Gangal H T, Gangal P H, Gangal M H
Nursing Home and Research Centre, Hosur, Karnataka, India.
Surg Endosc. 1993 Sep-Oct;7(5):455-8. doi: 10.1007/BF00311743.
The extensive laparoscopic tubectomy programs organized by the Indian government during 1978-1981 as a measure to curb the population explosion brought some unanticipated problems for the authors. One of these, surgical emphysema, gave the authors the opportunity to explore laparoscopically extraperitoneal appearances. So deliberate retroperitoneal surgical emphysema was created, to isolate the ureter so as to locate the stone in it, and to study the feasibility of its removal via laparoscopy itself. The procedure entails minimal trauma and gives the considerable advantage of clear vision for total removal of stone(s). This procedure offers an alternative to the conventional method and to other, newer methods. The conventional method involves wide exposure with attendant morbidity and prolonged hospital stay. Other newer methods require high-tech multimode prerequisites, such as a extracorporeal shock-wave lithotriptor, ultrasound, screening, software, endourological instruments (including lithotriptor), necessarily supplemented by technical experts in each field. Hence such methods require an institutional arrangement at an exorbitant cost to the patient.
1978年至1981年期间，印度政府组织了广泛的腹腔镜输卵管切除术项目，作为遏制人口爆炸的一项措施，这给作者带来了一些意想不到的问题。其中之一是手术性气肿，这使作者有机会通过腹腔镜探索腹膜外外观。因此，特意制造了逆行性腹膜后手术性气肿，以分离输尿管以便定位其中的结石，并研究通过腹腔镜本身取出结石的可行性。该手术创伤极小，具有视野清晰便于完全取出结石的显著优势。此手术为传统方法和其他更新的方法提供了一种替代方案。传统方法需要广泛暴露，伴有发病率高和住院时间延长的问题。其他更新的方法需要高科技的多模式先决条件，如体外冲击波碎石机、超声、筛查、软件、腔内泌尿外科器械（包括碎石机），每个领域都必须有技术专家提供支持。因此，这些方法需要高昂的机构安排成本，给患者带来沉重负担。
