Description

At the World Association of Laparoscopic Surgeons (WALS) 2025 conference, Dr. Shailesh Puntambekar, a renowned laparoscopic oncosurgeon, shared his extensive insights into pelvic anatomy, emphasizing its critical role in enhancing surgical precision and patient outcomes. Dr. Puntambekar, serving as the Medical Director at Galaxy Care Hospital in Pune, India, has significantly advanced the field of laparoscopic pelvic surgery, particularly in gynecologic oncology. Advancements in Laparoscopic Pelvic Surgery Dr. Puntambekar's pioneering work in laparoscopic radical hysterectomy for cervical cancer, internationally recognized as the "Pune Technique," has revolutionized surgical approaches to gynecologic malignancies. This technique underscores the importance of a profound understanding of pelvic anatomy to achieve optimal surgical outcomes. citeturn0search0 Comprehensive Understanding of Pelvic Boundaries A thorough comprehension of pelvic boundaries is essential for surgeons to navigate the complex anatomical landscape effectively. The pelvic cavity begins at the sacral promontory and is enclosed by bony structures laterally, with the pelvic floor forming its caudal limit. Key structures within this cavity include the uterus with adnexa, ureters, urinary bladder, rectum, and, in males, the prostate. Dr. Puntambekar's detailed dissections have illuminated these boundaries, providing surgeons with a clearer roadmap during procedures. Significance of the Pelvic Diaphragm The pelvic diaphragm, comprising muscles and fascia, serves as the floor of the pelvic cavity and plays a pivotal role in supporting pelvic organs. Understanding its anatomy is crucial, especially during procedures like total pelvic exenteration for recurrent ovarian cancer. Dr. Puntambekar's work highlights the importance of recognizing the extent of the pelvic diaphragm, as indicated by the endopelvic fascia, to ensure comprehensive surgical interventions. citeturn0search1 Differentiating Male and Female Pelvic Anatomy While the pelvic anatomy shares similarities between genders, notable differences exist, particularly concerning the prostate in males. In females, structures such as the uterus, bladder, and rectum are organized distinctly, necessitating tailored surgical approaches. Dr. Puntambekar's analyses emphasize these differences, guiding surgeons in adopting gender-specific strategies during pelvic surgeries. Nerve-Sparing Techniques and Functional Outcomes Preserving nerve integrity during pelvic surgeries is vital for maintaining postoperative functions, including bladder, rectal, and sexual functions. Dr. Puntambekar's research into nerve-sparing laparoscopic eradication of deep infiltrating endometriosis demonstrates that meticulous anatomical knowledge enables surgeons to achieve effective pain relief while preserving essential functions. This approach significantly enhances patients' quality of life post-surgery. Educational Contributions and Global Impact Beyond his surgical innovations, Dr. Puntambekar has dedicated himself to educating the global medical community. His publications, such as "Laparoscopic Pelvic Anatomy in Females: Applied Surgical Principles," serve as invaluable resources for surgeons worldwide, offering detailed insights into pelvic anatomy and its surgical applications. By disseminating his knowledge through workshops and scholarly articles, Dr. Puntambekar has significantly elevated the standards of laparoscopic surgery globally. Conclusion Dr. Shailesh Puntambekar's contributions to understanding pelvic anatomy have profoundly influenced laparoscopic surgical practices. His emphasis on precise anatomical knowledge not only enhances surgical accuracy but also ensures better patient outcomes. As presented at WALS 2025, his work continues to inspire and educate surgeons, reinforcing the indispensable role of detailed anatomical understanding in advancing surgical excellence.