Nezhat is best known for the surgical innovation referred to as video-laparoscopy or "operating off the monitor", a method now widely accepted but which was, until recently, considered a controversial and questionable departure from classical laparotomy or open surgery.
[6][7] After fulfilling a military conscription requirement, Nezhat attended and completed his residency program in obstetrics and gynecology at the State University of New York at Buffalo, from 1974 to 1978.
With these physical limitations in place, surgeons found it difficult to believe that operative laparoscopic techniques could replace classical surgery and, initially, many in the medical community considered the entire notion to be an untenable, unrealistic, and dangerous idea.
[19][20] For approximately the next 25 years, Nezhat became one of the most visible and controversial figures in the minimally invasive movement because of his vocal advocacy of these new techniques and for continuing to push the envelope by performing more advanced procedures laparoscopically.
The mainstream medical community has acknowledged operating off the monitor in video-laparoscopy to be the gold standard[13][23][24][25][26] in various disciplines, such as gynecologic, gastrointestinal,[13] 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.
[4][27][28][29][30][31][32] 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.
[25][33][34][35][36][37][38][39][40][41][42] By the late 1970s, with the exception of a few surgical virtuosos, such as Raoul Palmer,[43] Patrick Steptoe,[44] and Kurt Semm,[45] 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.
[46][47] Prior to the advent of video laparoscopy, other types of surgeries (from other disciplines), such as the removal of the gallbladder (colecystectomy), bowel, bladder, and ureter resections and reaanastomoses, etc., were also only possible via laparotomy.
Opponents of minimally invasive surgery accused laparoscopists of hiding their complication rates and advancing dangerous methods in order to seek fame and financial gain.
Proponents accused classical surgeons of advocating outdated surgical procedures that were dangerous for patients, because they didn't want to take the time and expense to learn the new techniques.
By the late 1990s and early 2000s, this internecine fighting became especially intense, culminating in even more serious allegations made against laparoscopists, including Nezhat, who had come to represent one of the minimally invasive movement's most visible leaders.
Starting in approximately April 2000, a series of newspaper articles were published about Nezhat, and his two surgeon brothers, Farr and Ceana, outlining all of the allegations claimed in these lawsuits.
Spirtos and Margolis, two gynecologic surgeons who were partners in a Palo Alto clinic called Women's Cancer Center (now closed), also accused Nezhat of various offenses, including of performing dangerous, experimental surgeries with the laparoscope.
[53] They suggested that Stanford failed to fully investigate Nezhat because his high-profile status - he was referred to by the press as a celebrity surgeon - was reportedly translating to millions of dollars for their bottom line.
[59] In response to these growing concerns about Nezhat's work, in November 2000 Stanford put together a blue-ribbon committee, with former California Supreme Court Justice Edward A. Panelli as the lead investigator.