incision laparoscopic surgery is a very exciting modality in the field of minimal access surgery which works for further reducing the scars of standard laparoscopy and towards scarless surgery. This kind of technique has been very appealing to patients who worry about the presence of scars in their bodies. With single incision traditional laparoscopy and da Vinci Single-Site Surgery, the surgeon operates through one small hidden incision in the navel (belly button).

If you have severe gallbladder symptoms, your doctor may recommend surgery to remove your gallbladder. It’s an organ you can live without. Gallbladder removal is known as a cholecystectomy. It can be performed using open surgery through a large incision or with minimally invasive surgery (laparoscopy).

Appendicectomies (removal of the appendix) have been done with a single puncture as early as 1992.  More recently this has even been described with transumbilical flexible endoscopy.[29] The use of multiple trocars rapidly gained popularity over the disadvantages of a single puncture. As conventional laparoscopy became popular even for complex procedures in surgery, it was usually carried out through four or more ports.

Increasing the number of ports led to reduced cosmesis, more pain and increased risk of complications due to port site infections and hernias. One advantage of reducing the number of ports over cosmesis, would be to reduce these complications.

The minimal access surgical techniques have come a full circle with the single-incision surgery gaining popularity once again.

Minimally invasive surgery (MIS) or laparoscopic surgery has offered the patients many benefits including, but not limited to, early recovery, less postoperative pain, cosmetic incisions and less incidence to incisional hernias.  Since the first laparoscopic cholecystectomy in 1985, laparoscopic surgery has expanded in leaps and bounds to become the standard procedure for many intra-abdominal surgeries. With traditional laparoscopy and multi-port da Vinci Robotic Surgery, surgeons operate through a few small incisions. 

The quest for scar reduction beyond standard laparoscopy led to the experimentation with natural orifice surgery and single scar (incision) surgery. 

Single-incision laparoscopic surgery is a very exciting new modality in the field of minimal access surgery which works for further reducing the scars of standard laparoscopy and towards scarless surgery. This kind of technique has been very appealing to patients who worry about the presence of scars in their bodies.

The use of multiple trocars rapidly gained popularity over the disadvantages of a single puncture. As conventional laparoscopy became popular even for complex procedures in surgery, it was usually carried out through four or more ports.

Increasing the number of ports led to reduced cosmesis, more pain and increased risk of complications due to port site infections and hernias. One advantage of reducing the number of ports over cosmesis, would be to reduce these complications.

If you have severe gallbladder symptoms, your doctor may recommend surgery to remove your gallbladder. It’s an organ you can live without. Gallbladder removal is known as a cholecystectomy. It can be performed using open surgery through a large incision or with minimally invasive surgery (laparoscopy).

With single incision traditional laparoscopy and da Vinci Single-Site Surgery, the surgeon operates through one small hidden incision in the navel (belly button).

Dr. Niazy Selim continue to serve his roots, Egypt. He is active in educating the Middle Eastern surgeons and physicians. He is committed to sharing his knowledge with the international communities.

The Department of Surgery at The University of Cairo invited Dr. Niazy Selim as a Program Director of their advanced Minimally Invasive and Bariatric Course. Dr. Selim prepared the syllabus and chose the speakers and the faculty. He also was responsible about coordinating the animal lab and the live training of the advanced skill lab.

The Annual Taif Digestive Diseases and Surgery Conference is held in Taif, Saudi Arabia. This program focuses on the current and evolving topics in Digestive Diseases and Surgery with a particular focus about the regional diseases. It offer a place for clinicians and scientists involved in the diagnosis and management of Digestive Diseases and Surgery to meet and exchange ideas concerning current issues and solutions on these challenging topics.
The conference is focused on Hepatitis, Liver and Pancreas Diseases and Surgery, Digestive Diseases and Surgery, Digestive Pediatric Surgery, Digestive Laparoscopic Surgery, Digestive Oncology, Digestive Radiology and Digestive Endoscopy & Endoscopic Ultrasound. Dr. Niazy Selim is a speaker and presenter in Taif conference.

Surgery has been the passion for many people to practice but few surgeons elected to practice academic surgery as a career. One of the unique aspects of academic surgery has been the ability to teach young surgeons to learn how to practice surgery and with increasing seniority, to serve in a leadership role.

A career in academic surgery is different from many other areas of academic medical life because a significant amount of time must be spent in clinical activity. Although this fits clearly with being a surgeon it absorbs real amount of time that competing researchers can put into their scholarly activities. The competition for funding, high quality papers, grants, students, etc… is made more difficult by the reality that if we operate on a patient, their problems become ours. They have first call on our time.

Nevertheless, the positive aspects of an academic surgical career are rewarding. The life of the productive academic is exciting, involves new knowledge, the rewards of successful students, contact with very bright colleagues and competitors, travel, contribution to society clinically as well as academically, and opportunities for a career path with advancement institutionally and at the leading edge of our academic field.

Many patients have questioned Dr. Niazy Selim in regard to working with surgery residents and medical students. “I have the utmost respect for my students and residents. They work hard and they are eager to learn. They dedicated their life to a long term education by putting enormous amount of hard working hours.” Says Selim.

Dr. Selim explains further to his patients that every surgeon needs assistance in the operating room. Assistants help in exposure, retraction, tying and cutting sutures but more importantly they should participate actively in procedure decision making. The mutual surgical discussion between the surgeon and the assistant in the operating room also ensure the best result for the patient. Dr. Niazy Selim believes that this discussion is best carried when the assistant is an MD with great dedication to surgery career.

“Surgery resident are part of the surgery team in the hospital. They round and examine patients daily. They are the first to respond if an acute event arises in the postoperative period. Their medical education and they years they are dedicating to surgery is your best asset to trust them.” Niazy Selim explains.

The University of Kansas (KU) and Kansas University Medical Center (KUMC) welcomed distinguished visitors from China on Dec. 16-18 as part of an information sharing program.

Dr. Niazy Selim had the privilege to host the delegates in the operating suite. He introduced them to the advanced technology and top notch surgeries performed at the University of Kansas Medical Center. The delegates were introduced to the Robotic Surgery (da Vinci). They had a chance to learn about the Single Incision Laparoscopic Surgery and Robotic Single Site Surgery.  Also, they toured the new operating rooms which are equipped with new telemedicine technology.

The China Executive Healthcare Leadership Training Program, sponsored by the U.S. Trade and Development Agency, works to build closer working relations with American and Chinese governments and seeks to familiarize delegates with U.S. policies and technologies, standards, and industry best practices to meet China’s development and modernization needs.

The delegation included 24 representatives from the Ministry of Health of the People’s Republic of China.

For more information, please visit The University of Kansas Web Site

The esophagus is a muscular tube that connects the back of your mouth (the throat) to your stomach. The length of the esophagus is about 8 inches that travels in your neck then chest before enetering your abdomen. It runs behind the trachea (windpipe) and the heart, and in front of the vertebral column (spine). The esophagus enters the abdominal cavity by passing through a small openning in the diaphragm (a sheet of muscle separating the chest and lungs from the abdomen) called the esophageal hiatus.

The  esophagus is lined by moist pink tissue called mucosa which is thick and resembles your skin in some ways.

There are two valves at each end of the esophagus to keep closed at all time. The upper esophageal sphincter (UES) and the the lower esophageal sphincter (LES).

What Is Gastroesophageal Reflux Disease (GERD)?

GERD (acid reflux disease) occurs when the acid from the stomach flows up into the esophagus. The acid in the stomach is a strong chemical that helps digesting your food. While the stomach is designed to handle its own acid, the linning of the esophagus will be severly burned by the repititive exposure to this acid. This exposure may cause symptoms that vary in severity depending on the damage. To some extent, every normal person has acid reflux. Normal non pathologic reflux happens after meals. This reflux is usually brief and without symptoms, and rarely occurs during sleep.

The diagnosis of abnormal reflux is easy when heartburn or other related GERD symptoms occur frequently.

Causes of GERD:

There is a valve that is located at the connection of the esophagus and the stomach. This valve is a one way valve that is called the lower esophageal sphincter (LES). The value of this valve is to allow food to pass to the stomach while prevents the acid from flowing up to the esophagus.

Any damage or weakness to the this valve located at the bottom of the esophagus (LES) will cause GERD symptoms. Other causes include:

Hiatal hernias

Fatty meals

Increase pressure on the stomach, such as pregnancy and being overweight.

Smoking

Caffeine

Alcohol consumption

Drugs

• Obesity
• Hiatal hernia
• Dry mouth
• Asthma and chronic cough
• Diabetes
• Delayed stomach emptying
• Connective tissue disorders, such as scleroderma
• Zollinger-Ellison syndrome

A hiatal hernia is the bulging of the upper part of the stomach into the posterior chest through an enlarged hiatal opening.

What Are the Symptoms of GERD?

The most common symptom is heartburn, a burning feeling in the middle of the chest. It sometimes spreads to the throat. An acid taste may occur. Heartburn affects about 10 million adults in the United States daily. Other symptoms include chronic cough, hoarseness, upset stomach, stomach bloating, and wheezing. More serious symptoms are bleeding, weight loss, and diffi culty swallowing.

How Is GERD Diagnosed?

The doctor relies on symptoms and the response to treatment for diagnosis. Life-threatening diseases, such as heart disease, that can cause symptoms similar to those of GERD must be ruled out. Specifi c tests are needed for an unclear diagnosis or more serious symptoms. These tests may include upper GI (gastrointestinal) x-ray series, endoscopy (using a scope to look at your esophagus and stomach directly), 24-hour esophageal pH study (measurement of acidity), and esophageal manometry (measures esophageal muscle pressure).

How Is GERD Treated?

First options for mild refl ux include eating smaller portions and changing the diet. Certain foods, such as tomatoes and fatty foods, and medicines, such as aspirin, can make symptoms worse. Over-the-counter drugs, including antacids and acidblocking medicines called H2-blockers, may help. Antacids neutralize stomach acid. H2-blockers (e.g., ranitidine or famotidine) prevent or block production of stomach acid. These drugs can be taken before eating to prevent heartburn. Omeprazole is another over-the-counter drug now available, which blocks the action of stomach cells responsible for making acid. It is generally more effective than antacids and H2-blockers.

People with severe or frequent symptoms may need prescription drugs. In resistant cases, your doctor may refer you to a surgeon to perform an operation called fundoplication to strengthen the LES.