Pioneer in Minimally

Invasive Surgery

Namir Katkhouda, M.D.
Chief, Division of Emergency Non Trauma
and Minimally Invasive Surgery

Dr. Katkhouda, an international leader in the field of minimally invasive surgery, pioneered the development of laparoscopic ulcer operations, called vagotomies.  He served as vice chairman, Department of Surgery, and chief of Surgical Endoscopy at the Hospital St. Roch, University of Nice School of Medicine, Nice, France before joining USC as associate professor of Surgery, Chief of the Division of Outpatient and Minimally Invasive Surgery, and director of the Minimally Invasive Surgery Program at USC University Hospital.

Dr. Katkhouda has authored numerous peer review articles and book chapters that document several advances in minimally invasive surgery, and in December 1994 published a book, "Principles of Laparoscopic Surgery: Basic and Advanced Techniques" (Springer Verlag, New York).  This text covers the range of laparoscopic principles, from the basic instrumentation to the critical review of complications to descriptions of advanced procedures.  The book also includes other areas such as urology, obstetrics/gynecology and thoracic surgery.

New Field is Born

Dr. Katkhouda's own experience chronicles the birth and subsequent growth of this emerging field.  In France, he closely followed the initial developments, and soon became a participant.  He background sheds light on the excitement these techniques generated less than a decade ago.  "Minimally invasive surgical techniques had their origin with two of my friends - Dr. Phillippe Mouret and Dr. Francois Dubois," Dr. Katkhouda recalls.  "In March 1987, Dr. Mouret had done the first laparoscopic cholecystectomy, an extraordinary procedure that was not widely publicized at the time.  A few months later, Dr. Dubois was performing an operation through mini laparotomies and, in passing, asked his OR team, 'I wonder who can do this better?'   His new nurse who had worked with Dr. Mouret only a few months before, replied that Dr. Mouret had operated on a man without making larger incisions.  Dr. Dubois immediately phoned Dr. Mouret to learn more about the operation."

According to Dr. Katkhouda, the two set up a private meeting and shared their knowledge.  Dr, Mouret had initially performed the procedure using traditional surgical instruments and incision locations.  Dr. Dubois believed this approach could be improved and introduced the trocar concept for laparoscopic cholecystectomy.  In addition, while Dr. Mouret did the first procedure with a one-handed techniques, holding a camera in one hand similar to a gynecologist, Dr. Dubois was the first to describe the reproduction of open surgery techniques in minimally invasive surgery - holding the surgical instruments with two hands.  These innovations, which standardized the minimally invasive surgical approach, were Dr. Dubois' contributions to the field, and he subsequently published the first scientific piece on the technique in the Annals of Surgery.

Through the internal network of surgeons in France, Dr. Katkhouda learned about the laparoscopic cholecystectomy before it became widely publicized.  He traveled from Nice, where he was practicing, to Paris to observe one of Dr. Dubois' initial cases.   "I felt fortunate to be among the first to witness what was truly an event," he says.  "No one was speaking about the operation at the time, and we were among the few to see it.  As Dr. Dubois performed the laparoscopic cholecystectomy, I remember thinking, 'How will he extract the gall bladder from the umbilicus?'  When I saw the gall bladder being actually removed, it seemed like the birth of a child.  I was amazed.

Next: The French-American Connection

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