began offering fellowships in advanced operative video-laparoscopy. There are still several contraindications for advanced operative video-laparoscopy, such as in emergency room medicine. However, with these and a few other exceptions, today the debate has now been resolved in favor of advanced operative video-laparoscopy for most surgical situations. The mainstream medical community has acknowledged operating off the monitor in video-laparoscopy to be the gold standard in various disciplines, such as gynecologic, gastrointestinal, thoracic, vascular, urological, and general surgery. For this reason, Nezhat has been cited by laparoendoscopic surgeons as the father of modern operative laparoscopy, for introducing important technological and conceptual breakthroughs that helped medicine move toward minimally invasive surgery. The reason that the medical community now considers advanced operative video-laparoscopy so important is that it provided an alternative to classical surgery – laparotomy – which required a large incision, between 12-14 inches, which exposed patients to serious, life-threatening complications. These large incisions were held open by metal clamps, called retractors (see image), which created even more trauma to the tissue. Though these open methods were convenient for the surgeon, it was very debilitating and painful for the patient, causing more adhesions (scar tissue), more extensive blood loss, necessitating large volume blood transfusions, and requiring longer hospital stays, with 1–3 weeks in the hospital, including possible time in the ICU, considered as normal outcomes. Another serious complication was chronic incisional hernias, a condition in which the incision fails to heal, causing it to continually ooze and break open, even for years after the surgery. However, the most important difference was that, when compared to video-laparoscopy, a laparotomy posed more serious, permanent, and life-threatening complications, including a higher incidence of death. By the late 1970s, with the exception of a few surgical virtuosos, such as Raoul Palmer, Patrick Steptoe, and Kurt Semm, gynecologic surgeons were only able to use the laparoscope to perform a few simple operative procedures, such as aspiration of cysts, lysis of adhesions, cauterizing of neoplasms, biopsies, and tubal ligations. This meant that other, more complicated gynecologic surgical procedures, such as the treatment of advanced stage (stage IV) endometriosis, hysterectomies, radical hysterectomies for cancer, para aortic node dissections, tubal reaanastomosis (reconstructive surgery of the fallopian tubes), full removal of ovarian cysts, and myomectomies (full removal of fibroids), could only be done via laparotomy. Some of these conditions, such as endometriosis, fibroids, and cysts, can be chronic diseases that require