The second millennium has brought with it a new era of modern surgery. The creation of video surgery is as revolutionary to this century as the development of anesthesia and sterile technique was to the last one. With ten years of solid experience behind them, surgeons can now confidently approach almost every part of the human body with cameras and video monitors. First they make a small cut in the skin and then introduce a harmless gas, such as carbon dioxide, into the body cavity to expand it and create a large working space. Through additional small cuts, a rod shaped telescope, attached to a camera, and other long and narrow surgical instruments are placed into the newly formed space. By this means, under high magnification diseased organs are able to be examined with minimal trauma to the patient. Instead of making a large cut into the skin and underlying muscles, surgeons are now able to make small entry ports into the area of interest and perform all the major maneuvers previously done when a large opening was present.

Almost every organ in the human body has become accessible to the surgeon's camera and scalpel. Gall stones can now be removed with the gallbladder by laparoscopic surgery in over 90% of patients presenting with this disorder. Instead of months of bed rest and limited activities, which was associated with the old method of removing the gallbladder, patients can now usually resume their normal activities in several weeks.

Many other organs can now also be approached in a similar manner. These include the stomach, intestines, pancreas and spleen, kidneys and all the females organs. More recently operations have also been developed for diseases of the bladder and the prostate in men.

As new surgical instruments and better cameras and video display systems are developed, the frontiers for laparoscopic surgery will expand even further. Hopefully, in time the cost of this impressive technology should decrease - allowing surgeons in all corners of the global community to practice it.

The advantages of this method of operating are several. First, since the overall trauma to the skin and muscles is reduced, post operative pain is less - allowing patients to get out of bed sooner. They are often able then to walk and move around within a few short hours following their operations.

The second advantage is a reduced infection rate. This is because delicate tissues are not exposed to the air of the operating room over long periods of time - as they are when the body is wide open in traditional operations. Video magnification also offers surgeons better exposure of the diseased organ and its surrounding vessels and nerves. As a result, delicate maneuvers can be performed to protect these vital structures during the removal or repair of target organs.

The disadvantages of laparoscopy include the expensive equipment involved in performing it. Not all hospital operating rooms can afford to offer it because of cost containment. The other major issue is the need for surgeons to take special training in performing the many operations that are available by this means. Even surgeons that are brilliant in open techniques need special training to transfer their excellent surgical skills to the video monitor and display.

The need for additional training is because laparoscopic surgeons leave the familiar territory of a three dimensional operating field to working on a two dimensional flat video display. The shift is a critical one, and requires some degree of practice moving around long laparoscopic instruments while handling delicate tissues. Despite these temporary disadvantages, with the proper training, surgeons are able to adapt to this means of operating.

Finally, laparoscopy cannot always be performed on everyone. Some patients with many prior operations may have so much scar tissue within the body that a safe operation cannot be done. In time, what disadvantages exist may be overcome with continued laparoscopic research and development. The future is still wide open for this new and revolutionary way of performing surgery. As new generations of surgeons come into training with solid computer and video skills established since childhood - only time will tell what wonderful innovations lie in store for all of us!

	Dr. Baghai completed her Doctorate of Medicine at the University of California, San Francisco. Her general surgery training was completed at Mayo Clinic in Rochester, Minnesota. She subsequently went to Emory University in Atlanta, Georgia to complete a two year fellowship in advanced minimally invasive GI surgery and Bariatric surgery. Dr. Baghai’s expertise is in the area of minimally invasive abdominal surgery, which besides Bariatric (weight loss) surgery includes surgery for gastroesophageal reflux disease, colorectal disease, complex hernias, and gastrointestinal malignancies. She also has a special interest in incorporating new technologies such as robotics into our minimally invasive gastrointestinal surgery program.
	Dr. Camel received his general surgery training at both the Baylor College of Medicine in Houston, TX and L.A. County/USC medical center in Los Angeles, CA. He also spent one year in a Pediatric Surgery Fellowship at L.A. Children’s Hospital. After his training, he became one of the busiest general surgeons in Ventura County excelling in advance laparoscopic and radioguided surgery. He has now relocated and brought his new family to Torrance joining the Association of South Bay Surgeons. He has special interest in gastroesophageal reflux disease, and advance laparoscopic, endocrine, cancer, and breast surgery.
	After completion of his surgical residency, Dr. Dumke did a trauma fellowship at the Maryland Institute of Emergency Medicine in Baltimore, Maryland under the direction of Dr. Adam Cauley. Dr. Dumke then entered the United States Army Medical Corp and was the director of the trauma unit at William Beaumont Army Medical Center. Since discharge from the army Dr. Dumke has maintained a general and vascular surgical practice in the south bay area. Dr. Dumke joined the Association of South Bay Surgeons in 2002.
	After completion of his General Surgery training at Harbor/UCLA Medical Center, Dr. Fisher spent one year in an Oncological Surgery fellowship at City of Hope Medical Center, where he obtained additional experience in performing more extensive operations for treating cancer. He has been in a busy surgical practice in our area for the past twenty-five years. Dr. Fisher has been active in numerous hospital committees and tumor boards and has a special interest in breast surgery. Dr. Fisher is a Fellow of the American College of Surgeons and a charter member of the American Society of General Surgeons.
	Dr. Friedlander was appointed Clinical Instructor of Surgery at the University of Southern California in 1999. Throughout her career she has developed and published a variety of scientific studies in well-known medical journals. Dr. Friedlander is a member of the Society of American Gastrointestinal Endoscopic Surgeons, the Society of Laparoscopic Surgeons, and the American Medical Association. She has also presented several research projects at national medical conferences. Now in clinical practice, she enjoys all aspects of general surgery and primarily focuses on two areas of expertise: breast and laparoscopic surgery.
	After obtaining his medical degree at Albany Medical College in Albany, New York, where he was a scholarship recipient, Dr. Lam received his surgical training from the world renowned Barnes Hospital at Washington University in St. Louis, Missouri. While at Barnes Hospital, Dr. Lam trained exclusively in General, Vascular, and Thoracic Surgery. He utilized that experience as the Chief of Surgery at Hawthorne Community Medical Group, where he delivered all aspects of General Surgery to thousands of patients in Southern California. Dr. Lam is a diplomat of the Medical Board of Surgery and a Fellow of the American College of Surgeons. He continues to further the education of medical students and fellow colleagues by being a volunteer faculty member at Harbor-UCLA Medical Center for over 20 years.
	Dr. Takahashi completed her general surgery training at LA County + USC Medical Center. During her residency at USC she spent an additional year in fellowship training in Trauma and Critical Care. She then went on to UCLA where she spent a year focused on Minimally Invasive and Bariatric Surgery. She is Board Certified in General Surgery and Surgical Critical Care. She is a Candidate member of the American College of Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), and the American Society of Bariatric Surgeons (ASBS). She has recently joined Association of South Bay Surgeons. Her special interests include advanced laparoscopic and bariatric surgery.