Table Of ContentLasers in
Proctology
Kamal Gupta
123
Lasers in Proctology
Kamal Gupta
Lasers in Proctology
Kamal Gupta
Department of Surgery
Karan Hospital
Jalandhar, India
ISBN 978-981-19-5824-3 ISBN 978-981-19-5825-0 (eBook)
https://doi.org/10.1007/978-981-19-5825-0
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Dedicated to
A few good women
My mother, Mrs. Ved Gupta; my wife, Dr. Ruby; and my
daughters Ankita and Nikita
and
A few good men
My father, Dr. Sat Paul Gupta; my mentor, Guru, and teacher,
Dr. Kushal Mital; and my friend and critic, Dr. Niranjan
Agarwal
Foreword
In the last decade, there has been a surge in publications on Lasers in
Proctology. Many surgeons own laser equipment, yet there is no in-depth nar-
rative on using lasers in proctology. A considerable variation in results, the
wavelength used, type of laser machines, and amount of energy used has been
mentioned in the literature, leaving a surgeon dazed. The missing piece is
how exactly the procedure is done, how to select patients, how much energy
is safe, and what steps are to be taken to avoid potential complications. The
book Lasers in Proctology arrives when there is a surge in patients opting for
lasers for anorectal diseases.
Lasers in Proctology is a comprehensive book with 19 chapters spread
over 200 pages with more than 200 professional illustrations, giving in-depth
knowledge of the “Art of Application of Laser Technology in Proctology.” If
a surgeon is practicing proctology, this book should be read cover to cover,
over and over again. After reading it, practice it. You would notice a differ-
ence in the outcome of the results.
The book came out on the demand of surgeons using LASERS in practice.
I met Dr. Kamal Gupta for the first time in the Minimal Invasive Benign
Proctology course at CeMAST, Mumbai, in 2017. He was a student seeking
knowledge, and I was the Director and one of the course faculty. As a student,
he was seeking answers to never-ending questions. At the time, he was far
ahead of us in lasers but not quite getting the desired results. After thoroughly
understanding the anatomy taught in the course, he focused on improving
outcomes in patients undergoing laser surgery. After he proved that lasers
were safe and the techniques reproducible, he was offered a faculty position
to teach lasers in proctology at CeMAST.
Over the next 6 months, he sent me over 300 articles from PubMed on
lasers in proctology and videos of his procedures. Impressed, I invited him to
train me in lasers for all anorectal diseases. In three sessions, one each month,
I did 30 cases with him hovering over me. The next step was to promote safe
laser surgery among surgeons across India. Because of the repeatable tech-
niques, safety, and good results, soon he was a guest speaker at all surgical
conferences in India. He started demonstrating live surgeries in the confer-
ences, and surgeons started following his surgical techniques.
As the tale goes, he has been faculty at IMMAST (formerly known as
CEMAST), Mumbai, India, and MASST, Chennai, India, since 2018 and
2022, respectively. I was his strongest critic. Newer techniques were designed,
lower wattage was used, different sites of entry points were devised, and
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viii Foreword
safety points were created. Above all, everything was documented. Several
papers have been published on the laser in proctology in the past 4 years.
However, one issue was left, how do we train surgeons worldwide? It is
just not laser surgery; he needed surgeons to understand why a particular
method was used. The book Laser in Proctology answers all the queries.
Lasers in Proctology book has been built from the base up. The text is
written in a simple format as if the author is speaking to the reader. The
author offers time-tested techniques based on evidence-based practices to
improve patient management outcomes.
I wish the best for Dr. Kamal Gupta. The readers are in for a surgical feast.
Kushal Mital
Hon. Secretary
Association of Colon and Rectal
Surgeons of India
Medicare Hospital
Thane, Maharashtra, India
Foreword
It is a proud privilege to write this foreword for this book authored by Dr.
Kamal Gupta. Having witnessed his journey in the field of proctology for the
last 5–6 years, I have no reservations in acclaiming that I am yet to see a more
dedicated person in the field. His yearning to know the minutest details of the
anal canal anatomy, the various principle behind each surgery, and the rea-
sons for their failures based on anatomy physiology have made him a perfec-
tionist, if I could call it so. He is never tired of learning, de-learning, relearning,
and readopting anything in proctology. His indent knowledge in the field of
laser proctology is unmatched, and his desire to teach the intricacies of the
same to all has persuaded him to write this book.
Having him as a co-author for the chapter on hemorrhoids, I can tell he can
improvize on anything he writes within a day. This is because he reads and
studies the topic repeatedly and has something new to add every time.
Though he describes me as his strongest critic, I know how impressed I am
with this personality. His penchant for learning and teaching has resulted in
developing clear concepts in this field.
This book of his on lasers in proctology reflects his hard work. It will act
as a ready reckoner for the readers to understand the various aspects of ano-
rectal disorders as well as their surgical management, especially the laser-
based procedure. He has explained each aspect in simple language and helps
develop a clear understanding of the subject. The opinions of surgeons with
extensive training who, in some or other way, are experts in their respective
fields speak volumes about the book. His innovative ideas of hybridizing
minimally invasive procedures in proctology have shown great results. If
duplicated by others may lead to change in gold standard managements of
some of these disorders.
In addition to general surgeons, surgery residents, and medical students
interested in laser surgery, the book will hopefully be a source of helpful
knowledge and perhaps even a guide for surgeons who want to develop exper-
tise in the field of lasers in colorectal surgery. Kamal has put a lot of work into
the book, taking time out of his hectic schedule to put his frequently original
perspectives on paper.
I commend Kamal on his superb work in publishing this textbook. I'm
expecting that after reading this book, readers will have new insights into the
concept of employing lasers in anorectal surgery, especially in fistula surgery,
where it’s crucial to know when to use lasers and when not to.
ix
x Foreword
To conclude, I must say everything may be accomplished by taking small
steps, one at a time: overcoming anxieties and apprehensions, realizing aspi-
rations, or becoming someone you want to be different from the mass.
The journey of a thousand miles begins with one step.—Lao Tzu.
Niranjan Agarwal
Consultant Colorectal Surgeon
Bombay Hospital
Mumbai, India
Foreword
My first reaction to Kamal’s request for a foreword was a surprise mixed with
great satisfaction of his achievements in such a short time over a decade. I
vividly remember an inquisitive young surgeon asking me for a few minutes
to discuss various aspects of anorectal problems, predominantly DGHAL
AND RAR. I always enjoyed expressing tricks and tips for success in these
procedures. Shortly, I started seeing him as a faculty performing surgeries at
state, national, and international conferences. This was soul-satisfying to me
as he addressed me as his GURU. He focused more and more on Lasers in
Proctology, soon becoming famous as the LASER MAN OF INDIA. Now
was the turn of Guru, making students learn laser procedures in anorectal
surgeries. He has trained over 400 surgeons in laser in anorectal procedures
through regular workshops.
I saw an excellent teacher in him, inspiring, talented, precise, revealing
tricks and tips, and encouraging full audience participation. Thus, teacher in
him evolved to a level to research, study, get peers’ views, discuss, express,
and write a comprehensive book. Right from anatomy, physiology, physiopa-
thology, and functional disturbances, he has written so well that with the aca-
demic experience of decades, I feel this book will be a boon in understanding,
practicing, managing complications, and improving their skills by practical
demonstrations and live operating workshops to young surgeons and experi-
enced to refresh the standard to latest advances in knowledge. Kamal has
solicited a galaxy of authors of repute to contribute and share their less-known
secrets of success in this broad specialty.
It is a great pleasure to see a student and my teacher in laser proctology
progressing so fast and so well with a down-to-earth attitude and exemplary
humility.
I wish him all success in life.
NEVER MISTAKE KNOWLEDGE FOR WISDOM. ONE HELPS YOU MAKE A
LIVING, AND THE OTHER HELPS MAKE A LIFE.
Prof. (Dr.) Rama Kant
Former Head of Department of Surgery
King George Medical University
Lucknow, India
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