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1

Hysterectomy - laparoscopic - discharge  

MedlinePLUS

... Frequently asked questions, FAQ008, special procedures: Hysterectomy. American College of Obstetrics and Gynecology Web site. http://www.acog.org/~/media/For%20Patients/faq008.pdf. Accessed August 5, 2013. ...

2

Laparoscopic Hysterectomy and Prolapse: A Multiprocedural Concept  

PubMed Central

Background and Objectives: Today, laparoscopic intrafascial hysterectomy and laparoscopic supracervical hysterectomy are well-accepted techniques. With our multimodal concept of laparoscopic hysterectomy for benign indications, preservation of the pelvic floor as well as reconstruction of pelvic floor structures and pre-existing prolapse situations can be achieved. Methods: The multimodal concept consists of 3 steps: Intrafascial hysterectomy with preservation of existing structures Technique 1: Primary uterine artery ligationTechnique 2: Classic intrafascial hysterectomyA technique for the stable fixation of the vaginal or cervical stumpA new method of pectopexy to correct a pre-existing descensus situation Results and Conclustion: This well-balanced concept can be used by advanced endoscopic gynecologic surgeons as well as by novices in our field. PMID:24680150

Mettler, Liselotte; Peters, Goentje; Noe, Gunter; Holthaus, Bernd; Jonat, Walter; Schollmeyer, Thoralf

2014-01-01

3

Total laparoscopic hysterectomy: a tried and tested technique.  

PubMed

Gynecologists are increasingly adopting total laparoscopic hysterectomy as their preferred method for performing a hysterectomy. The laparoscopic approach offers a superior view of the anatomy, facilitates meticulous hemostasis, enables the surgeon to perform adnexal surgery and pelvic reconstructive surgery, and reduces morbidity associated with large abdominal incisions. During the last 10 years, the surgeons at the Sydney Women's Endosurgery Centre (SWEC) have developed a laparoscopic technique using the same well-known steps as in the open abdominal approach. The ovarian pedicles are ligated, the uterine pedicles and vaginal vault are sutured laparoscopically, and some novel time-saving maneuvers are adopted. PMID:15922986

Elkington, Nicholas; Cario, Gregory; Rosen, David; Carlton, Mark; Chou, Danny

2005-01-01

4

Laparoscopic assisted vaginal radical hysterectomy - evolution of a concept  

Microsoft Academic Search

The evolution of the laparoscopic techniques for the treatment of patients with early cervical cancer is presen- ted. The laparoscopic assistance makes the pelvic lymphade- nectomy and the removal of the lateral portion of the para- metrium feasible during radical vaginal hysterectomy without the need for the muscle-cutting vulvovaginal incision. The technique is also applicable to patients with early cervical

DANIEL DARGENT

5

Assessing the Learning Curve for Laparoscopic Supracervical Hysterectomy  

PubMed Central

Objective: We assessed the learning curve for laparoscopic supracervical hysterectomy. Methods: This was a prospective cohort study. We analyzed the first 60 consecutive laparoscopic supracervical hysterectomy procedures performed by a team of 2 gynecological laparoscopic surgeons between May 2001 and July 2006 to examine whether a learning curve exists as defined by a decrease in operating time and complications as the sequence increased. Based on previous reports, we defined the first 30 laparoscopic supracervical hysterectomies as “early” cases and the subsequent cases as “late” cases. Results: The mean operating time for laparoscopic supracervical hysterectomy was significantly reduced from 166 minutes to 142.3 minutes (P?0.05) between the early and the late cases. The mean first postoperative day drop in hemoglobin between the early and the late cases was from 2.4gm/dL to 2.0gm/dL (P=0.08). Two complications occurred in the series: one delayed bowel injury in the early cases and one conversion to laparotomy due to a cystotomy in the late cases. No difference existed between the early and the late patients regarding age, parity, body mass index, uterine weight, previous abdominal surgery, or hospital stay. There was an overall linear correlation between the operating time and uterine weight (R=0.384). Conclusion: There is a learning curve for laparoscopic supracervical hysterectomy. After gaining experience in performing 30 cases, the operating time is significantly reduced. The operation can be performed safely during the learning period. PMID:17761078

Littman, Paul; Prasad, Aru; Einarsson, Jon Ivar

2007-01-01

6

Patient Satisfaction after Laparoscopic Total or Supracervical Hysterectomy  

Microsoft Academic Search

Background\\/Aims: To evaluate patient satisfaction after laparoscopic supracervical (LASH) or total hysterectomy (TLH). Methods: Retrospective study of patient satisfaction after LASH or TLH. Results: We studied 40 cases of LASH and another 40 of TLH. The age of the patients, marital status, education level and employment status between the two groups were comparable. Both LASH and TLH results in improvement

Souzan Kafy; Baydaa Al-Sannan; Nadia Kabli; Togas Tulandi

2009-01-01

7

Deep vein thrombosis following laparoscopic hysterectomy in a nulliparous woman.  

PubMed

A nulliparous woman aged 45 years was referred to us with painful swelling in left lower limb. She underwent laparoscopic hysterectomy for menorrhagia 12 days prior to the admission. The laparoscopic surgery was completed in 90 min without blood loss and blood transfusion. The size of the uterus was approximately 12 weeks. Duplex scan of the left lower limb confirmed thrombosis of the left external iliac vein, femoral vein, popliteal vein and tibial veins. On examination the laparoscopic puncture wounds healed well. She was hospitalized for initial anticoagulation with low molecular weight heparin (Enoxapain 1 mg/kg body weight twice daily) and compression bandages. Histological examination of the hysterectomy specimen was noted to be benign (Adenomyosis and cervical Leiomyoma). She responded to anticoagulation therapy and was discharged with an advice to attend the follow up clinic for long term anticoagulation advice for the next 6 months to prevent recurrent thromboembolic episodes. PMID:22851832

Pinjala, Ramakrishna; Lankala, Ramachandra Reddy; Pulipati, V N L S Vani

2011-08-01

8

Converting Potential Abdominal Hysterectomy to Vaginal One: Laparoscopic Assisted Vaginal Hysterectomy  

PubMed Central

Background. The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy. Material and methods. A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise. Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06 + 31.97?min versus 135.25 + 31.72 min; P < 0.05). However, the mean blood loss in LAVH was 100?mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24 + 117.79?mL versus 340.00 + 119.86?mL; P < 0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. Overall complications and postoperative hospital stay were not significantly different between the two groups. PMID:24729873

Shetty, Jyothi; Shanbhag, Asha

2014-01-01

9

Laparoscopic-assisted vaginal hysterectomy of large myomatous uteri with supracervical amputation followed by trachelectomy  

Microsoft Academic Search

Since most abdominal hysterectomies are performed for treatment of large uterine fibroids, an effective laparoscopic approach must be discovered for the endoscopic treatment of large uterine fibroids. We performed a retrospective analysis of all laparoscopic-assisted vaginal hysterectomies (LAVHs) we performed on uteri that were both greater than 12 weeks' size on preoperative examination and heavier than 450 g on pathologic

Michael L. Nimaroff; Michael Dimino; Susan Maloney

1996-01-01

10

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy: Cohort Review of Patients With Uterine Neoplasia  

PubMed Central

Objective: Retrospective analysis of surgico-pathologic data comparing total laparoscopic hysterectomy (TLH) with total abdominal hysterectomy (TAH) patients with uterine neoplasia Methods: We conducted a chart abstraction of all patients undergoing hysterectomy for uterine neoplasia from September 1996 to November 2004. Patients were assigned to undergo the abdominal or laparoscopic approach based on established clinical safety criteria. Results: The study included 105 patients, 29 with TAH and 76 with TLH. TAH patients were older (68 vs. 61, P=0.021); however, both groups had similar body mass indexes (31) and parities (1.6). Controlling for age, surgical duration was similar (152 minutes). Average blood loss was higher for TAH, (504 vs.138 mL, P<0.001). Hospital stays were significantly longer for patients with TAH than for those with TLH (5.4 vs. 1.8 days, P<0.0001). Uterine weight was greater (197 vs. 135 g, P=0.008) and myometrial invasion deeper in the TAH group (48% outer half vs. 17%, P=0.001). More patients had Stage II or higher disease in the TAH group (35% vs. 17%, P=0.038). More TAH patients needed node dissection (79% vs. 28%, P<.001). Node yields from dissections of 23 TAH cases and 21 laparoscopic cases were similar (17 nodes). Total and reoperative complications from TAH versus TLH were not statistically different in our small sample (14.3 vs. 5.2% total, NS; 10.3 vs. 2.6% reoperative). One conversion was necessary from laparoscopy to laparotomy for unsuspected bulky metastatic disease. Conclusion: Based on clinical selection criteria, TLH performed for endometrial pathology has few complications and is well tolerated by select patients. The advantages are less blood loss and a shorter length of hospital stay for qualified patients. PMID:16121872

Huang, Gloria Shining; Garnier, Anne-Caroline; Dibble, Suzanne L.; Reuland, Mirjam L.; Lopez, Lisbeth; Pinto, Rebecca L.

2005-01-01

11

A New Technique for Performing a Laparoscopic Hysterectomy Using Microlaparoscopy: Microlaparoscopic Assisted Vaginal Hysterectomy (mLAVH)  

PubMed Central

In an effort to further decrease patient postoperative scarring and discomfort, a new technique of micro-laparoscopic assisted vaginal hysterectomy is employed. Using a 2-mm lateral port, a single infraumbilical port for the power source, and a 3-mm or 5-mm suprapubic port for aid in manipulation, seven consecutive patients underwent hysterectomy without complication and had rapid return to their daily activities. PMID:10917113

Oliver, Kari A.

2000-01-01

12

Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy  

PubMed Central

Context: Spinal anesthesia (SA) was combined with general anesthesia (GA) for achieving hemodynamic stability in laparoscopic hysterectomy. Aims: The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. Settings and Design: We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Materials and Methods: Patients were randomly assigned to receive SA with GA (group SGA) or plain GA (group GA). Group SGA received 10 mg bupivacaine (heavy) for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Statistical analysis used: Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance (ANOVA) was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate (HR), mean arterial pressure (MAP), SPO2, and etCO2 was done with Student's t-test or Mann–Whitney test, wherever applicable. Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant (P < 0.01). Group GA showed additional requirement of metoprolol (53.33%) and higher concentration of isoflurane (P < 0.001) to combat the increased MAP. Recovery was early and quick in group SGA as against group GA (P = 0.000). There were no adverse/residual effects of SA. Conclusion: The hemodynamic repercussions during pneumoperitoneum can be effectively attenuated by combining SA and GA, without any adverse effects.

Ghodki, Poonam S.; Sardesai, Shalini P.; Naphade, Ramesh W.

2014-01-01

13

Laparoscopic splenectomy using conventional instruments  

PubMed Central

Introduction: Laparoscopic splenectomy (LS) is an accepted procedure for elective splenectomy. Advancement in technology has extended the possibility of LS in massive splenomegaly [Choy et al., J Laparoendosc Adv Surg Tech A 14(4), 197–200 (2004)], trauma [Ren et al., Surg Endosc 15(3), 324 (2001); Mostafa et al., Surg Laparosc Endosc Percutan Tech 12(4), 283–286 (2002)], and cirrhosis with portal hypertension [Hashizume et al., Hepatogastroenterology 49(45), 847–852 (2002)]. In a developing country, these advanced gadgets may not be always available. We performed LS using conventional and reusable instruments in a public teaching the hospital without the use of the advanced technology. The technique of LS and the outcome in these patients is reported. Materials and Methods: Patients undergoing LS for various hematological disorders from 1998 to 2004 were included. Electrocoagulation, clips, and intracorporeal knotting were the techniques used for tackling short-gastric vessels and splenic pedicle. Specimen was delivered through a Pfannensteil incision. Results: A total of 26 patients underwent LS. Twenty-two (85%) of patients had spleen size more than 500 g (average weight being 942.55 g). Mean operative time was 214 min (45–390 min). The conversion rate was 11.5% (n = 3). Average duration of stay was 5.65 days (3–30 days). Accessory spleen was detected and successfully removed in two patients. One patient developed subphrenic abscess. There was no mortality. There was no recurrence of hematological disease. Conclusion: Laparoscopic splenectomy using conventional equipment and instruments is safe and effective. Advanced technology has a definite advantage but is not a deterrent to the practice of LS. PMID:21206648

Dalvi, A. N.; Thapar, P. M.; Deshpande, A. A.; Rege, S. A.; Prabhu, R. Y.; Supe, A. N.; Kamble, R. S.

2005-01-01

14

Total Laparoscopic Hysterectomy: Technique and Complications of 830 Cases  

PubMed Central

Objective: This study analyses the technique and complications from total laparoscopic hysterectomy. Methods: Retrospective chart abstraction was performed on 830 consecutive patients operated on between 1996 and 2006. Demographic and surgical data were analyzed by ANOVA, chi-square, and Spearman and Pearson correlation techniques were used with significance set at P<0.05. Results: Of 830 consecutive patients, 5 (0.6%) were converted to laparotomy. Patients had a mean age of 50 (±11) years, a mean of 1.3 (±1.3) pregnancies, and a mean BMI of 27.6 (±6.8) kg/m2. The mean surgical duration was 132 (±55) minutes, with mean blood loss of 130 (±189) mL and average hospital stay of 1.4 (±0.9) days. Duration of surgery, blood loss, and hospital stay all decreased with the surgeon's increasing experience. Reoperative complications occurred in 38 patients (4.7%). Urologic injuries were observed in 23 patients (2.6%), with 9 (1.1%) requiring reoperation. Conclusions: This technique for TLH offers the benefits of minimally invasive surgery for patients needing hysterectomy, even those without vaginal capacity and uterine prolapse. PMID:17651556

Dibble, Suzanne L.; Garnier, Anne-Caroline; Reuland, Mirjam Leuchtenberger

2007-01-01

15

[A technique for total laparoscopic hysterectomy with vaginal morcellation on large uteri in order to maintain minimal invasion].  

PubMed

The advancement and increasing popularity of laparoscopic hysterectomy and the patient's foremost cosmetic concern has made the need for performing laparoscopic hysterectomy in a less morbile and time-consuming manner, we present a technique for large uteri using only three 5 mm entry ports, with tissue morcellation and removal vaginally using the Koh colpo-pneumo occluder. PMID:23405507

Nevarez Bernal, Roberto Armando; Chaya Hajj, Miguel; Velázquez Magaña, Mauricio; Vilchis Nava, Pablo; Buen-Abad, Eduardo Ibarrola

2012-12-01

16

Robotic Radical Hysterectomy Versus Total Laparoscopic Radical Hysterectomy With Pelvic Lymphadenectomy for Treatment of Early Cervical Cancer  

PubMed Central

Background and Objectives: To compare intraoperative, pathologic and postoperative outcomes of robotic radical hysterectomy (RRH) to total laparoscopic radical hysterectomy (TLRH) in patients with early stage cervical carcinoma. Methods: We prospectively analyzed cases of TLRH or RRH with pelvic lymphadenectomy performed for treatment of early cervical cancer between 2000 and 2008. Results: Thirty patients underwent TLRH and pelvic lymph-adenectomy for cervical cancer from August 2000 to June 2006. Thirteen patients underwent RRH and pelvic lymph-adenectomy for cervical cancer from April 2006 to January 2008. There were no differences between groups for age, tumor histology, stage, lymphovascular space involvement or nodal status. No statistical differences were observed regarding operative time (323 vs 318 min), estimated blood loss (157 vs 200 mL), or hospital stay (2.7 vs 3.8 days). Mean pelvic lymph node count was similar in the two groups (25 vs 31). None of the robotic or laparoscopic procedures required conversion to laparotomy. The differences in major operative and postoperative complications between the two groups were not significant. All patients in both groups are alive and free of disease at the time of last follow up. Conclusion: Based on our experience, robotic radical hysterectomy appears to be equivalent to total laparoscopic radical hysterectomy with respect to operative time, blood loss, hospital stay, and oncological outcome. We feel the intuitive nature of the robotic approach, magnification, dexterity, and flexibility combined with significant reduction in surgeon's fatigue offered by the robotic system will allow more surgeons to use a minimally invasive approach to radical hysterectomy. PMID:18765043

Datta, M. Shoma; Liu, Connie; Chuang, Linus; Zakashansky, Konstantin

2008-01-01

17

Abdominal Hysterectomy: A New Approach for Conventional Procedure  

PubMed Central

Objective: The present comparative study helps in developing a new approach to conventional hysterectomy procedure so as prevent intra-operative and Post-operative complications during the procedure. Methods: Ligation of uterine and ovarian arteries was performed, prior to abdominal hysterectomy procedures, in Group A (n-1000) and conventional method of abdominal hysterectomy in Group B (n-450) from January 2000 to December 2009. It was a prospective study. Results: In Group A it was noted that traumatic injury to (L) uterine vessel was present in 4 (0.4%) cases and (R) uterine vessel in 3 (0.3%) cases without any noticeable injury to the ovarian vessels, ureters or bladder as compared to in Group B where injury to (L) uterine was noted in 11 (2.4%) cases, ureters in 1 (0.1%) case, bladder in 6(1.5%) cases, hematoma in 10 (2.2%). Post-operative complications were found to be uneventful in Group A. Conclusion: The Present study concludes that ligation of uterine and ovarian arteries, prior to conventional abdominal hysterectomy procedures is found to be extremely safe procedure thereby reducing the risk of intra-operative and post- operative complications. PMID:24959484

Dutta, Indranil

2014-01-01

18

Sentinel node mapping in high risk endometrial cancer after laparoscopic supracervical hysterectomy with morcellation?  

PubMed Central

INTRODUCTION Occult endometrial cancer after supracervical hysterectomy is very uncommon. Even if optimal management of those rare cases is still unproven, to guide the need for further therapies, restaging should be recommended in this situation. PRESENTATION OF CASE We report of a 60-year old woman with occult high risk endometrial cancer after supracervical hysterectomy with morcellation. We describe the feasibility of laparoscopic intraoperative sentinel node identification with cervical stump removing to restage the suspicious early stage high risk endometrial cancer. DISCUSSION In high risk endometrial cancer surgical restaging is important, considering that 10–35% of cases can present pelvic nodal metastasis. To reduce the treatment related morbidity maintaining the benefit of surgical staging, with a negative preoperative PET/CT, we performed a laparoscopic SN mapping with cervical stump removing. CONCLUSION This report highlight the fact that SN mapping with cervical injection is a feasible and safe technique also without the uterine corpus after supracervical hysterectomy with morcellation. PMID:23959405

Buda, Alessandro; Marco, Cuzzocrea; Dolci, Carlotta; Elisei, Federica; Baldo, Romina; Locatelli, Luca; Milani, Rodolfo; Messa, Cristina

2013-01-01

19

Antimicrobial Prophylaxis in Laparoscopic and Conventional Cholecystectomy  

Microsoft Academic Search

Background: Postoperative infection following cholecystectomy poses a significant threat to recovery, with major cost repercussions. Though antimicrobial prophylaxis is commonly practiced, its value – particularly in laparoscopic cholecystectomy – has not yet been adequately documented. Method: In a prospective multicenter quality assurance study in 28 German hospitals, an analysis of data collected on 4,477 patients undergoing conventional (n = 1,349)

H. Lippert; J. Gastinger

1998-01-01

20

Do New Vessel Sealing Devices and Harmonic Ace Increase Ureteric Injury in Total Laparoscopic Hysterectomy?  

PubMed Central

Objectives: To compare the risk of ureteric injury in total laparoscopic hysterectomy (TLH) using new vessel sealing devices (VSDs) and harmonic scalpel with simple scissors, bipolar and suturing. This was an evaluation of 1209 cases, carried out from May 1999 to April 2010. Design and Setting: A retrospective comparative study was carried out at a tertiary gynecological endoscopic unit. Materials and Methods: Out of 1209 patients, who had hysterectomies for various indications, TLH was done in 892 patients, 273 had vaginal hysterectomy and 44 had abdominal hysterectomy. We evaluated the incidence of ureteric injury in these cases. Results: There was no mortality. In the group of vaginal and abdominal hysterectomy, there were no ureteric injuries. In the TLH group, we had 390 cases with simple scissors, bipolar and suturing with no ureteric injury. In 502 cases, new VSDs, e.g., plasma kinetic gyrus, Martin Maxim with Robi grasper, with or without harmonic 5 mm scalpel/ace were used. There were five ureteric injuries, all on the right side (one double ureter): first case was with Martin Maxim and Robi grasper, two with plasma kinetic gyrus 10 mm trissector, one with harmonic scalpel and the last one with scissors. We evaluated the reasons for such ureteric injuries, with experienced laparoscopic surgeons and the best possible set up. There were seven conversions to open surgery out of 892 cases of TLH, more due to poor case selection. PMID:22442518

Trivedi, Prakash; D'Costa, Sylvia; Shirkande, Preeti; Wahi, Meenu; Kumar, Shilpi

2009-01-01

21

Transvaginal Laparoscopic Appendectomy Simultaneously with Vaginal Hysterectomy: Initial Experience of 10 Cases  

PubMed Central

Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material/Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy. A laparoscopic approach was established after removal of the uterus, and the appendix was removed transvaginally. Among the 10 cases, 5 were conducted under gasless laparoscopy by using a simple abdominal wall-lifting instrument. Results All procedures were performed successfully without intraoperative or major postoperative complications. The appendectomy portion of the procedure took approximately 21 minutes to 34 minutes. All patients were discharged less than 4 days after surgery, without external scars. Conclusions Transvaginal appendectomy with rigid laparoscopic instruments following vaginal hysterectomy appears to be a feasible and safe modification of established techniques, with acceptable outcomes. PMID:25300522

Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

2014-01-01

22

Transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy: initial experience of 10 cases.  

PubMed

Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material and Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy. A laparoscopic approach was established after removal of the uterus, and the appendix was removed transvaginally. Among the 10 cases, 5 were conducted under gasless laparoscopy by using a simple abdominal wall-lifting instrument. Results All procedures were performed successfully without intraoperative or major postoperative complications. The appendectomy portion of the procedure took approximately 21 minutes to 34 minutes. All patients were discharged less than 4 days after surgery, without external scars. Conclusions Transvaginal appendectomy with rigid laparoscopic instruments following vaginal hysterectomy appears to be a feasible and safe modification of established techniques, with acceptable outcomes. PMID:25300522

Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

2014-01-01

23

Safe total intrafascial laparoscopic (TAIL(TM)) hysterectomy: a prospective cohort study  

PubMed Central

This study directly compares total intrafascial laparoscopic (TAIL™) hysterectomy with vaginal (VH) and abdominal (AH) hysterectomy with regard to safety, operating time and time of convalescence. The study is a prospective cohort study (Canadian Task Force classification II-2), including data from patients of a single university-affiliated teaching institution, admitted between 1997 and 2008 for hysterectomy due to benign uterus pathology. Patient data were collected pre-, intra- and postoperatively and complications documented using a standardised data sheet of a Swiss obstetric and gynaecological study group (Arbeitsgemeinschaft Schweizerische Frauenkliniken, Amlikon/Switzerland). Classification of complications (major complications and minor complications) for all three operation techniques, evaluation of surgeons and comparison of operation times and days of hospitalisation were analysed. 3066 patients were included in this study. 993 patients underwent AH, 642 VH and 1,431 total intrafascial hysterectomy. No statistically significant difference for the operation times comparing the three groups can be demonstrated. The mean hospital stay in the TAIL™ hysterectomy, VH and AH groups is 5.8?±?2.4, 8.8?±?4.0 and 10.4?±?3.9 days, respectively. The postoperative minor complications including infection rates are low in the TAIL™ hysterectomy group (3.8%) when compared with either the AH group (15.3%) or the VH group (11.2%), respectively. The total of minor complications is statistically significant lower for TAIL™ hysterectomy as for AH (O.R. 4.52, CI 3.25–6.31) or VH (O.R. 3.16, CI 2.16–4.62). Major haemorrhage with consecutive reoperation is observed statistically significantly more frequent in the AH group when compared to the TAIL™ hysterectomy group, with an O.R. of 6.13 (CI 3.05–12.62). Overall, major intra- and postoperative complications occur significant more frequently in the AH group (8.6%) when compared to the VH group (3%) and the TAIL™ hysterectomy group (1.8%). The incidence of major complications applying the standardised TAIL™ hysterectomy technique is not related to the experience of the surgeons. We conclude that a standardised intrafascial technique of total laparoscopic (TAIL™) hysterectomy using an anatomically developed special uterine device is associated with a very low incidence of minor and major intra- and postoperative complications. The direct comparison of complication rates with either vaginal or abdominal hysterectomy favours the total laparoscopic technique, and therefore, this technique can be recommended as a relatively atraumatic procedure. The operation times are comparable for all three techniques without any statistically significant differences. This technique for laparoscopic hysterectomy is shown to be equally safe when applied by experienced gynaecologic surgeons or by residents in training. Electronic supplementary material The online version of this article (doi:10.1007/s10397-010-0569-0) contains supplementary material, which is available to authorized users. PMID:20700518

Hohl, Michael K.

2010-01-01

24

The effects of laparoscopic cholecystectomy, hysterectomy, and appendectomy on nosocomial infection risks  

Microsoft Academic Search

Background  Recent reviews of the literature have concluded that additional, well-defined studies are required to clarify the superiority\\u000a of laparoscopic or open surgery. This paper presents precise estimates of nosocomial infection risks associated with laparoscopic\\u000a as compared to open surgery in three procedures: cholecystectomy, appendectomy, and hysterectomy.\\u000a \\u000a \\u000a \\u000a Methods  A retrospective analysis was performed on 11,662 admissions from 22 hospitals that have a

Andrew Brill; Kathakali Ghosh; Candace Gunnarsson; John Rizzo; Terrence Fullum; Craig Maxey; Stephen Brossette

2008-01-01

25

Surgical Outcomes of Robotic Radical Hysterectomy Using Three Robotic Arms versus Conventional Multiport Laparoscopy in Patients with Cervical Cancer  

PubMed Central

Purpose To compare surgical outcomes of robotic radical hysterectomy (RRH) using 3 robotic arms with those of conventional laparoscopy in patients with early cervical cancer. Materials and Methods A retrospective cohort study included 102 patients with stage 1A1-IIA2 cervical carcinoma, of whom 60 underwent robotic and 42 underwent laparoscopic radical hysterectomy (LRH) with pelvic lymph node dissection performed between December 2009 and May 2013. Perioperative outcomes were compared between two surgical groups. Results Robotic approach consisted of 3 robotic arms including the camera arm and 1 conventional assistant port. Laparoscopic approach consisted of four trocar insertions with conventional instruments. There were no conversions to laparotomy. Mean age, body mass index, tumor size, cell type, and clinical stage were not significantly different between two cohorts. RRH showed favorable outcomes over LRH in terms of estimated blood loss (100 mL vs. 145 mL, p=0.037), early postoperative complication rates (16.7% vs. 30.9%, p=0.028), and postoperative complications necessitating intervention by Clavien-Dindo classification. Total operative time (200.5±61.1 minutes vs. 215.6±83.1 minutes, p=0.319), mean number of lymph node yield (23.3±9.3 vs. 21.7±9.8, p=0.248), and median length of postoperative hospital stay (11 days vs. 10 days, p=0.129) were comparable between robotic and laparoscopic group, respectively. The median follow-up time was 44 months with 2 recurrences in the robotic and 3 in the laparoscopic cohort. Conclusion Surgical outcomes of RRH and pelvic lymphadenectomy were comparable to that of laparoscopic approach, with significantly less blood loss and early postoperative complications. PMID:25048478

Yim, Ga Won; Kim, Sang Wun; Nam, Eun Ji; Kim, Sunghoon; Kim, Hee Jung

2014-01-01

26

Various types of total laparoscopic nerve-sparing radical hysterectomies and their effects on bladder function  

PubMed Central

Objective This study was conducted to ascertain the correlation between preserved pelvic nerve networks and bladder function after laparoscopic nerve-sparing radical hysterectomy. Methods Between 2009 and 2011, 53 patients underwent total laparoscopic radical hysterectomies. They were categorized into groups A, B, and C based on the status of preserved pelvic nerve networks: complete preservation of the pelvic nerve plexus (group A, 27 cases); partial preservation (group B, 13 cases); and complete sacrifice (group C, 13 cases). To evaluate bladder function, urodynamic studies were conducted preoperatively and postoperatively at 1, 3, 6, and 12 months after surgery. Results No significant difference in sensory function was found between groups A and B. However, the sensory function of group C was significantly lower than that of the other groups. Group A had significantly better motor function than groups B and C. No significant difference in motor function was found between groups B and C. Results showed that the sensory nerve is distributed predominantly at the dorsal half of the pelvic nerve networks, but the motor nerve is predominantly distributed at the ventral half. Conclusion Various types of total laparoscopic nerve-sparing radical hysterectomies can be tailored to patients with cervical carcinomas. PMID:25045432

Fujiwara, Kazuko; Ebisawa, Keiko; Hada, Tomonori; Ota, Yoshiaki; Andou, Masaaki

2014-01-01

27

Laparoscopic Assistance After Vaginal Hysterectomy and Unsuccessful Access to the Ovaries or Failed Uterine Mobilization: Changing Trends  

PubMed Central

Objectives: We conducted retrospective and prospective clinical studies at the Columbus Hospital of Rome to point out changes in choosing the route for performing hysterectomy; to evaluate the feasibility of vaginal hysterectomy (VH) and oophorectomy, even in commonly considered contraindications to the vaginal route; to describe a method of laparoscopic oophorectomy following vaginal hysterectomy; and laparoscopic assistance in impossible vaginal hysterectomies. Methods: From November 1999 to November 2001, 226 patients (age 46.1±4.6 years, range 35 to 58) underwent hysterectomy for benign pathologies: 22 (9.7%) underwent total laparoscopic hysterectomy for the presence of severe endometriosis, limited access to the fornices, or immobile uterus with no lateral mobilization; 204 (90.3%) underwent vaginal hysterectomy. Patients with uterine prolapse were excluded. Uterine size, previous cesarean deliveries, pelvic surgeries and the requirement of prophylactic oophorectomy were not considered contraindications to the vaginal approach. We retrospectively analyzed 509 hysterectomies performed in the previous 2 years from 1997 through 1998. Results: During vaginal hysterectomy, adnexectomy was possible in 90.6% of the cases in which it was indicated (unilateral in 21.8% because of adnexal pathology) and was technically impossible in 9.3%. In 4 patients (1.9%), it was not possible to complete a vaginal hysterectomy, owing to the presence of thick adhesions obliterating the cul-de-sac, to severe endometriosis, or to other unforeseen circumstances. In these few patients with difficult access to the ovaries (2.9% of all VH) or with difficulties in mobilizing the uterus, we resorted to laparoscopy. The pneumoperitoneum was achieved with an insufflation tube inserted via the vagina into the abdominal cavity and packing the vagina. Thus, the risks associated with the insertion of the Veress needle were avoided. In all but 2 patients in whom conversion to laparotomy was necessary, laparoscopy was successfully completed. No major complications occurred. In the retrospective analysis of 509 hysterectomies, we determined that 29% were vaginal, 43% abdominal, and 28% laparoscopic (mostly LAVH). In the following years, LAVH allowed the conversion of a significant number of abdominal or laparoscopic hysterectomies to a vaginal route, showing that the vaginal approach was possible in most of cases. Conclusions: The vaginal approach is feasible in more than 90% of cases even if oophorectomy is required. In the few cases with difficult access to ovaries or difficulties in mobilizing the uterus, the laparoscopic route can easily be adapted by packing the vagina and obtaining a pneumoperitoneum without the risk and loss of time of the insertion of the Veress needle. In this way, it is possible to avoid a great number of LAVH, reducing operating time and the risks of a concomitant procedure. PMID:15554277

Paparella, Pierluigi; Bonito, Claudio; Paparella, Raffaele; Rossetti, Alfonso

2004-01-01

28

Laparoscopic or open conventional cholecystectomy: clinical and economic considerations  

Microsoft Academic Search

Objective: To compare clinical aspects and é nancial costs of open conventional and laparoscopic cholecystectomy. Design: Retrospective analysis of hospital records of patients who were operated on electively for symptomatic gallstone disease. Setting: University clinic, Germany. Subjects: 153 consecutive patients who had open conventional (1991-92) and 222 who had laparoscopic cholecystectomy (1993-96). A total of 251 cholecystectomies were done during

Florian Bosch; Ursula Wehrman; Hans-Detlef Saeger; Wilhelm Kirch

2002-01-01

29

Robot-assisted laparoscopic hysterectomy, gonadal biopsy, and orchiopexies in an infant with persistent mullerian duct syndrome.  

PubMed

An infant born with hypospadias and no palpable gonads was diagnosed with persistent mullerian duct syndrome (PMDS) based on history, physical examination, laboratory testing, and radiologic imaging. A robot-assisted laparoscopic hysterectomy, right gonadal biopsy, and bilateral orchiopexies were performed without incident. Final pathology confirmed the diagnosis of PMDS. To our knowledge, this is only the second report of PMDS managed through a robot-assisted laparoscopic approach. PMID:24246315

Wu, Jonathan A; Hsieh, Michael H

2014-04-01

30

Laparoscopic ovariohysterectomy and hysterectomy on African lions (Panthera leo) using the ultracision harmonic scalpel.  

PubMed

Two laparoscopic ovariohysterectomies and three laparoscopic hysterectomies were performed on normal, healthy, adult African lions (Panthera leo) in dorsal recumbency, with the body tilted at 25 degrees with the head down. One 12-mm trocar and two 5-mm trocars were used to access the uterus and ovaries, and the UltraCision (Harmonic Scalpels clamp or coagulation shears was used to coagulate and divide the ovarian- and the uterine-supporting structures and the uterine body. The animals recovered uneventfully from anesthesia and were released to their exhibits within 5-10 days of surgery. Such procedures can be performed safely on large felids and can reduce postoperative recovery time and postoperative complications. The scalpel facilitated the procedure by coagulating and dividing tissue in a continuous sequence and reducing the number of instruments required. PMID:12462496

Kolata, Ronald J

2002-09-01

31

Laparoscopic subtotal hysterectomy for large uteri using modified five port technique  

Microsoft Academic Search

Objective  To evaluate outcome of laparoscopic subtotal hysterectomy (LASH) performed in women with large uteri using a modified five\\u000a port technique.\\u000a \\u000a \\u000a \\u000a \\u000a Design  Prospective Cohort Study (Canadian Task Force classification III).\\u000a \\u000a \\u000a \\u000a Setting  Advanced laparoscopic Unit at the Whipps Cross University Hospital, London, UK.\\u000a \\u000a \\u000a \\u000a Inclusion criteria  (1) All women with symptomatic and large uteri undergoing LASH, (2) previous three normal cervical smears and consent for\\u000a future

Anupama Shahid; Sridevi Sankaran; Funlayo Odejinmi

2011-01-01

32

The influence of ondansetron on the analgesic effect of acetaminophen after laparoscopic hysterectomy.  

PubMed

The 5-HT(3) antagonists tropisetron and granisetron have been shown to block the analgesic effect of acetaminophen in healthy volunteers. To study the interaction between ondansetron and acetaminophen in women undergoing laparoscopic hysterectomy, we randomized 134 patients into three groups to receive acetaminophen-placebo (AP), acetaminophen-ondansetron (AO), or placebo-placebo (PP). One gram of intravenous acetaminophen or placebo was administered at the induction of anesthesia and every 6 h thereafter for 24 h, and 4 mg of ondansetron or placebo was administered at the end of surgery. Pain control was provided by patient-controlled analgesia (PCA)-oxycodone. Acetaminophen (as compared to placebo) in periodic doses starting at induction of anesthesia reduced the total dosage of oxycodone required over 0-24 h (P = 0.031), but ondansetron given at the end of the surgery had no impact on the analgesic effect of acetaminophen (P = 0.723). The Numeric Rating Scale (NRS) scores for pain were similar whether ondansetron or placebo was administered at the end of the surgery. Therefore, it may be concluded that in women undergoing laparoscopic hysterectomy, the administration of periodic doses of intravenous acetaminophen (as compared to placebo) starting at induction of anesthesia reduces the total dose requirement of oxycodone, and a concomitant dose of a 5-HT(3) antagonist such as ondansetron at the end of the surgery does not block the analgesic effect of acetaminophen. PMID:20220746

Jokela, R; Ahonen, J; Seitsonen, E; Marjakangas, P; Korttila, K

2010-06-01

33

Robotic Assisted, Total Laparoscopic, and Total Abdominal Hysterectomy for Management of Uterine Cancer  

PubMed Central

Objectives The purpose was to compare robotic assisted total laparoscopic hysterectomy (TRH), laparoscopic assisted hysterectomy (TLH) and total abdominal hysterectomy (TAH) with surgical staging +/- lymphadenectomy for the management of uterine cancer. Methods Institutional review board approval was obtained and patient characteristics, pathologic data, and data related to the surgical procedure were collected from chart review. Data were analyzed with SAS statistical software. Results A total of 102 TRHs were compared to 115 TLHs and 79 TAHs. There were more grade I and endometrial intraepithelial (EIN) lesions in the preoperative pathology of TLHs (P < 0.01). Pelvic lymphadenectomy was performed in 71 (70%) TRH, 46 (58%) TAH, and 28 (24%) TLH cases (P < 0.01). Mean surgical time was 203, 133 and 132 minutes for TRHs, TLHs, and TAHs (P < 0.05). Estimated blood loss was 69, 86, and 215 ml for TRH, TLH, and TAH (P < 0.05). Blood transfusions were 19% in TAHs versus 3% and 2% in TLHs and TRHs (P < 0.01). There were fewer wound infections (2% vs. 10%) in TRHs versus TAHs (P < 0.01). Length of stay was shorter for the TRH and TLH groups (P < 0.05). Conclusion Despite longer surgical times, benefits of minimally invasive technology included shortened length of stay, decreased wound infections, transfusions, and blood loss. In our population, procedure selection for TLH versus TRH may have been influenced by lower preoperative grade, with reservation of robotic technology for cases anticipated to be more complex, and therefore justifying increased technology costs and operating times. PMID:24482733

Nicole, Nevadunsky; Rachel, Clark; Michael, Muto; Ross, Berkowitz; Sue, Ghosh; Allison, Vitonis; Colleen, Feltmate

2013-01-01

34

Effect of a Disposable Automated Suturing Device on Cost and Operating Room Time in Benign Total Laparoscopic Hysterectomy Procedures  

PubMed Central

Background and Objectives: To determine the effect of a disposable automated laparoscopic suturing device, the Endo Stitch (ES) (Covidien, Mansfield, MA, USA), on hospital cost and surgical time in patients undergoing a benign total laparoscopic hysterectomy procedure compared with the use of the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA) or traditional laparoscopic suturing technique. Methods: The Premier Perspective Database (Premier, Charlotte, NC, USA) was used to identify all inpatient hospital discharges with the primary procedure of a total laparoscopic hysterectomy (International Classification of Diseases, Ninth Revision, Clinical Modification code 68.41) for benign conditions between January 1, 2009, and June 30, 2011. Patients were further categorized into 3 groups: (1) those for whom the ES was used during the laparoscopic hysterectomy procedure, (2) those for whom robotic assistance (RA) was used, and (3) those for whom neither ES nor RA (NER) was used. Multivariate analysis was performed to examine the association among the ES, RA, and NER groups with respect to hospital cost, length of stay, and surgery time. The multivariate analysis controlled for the patient's age, race, severity of illness, and comorbid conditions, as well as hospital characteristics, such as bed size, region, and teaching status. Results: A total of 9308 patients undergoing an inpatient total laparoscopic hysterectomy procedure between January 1, 2009, and June 30, 2011, were eligible for the study. The ES was used in 974 of the patients (10%), RA was used in 3971 (43%), and neither technique was used in 4363 (47%). After adjusting for confounding variables, the mean hospital cost was $1769 (P = .0332) lower, with a 42-minute (P < .001) surgery time savings, for the ES group compared with the RA group. The mean hospitalization cost for the ES group was also $634 (P < .0879) less expensive, with a 21-minute (P = .0131) surgery time savings, compared with the NER group. Conclusion: Use of a disposable automated laparoscopic suturing device, the ES, is significantly more cost-effective than the use of the da Vinci surgical system or traditional laparoscopic suturing techniques for the performance of a total laparoscopic hysterectomy procedure for benign conditions. PMID:24398190

Hashemi, Lobat; Sobolewski, Craig J.

2013-01-01

35

A randomized prospective trial of the postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids: clinical trial design  

Microsoft Academic Search

BACKGROUND: Laparoscopy-assisted vaginal hysterectomy is one of the definite methods for the treatment of symptomatic uterine fibroids with lesser intraoperative bleeding and shorter hospitalization compared with abdominal hysterectomy. However, laparoscopy-assisted vaginal hysterectomy cannot preserve uterus and can show postoperative complications by the change of pelvic structure. Thus, laparoscopic uterine artery ligation has been introduced for relieving the symptoms caused by

Hee Seung Kim; Jae Weon Kim; Mi-Kyung Kim; Hyun Hoon Chung; Taek Sang Lee; Yong-Tark Jeon; Yong Beom Kim; Hye Won Jeon; Young Ho Yun; Noh Hyun Park; Yong Sang Song; Soon-Beom Kang

2009-01-01

36

[Hysterectomy for fibroids].  

PubMed

Occasionally, the indicated treatment for cases of fibroid uterus is a hysterectomy. Surgical approaches for hysterectomy include abdominal, vaginal or laparoscopic. The determinant for selecting the surgical approach is uterine weight. In this article, we conducted a review of studies that compared the various surgical techniques for hysterectomy, as well as the steps to consider when performing a laparoscopic hysterectomy in large uteri. PMID:24314562

Lete, Iñaki

2013-07-01

37

A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report  

Microsoft Academic Search

Background: Uncontrolled studies using laparoscopic techniques in colorectal surgery have not demonstrated clear advantages to these procedures compared with conventional ones, and surgeons are concerned about unusual early recurrences reported after laparoscopic colorectal cancer surgery.Study Design: We conducted a prospective, randomized trial in one surgical department comparing laparoscopic (LAP) and conventional (CON) techniques in 109 patients undergoing bowel resection for

Jeffrey W Milsom; Bartholomäus Böhm; Katherine A Hammerhofer; Victor Fazio; Ezra Steiger; Paul Elson

1998-01-01

38

Incidence of and risk factors for febrile morbidity after laparoscopic-assisted vaginal hysterectomy  

PubMed Central

Background The purpose of this study was to assess the incidence of and risk factors for postoperative febrile morbidity after laparoscopic-assisted vaginal hysterectomy (LAVH). Methods This retrospective study was carried out using the medical records of women with benign gynecologic conditions who underwent LAVH between June 2007 and May 2012 at Srinagarind Hospital in Thailand. Data were collected to assess baseline patient characteristics, occurrence of body temperature ?38°C on two occasions at least 6 hours apart in the 24 hours following the surgical procedure, and possible risk factors related to postoperative febrile morbidity. Results In total, 199 women underwent LAVH during the study period. They had a mean age of 46±6 years, a mean body mass index of 24.0±3.2 kg/m2, a mean surgical duration of 134±52 minutes, median estimated blood loss of 200 mL, a mean total hospital stay of 5±2 days, and a mean postoperative hospital stay of 3±2 days. Postoperative febrile morbidity was documented in 31 cases (15.6%). The cause of postoperative fever was unknown in most cases, with only two cases having an identifiable cause. The risk of postoperative febrile morbidity was highest in women treated with more than two antibacterial agents and with a regimen of more than 3 days. Conclusion This study shows a moderately high rate of febrile morbidity after LAVH, for which the main risk factors were use of multiple drugs and doses for antibiotic prophylaxis. PMID:24748819

Wongpia, Iyara; Thinkhamrop, Jadsada; Seejorn, Kanok; Buppasiri, Pranom; Luanratanakorn, Sanguanchoke; Temtanakitpaisan, Teerayut; Khampitak, Kovit

2014-01-01

39

Which one is safer - performing a laparoscopic hysterectomy with a tissue fusion device involving diagnostic cystoscopy or traditional abdominal hysterectomy with ureteral dissection?  

PubMed Central

Introduction It still remains an unanswered question whether, in the absence of gynecological malignancy and under elective conditions, to perform abdominal hysterectomy (AH), offering a safer approach, or to perform a laparoscopic hysterectomy (LH) procedure. Aim We aimed to compare LH operations performed with a tissue fusion device accompanied by intraoperative diagnostic cystoscopy with traditional AH operations involving bilateral ureteral dissection. Material and methods The integrity of the ureters, ureteral peristalsis and the diameter of the ureters were examined during AH by inspection. At the end of LH, the bladder wall was systematically evaluated by cystoscopy and a jet of urine spurting was noted from both ureteral orifices. Results The operation time was longer in patients who underwent LH + CYS (p = 0.0001). The decline in hematocrit and hemoglobin levels in the postoperative period was significantly higher in patients who underwent AH + UD (p = 0.0001 and p = 0.002, respectively). No significant difference was found between the two groups in terms of ureteral injury, bowel injury or bladder injury (p = 0.378, p = 1.000 and p = 1.000, respectively). There was no statistically significant difference between the two groups in terms of mean body temperature and postoperative blood transfusion requirements (p = 0.051 and p = 0.210, respectively). Mean parenteral analgesic requirement and length of hospital stay were significantly different between the groups (p = 0.005 and p = 0.0001). No statistically significant difference was found between the two groups in terms of postoperative cardiopulmonary complications, re-operation rate or occurrence of genitourinary fistula (p = 1.000, p = 1.000 and p = 1.000, respectively). Conclusions We concluded that LH performed with a tissue fusion device involving diagnostic cystoscopy yields major and minor complication rates similar to safely performed AH operations preserving ureters. PMID:24501597

Yildiz, Gazi; Caglar, Mete; Alt?ntas, Rasit; Dilbaz, Serdar; Yildiz, Pinar; Kumru, Selahattin; Ustun, Yusuf

2013-01-01

40

Complications of hysterectomy.  

PubMed

Hysterectomy is the most common gynecologic procedure performed in the United States, with more than 600,000 procedures performed each year. Complications of hysterectomy vary based on route of surgery and surgical technique. The objective of this article is to review risk factors associated with specific types of complications associated with benign hysterectomy, methods to prevent and recognize complications, and appropriate management of complications. The most common complications of hysterectomy can be categorized as infectious, venous thromboembolic, genitourinary (GU) and gastrointestinal (GI) tract injury, bleeding, nerve injury, and vaginal cuff dehiscence. Infectious complications after hysterectomy are most common, ranging from 10.5% for abdominal hysterectomy to 13.0% for vaginal hysterectomy and 9.0% for laparoscopic hysterectomy. Venous thromboembolism is less common, ranging from a clinical diagnosis rate of 1% to events detected by more sensitive laboratory methods of up to 12%. Injury to the GU tract is estimated to occur at a rate of 1-2% for all major gynecologic surgeries, with 75% of these injuries occurring during hysterectomy. Injury to the GI tract after hysterectomy is less common, with a range of 0.1-1%. Bleeding complications after hysterectomy also are rare, with a median range of estimated blood loss of 238-660.5 mL for abdominal hysterectomy, 156-568 mL for laparoscopic hysterectomy, and 215-287 mL for vaginal hysterectomy, with transfusion only being more likely after laparoscopic compared to vaginal hysterectomy (odds ratio 2.07, confidence interval 1.12-3.81). Neuropathy after hysterectomy is a rare but significant event, with a rate of 0.2-2% after major pelvic surgery. Vaginal cuff dehiscence is estimated at a rate of 0.39%, and it is more common after total laparoscopic hysterectomy (1.35%) compared with laparoscopic-assisted vaginal hysterectomy (0.28%), total abdominal hysterectomy (0.15%), and total vaginal hysterectomy (0.08%). With an emphasis on optimizing surgical technique, recognition of surgical complications, and timely management, we aim to minimize risk for women undergoing hysterectomy. PMID:23635631

Clarke-Pearson, Daniel L; Geller, Elizabeth J

2013-03-01

41

A randomized prospective trial of the postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids: clinical trial design  

PubMed Central

Background Laparoscopy-assisted vaginal hysterectomy is one of the definite methods for the treatment of symptomatic uterine fibroids with lesser intraoperative bleeding and shorter hospitalization compared with abdominal hysterectomy. However, laparoscopy-assisted vaginal hysterectomy cannot preserve uterus and can show postoperative complications by the change of pelvic structure. Thus, laparoscopic uterine artery ligation has been introduced for relieving the symptoms caused by uterine fibroids in place of hysterectomy. The current study was designed to compare postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy, and to evaluate the efficacy of laparoscopic uterine artery ligation which can treat symptomatic uterine fibroids with the preservation of uterus. Methods and design Patients enrolled the current study are randomized to laparoscopic uterine artery ligation or laparoscopy-assisted vaginal hysterectomy. The primary outcome is to compare postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Cancer patients version 3.0. Secondary outcomes are to evaluate the volume reduction of uterus, uterine fibroids and ovaries by the 2 treatments, to compare the improvement of subjective symptoms using 11-point symptom score and postoperative clinical outcomes between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy, and to investigate the improvement of postoperative vaginal bleeding by laparoscopic uterine artery ligation. Discussion Among treatment methods for symptomatic uterine fibroids with the preservation of uterus, laparoscopic uterine artery ligation is expected to have the efficacy like uterine artery embolization, which appeared to be safe for routine use with symptomatic relief. The current study fully recruited in June 2008 and the results will be available in June 2009. If there is no difference of postoperative QOL between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids, the comparison of quality of life between laparoscopic uterine artery ligation and uterine artery embolization will be also needed as a surgical treatment for preserving uterus. Trial registration Current Controlled Trials ISRCTN76790866 PMID:19178748

Kim, Hee Seung; Kim, Jae Weon; Kim, Mi-Kyung; Chung, Hyun Hoon; Lee, Taek Sang; Jeon, Yong-Tark; Kim, Yong Beom; Jeon, Hye Won; Yun, Young Ho; Park, Noh Hyun; Song, Yong Sang; Kang, Soon-Beom

2009-01-01

42

Laparoscopic versus conventional colorectal resection: a prospective randomised study of postoperative ileus and early postoperative feeding  

Microsoft Academic Search

Background: A shorter duration of postoperative ileus and earlier oral alimentation of patients may be a clinically relevant benefit\\u000a of laparoscopic compared with conventional colorectal resection. Patients\\/Methods: A total of 60 patients were randomised to either laparoscopic (n=30) or conventional (n=30) resection of colorectal tumours. Major endpoints were the postoperative time to the first bowel movement and the time\\u000a until

W. Schwenk; B. Böhm; O. Haase; T. Junghans; J. M. Müller

1998-01-01

43

Innovations in minimally invasive hysterectomy.  

PubMed

Vaginal hysterectomy, when feasible, is the safest and most cost-effective route for hysterectomy, however, when this is not possible, minimally invasive hysterectomy is often the next best option. Laparoscopic hysterectomy has advanced significantly since 1988, when it was first introduced. Continued improvements in instrumentation, energy sources, hemostatic agents, and vaginal cuff closure techniques have expanded the use of minimally invasive hysterectomy. Variations of laparoscopy, specifically laparoendoscopic single-site surgery hysterectomy and robotic-assisted laparoscopic hysterectomy, have further expanded the role of minimally invasive hysterectomy with the goal of decreasing morbidity. As with any evolving technology, well-designed studies are needed to demonstrate safety, efficacy, and cost-effectiveness before wide-spread adoption. PMID:24145361

Ridgeway, Beri; Falcone, Tommaso

2014-03-01

44

Enclosure module design thesis for Endoblend : a novel surgical device for laparoscopic hysterectomy  

E-print Network

The Endoblend device concept was developed by a 2.75 design team,of which I was a member; the purpose of the device is to remove tissue laparoscopically. The detailed design of one of its modules, the enclosure module, is ...

Hernandez-Stewart, Daniel

2007-01-01

45

Hysterectomy: evolution and trends.  

PubMed

Hysterectomy was mentioned in Greek manuscripts 2000 years ago, but there is no proof that it was performed. Early--usually fatal--attempts at vaginal hysterectomy are recorded from the 16th century. The origins of vaginal and abdominal hysterectomy are traced from the 19th century after the pioneering work of Langenbeck and Clay. Advances in anaesthesia, blood transfusion, antibiotics and surgical technique led to hysterectomy becoming the second most common operation in women. In the first part of the 20th century subtotal abdominal hysterectomy was standard, but by the 1950s this was replaced by total abdominal hysterectomy. There has been a recent, albeit minor, resurgence of interest in subtotal hysterectomy. The development of laparoscopic assisted hysterectomy in the 1990s has, ironically, led to the re-emergence of standard vaginal hysterectomy as the method of choice for most cases of benign gynaecological disease requiring hysterectomy. At the start of the 21st century there are signs that alternatives to hysterectomy-such as hysteroscopic surgery, uterine fibroid embolization, and the levonorgestrel intrauterine device-are leading to a reduction in hysterectomy rates. PMID:15985249

Baskett, Thomas F

2005-06-01

46

Single incision versus conventional laparoscopic resection in gastrointestinal stromal tumors: a retrospective cohort analysis at a single tertiary care center  

PubMed Central

Background Single-incision laparoscopic surgery (SILS), an advanced form of minimally invasive surgery, has recently been used for surgical management of gastrointestinal stromal tumors (GIST). The literature comparing SILS to conventional laparoscopic surgery for treatment of this disease is limited. This study aimed to evaluate the feasibility and effectiveness of SILS compared with conventional laparoscopic resection for GIST. Methods A retrospective case-cohort study compared the benefits and outcomes of SILS and conventional laparoscopic partial gastrectomy for GIST. Between April 2008 and December 2012, 39 patients underwent laparoscopic gastrectomy for gastric stromal tumors in our department. All operations were performed by a single experienced surgeon. The medical records of these patients were reviewed retrospectively with regard to tumor size, operating time, and other clinical features. Results SILS resection was performed on 19 patients, whereas 20 patients had conventional laparoscopic resection. Compared with the conventional laparoscopic group, the operative time for the SILS group was shorter, but the time for recovery of gastrointestinal function and postoperative hospital stay for the SILS group was similar to that of the conventional laparoscopic group. No intraoperative or postoperative complications were recorded in either group. Conclusion Compared with the conventional laparoscopic procedure, SILS in gastric stromal tumors is as feasible and safe when performed by experienced surgeons. PMID:24959086

Kong, Jing; Wu, Shuo-Dong; Su, Yang; Fan, Ying

2014-01-01

47

[Laparoscopic or conventional repair of inguinal hernia with synthetic mesh?].  

PubMed

Laparoscopic inguinal hernia repair by means of the transabdominal preperitoneal technique (TAPP) was compared with open plug-and-patch-repair (PP) in a prospective study. From September 1992 until July 1994, 86 patients were operated using the TAPP technique; after introduction of PP in August 1994, 105 patients were operated using this technique. From August 1994 until April 1995, 24 more patients wanted the laparoscopic procedure. The two groups were comparable with regard to age, sex and the distribution of hernia types. Eighty-eight (84%) of the PP patients were operated under local anesthesia, while the others chose general anesthesia. The only intraoperative complication was a bleeding from the epigastric vessel in the laparoscopic group. Postoperative complications were three wound hematomas after TAPP (2.2%) and two wound hematomas and one superficial wound infection after PP (2.4%). All complications healed spontaneously. No detectable statistical difference was noted between the two groups with respect to postoperative pain, the consumption of analgetics, duration of hospitalization and reconvalescence. After a median follow-up of 34 months, two recurrences after TAPP (1.4%) and no recurrences after PP has been detected. Based on our experience we prefer PP for inguinal hernia repair in adults because it affords the same patient comfort as TAPP but is less expensive and can be performed under local anesthesia. PMID:9064469

Zieren, J; Zieren, H U; Wenger, F A; Müller, J M

1996-01-01

48

Total laparoscopic hysterectomy versus abdominal hysterectomy in the treatment of patients with early stage endometrial cancer: A randomized multi center study  

Microsoft Academic Search

BACKGROUND: Traditionally standard treatment for patients with early stage endometrial cancer (EC) is total abdominal hysterectomy and bilateral salpingo oophorectomy (TAH+BSO) with or without lymph node dissection through a vertical midline incision. While TAH is an accepted effective treatment, it is highly invasive, visibly scarring and associated with morbidity. An alternative treatment is the same operation by laparoscopy. Though in

Claudia BM Bijen; Justine M Briët; Geertruida H de Bock; Henriëtte JG Arts; Johanna A Bergsma-Kadijk; Marian JE Mourits

2009-01-01

49

Robotic vs. conventional laparoscopic gastric banding: a comparison of 407 cases  

Microsoft Academic Search

Background  The current indications for using a robotic technique in bariatric surgery remain unclear. The objective of this study was\\u000a to quantify the safety and potential benefits of this novel technology as compared to the conventional laparoscopic approach.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective database of patients who underwent laparoscopic adjustable gastric banding (LAGB) between December 2006 and\\u000a June 2009 was examined. During this period

Paula K. Edelson; Kristoffel R. Dumon; Seema S. Sonnad; Bilal M. Shafi; Noel N. Williams

2011-01-01

50

Laparoscopic Mesh Versus Open Preperitoneal Mesh Versus Conventional Technique for Inguinal Hernia Repair  

PubMed Central

Objective To evaluate the influence of the laparoscopic technique in hernia repair regarding time to full recovery and return to work, complications, recurrence rate, and economic aspects. Summary Background Data Several studies have shown advantages in terms of less pain and faster recovery after laparoscopic hernia repair, whereas others have not, and the cost-effectiveness has been questioned. The laparoscopic technique must be thoroughly compared with the open procedures before its true place in hernia surgery can be defined. Methods Six hundred thirteen male patients aged 40 to 75 years were randomized to the conventional procedure, preperitoneal mesh placed by the open technique, or laparoscopic preperitoneal mesh (TAPP). Follow-up was after 7 days, 8 weeks, and 1 year. Results Of 613 patients undergoing surgery, 604 (98.5%) were followed for 1 year. Patients who underwent TAPP gained full recovery after 18.4 days, compared with 24.2 days for open mesh (p < 0.001) and 26.4 days for the conventional procedure (p < 0.001). Patients who underwent TAPP returned to work after 14.7 days, compared with 17.7 days for open mesh (p = 0.05) and 17.9 days for the conventional procedure (p = 0.04). They also had significantly less restriction in physical activities after 7 days. The TAPP procedure was more expensive, mainly as a result of longer surgical time and equipment costs, even after compensation for earlier return to work. Complications were more common in the TAPP group, with a varying pattern between the groups. Four recurrences in the conventional, 11 in the open mesh, and 4 in the TAPP group were recorded after 1 year (p = n.s.). Conclusion The laparoscopic technique results in both shorter time to full recovery and shorter time to return to work, at the price of substantially increased costs. PMID:10450737

Johansson, Bo; Hallerback, Bengt; Glise, Hans; Anesten, Bengt; Smedberg, Sam; Roman, Jonas

1999-01-01

51

Systematic Review and Meta-Analysis of Robotic-Assisted versus Conventional Laparoscopic Pyeloplasty for Patients with Ureteropelvic Junction Obstruction: Effect on Operative Time, Length of Hospital Stay, Postoperative Complications, and Success Rate  

Microsoft Academic Search

BackgroundAlthough robotic-assisted procedures may theoretically be more advantageous than conventional laparoscopic ones, few studies have shown clear superiority of robotic-assisted laparoscopic pyeloplasty (RAP) over conventional laparoscopic pyeloplasty (CLP) for ureteropelvic junction obstruction (UPJO).

Luis H. P. Braga; Kenneth Pace; Jorge DeMaria; Armando J. Lorenzo

2009-01-01

52

Laparoscopic totally extraperitoneal repair without suprapubic port: comparison with conventional totally extraperitoneal repair  

PubMed Central

Purpose We have treated 24 patients through laparoscopic totally extraperitoneal (TEP) repair without suprapubic port by using reliability and reducing the invasiveness of two surgery. This study is aimed to assess the safety and feasibility of the TEP repair without suprapubic port compared to conventional TEP repair. Methods From September 2007 to 11 May 2010, we compared two groups that suffer from inguinal hernias. One is comprised of 24 patients who were treated without suprapubic port laparoscopic totally extraperitoneal repair (Group A), and the other is comprised of 100 patients who were treated with conventional laparoscopic totally extraperitoneal repair (Group B). Data regarding patient demographics (sex, age, site of hernia, and the type of hernia), operating time, postoperative hospital stay, the use of analgesics, and complications were prospectively collected. Results There was no significant difference noted between two groups in relation to sex, age, site, and the type of hernia. The mean operating time and postoperative hospital stay was longer for the Group B (62.9 minutes, 3.55 days) than for the Group A (59.0 minutes, 2.54 days) (P = 0.389, P < 0.001). Postoperative urinary retention, seroma, wound infection were respectively 4.2%, 8.3%, 0% in Group A, and 12.0%, 8.0%, 7% in group B. There was difference between the two groups, but not statistical significance. Group B used more analgesics than Group A (0.33 vs. 0.48), but it wasn't significant statistically (P = 0.234). Conclusion Although prospective randomized studies with long-term follow-up evaluation are needed to confirm our study between laparoscopic totally extraperitoneal repair without suprapubic-port and conventional laparoscopic totally extraperitoneal repair, our method have some advantages in postoperative pain, urinary retention, operating time, postoperative hospital stay, and cosmetic effect. PMID:22066055

Kwon, Ki-Hwak; Han, Won-Kon

2011-01-01

53

Changing the Route of Hysterectomy into a Minimal Invasive Approach  

PubMed Central

Objective. To describe the route of hysterectomy in a county hospital and evaluate the shift towards a minimal invasive approach. Design. Retrospective cohort study. Setting. A county hospital in Norway. Population. All women were scheduled for hysterectomy. Methods. Audit the route of hysterectomy in the period 2004–2012. Analyze the outcome of total laparoscopic hysterectomies. Main Outcome Measures. Complications after total laparoscopic hysterectomy. Results. A shift towards a minimal invasive approach has been achieved during the study period. In 2012 only 17.4% of the hysterectomies were performed abdominally, compared to yearly percentages of above 50% in the period 2004–2009. Laparoscopic supracervical hysterectomy was introduced in 2003, but the percentage of abdominal hysterectomy remained above 50% until total laparoscopic hysterectomy was introduced in 2010. Since the introduction of total laparoscopic hysterectomy in April 2010, 58 procedures have been performed. There have been no major complications. Two vaginal vault hematomas and one case of urinary tract infection were reported. Conclusions. It is possible for a county hospital to alter their praxis and perform mini-invasive hysterectomies, but it requires dedicated gynecologists. This change to an advanced procedure like total laparoscopic hysterectomy could be achieved without patients suffering from major complications. PMID:23762574

Hoyer-Sorensen, Christian; Hortemo, Sigurd; Lieng, Marit

2013-01-01

54

Single port robotic hysterectomy technique improving on multiport procedure  

PubMed Central

The benefits of laparoscopic surgery over conventional abdominal surgery have been well documented. Reducing postoperative pain, decreasing postoperative morbidity, hospital stay duration, and postoperative recovery time have all been demonstrated in recent peer-review literature. Robotic laparoscopy provides the added dimension of increased fine mobility and surgical control. With new single port surgical techniques, we have the added benefit of minimally invasive surgery and greater patient aesthetic satisfaction, as well as all the other benefits laparoscopic surgery offers. In this paper, we report a successful single port robotic hysterectomy and the simple process by which this technique is performed. PMID:23248446

Lue, John R; Murray, Brian; Bush, Stephen

2012-01-01

55

General anesthesia versus segmental thoracic or conventional lumbar spinal anesthesia for patients undergoing laparoscopic cholecystectomy  

PubMed Central

Background: Laparoscopic cholecystectomy became the standard surgery for gallstone disease because of causing less postoperative pain, respiratory compromise and early ambulation. Objective: This study was designed to compare spinal anesthesia, (segmental thoracic or conventional lumbar) vs the gold standard general anesthesia as three anesthetic techniques for healthy patients scheduled for elective laparoscopic cholecystectomy, evaluating intraoperative parameters, postoperative recovery and analgesia, complications as well as patient and surgeon satisfaction. Materials and Methods: A total of 90 patients undergoing elective laparoscopic cholecystectomy, between January 2010 and May 2011, were randomized into three equal groups to undergo laparoscopic cholecystectomy with low-pressure CO2 pneumoperitoneum under segmental thoracic (TSA group) or conventional lumbar (LSA group) spinal anesthesia or general anesthesia (GA group). To achieve a T3 sensory level we used (hyperbaric bupivacaine 15 mg, and fentanyl 25 mg at L2/L3) for LSAgroup, and (hyperbaric bupivacaine 7.5 mg, and fentanyl 25 mg at T10/T11) for TSAgroup. Propofol, fentanyl, atracurium, sevoflurane, and tracheal intubation were used for GA group. Intraoperative parameters, postoperative recovery and analgesia, complications as well as patient and surgeon satisfaction were compared between the three groups. Results: All procedures were completed laparoscopically by the allocated method of anesthesia with no anesthetic conversions. The time for the blockade to reach T3 level, intraoperative hypotensive and bradycardic events and vasopressor use were significantly lower in (TSA group) than in (LSA group). Postoperative pain scores as assessed throughout any time, postoperative right shoulder pain and hospital stay was lower for both (TSA group) and (LSA group) compared with (GA group). The higher degree of patients satisfaction scores were recorded in patients under segmental TSA. Conclusion: The present study not only confirmed that both segmental TSA and conventional lumber spinal anesthesia (LSA) are safe and good alternatives to general anesthesia (GA) in healthy patients undergoing laparoscopic cholecystectomy but also showed better postoperative pain control of both spinal techniques when compared with general anesthesia. Segmental TSA provides better hemodynamic stability, lesser vasopressor use and early ambulation and discharge with higher degree of patient satisfaction making it excellent for day case surgery compared with conventional lumbar spinal anesthesia.

Yousef, Gamal T.; Lasheen, Ahmed E.

2012-01-01

56

Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy  

Microsoft Academic Search

PURPOSE: The aim of this study was to assess the functional outcome and the quality of life of laparoscopic-assisted ileal pouch-anal anastomosis compared with conventional ileal pouch-anal anastomosis. Further, body image and cosmesis were evaluated in both groups. METHODS: Sixteen patients who underwent a laparoscopic-assisted ileal pouch-anal anastomosis between March 1996 and September 1999 were matched with 19 patients who

M. S. Dunker; W. A. Bemelman; J. F. M. Slors; P. van Duijvendijk; D. J. Gouma

2001-01-01

57

Two cases of post-coital vaginal cuff dehiscence with small bowel evisceration after robotic-assisted laparoscopic hysterectomy  

PubMed Central

INTRODUCTION Vaginal cuff dehiscence following robotic surgery is uncommon. Published reports of vaginal cuff dehiscence following robotic surgery are increasing, but the true incidence is unknown. PRESENTATION OF CASE Case 1. A 45 year old female had sexual intercourse and presented with a vaginal cuff dehiscence complicated by small bowel evisceration 4 months after RA-TLH. Case 2. A 44 year old female had sexual intercourse and presented with a vaginal cuff dehiscence with small bowel evisceration 6 weeks after RA-TLH. DISCUSSION We discuss the rate of vaginal cuff dehiscence by mode of hysterectomy, surgical and non-surgical risk factors that may contribute to vaginal cuff dehiscence, and proposed preventative methods at the time of RA-TLH to reduce this complication. CONCLUSION Vaginal cuff dehiscence with associated evisceration of intraabdominal contents is a potentially severe complication of hysterectomy. We recommend counseling patients who undergo RA-TLH to abstain from vaginal intercourse for a minimum of 8–12 weeks. PMID:23708306

Nguyen, My-Linh T.; Kapoor, Monica; Pradhan, Tana S.; Pua, Tarah L.; Tedjarati, Sean S.

2013-01-01

58

Vaginal repair of vaginal vault dehiscence after postpartum hysterectomy  

PubMed Central

Vaginal vault dehiscence (VVD) may occur rarely after hysterectomy. Although mostly, a vaginal cuff dehiscence is seen after robotic or laparoscopic hysterectomy, it may also be observed as a complication of abdominal or vaginal hysterectomy. Vaginal repair is one of the techniques used for VVD. Here, we will describe a case of vaginally repaired VVD, associated with intra-abdominal hematoma after postpartum hysterectomy. PMID:24876366

Avc?oglu, Sumeyra Nergiz; Alt?nkaya, Sunduz Ozlem; Kucuk, Mert; Yuksel, Hasan; Demircan-Sezer, Selda

2014-01-01

59

Comparison of Outcome and Side Effects Between Conventional and Transvaginal Laparoscopic Cholecystectomy: A Meta-analysis.  

PubMed

Transvaginal laparoscopic cholecystectomy (TVC) is becoming an attractive alternative to conventional laparoscopic cholecystectomy (CLC). We conducted a meta-analysis study to compare the outcome and side effects between TVC and CLC. Clinical studies on TVC with CLC as control were identified by searching PubMed and EMBASE (from 2007 to December 2013). Nine studies were identified for meta-analysis. Our results showed that TVC required much longer operative time [MD, 30.82; 95% confidence interval (CI), 13.00-48.65; P=0.0007] and had significantly lower pain score on postoperative day 1 as compared with CLC (MD, -1.77; 95% CI, -2.91 to -0.63; P=0.002). No statistical difference in days of hospital stay (MD, -1.60; 95% CI, -4.73 to 1.54; P=0.32) and number of complications was found between the 2 groups (risk ratio, 0.52; 95% CI, 0.25-1.10; P=0.09). Safety of TVC is similar as CLC. In conclusion, TVC patients have significantly less postoperative pain but need much longer operative time. PMID:25084449

Xu, Jian; Xu, Liang; Li, Lintao; Zha, Siluo; Hu, Zhiqian

2014-10-01

60

Comparison of needlescopic appendectomy versus conventional laparoscopic appendectomy: a randomized controlled trial.  

PubMed

Laparoscopic appendectomy has been shown to improve postoperative recovery when compared with open appendectomy. The present randomized trial was conducted to evaluate any further difference in outcome between needlescopic appendectomy (NA) and conventional laparoscopic appendectomy (CLA) in the management of acute appendicitis. Patients with the clinical diagnosis of acute appendicitis were randomized to either NA (instrument size < or = 3 mm) or CLA (instrument size > or = 5 mm). Standardized anesthetic technique and perioperative management were adopted. The primary end point was length of postoperative hospital stay. Other parameters such as conversion rate, postoperative pain score and analgesic requirement, return of bowel function, resumption of normal activities, complication rate, and length of the final scars were also assessed and compared. A total of 363 patients (NA: 174, CLA: 189) were recruited. Both approaches could accurately arrive at the diagnosis (NA: 98.3%; CLA: 100%). Compared with CLA, NA resulted in a significantly longer operation time (P = 0.015) and a higher conversion rate (P < 0.001). The final scars of the NA group were significantly shorter when compared with the CLA group (P < 0.001). Otherwise, there was no statistical difference between the 2 groups in terms of complication rate, postoperative pain score, length of postoperative stay, and other recovery parameters. NA resulted in a longer operation time and higher conversion rate. Except for a smaller scar, the present study was unable to demonstrate any other short-term benefits. Thus, the technique cannot be routinely recommended. PMID:15821618

Lau, Daniel H W; Yau, Kevin K K; Chung, C C; Leung, Fiona C S; Tai, Y P; Li, Michael K W

2005-04-01

61

EnROL: A multicentre randomised trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme  

PubMed Central

Background During the last two decades the use of laparoscopic resection and a multimodal approach known as an enhanced recovery programme, have been major changes in colorectal perioperative care. Clinical outcome improves using laparoscopic surgery to resect colorectal cancer but until recently no multicentre trial evidence had been reported regarding whether the benefits of laparoscopy still exist when open surgery is optimized within an enhanced recovery programme. The EnROL trial (Enhanced Recovery Open versus Laparoscopic) examines the hypothesis that laparoscopic surgery within an enhanced recovery programme will provide superior postoperative outcomes when compared to conventional open resection of colorectal cancer within the same programme. Methods/design EnROL is a phase III, multicentre, randomised trial of laparoscopic versus open resection of colon and rectal cancer with blinding of patients and outcome observers to the treatment allocation for the first 7?days post-operatively, or until discharge if earlier. 202 patients will be recruited at approximately 12 UK hospitals and randomised using minimization at a central computer system in a 1:1 ratio. Recruiting surgeons will previously have performed >100 laparoscopic colorectal resections and >50 open total mesorectal excisions to minimize conversion. Eligible patients are those suitable for elective resection using either technique. Excluded patients include: those with acute intestinal obstruction and patients in whom conversion from laparoscopic to open procedure is likely. The primary outcome is physical fatigue as measured by the physical fatigue domain of the multidimensional fatigue inventory 20 (MFI-20) with secondary outcomes including postoperative hospital stay; complications; reoperation and readmission; quality of life indicators; cosmetic assessments; standardized performance indicators; health economic analysis; the other four domains of the MFI-20. Pathological assessment of surgical quality will also be undertaken and compliance with the enhanced recovery programme will be recorded for all patients. Discussion Should this trial demonstrate that laparoscopic surgery confers a significant clinical and/or health economic benefit this will further support the transition to this type of surgery, with implications for the training of surgeons and resource allocation. Trial registration ISRCTN48516968. PMID:22591460

2012-01-01

62

Prospective Comparison of 3Dimensional Volume Rendered Computerized Tomography and Conventional Renal Arteriography for Surgical Planning in Patients Undergoing Laparoscopic Donor Nephrectomy  

Microsoft Academic Search

PurposeWe prospectively assessed the accuracy of 3-dimensional (3-D) volume rendered computerized tomography (CT) and conventional renal arteriography to visualize renovascular anatomy in patients undergoing laparoscopic donor nephrectomy.

HAZEM ABOU EL FETTOUH; BRIAN R. HERTS; TONI NIMEH; SUSAN L. WIRTH; AUDREY CAPLIN; MARK SANDS; ANUP P. RAMANI; JIHAD KAOUK; DAVID A. GOLDFARB; INDERBIR S. GILL

2003-01-01

63

Vaginal hysterectomy for the woman with a moderately enlarged uterus weighing 200 to 700 grams  

Microsoft Academic Search

Objectives: The purpose of this study was to compare the surgical outcomes of women with moderately enlarged uteri undergoing vaginal hysterectomy with those of women with uteri of normal size undergoing vaginal hysterectomy. A secondary objective was to investigate the roles of uterine morcellation and laparoscopically assisted vaginal hysterectomy in the treatment of these women. Study Design: Thirty consecutive women

James B. Unger

1999-01-01

64

Transumbilical single incision laparoscopic cholecystectomy with conventional instruments: A continuing study  

PubMed Central

INTRODUCTION: The feasibility of the single incision, multiport transumbilical approach(SILC) for the treatment of symptomatic gallbladder calculus disease has been established. AIMS: The study examines both short and long term morbidity of the SILC approach. MATERIALS AND METHODS: All the 1338 patients were operated by the same surgeon through a transversely placed umbilical incision in the upper third of the umbilicus. Three conventional ports,10,5 and 5 mm were introduced through the same skin incision but through separate transfascial punctures. The instruments were those used for standard laparoscopic cholecystectomy(SLC).Patients with acute cholecystitis and calculous pancreatitis were included,while those with choledocholithiasis were excluded. Results were compared with those of SLC. RESULTS: Forty patients had difficult gall bladders, 214 had acute cholecystitis, and 16 had calculous pancreatitis. The mean operating time was 24.7 mins as compared to 18.4 mins in SLC. Intracorporeal knotting was required in four patients. Conversion to SLC was required in 12 patients. Morrisons pouch drain was left in 3 patients. Injectable analgesics were required in 85% vs 90% (SILC vs SLC) on day 1 and 25% vs 45% on day 2 and infection was seen in 6(0. 45%) patients. Port site hernia was seen in 2 patients. The data was compared with that of SLC and significance calculated by the student ‘t’ test. A p value less than 0.05 was considered as significant. CONCLUSIONS: Trans umbilical SILC gives comparable results to SLC, and is a superior alternative when cosmesis and postoperative pain are considered, but the operative time is significantly more.

Sinha, Rajeev; Yadav, Albel S

2014-01-01

65

NOTES cholecystectomy: matched-pair analysis comparing the transvaginal hybrid and conventional laparoscopic techniques in a series of 216 patients  

Microsoft Academic Search

Background  Natural orifice transluminal endoscopic surgery (NOTES) is currently a very important topic for both gastroenterologists and\\u000a surgeons. We have developed a technique of transvaginal hybrid NOTES cholecystectomy (TVC) that leaves no visible scar and\\u000a is applicable to daily use. This technique is compared to the conventional laparoscopic cholecystectomy (CLC) in a matched-pair\\u000a analysis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  From June 2007 until February 2009, 108

Carsten Zornig; Linn Siemssen; Alice Emmermann; Margrit Alm; Hans A. von Waldenfels; Conrad Felixmüller; Hamid Mofid

2011-01-01

66

Types of radical hysterectomies  

PubMed Central

Abstract The treatment for cervical cancer is a complex, multidisciplinary issue, which applies according to the stage of the disease. The surgical elective treatment of cervical cancer is represented by the radical abdominal hysterectomy. In time, many surgeons perfected this surgical technique; the ones who stood up for this idea were Thoma Ionescu and Ernst Wertheim. There are many varieties of radical hysterectomies performed by using the abdominal method and some of them through vaginal and mixed way. Each method employed has advantages and disadvantages. At present, there are three classifications of radical hysterectomies which are used for the simplification of the surgical protocols: Piver-Rutledge-Smith classification which is the oldest, GCG-EORTC classification and Querlow and Morrow classification. The last is the most evolved and recent classification; its techniques can be adapted for conservative operations and for different types of surgical approaches: abdominal, vaginal, laparoscopic or robotic. Abbreviations: GCG-EORTC = Gynecologic Cancer Group of the European Organization of Research and Treatment of Cancer; LEEP = loop electrosurgical excision procedure; I.O.B. = Institute of Oncology Bucharest; PRS = Piver-Rutledge-Smith

Marin, F; Plesca, M; Bordea, CI; Moga, MA; Blidaru, A

2014-01-01

67

Clinical results between single incision laparoscopic cholecystectomy and conventional 3-port laparoscopic cholecystectomy: prospective case-matched analysis in single institution  

PubMed Central

Purpose The aim of our study was to compare single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) with respect to clinical outcomes. Methods Patients with less than a 28 body mass index (BMI) and a benign gall bladder disease were enrolled in this study. From January 2011 to February 2012, 30 consecutive patients who underwent SILC were compared with 30 patients who underwent CLC during the same period. In this study, all operations were performed by one surgeon. In each group, patient characteristics and perioperative data were collected. Results There was no significant difference in the preoperative characteristics. There was no significant difference in the postoperative laboratory result (alanine aminotransferase, aspartate aminotransferase, and alanine aminotransferase), number of conversion and complication cases, and length of hospital stay. The operation time was significantly longer in the SILC group (78.5 ± 17.8 minutes in SILC group vs. 34.9 ± 5.75 minutes in CLC group, P < 0.0001). The total nonsteroidal antiinflammatory drug usage during perioperative period showed significantly higher in SILC groups (162 ± 51 mg in the SILC group vs. 138 ± 30 mg in the CLC group), but there was no statistically significant difference in opioid usage between two groups. The postoperative pain score was significantly higher in the SILC group at second, third, and tenth postoperative day. Satisfaction of postoperative wound showed superiority in SILC group. Conclusion SILC seems to be an acceptable alternative to CLC with acceptable results. However, it is not enough to propose any real benefits of SILC when compared with CLC in terms of operation time and postoperative pain. PMID:23230556

Jung, Gum O; Park, Dong Eun

2012-01-01

68

FDA Warns against Using Laparoscopic Power Morcellators to Treat Uterine Fibroids  

MedlinePLUS

... FDA News Release FDA warns against using laparoscopic power morcellators to treat uterine fibroids Agency recommends adding ... April 2014, the FDA warns against using laparoscopic power morcellators in the removal of the uterus (hysterectomy) ...

69

Conventional box model training improves laparoscopic skills during salpingectomy on LapSim: a randomized trial  

PubMed Central

Objective Box model trainers have been used for many years to facilitate the improvement of laparoscopic skills. However, there are limited data available on box trainers and their impact on skill acquisition, assessed by virtual reality systems. Material and Methods Twenty-two Postgraduate Year 1 gynecology residents with no laparoscopic experience were randomly divided into one group that received structured box model training and a control group. All residents performed a salpingectomy on LapSim before and after the training. Performances before and after the training were assessed using LapSim and were recorded using objective parameters, registered by a computer system (time, damage, and economy of motion scores). Results There were initially no differences between the two groups. The box trainer group showed significantly greater improvement in time (p=0.01) and economy of motion scores (p=0.001) compared with the control group post-training. Conclusion The present study confirmed the positive effect of low cost box model training on laparoscopic skill acquisition as assessed using LapSim. Novice surgeons should obtain practice on box trainers and teaching centers should make efforts to establish training laboratories. PMID:24592096

Akdemir, Ali; Ergeno?lu, Ahmet Mete; Yeniel, Ahmet Özgür; ?enda?, Fatih

2013-01-01

70

A comparison of laparascopic-assisted radical vaginal hysterectomy and radical abdominal hysterectomy in the treatment of cervical cancer  

Microsoft Academic Search

Objectives. The aim of this study was to compare peri-operative morbidity and recurrence-free survival of early-stage cervical cancer patients treated by laparoscopic-assisted radical vaginal hysterectomy (LARVH) with time-matched radical abdominal hysterectomy (RAH) controls at our center.Methods. Since July 1984, all patients with FIGO stage IA\\/IB cervical cancer undergoing radical surgery by members of our division have been entered into a

H Steed; B Rosen; J Murphy; S Laframboise; D De Petrillo; A Covens

2004-01-01

71

Slow-transit constipation after radical hysterectomy type III  

Microsoft Academic Search

Background  This study investigated ways to reduce the rate of slow-transit constipation after radical hysterectomy type III.\\u000a \\u000a \\u000a \\u000a Methods  A prospective study was conducted involving 59 consecutive patients with cervical cancer stage IB1-IIIA at high risk for parametrial or lymph node involvement who were treated between May 1996 and March 1999 by laparoscopically\\u000a assisted radical vaginal hysterectomy type III.\\u000a \\u000a \\u000a \\u000a Results  During laparoscopic transection of

M. Possover; A. Schneider

2002-01-01

72

Evaluation of risk factors of vaginal cuff dehiscence after hysterectomy  

PubMed Central

Objective The purpose of this study was to evaluate risk factors of vaginal cuff dehiscence or evisceration according to the type of operation. Methods Medical records of 604 women who underwent hysterectomies at Korea University Anam Hospital between June 2007 and June 2011 were reviewed. They were allocated to six groups. The six types of hysterectomies included robotic hysterectomy (n = 7), robotic radical hysterectomy and node dissection (RRHND, n = 9), total laparoscopic hysterectomy (TLH, n = 274), laparoscopy assisted vaginal hysterectomy (LAVH, n = 238), laparoscopic radical hysterectomy and node dissection (n = 11), and abdominal radical hysterectomy (ARH, n = 63). The characteristics and outcomes of each groups were compared. Results There was no difference in the characteristics of patients between 6 groups. In total of 604 hysterectomies, 3 evisceration (0.49%) and 21 dehiscences (3.47%) occurred. Evisceration were found in RRHND (1/9, 11.1%), TLH (1/276, 0.36%), and ARH (1/63, 1.56%). Dehiscences occurred in TLH (15/274, 5.42%), LAVH (4/238, 1.68%), and ARH (2/63, 3.17%). In 169 cases of TLH with intra-corporeal continuous suture, 1 evisceration and 4 dehiscences occurred, whereas 11 dehiscences occurred in 105 TLH cases with vaginal continuous locking suture (2.96% vs. 10.47%, P = 0.02). Conclusion The incidence of vaginal cuff dehiscenceand eviscerationwas significantly higher in TLH than LAVH. The intra-corporeal cuff suture was superior to the vaginal suture to prevent the vaginal cuff complications in TLH. PMID:24678487

Kim, Myung Ji; Kim, Seongmin; Bae, Hyo Sook; Lee, Jae Kwan; Lee, Nak Woo

2014-01-01

73

Laparoscopic management of recurrent vesicovaginal fistula.  

PubMed

Vesicovaginal fistula repair is most commonly undertaken via a transvaginal approach. We report a recurrent case of vesicovaginal fistula which was ultimately repaired using a laparoscopic approach. The fistula followed a hysterectomy and persisted despite two operations using the Latzko partial colpocleisis and prolonged catheterization. The fistulous tract was ultimately repaired by closing the vagina and bladder with an interposing omental flap utilizing a laparoscopic approach. PMID:10384974

Miklos, J R; Sobolewski, C; Lucente, V

1999-01-01

74

Robot-assisted versus conventional laparoscopic fundoplication: short-term outcome of a pilot randomized controlled trial  

Microsoft Academic Search

Background  Robotic technology represents the latest development in minimally-invasive surgery. Nevertheless, robotic-assisted surgery\\u000a seems to have specific disadvantages such as an increase in costs and prolongation of operative time. A general clinical implementation\\u000a of the technique would only be justified if a relevant improvement in outcome could be demonstrated. This is also true for\\u000a laparoscopic fundoplication. The present study was designed

B. P. Müller-Stich; M. A. Reiter; M. N. Wente; V. V. Bintintan; J. Köninger; M. W. Büchler; C. N. Gutt

2007-01-01

75

Hysterectomy surgery trends: a more accurate depiction of the last decade?  

PubMed Central

Objective To describe trends in hysterectomy route at a large tertiary center Study Design We reviewed all hysterectomies performed at Magee-Womens Hospital from 2000–2010. This database was chosen over larger national surveys as it has been tracking laparoscopic procedures since 2000, well before laparoscopic hysterectomy ICD-9 codes were developed. Results There were 13,973 patients included who underwent hysterectomy at Magee-Womens Hospital. In 2000, 3.3% were laparoscopic (LH), 74.5% abdominal (AH), and 22.2% vaginal (VH). By 2010, LH represented 43.5%, AH 36.3%, VH 17.2%, and 3.0% laparoscopic converted to open (LH?AH). Hysterectomies performed for gynecologic malignancy represented 24.4% of cases. The average length of stay for benign LH and VH, 1.0±1.0 and 1.6±1.0 days respectively, was significantly shorter than the average 3.1±2.3 day stay associated with AH (p<.001). Average patient age was 46.9±10.9 for LH, 51.5±12.1 for AH, and 51.7±14.1 for VH, and over the study period there was a significant trend of increasing patient age b1=0.517, 0.583, and 0.513 respectively (p<.001 for all). Conclusions The percentage of LH increased over the last decade, and by 2010 had surpassed AH. The 43.4% LH rate in 2010 is much higher than previously reported in national surveys. This is likely due to an increase in the number of laparoscopic procedures being performed over the last few years as well as the ability of our study to capture LH prior to development of appropriate ICD-9 codes. Our unique ability to determine hysterectomy route, which predates appropriate coding, may provide a more accurate characterization of hysterectomy trends. PMID:23333543

Turner, Lindsay C; Shepherd, Jonathan P; Wang, Li; Bunker, Clareann H; Lowder, Jerry

2013-01-01

76

Energy sources for laparoscopic colectomy: a prospective randomized comparison of conventional electrosurgery, bipolar computer-controlled electrosurgery and ultrasonic dissection. Operative outcome and costs analysis.  

PubMed

The development of operative laparoscopic surgery is linked to advances in ancillary surgical instrumentation. Ultrasonic energy devices avoid the use of electricity and provide effective control of small- to medium-sized vessels. Bipolar computer-controlled electrosurgical technology eliminates the disadvantages of electrical energy, and a mechanical blade adds a cutting action. This instrument can provide effective hemostasis of large vessels up to 7 mm. Such devices significantly increase the cost of laparoscopic procedures, however, and the amount of evidence-based information on this topic is surprisingly scarce. This study compared the effectiveness of three different energy sources on the laparoscopic performance of a left colectomy. The trial included 38 nonselected patients with a disease of the colon requiring an elective segmental left-sided colon resection. Patients were preoperatively randomized into three groups. Group I had electrosurgery; vascular dissection was performed entirely with an electrosurgery generator, and vessels were controlled with clips. Group II underwent computer-controlled bipolar electrosurgery; vascular and mesocolon section was completed by using the 10-mm Ligasure device alone. In group III, 5-mm ultrasonic shears (Harmonic Scalpel) were used for bowel dissection, vascular pedicle dissection, and mesocolon transection. The mesenteric vessel pedicle was controlled with an endostapler. Demographics (age, sex, body mass index, comorbidity, previous surgery and diagnoses requiring surgery) were recorded, as were surgical details (operative time, conversion, blood loss), additional disposable instruments (number of trocars, EndoGIA charges, and clip appliers), and clinical outcome. Intraoperative economic costs were also evaluated. End points of the trial were operative time and intraoperative blood loss, and an intention-to-treat principle was followed. The three groups were well matched for demographic and pathologic features. Surgical time was significantly longer in patients operated on with conventional electrosurgery vs the Harmonic Scalpel or computed-based bipolar energy devices. This finding correlated with a significant reduction in intraoperative blood loss. Conversion to other endoscopic techniques was more frequent in Group I; however, conversion to open surgery was similar in all three groups. No intraoperative accident related to the use of the specific device was observed in any group. Immediate outcome was similar in the three groups, without differences in morbidity, mortality, or hospital stay. Analysis of operative costs showed no significant differences between the three groups. High-energy power sources specifically adapted for endoscopic surgery reduce operative time and blood loss and may be considered cost-effective when left colectomy is used as a model. PMID:16424955

Targarona, Eduardo Ma; Balague, Carmen; Marin, Juan; Neto, Rene Berindoague; Martinez, Carmen; Garriga, Jordi; Trias, Manuel

2005-12-01

77

Conventionalism  

E-print Network

Certain fundamental philosophical disputes, in contrast to disputes in the empirical sciences, are characterized by the persistence of disagreement. This has led some to endorse conventionalism, the view that the 'facts ...

Einheuser, Iris, 1969-

2003-01-01

78

The First Laparoscopic Cholecystectomy  

PubMed Central

Prof Dr Med Erich Mühe of Böblingen, Germany, performed the first laparoscopic cholecystectomy on September 12, 1985. The German Surgical Society rejected Mühe in 1986 after he reported that he had performed the first laparoscopic cholecystectomy, yet in 1992 he received their highest award, the German Surgical Society Anniversary Award. In 1990 in Atlanta, at the Society of American Gastrointestinal Surgeons (SAGES) Convention, Perissat, Berci, Cuschieri, Dubois, and Mouret were recognized by SAGES for performing early laparoscopic cholecystectomies, but Mühe was not. However, in 1999 he was recognized by SAGES for having performed the first laparoscopic cholecystectomy–sAGES invited Mühe to present the Storz Lecture. In Mühe's presentation, titled “The First Laparoscopic Cholecystectomy,” which he gave in March 1999 in San Antonio, Texas, he described the first procedure. Finally, Mühe had received the worldwide acclaim that he deserved for his pioneering work. One purpose of this article is to trace the development of the basic instruments used in laparoscopic cholecystectomy. The other purpose is to give Mühe the recognition he deserves for being the developer of the laparoscopic cholecystectomy procedure. PMID:11304004

2001-01-01

79

Effects of Laparoscopic and Conventional (Open) Cholecystectomy on Human Leukocyte Antigen-DR Expression in Peripheral Blood Monocytes: Correlations with Immunologic StatusRID=\\  

Microsoft Academic Search

. It is well known that surgery\\u000a \\u000a significantly decreases immune responses. Laparoscopic cholecystectomy\\u000a \\u000a (LC) is a “miniinvasive” surgical procedure; and on the basis of\\u000a \\u000a this consideration we have investigated if and how the immune response\\u000a \\u000a is modified in patients after laparoscopic cholecystectomy compared to\\u000a \\u000a patients who underwent open cholecystectomy. Immune activity\\u000a \\u000a [neutrophils, total lymphocytes count, lymphocytes subpopulations,\\u000a \\u000a human leukocyte antigen-DR

Francesco Carlei; Mario Schietroma; Giovanni Cianca; Alberto Risetti; Sandro Mattucci; Gerard Ngome Enang; Mario Simi

1999-01-01

80

SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy  

PubMed Central

Superior mesenteric artery (SMA) syndrome is a mechanical duodenal obstruction by the SMA. The traditional approach to SMA syndrome was open bypass surgery. Nowadays, a conventional approach has been replaced by laparoscopic surgery. But single incision laparoscopic approach for SMA syndrome is rare. Herein, we report the first case of SMA syndrome patient who was treated by single incision laparoscopic duodenojejunostomy. PMID:25210483

Kim, Sungsoo; Kim, Yoo Seok; Min, Young-Don

2014-01-01

81

Robot-Assisted Radical Hysterectomy for Cervical Cancer: Review of Surgical and Oncological Outcomes  

PubMed Central

Robot-assisted procedures are being increasingly incorporated in gynaecologic oncology. Several studies have confirmed the feasibility and safety of robotic radical hysterectomy for selected patients with early-stage cervical cancer. It has been demonstrated that robotic radical hysterectomy offers an advantage over other surgical approaches with regard to operative time, blood loss, and hospital stay. Also initial evidences concerning oncological outcomes seem to confirm the equivalence to traditional open technique. Despite the fact that costs of robotic system are still high, they could be partially offset by several health-related and social benefits: less pain, faster dismissal, and return to full activity than other surgical approaches. The development of robotic technology may facilitate the spread of minimally invasive surgery in gynaecological oncology, overcoming some drawbacks of laparoscopic technique for challenging intervention such as radical hysterectomy. Further studies are needed to evaluate overall and disease-free survival of this technique and associated morbidity after adjuvant therapies. PMID:22111022

Renato, Seracchioli; Mohamed, Mabrouk; Serena, Solfrini; Giulia, Montanari; Giulia, Ferrini; Giulia, Giovanardi; Diego, Raimondo; Riccardo, Schiavina

2011-01-01

82

Stress response to laparoscopic liver resection  

PubMed Central

Background: The magnitude of the systemic response is proportional to the degree of surgical trauma. Much has been reported in the literature comparing metabolic and immune responses, analgesia use, or length of hospital stay between laparoscopic and open procedures. In particular, metabolic and immune responses are represented by measuring various chemical mediators as stress responses. Laparoscopic procedures are associated with reduced operative trauma compared with open procedures, resulting in lower systemic response. As a result, laparoscopic procedures are now well accepted for both benign and malignant processes. Laparoscopic liver resection, specifically, is employed for symptomatic and some malignant tumors, following improvements in diagnostic accuracy, laparoscopic devices, and techniques. However, laparoscopic liver resection is still controversial in malignant disease because of complex anatomy, the technical difficulty of the procedure, and questionable indications. There are few reports describing the stress responses associated with laparoscopic liver resection, even though many studies reviewing stress responses have been performed recently in both humans and animal models comparing laparoscopic to conventional open surgery. Although this review examines stress response after laparoscopic liver resection in both an animal and human clinical model, further controlled randomized studies with additional investigations of immunologic parameters are needed to demonstrate the consequences of either minimally invasive surgery or open procedures on perioperative or postoperative stress responses for laparoscopic liver resection. PMID:18333082

Ueda, Kazuki; Turner, Patricia

2004-01-01

83

COMPARATIVE OUTCOMES OF OPEN VERSUS LAPAROSCOPIC SACROCOLPOPEXY AMONG MEDICARE BENEFICIARIES  

PubMed Central

Introduction Since the first reported laparoscopic sacrocolpopexy in 1991, a limited number of single-center studies have attempted to assess the procedure’s effectiveness and safety. Therefore, we analyzed a national Medicare database to compare real-world short-term outcomes of open and laparoscopic-assisted (including robotic) sacrocolpopexy on a United States sample of patients. Methods Public Use File data for a 5% random national sample of all Medicare beneficiaries age 65 and older were obtained from the Centers for Medicare and Medicaid Services for years 2004–2008. Women with pelvic organ prolapse were identified using ICD-9 diagnosis codes. CPT-4 procedure codes were used to identify women who underwent open (code 57280) or laparoscopic (code 57425) sacrocolpopexy. Individual subjects were followed for one year post-operatively. Outcomes measured, using ICD-9 and CPT-4 codes, included medical and surgical complications and re-treatment rates. Results 794 women underwent open and 176 underwent laparoscopic sacrocolpopexy. Laparoscopic sacrocolpopexy was associated with a significantly increased rate of re-operation for anterior vaginal wall prolapse (3.4% vs. 1.0%, p = 0.018). However, more medical (primarily cardiopulmonary) complications occurred post-operatively in the open group (31.5% vs. 22.7%, p = 0.023). When sacrocolpopexy was performed with concomitant hysterectomy, mesh-related complications were significantly higher in the laparoscopic group (5.4% vs. 0%, p = 0.026). Conclusion Laparoscopic sacrocolpopexy resulted in increased rate of reoperation for prolapse in anterior compartment. When hysterectomy was performed at the time of sacrocolpopexy, the laparoscopic approach was associated with an increased risk of mesh-related complications. PMID:23652338

Khan, Aqsa; Alperin, Marianna; Wu, Ning; Clemens, J. Quentin; Dubina, Emily; Pashos, Chris L.; Anger, Jennifer T.

2014-01-01

84

Indications and alternatives to hysterectomy.  

PubMed

Hysterectomy remains one the most common procedures performed in North America. Because of a better understanding of a wide array of disease states and with emerging, more focused minimally invasive treatment options, a relative decline has been documented in the last several years. Although hysterectomy will ultimately eliminate all potential sources of abnormal uterine bleeding, various pharmacologic and surgical alternatives exist that may provide comparable benefit to the majority of women, especially if older than 40 years. Women experiencing chronic pelvic pain; however, should be counseled against hysterectomy until a more clear etiology has been identified. PMID:24488051

Solnik, M Jonathan; Munro, Malcolm G

2014-03-01

85

A Comparative Study of Fast-Track Verus Conventional Surgery in Patients Undergoing Laparoscopic Radical Cystectomy and Ileal Conduit Diversion: Chinese Experience  

PubMed Central

Fast-track surgery (FTS), which combines various techniques with evidence-based adjustments, is aimed to reduce postoperative morbidity, attenuate surgical stress response, thereby accelerating recovery and shorting length of stay. To further investigate the effectiveness of fast-track surgery, we compared the short-term outcomes of laparoscopic radical cystectomy and ileal conduit diversion for Chinese bladder cancer patients with FTS or with CS in our hospital. Patients with bladder cancer were included and divided into two consecutive groups: CS group and FTS group. Duration to first flatus and regular diet, postoperative hospital days, hospital expense, incidence of complications and postoperative surgical stress response were compared. There was no significant difference between the two groups in age, sex, BMI and postoperative TNM classification. Compared with the CS group, the FTS group had significantly shorter duration to first flatus, time to regular diet, postoperative hospital days and hospital expense, less complications, lower white blood count (WBC) and serum of C-reactive protein (CRP) on postoperative day 5 and 7. Our study indicates that FTS program is safe and efficacious for Chinese patients undergoing laparoscopic radical cystectomy and ileal conduit diversion. It can accelerate recovery, reduce stress action, shorten postoperative hospitals days and reduce hospital expenses. PMID:25352195

Guan, Xiao; Liu, Longfei; Lei, Xiang; Zu, Xiongbing; Li, Yuan; Chen, Mingfen; Wang, Long; Qi, Lin

2014-01-01

86

A comparative study of fast-track verus conventional surgery in patients undergoing laparoscopic radical cystectomy and ileal conduit diversion: chinese experience.  

PubMed

Fast-track surgery (FTS), which combines various techniques with evidence-based adjustments, is aimed to reduce postoperative morbidity, attenuate surgical stress response, thereby accelerating recovery and shorting length of stay. To further investigate the effectiveness of fast-track surgery, we compared the short-term outcomes of laparoscopic radical cystectomy and ileal conduit diversion for Chinese bladder cancer patients with FTS or with CS in our hospital. Patients with bladder cancer were included and divided into two consecutive groups: CS group and FTS group. Duration to first flatus and regular diet, postoperative hospital days, hospital expense, incidence of complications and postoperative surgical stress response were compared. There was no significant difference between the two groups in age, sex, BMI and postoperative TNM classification. Compared with the CS group, the FTS group had significantly shorter duration to first flatus, time to regular diet, postoperative hospital days and hospital expense, less complications, lower white blood count (WBC) and serum of C-reactive protein (CRP) on postoperative day 5 and 7. Our study indicates that FTS program is safe and efficacious for Chinese patients undergoing laparoscopic radical cystectomy and ileal conduit diversion. It can accelerate recovery, reduce stress action, shorten postoperative hospitals days and reduce hospital expenses. PMID:25352195

Guan, Xiao; Liu, Longfei; Lei, Xiang; Zu, Xiongbing; Li, Yuan; Chen, Mingfen; Wang, Long; Qi, Lin

2014-01-01

87

Infection After Hysterectomy  

PubMed Central

Antibiotic prophylaxis and advances in technology have reduced operative site infections after hysterectomy to a minimum. Pelvic infections are the most common infection type and respond promptly to a variety of parenteral single-agent and combination antibiotic regimens. Oral antibiotic regimens following parenteral therapy are unnecessary. Abdominal incision infections are less common than pelvic infections, less common than seromas or hematomas, and usually do not require antimicrobial therapy. Abscesses or infected hematomas require parenteral antimicrobial therapy, and drainage of those located above the cuff will predictably shorten therapy time. With early discharge from the hospital, many infections will not become evident until after the patient is home. For that reason, it is important that the patient's discharge instructions outline symptoms and signs associated with these infections so she can present for care at the earliest possible time. PMID:18476134

1997-01-01

88

Hysterectomy versus hysterectomy plus oophorectomy for premenopausal women.  

PubMed

Background Prophylactic oophorectomy alongside hysterectomy in premenopausal women is a common procedure. The decision to remove or conserve the ovaries is often based on the perceived risk for ovarian cancer and the need for additional gynaecological surgical interventions,and is weighed against the perceived risk of negative health effects caused by surgically induced menopause. The evidence needed to recommend either prophylactic bilateral oophorectomy or conservation of ovaries at the time of hysterectomy in premenopausal women is limited. This is an update of the original version of this systematic review published in 2008.Objectives To compare hysterectomy alone versus hysterectomy plus bilateral oophorectomy in women with benign gynaecological conditions,with respect to rates of mortality or subsequent gynaecological surgical interventions.Search methods We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (December 2005 to January 2014) and the following electronic databases: CENTRAL (The Cochrane Library 2013, Issue 12), MEDLINE (January 1966 to January 2014),EMBASE (January 1985 to January 2014), and PsycINFO (1806 to January 2014).Selection criteria Randomised controlled trials (RCTs) of hysterectomy alone versus hysterectomy with bilateral oophorectomy in premenopausal women with benign gynaecological conditions were eligible. Any surgical approach could be used.Data collection and analysis Three review authors independently assessed trials for inclusion. Study authors were contacted if information was unclear.Main results Only one RCT comparing the benefits and risks of hysterectomy with or without oophorectomy was identified. The results of this pilot RCT have not been published and we have not been able to obtain the results. Therefore, no data could be included in this review. Authors' conclusions The conclusions of this review are limited by a lack of RCTs. Although no evidence is available from RCTs, there is growing evidence from observational studies that surgical menopause may impact negatively on cardiovascular health and all cause mortality. PMID:25101365

Orozco, Leonardo J; Tristan, Mario; Vreugdenhil, Maria M T; Salazar, Arturo

2014-01-01

89

Prevention and management of hysterectomy complications.  

PubMed

Hysterectomy is the most common gynecologic surgical procedure performed in the United States. Although most hysterectomies proceed without incident, complications with serious consequences may occur. This chapter reviews the incidence, predisposing factors, intraoperative risk, diagnosis, and management and prevention of complications of hysterectomy. These include hemorrhage, infection, thromboembolism, injury to viscera, and neuropathy. The prepared surgeon is familiar with anatomy, surgical risk factors, current recommendations for prophylaxis and prevention, as well as modern management of complications of hysterectomy. PMID:24488052

Hodges, Kelly R; Davis, Beth R; Swaim, Laurie S

2014-03-01

90

Laparoscopic appendectomy  

NASA Astrophysics Data System (ADS)

The accurate and timely diagnosis of acute appendicitis remains a difficult clinical dilemma. Misdiagnosis rates of up to 40% are not unusual. Laparoscopic appendectomy provides a definitive diagnosis and an excellent method for routine removal of the appendix with very low morbidity and patient discomfort.

Richards, Kent F.; Christensen, Brent J.

1991-07-01

91

Entry Complications in Laparoscopic Surgery  

PubMed Central

To review the complications associated with laparoscopic surgery and provide clinical direction regarding the best practice based on the best available evidence. The laparoscopic entry techniques and technologies reviewed include the classic pneumoperitoneum (Veress/trocar), the open (Hasson), the direct trocar insertion, the use of disposable shielded trocars, radially expanding trocars and visual entry systems. Medline, Pubmed and Cochrane Databases were searched for English language articles published before December 2008. It is an evidence based fact that minimal access surgery is superior to conventional open surgery since this is beneficial to the women, community and the healthcare system.Over the past 50 years, many techniques, technologies and guidelines have been introduced to eliminate the risks associated with laparoscopic entry. No single technique or instrument has been proved to eliminate laparoscopic entry associated injury. Proper evaluation of the women, supported by surgical skills and good knowledge of the technology and instrumentation is the keystone to safe access and prevention of complications during laparoscopic surgery. PMID:22442503

Krishnakumar, S; Tambe, P

2009-01-01

92

Total Microlaparoscopic Radical Hysterectomy in Early Cervical Cancer  

PubMed Central

Background and Objective: In less than 2 decades, laparoscopy has contributed to modification in the management of early cervical cancer patients, and all comparisons between open and laparoscopic-based radical operations showed an identical oncological outcome. The aim of this study is to describe surgical instrumentations and technique to perform total microlaparoscopy radical hysterectomy in early cervical cancer patients and report our preliminary results in terms of operative time and perioperative outcomes. Methods: Between January 1, 2012, and March 25, 2012, 4 consecutive early cervical cancer patients were enrolled in this study. Results: We performed 3 type B2 and 1 type C1-B2 total microlaparoscopy radical hysterectomy, and in all cases concomitant bilateral salpingo-oophorectomy and pelvic lymphadenectomy were carried out. Median operative time was 165 minutes (range: 155 to 215) (mean: 186), and median estimated blood loss was 30 mL (range: 20 to 50). Median number of pelvic lymph nodes removed was 12 (range: 11 to 15). All procedures were completed without 5-mm port insertion and without conversion. No intraoperative or early postoperative complications were reported. Conclusions: This report suggests a role of microlaparoscopy in the surgical management of early cervical cancer with adequate oncological results, superimposable operative time, and perioperative outcomes with respect to standard laparoscopy. PMID:23743381

Gallotta, Valerio; Fagotti, Anna; Rossitto, Cristiano; Piovano, Elisa; Scambia, Giovanni

2013-01-01

93

Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution  

Microsoft Academic Search

Background: Laparoscopic surgery has been used increasingly as a less invasive alternative to conventional open surgery. Recently, laparoscopic therapy for pancreatic diseases has made significant strides. The current investigation studied pancreatic resection by laparoscopy. The objective of this study was to assess the feasibility, safety, and outcome of laparoscopic pancreatic major resection for benign and malignant lesions of the pancreas.

J. L. Dulucq; P. Wintringer; C. Stabilini; T. Feryn; J. Perissat; A. Mahajna

2005-01-01

94

Laparoscopic gastric banding  

MedlinePLUS

Lap-Band; LAGB; Laparoscopic adjustable gastric banding; Bariatric surgery - laparoscopic gastric banding ... J, Welch G, Zagarins S, Kuhn J, Romanelli J. Bariatric surgery for the treatment of morbid obesity: a meta- ...

95

Laparoscopic Radical Nephrectomy  

Microsoft Academic Search

Laparoscopic radical nephrectomy has gained in popularity as an accepted treatment modality for localized renal cell carcinoma at many centers worldwide. Laparoscopic radical nephrectomy may be performed via a transperitoneal or retroperitoneal approach. Mostly, the transperitoneal approach is used. Current indications for laparoscopic radical nephrectomy include patients with T1–T3aN0M0 renal tumors. Herein, transperitoneal as well as retroperitoneal laparoscopic approaches are

James D. D. Allan; David A. Tolley; Jihad H. Kaouk; Andrew C. Novick; Inderbir S. Gill

2001-01-01

96

Past, Present, and Future of Hysterectomy  

Microsoft Academic Search

Until the late 1930s, the standard type of abdominal hysterectomy was subtotal, leaving the cervix behind to decrease the risk of peritonitis with its attendant high mortality. With the discovery of antibiotics, careful attention to antisepsis, and other medical and surgical advances, this method was gradually replaced by total abdominal hysterectomy in the United States and the United Kingdom, although

Chris Sutton

2010-01-01

97

[Robotic assisted laparoscopic colposacropexy in the treatment of pelvic organ prolapse].  

PubMed

Laparoscopic colposacropexy has become a substitute for open surgery in the treatment of pelvic organ prolapse. In the same way, robotic assisted surgery is a new step in the evolution of the procedure. In this paper we intend to show our surgical technique and preliminary results. From November 2006 to date, 10 patients have undergone this procedure at the Hospital Clinico San Carlos. The main indication for the operation was existence of symptomatic pelvic prolapse. Both patients with or without hysterectomy have been operated, without making significant differences between them. Preoperative evaluation workout included: cystogram, urinary tract ultrasound and urodynamics in all cases; urinary tract MRI was performed only in selected cases. All patients underwent surgery under general anesthesia, with at least three robotic trocars (8 mm) and one conventional trocar for the assistant; 2 accessory trocars were necessary in some cases, mainly at the beginning of the series. Most procedures in our series were associated with a transobturator suburethral sling for the treatment of stress urinary incontinence or prevention of its appearance after prolapse repair. Our results are comparable to those reported in other larger series in terms of operative time, hospital stay and early or late complications. Pending an evaluation on the long term with larger series, we can include robot assisted colposacropexy among the therapeutic options for symptomatic pelvic floor prolapse repair. PMID:17626540

Moreno Sierra, Jesús; Galante Romo, Isabel; Ortiz Oshiro, Elena; Núñez Mora, Carlos; Silmi Moyano, Angel

2007-05-01

98

Transient large urinoma following hysterectomy.  

PubMed

This case report describes the formation of a very large urinoma 1 day after vaginal surgery. A 59-year-old woman was diagnosed with a urinoma measuring 30.5 cm in length, 23 cm in the transverse plane and 12 cm in the anteroposterior dimension on day 1 after a vaginal hysterectomy and prolapse repair surgery. The urinoma resolved completely after trans-abdominal catheter drainage. This case demonstrates that even a large urinoma can initially be managed conservatively. Furthermore, it emphasizes the importance of the early detection and management of urinary tract injuries after vaginal surgery. PMID:24969026

Becuzzi, Nadine; Scherman, Samantha; Rane, Ajay

2014-12-01

99

Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy  

PubMed Central

Objectives To describe a novel dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and to evaluate its postoperative outcomes. Methods A total of 109 patients who underwent laparoscopic radical prostatectomy by a single surgeon were evaluated, including 44 patients with dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy, 20 patients with conventional intrafascial nerve-sparing laparoscopic radical prostatectomy and 45 patients with non-nerve-sparing laparoscopic radical prostatectomy. Functional outcomes were evaluated using a self-administered questionnaire (Expanded Prostate Cancer Index Composite). Continence was defined as zero to one security pad per day. Oncological outcomes were evaluated based on positive surgical margin. Results In the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group, the continence rate was 57%, 77% and 95% at 1, 3 and 12 months, respectively. The continence rate in the conventional intrafascial nerve-sparing laparoscopic radical prostatectomy group was 37%, 63% and 90%, and in the non-nerve-sparing laparoscopic radical prostatectomy group it was 23%, 57% and 82% at 1, 3, and 12 months, respectively. The dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group showed a significantly earlier recovery from incontinence compared with that in the conventional intrafascial nerve-sparing laparoscopic radical prostatectomy and non-nerve-sparing laparoscopic radical prostatectomy groups (log–rank test, P = 0.044 and P < 0.001). Similarly, the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group tended to show a more early recovery in relation to urinary function of the Expanded Prostate Cancer Index Composite. Regarding sexual function, there were no significant differences between the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and conventional intrafascial nerve-sparing laparoscopic radical prostatectomy groups. In pT2 patients, the positive surgical margin rate of the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group (11%) was similar to that of the other two groups (conventional intrafascial nerve-sparing laparoscopic radical prostatectomy 7%; non-nerve-sparing laparoscopic radical prostatectomy 11%). Conclusions The dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy technique provides early recovery from incontinence without adversely affecting the oncological outcome. PMID:23039276

Hoshi, Akio; Usui, Yukio; Shimizu, Yuuki; Tomonaga, Tetsuro; Kawakami, Masayoshi; Nakajima, Nobuyuki; Hanai, Kazuya; Nomoto, Takeshi; Terachi, Toshiro

2013-01-01

100

Laparoscopic repair of ventral / incisional hernias  

PubMed Central

Despite its significant prevalence, there is little in the way of evidence-based guidelines regarding the timing and method of repair of incisional hernias. To add to the above is the formidable rate of recurrence that has been seen with conventional tissue repairs of these hernias. With introduction of different prosthetic materials and laparoscopic technique, it was hoped that an improvement in the recurrence and complication rates would be realized. The increasing application of the laparoscopic technique across the world indicates that these goals might indeed be achieved. PMID:21187995

Chowbey, Pradeep K; Sharma, Anil; Mehrotra, Magan; Khullar, Rajesh; Soni, Vandana; Baijal, Manish

2006-01-01

101

[Laparoscopic appendectomy. The new standard?].  

PubMed

Since the introduction of laparoscopic appendectomy by Semm in 1983, the role of this minimally invasive surgical technique has been the focus of controversial discussion. Meta-analyses have identified its advantages as having significantly lower wound infection rates, less postoperative pain and earlier resumption of normal everyday activities. The disadvantages are higher rates of intra-abdominal abscesses, longer operating times and higher inpatient treatment costs. However, some of the advantages identified by meta-analyses have been called into question by the results obtained from research into aspects of care. These discrepancies are attributable to the different surgeons involved in the various studies. The results are greatly influenced by the qualifications and experience of the surgeons. Therefore conventional appendectomy using a right lower lateral McBurney incision should continue to be the gold standard. Surgeons who have extensive experience in the field of laparoscopic surgery can achieve better results with minimally invasive appendectomy than with open surgery. This also holds true for specific situations such as complicated appendicitis and for morbidly obese patients. However, the operating costs incurred for laparoscopic appendectomy are higher because it has been shown that removal of the appendix with a linear stapler is the most reliable method. PMID:19455285

Köckerling, F; Schug-Pass, C; Grund, S

2009-07-01

102

Hysterectomies and gender identity among Serbian women  

E-print Network

In this qualitative study, I explore the impact of national culture on the gender identity of Serbian women with hysterectomies, with special emphasis on traditional motherhood discourse and its implications for women who cannot bear children. More...

Sukovic, Masa

2009-05-15

103

LAPAROSCOPIC RETROPUBIC SIMPLE PROSTATECTOMY  

Microsoft Academic Search

Purpose:Open retropubic simple prostatectomy is occasionally performed for symptomatic, large volume benign prostatic hyperplasia. We describe the technique of laparoscopic simple retropubic prostatectomy.

RENÉ SOTELO; MASSIMILIANO SPALIVIERO; ALEJANDRO GARCIA-SEGUI; WALEED HASAN; JOHN NOVOA; MIHIR M. DESAI; JIHAD H. KAOUK; INDERBIR S. GILL

2005-01-01

104

[Robotics-assisted laparoscopic colorectal resection].  

PubMed

The value of laparoscopic surgery for rectal cancer is still controversially discussed. Robotics offers the opportunity to leave the limitations of conventional laparoscopy behind us. The three-dimensional visualization and the superior dexterity by wristed instruments should be particularly helpful in complex laparoscopic procedures in confined spaces such as the small pelvis. Colorectal resections using the Da Vinci® system are well established and becoming increasingly more standard procedures. Nerve-sparing total mesorectal excision in patients with rectal cancer, total mesocolic excision in patients with right-sided colon cancer and rectopexy in patients with pelvic floor insufficiency are the most promising indications. The prospective randomized ROLARR study has been evaluating the application of the Da Vinci® system in laparoscopic rectal cancer surgery since 2011. Besides the currently available clinical data the perioperative and intraoperative logistics and strategy will be presented in detail. PMID:23942962

Mann, B; Virakas, G; Blase, M; Soenmez, M

2013-08-01

105

A novel technique of uterine manipulation in laparoscopic pelvic oncosurgical procedures: "the uterine hitch technique".  

PubMed

Aim. To describe a new technique of uterine manipulation in laparoscopic management of pelvic cancers. Material and Methods. We used a novel uterine hitch technique in 23 patients from May 2008 to October 2008. These patients underwent pelvic oncologic surgery including laparoscopic radical hysterectomy (n = 7), laparoscopic anterior resection (n = 4), laparoscopic abdominoperineal resection (n = 3), laparoscopic posterior exenteration (n = 4), or laparoscopic anterior exenteration (n = 5). The uterus was hitched to the anterior abdominal.wall by either a single suture in the fundus or by sutures through the round ligaments. Results. The uterine hitch technique was successfully accomplished in all procedures. It was performed in less than 5 minutes in all cases. It obviated the need for vaginal manipulation. An extra port for retraction could be avoided. There were no intraoperative complications. Conclusion. A practical, cheap and reproducible method for uterine manipulation, during pelvic oncologic surgery is described. It improves the stability of the uterus and also obviates the need for keeping an additional assistant for vaginal manipulation in any of the procedures. PMID:22091356

Puntambekar, S P; Patil, A M; Rayate, N V; Puntambekar, S S; Sathe, R M; Kulkarni, M A

2010-01-01

106

Is There Additional Information from Laparoscopic Ultrasound in Tumor Staging?  

Microsoft Academic Search

Accurate preoperative staging of gastrointestinal malignancies is of major importance in the decision for adequate stage-related therapy. There is evidence that laparoscopy in combination with laparoscopic ultrasound is more accurate in the detection of intra-abdominal metastases than conventional preoperative imaging. Staging laparoscopy in combination with laparoscopic ultrasound is a minimally invasive technique that reveals intra-abdominal disseminated tumor spread and local

Beate Rau; Michael Hünerbein; Peter M. Schlag

2002-01-01

107

Laparoscopic total abdominal colectomy  

Microsoft Academic Search

The aim of this study was to prospectively assess the impact of laparoscopy upon the outcome of total abdominal colectomy (TAC). Specifically, patients underwent standard laparotomy with TAC and ileoproctostomy (TAC + IP), TAC and ileoanal reservoir (TAC + IAR), laparoscopically assisted TAC + IP (L-TAC + IP), or laparoscopically assisted TAC + IAR (L-TAC + IAR). Parameters studied included

Steven D. Wexner; Olaf B. Johansen; Juan J. Nogueras; David G. Jagelman

1992-01-01

108

Laparoscopic splenectomy in children  

Microsoft Academic Search

To determine the safety and efficiacy of laparoscopic splenectomy (LS) in children, a retrospective review of our preliminary experience using LS was compared to results in patients who previously underwent open splenectomy (OS). From July 1993 to January 1995, we performed eight LS procedures in six children with hereditary spherocytosis (HS) and two with immune thrombocytopenic purpura (ITP). Laparoscopic cholecystectomy

K. Yoshida; Y. Yamazaki; R. Mizuno; H. Yamadera; A. Hara; J. Yoshizawa; M. Kanai

1995-01-01

109

[Tubal pregnancy after a previous tubal ligation and hysterectomy].  

PubMed

This is a case report on extra-uterine pregnancy occurring several years after hysterectomy. The special aspect of this particular case is that years before hysterectomy the patient had been subjected to sterilization surgery with partial tubal resection. Such cases can be expected more often in future in view of today's liberal indications for hysterectomy and also for tubal sterilization. PMID:3845899

Beuthe, D; Wemken, K

1985-03-01

110

Cost analysis of myomectomy, hysterectomy, and uterine artery embolization  

Microsoft Academic Search

Objective: The purpose of this study was to compare inpatient hospital costs of different treatments of uterine fibroid tumors, including myomectomy, hysterectomy, and uterine artery embolization in a teaching hospital. Study Design: We reviewed the hospital database of 545 women with uterine fibroid tumors who were treated with abdominal myomectomy, total abdominal hysterectomy, vaginal hysterectomy, and uterine artery embolization between

Haya Al-Fozan; Joanne Dufort; Marilyn Kaplow; David Valenti; Togas Tulandi

2002-01-01

111

Acute phase response in laparoscopic and open colectomy in colon cancer  

Microsoft Academic Search

PURPOSE: All types of trauma to the organism produce a systemic response that is proportional to the severity of the lesion caused. The more rapid clinical recovery during the postoperative period of patients undergoing laparoscopic-assisted colectomyvs. patients receiving conventional surgery suggests that laparoscopic surgery produces less surgical trauma. The aim of this randomized, prospective study was to compare acute phase

Salvadora Delgado; Antonio M. Lacy; Xavier Filella; Antoni Castells; Juan C. García-Valdecasas; Josep M. Pique; Dulce Momblán; Josep Visa

2001-01-01

112

Intraoperative and Postoperative Outcome of Robot-Assisted and Traditional Laparoscopic Nissen Fundoplication  

Microsoft Academic Search

Background: Robotics has been proposed as a tool to improve laparoscopic Nissen fundoplication. However, a clear benefit of this technology for minimally invasive antireflux surgery has not been demonstrated. Materials and Methods: A retrospective review of a prospective database was used to compare the intraoperative and postoperative outcome of 137 patients who underwent conventional laparoscopic fundoplication (CLF) and 45 patients

G. Ceccarelli; A. Patriti; A. Biancafarina; A. Spaziani; A. Bartoli; R. Bellochi; L. Casciola

2009-01-01

113

[Hysterectomy of "necessity"--current evaluation].  

PubMed

Hysterectomy after caesarian section is a radical surgery intervention. The obstetricians take the decision as a last surgical attitude in major obstetrical emergency. We tried in this study to analyze the causes of post-caesarian section, because this surgical intervention is a mutilant one. In many cases this surgical intervention had been effectuated for abundant hemorrhage, uterine hypotonia, utero-placentar apoplexy. In some cases the intervention was indicated from the beginning of intervention. The clinic evolution after hysterectomy was a good one without major complications. PMID:14870541

Grigore, T; Ne?tianu, A; Novac, L; Ne?tianu, L; Popovici, C

2000-01-01

114

Fibroid after Hysterectomy: A Diagnostic Dilemma  

PubMed Central

Broad ligament fibroids are rare and often pose clinical diagnostic difficulties. We report a case of broad ligament fibroid in a woman after hysterectomy. The lady presented to us with continuous lower abdominal pain of seven months duration. Bimanual examination revealed a firm mass on the right side of the vaginal vault. Transvaginal sonogram and computed tomography scan was suggestive of possible parasitic leiomyoma or a broad ligament fibroid. Exploratory laparotomy and removal of the mass, followed by histological examination confirmed leiomyoma. Extra-uterine fibroid should be considered in the differential diagnosis of pelvic masses even in the post-hysterectomy state. PMID:25177605

Ghose, Seetesh; Samal, Sunita; Begum, Jasmina; Zabeen, Mariyam

2014-01-01

115

Designing an active motor skill learning platform with a robot-assisted laparoscopic trainer.  

PubMed

Laparoscopic Surgery poses significant complexity in hand-eye coordination to the surgeon. In order to improve their proficiency beyond the limited exposure in the operating theatre, surgeons need to practice on laparoscopic trainers. We have constructed a robotic laparoscopic trainer with identical degrees of freedom and range of motion as a conventional laparoscopic instrument. We hypothesize that active robotic assistance through a laparoscopic trainer improves training efficacy as compared to autonomous practice. In order to test the hypothesis, we have divided the subjects into two groups. The control group practiced on two laparoscopic tasks manually without feedback or supervision. The other group practiced on the same tasks with robotic assistance. Results from the robot-assisted group show that tool orientation (pitch and yaw joint motion) in the pointing task improved by more than 15%. PMID:22255346

Lee, Chun Siong; Yang, Liangjing; Yang, Tao; Chui, Chee Kong; Liu, Jiang; Huang, Weimin; Su, Yi; Chang, Stephen K Y

2011-01-01

116

Laparoscopic inguinal herniorrhaphy: appraisal of a cohort study  

PubMed Central

Objectives To assess the safety and effectiveness of individualized laparoscopic herniorrhaphy and to compare its intraoperative cost to that of the standard Bassini operation. Design An analytic cohort study. Setting A university teaching hospital. Patients One group of 158 patients underwent 167 laparoscopic herniorrhaphies for symptomatic groin hernias. The approach was transabdominal preperitoneal for the first 124 patients and totally preperitoneal for the last 34 patients. A second group of 50 patients underwent a conventional Bassini operation. Intervention Individualized laparoscopic inguinal herniorrhaphy or Bassini herniorrhaphy. Main Outcome Measures Complications and recurrences encountered in the laparoscopic group. Total operative time and intraoperative cost involved in both procedures. Analgesia required in each group during the first 2 postoperative days. Results Intra- and postoperative complications of the laparoscopic approach were not life threatening. The recurrence rate at a mean follow-up of 16.8 months was 1.2%. Total operative time was significantly (p < 0.001) longer in the laparoscopy group than in the Bassini group. Patients in the Bassini group took more parenteral analgesics than those in the laparoscopy group (p = 0.02), but there was no difference with respect to the number of times enteral analgesics were required (p = 0.32). Use of mesh and staples was more expensive than sutures alone inserted laparoscopically. The Bassini procedure was a less expensive procedure than laparoscopic herniorrhaphy. Conclusions The laparoscopic treatment of groin hernias is safe. The recurrence rate is low. Primary unilateral inguinal hernias could be adequately treated at a lesser cost by a standard approach. Bilateral, recurrent and femoral hernias could benefit from a laparoscopic approach. PMID:8640623

Dion, Yves-Marie

1996-01-01

117

Gallbladder Removal: Laparoscopic Method  

MedlinePLUS

... complications? Complications are rare but may include bleeding, infection and injury to the duct (tube) that carries bile from your gallbladder to your stomach. Also, during laparoscopic cholecystectomy, the intestines or major blood vessels may be ...

118

Laparoscopic Ureterocalicostomy: Initial Experience  

Microsoft Academic Search

PurposeUreterocalicostomy is a reconstructive option in the rare patient with surgically failed or difficult ureteropelvic junction (UPJ) obstruction with fibrosis and significant hydronephrosis. We introduce the technique of laparoscopic ureterocalicostomy.

INDERBIR S. GILL; EDWARD E. CHERULLO; ANDREW P. STEINBERG; MIHIR M. DESAI; SIDNEY C. ABREU; CHRISTOPHER NG; JIHAD H. KAOUK

2004-01-01

119

Laparoscopic refundoplication in children  

Microsoft Academic Search

Background: Gastroesophageal fundoplication currently is one of the three most common major operations performed on infants and children\\u000a by pediatric surgeons in the United States. With the advent of laparoscopic surgery, the number of gastroesophageal fundoplications\\u000a has virtually exploded. Morbidity always was substantial with this operation, and laparoscopy has not changed this. We describe\\u000a our results with laparoscopic refundoplication in

D. C. van der Zee; N. M. A. Bax; B. M. Ure

2000-01-01

120

Laparoscopic Management of Huge Ovarian Cysts  

PubMed Central

Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42?cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1–12 liters were drained from the cysts (mean 5.2?L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy. PMID:23766763

Alobaid, A.; Memon, A.; Alobaid, S.; Aldakhil, L.

2013-01-01

121

Robotic-assisted laparoscopic adrenalectomy  

Microsoft Academic Search

IntroductionRemote robotic telemanipulators have been recently used in performing laparoscopic urologic procedures, both in the laboratory and in clinical practice. We present, to our knowledge, the initial 2 cases of robotic-assisted laparoscopic adrenalectomy in humans.

Mihir M Desai; Inderbir S Gill; Jihad H Kaouk; Surena F Matin; Gyung Tak Sung; Emmanuel L Bravo

2002-01-01

122

Laparoscopic repair for groin hernias  

Microsoft Academic Search

Laparoscopic inguinal herniorrhaphy was first described by Ger, Schultz, Corbitt, and Filipi in the early 1990s (1-4) and burst upon the surgical scene just after laparoscopic cholecystectomy. It rapidly became popular, and many different techniques for repair were developed. Over the last decade much good work has been done to find which type of laparoscopic repair is best, to determine

Chad J. Davis; Maurice E. Arregui

123

Recovery after uncomplicated laparoscopic cholecystectomy  

Microsoft Academic Search

Background. After laparoscopic cholecystectomy, the duration of convalescence is 2 to 3 weeks with an unclear pathogenesis. This study was undertaken to analyze postoperative recovery after uncomplicated elective laparoscopic cholecystectomy. Methods. Twenty-four consecutive unselected employed patients were followed up prospectively from 1 week before to 1 week after outpatient laparoscopic cholecystectomy. Daily computerized monitoring of physical motor activity and sleep

Thue Bisgaard; Birthe Klarskov; Henrik Kehlet; Jacob Rosenberg

2002-01-01

124

Complex organ injuries after mid-trimester termination of pregnancy: pushing boundaries in laparoscopic management.  

PubMed

Surgical termination of pregnancy is one of the most often performed gynecologic procedures in the United Kingdom and worldwide. Although complications are rare, they can be devastating because they include hemorrhage and pelvic organ damage often necessitating hysterectomy. Traditionally, these complications have been managed via laparotomy; however, with increasing technological advances and surgical expertise, it is now possible to manage extreme complications of these procedures via operative laparoscopy. Herein is reported successful laparoscopic management of 3 cases of complex uterine perforation in young women after mid-trimester surgical termination of pregnancy. PMID:24183279

Lawin-O'Brien, Anna; Olowu, Ola; Shahid, Anupama; Odejinmi, Funlayo

2013-01-01

125

Single-port access laparoscopic staging operation for a borderline ovarian tumor  

PubMed Central

Minimally invasive surgery is widely used in benign gynecologic diseases and may be used in malignancies. We performed a single-port access laparoscopy staging - bilateral salpingo-oophorectomy, laparoscopy-assisted vaginal hysterectomy, bilateral pelvic lymphadenectomy, infracolic omentectomy, and washing cytology - in a borderline ovarian tumor. The number of harvested pelvic lymph nodes were twenty-three and there were no intraoperative or postoperative complications. Single-port access laparoscopic staging may be performed in selected patients. The efficacy, safety, and potential benefits of this technique should be evaluated in further trials. PMID:21860739

Yoon, Aera; Kim, Tae-Joong; Lee, Woo Seok; Kim, Byoung-Gie

2011-01-01

126

Risk Factors for Pelvic Floor Repair After Hysterectomy  

PubMed Central

Objective Having demonstrated that prior history of prolapse was a risk factor for pelvic floor repair procedures after hysterectomy, the objective of this study was to assess medical risk factors for pelvic floor repair after hysterectomy. Methods Using the Rochester Epidemiology Project database of 8,220 Olmsted County, Minnesota women who had hysterectomy for benign indications in 1965-2002, we conducted a nested case-control study in 144 pairs, comparing women who underwent pelvic floor repair after hysterectomy (cases) to controls matched for known risk factors (ie, age, pelvic floor disorders at baseline, year and type of hysterectomy, and pelvic floor repair during hysterectomy). Results The median duration between hysterectomy and pelvic floor repair was 13 years. Chronic pulmonary disease (odds ratio [OR] 14.3; 95% CI 1.2 to 178) but not obstetric history, obesity, indication for hysterectomy, or chronic constipation was associated with an increased risk of pelvic floor repair after hysterectomy. Between the hysterectomy and subsequent pelvic floor repair, overall pelvic organ prolapse severity changed by 1 grade or less in 54 cases (38%, Group A) but increased by 2 or more grades in 72 cases (50%, Group B). In Group A, but not Group B, uterine prolapse (OR 25; 95% CI 2.1 to 300) and chronic pulmonary disease (OR 22; 95% CI 1.5 to 328) at baseline remained risk factors for pelvic floor repair after hysterectomy. Conclusion In this matched case-control study, chronic pulmonary disease was the only risk factor for pelvic floor repair after hysterectomy for benign indications, underscoring the need to address pulmonary status prior to surgery. PMID:19300323

Blandon, Roberta E.; Bharucha, Adil E.; Melton, L. Joseph; Schleck, Cathy D.; Zinsmeister, Alan R.; Gebhart, John B.

2009-01-01

127

Variation in NHS utilisation of vault cytology post-hysterectomy.  

E-print Network

??Hysterectomy is commonly performed but there is scant evidence concerning appropriate follow-up by vaginal vault cytology testing. This observational, retrospective cohort study, using routinely collected… (more)

Stokes-Lampard, Helen Jayne

2010-01-01

128

Socioeconomic indicators and hysterectomy status in the United States, 2004  

PubMed Central

Background Hysterectomy is one of the most common surgical procedures performed in the United States. The purpose of this study is to examine the association between socioeconomic indicators and hysterectomy. Study Design We performed a cross-sectional analysis of the 2004 Behavioral Risk Factor Surveillance Survey database. The effect of multiple socioeconomic exposures (education level, annual income, and employment status) on hysterectomy status was evaluated. Logistic regression was used to estimate odds ratios between the multiple exposures and the outcome of hysterectomy status. Results Our analytic sample included 180,982 women. Prior hysterectomy was reported by 26.4%. After adjusting for confounders, women who had not graduated from high school had 1.75 times higher odds (95% CI 1.68 to 1.83) of having a hysterectomy compared to women who were college graduates; and women with an annual household income of less than $15,000 had 1.06 times higher odds (95% CI 1.02 to 1.10) of having a hysterectomy compared to women who reported an income of greater than $50,000/year. Women who were unemployed did not have higher odds of having a hysterectomy than women who were employed. Conclusion Socioeconomic indicators of education level and income are associated with hysterectomy status, however employment status is not. PMID:19947032

Erekson, Elisabeth A.; Weitzen, Sherry; Sung, Vivian W.; Raker, Christina A.; Myers, Deborah L.

2010-01-01

129

Initial experience of single port laparoscopic totally extraperitoneal hernia repair: nearly-scarless inguinal hernia repair  

PubMed Central

Purpose In the early 1990's laparoscopic hernioplasty gained popularity worldwide. Thereafter, laparoscopic surgeons have attempted to improve cosmesis using single port surgery. This study aims to introduce and assess the safety and feasibility of single port laparoscopic total extraperitoneal (TEP) hernia repair with a nearly-scarless umbilical incision. Methods Sixty three single port laparoscopic TEP hernia repairs were performed in sixty patients from June 2010 to March 2011 at Incheon St. Mary's Hospital, with the use of a glove single-port device and standard laparoscopic instruments. Demographic and clinical data, intraoperative findings, and postoperative course were reviewed. Results Of the 63 hernias treated, 31 were right inguinal hernias, 26 were left inguinal hernias and 3 were both inguinal hernias. There was one conversion to conventional three port laparoscopic transabdominal preperitoneal hernioplasty. Mean operative time was 62 minutes (range, 32 to 150 minutes). There were no intraoperative complications. Postoperative complications occurred in two cases (wound seroma and urinary retension) and were successfully treated conservatively. Mean hospital stay was 2.15 days. Conclusion Single port laparoscopic TEP hernia repair is safe and feasible. Umbilical incision provides an excellent cosmetic outcome. Prospective randomized studies comparing single port and conventional three port laparoscopic TEP repairs with short-term outcome and long-term recurrence rate are needed for confirmation. PMID:22148127

Kim, Ji Hoon; Kim, Jin Jo; Lee, Yoon Suk

2011-01-01

130

[Laparoscopic adrenalectomy: our experience].  

PubMed

Since 2002 19 laparoscopic adrenalectomies with a lateral transperitoneal access have been performed at our Division of Surgery. Three patients had Conn's syndrome, 8 incidentaloma, 4 pheochromocytoma, 2 Cushing's syndrome, 1 metastases from a contralateral renal cancer and 1 metastases from lung cancer. The parameters considered for data analysis were: intra- and postoperative hypertensive crises, haemorrhage, subcutaneous emphysema, conversions, dura- tion of surgery, hospital stay, postoperative comfort, and canalisation and mobilisation times. The results obtained in our experience were comparable to those reported in the literature, confirming the reproducibility and feasibility of this type of surgical procedure. Comparison of the data obtained with laparoscopic, surgery and those obtained with traditional surgical treatment suggest that it is reasonable to claim that the laparoscopic approach is today the gold standard for adrenal surgery. PMID:17663364

Pantuso, Gianni; Grassi, Nello; Bottino, Alessandro; Cipolla, Calogero; Lo Iacono, Angelo; Cacace, Ermenegilda; Rizzo, Marta; Farinella, Eleonora

2007-01-01

131

Dextromethorphan and pain after total abdominal hysterectomy  

Microsoft Academic Search

Summary Dextromethorphan is an N-methyl-D-aspartate (NMDA) receptor antagonist which has been shown to inhibit the development of cutaneous secondary hyperalgesia after tissue trauma. We studied 60 ASA I-II patients undergoing total abdominal hysterectomy in a randomized, double-blind, placebo-controlled study. Patients received either dextromethorphan 27 mg cap- sules, two doses before operation and three doses in the first 24 h after

P. M. MCCONAGHY; P. MCSORLEY; W. MCCAUGHEY; W. I. CAMPBELL

1998-01-01

132

Cost Assessment of Instruments for Single-Incision Laparoscopic Cholecystectomy  

PubMed Central

Background and Objectives: Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed as conventional laparoscopic 4-port cholecystectomy or as single-incision laparoscopic cholecystectomy. Methods: Two consecutive series of patients undergoing single-incision laparoscopic cholecystectomy were assessed: (1) single-incision cholecystectomy using a commercially available multichannel port (n=80) and (2) a modified single-incision cholecystectomy using 2 regular trocars inserted through the umbilicus (n=20) with transabdominal sutures for gallbladder mobilization (puppeteering technique). Patients who underwent conventional 4-port cholecystectomy during the same time period (n=100) were selected as controls. Results: The instrumental cost of the single-incision cholecystectomy using a commercial port was significantly higher (median, $1123) than the cost for conventional 4-port (median $441, P < .0005) and modified single-incision cholecystectomy (median $342, P < .0005). The cost of the modified single-incision procedure was significantly lower than that for the 4-port cholecystectomy (P < .0005). Conclusion: The modified single-incision procedure using 2 regular ports inserted through the umbilicus can be performed at lower cost than conventional 4-port cholecystectomy. PMID:23318059

Al-Tayar, Haytham; Rosenberg, Jacob; Jorgensen, Lars Nannestad

2012-01-01

133

ROLE AND LONG-TERM RESULTS OF LAPAROSCOPIC DECORTICATION IN SOLITARY CYSTIC AND AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE  

Microsoft Academic Search

PurposeAccess to retroperitoneal structures via the laparoscope has become established for various conditions. This minimally invasive approach has distinct advantages over conventional open surgery. We document our experience with laparoscopic cyst decortication for diseases of the kidney, including simple and complex cysts, multiple cysts and autosomal dominant polycystic kidney disease.

BARRY J. LIFSON; JOEL M. H. TEICHMAN; JOHN C. HULBERT

1998-01-01

134

Laparoscopic intussuscepting pancreaticojejunostomy.  

PubMed

Perhaps the greatest barrier to adoption of laparoscopic pancreaticoduodenectomy by experienced pancreatic surgeons is the technical challenge of constructing the pancreaticojejunostomy (PJ). The authors present a less demanding PJ technique they have developed that creates an end-to-end intussuscepting anastomosis using a running monofilament suture. This method reduces technical complexity and operative time while producing acceptably comparable outcomes. PMID:23929187

Hughes, S J; Neichoy, B; Behrns, K E

2014-01-01

135

Laparoscopic Reconstructive Urology  

Microsoft Academic Search

PurposeAlthough laparoscopy has emerged as a feasible and effective alternative for a majority of open ablative abdominopelvic urological procedures, minimally invasive reconstruction has come to the forefront only recently. We present the current state of the art of laparoscopic reconstructive urology.

JIHAD H. KAOUK; INDERBIR S. GILL

2003-01-01

136

Laparoscopic retroperitoneal partial nephrectomy.  

PubMed

To our knowledge we report the initial case of laparoscopic partial nephrectomy performed completely via the retroperitoneal approach. The retroperitoneal space was developed by inflating a balloon. Renal parenchymal hemostasis was obtained by a newly designed double loop apparatus and the argon beam coagulator. Convalescence was rapid and no complications have been noted during a followup of 7 months. PMID:7933195

Gill, I S; Delworth, M G; Munch, L C

1994-11-01

137

Pediatric Laparoscopic Dismembered Pyeloplasty  

Microsoft Academic Search

We performed laparoscopic dismembered pyeloplasty in a boy with right ureteropelvic junction obstruction using 4 cannula sites, and a dismembering and reanastomosis technique identical to that used in open pyeloplasty. Interrupted sutures were placed and tied intracorporeally. A nephrostomy tube was placed under direct vision for drainage but no ureteral stent was used. Total operating time was 5 hours. The

Craig A. Peters; Richard N. Schlussel; Alan B. Retik

1995-01-01

138

[Laparoscopic appendectomy. Our experience].  

PubMed

The advantages and applications of the videolaparoscopic technique (VL) versus open surgery in the treatment of acute and complicated appendicitis are not well defined. Our study examined 150 patients, 67 males and 83 females. They underwent surgery for acute appendicitis in emergency. The choice between open or laparoscopic tecnique was due to patient's clinical conditions and surgeon's experience. Two of these patients had no infiammatory process. Eleven patients were affected by gynaecological diseases. The last 137 patients underwent surgery for acute appendicitis and the diagnosis was confirmed. Among them, 35 (25%) were affected by a complicated appendicitis with diffuse or clearly defined peritonitis. In 134 patients the surgery was completed laparoscopically. The conversion rate was 2%. Morbility rate was 3%, due to intra abdominal abscesses secondary to acute complicated appendicitis. The mean operative time was 76 min and the mean hospital stay was 4.8 days. The death rate was 0%. In our experience, laparoscopic appendectomy has significant advantages over traditional open surgery in both acute and complicated appendicitis, especially in young women. In this way, we can diagnose pelvic disease that could be characterized by the same symptoms of acute appendicitis, then we suggest laparoscopic appendectomy even just to complete the diagnostic iter. Laparoscopy is useful in terms of convalescence, postoperative pain, hospital stay, aesthetic outcome and an easier exploration of the peritoneal cavity. PMID:22595725

Pezzolla, Angela; Milella, Marialessia; Lattarulo, Serafina; Barile, Graziana; Pascazio, Bianca; Ialongo, Paolo; Fabiano, Gennaro; Palasciano, Nicola

2012-01-01

139

Laparoscopic surgery in pregnancy  

Microsoft Academic Search

A 32-year-old white lady suffering from tubal infertility was referred to our institution in November 1992 because of low abdominal pain due to a heterotopic pregnancy (one intrauterine sac and the other in the right tube). The patient had undergone, 8 weeks before, her second successful attempt at in vitro fertilization and embryo transfer. We decided to perform a laparoscopic

V. Remorgida; C. Carrer; A. Ferraiolo; M. Natucci; P. Anserini

1995-01-01

140

Laparoscopic inguinal herniorrhaphy.  

PubMed

Between Mar. 13 and Sept. 16, 1991, the authors performed 10 inguinal herniorrhaphies laparoscopically. Two patients with a type II hernia (indirect with dilated internal ring but intact posterior inguinal wall) had laparoscopic preperitoneal closure of the internal ring with interrupted 0-Prolene. Seven patients had a type IIIA hernia (direct), and one patient had a large type IIIB hernia (indirect with dilated internal ring and medial encroachment or destruction of transversalis fascia of Hesselbach triangle). They all underwent laparoscopic preperitoneal placement of Prolene mesh, which was fixed in place with interrupted 0-Prolene sutures. All patients recovered promptly, with less pain and minimal limping, resulting in high patient acceptance of the procedure. There were no complications. Although no recurrence was noted and the technique appears sound, it is too early to predict its long-term success. At present, the preperitoneal approach is difficult to perform because of lack of appropriate instrumentation. The surgeon who plans to perform such a procedure must be familiar with the anatomy. We suggest that every potential candidate for laparoscopic inguinal hernia repair should be apprised of the advantages and disadvantages of this approach. A research consent form should be read and signed by every patient. PMID:1532920

Dion, Y M; Morin, J

1992-04-01

141

Conversion to Stoppa Procedure in Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair  

PubMed Central

Background and Objectives: Conversion to open surgery is an important problem, especially during the learning curve of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. Methods: Here, we discuss conversion to the Stoppa procedure during laparoscopic TEP inguinal hernia repair. Outcomes of patients who underwent conversion to an open approach during laparoscopic TEP inguinal hernia repair between September 2004 and May 2010 were evaluated. Results: In total, 259 consecutive patients with 281 inguinal hernias underwent laparoscopic TEP inguinal hernia repair. Thirty-one hernia repairs (11%) were converted to open conventional surgical procedures. Twenty-eight of 31 laparoscopic TEP hernia repairs were converted to modified Stoppa procedures, because of technical difficulties. Three of these patients underwent Lichtenstein hernia repairs, because they had undergone previous surgeries. Conclusion: Stoppa is an easy and successful procedure used to solve problems during TEP hernia repair. The Lichtenstein procedure may be a suitable option in patients who have undergone previous operations, such as a radical prostatectomy. PMID:23477173

Dirican, Abuzer; Ozgor, Dincer; Gonultas, Fatih; Isik, Burak

2012-01-01

142

Single incision laparoscopic cholecystectomy (SILS) for a patient with situs inversus totalis  

PubMed Central

Laparoscopic surgery has become the gold standard for the surgical treatment of benign disorders of bile ducts, for example, symptomatic cholelithiasis. Nowadays, laparoscopic surgery is becoming less invasive by means of the advanced technologic capabilities. In this article, the authors present a 65-year-old patient with situs inversus totalis who was examined because of abdominal pain and dyspeptic symptoms. Ultrasonography and tomography revealed cholecystitis with gallstones (calculous cholecystitis), besides, it was observed that the liver and the gall bladder were on the left side and the heart, the stomach and the spleen were located on the right side of the patient. The patient was performed single incision laparoscopic cholecystectomy. The patient was discharged on the postoperative day 1. In the present article, the authors described how easily the single incision laparoscopic cholecystectomy could resolve the technical difficulties encountered in the patients with situs inversus totalis during the conventional laparoscopic surgery. PMID:22679325

Ozsoy, Mustafa; Haskaraca, Mehmet Fatih; Terzioglu, Alihan

2011-01-01

143

Laparoscopic vs . Hand-Assisted Laparoscopic Sigmoidectomy for Diverticulitis  

Microsoft Academic Search

Introduction Sigmoid colectomy for diverticulitis can be technically challenging because of severe inflammation in the left-lower quadrant and pelvis. We hypothesized that hand-assisted laparoscopic technique may facilitate laparoscopic completion of this surgery while retaining the short-term benefits associated with “pure” laparoscopic surgery, in which an incision is made only for extracting the specimen. This study was designed to compare the

Sang W. Lee; James Yoo; Nadav Dujovny; Toyooki Sonoda; Jeffrey W. Milsom

2006-01-01

144

Hysterectomy and Disability Among U.S. Women  

PubMed Central

CONTEXT Hysterectomies are the second most common surgery performed on women in the United States, and most are done for elective reasons. Although women with disabilities appear to have an increased risk of undergoing the procedure, little research has evaluated the relationship between disability and hysterectomy. METHODS Data on 42,842 women aged 18 or older from the 2000, 2005 and 2010 National Health Interview Surveys were used to evaluate the relationship between disability and the risk of having a hysterectomy over the life course. Piecewise exponential event history models were estimated to identify associations between timing of disability onset, type of disability, and the occurrence and timing of hysterectomy. RESULTS Women with multiple disabilities experienced a higher risk of undergoing a hysterectomy than women with no disability (hazard ratio, 1.3), and this heightened risk was concentrated at younger ages. During their 20s, 30s and early 40s, women who had multiple disabilities were more likely to have had a hysterectomy than their same-age counterparts with no or one disability (1.3–2.4). Women with a single type of disability, as well as most women who had multiple disabilities and were aged 46 or older, were not at increased risk of having had a hysterectomy. CONCLUSIONS Additional research is needed to investigate why young women with multiple disabilities appear to face an increased risk of having a hysterectomy, especially because it is major surgery that can carry significant health risks. PMID:24020777

Drew, Julia A. Rivera

2013-01-01

145

Therapeutic advances: Single incision laparoscopic hepatopancreatobiliary surgery  

PubMed Central

Single-port laparoscopic surgery (SPLS) is proposed to be a step towards minimizing the invasiveness of surgery, and has since gained popularity in several surgical sub-specialties including hepatopancreatobiliary surgery. SPLS has since been applied to cholecystectomy, liver resection as well as pancreatectomy for a multitude of pathologies. Benefits of SPLS over conventional multi-incision laparoscopic surgery include improved cosmesis and potentially post-operative pain at specific time periods and extra-umbilical sites. However, it is also associated with longer operating time, increased rate of complications, and increased rate of port-site hernia. There is no significant difference between length of hospital stay. SPLS has a significant learning curve that affects operating time, rate of conversion and rate of complications. In this article, we review the literature on SPLS in hepatobiliary surgery - cholecystectomy, hepatectomy and pancreatectomy, and offer tips on overcoming potential technical obstacles and minimizing the complications when performing SPLS - surgeon position, position of port and instruments, instrument crossing position, standard hand grip vs reverse hand grip, snooker cue guide position, prevention of incisional hernia. SPLS is a promising direction in laparoscopic surgery, and we recommend step-wise progression of applications of SPLS to various hepatopancreatobiliary surgeries to ensure safe adoption of the surgical technique. PMID:25339820

Chang, Stephen Kin Yong; Lee, Kai Yin

2014-01-01

146

[Errors and risks in oncologic laparoscopic surgery].  

PubMed

Oncological problems associated with laparoscopic colorectal surgery with curative intent include port site metastases, inadequate radicality, seeding of tumour cells through unprotected recovery of the surgical specimen, faulty surgical technique, and failure to observe the technical and/or oncological limitations applicable to certain tumour sites. Investigations so far reported reveal a preponderance of mechanical pathogenesis of port site metastases caused by the contamination of trocar entry ports by tumour cells borne on instruments, trocars and resected material. This suggests that appropriate precautionary measures could resolve the problem. It appears that the CO2 pneumoperitoneum plays only a minor role in the development of port site metastases. Owing to a lack of long-term data, the oncological radicality of laparosopic resections for colorectal carcinoma cannot be assessed; merely a few reports on the number of lymph nodes removed during such operations have been published. Nevertheless, it would appear that fewer lymph nodes were removed than with comparable conventional surgery. However, a more accurate analysis needs to take account of the fact that the indication for laparoscopic surgery is determined by the size and location of the tumour. The many potential pitfalls and hazards of oncological laparoscopic surgery make it mandatory that such interventions should be done only within the framework of prospective clinical studies covering limited indications. Randomized prospective studies to cover all tumour stages and sites cannot be recommended. PMID:9198562

Köckerling, F; Reymond, M A; Schneider, C; Hohenberger, W

1997-03-01

147

Insulation failure in laparoscopic instruments  

Microsoft Academic Search

Background  Electrosurgery is used in virtually every laparoscopic operation. In the early days of laparoscopic surgery, capacitive coupling,\\u000a associated with hybrid trocars, was thought to be the major cause of laparoscopic electrosurgery injuries. Modern laparoscopy\\u000a has reduced capacitive coupling, and now insulation failure is thought to be the main cause of electrosurgical complications.\\u000a The aim of this study was (1) to

Paul N. Montero; Thomas N. Robinson; John S. Weaver; Greg V. Stiegmann

2010-01-01

148

Laparoscopic Management of Large Myomas  

PubMed Central

The objective of this article is to review the different techniques that have been adopted for removal of large myomas laparoscopically. We have also quoted literature about the impact of myomas on Pregnancy and obstetrical outcome and the effect of laparoscopic myomectomy on the same. Technical modifications to remove large myomas have been described along with methods to reduce intraoperative bleeding. This comprehensive review describes all possibilities of laparoscopic myomectomy irrespective of size, site and number. PMID:22442517

Sinha, Rakesh; Sundaram, Meenakshi

2009-01-01

149

Variations in hysterectomy rates in Ontario: does the indication matter?  

PubMed Central

OBJECTIVES: To examine variations in rates of hysterectomy for the five main indications for the procedure in regions of Ontario. DESIGN: Cross-sectional population-based analysis of hospital discharge abstracts. SETTING: All acute care facilities in Ontario. PARTICIPANTS: All 65,599 women whose hospital record contained a procedure code indicating that a hysterectomy was performed between Apr. 1, 1988, and Mar. 31, 1991. Duplicate cases, records of cancelled procedures and nonresidents were excluded. MAIN OUTCOME MEASURES: Crude and age-adjusted rates of hysterectomy, by indication, for each region of Ontario. RESULTS: Five indications accounted for more than 80% of hysterectomies performed. The median age-adjusted rate of hysterectomy for Ontario regions during the study period was 6.25 per 1000 women, with a 2.7-fold variation among regions. The regions with rates of hysterectomy in the highest quartile tended to be rural, and those with rates in the lowest quartile tended to be urban areas with teaching hospitals. When rates of hysterectomy for specific indications were examined, they showed substantial variations among regions in the rate of the procedure for menstrual hemorrhage (18-fold variation), uterine prolapse (9.3-fold) and endometriosis (6.3-fold). A smaller but still significant variation was shown in the rate of hysterectomy for leiomyoma (2.3-fold). Regional variation in the rate of hysterectomy for cancer (2.5-fold) was not statistically significant. CONCLUSIONS: There are large interregional variations in rates of hysterectomy, especially for indications that are more discretionary than others (i.e., menstrual hemorrhage, uterine prolapse and endometriosis) and less variation in rates when treatment options and diagnosis are clear-cut. This result suggests the need for more definitive practice guidelines on treatment of the indications for which the rate is more variable. PMID:7994690

Hall, R E; Cohen, M M

1994-01-01

150

Assessment of cosmetic outcome after laparoscopic cholecystectomy among women 4 years after laparoscopic cholecystectomy: is there a problem?  

Microsoft Academic Search

Background  Advocates of single-port laparoscopic cholecystectomy (SPLC) claim that improved cosmetic outcome is one of its main benefits\\u000a over conventional laparoscopic cholecystectomy (CLC). However, the published data quantifying the cosmetic outcome after CLC\\u000a is sparse. This study aimed to determine the cosmetic outcome after CLC using a validated scar assessment tool.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The patient scar assessment questionnaire was sent to all women

Mark Bignell; Andrew Hindmarsh; Haritharan Nageswaran; Bhavani Mothe; Andrew Jenkinson; David Mahon; Michael Rhodes

2011-01-01

151

Laparoscopic en bloc kidney transplantation  

PubMed Central

Laparoscopic donor nephrectomy is well establish procedure and having advantages over open donor nephrectomy in terms of having less pain, early ambulation and rapid post operative recovery. To extend the advantages of laparoscopic surgery to the recipient, recently we have performed laparoscopic kidney transplantations when kidney was procured from deceased donors. As a further extension of the procedure, here we present a case of laparoscopic en bloc kidney transplantation in obese diabetic recipient who received kidneys from 70 year old non-heart beating donor. PMID:23204675

Modi, Pranjal; Thyagaraj, Krishnaprasad; Rizvi, Syed Jamal; Vyas, Jigish; Padhi, Sukant; Shah, Kamlesh; Patel, Ram

2012-01-01

152

Laparoscopic Versus Open Colorectal Surgery  

PubMed Central

Objective The primary endpoint was to compare the impact of laparoscopic and open colorectal surgery on 30-day postoperative morbidity. Lymphocyte proliferation to mitogens and gut oxygen tension were surrogate endpoints. Summary Background Data Evidence-based proof of the effect of laparoscopic colorectal surgery on immunometabolic response and clinically relevant outcome variables is scanty. Further randomized trials are desirable before proposing laparoscopy as a superior technique. Methods Two hundred sixty-nine patients with colorectal disease were randomly assigned to laparoscopic (n = 136) or open (n = 133) colorectal resection. Four trained members of the surgical staff who were not involved in the study registered postoperative complications. Lymphocyte proliferation to Candida albicans and phytohemagglutinin was evaluated before and 3 and 15 days after surgery. Operative gut oxygen tension was monitored continuously by a polarographic microprobe. Results In the laparoscopic group the conversion rate was 5.1%. The overall morbidity rate was 20.6% in the laparoscopic group and 38.3% in the open group. Postoperative infections occurred in 15 of the 136 patients in the laparoscopic group and 31 of the 133 patients in the open group. The mean length of hospital stay was 10.4 ± 2.9 days in the laparoscopic group and 12.5 ± 4.1 days in the open group. On postoperative day 3, lymphocyte proliferation was impaired in both groups. Fifteen days after surgery, the proliferation index returned to baseline values only in the laparoscopic group. Intraoperative gut oxygen tension was higher in the laparoscopic than in the open group. Conclusions Laparoscopic colorectal surgery resulted in a significant reduction of 30-day postoperative morbidity. Lymphocyte proliferation and gut oxygen tension were better preserved in the laparoscopic group than in the open group. PMID:12454514

Braga, Marco; Vignali, Andrea; Gianotti, Luca; Zuliani, Walter; Radaelli, Giovanni; Gruarin, Paola; Dellabona, Paolo; Di Carlo, Valerio

2002-01-01

153

Laparoscopic and thoracoscopic esophagectomy.  

PubMed

Over the past decade, our technique of MIE has evolved considerably. In the incipient phase of our experience, we used a totally laparoscopic approach similar to that described in the initial reports from DePaula and colleagues and Swanstrom and Hansen. However, it was soon apparent that there were several critical disadvantages to a purely laparoscopic approach. Laparoscopic transhiatal mobilization of the esophagus offers suboptimal visualization of important periesophageal structures, including the inferior pulmonary vein and the left mainstem bronchus. Moreover, decreased visibility hindered hemostatic division of periesophageal vessels and negatively impacted the completeness of the mediastinal lymph node dissection. These problems are further exacerbated in taller patients. In light of these considerations, we soon transitioned to a laparoscopic-thoracoscopic McKeown approach (thoracoscopic mobilization of the intrathoracic esophagus, laparoscopic gastric tube creation, cervical anastomosis). To this date, the great majority of our minimally invasive esophagectomies (>500 cases) have been performed with this 3-field technique. Indeed, the procedure has been the mainstay of our experience in the past 10 years with reduced perioperative morbidity and mortality compared with many other open series. In our experience, perhaps the most significant technical concern with this operation is the cervical dissection. Recurrent laryngeal nerve injuries, perturbations in pharyngeal transit, and swallowing dysfunction even in the absence of recurrent nerve injury are not infrequent. Moreover, as described in open series using a cervical anastomosis, anastomotic stricture and leak have been shown to occur with increased frequency [35]. In short, there is a significant learning curve with the cervical dissection. Out of these concerns emerged our more recent experience with completely thoracoscopic-laparoscopic Ivor Lewis esophagectomy. However, we did first evolve through a transition phase whereby a mini-thoracotomy (hybrid approach) was performed for creation of the intrathoracic anastomosis. We believe that the experience with totally thoracoscopic-laparoscopic Ivor Lewis esophagectomy will ultimately reproduce the low morbidity and mortality we have previously published with our established MIE technique. The omission of a cervical dissection has reduced our recurrent nerve injury rate to zero. From a theoretical standpoint, one would presume that pharyngeal transit problems and oropharyngeal swallowing dysfunction should be reduced as well with a chest anastomosis. It should be emphasized that there is a steep operator learning curve associated with this approach. Indeed, thoracoscopic port placement is critical, as poorly positioned trocars can result in difficulty maneuvering instruments through the rigid chest wall. Additionally, both blood and lung can obscure visualization of the esophagus, which lies at the dependent aspect of the operative field. Prone positioning has been described as an alternative approach that may facilitate operative exposure and address such technical concerns. Low rates of anastomotic leak (3%), low mortality (1.5%), and equivalent stage-specific survival compared with open series have been shown with this thoracoscopic prone approach [36]. In conclusion, our technique of MIE has evolved such that laparoscopic-thoracoscopic Ivor Lewis esophagectomy has become our preferred approach. Although somewhat early in our experience, we are convinced that this operative technique is feasible with reproducible results. Perioperative morbidity and mortality are comparable with our previously established MIE with cervical anastomosis while essentially eliminating recurrent nerve injury, limiting the length of the gastric conduit required, and allowing a more aggressive gastric resection margin. Recent data from other publications also suggests that lymph node yields may be improved, although insufficient data exist at this time to comment on oncologic results or outcomes with this technique. PMID:20919

Levy, Ryan M; Wizorek, Joseph; Shende, Manisha; Luketich, James D

2010-01-01

154

Total Laparoscopic Pancreaticoduodenectomy  

PubMed Central

Introduction: Total laparoscopic pancreaticoduodenectomy (TLPD) remains one of the most advanced laparoscopic procedures. Owing to the evolution in laparoscopic technology and instrumentation within the past decade, laparoscopic pancreaticoduodenectomy is beginning to gain wider acceptance. Methods: Data were collected for all patients who underwent a TLPD at our institution. Preoperative evaluation consisted of computed tomography scan with pancreatic protocol and selective use of magnetic resonance imaging and/or endoscopic ultrasonography. The TLPD was done with 6 ports on 3 patients and 5 ports in 2 patients and included a celiac, periportal, peripancreatic, and periduodenal lymphadenectomy. Pancreatic stents were used in all 5 cases, and intestinal continuity was re-established by intracorporeal anastomoses. Results: Five patients underwent a TLPD for suspicion of a periampullary tumor. There were 3 women and 2 men with a mean age of 60 years and a mean body mass index of 32.8. Intraoperatively, the mean operative time was 9 hours 48 minutes, with a mean blood loss of 136 mL. Postoperatively, there were no complications and a mean length of stay of 6.6 days. There was no lymph node involvement in 4 out of 5 specimens. The pathological results included intraductal papillary mucinous neoplasm in 2 patients, pancreatic adenocarcinoma in 1 patient (R0 resection), benign 4-cm periampullary adenoma in 1 patient, and a somatostatin neuroendocrine carcinoma in 1 patient (R0, N1). Conclusion: TLPD is a viable alternative to the standard Whipple procedure. Our early experience suggests decreased length of stay, quicker recovery, and improved quality of life. Complication rates appear to be improved or equivalent. PMID:23925010

Kamyab, Armin

2013-01-01

155

Laparoscopic surgery for diverticulitis  

Microsoft Academic Search

Background: Resection of diverticular disease may be quite challenging; the acute inflammatory process, thick sigmoid mesentery, and\\u000a any associated fistula or abscess can make this procedure technically demanding. The aim of this study was to compare the\\u000a results between laparoscopic and laparotomy-type resections stratified by disease severity and thereby predict outcome and\\u000a possibly a subset of patients who may benefit

M. E. Sher; F. Agachan; M. Bortul; J. J. Nogueras; E. G. Weiss; S. D. Wexner

1997-01-01

156

Laparoscopic pancreatic necrosectomy.  

PubMed

We describe a patient with infected pancreatic necrosis who was treated successfully with minimally invasive surgery. Five weeks after an episode of acute uncomplicated pancreatitis, he was found to have infected pancreatic necrosis and splenic vein thrombosis. The patient underwent a laparoscopic pancreatic necrosectomy, splenectomy, and cholecystectomy. Seven days after surgery, the patient was discharged and continued to be asymptomatic for the 6 months of follow-up. PMID:10794217

Hamad, G G; Broderick, T J

2000-04-01

157

Hysterectomy for the treatment of gynecologic malignancy.  

PubMed

The current literature shows that minimally invasive hysterectomy for cancer is relatively safe and provides benefits in terms of blood loss and length of stay with less or equal complication rates over laparotomy. These benefits may even be greater in the morbidly obese and those with other comorbidities. Available techniques include laparotomy, laparoscopy, single-site laparoscopy, robotics, and single-site robotics. Collection of comprehensive and reliable data on complications and outcomes will prove to be the key in defining the role of new techniques in the treatment of women with gynecologic malignancies. PMID:24488054

Backes, Floor J; Fowler, Jeffrey M

2014-03-01

158

Transfusion rate associated with hysterectomy for benign disease.  

PubMed

The transfusion rate associated with hysterectomy for benign disease is an indirect indicator of haemorrhage. It is used in quality assurance activities and is one measure of standard of care. This retrospective study was conducted to determine the transfusion rate for these operations in a tertiary referral hospital. In addition, it was considered that the information could be used in deciding the need for a routine preoperative group and save policy (G and S). The Blood Bank records of all women undergoing hysterectomy for benign disease from 1993-1998 were examined and the number of women transfused was recorded. A total of 1220 hysterectomies were performed. Of women having vaginal hysterectomies only 0.38% required transfusion compared with 2.18% for abdominal hysterectomies. These data suggest that there is no need for a strict policy of preoperative G and S for all patients. In addition, this information can be used as a benchmark when reviewing morbidity associated with hysterectomy and in particular when various methods of hysterectomy are compared. PMID:11787922

Otton, G R; Mandapati, S; Streatfeild, K A; Hewson, A D

2001-11-01

159

Effect of Hysterectomy With Ovarian Preservation on Ovarian Function  

PubMed Central

Objective To prospectively estimate the risk for earlier ovarian failure among women undergoing hysterectomy with ovarian preservation, as compared to women of similar age without hysterectomy. Methods A prospective cohort study was conducted among women aged 30 to 47 years undergoing hysterectomy without bilateral oophorectomy (n=406) and women with intact uteri (n=465). Blood samples and questionnaire data were obtained at baseline and annually for up to 5 years. Hazard ratios (HR) for ovarian failure, defined as follicle-stimulating hormone (FSH) levels 40 IU/L or higher, were calculated using Cox proportional hazards models. Results Ovarian failure occurred among 60 of the women with hysterectomy and 46 of the control women. Women undergoing hysterectomy were at nearly a twofold increased risk for ovarian failure as compared to women with intact uteri (HR=1.92, 95% confidence interval (CI) 1.29 – 2.86). The proportional hazards model further estimated that 14.8% of women with hysterectomy experienced ovarian failure after four years of follow-up compared to 8.0% of the control women. Risk for ovarian failure was greater for women who had a unilateral oophorectomy along with their hysterectomy (HR=2.93, 95% CI 1.57 – 5.49), but also was significantly increased for women who retained both ovaries (HR=1.74, 95% CI 1.14 – 2.65). Conclusions Increased risk of earlier ovarian failure is a possible consequence of premenopausal hysterectomy. While it is unresolved whether it is the surgery itself or the underlying condition leading to hysterectomy that is the cause of earlier ovarian failure, physicians and patients should take into account this possible sequela when considering options for treatment of benign conditions of the uterus. PMID:22067716

Moorman, Patricia G.; Myers, Evan R.; Schildkraut, Joellen M.; Iversen, Edwin S.; Wang, Frances; Warren, Nicolette

2011-01-01

160

Laparoscopic transvesical repair of recurrent vesicovaginal fistula using with fleece-bound sealing system  

Microsoft Academic Search

Background  Vesicovaginal fistula (VVF) is an epithelium-lined communication between the urinary bladder and vagina. Most of VVFs are\\u000a repaired by conventional open surgery. Laparoscopic repair of VVFs is rare and so far no report is available about laparoscopic\\u000a repair of persistent VVF using fleece-bound sealing system as a tissue barrier in the literature. Here we describe the operative\\u000a technique and briefly

Tibet Erdogru; Ahmet Sanl?; Orcun Celik; Mehmet Baykara

2008-01-01

161

Laparoscopic surgery—anesthetic implications  

Microsoft Academic Search

Laparoscopic cholecystectomy is a relatively new surgical procedure which is enjoying everincreasing popularity and presenting new anesthetic challenges. The advantages of shorter hospital stay and more rapid return to normal activities are combined with less pain associated with the small limited incisions and less postoperative ileus compared with the traditional open cholecystectomy. The efficacy of laparoscopic appendectomy and hemicolectomy has

A. J. Cunningham

1994-01-01

162

Laparoscopic pylorus-preserving pancreatoduodenectomy  

Microsoft Academic Search

A case of chronic pancreatitis localized in the head of the pancreas with pancreas divisum was treated by laparoscopic pylorus-preserving pancreatoduodenectomy. The laparoscopic technique of resection and reconstruction with a gastrojejunostomy, hepaticojejunostomy, and pancreaticojejunostomy is described. The postoperative period was complicated by a jejunal ulcer and delayed gastric emptying necessitating a prolonged hospitalization and intravenous hyperalimentation. No fistulas occurred, a

M. Gagner; A. Pomp

1994-01-01

163

Three-dimensional power Doppler ultrasound diagnosis and laparoscopic management of a pregancy in a previous cesarean scar.  

PubMed

An ectopic pregnancy developing in a previous Cesarean section scar is a rare event, and there is still a lack of information concerning the adequacy of management strategies. So far, no modality can guarantee the integrity of the uterus. We report the case of a 29-year-old woman with three Cesarean deliveries who was transferred to our hospital with a diagnosis of cervical pregnancy. Transvaginal three-dimensional power Doppler ultrasound revealed a well-encapsulated bulging mass displacing anteriorly over the lower anterior uterine wall sounding with an irregular course and branching vessels. The diagnosis of pregnancy in a previous Cesarean scar was made. Laparoscopic ligation of bilateral uterine arteries followed by excision of the ectopic pregnant mass was undertaken, and the patient's uterus was successfully preserved. Conservative management with the laparoscopic approach may be a safe and effective alternative to hysterectomy in patients with a pregnacy in a previous Cesarean scar. PMID:15684790

Wang, Chin-Jung; Yuen, Leung-To; Yen, Chih-Feng; Lee, Chyi-Long; Soong, Yung-Kuei

2004-12-01

164

Laparoscopic Sacropexy: A Retrospective Analysis of Perioperative Complications and Anatomical Outcomes  

PubMed Central

Background and Objective: The aim of this study was to evaluate the surgical outcomes and complications of laparoscopic sacropexy with regard to 3 varying mesh attachment points: the vaginal stump, the cervical stump, and the posterior side of the cervix in the case of uterus preservation. Method: A retrospective study was conducted among 310 women treated for descensus with laparoscopic sacropexy between January 2000 and December 2007. Information was obtained from medical files and follow-up examinations. Results: Sacropexies with mesh attachment to the cervical stump, to the vaginal stump, and with uterus preservation were performed in 213, 67, and 30 cases, respectively. In 40 cases, no concomitant interventions were necessary. One perioperative conversion and 2 terminations occurred. Short-term complications included fever in 15 cases and urinary incontinence in 7 cases. Average follow-up was 7.9 mo with 211 patients completing follow-up. Prolapse recurrence rate was 10.4%; the reoperation rate was 4%. No significant differences between groups were detected for cystocele recurrence. Rectocele recurrence was significantly higher (P < .05) for sacropexy with vaginal mesh attachment. A reduction of incontinence was observed, which was significant (P < .05) for those patients treated with simultaneous or previous hysterectomy. Conclusion: Laparoscopic sacropexy shows good short-term results with low reprolapse and complication rates. PMID:23318069

Tchartchian, Garri; Waldschmidt, Matthias; Schollmeyer, Thoralf; De Wilde, Rudy L.

2012-01-01

165

Tubal ligation, hysterectomy and ovarian cancer: A meta-analysis  

PubMed Central

Purpose The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, tubal ligation and hysterectomy, and ovarian cancer. Methods We searched the PubMed, Web of Science, and Embase databases for all English-language articles dated between 1969 through March 2011 using the keywords “ovarian cancer” and “tubal ligation” or “tubal sterilization” or “hysterectomy.” We identified 30 studies on tubal ligation and 24 studies on hysterectomy that provided relative risks for ovarian cancer and a p-value or 95% confidence interval (CI) to include in the meta-analysis. Summary RRs and 95% CIs were calculated using a random-effects model. Results The summary RR for women with vs. without tubal ligation was 0.70 (95%CI: 0.64, 0.75). Similarly, the summary RR for women with vs. without hysterectomy was 0.74 (95%CI: 0.65, 0.84). Simple hysterectomy and hysterectomy with unilateral oophorectomy were associated with a similar decrease in risk (summery RR?=?0.62, 95%CI: 0.49-0.79 and 0.60, 95%CI: 0.47-0.78, respectively). In secondary analyses, the association between tubal ligation and ovarian cancer risk was stronger for endometrioid tumors (summary RR?=?0.45, 95%CI: 0.33, 0.61) compared to serous tumors. Conclusion Observational epidemiologic evidence strongly supports that tubal ligation and hysterectomy are associated with a decrease in the risk of ovarian cancer, by approximately 26-30%. Additional research is needed to determine whether the association between tubal ligation and hysterectomy on ovarian cancer risk differs by individual, surgical, and tumor characteristics. PMID:22587442

2012-01-01

166

Laparoscopic anatomic liver resection  

PubMed Central

Background Liver resection is reputed to be one of the most difficult procedures embraced in laparoscopy. This report shows that with adequate training, anatomical liver resection including major hepatectomies can be performed. Methods This is a retrospective study. Results From 1995 to 2004, among 84 laparoscopic liver resections, 46 (54%) anatomical laparoscopic hepatectomies were performed in our institution by laparoscopy. Nine (20%) patients had benign disease while 37 (80%) had malignant lesions. Among those with malignant lesions, 14 patients had hepatocellular carcinoma (HCC), 18 had colorectal metastasis (CRM), while 5 had miscellaneous tumours. For benign disease, minor (two Couinaud's segments or less) and major anatomic hepatectomies were performed in five and four patients, respectively. For malignant lesions, minor and major anatomic hepatectomies were performed in 15 and 22 patients, respectively. Overall, conversion to laparotomy was necessary in 7 (15%) patients. Blood transfusion was required in five (10%) patients. One patient died of cerebral infarction 8 days after a massive peroperative haemorrhage. The overall morbidity rate was 34% whatever the type of resection. Three patients required reoperation, either for haemorrhage (n=1) and/or biliary leak (n=2). For CRM (n=18), overall and disease-free survival at 24 months (mean follow-up of 17 months) were 100% and 56%, respectively. For HCC (n=14), overall and disease-free survival at 36 months (mean follow-up of 29 months) were 91% and 65%, respectively. No port site metastasis occurred in patients with malignancy. Conclusions After a long training with limited liver resection in superficial segments, laparoscopic anatomical minor and major resections are feasible. Short-term carcinological results seem to be similar to those obtained with laparotomy. PMID:18333079

Vibert, Eric; Kouider, Ali

2004-01-01

167

[Radical laparoscopic nephroureterectomy].  

PubMed

As with the increasingly common presence of laparoscopic surgery in renal adenocarcinoma, the same situation is also occurring with radical management of tumours of the upper urothelium. In this type of clinical condition, it is important to emphasize the different ways to mobilise the distal ureter (with transuretral resection or unroofing, pure laparoscopy, or open), and to take into account that this tumour has the highest risk of implantation at the ports of entry. Here, we conduct a literature review and up-date of the different approaches to the distal urethra. PMID:16884102

Fariña Pérez, L A

2006-05-01

168

Laparoscopic Duodenal Switch  

Microsoft Academic Search

Laparoscopic biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective weight loss procedures currently\\u000a available. Both short- and long-term weight loss exceed that of any other bariatric operation. BPD-DS involves a 150- to 200-cc\\u000a sleeve or vertical gastrectomy, a duodenoileal anastomosis, and a long Roux-en-Y with a 150-cm alimentary limb and a 100-cm\\u000a common channel (Fig. 14.1).

Manish Parikh; Michel Gagner; Alfons Pomp

169

Outcomes after laparoscopic adrenalectomy  

Microsoft Academic Search

Background  Laparoscopic adrenalectomy (LA) has become the standard of care for many conditions requiring removal of the adrenal gland.\\u000a Previous studies on outcomes after LA have had limitations. This report describes the 30-day morbidity and mortality rates\\u000a after LA and analyzes factors affecting operative time, hospital length of stay (LOS), and postoperative morbidity.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients undergoing LA in 2007and 2008 were identified

Prateek K. Gupta; Bala Natarajan; Pradeep K. Pallati; Himani Gupta; Jyothsna Sainath; Robert J. Fitzgibbons

2011-01-01

170

[Radical prostatectomy - pro laparoscopic].  

PubMed

Recent publications have failed to demonstrate significant differences in perioperative oncological and functional outcomes between laparoscopic radical prostatectomy (LRPE) and R-LRPE. Reports suggesting better functional results, in particular better potency rates for R-LRPE, are rare. However, to date no large prospective, randomized, multicenter studies have compared the two methods. With an experienced operator both methods produce comparably good results. The monopoly of the intuitive system with extremely high cost of purchase and maintenance are the major disadvantages of R-LRPE. PMID:22526174

Do, H M; Holze, S; Qazi, H; Dietel, A; Häfner, T; Liatsikos, E; Stolzenburg, J-U

2012-05-01

171

The technique of robotic assisted laparoscopic surgery in gynaecology, its introduction into the clinical routine of a gynaecological department and the analysis of the perioperative courses - a German experience  

PubMed Central

Objective Robotic assisted surgery is an advancement on conventional laparoscopy. The first and single FDA-approved device is the da-Vinci™ system, which provides means to overcome the limitations of conventional laparoscopy. In Germany the use of the robotic system in gynaecology is at the threshold of a promising development. There is a wide spectrum of indications, such as simple and radical hysterectomies, including pelvic and paraaortic lymph node dissection. The introduction of the robotic system into the clinical routine is demonstrated. Material and Methods Robotic assisted laparoscopic interventions have been performed in the reporting hospital since April 2008. In the course of treatment of 172 cases, an increasing rise of complexity of surgical procedure has been achieved. The daVinci™ system is well adaptable in clinical routine. Hitherto, the clinical outcome has been favourable, higher-grade specific complications occurred very rarely. The short time advantages are a decrease of postoperative length of stay, a reduction of postinterventional need of analgetics and an overall accelerated period of recovery has been demonstrated compared to conventional abdominal procedures. It also shows that a drastic decrease of open conventional abdominal procedures concerning uterine pathologies appeared in the reporting department. Results Perioperative advantages of robotic assisted laparoscopic interventions are, above all, the decrease of morbidity (concerning blood loss, need of analgetics, length of stay, etc.). Surgical advantages are the more complex applicability, improved precision, dexterity and vision (3D), a greater autonomy of the surgeon, a smaller learning curve and an increase of preparation consistent with the anatomical structures. In contrast, disadvantages concern an initial greater time investment, the potentially different management of complications, the limited applicability in multiquadrant surgery and the difficulty regarding cost coverage respective to recovery. Conclusions In conclusion, robotic assisted minimal invasive surgery has an enormous potential in gynaecology; by simplifying the essential surgical procedure. The advantages of this technique will be approachability for a majority of gynaecological patients. The feasibility of a multitude of gynaecological surgical interventions has already been approved partially in a small number of cases. The upcoming challenge now is to verify the short and long term advantages of robotic surgery in prospective trials, especially concerning gynaecological oncology. PMID:24591970

Ertan, A. Kubilay; Ulbricht, Michael; Huebner, Kirsten; Di Liberto, Alexander

2011-01-01

172

Emergency peripartum hysterectomy in Isfahan; maternal mortality and morbidity rates among the women who underwent peripartum hysterectomy  

PubMed Central

Background: Peripartum hysterectomy is associated with significant morbidity and mortality. We determined the factors leading to and maternal mortality and morbidity rates among the women whose underwent peripartum hysterectomy in Iran. Materials and Methods: This case-series study was conducted from March 2004 to March 2009 in the Department of Gynecology and Obstetrics at two central university hospitals (Azahra hospital and Shahid Beheshti Hospital) in Isfahan. Forty one women among 29,444 deliveries underwent peripartum hysterectomy. Women who had delivery before 24 weeks and a hysterectomy for other reasons like sterilizations were excluded. Incidence, indications and maternal complications including maternal death and urological, infectious and wound complications were evaluated after operation. Results: During the study period, the incidence of peripartum hysterectomy estimated about 1.39 per 1,000 deliveries. The maternal mortality rate was 17.07%. There was no statistical difference in mortality rates between referrals and non-referrals women (P = 0.6). Post-operative complications included infection (22%), bladder injuries (7.3%), urine retention (4.8%) and wound dehiscence (4.87%). The main indication was placenta accreta 28 (68.3%). Conclusion: This study indicated the high rate of mortality among patients underwent peripartum hysterectomy. Evaluation of management during referring the patients and designing more studies to evaluate the mortality and morbidities are warranted. PMID:23930265

Gurtani, Fatemeh Mostajeran; Fadaei, Behrooz; Akbari, Mojtaba

2013-01-01

173

Controversies in laparoscopic repair of incisional hernia  

PubMed Central

Background: Incisional hernias can be a significant problem after open abdominal surgery. Laparoscopic incisional hernia repair (LIHR) is conceptually appealing: a large, abdominal wall re-incision with potential wound-related ill effects is avoided and an intra-peritoneal onlay mesh is expected to provide security that is equivalent to open, retro-muscular mesh repair. As such, LIHR has gained substantial popularity despite sparse, randomised clinical data to compare with conventional, open repair. Aim: To enumerate and discuss important, controversial issues in patient-selection, technique and early post-operative care for LIHR. Materials and Methods: Pragmatic summary of comprehensive review of English language literature, discussion with experts and personal experience. Outcomes: Six important areas of some dispute were identified: 1. Size of abdominal-wall defect that is suitable for LIHR: Generally, defect-diameter > 10 cm is better served by open retromuscular repair with tension-free re-approximation of the edges of the defect. 2. Extent of adhesiolysis: Complete division of adhesions to the anterior abdominal wall may identify sub-clinical “Swiss-cheese” defects but incurs some risk of additional complications. 3. Intra-operative recognition of enterotomy: Possible options are either laparoscopic suture of bowel injury and simultaneous completion of LIHR, or staged LIHR or conversion to open suture-repair. 4. Choice of mesh: “Composite” meshes are regarded as the current standard of care but there is paucity of data regarding potential dangers of intra-peritoneal polypropylene mesh. 5. Technique of mesh-fixation: Trans-parietal sutures are more secure than tacks, with limited data to correlate with post-operative pain. 6. Alarm over post-operative pain: Unlike other advanced laparoscopic operations, the specificity of pain as a marker of intra-abdominal sepsis after LIHR remains unclear. Conclusion: Recognition of and attention to controversial issues will promote increased success of LIHR. PMID:21170220

Sarela, Abeezar I.

2006-01-01

174

Laparoscopic excision of Meckel's diverticulum in children: What is the current evidence?  

PubMed Central

Complications aroused from Meckel’s diverticulum tend to developed in children. Children presented with abdominal pain, intestinal obstruction, intussusception or gastrointestinal bleeding may actually suffered from complicated Meckel’s diverticulum. With the advancement of minimally invasive surgery (MIS) in children, the use of laparoscopy in the diagnosis and subsequent laparoscopic excision of Meckel’s diverticulum has gained popularity. Recently, single incision laparoscopic surgery (SILS) has emerged as a new technique in minimally invasive surgery. This review offers the overview in the development of MIS in the management of children suffered from Meckel’s diverticulum. The current evidence in different laparoscopic techniques, including conventional laparoscopy, SILS, the use of special laparoscopic instruments, intracorporeal diverticulectomy and extracorporeal diverticulectomy in the management of Meckel’s diverticulum in children were revealed. PMID:25386065

Chan, Kin Wai Edwin; Lee, Kim Hung; Wong, Hei Yi Vicky; Tsui, Siu Yan Bess; Wong, Yuen Shan; Pang, Kit Yi Kristine; Mou, Jennifer Wai Cheung; Tam, Yuk Him

2014-01-01

175

Mesh-Based Transperineal Repair of a Perineal Hernia After a Laparoscopic Abdominoperineal Resection  

PubMed Central

A perineal hernia (PH) is formed by a protrusion of intra-abdominal viscera through a defect in the pelvic floor. This is a rare complication after a conventional abdominoperineal resection (APR). However, the risk of a PH may be increased after a laparoscopic resection because this technique can cause fewer postoperative adhesions, predisposing the small bowel to sliding down toward the pelvis. However, only a few case reports describe the transperineal approach for the repair of a PH after a laparoscopic APR. We present a case of a PH after a laparoscopic APR; the PH was repaired with synthetic mesh by using a transperineal approach. A transperineal approach using a mesh to reconstruct the pelvic floor is less invasive and more effective. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.

Lee, Taek-Gu

2014-01-01

176

Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery  

PubMed Central

Background In the late '80s the successes of the laparoscopic surgery for gallbladder disease laid the foundations on the modern use of this surgical technique in a variety of diseases. In the last 20 years, laparoscopic colorectal surgery had become a popular treatment option for colorectal cancer patients. Discussion Many studies emphasized on the benefits stating the significant advantages of the laparoscopic approach compared with the open surgery of reduced blood loss, early return of intestinal motility, lower overall morbidity, and shorter duration of hospital stay, leading to a general agreement on laparoscopic surgery as an alternative to conventional open surgery for colon cancer. The reduced hospital stay may also decrease the cost of the laparoscopic surgery for colorectal cancer, despite th higher operative spending compared with open surgery. The average reduction in total direct costs is difficult to define due to the increasing cost over time, making challenging the comparisons between studies conducted during a time range of more than 10 years. However, despite the theoretical advantages of laparoscopic surgery, it is still not considered the standard treatment for colorectal cancer patients due to technical limitations or the characteristics of the patients that may affect short and long term outcomes. Conclusions The laparoscopic approach to colectomy is slowly gaining acceptance for the management of colorectal pathology. Laparoscopic surgery for colon cancer demonstrates better short-term outcome, oncologic safety, and equivalent long-term outcome of open surgery. For rectal cancer, laparoscopic technique can be more complex depending on the tumor location. The advantages of minimally invasive surgery may translate better care quality for oncological patients and lead to increased cost saving through the introduction of active enhanced recovery programs which are likely cost-effective from the perspective of the hospital health-care providers. PMID:24267544

2013-01-01

177

Laparoscopic Surgery - What Is It?  

MedlinePLUS

... cavity to high-resolution video monitors in the operating room. During the operation the surgeon watches detailed images ... past there had been concern raised about the safety of laparoscopic surgery for cancer operations. Recently several ...

178

LAPAROSCOPIC HEMINEPHROURETERECTOMY IN PEDIATRIC PATIENTS  

Microsoft Academic Search

PurposeAn increasing number of operative procedures in pediatric urology can be performed by laparoscopy. We report our experience with laparoscopic heminephroureterectomy, which is a typical operation in pediatric patients.

Gunter Janetschek; Jorg Seibold; Christian Radmayr; Georg Bartsch

1997-01-01

179

Laparoscopic treatment of perforated appendicitis  

PubMed Central

The use of laparoscopy has been established in improving perioperative and postoperative outcomes for patients with simple appendicitis. Laparoscopic appendectomy is associated with less wound pain, less wound infection, a shorter hospital stay, and faster overall recovery when compared to the open appendectomy for uncomplicated cases. In the past two decades, the use of laparoscopy for the treatment of perforated appendicitis to take the advantages of minimally invasiveness has increased. This article reviewed the prevalence, approaches, safety disclaimers, perioperative and postoperative outcomes of the laparoscopic appendectomy in the treatment of patients with perforated appendicitis. Special issues including the conversion, interval appendectomy, laparoscopic approach for elderly or obese patient are also discussed to define the role of laparoscopic treatment for patients with perforated appendicitis. PMID:25339821

Lin, Heng-Fu; Lai, Hong-Shiee; Lai, I-Rue

2014-01-01

180

Laparoscopic salpingostomy versus laparoscopic local methotrexate injection in the management of unruptured ectopic gestation  

Microsoft Academic Search

OBJECTIVE: Our goal was to determine whether laparoscopic salpingostomy is preferable to laparoscopic methotrexate injection in the management of unruptured tubal gestation. STUDY DESIGN: Forty-eight patients with unruptured tubal pregnancy were prospectively randomized to either laparoscopic salpingostomy or laparoscopic local methotrexate injection in a university medical center. Operation time, duration of hospital stay, decrease in levels of ?-human chorionic gonadotropin,

Zilber; Pansky; Bukovsky; Golan

1996-01-01

181

Simulation of Laparoscopic Surgery Lab  

NSDL National Science Digital Library

This simulation of laparoscopic surgery enables learners to practice and to learn this modern surgical technique. Learners discover how to manipulate a variety of instruments while watching a TV monitor, thereby learning to compensate while going from a 3-D situation to a 2-D situation. Learners also analyze the pros and cons of the procedure. Note: Laparoscopic instruments are needed for this activity; adult supervision and safety demonstration recommended. A/V equipment is also required.

Robitaille, Phyllis

2009-01-01

182

Laparoscopic colorectal resection for diverticulitis  

Microsoft Academic Search

This study evaluated outcome in patients undergoing laparoscopically assisted sigmoid resection for diverticular disease.\\u000a A total of 29 consecutive patients were treated surgically for colonic diverticulitis; in 27 of these laparoscopy was performed.\\u000a The review of medical records from a control group of 34 patients undergoing open resection were used for comparison. The\\u000a conversion rate was 7.5%. Using the laparoscopic

L. Köhler; D. Rixen; H. Troidl

1998-01-01

183

[Laparoscopic reconstruction of the diaphragm].  

PubMed

The authors report the case of a 63-year-old patient who was polytraumatized in a motor vehicle accident and suffered multiple traumatic injuries. Chest and pelvic fractures as well as left-sided diaphragmatic rupture with associated omentum herniation were diagnosed on CT scan. None of the injuries required urgent surgical intervention. After 10 days supportive therapy, elective laparoscopic reconstruction of the diaphragmatic hernia was performed. The authors discuss the role of laparoscopic diaphragm reconstruction. PMID:25327405

Halvax, Péter; Légner, András; Paál, Balázs; Somogyi, Rózsa; Ukös, Mária; Altorjay, Aron

2014-10-01

184

Rhabdomyolysis after Laparoscopic Bariatric Surgery  

Microsoft Academic Search

Background: Postoperative rhabdomyolysis is an uncommon event. The aim of this study was to determine the incidence of rhabdomyolysis\\u000a following laparoscopic obesity surgery. Methods: Rhabdomyolysis was studied prospectively. Over a 6-month period, 66 consecutive\\u000a patients underwent bariatric surgery (gastric banding (n=50) and gastric bypass (n=16)). All patients underwent laparoscopic\\u000a procedures. A range of blood tests, including serum creatine phosphokinase (CPK)

Philippe Mognol; Stéphane Vignes; Denis Chosidow; Jean-Pierre Marmuse

2004-01-01

185

LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR HILAR TUMORS  

Microsoft Academic Search

PurposePartial nephrectomy for hilar tumors represents a technical challenge not only for laparoscopic, but also for open surgeons. We report the technical feasibility and perioperative outcomes of laparoscopic partial nephrectomy (LPN) for hilar tumors.

INDERBIR S. GILL; JOSE R. COLOMBO; IGOR FRANK; ALIREZA MOINZADEH; JIHAD KAOUK; MIHIR DESAI

2005-01-01

186

Design of a pressure sensing laparoscopic grasper  

E-print Network

With smaller incisions, laparoscopic, or minimally invasive, surgery is considered safer for patients than open surgery. However, the safety of current laparoscopic grasping instruments can still be improved. Current devices ...

Reyda, Caitlin J. (Caitlin Jilaine)

2011-01-01

187

Complete laparoscopic removal of a gastric trichobezoar  

PubMed Central

Trichobezoars are seen usually in adolescent girls and laparotomy is required to remove them, though recently laparoscopic assisted and laparoscopic removal have been reported in adults and older children. We report this 4-year-old boy who underwent complete laparoscopic removal of a gastric trichobezoar, both for its rarity in such young boys and also because he is the youngest reported patient to undergo complete laparoscopic removal of a gastric trichobezoar. PMID:25013333

Vepakomma, Deepti; Alladi, Anand

2014-01-01

188

Complete laparoscopic removal of a gastric trichobezoar.  

PubMed

Trichobezoars are seen usually in adolescent girls and laparotomy is required to remove them, though recently laparoscopic assisted and laparoscopic removal have been reported in adults and older children. We report this 4-year-old boy who underwent complete laparoscopic removal of a gastric trichobezoar, both for its rarity in such young boys and also because he is the youngest reported patient to undergo complete laparoscopic removal of a gastric trichobezoar. PMID:25013333

Vepakomma, Deepti; Alladi, Anand

2014-07-01

189

Laparoscopic Roux-en-Y gastric bypass  

Microsoft Academic Search

  Background: Increasing numbers of laparoscopic surgeons are performing laparoscopic Roux-en-Y gastric bypass (LGB). Our aim\\u000a was to determine the length of the learning curve for a skilled laparoscopic surgeon. Methods: The study population consisted\\u000a of the first 225 consecutive LGB procedures attempted by one laparoscopic surgeon (HJS). Outcome parameters included mortality,\\u000a morbidity, operative time, and conversion to an open procedure.

D. Oliak; G. H. Ballantyne; P. Weber; A. Wasielewski; R. J. Davies; H. J. Schmidt

2003-01-01

190

Laparoscopic Radical Prostatectomy: An Approach in Evolution  

Microsoft Academic Search

Laparoscopic radical prostatectomy has become an attractive and exciting approach for the surgical treatment of localized prostate cancer. Two main routes are mainly used, namely the transperitoneal and the extraperitoneal approach. Minimal bleeding, shorter hospitalization and recovery time are unquestionable advantages for laparoscopic procedures. Oncological and functional results of laparoscopic prostatectomies today are comparable to those of the open retropubic

Hubert John

2005-01-01

191

Application of Augmented Reality to Laparoscopic Surgery  

E-print Network

Application of Augmented Reality to Laparoscopic Surgery by Jeremy D. Ackerman A Dissertation to Laparoscopic Surgery. (Under the direction of Henry Fuchs, Ph. D..) ABSTRACT The usefulness and feasibility of an augmented reality visualization system for laparoscopic surgery is examined. This technology could enable

Whitton, Mary C.

192

Laparoscopic subtotal cholecystectomy for severe cholecystitis  

Microsoft Academic Search

Background: In severe cholecystitis, laparoscopic cholecystectomy can be technically difficult, and is associated with an increased rate of procedure conversions and common bile duct lesions. Methods: We investigated the safety and complications of laparoscopic subtotal cholecystectomy for severe cholecystitis in a medium- to long-term follow-up evaluation. Laparoscopic cholecystectomy was performed in 345 patients during a period of 64 months. In

G. Beldi; A. Glättli

2003-01-01

193

Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis  

Microsoft Academic Search

Although great advances in laparoscopic techniques have been made in the field of adult surgery, its application in infants and young children has been limited. We present a technique of laparoscopic pyloromyotomy that has been successfully used in two babies, employing specially made instruments. Laparoscopic surgery deserves further consideration in this age group.

H. L. Tan; A. Najmaldin

1993-01-01

194

Proceed(TM) Mesh for Laparoscopic Ventral Hernia Repair  

PubMed Central

Background and Objectives: Laparoscopic technique to repair ventral hernia offers advantages over conventional open surgery such as shorter recovery time, decreased pain, and lower recurrence rates. There are a myriad of meshes available for laparoscopic repair of ventral hernias. This study evaluated the outcomes of laparoscopic repair of ventral hernias with Proceed mesh (Ethicon, Somerville, NJ, USA) in a single academic institution. Methods: An institutional review board–approved retrospective review was performed for 100 consecutive patients with ventral hernia who underwent a laparoscopic approach at our institution from August 2006 to February 2009. All patients were operated on by a single surgeon using a standard technique with transabdominal suture fixation and tacks. Results: The study included 100 consecutive patients (57 female and 43 male patients). The mean age was 55 years (range, 16–78 years), and the mean body mass index was 33.3 kg/m2 (range, 19.6–68.9 kg/m2). Of the repairs, 27% were performed for a recurrent hernia. The mean and median size of the defect were 128 cm2 and 119.5 cm2 (range, 4–500 cm2), respectively. To ensure appropriate mesh overlap, the mean size of mesh was 253 cm2 (range, 36–700 cm2). There were 4 conversions. The mean operative time was 117 minutes (range, 35–286 minutes). The mean length of stay was 1.9 days. There were no major abdominal complications. With a mean follow-up period of 50 months (range, 38–68 months), we have not recorded any recurrences. No mesh-related complications have been documented. Conclusions: The laparoscopic approach to ventral hernia repairs using Proceed mesh is associated with a low conversion rate and no major complications. At 50 months of follow-up, the recurrence rate is 0%. There were no mesh-related complications. PMID:24398198

Franklin, Brenton R.; Patel, Ketan M.

2013-01-01

195

Laparoscopic Adrenalectomy for Adrenal Tumors  

PubMed Central

Objective. To evaluate the indication and the clinical value of laparoscopic adrenalectomy of different types of adrenal tumor. Methods. From 2009 to 2014, a total of 110 patients were diagnosed with adrenal benign tumor by CT scan and we performed laparoscopic adrenalectomy. The laparoscopic approach has been the procedure of choice for surgery of benign adrenal tumors, and the upper limit of tumor size was thought to be 6?cm. Results. 109 of 110 cases were successful; only one was converted to open surgery due to bleeding. The average operating time and intraoperative blood loss of pheochromocytoma were significantly more than the benign tumors (P < 0.05). After 3 months of follow-up, the preoperative symptoms were relieved and there was no recurrence. Conclusions. Laparoscopic adrenalectomy has the advantages of minimal invasion, less blood loss, fewer complications, quicker recovery, and shorter hospital stay. The full preparation before operation can decrease the average operating time and intraoperative blood loss of pheochromocytomas. Laparoscopic adrenalectomy should be considered as the first choice treatment for the resection of adrenal benign tumor. PMID:25132851

Chuan-yu, Sun; Yat-faat, Ho; Wei-hong, Ding; Yuan-cheng, Gou; Qing-feng, Hu; Ke, Xu; Bin, Gu; Guo-wei, Xia

2014-01-01

196

Totally retroperitoneal laparoscopic aortobifemoral bypass.  

PubMed

The classic procedure for aortobifemoral bypass is open surgery. Since the first totally laparoscopic aortobifemoral bypass reported in 1997 by Yves-Marie Dion, laparoscopy has been accepted by several authors as a possible minimally invasive alternative for aorto-iliac occlusive disease. The transperitoneal left retrocolic and retrorenal ways are generally used. The totally retroperitoneal laparoscopic procedure has been described as an alternative to the transperitoneal approach. We report here a totally laparoscopic retroperitoneal approach to performing aortobifemoral bypass. This approach was proposed to a 51-year-old man with aorto-iliac occlusive disease. There was no indication for endovascular revascularization. The patient suffered from 10 metres of bilateral intermittent claudication and lower limb ulcers. During the surgical procedure our patient was placed in a 30-degree right lateral decubitus position. The optical system was first placed in an intra-abdominal position to check the positioning of the trocars in the left retroperitoneal space. The dissection of the retroperitoneal space was performed by CO2 insufflation and by blunt dissection using laparoscopic forceps. The infrarenal aorta was exposed and clamped by laparoscopic clamps. A bifurcated graft was sutured on the left-hand side of the aorta by a running suture. Both prosthetic limbs were tunnelized retroperitoneally to the groin under optical control. The femoral anastomoses were performed by classic open surgery. PMID:18074917

Segers, B; Lemaitre, J; Bosschaerts, Th; Guntz, E; Roman, A; Jozsa, B; Hazane, E; Horn, D; Pastijn, I; Barroy, J P

2007-01-01

197

Towards scar-free surgery: An analysis of the increasing complexity from laparoscopic surgery to NOTES  

PubMed Central

Background NOTES is an emerging technique for performing surgical procedures, such as cholecystectomy. Debate about its real benefit over the traditional laparoscopic technique is on-going. There have been several clinical studies comparing NOTES to conventional laparoscopic surgery. However, no work has been done to compare these techniques from a Human Factors perspective. This study presents a systematic analysis describing and comparing different existing NOTES methods to laparoscopic cholecystectomy. Methods Videos of endoscopic/laparoscopic views from fifteen live cholecystectomies were analyzed to conduct a detailed task analysis of the NOTES technique. A hierarchical task analysis of laparoscopic cholecystectomy and several hybrid transvaginal NOTES cholecystectomies was performed and validated by expert surgeons. To identify similarities and differences between these techniques, their hierarchical decomposition trees were compared. Finally, a timeline analysis was conducted to compare the steps and substeps. Results At least three variations of the NOTES technique were used for cholecystectomy. Differences between the observed techniques at the substep level of hierarchy and on the instruments being used were found. The timeline analysis showed an increase in time to perform some surgical steps and substeps in NOTES compared to laparoscopic cholecystectomy. Conclusion As pure NOTES is extremely difficult given the current state of development in instrumentation design, most surgeons utilize different hybrid methods – combination of endoscopic and laparoscopic instruments/optics. Results of our hierarchical task analysis yielded an identification of three different hybrid methods to perform cholecystectomy with significant variability amongst them. The varying degrees to which laparoscopic instruments are utilized to assist in NOTES methods appear to introduce different technical issues and additional tasks leading to an increase in the surgical time. The NOTES continuum of invasiveness is proposed here as a classification scheme for these methods, which was used to construct a clear roadmap for training and technology development. PMID:24902811

Chellali, Amine; Schwaitzberg, Steven D.; Jones, Daniel B.; Romanelli, John; Miller, Amie; Rattner, David; Roberts, Kurt E.; Cao, Caroline G.L.

2014-01-01

198

Hysterectomy and women satisfaction: total versus subtotal technique  

Microsoft Academic Search

Introduction  The impact of different surgical procedures on women’s satisfaction after hysterectomy is a topical issue. The aim of this\\u000a study was to investigate the impact of sub-total and total hysterectomy on women’s satisfaction, evaluated with questionnaire\\u000a assessment of sexual activity, body image, and health status.\\u000a \\u000a \\u000a \\u000a Materials and methods  A prospective, randomized, non-blind study was conducted. In the study period of 3 years,

Franco Gorlero; Davide Lijoi; Mariangela Biamonti; Paola Lorenzi; Alberto Pullè; Illaria Dellacasa; Nicola Ragni

2008-01-01

199

Vaginal intraepithelial neoplasia III detected after hysterectomy for benign conditions.  

PubMed

Because primary vaginal cancer is rare, many experts discourage routine cytologic sampling of the vaginal vault following hysterectomy for benign circumstances. The following report describes a case of vaginal intraepithelial neoplasia III (VAIN III) detected by a vaginal vault Papanicolaou smear obtained from an asymptomatic 57-year-old woman 23 years after she had a total abdominal hysterectomy for a benign condition. As VAIN III is a true vaginal cancer precursor, the innocent disregard of recommended screening practices averted significant morbidity and possibility mortality for this otherwise healthy woman. PMID:7807042

Ferris, D G; Messing, M J; Crosby, J H

1995-01-01

200

Laparoscopic repair of recurrent hernias.  

PubMed

The purpose of this study was to evaluate the results of a laparoscopic approach to recurrent inguinal hernia repair which dissected the entire inguinal floor and repaired all potential areas of recurrence without producing tension. Both a transabdominal preperitoneal and a totally extraperitoneal laparoscopic approach were utilized. Ninety recurrent hernias were repaired in 81 patients. The patients had 26 indirect, 36 direct, and 26 pantaloon recurrent hernias of which eight had a femoral component. In all but one patient the primary operations were open anterior repairs. The median follow-up was 14 months, ranging from 1 to 28 months. Patients returned to normal activities in an average of 1 week. The only recurrence observed was in the one patient whose primary repair was laparoscopic. When the entire inguinal floor of the recurrent hernia was redissected and buttressed with mesh, early recurrence was eliminated and recovery was shortened. PMID:7597580

Felix, E L; Michas, C A; McKnight, R L

1995-02-01

201

[Laparoscopic evaluation of the appendix].  

PubMed

In the Netherlands every year about 16,000 appendectomies are carried out. Despite the increase in preoperative radiological evaluation of the appendix, the negative appendectomy rate is still around 16%, with a morbidity of approximately 5%. The Dutch practice guideline on appendicitis states that a normal appendix should not be removed, although laparoscopic criteria to establish appendicitis are lacking. Retrospective analysis of negative appendectomies shows that in 51% of cases the surgeon was convinced the appendix was inflamed. Furthermore, in an online survey, 78% of responding Dutch surgeons stated that if good and reproducible criteria for identifying appendicitis during laparoscopy were available they would use them. In conclusion, laparoscopic evaluation of the appendix is not always easy and use of the laparoscopic appendicitis score (LAPP) might lead to fewer negative appendectomies with their associated morbidity. Surgeons should be more aware of the morbidity associated with a negative appendectomy. PMID:23548189

Hamminga, Jenneke T H; Hofker, H Sijbrand; Haveman, Jan Willem

2013-01-01

202

Laparoscopic renal cryoablation.  

PubMed

In light of evidence linking radical nephrectomy and consequent suboptimal renal function to adverse cardiovascular events and increased mortality, research into nephron-sparing techniques for renal masses widely expanded in the past two decades. The American Urological Association (AUA) guidelines now explicitly list partial nephrectomy as the standard of care for the management of T1a renal tumors. Because of the increasing utilization of cross-sectional imaging, up to 70% of newly detected renal masses are stage T1a, making them more amenable to minimally invasive nephron-sparing therapies including laparoscopic and robotic partial nephrectomy and ablative therapies. Cryosurgery has emerged as a leading option for renal ablation, and compared with surgical techniques it offers benefits in preserving renal function with fewer complications, shorter hospitalization times, and allows for quicker convalescence. A mature dataset exists at this time, with intermediate and long-term follow-up data available. Cryosurgical recommendations as a first-line therapy are made at this time in limited populations, including elderly patients, patients with multiple comorbidities, and those with a solitary kidney. As more data emerge on oncologic efficacy, and technical experience and the technology continue to improve, the application of this modality will likely be extended in future treatment guidelines. PMID:24596441

Schiffman, Marc; Moshfegh, Amiel; Talenfeld, Adam; Del Pizzo, Joseph J

2014-03-01

203

Histopathological Audit of 373 Nononcological Hysterectomies in a Teaching Hospital  

PubMed Central

Hysterectomy, the most common gynecological surgery, provides a definitive cure to various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. However, with advent of effective medical and conservative treatment modalities for nononcological causes it is now posing question mark on justification of hysterectomy. Therefore, an audit is required to assess the correlation between preoperative diagnosis and histopathological examination of specimen for justification of the procedure. In this study over period of one year (April 2013 to March 2014) 373 hysterectomies specimens were received in the department of pathology for nononcological causes. The age of patients ranged from 22 to 85 years with mean 45 ± 9.2 years. All cases were divided into five categories on the basis of age and audit was done. In this study the most common finding was leiomyoma (43.7%) followed by adenomyosis (19.3%). Almost 50% of hysterectomies causes were justified as preoperative diagnosis matched with histopathology. Cohen kappa statistics were used to measure agreement between preoperative and postoperative histopathological diagnosis which was found to be fair with ? value being 0.36. This study highlights that regular audit of surgeries can help improve quality of health care services and provide safe conservative option to patients. PMID:25295217

Tiwana, Kanwardeep Kaur; Nibhoria, Sarita; Monga, Tanvi; Phutela, Richa

2014-01-01

204

A multi-institutional internet-based hysterectomy database  

Microsoft Academic Search

Objective and methods: We have devised an easy to use, valid, comprehensive database for hysterectomy to measure patient care; to allow physician benchmarking, interaction, and collaboration; and to allow research investigations. It includes demographic stratification and medical, financial, and satisfaction factors. It can be used as a standalone or as an Internet system. A query is in place that allows

Victor P. Trinkus; H. K. Jacobs; Y. Castellanos; R. A. Jorgensen; T. E. Grande; K. A. Hallman; E. A. Jacobson

2000-01-01

205

Laparoscopic colectomy: A critical appraisal  

Microsoft Academic Search

A multicenter retrospective study was undertaken to assess the efficacy and safety of laparoscopy in colon and rectal surgery. To minimize potential bias in interpretation of the results, all data were registered with an independent observer, who did not participate in any of the surgical procedures. Sixty-six patients underwent a laparoscopic procedure. Operations performed included sigmoid colectomy (19), right hemicolectomy

P. M. Falk; R. W. Beart; S. D. Wexner; A. G. Thorson; D. G. Jagelman; I. C. Lavery; O. B. Johansen; R. J. Fitzgibbons

1993-01-01

206

Robot-assisted laparoscopic choledochojejunostomy  

Microsoft Academic Search

Background: Endoscopic stenting is the treatment of choice for palliative relief of biliary obstruction by a periampullary tumor. If treated surgically, a choledochojejunostomy and Roux-en-Y diversion is still performed by laparotomy in a large number of cases due to technical challenges of the biliodigestive anastomosis in the laparoscopic approach. Robotic systems may enhance dexterity and vision and might therefore support

J. P. Ruurda; K. W. van Dongen; J. Dries; I. H. M. Borel Rinkes; I. A. M. J. Broeders

2003-01-01

207

Stump Appendicitis following Laparoscopic Appendectomy  

PubMed Central

Stump appendicitis (SA) is a rare clinicopathologic entity characterised by inflammation of the appendiceal remnant after incomplete appendectomy. The diagnosis is not routinely suspected in patients who have previously undergone appendectomy. We report a case of SA in an adolescent boy who had previously undergone laparoscopic appendectomy. The case necessitated surgical completion of the appendectomy. PMID:21509217

Parameshwarappa, Suresh; Rodrigues, Gabriel; Prabhu, Raghunath; Sambhaji, Charudutt

2011-01-01

208

Laparoscopic management of appendicular mass  

PubMed Central

BACKGROUND: Laparoscopic appendectomy is becoming the preferred technique for treating acute appendicitis. However, its role in the treatment of complicated appendicitis is controversial. This study was undertaken to assess the feasibility of laparoscopic appendectomy for appendicular mass. MATERIALS AND METHODS: A retrospective review was performed of all the patients who were treated laparoscopically for appendicular mass from March 2007 to October 2009. Setting: Tertiary care hospital. RESULTS: A total of 120 patients were treated for appendicitis. A retrospective review of the patients’ records demonstrated that 19 patients (15.8%) had appendicular mass at the time of admission. The average operative time was 95 minutes (range 45-140 minutes). Pathological evidence of appendicitis was present in all the patients. The average length of hospital stay was six days (rang 6-9 days). Three patients (15.7%) had post- operative complications. Two patients developed wound infections and one patient was re-admitted with pain and a lump below the umbilical port. CONCLUSION: The findings suggest that laparoscopic appendectomy is feasible in patients with appendicular mass. The authors propose a prospective, randomized trial to verify this finding. PMID:21523236

Shindholimath, Vishwanath V; Thinakaran, K; Rao, T Narayana; Veerappa, Yenni Veerabhadrappa

2011-01-01

209

[Conversion in laparoscopic cholecystectomy].  

PubMed

Laparoscopic cholecystectomy (LC) has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion. The aim of this study was to analyze the factors that make LC difficult and determine conversion to open approach: Our study includes: 6985 cases which underwent LC and 1430 cases with open cholecystectomy, between March 1993 and April 2005 in our clinic of general surgery. The overall conversion rate was 5.1% (deliberate conversion--299 cases, conversion of necessity--62 cases). The conversion rate has decreased from 17.5% in 1993 to 3.2% in recent years. The most conversion happen after a simple inspection or a minimal dissection caused by the existence of perforation (105 cases), the discovery of a difficult anatomic situation (63 cases) or of another pathology (14 cases); more rarely, the conversion was necessary in the principal time, doing to hemorrhage (26 cases), impossible dissection (41 cases), visceral injury (1 case) or even at the end of the operation, doing to hemorrhage, loss piece or stone (10 cases), and other situations (101 cases). Significant predictors of conversion were acute cholecystitis , choledocholithiasis, past history of acute cholecystitis, male gender, gall bladder wall thickness exceeding 6 mm. In conclusion, based on our experience, we suggest limiting OC to patients with proven contraindications to LC (i.e., Mirizzi syndrome or systemic illness incompatible with general anesthesia or pneumoperitoneum), attempting LC in all other cases. Decision to convert to open approach is a proven of surgical maturity. Conversion must be decided from the beginning, in the moment of the recognition of a difficult situation and not after the occurrence of a complication. PMID:16372669

Târcoveanu, E; Niculescu, D; Georgescu, St; Epure, Oana; Bradea, C

2005-01-01

210

PROSPECTIVE, RANDOMIZED COMPARISON OF TRANSPERITONEAL VERSUS RETROPERITONEAL LAPAROSCOPIC ADRENALECTOMY  

Microsoft Academic Search

PurposeWe report a prospective, randomized comparison of transperitoneal laparoscopic adrenalectomy (TLA) vs retroperitoneal laparoscopic adrenalectomy (RLA) for adrenal lesions with long-term followup.

MAURICIO RUBINSTEIN; INDERBIR S. GILL; MONISH ARON; METE KILCILER; ANOOP M. MERANEY; ANTONIO FINELLI; ALI MOINZADEH; OSAMU UKIMURA; MIHIR M. DESAI; JIHAD KAOUK; EMMANUEL BRAVO

2005-01-01

211

Learning curve analysis of robot-assisted radical hysterectomy for cervical cancer: initial experience at a single institution  

PubMed Central

Objective The aim of this study was to evaluate the learning curve and perioperative outcomes of robot-assisted laparoscopic procedure for cervical cancer. Methods A series of 65 cases of robot-assisted laparoscopic radical hysterectomies with bilateral pelvic lymph node dissection for early stage cervical cancer were included. Demographic data and various perioperative parameters including docking time, console time, and total operative time were reviewed from the prospectively collected database. Console time was set as a surrogate marker for surgical competency, in addition to surgical outcomes. The learning curve was evaluated using cumulative summation method. Results The mean operative time was 190 minutes (range, 117 to 350 minutes). Two unique phases of the learning curve were derived using cumulative summation analysis; phase 1 (the initial learning curve of 28 cases), and phase 2 (the improvement phase of subsequent cases in which more challenging cases were managed). Docking and console times were significantly decreased after the first 28 cases compared with the latter cases (5 minutes vs. 4 minutes for docking time, 160 minutes vs. 134 minutes for console time; p<0.001 and p<0.001, respectively). There was a significant reduction in blood loss during operation (225 mL vs. 100 mL, p<0.001) and early postoperative complication rates (28% vs. 8.1%, p=0.003) in phase 2. No conversion to laparotomy occurred. Conclusion Improvement of surgical performance in robot-assisted surgery for cervical cancer can be achieved after 28 cases. The two phases identified by cumulative summation analysis showed significant reduction in operative time, blood loss, and complication rates in the latter phase of learning curve. PMID:24167665

Yim, Ga Won; Kim, Sang Wun; Nam, Eun Ji; Kim, Sunghoon

2013-01-01

212

Laparoendoscopic single-site radical hysterectomy: the first report of LESS type III hysterectomy involves a woman with cervical cancer.  

PubMed

Laparoendoscopic single-site surgery is a logical advance in the evolution of minimally invasive surgery and is being utilized to perform increasingly complex procedures. We report its use for completion of radical hysterectomy as treatment for cervical cancer. PMID:23111114

Garrett, Leslie A; Boruta, David M

2012-12-01

213

[Transperitoneal technique of preperitoneal mesh implantation in laparoscopic hernioplasty of direct and indirect inguinal hernias].  

PubMed

The method of transperitoneal application of a large polypropylene-mesh in the preperitoneal space for laparoscopic inguinal hernia repair is described. The own experiences with a total number of 64 inguinal hernias are presented. The technique takes the principle of conventional hernia repair into account and appears to be a safe and effective way to repair indirect and direct inguinal uni- or bilateral hernias. During a mean follow-up of 24 weeks one recurrence occurred resulting from an inadequate application of the mesh. The technique presented is effective for laparoscopic inguinal hernia repair with low morbidity. Long-term follow-up is needed to determine late recurrence rate. PMID:8203171

Germer, C T; Albrecht, D; Butz, C; Spröder, J; Wondzinski, A; Häring, R

1994-01-01

214

Early experience with laparoscopic herniorrhaphy: results after the first 60 procedures.  

PubMed Central

The results of the first 60 consecutive laparoscopic hernia repairs performed in Calderdale are presented. These results are encouraging as recovery from surgery is much quicker and allows a shorter hospital stay and a speedier return to work than conventional operations. The laparoscopic procedure takes longer to perform, although this does not seem unacceptable once experience is gained. At present it remains quite expensive and further reductions in hospital stay will need to be achieved to ensure that there is no overall increase in the financial resources required. PMID:8117019

Goodall, R. J.

1994-01-01

215

Single-Incision Laparoscopic Cholecystectomy in Situs Inversus Totalis  

PubMed Central

Background and Objectives: Situs inversus totalis (SIT) is a rare congenital anomaly that can cause difficulties during standard laparoscopic cholecystectomy due to its mirror-image anatomy. These cases require more technically demanding procedures, and handedness of the surgeon may influence performance of these operations. Single-incision laparoscopic surgery (SILS) has been proposed as a less-invasive alternative to conventional laparoscopic surgery. We report the first case of successful SILS cholecystectomy in a patient with SIT and discuss technical aspects of the operation related to the handedness of the surgeon. Case: A 49-year-old man who was known to have situs inversus totalis presented with symptomatic cholelithiasis. This patient was operated on by a right-handed surgeon. The surgeon and camera assistant were positioned on the right and left side respectively with the video monitor above the patient's left shoulder. The SILS port (Covidien), which has 3 operating channels, was placed in the abdomen via a 2-cm intraumbilical incision. SILS cholecystectomy was performed successfully. Dissection of Calot's triangle and the gallbladder bed was performed using a dissector and hook in the right hand without any technical problems. Conclusion: SIT may confer an advantage over the orthotopic position for right-handed surgeons. SILS cholecystectomy can be performed safely in SIT. PMID:21902984

Yetkin, Gurkan; Kartal, Abdulcabbar

2011-01-01

216

Laparoscopic cholecystectomy in the new millennium  

Microsoft Academic Search

Background  Laparoscopic cholecystectomy has become the gold standard for the treatment of symptomatic cholelithiasis. Many authors—including\\u000a investigators at our institution, who reported one of the initial experiences with laparoscopic cholecystectomy in July 1992—have\\u000a documented a definite learning curve associated with this procedure. We present a follow-up study of our experience with laparoscopic\\u000a cholecystectomy and compare these data to an earlier study

J. B. Lichten; J. J. Reid; M. P. Zahalsky; R. L. Friedman

2001-01-01

217

Laparoscopic management of gastric gastrointestinal stromal tumors.  

PubMed

Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gastrointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommendations have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach. PMID:25031788

Correa-Cote, Juan; Morales-Uribe, Carlos; Sanabria, Alvaro

2014-07-16

218

Laparoscopic management of gastric gastrointestinal stromal tumors  

PubMed Central

Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gastrointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommendations have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach. PMID:25031788

Correa-Cote, Juan; Morales-Uribe, Carlos; Sanabria, Alvaro

2014-01-01

219

Single-Port Laparoscopic Right Hemicolectomy: The Learning Curve  

PubMed Central

Background and Objectives: Single-port laparoscopic colectomy is described as a new technique in colorectal surgery. The initial case reports show the safety and feasibility, but the learning curve for this technique is unknown. Methods: Between July 2009 and September 2010, 20 consecutive patients with an indication for right hemicolectomy underwent a single-port laparoscopic approach without bias in selection. The only exclusion criterion was a prior midline laparotomy. The patients were followed up for 30 days. Chart review was completed for up to 35 months to assess long-term morbidity and mortality rates. Results: The median age was 65 years (range, 59–88 years). Ninety percent of patients were men. The median body mass index was 28 kg/m2 (range, 20–35 kg/m2). Seventy-five percent of patients had significant comorbidities with an American Society of Anesthesiologists class of 3 or 4. The estimated blood loss was 25 mL (range, 25–250 mL). The median number of pathologic lymph nodes for patients diagnosed with adenocarcinoma was 16 (range, 8–23). There was one conversion to hand-assisted laparoscopic (case 6) and one to open colectomy (case 9) because of the inability to achieve safe vessel ligation. The median hospital stay was 4.5 days (range, 3–7 days). The length of stay for the first 10 patients was 5.1 days, and it was 3.9 days for the last 10 patients (P = .045). There were no significant postoperative complications within 30 days. The mean operative time for the first 10 cases was 198 minutes (range, 148–272 minutes), and it was 123 minutes (range, 98–150 minutes) for the subsequent 10 cases (P = .0001). All intraoperative complications (minor bleeding) occurred within the first 10 patients, with no significant bleeding recorded for the last 10 cases. Conclusion: Single-port laparoscopic right hemicolectomy can be safely performed in patients who are candidates for conventional or hand-assisted right hemicolectomy with very low intraoperative and postoperative complication rates. The 30-day morbidity rate remained low with this technique. The higher technical difficulty compared with conventional laparoscopy is reflected in the longer initial operative times. The learning curve for a surgeon with advanced laparoscopic skills and adequate procedure numbers seems to be short, requiring approximately 10 cases to decrease operative times to baseline. The role and feasibility of broad adaptation for single-incision laparoscopy in colorectal surgery need to be further evaluated in larger case series and trials. PMID:23925011

Hopping, Jacob R.

2013-01-01

220

Enhanced visualization of the bile duct via parallel white light and indocyanine green fluorescence laparoscopic imaging  

NASA Astrophysics Data System (ADS)

Despite best efforts, bile duct injury during laparoscopic cholecystectomy is a major potential complication. Precise detection method of extrahepatic bile duct during laparoscopic procedures would minimize the risk of injury. Towards this goal, we have developed a compact imaging instrumentation designed to enable simultaneous acquisition of conventional white color and NIR fluorescence endoscopic/laparoscopic imaging using ICG as contrast agent. The capabilities of this system, which offers optimized sensitivity and functionality, are demonstrated for the detection of the bile duct in an animal model. This design could also provide a low-cost real-time surgical navigation capability to enhance the efficacy of a variety of other image-guided minimally invasive procedures.

Demos, Stavros G.; Urayama, Shiro

2014-03-01

221

Laparoscopic devascularization of uterine myomata followed by enucleation of the myomas by direct morcellation.  

PubMed

Most intraoperative conversions of laparoscopic myomectomy to laparotomy reported in the literature occur because of intraoperative bleeding. Devascularization of a uterine myoma at the start of myomectomy would help reduce the blood supply to the uterus and hence to the myoma. Another advantage of the procedure is that the need to separate the myoma from the uterus completely before morcellation, as in conventional laparoscopic myomectomy, is obviated. The tumor can be enucleated only up to about half its circumference by standard enucleation before morcellation is begun. Traction accorded by the 15-mm traumatic serrated-edge claw forceps of the morcellator during morcellation causes progressive separation of the myoma from the uterine wall, thus completing enucleation. In two patients, myomas were devascularized at the outset of myomectomy, in one by intracorporeal suturing of uterine vessels and in the other by laparoscopic bipolar coagulation of uterine vessels. PMID:15104844

Sinha, Rakesh Y; Hegde, Aparna; Warty, Neeta; Jain, Ritu

2004-02-01

222

Laparoscopic splenectomy. Technique and results in a series of 27 cases.  

PubMed

Between early 1992 and December 1994, laparoscopic splenectomy was performed in 27 patients with idiopathic thrombocytopenia (ITP), hairy-cell leucemia, HIV, or Hodgkin's disease. In all cases medical treatment, especially cortisone therapy, failed. In Hodgkin's disease the splenectomy was combined with liver biopsies and dissection of parailiacal, paraaortic, and mesenteric lymph nodes for abdominal staging. The operation was performed using four trocars; the splenic vessels were divided by a linear stapler. In general the spleen was removed in a bag through a slightly enlarged trocar incision or after morcellation. Three patients needed a small laparotomy for the removal (laparoscopic assisted). In a recent case of Hodgkin's disease the intact spleen was removed via posterior colpotomy. In 22 of 27 cases (81%) the operation was finished laparoscopically. Five times a conversion to conventional laparotomy was necessary because of bleeding of enlarged lymph nodes at the hilum. Wound infections occurred in two cases. In one patient with ITP the platelet count did not improve and continuous blood loss led to relaparotomy at the 1st postoperative day. No surgical bleeding was found. All patients tolerated a fluid diet at the 1st postoperative day and hospitalization time was 4.4 days (range 3-14). Regarding the low complication rate and the advantages of a smaller abdominal trauma in the postoperative period, the laparoscopic approach for elective splenectomy and laparoscopic abdominal staging has a substantial benefit for the patients. PMID:8525451

Emmermann, A; Zornig, C; Peiper, M; Weh, H J; Broelsch, C E

1995-08-01

223

Ureteral Obstruction Swine Model through Laparoscopy and Single Port for Training on Laparoscopic Pyeloplasty  

PubMed Central

This study aims firstly to assess the most adequate surgical approach for the creation of an ureteropelvic juntion obstruction (UPJO) animal model, and secondly to validate this model for laparoscopic pyeloplasty training among urologists. Thirty six Large White pigs (28.29±5.48 Kg) were used. The left ureteropelvic junction was occluded by means of an endoclip. According to the surgical approach for model creation, pigs were randomized into: laparoscopic conventional surgery (LAP) or single port surgery (LSP). Each group was further divided into transperitoneal (+T) or retroperitoneal (+R) approach. Time needed for access, surgical field preparation, wound closure, and total surgical times were registered. Social behavior, tenderness to the touch and wound inflammation were evaluated in the early postoperative period. After ten days, all animals underwent an Anderson-Hynes pyeloplasty carried out by 9 urologists, who subsequently assessed the model by means of a subjective validation questionnaire. Total operative time was significantly greater in LSP+R (p=0.001). Tenderness to the touch was significantly increased in both retroperitoneal approaches, (p=0.0001). Surgeons rated the UPJO porcine model for training on laparoscopic pyeloplasty with high or very high scores, all above 4 on a 1-5 point Likert scale. Our UPJO animal model is useful for laparoscopic pyeloplasty training. The model created by retroperitoneal single port approach presented the best score in the subjective evaluation, whereas, as a whole, transabdominal laparoscopic approach was preferred. PMID:23801892

Diaz-Guemes Martin-Portugues, Idoia; Hernandez-Hurtado, Laura; Uson-Casaus, Jesus; Sanchez-Hurtado, Miguel Angel; Sanchez-Margallo, Francisco Miguel

2013-01-01

224

Simultaneous laparoscopic adrenalectomy and laparoscopic nephron-sparing surgery – new experience with port placement  

PubMed Central

The aim of the study was to describe simultaneous laparoscopic adrenalectomy and laparoscopic nephron-sparing surgery, to discuss the details of a convenient laparoscopic approach and the way of port placement, as well as to present a review of the literature concerning combined laparoscopic procedures. A 72-year-old woman was admitted to our department because of a tumor of the right adrenal gland and a small tumor of the right kidney. The patient underwent simultaneous laparoscopic adrenalectomy and laparoscopic nephron-sparing surgery. The postoperative period was uncomplicated. The patient was discharged from the hospital on the 4th postoperative day. We believe that the proposed way of trocar placement would help to avoid a ‘rollover’ problem between the laparoscope and a Satinsky clamp or a ‘crossing swords’ problem between a Satinsky clamp and manipulators. PMID:24501608

Panek, Wojciech; Lewandowski, Jaroslaw; Tuchendler, Tomasz; Urba?czyk, Grzegorz; Litarski, Adam; Apozna?ski, Wojciech

2013-01-01

225

Laparoscopic left pancreatectomy: current concepts.  

PubMed

The minimally invasive approach has been slow to gain acceptance in the field of pancreatic surgery even though its advantages over the open approach have been extensively documented in the medical literature. The reasons for the reluctant use of the technique are manifold. Laparoscopic distal or left sided pancreatic resections have slowly become the standard approach to lesions of the pancreatic body and tail as a result of evolution in technology and experience. A number of studies have shown the potential advantages of the technique in terms of safety, blood loss, oncological and economic feasibility, hospital stay and time to recovery from surgery. This review aims to provide an overview of the recent advances in the field of laparoscopic left pancreatectomy (LLP) and discuss potential future developments. PMID:23890145

Abu Hilal, Mohammad; Takhar, Arjun S

2013-01-01

226

[Laparoscopic resection of an interstitial ectopic twin pregnancy resection: the role of barbed sutures in haemostatic control].  

PubMed

Interstitial pregnancy is a dangerous and uncommon variation of ectopic pregnancy occurring in the interstitial part of the fallopian tube and extending beyond the muscular layer of the uterus. This ectopic pregnancy-related mortality rate has been reported to be as high as 2%-2,5% due to complications involving bleeding and hypervascularity. No prospective clinical trials have evaluated available treatment options for interstitial ectopic pregnancy due to its low incidence; there is thus no consensus regarding optimal treatment. Surgical treatment can be divided into conservative approaches, such as cornuectomy or cornuostomy, and radical approaches such as hysterectomy. However, intraoperative hemorrhage is an ever-present risk, regardless of the surgical approach adopted. This paper presents a case involving a patient who underwent laparoscopic resection of an interstitial twin ectopic pregnancy; a barbed suture pursestring was used which proved useful during the surgical technique and improved hemostasia. PMID:23405508

Cardoso Medina, Byron; Hernández Giraldo, Cristian; Manual Clavijo, Juan; Sarmiento, Piedad

2012-12-01

227

Update: What Is Left for Laparoscopic Hernia Repair?  

Microsoft Academic Search

The risks, benefits and costs of laparoscopic hernia repair are still being debated. According to a current survey on the situation of hernia surgery in Germany in 1996, laparoscopic hernioplasty was done in about 60% of the answering hospitals; about a quarter of all hernia repairs are done laparoscopically. Since April 1993, about 2,700 laparoscopic hernia repairs were done at

R. Bittner; B. Leibl; K. Kraft; J. Schwarz; C.-G. Schmedt

1998-01-01

228

Robotic-assisted laparoscopic radical prostatectomy: the Frankfurt technique  

Microsoft Academic Search

The robotic technique, which was first introduced in laparoscopic heart surgery, has revolutionized laparoscopic surgery over the last 5 years. In May 2000, our department accomplished the first robot assisted laparoscopic radical prostatectomy. Since that time we have performed more than 118 such procedures and several other laparoscopic operations using the robotic technique. We here summarize our experience in robot assisted

M. Wolfram; R. Bräutigam; T. Engl; W. Bentas; S. Heitkamp; M. Ostwald; W. Kramer; J. Binder; R. Blaheta; D. Jonas; W.-D. Beecken

2003-01-01

229

Laparoscopic resection of sigmoid diverticulitis  

Microsoft Academic Search

Background: In the large bowel, resection of the sigmoid colon is the most commonly performed laparoscopic intervention because large\\u000a bowel lesions often are located in this part of the bowel and the procedure technically is the most favorable one. A number\\u000a of publications involving case series or the results of highly experienced individual surgeons already have confirmed the\\u000a feasibility of

F. Köckerling; C. Schneider; M. A. Reymond; H. Scheuerlein; J. Konradt; H. P. Bruch; C. Zornig; L. Köhler; E. Bärlehner; A. Kuthe; G. Szinicz; H. A. Richter; W. Hohenberger

1999-01-01

230

Multimodal Interfaces for Laparoscopic Training  

Microsoft Academic Search

Multimodal interfaces are providing promising simulation solutions for training different practitioners as surgeons. These\\u000a environments present visual and haptic interaction to the trainee, as in a real intervention. They offer numerous advantages\\u000a over the traditional learning process, like the possibility of monitoring the skills and delivering constructive feedback.\\u000a This chapter presents a multimodal interface for laparoscopic training describing the functionality

Pablo Lamata; Carlos Alberola; Francisco Sánchez-Margallo; Miguel Ángel Florido; Enrique J. Gómez

231

Laparoscopic hernia repair in 2000  

Microsoft Academic Search

The 1994 meeting of the European Association for Endoscopic Surgery (E.A.E.S.) in Madrid highlighted a consensus-developing conference on the then new laparoscopic procedure for hernia repair. The conference was chaired by A. Paul from Cologne, Germany, and A. Fingerhut, from Poissy, France. The other members of the jury were B. Millat (France), L. Nyhus (USA), J. Himpens (Belgium), J.-L. Dulucq

A. Fingerhut; B. Millat; N. Bataille; E. Yachouchi; C. Dziri; M.-J. Boudet; A. Paul

2001-01-01

232

Laparoscopic cholecystectomy after bariatric surgery  

Microsoft Academic Search

Background: This prospective study determines the value of laparoscopic cholecystectomy (LC) in patients with cholelithiasis after bariatric surgery. Methods: Eighty-four consecutive patients who underwent bariatric surgery without concomitant cholecystectomy were studied. Patients were divided in two groups; group A including 50 patients (59.5%) without gallbladder disease, and group B included 34 patients (40.5%) with symptomatic cholelithiasis within 2 years postoperatively.

S. Papavramidis; N. Deligianidis; T. Papavramidis; K. Sapalidis; M. Katsamakas; O. Gamvros

2003-01-01

233

Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy  

PubMed Central

Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function. PMID:25379314

Pieh-Holder, Kelly L.; DeVente, James E.

2014-01-01

234

Laparoscopic transvesical removal of erosive mesh after transobturator tape procedure.  

PubMed

We have experienced two cases of intravesical transobturator tape (TOT) tape successfully removed by laparoscopic transvesical procedure. Patient 1 was a 67-year-old woman complaining of irritative symptoms of the urinary bladder. In another hospital she had undergone anterior corporrhaphy and a TOT procedure to treat a cystocele and stress urinary incontinence (SUI) 17 months before the initial consultation. A cystoscopy revealed tape extrusion and adherent calculi at the 4 to 5 O'clock position of the bladder neck. After filling the bladder with carbon dioxide, three 5-mm ports were placed in lower abdomen directly into the bladder. The tape extruding from the bladder muscle layer was completely excised, and extirpated with the adherent calculi. The bladder mucosa and muscle layer were continuously sutured using 4-0 Vicryl (Ethicon Inc., Somerville, NJ, USA). The port entry sites were closed under direct vision using 4-0 Vicryl. SUI recurred 15 months later and a second TOT surgery was performed. Neither SUI nor mesh extrusion have been observed during the 18 months following the second TOT. Patient 2 was a 74-year-old woman. She consulted our hospital for the removal of an intravesically extruded tape and adherent calculi. She had undergone a vaginal hysterectomy and TOT surgery for uterine prolapse and SUI at another hospital 3 years before her visit. A cystoscopy revealed tape extrusion and adherent calculi on the right bladder wall. We performed an endoscopic transvesical extirpation of the intravesical foreign bodies in a same manner described below. There has been no recurrent SUI or mesh erosion during the 18-month follow up. PMID:21992000

Yoshizawa, Tsuyoshi; Yamaguchi, Kenya; Obinata, Daisuke; Sato, Katsuhiko; Mochida, Junichi; Takahashi, Satoru

2011-12-01

235

Laparoscopic pancreatectomy: Indications and outcomes  

PubMed Central

The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and short-term oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons’ experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. PMID:25339811

Liang, Shuyin; Hameed, Usmaan; Jayaraman, Shiva

2014-01-01

236

Learning curve of single port laparoscopic cholecystectomy determined using the non-linear ordinary least squares method based on a non-linear regression model  

Microsoft Academic Search

Introduction  Single port laparoscopic surgery has come to the forefront of minimally invasive surgery. For those familiar with conventional\\u000a techniques, however, this type of operation demands a different type of eye\\/hand coordination and involves unfamiliar working\\u000a instruments. Herein, the authors describe the learning curve and the clinical outcomes of single port laparoscopic cholecystectomy\\u000a for 150 consecutive patients with benign gallbladder disease.

Hyung Joon Han; Sae Byeol Choi; Man Sik Park; Jin Suk Lee; Wan Bae Kim; Tae Jin Song; Sang Yong Choi

2011-01-01

237

Laparoscopic Prostatectomy: Where Do We Stand?  

PubMed Central

Laparoscopic radical prostatectomy is an effective treatment for localized prostate cancer. This cost-intensive and technically demanding operation currently takes longer than the standard open procedures, but with increasing experience, it is eventually associated with lower costs and is nearly as fast. As more urologists gain such experience, the laparoscopic approach may challenge the standard approaches. PMID:16985647

Remzi, Mesut; Djavan, Bob

2002-01-01

238

Laparoscopic versus open left lateral segmentectomy  

Microsoft Academic Search

BACKGROUND: Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. METHODS: Between 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of

Kirstin A Carswell; Filippos G Sagias; Beth Murgatroyd; Mohamed Rela; Nigel Heaton; Ameet G Patel

2009-01-01

239

Hand-assisted laparoscopic sigmoidectomy for diverticulitis  

Microsoft Academic Search

BACKGROUND: Sigmoid colectomy for diverticular disease, a routine procedure when performed using standard open methods, can prove much more challenging using minimum access techniques. Hand-assisted laparoscopic colectomy is a new technique that reportedly has a minimum learning curve, yet retains the benefits of a laparoscopic procedure. The purpose of this study was to perform and then prospectively to evaluate the

Michael J. Mooney; Patrick L. Elliott; Derrick B. Galapon; Linda K. James; Laura J. Lilac; Michael J. O'Reilly

1998-01-01

240

Laparoscopic excision of hepatoduodenal ligament cyst  

PubMed Central

Hepatoduodenal ligament cysts are rare. These may be confused with hepatic cysts even on advanced investigative modalities like Computerized tomography scanning or Magnetic Resonance Imaging. Diagnosis is often an intraoperative surprise. Laparoscopic treatment of such hepatoduodenal cysts is not described in available medical literature. We report one such case treated laparoscopically PMID:22837598

Deshpande, Aparna; Dalvi, Abhay N; Thanky, Harsh B; Khobragade, Krunal

2012-01-01

241

Laparoscopic adrenalectomy: a report on 50 operations  

Microsoft Academic Search

Objective: To investigate the feasibility, safety and results of laparoscopic transperitoneal adrenalec- tomies performed with the patient supine, in patients affected by secreting and silent adrenal lesions. Methods: Exclusion criteria were suspected adrenal primary malignancies. Fifty patients (33 women and 17 men; mean age 49.6 years, range 19-75 years) underwent 51 laparoscopic adrenalectomies (one bilateral). After complete endocrinological evaluation, computed

Silvia Filipponi; Mario Guerrieri; Giorgio Arnaldi; Marilena Giovagnetti; Ana M Masini; Emanuele Lezoche; Franco Mantero

1998-01-01

242

Laparoscopic cholecystectomy in the scarred abdomen  

Microsoft Academic Search

Summary  Laparoscopic cholecystectomy is rapidly becoming the definitive method for treating symptomatic gallbladder stones. Previous\\u000a upper abdominal surgery is a relative contraindication to this technique. We describe a method for safely placing the trocars\\u000a in a scarred abdomen, thus facilitating laparoscopic cholecystectomy in a wider group of patients.

P. A. Grace; A. Leahy; G. McEntee; D. Bouchier-Hayes

1991-01-01

243

Laparoscopic Surgery for Inflammatory Bowel Disease  

Microsoft Academic Search

Laparoscopic surgery has recently been gaining acceptance as an alternative approach for patients with inflammatory bowel disease. There is increasing evidence demonstrating the multiple potential benefits of laparoscopy including faster recovery, reduced costs, and lower morbidity. For patients with acute colitis, a laparoscopic subtotal colectomy and end ileostomy have been shown to be feasible and safe in experienced hands. When

Sergio Casillas; Conor P. Delaney

2005-01-01

244

Cicatrical Cecal Volvulus Following Laparoscopic Cholecystectomy  

PubMed Central

Laparoscopic cholecystectomy is the procedure of choice for the treatment of symptomatic biliary disease. There is currently no agreement on the management of spilled gallstones, which commonly occurs during laparoscopic cholecystectomy and may produce significant morbidity. We present a case of spilled gallstones causing cicatrical cecal volvulus and also provide a review of pertinent literature. PMID:23925032

Morris, Michael W.; Barker, Andrea K.; Harrison, James M.; Anderson, Andrew J.

2013-01-01

245

[Laparoscopic partial nephrectomy: technique and outcomes].  

PubMed

The indication of laparoscopic partial nephrectomy (LPN) has evolved considerably, and the technique is approaching established status at our institution. Over the past 5 years, the senior author has performed more than 450 laparoscopic partial nephrectomies at the Cleveland Clinic. Herein we present our current technique, review contemporary data and oncological outcomes of LPN. PMID:16884101

Colombo, J R; Gill, I S

2006-05-01

246

Understanding Perceptual Boundaries in Laparoscopic Surgery  

Microsoft Academic Search

Human perceptual capabilities related to the laparoscopic interaction paradigm are not well known. Its study is important for the design of virtual reality simulators, and for the specification of augmented reality applications that overcome current limitations and provide a supersensing to the surgeon. As part of this work, this article addresses the study of laparoscopic pulling forces. Two definitions are

Pablo Lamata; Enrique J. Gómez; Félix Lamata Hernández; Alfonso Oltra Pastor; Francisco Miguel Sanchez-Margallo; Francisco del Pozo Guerrero

2008-01-01

247

Dropped Gallstones During Laparoscopic Cholesystectomy: The Consequences  

Microsoft Academic Search

During laparoscopic cholecystectomy, gallbladder perforation has been reported, leading to bile leak and spillage of gallstones into the peritoneum. Because the consequences can be dangerous, conversion to laparotomy as an instant management for gallstone spillage is one of the topics of current discussion in laparoscopic cholesystectomy. In this article, we discussed the option of not converting to laparotomy after intraperitoneal

Ali Riza Tumer; Yunus Nadi Yüksek; Ahmet Cinar Yasti; Ugur Gözalan; Nuri Aydin Kama

2005-01-01

248

Laparoscopic Era of Operations for Morbid Obesity  

Microsoft Academic Search

he goal of this article is to review the status of the emerging field of laparoscopic bariat- ric surgery, to discuss developmental issues regarding technique and training, and fi- nally, to summarize the present and future roles of laparoscopic bariatric surgery. We reviewed all published literature from 1992 to the present on MEDLINE. Articles were excludedforanalysesthatwerecasereportsorarticlesontechnicalaspectsofgivenprocedures.Lap- aroscopic vertical banded gastroplasty

Daniel R. Cottam; Samer G. Mattar; Philip R. Schauer

2003-01-01

249

Symptomatic internal hernias after laparoscopic bariatric surgery  

Microsoft Academic Search

Background: The aim of this study was to describe the occurrence and clinical characteristics of symptomatic internal hernias (IH) after laparoscopic bariatric procedures. Methods: We conducted a retrospective review of cases of IH after 1,064 laparoscopic gastric bypasses (LGB) and biliopancreatic diversions with duodenal switch (LBPD-DS) performed from September 1998 to August 2002. Results: We documented 35 cases of IH

E. Comeau; M. Gagner; W. B. Inabnet; D. M. Herron; T. M. Quinn; A. Pomp

2005-01-01

250

Comparison of Clinical Safety and Outcomes of Early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis  

PubMed Central

Objective. To compare the clinical safety and outcomes of early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy for acute cholecystitis. Methods. Pertinent studies were selected from the Medline, EMBASE, and Cochrane library databases, references from published articles, and reviews. Seven randomized controlled trials (early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy) were selected. Conventional meta-analysis according to Cochrane Collaboration was used for the pooling of the results. Results. Seven trials with 1106 patients were included. There was no significant difference between the two groups in terms of bile duct injury (Peto odds ratio 0.49 (95% confidence interval 0.05 to 4.72); P = 0.54) or conversion to open cholecystectomy (risk ratio 0.91 (95% confidence interval 0.69 to 1.20); P = 0.50). The total hospital stay was shorter by 4 days for early laparoscopic cholecystectomy (mean difference ?4.12 (95% confidence interval ?5.22 to ?3.03) days; P < 0.00001). Conclusion. Early laparoscopic cholecystectomy during acute cholecystitis is safe and shortens the total hospital stay. PMID:25133217

Zhou, Min-Wei; Gu, Xiao-Dong; Xiang, Jian-Bin; Chen, Zong-You

2014-01-01

251

Section 17. Laparoscopic and minimal incisional donor hepatectomy.  

PubMed

Living donor hepatectomy is now a well-established surgical procedure. However, a large abdominal incision is still required, which results in a large permanent scar, especially for a right liver graft. This report reviews our techniques of minimally invasive or minimal incisional donor hepatectomy using a transverse incision.Twenty-five living donors underwent right hepatectomy with a transverse incision and 484 donors with a conventional incision between April 2007 and December 2012. Among the donors with a transverse incision, two cases were totally laparoscopic procedures using a hand-port device; 11 cases were laparoscopic-assisted hepatectomy (hybrid technique), and 14 cases were open procedures using a transverse incision without the aid of the laparoscopic technique. Currently, a hybrid method has been exclusively used because of the long operation time and surgical difficulty in totally laparoscopic hepatectomy and the exposure problems for the liver cephalic portion during the open technique using a transverse incision.All donors with a transverse incision were women except for one. Twenty-four of the grafts were right livers without middle hepatic vein (MHV) and one with MHV. The donors' mean BMI was 21.1 kg/m. The median operation time was 355 minutes, and the mean estimated blood loss was 346.1±247.3 mL (range, 70-1200). There was no intraoperative transfusion. These donors had 29 cases of grade I [14 pleural effusions (56%), 11 abdominal fluid collections (44%), 3 atelectasis (12%), 1bile leak (4%)], 1 case of grade II (1 pneumothorax) and two cases of grade III complications; two interventions were needed because of abdominal fluid collections by Clavien-Dindo classification. Meanwhile, donors with a conventional big incision, which included the Mercedes-Benz incision or an inverted L-shaped incision, had 433 cases of grade I, 19 cases of grade II and 18 cases of grade III complications. However, the liver enzymes and total bilirubin of all donors were normalized within 1 month, and they recovered fully. Additionally, in a survey inquiring about cosmetic outcomes with a numeric scale of 1 through 10 (1, Not confident; 10, Very confident), the transverse incision had more satisfactory scores compared to the conventional big incision (9.80 vs. 6.17, P=0.001). In conclusion, the hybrid technique can be safely performed in donor right hepatectomy, with a minimal transverse skin incision, resulting in a good cosmetic outcome. PMID:24849839

Choi, YoungRok; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk

2014-04-27

252

Risk Factors for Major Depressive Disorder and the Psychological Impact of Hysterectomy: A Prospective Investigation  

Microsoft Academic Search

The authors prospectively evaluated the risk of major depressive disorder and the psychological impact of recent hysterectomy in 68 women who underwent hysterectomy for non-malignant con- ditions. Depression, anxiety, body image, sexual functioning, family support, life stress, and sub- jective gynecological symptoms were assessed 2 weeks before surgery and at 1 month and 4 months after surgery. Depression, anxiety, body

JU-YU YEN; YUNG-HUNG CHEN; C.-Y. Long; YU CHANG; C.-F. Yen; CHENG-CHUNG CHEN; C.-H. Ko

2008-01-01

253

Laparoscopic intersphincteric resection using needlescopic instruments  

PubMed Central

Intersphincteric resection (ISR) is a procedure designed to preserve anal function in cases with very low rectal cancer. We report our clinical experience with laparoscopic ISR (Lap ISR) performed using needlescopic instruments. First, a camera port is created at the umbilicus. Two 5-mm ports are then inserted at the right upper and lower quadrants. Two needlescopic forceps (Endo-Relief™ Hope Denshi Co., Chiba, Japan) are inserted at the left upper and lower quadrants. We then perform the following procedures; ligation of the inferior mesenteric artery and vein, total mesorectal excision and dissection of the intersphincteric space. After the transanal intersphincteric dissection, the specimen is extracted through the anus and a hand —sewn coloanal anastomosis is performed. The covering ileostomy is finally created at the right upper port. We performed Lap ISR using needlescopic forceps in two patients with very low rectal cancer. In both cases, we were able to perform this procedure without insertion of an additional port or to change the needlescopic forceps to conventional 5-mm forceps. Lap ISR with needlescopic instruments is a feasible procedure for minimally invasive surgery.

Sakamoto, Kazuhiro; Okazawa, Yu; Takahashi, Rina; Sugimoto, Kiichi; Komiyama, Hiromitsu; Takahashi, Makoto; Kojima, Yutaka; Goto, Michitoshi; Okuzawa, Atsushi; Tomiki, Yuichi

2014-01-01

254

Laparoscopic cholecystectomy: technique, safety, and results  

NASA Astrophysics Data System (ADS)

Laparoscopic cholecystectomy (LC) is a minimally invasive method of removing the diseased gallbladder. It was introduced into Lithuania in December 1992 and has gained wide acceptance. While LC offers many advantages over the conventional laparotomy procedure one of its drawbacks is delayed biliary complications. Those complications may be avoided with appropriate precautions. The aim of this research is to maximize the safety of LC. The potential way to solve this problem is to minimize the possible heat damage and electrical injury remote from the site of surgery during dissection of the cystic duct, cystic artery, and the gallbladder. Neodymium:YAG laser applications with endoscopic fiber have been investigated. The possibilities to use it as a scalpel and as coagulator to release the gallbladder from all its peritoneal attachments during LC have been investigated. The controversy over optimal sources for thermal dissection of the gallbladder has been performed. The potential benefits of Nd:YAG laser in surgery -- precise cutting, limited collateral tissue damage, and improved capillary and arteriole hemostasis -- have been found.

Simutis, Gintaras; Bubnys, A.; Vaitkuviene, Aurelija

1994-12-01

255

Laparoscopic versus open left lateral segmentectomy  

PubMed Central

Background Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. Methods Between 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of 20 patients analysed, laparoscopic (n = 10) were compared with open left lateral segmentectomy (n = 10). Both groups had similar patient characteristics. Results Morbidity rates were similar with no wound or chest infection in either group. The conversion rate was 10% (1/10). There was no difference in operating time between the groups (median time 220 minutes versus 179 minutes, p = 0.315). Surgical margins for all lesions were clear. Less postoperative opiate analgesics were required in the laparoscopic group (median 2 days versus 5 days, p = 0.005). The median postoperative in-hospital stay was less in the laparoscopic group (6 days vs 9 days, p = 0.005). There was no mortality. Conclusion Laparoscopic left lateral segmentectomy is safe and feasible. Laparoscopic patients may benefit from requiring less postoperative opiate analgesia and a shorter post-operative in-hospital stay. PMID:19735573

Carswell, Kirstin A; Sagias, Filippos G; Murgatroyd, Beth; Rela, Mohamed; Heaton, Nigel; Patel, Ameet G

2009-01-01

256

[The importance and role of laparoscopic appendectomy].  

PubMed

Inspite of earlier beginning the laparoscopic appendectomy is in the shadow of laparoscopic cholecystectomy. In connection with laparoscopic appendectomy some problems are discussed--his significance or substantiality, techniques, advantages or disadvantages in contrast to classical appendectomy. The authors discussed these questions on the base of their own experiences with 56 laparoscopic appendectomies. These were done from 21. October 1992 to 7. February 1994. Known advantages of laparoscopic procedures are expressed--shorter hospital stay after the operation (in average 2.3 days), better view in the operating field with possibility of the treatment of gynecological pathology. Technical aspects are also discussed. The equipment with staplers according their opinion is needed. The time of the operations--average 44 minutes--is acceptable. The complication and conversion rate, which were noted in 3.6% resp. 5.3%, is quite good. There is a possibility to lower these numbers with increasing experience. The possibility for training in the laparoscopic field is great opportunity especially for young surgeons. In the end there is stated, that the authors consider laparoscopic appendectomy as an important step to the advanced procedures. The broad acceptance is recommended. PMID:7940038

Holéczy, P; Novák, P; Malina, J

1994-07-01

257

Outcomes after Combined Laparoscopic Gastrectomy and Laparoscopic Cholecystectomy in Gastric Cancer Patients  

Microsoft Academic Search

Background\\/Aims: The purpose of this study was to determine the effect of performing laparoscopic cholecystectomy on patients undergoing laparoscopic-assisted gastrectomy for gastric cancer. Methods: This single center study involved a retrospective review of a database of 400 patients who underwent consecutive laparoscopic-assisted gastrectomy for early gastric cancer from June 2003 to July 2007. Outcomes in 26 patients who underwent both

I. H. Jeong; S. U. Choi; S. R. Lee; J. H. Kim; J. M. Park; S. H. Jin; E. K. Choi; Y. K. Cho; S. U. Han

2009-01-01

258

Hand-assisted laparoscopic surgery using Gelport  

PubMed Central

Introduction: Minimally invasive surgery has revolutionized general surgery during the past 10 years. However, for more advanced surgical procedures, the acceptance of the minimally invasive approach has been slower than expected. Advanced laparoscopic surgery is complex and time-consuming. The major drawbacks of laparoscopic surgery are two-dimensional view, lack of depth perception and loss of tactile sensation. This has led to the innovation of hand-assisted laparoscopic surgery (HALS). The objective of the present study was to determine that safety of HALS. Materials and Methods: We preformed 18 HALS procedures in our department between July 2003 and January 2005 on patients who had given their informed consent for the use of Gelport. Out of these, 15 were colectomy, 2 nephrectomy and 1 splenectomy. Out of the 18 patients, 13 were males and 5 were females with the age group ranging from 44 to 72 years. Results: Hand-assisted laparoscopic surgery could be completed in 17 patients maintaining all the oncological principals of surgery. The mean operating times were 120 min for right haemicolectomy, 135 min for left colectomy, 150 min for splenectomy, and 150 min for nephrectomy. The patient undergoing radical nephrectomy by HALS had to be converted to open surgery. As the tumour was large and adherent to the spleen and posterior peritoneal wall. Postoperative recovery was excellent with an average hospital stay of 5 days. Histopathology report showed wide clearance and till date we have a good follow up of 30–380 days. Conclusion: Hand-assisted laparoscopic surgery allows tactile sensation and depth perception thereby may simplify the complex procedures. This may result in reduction of operating time and conversion rates at the same time maintaining all the oncological principles. Hand-assisted laparoscopic surgery strikes a perfect balance between an extended open laparotomy incision and an excessively tedious laparoscopic exercise. Hand assistance is an initial tool for the trainee laparoscopic surgeon or a last resort for the experienced laparoscopic surgeon. PMID:21188007

Gupta, Puneet; Bhartia, V K

2005-01-01

259

Laparoscopic cholecystectomy utilizing two ports.  

PubMed

Laparoscopic cholecystectomy is usually performed via four to five cannulas; a few surgeons employing only three. A technique utilizing two entry ports, an infraumbilical Hasson 10 mm and a medial subcostal 5 mm, is described. The operation was feasible in six of seven patients. In the seventh, a third cannula was placed to allow traction on a floppy gallbladder. No complications ensued and all patients went home the day following operation. While cosmesis was impressive, the patients appeared to experience pain similar to that of patients in whom more cannulas were employed. PMID:8694956

Laws, H L

1996-08-01

260

Laparoscopic colectomy for colonic polyps  

Microsoft Academic Search

Background  Benign colonic polyps not amenable to colonoscopic resection or those containing carcinoma require surgical excision. Traditionally,\\u000a formal colectomy with clearance of the lymphatic basin has been performed. The aim of this study was to review our experience\\u000a with the laparoscopic approach for retrieval of colonic polyps with specific emphasis on safety, feasibility, and tumor localization.\\u000a \\u000a \\u000a \\u000a Methods  Retrospective chart review of all

Oded Zmora; Barak Benjamin; Avi Reshef; David Neufeld; Danny Rosin; Ehud Klein; Amram Ayalon; Baruch Shpitz

2009-01-01

261

Outcome after cholecystectomy for symptomatic gall stone disease and effect of surgical access: laparoscopic v open approach  

Microsoft Academic Search

The pre and postoperative symptoms and outcome after surgery in patients with symptomatic gall stone disease were evaluated by a detailed self administered postal questionnaire. The survey was conducted in two groups: 80 patients treated by laparoscopic cholecystectomy and an age matched cohort of patients who had conventional open cholecystectomy. The overall response rate on which the data were calculated

G C Vander Velpen; S M Shimi; A Cuschieri

1993-01-01

262

Present status of endoscopic surgery in Japan: laparoscopic surgery and laparoscopic assisted surgery for gastric cancer  

NASA Astrophysics Data System (ADS)

In this report, I would like to explain the latest data from the 7th National Survey 2004, by the Japan Society for Endoscopic Surgery (1). Next, I will explain you the comment on laparoscopic gastric cancer operation, in particular. We perform the following 3 surgical procedures. (1) Intragastric method (2) Laparoscopic lesion lifting method (3) Laparoscopic assisted gastric resection Mastery of basic techniques and thorough understanding of topographic anatomy are the most important (2). Furthermore, it is necessary for a surgeon with experience of at least 50 cases of laparoscopic surgery to be involved in surgery as an assistant.

Hiki, Yoshiki; Kitano, Seigo

2005-07-01

263

Laparoscopic versus open approach for solitary insulinoma  

Microsoft Academic Search

Background  In recent years, advances in laparoscopic techniques have allowed surgeons to treat pancreatic lesions laparoscopically. Insulinoma,\\u000a the most prevalent pancreatic endocrine tumor, is mostly benign and curable with surgical resection. This study aimed to assess\\u000a the results from laparoscopic resection (LG) of insulinomas and to compare them with the results from open surgery (OG).\\u000a \\u000a \\u000a \\u000a Methods  From September 1999 to December 2005,

Antonio Sa Cunha; Cedric Beau; Alexandre Rault; Bogdan Catargi; Denis Collet; Bernard Masson

2007-01-01

264

Laparoscopic transperitoneal bladder diverticulectomy: surgical technique.  

PubMed

A large bladder diverticulum causing poor emptying in an 84-year-old man was removed laparoscopically in a 6.5-h operation. The patient was discharged from the hospital on the third postoperative day, having had minimal analgesic requirements. A Council catheter and stylet in the diverticulum greatly facilitated identification of the sac with the laparoscope. Difficulties with intracorporeal knot tying were avoided by using the Lapra-Ty system. Experienced laparoscopic surgeons may find this method of diverticulectomy valuable. With experience, the operating time should be reduced. PMID:7612940

Jarrett, T W; Pardalidis, N P; Sweetser, P; Badlani, G H; Smith, A D

1995-04-01

265

Single-incision laparoscopic surgery - current status and controversies  

PubMed Central

Scarless surgery is the Holy Grail of surgery and the very raison d’etre of Minimal Access Surgery was the reduction of scars and thereby pain and suffering of the patients. The work of Muhe and Mouret in the late 80s, paved the way for mainstream laparoscopic procedures and it rapidly became the method of choice for many intra-abdominal procedures. Single-incision laparoscopic surgery is a very exciting new modality in the field of minimal access surgery which works for further reducing the scars of standard laparoscopy and towards scarless surgery. Natural orifice translumenal endoscopic surgery (NOTES) was developed for scarless surgery, but did not gain popularity due to a variety of reasons. NOTES stands for natural orifice translumenal endoscopic surgery, a term coined by a consortium in 2005. NOTES remains a research technique with only a few clinical cases having been reported. The lack of success of NOTES seems to have spurred on the interest in single-incision laparoscopy as an eminently doable technique in the present with minimum visible scarring, rendering a ‘scarless’ effect. Laparo-endoscopic single-site surgery (LESS) is, a term coined by a multidisciplinary consortium in 2008 for single-incision laparoscopic surgery. These are complementary technologies with similar difficulties of access, lack of triangulation and inadequate instrumentation as of date. LESS seems to offer an advantage to surgeons with its familiar field of view and instruments similar to those used in conventional laparoscopy. LESS remains a evolving special technique used successfully in many a centre, but with a significant way to go before it becomes mainstream. It currently stands between standard laparoscopy and NOTES in the armamentarium of minimal access surgery. This article outlines the development of LESS giving an overview of all the techniques and devices available and likely to be available in the future. PMID:21197236

Rao, Prashanth P; Rao, Pradeep P; Bhagwat, Sonali

2011-01-01

266

Laparoscopy and laparoscopic ultrasonography for staging pancreatic cancer: critical appraisal.  

PubMed

A pilot study was designed to elucidate the role of staging laparoscopy for determining resectability in patients with pancreatic cancer. The additional value of laparoscopic contact ultrasonography (LCU) was also evaluated with specific regard to its ability to detect hepatic metastases and assess vascular infiltration of the portomesenteric trunk. A consecutive sample of 50 patients referred for operation of a suspected pancreatic cancer were submitted to preoperative contrast-enhanced high-resolution computed tomography (CT) and staging laparoscopy combined with LCU at a university hospital. For those progressing to exploratory laparotomy, the intraoperative findings relating to tumor diffusion and vascular infiltration were compared to CT, laparoscopic, and LCU data. Analytical description of the laparoscopic findings is given. Row data of predicted versus observed vascular infiltration were tabulated for CT and LCU. The sensitivity, specificity, and overall accuracy of each diagnostic test were calculated for comparative analysis. Laparoscopy alone prevented unnecessary laparotomy in 20% of cases. A complete procedure could not be achieved in 28% of patients. Three false-negative staging results occurred. LCU identified small (benign) hepatic nodules not seen by CT in 8% of patients. Sensitivity, specificity, and overall accuracy for assessing vascular infiltration were 82%, 53%, and 69% for CT and 94%, 80%, and 87% for LCU. Laparoscopy was confirmed to be safe and effective for staging pancreatic cancer. Because of its unique capabilities to detect even small peritoneal tumor deposits a quick exploration immediately before laparotomy is advised in all patients. The additional benefit of a more extensive procedure is not supported by our results. Although LCU appears to define the vascular involvement more accurately than conventional CT, the limitation of getting clinically useful ultrasound data in all the patients suggests its adoption in only a selected population. PMID:10512938

Pietrabissa, A; Caramella, D; Di Candio, G; Carobbi, A; Boggi, U; Rossi, G; Mosca, F

1999-10-01

267

Radical Hysterectomy with Pelvic Lymphadenectomy: Indications, Technique, and Complications  

PubMed Central

Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA2 and IB1 carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (<1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases. PMID:20871657

Ware, Rachel A.; van Nagell, John R.

2010-01-01

268

Constipation does not develop following elective hysterectomy: a prospective, controlled study.  

PubMed

Although there have been reports that women develop constipation following hysterectomy, previous studies were either retrospective or uncontrolled. The aim of this prospective, controlled study was to assess whether constipation develops after elective hysterectomy. Women undergoing elective gynaecological surgery were compared to matched non-surgery controls at enrollment and 3 and 12 months after surgery. The subset of women who underwent elective hysterectomy was the study group for the present report. Fifty-eight of the 132 elective surgery patients underwent hysterectomy and were compared to 123 controls. There was no difference between the groups at any follow-up point in functional constipation (P = 1.0), frequency of stools (P = 0.92), stool consistency (P = 0.42), straining (P = 0.43), feeling of obstruction (P = 0.6) or need to manually evacuate stool (P = 1.0). Significantly, more hysterectomy patients without baseline pain did develop abdominal pain at 3 or 12 months than non-surgery controls (16.7% vs 3.6%, P = 0.008). We conclude that there was no significant change in bowel habit or stool characteristics in women undergoing hysterectomy even though many developed abdominal pain. This prospective, controlled study challenges existing data regarding the effect of hysterectomy on constipation. PMID:18798795

Sperber, A D; Morris, C B; Greemberg, L; Bangdiwala, S I; Goldstein, D; Sheiner, E; Rusabrov, Y; Hu, Y; Katz, M; Freud, T; Neville, A; Drossman, D A

2009-01-01

269

The need for counselling of women who undergo hysterectomy: a feminist perspective.  

PubMed

Many women have hysterectomies in Australia each year, yet the consequences of hysterectomy in women's lives are not well understood. Approximately 36,015 hysterectomies are performed annually in Australia (Australian Institute of Health and Welfare 1998). Recent nursing literature suggests that information regarding hysterectomy is inadequately discussed with the patient, and for whatever reason the patient has made the 'choice' to undergo hysterectomy, it appears little information or counselling is available to many women in this position. Many women view the uterus as their 'function' and with its removal, they may perceive that their femininity is challenged. Nursing literature is gathering momentum, and proposing a greater commitment from nurses to counsel in the gynaecological area (McQueen 1997). Nurses working in all specialities need to develop an awareness of how illness can impact upon the sexuality or sexual health of their client group, and be able to facilitate the provision of appropriate support (Palmer 1998). This paper will explore the symbolic themes of hysterectomy identified in Wood & Giddings' (1991) research, and will consider the reasons why women who undergo hysterectomy are not receiving sufficient information, counselling and follow-up. PMID:11096795

Le Cornu, J

1999-06-01

270

Laparoscopic repair of a Littre’s hernia with porcine dermal collagen implant (Permacol)  

Microsoft Academic Search

Background  Littre’s hernia was originally defined as “the presence of a Meckel’s diverticulum in any hernia sac” by Rieke in 1841. It\\u000a is a rare finding at any age,\\u0009 and its true incidence is unknown. The conventional treatment for Littre’s hernia is wedge\\u000a resection of the diverticulum and repair of the hernia from within the sac. However, the advent of laparoscopic

N. Smart; A. Immanuel; M. Mercer-Jones

2007-01-01

271

Minimizing knot tying during reconstructive laparoscopic urology  

Microsoft Academic Search

ObjectivesIntracorporeal knot tying during urologic reconstructive surgery is one of the most technically challenging skills of laparoscopic surgery. We describe our experience using the Lapra-Ty clip to substitute for knot tying.

Arieh L. Shalhav; Marcelo A. Orvieto; Gary W. Chien; Albert A. Mikhail; Gregory P. Zagaja; Kevin C. Zorn

2006-01-01

272

Should all distal pancreatectomies be performed laparoscopically?  

PubMed

Despite the relatively slow start of laparoscopic pancreatectomy relative to other laparoscopic resections, an increasing number of these procedures are being performed around the world. Operations that were once considered impossible to perform laparoscopically, such as pancreaticoduodenectomy and central pancreatectomy are gaining momentum. Technology continues to improve, as does surgical experience and prowess. There are both enough experience and data (though retrospective) to confirm that LDP with or without spleen preservation appears to be a safe treatment for benign or noninvasive lesions of the pancreas. Based on the fact that LDP can be performed with similar or shorter operative times, blood loss, complication rates, and length of hospital stay than ODP, it can be recommended as the treatment of choice for benign and noninvasive lesions in experienced hands when clinically indicated. It is very difficult to make clear recommendations with regard to laparoscopic resection of malignant pancreatic tumors due to the lack of conclusive data. As long as margins are negative and lymph node clearance is within accepted standards, LDP appears to have no untoward oncologic effects on outcome. Certainly more data, preferably in the manner of a randomized clinical trial, are needed before additional recommendations can be made. Potential benefits of laparoscopic resection for cancer include the ability to inspect the abdomen and abort the procedure with minimal damage if occult metastases are identified. This does not delay the onset of palliative chemotherapy, which would be the primary treatment in that circumstance. In fact, there is evidence to suggest that there is a greater likelihood of receiving systemic therapy if a laparotomy is avoided in patients who have radiologically occult metastases. Patients may also undergo palliative laparoscopic gastric and biliary bypass if indicated. Faster wound healing may also translate into a shorter waiting time before initiating adjuvant chemotherapy and/or radiation therapy. If the patient develops a wound infection, the infection should be more readily manageable with smaller incisions. Although not proven clinically relevant in humans, the reduction in perioperative stress associated with laparoscopic resection may translate to a cancer benefit for some patients. One report compared markers of systemic inflammatory response in 15 subjects undergoing left pancreatectomy. Eight had hand-access laparoscopic procedures and the rest had standard open surgery. The subjects in the laparoscopic group had statistically lower C-reactive protein levels than the open group on postoperative days one (5.5 mg/dL versus 9.7 mg/dL, P = .006) and three (8.5 mg/dL versus 17.7 mg/dL, P = .003), suggesting that the laparoscopic approach to left pancreatectomy is associated with less inflammation. While this report is underpowered, it supports the notion that MIS cancer surgery may induce less of a systemic insult to the body than standard open cancer surgery. More work in this area is necessary before any firm conclusions can be drawn. An important issue to consider is that of training surgeons to perform these complex procedures laparoscopically. Not all pancreatectomies are amenable to the laparoscopic approach, even in the most skilled hands. As such, only a percentage of cases will be performed this way and expectations to educate surgeons adequately to perform advanced laparoscopic procedures can be unrealistic, resulting in more "on-the-job" training. Another aspect that draws some controversy is that of the totally laparoscopic procedure versus the hand-access approach. No laparoscopic instrument provides the tactile feedback possible to obtain with the hand. The HALS approach allows for this, and the opportunity to control bleeding during the procedure. HALS also provides a way to improve confidence during the learning-curve phase of these operations. Finally, it is important to remember that if the procedure is failing to progress laparoscopically, or if cancer surgery princ

Merchant, Nipun B; Parikh, Alexander A; Kooby, David A

2009-01-01

273

Laparoscopic Marsupialization of Symptomatic Polycystic Kidney Disease  

Microsoft Academic Search

PurposeAlthough laparoscopic unroofing of simple renal cysts has proved to be an effective form of therapy, its use for treatment of multiple renal cysts or symptomatic autosomal dominant polycystic kidney disease only recently has been investigated.

James A. Brown; Vicente E. Torres; Bernard F. King; Joseph W. Segura

1996-01-01

274

LAPAROSCOPIC RADICAL CYSTECTOMY IN THE FEMALE  

Microsoft Academic Search

Purpose:We detail the technique of completely intracorporeal laparoscopic radical cystectomy in the female patient, which has previously not been well described in the literature. Additionally, perioperative and short-term oncological outcome data are presented.

ALIREZA MOINZADEH; INDERBIR S. GILL; MIHIR DESAI; ANTONIO FINELLI; TOMMASO FALCONE; JIHAD KAOUK

2005-01-01

275

Infected Aortic Pseudoaneurysm following Laparoscopic Cholecystectomy  

Microsoft Academic Search

A 38-year-old hemodialysis-dependent diabetic female patient underwent a laparoscopic cholecystectomy for symptomatic cholelithiasis. Postoperatively, she developed chronic back pain. Eight months following laparoscopic cholecystectomy, she developed fevers and recurrent bacteremia with methicillin-resistant Staphylococcus aureus, despite removal of all indwelling intravenous dialysis access. An abdominal CT scan demonstrated a 7-cm pseudoaneurysm extending from the right anterolateral lower abdominal aorta. Following resection

Mark M. Levy

2001-01-01

276

Laparoscopic cholecystectomy as an outpatient procedure  

Microsoft Academic Search

Background:Laparoscopic cholecystectomy is still done mainly on an inpatient basis at hospitals or on an outpatient basis at ambulatory care departments inside hospitals.Study Design:We reviewed 213 cases in which outpatient laparoscopic cholecystectomy was done at an ambulatory surgical center not associated with a hospital physically or administratively. Patients were selected solely on the basis of medical history and physical examination

David Lam; Rodrigo Miranda; Shirley J Hom

1997-01-01

277

Laparoscopic-assisted surgery for constipation  

Microsoft Academic Search

:   The aim of this study was to evaluate the safety, outcome and disability of various forms of laparoscopic-assisted colectomy\\u000a for constipation. Between August 1991 and February 1995, 14 patients with constipation who underwent laparoscopic assisted\\u000a total abdominal colectomy with ileorectal anastomosis (TAC + IR) or sigmoidectomy with colorectal anastomosis (SC + CR) with\\u000a or without rectopexy were analyzed. Parameters

O. Alabaz; A. Nessim; A. Iroatulam; S. D. Wexner

1999-01-01

278

Laparoscopic vs open approach for Nissen fundoplication  

Microsoft Academic Search

  Background: Several studies, most of them nonrandomized, have shown similar functional results for both laparoscopic and open\\u000a Nissen fundoplication, the operation of choice for the treatment of gastroesophageal reflux disease (GERD). Methods: A total\\u000a of 106 patients with documented GERD were randomized to receive either a laparoscopic or an open Nissen fundoplication. Preoperative\\u000a and postoperative investigations included clinical assessment, esophagogram,

E. Chrysos; J. Tsiaoussis; E. Athanasakis; O. Zoras; J. S. Vassilakis; E. Xynos

2002-01-01

279

Laparoscopic ventral hernia repair during pregnancy  

Microsoft Academic Search

Background  Laparoscopic ventral hernia repair in comparison to open herniorrhaphy results in reduced length of stay, less post-operative\\u000a pain, earlier return to work, and reduced complications for the repair of complex ventral hernias. The laparoscopic approach\\u000a has been the standard of care for complex or large ventral hernias for non-pregnant patients over the past decade. Despite\\u000a evidence that demonstrates that laparoscopy

P. Y. Wai; J. A. Ruby; K. A. Davis; A. C. Roberts; K. E. Roberts

2009-01-01

280

Functional results two years after laparoscopic rectopexy  

Microsoft Academic Search

Background: Rectopexy is one of the accepted treatment options for full-thickness rectal prolapse, but the details of the technique remain controversial. This unit has adopted a laparoscopic approach as an alternative to open surgery, and has used three techniques: mesh, suture, and resection. This retrospective study compares the long-term outcome.Methods: From 1993 to 1995, 14 patients underwent a laparoscopic posterior

Stéphane Benoist; Nick Taffinder; Stuart Gould; Avril Chang; Ara Darzi

2001-01-01

281

Postoperative complications after laparoscopic incisional hernia repair  

Microsoft Academic Search

  Background: The popularity of laparoscopic repair of incisional hernias is increasing due to the apparent advantages of laparoscopy.\\u000a Patients and methods: A group of 150 consecutive patients with incisional hernias were treated by laparoscopic IPOM technique\\u000a with a Goretex Dualmesh between September 1999 and September 2001 and subsequently followed up. Some minor and major complications\\u000a could clearly identify advantages as

D. Berger; M. Bientzle; A. Müller

2002-01-01

282

Laparoscopic-assisted abdominal aortic aneurysmectomy  

Microsoft Academic Search

Purpose: The technical elements and early results of laparoscopic-assisted abdominal aortic aneurysmectomy are described. Methods: From February 1997 to May 1999, 60 patients underwent elective laparoscopic surgery for infrarenal abdominal aortic aneurysm. Patients ranged in age from 53 to 87 years (mean age, 70.6 years). The mean aneurysm size was 5.7 cm (range, 4.4-8.0 cm). All patients underwent aortography and

John J. Castronuovo; Kevin V. James; Michael Resnikoff; Edward R. McLean; John K. Edoga

2000-01-01

283

Robotic-assisted laparoscopic vesiculectomy for lower urinary tract obstruction by a large seminal vesicle cyst  

PubMed Central

INTRODUCTION Seminal vesicle (SV) cysts are rare, benign lesions. Most of them are congenital in origin and are usually diagnosed incidentally due to extensive imaging. When symptomatic, surgical excision is recommended. PRESENTATION OF CASE We describe the case of a 17.2 cm seminal vesicle cyst removed using a transperitoneal, robotic-assisted laparoscopic approach in a 45-year old male with lower urinary tract symptoms and no other genitourinary abnormality. DISCUSSION Laparoscopic excision of seminal vesicle cysts is a minimal invasive alternative to the open technique with single-center studies reporting high success rates. With the advent of the robotic platform, urologists have shifted to this approach especially for confined anatomical spaces such as the pelvis. To our knowledge this is the largest seminal vesicle cyst described in the literature that has been managed by minimally invasive surgery. CONCLUSION With the advantage of combined 3D vision and wristed instrumentation, excision of large seminal vesicle cysts by robotic assisted laparoscopic approach is feasible, safe and regarded as a natural continuity of conventional laparoscopy. Previous experience in Robotic assisted laparoscopic prostatectomy (RALP) especially in the posterior dissection technique is recommended. PMID:22613183

Ploumidis, Achilles; Sooriakumaran, Prasanna; Philippou, Prodromos; Wiklund, N. Peter

2012-01-01

284

Mexican beliefs and attitudes toward hysterectomy and gender-role ideology in marriage.  

PubMed

One hundred and sixty-one Mexican respondents completed a questionnaire that measured beliefs and attitudes toward hysterectomy and another that measured gender-role ideology in marriage (GRIMQ). The participants were divided into two groups according to the GRIMQ: "high machismo/marianismo" and "low machismo/marianismo" groups. The participants belonging to the first group showed the most negative attitudes toward hysterectomy. In this group, men showed more negative attitudes toward hysterctomy and were less likely than women to believe that hysterectomy has positive aspects. The findings are discussed in light of male dominance and female subordination that prevail in certain cultural groups of Mexico.xs. PMID:22577739

Marván, Ma Luisa; Quiros, Vanessa; López-Vázquez, Esperanza; Ehrenzweig, Yamilet

2012-01-01

285

Automated Instrument Tracking in Robotically-Assisted Laparoscopic Surgery  

E-print Network

Automated Instrument Tracking in Robotically-Assisted Laparoscopic Surgery Darrin R. Uecker automated instrument localization and scope maneuvering in robotically-assisted laparoscopic surgery efficient in performing surgery without requiring additional use of the hands. Key Words: Laparoscopy

Wang, Yuan-Fang

286

LAPAROSCOPIC RADICAL ADRENALECTOMY FOR MALIGNANCY IN 31 PATIENTS  

Microsoft Academic Search

Purpose:Laparoscopic adrenalectomy for malignancy is controversial. We analyzed our experience with laparoscopic radical adrenalectomy for cancer with an emphasis on predictors of surgical outcome and oncological followup data.

ALIREZA MOINZADEH; INDERBIR S. GILL

2005-01-01

287

Postural mechatronic assistant for laparoscopic solo surgery (PMASS)  

Microsoft Academic Search

Background and purpose  Laparoscopes used in laparoscopic surgery are manipulated by human means, passive systems or robotic systems. All three methods\\u000a accumulate downtime when the laparoscope is cleaned and the optical perspective is adjusted. This work proposes a new navigation\\u000a system that autonomously handles the laparoscope, with a view to reducing latency, and that allows real-time adjustment of\\u000a the visual perspective.

Arturo Minor Martinez; Jesús Villalobos Gomez; Ricardo Ordorica Flores; Daniel Lorias Espinoza

2009-01-01

288

Single-Incision Laparoscopic Splenectomy  

PubMed Central

Background and Objectives: The single-incision approach in laparoscopic surgery is a relatively new concept. This systematic review of the literature was performed to appraise the existing clinical evidence concerning the use of the single-incision technique for spleen resection. Methods: We performed a systematic search of the PubMed and Scopus databases, and the studies retrieved were included in our review. The references of the included studies were also hand searched. Results: Thirty-one relevant studies were found in the field including 81 patients with an age range from 0.6 to 90 years and a body mass index range from 18 to 36.7 kg/m2. Splenomegaly (44.6%), idiopathic thrombocytopenic purpura (31%), and immune thrombocytopenic purpura (6.8%) were the most common indications for the procedure. Concerning the applied port system, multiple single ports (5 to 12 mm) were used in 54.4% of patients, the SILS port (Covidien, Mansfield, Massachusetts) was used in 26.6%, the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) was used in 7.6%, glove ports were used in 6.3%, and the GelPort (Applied Medical, Rancho Santa Margarita, California) was used in 5.1%. The median operative time was 125 minutes (range, 45–420 minutes), and the median quantity of blood loss was 50 mL (range, 10–450 mL). No conversion to open surgery and no transfusion were needed. The length of hospital stay was between 1 and 9 days. Low rates of complications and no patient deaths were found. The existing evidence on cosmesis is limited. Conclusion: Single-site/single-port laparoscopic surgery is a minimally invasive procedure that seems to be a challenging alternative in the management of spleen resection.

Mourtarakos, Sarantis; Iavazzo, Christos

2014-01-01

289

Laparoscopic Colectomy vs. Open Colectomy For Sigmoid Diverticular Disease  

Microsoft Academic Search

PURPOSE: The feasibility of laparoscopic colectomy for colon surgery has now been well established. Most of the studies on laparoscopic colectomies include all types of colonic pathologies without discrimination. Our goal was to compare laparoscopic sigmoid colectomy vs. open sigmoid colectomy for simple sigmoid diverticular disease, to assess whether it can be done safely and whether the proposed advantages could

Amit Dwivedi; Fadi Chahin; Sunita Agrawal; W. Y. Chau; A. Tootla; F. Tootla; Yvan J. Silva

2002-01-01

290

Laparoscopic splenectomy in the elderly: a morbid procedure?  

Microsoft Academic Search

Background: Laparoscopic splenectomy has emerged as the gold standard for elective splenectomy. Few reports have critically evaluated the results of laparoscopic splenectomy in elderly patients. Methods: All laparoscopic splenectomies performed between August 19, 1998 and June 8, 2004 were reviewed retrospectively. Results: Of 235 splenectomies, 188 were performed for patients younger than age 65 years (group 1), and 45 were

S. M. Kavic; R. D. Segan; A. E. Park

2005-01-01

291

Enhancing cosmesis in laparoscopic colon and rectal surgery  

Microsoft Academic Search

PURPOSE: The only unanimously accepted advantage of laparoscopic colon and rectal surgery, at present, is cosmesis. Techniques to enhance cosmesis in laparoscopic surgery are presented. METHOD: Careful and meticulous placement of laparoscopic ports and incisions enhance the cosmetic effect of the procedure. Determination of port sites is aided, in part, by preoperative assessment of natural skin folds and creases by

Tiong-Ann Teoh; Petachia Reissman; Eric G. Weiss; Roberto Verzaro; Steven D. Wexner

1995-01-01

292

Hospital Costs of Uterine Artery Embolization and Hysterectomy for Uterine Fibroid Tumors  

Microsoft Academic Search

Rationale and ObjectivesThe purpose of this study was to compare the total actual hospital costs of uterine artery embolization (UAE) and hysterectomy for treatment of uterine fibroid tumors and to evaluate factors that might influence cost.

Molly T Beinfeld; Johanna L Bosch; G. Scott Gazelle

2002-01-01

293

Vaginal Hysterectomy by Electrosurgery for Benign Indications Associated with Previous Cesarean Section  

PubMed Central

Abstract Background: Vaginal hysterectomies have been associated with difficulties in patients who have had cesarean sections prior to such hysterectomies. However, the Purohit technique may obviate the problems and make it easier to perform these operations. Objectives: This research tested an approach designed to facilitate vaginal hysterectomy in patients with previous cesarean sections in the absence of fixed adhesions of uterine corpi to previous anterior abdominal scarring. Design/Method: An observational study was conducted in a private general hospital between February 2010 and June 2012. All candidates for hysterectomy for benign indications who had had previous cesarean sections were examined for the presence of clinical and sonographic signs of fixed adhesions of uterine corpi to anterior abdominal-wall incisions caused by prior cesarean sections. Candidates who had such adhesions were not given vaginal hysterectomies. Results: Sixty-four (64) consecutive candidates were selected for vaginal hysterectomies. Of these patients, 26 (40.62%) had 1 cesarean section, 33 (51.56 %) had 2 cesarean sections, and 5 (7.81%) had 3 cesarean sections. Four (4) patients had had prior pelvic operations. The uteri were smaller than 12 weeks' gestation-size in 62 (96.87%) cases. In 26 (40.62 %) cases, there were no obstruction to accessing the anterior cul-de-sacs and vaginal hysterectomies were performed using the Purohit technique. In 38 (59.37 %) cases, dense uterovesical adhesions obstructed access to the anterior cul-de-sacs and a posterioanterior approach was used to perform vaginal hysterectomy in these patients. Vaginal hysterectomy was completed in all 64 cases. Vaginal salpingo-oophorectomy was performed in 3 (4.68%) cases. The mean operative time was 78.59±33.15 (35–190) minutes. The mean weight of specimen uteri was 161.01±108.87 (50–550) g. No patients needed conversions or blood transfusions. No patients had bladder, ureteric, or thermal injuries. Finally, there were no other major postoperative complications. Conclusions: In the absence of fixed adhesions of the uterine corpus to previous anterior abdominal scarring, vaginal hysterectomy for benign indications associated with previous cesarean section may be accomplished safely. The posterioanterior approach during vaginal hysterectomy may avoid unintended bladder injury in the presence of dense uterovesical adhesions caused by previous cesarean sections. (J GYNECOL SURG 29:7) PMID:24761130

Sharma, Jay Gopal; Singh, Sarabjeet; Giri, Dipak Kumar

2013-01-01

294

Laparoscopic Sigmoidectomy for Diverticulitis: a Prospective Study  

PubMed Central

Background: Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of this prospective study was to evaluate the outcome of laparoscopic sigmoid colectomy in patients with diverticulitis. Patients offered laparoscopic surgery presented with acute complicated diverticulitis (Hinchey type I, II, III), chronically recurrent diverticulitis, bleeding, or sigmoid stenosis caused by chronic diverticulitis. Method: All patients who underwent laparoscopic colectomy within a 12-year period were prospectively entered into a database registry. One-stage laparoscopic resection and primary anastomosis constituted the planned procedure. A 4-trocar approach with suprapubic minilaparotomy was performed. Main data recorded were age, sex, postoperative pain, return of bowel function, operation time, duration of hospital stay, and early and late complications. Results: During the study period, 260 sigmoid colectomies were performed for diverticulitis. The cohort included 104 male and 156 female patients; M to F ratio was 4:6. Postoperative pain was controlled by NSAIDs or weak opioid analgesia. Fifteen patients (5.7%) required conversion from laparoscopic to open colectomy. The most common reasons for conversion were directly related to the inflammatory process, abscess, and peritonitis. Mean operative time was 130±54. Average postoperative hospital stay was 10±3 days. A longer hospital stay was recorded for Hinchey type IIb patients. Complications were recorded in 30 patients (11.5%). The most common complications that required reoperation were hemorrhage in 2 patients (0.76) and anastomotic leak in 5 patients (only 3 of them required reoperation). The mortality among them was 2 patients (0.76%). Conclusions: Laparoscopic surgery for diverticular disease is safe, feasible, and effective. Therefore, laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis at our institution. PMID:21605507

Baca, Ivo; Grzybowski, Leszek; Jaacks, Armin

2010-01-01

295

Prevalence of hysterectomy among rural and urban women with and without health insurance in Gujarat, India  

Microsoft Academic Search

This paper presents findings on hysterectomy prevalence from a 2010 cross-sectional household survey of 2,214 rural and 1,641 urban, insured and uninsured women in low-income households in Ahmedabad city and district in Gujarat, India. The study investigated why hysterectomy was a leading reason for use of health insurance by women insured by SEWA, a women's organisation that operates a community-based

Sapna Desai; Tara Sinha; Ajay Mahal

2011-01-01

296

Triple, double- and single-incision laparoscopic cholecystectomy: a prospective study  

PubMed Central

Purpose: Advances in laparoscopic techniques have enabled complicated intra-abdominal surgical procedures to be made with less trauma and a better cosmetic appearance. The techniques have been developed by decreasing the number of incisions in conventional laparoscopic procedures in order to increase patient satisfaction. The aim of this study was to compare the results of cholecystectomies made with 3, 2 or a single incision. Method: A total of 95 cholecystectomy patients from Elbistan State Hospital and Suleyman Demirel University Hospital between 2011 and 2013 were prospectively evaluated. The patients were separated into 3 groups as triple incision laparoscopic cholecystectomy (TILC), double incision laparoscopic cholecystectomy (DILC) and single incision laparoscopic cholecystectomy (SILC). Patients were evaluated in respect of demographic characteristics, operation time, success rate, analgesia requirement, length of hospital stay and patient satisfaction. Results: Successful procedures were completed in 40 TILC, 40 DILC and 15 SILC cases. Transfer to open cholecystectomy was not required in any case. The mean duration of operation was 71 mins (range, 55-120 mins) for SILC cases, 45 mins (range, 32-125 mins) for DILC cases and 42 mins (range, 29-96 mins) for TILC cases. The mean time for the SILC cases was statistically significantly longer than the other two groups (p < 0.000). Conclusions: At a comparable level with DILC and TILC, single incision laparosccopic cholecystectomy is a method which can be used without incurring any extra costs or requiring additional instrumentation or training and which has good cosmetic results and a low requirement for analgesia.

Sabuncuoglu, Mehmet Zafer; Benzin, Mehmet Fatih; Cakir, Tugrul; Sozen, Isa; Sabuncuoglu, Aylin

2014-01-01

297

The impact of a laparoscopic colorectal surgeon on the laparoscopic colectomy experience of a single academic center  

Microsoft Academic Search

Background: The objective of this study was to evaluate the impact of a laparoscopic colorectal surgeon (LCRS) on the laparoscopic colectomy experience of a single academic center. Methods: We performed a retrospective review of case complexity, patient characteristics, operative and preparation time, and trends over time for the LCRS compared to two veteran laparoscopic surgeons (VLS). Results: The LCRS performed

M. T. Austin; I. D. Feurer; M. D. Holzman; W. O. Richards; C. W. Pinson; A. J. Herline

2005-01-01

298

Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison  

Microsoft Academic Search

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized\\u000a comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized\\u000a controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the

Wouter J. K. Hehenkamp; Nicole A. Volkers; Wouter Bartholomeus; Sjoerd de Blok; Erwin Birnie; Jim A. Reekers; Willem M. Ankum

2007-01-01

299

Salpingectomy as standard at hysterectomy? A Danish cohort study, 1977-2010  

PubMed Central

Objective To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation. Design A historical cohort study. Setting Denmark. Participants 170?000 randomly selected women born 1947–1963 (10?000/year) were followed from 1977 until the end of 2010. Main outcome measures Effect of hysterectomy with retained fallopian tubes or sterilisation on the risk of salpingectomy. Both were modelled in a Cox proportional hazards model as time-dependent covariates, analysing time to first salpingectomy. End of follow-up period was 31 December 2010. Results Of 9591 hysterectomies, 6456 (67.3%) had both fallopian tubes retained. HRs for salpingectomy after hysterectomy with retained fallopian tubes and sterilisation were 2.13 (95% 1.88 to 2.42) and 2.42 (2.21 to 2.64), as compared with those for non-hysterectomised and non-sterilised women. Conclusions Women undergoing hysterectomy with retained fallopian tubes or sterilisation have at least a doubled risk of subsequent salpingectomy. Removal of the fallopian tubes at hysterectomy should therefore be recommended. PMID:23794553

Guldberg, Rikke; Wehberg, Sonja; Skovlund, Charlotte Wessel; Mogensen, Ole; Lidegaard, ?jvind

2013-01-01

300

Cost and Reimbursement for Three Fibroid Treatments: Abdominal Hysterectomy, Abdominal Myomectomy, and Uterine Fibroid Embolization  

SciTech Connect

Purpose. To compare costs and reimbursements for three different treatments for uterine fibroids. Methods. Costs and reimbursements were collected and analyzed from the Thomas Jefferson University Hospital decision support database from 540 women who underwent abdominal hysterectomy (n 299), abdominal myomectomy (n = 105), or uterine fibroid embolization (UFE) (n = 136) for uterine fibroids during 2000-2002. We used the chi-square test and ANOVA, followed by Fisher's Least Significant Difference test, for statistical analysis. Results. The mean total hospital cost (US$) for UFE was $2,707, which was significantly less than for hysterectomy ($5,707) or myomectomy ($5,676) (p < 0.05). The mean hospital net income (hospital net reimbursement minus total hospital cost) for UFE was $57, which was significantly greater than for hysterectomy (-$572) or myomectomy (-$715) (p < 0.05). The mean professional (physician) reimbursements for UFE, hysterectomy, and myomectomy were $1,306, $979, and $1,078, respectively. Conclusion. UFE has lower hospital costs and greater hospital net income than abdominal hysterectomy or abdominal myomectomy for treating uterine fibroids. UFE may be more financially advantageous than hysterectomy or myomectomy for the insurer, hospital, and health care system. Costs and reimbursements may vary amongst different hospitals and regions.

Goldberg, Jay, E-mail: jaygoldbergmd@yahoo.com; Bussard, Anne [Jefferson Medical College, Department of Obstetrics and Gynecology (United States); McNeil, Jean [Jefferson Medical College, Department of Finance (United States); Diamond, James [Jefferson Medical College, Department of Family Medicine (United States)

2007-02-15

301

Bile Duct Injury During Laparoscopic Cholecystectomy  

PubMed Central

Objective To determine whether surgical residency training has influenced the occurrence of common bile duct injuries during laparoscopic cholecystectomy, and to asses the anatomic and technical details of bile duct injuries from the practices of surgeons trained in laparoscopic cholecystectomy after residency versus surgeons trained in laparoscopic cholecystectomy during residency. Summary Background Data Shortly after the introduction of laparoscopic cholecystectomy, the rate of injury to the common bile duct increased to 0.5%, and injuries were more commonly reported early in each surgeon’s experience. It is not known whether learning laparoscopic cholecystectomy during surgery residency influences this pattern. Methods An anonymous questionnaire was mailed to 3,657 surgeons across the United States who completed an Accreditation Council for Graduate Medical Education (ACGME)-approved residency between 1980 and 1990 (group A) or 1992 and 1998 (group B). All surgeons in group A learned laparoscopic cholecystectomy after residency, and all those in group B learned laparoscopic cholecystectomy during residency. Information obtained included practice description, number of laparoscopic cholecystectomies completed since residency, postgraduate training in laparoscopy, and annual volume of laparoscopic cholecystectomy in the surgeon’s hospital. In addition, technical details queried included the completion of a cholangiogram, the interval between injury and identification, the method of repair, and the site of definitive treatment. The primary endpoint was the occurrence of a major bile duct injury during laparoscopic cholecystectomy (bile leaks without a major bile duct injury were not tabulated). Results Forty-five percent (n = 1,661) of the questionnaires were completed and returned. Mean practice experience was 13.6 years for group A and 5.4 years for group B. At least one injury occurrence was reported by 422 surgeons (37.6%) in group A and 143 surgeons (26.5%) in group B. Forty percent of the injuries in group A occurred during the first 50 cases compared with 22% in group B. Thirty percent of bile duct injuries in group A and 32.9% of all injuries in group B occurred after a surgeon had performed more than 200 laparoscopic cholecystectomies. Independent of the number of laparoscopic cholecystectomies completed since residency, group A surgeons were 39% more likely to report one or more biliary injuries and 58% more likely to report two or more injuries than their counterparts in group B. Bile duct injuries were more likely to be discovered during surgery if a cholangiogram was completed than if cholangiography was omitted (80.9% vs. 45.1%). Sixty-four percent of all major bile duct injuries required biliary reconstruction, and most injuries were definitively treated at the hospital where the injury occurred. Only 14.7% of injuries were referred to another center for repair. Conclusions Accepting that the survey bias underestimates the true frequency of bile duct injuries, residency training decreases the likelihood of injuring a bile duct, but only by decreasing the frequency of early “learning curve” injuries. If one accepts a liberal definition of the learning curve (200 cases), it appears that at least one third of injuries are not related to inexperience but may reflect fundamental errors in the technique of laparoscopic cholecystectomy as practiced by a broad population of surgeons in the United States. Intraoperative cholangiography is helpful for intraoperative discovery of injuries when they occur. Most injuries are repaired in the hospital where they occur and are not universally referred to tertiary care centers. PMID:11573048

Archer, Stephen B.; Brown, David W.; Smith, C. Daniel; Branum, Gene D.; Hunter, John G.

2001-01-01

302

Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is lengthy -- analysis of learning curves for a novice minimally invasive surgeon  

PubMed Central

Background Associated with reduced trauma, laparoscopic colon surgery is an alternative to open surgery. Furthermore, complete mesocolic excision (CME) has been shown to provide superior nodal yield and offers the prospect of better oncological outcomes. Methods All oncologic laparoscopic right colon resections with CME performed by a single surgeon since the beginning of his surgical practice were retrospectively analyzed for operative duration and perioperative outcomes. Results The study included 81 patients. The average duration of surgery was 220.0 (range 206–233) minutes. The initial durations of about 250 minutes gradually decreased to less than 200 minutes in an inverse linear relationship (y = ?0.58x × 248). The major complication rate was 3.6% ± 4.2% and the average nodal yield was 31.3 ± 4.1. CumulativeSum analysis showed acceptable complication rates and oncological results from the beginning of surgeon’s laparoscopic career. Conclusion Developing laparoscopic skills can provide acceptable outcomes in advanced right hemicolectomy for a surgeon who primarily trained in open colorectal surgery. Operative duration is nearly triple that reported for conventional laparoscopic right hemicolectomy. The slow operative duration learning curve without a plateau reflects complex anatomy and the need for careful dissection around critical structures. Should one wish to adopt this strategy either based on some available evidence of superiority or with intention to participate in research, one has to change the view of right hemicolectomy being a rather simple case to being a complex, lengthy laparoscopic surgery. PMID:25265107

Melich, George; Jeong, Duck Hyoun; Hur, Hyuk; Baik, Seung Hyuk; Faria, Julio; Kim, Nam Kyu; Min, Byung Soh

2014-01-01

303

Laparoscopic cholecystectomy. Experience with 375 consecutive patients.  

PubMed Central

Three hundred seventy-five consecutive patients underwent laparoscopic cholecystectomy from September 1989 to January 1991. Three hundred forty-one (91%) presented on an elective basis, and the remaining 34 patients (9%) were admitted for acute cholecystitis (24), gallstone pancreatitis (9), and cholangitis (1). Of the 375 patients, 20 were converted to laparotomy and cholecystectomy, for an overall success rate of 95% for patients undergoing laparoscopic cholecystectomy. Three hundred nineteen patients (90%) were discharged within 24 hours of surgery. Operative cholangiography was completed in 141 patients, showing choledocholithiasis in five (managed by postoperative endoscopic retrograde cholangiopancreatography [ERCP] in 4, common bile duct exploration [CBDE] in 1). Two retained stones (0.9%) were detected in 214 patients not undergoing cholangiography. Three patients (0.8%) were reoperated on because of perioperative complications. Overall morbidity for patients undergoing laparoscopic cholecystectomy was 3.5%. Major complications (0.6%) included a single common hepatic duct injury and a delayed cystic duct leak at 10 days. Minor complications occurred in 11 patients (2.9%). The single perioperative death (0.3%) was due to a myocardial infarction on postoperative day 3, after an otherwise uncomplicated laparoscopic procedure. Laparoscopic cholecystectomy appears to offer significant advantages to patient recovery, and these data suggest that it can be performed with an efficacy, morbidity rate, and mortality rate similar to those of open cholecystectomy. Images Fig. 4. Fig. 5. Fig. 2. Fig. 3. Fig. 6. PMID:1835346

Bailey, R W; Zucker, K A; Flowers, J L; Scovill, W A; Graham, S M; Imbembo, A L

1991-01-01

304

[A study on the relationship between pre- and post-hysterectomy sexual behavior differences and the sexual satisfaction of women who have had a hysterectomy].  

PubMed

The objective of this study was to provide a basis for sexual counselling and education for women who have had a hysterectomy. This was a cross sectional descriptive correlation study. There were 230 subjects in the study. The time period from the hysterectomy varied from one month to eighteen months. The subjects were selected by a convenient sampling method. The tool for this study was developed by the researcher through a literature review, consultation from 36 women who have had a hysterectomy and nursing faculty. A pilot study was done to determine the necessary modifications. Data collection was done between Sept. 1987 and Dec. 1987 using a mailed questionnaire. The results of this study are summarized as follows; 1. The differences between pre-post hysterectomy sexual behavior in frequency was that all the sexual behaviors were decreased; the decreased rate of coitus was 20.7%, of kissing or embracing 10.9%, of fondling of sexual organs 8.7%, of female prone-position 3.3%, of petting 7.7%, of sexual day dream 1.0%. 2. For the low income group, the sexual behavior with the most significant decrease in frequency was fondling the sex organs (t = 2.21, p less than .05). For the housewife group, it was a decrease in the one of the female prone position (t = -2.02, p less than .05). For the group under the age of 39, it was petting (t = -2.13, p less than .05). The housewife group showed an increase in sexual day dreams as compared to the group having a job (t = -3.12, p less than .01). The group that did not received the post-op information, showed a significant decrease in kissing or embracing behavior (t = 2.73, p less than .01), and male prone position (t = -2.46, p less than .01), and also the group that did not receive the pre-op information showed a significant decrease of male prone position (t = -2.19, p less than .05), and also of petting (t = -2.95, p less than .01). 3. The relationship between sexual behavior pre-post hysterectomy differences and sexual satisfaction only showed a significant correlation for the sexual behavior of coitus (r = -2.012, p less than .001), and fondling of sex organs (r = -.1121, p less than .05). In conclusion, although there were a decrease in all sexual behavior after the hysterectomy, the difference between the pre hysterectomy sexual behavior and the post hysterectomy sexual behavior correlated with sexual satisfaction for only of the two behaviors. PMID:2927071

Choi, Y S; Chang, S B

1989-02-28

305

Pyometra necessitating hysterectomy after colpocleisis in an extremely elderly patient.  

PubMed

As the number of women more than the age 65 increases, so will the need for treatment of pelvic organ prolapse and the comorbidities that come with surgical treatment of an aging population gain significance. Colpocleisis is an option for women failing or refusing conservative prolapse management and not desiring sexual function. The advantages of colpocleisis are decreased operative time, low complication rate, and ability to use local or regional anesthesia. We report a case of a 95-year-old woman whose procidentia was treated with colpocleisis. Endometrial evaluation with dilation and curettage was performed at the time of colpocleisis. Postoperative course was complicated by pyometra necessitating total abdominal hysterectomy and bilateral salpingoopherectomy, leading to further complications including deep vein thrombosis, anemia, atrial fibrillation, and pleural effusions. Preoperative versus intraoperative endometrial evaluation may decrease the risk of developing pyometra after colpocleisis and, therefore, diminish the possibility of multiple complications. PMID:17657546

Carberry, Cassandra L; Hampton, Brittany Star; Aguilar, Vivian C

2007-09-01

306

Fluidic lens laparoscopic zoom camera for minimally invasive surgery  

NASA Astrophysics Data System (ADS)

This work reports a miniaturized laparoscopic zoom camera that can significantly improve vision for minimally invasive surgery (MIS), also known as laparoscopic surgery. The laparoscopic zoom camera contains bioinspired fluidic lenses that can change curvature and focal length in a manner similar to the crystalline lenses in human eyes. The traditional laparoscope is long, rigid, and made of fixed glass lenses with a fixed field of view. The constricted vision of a laparoscope is often an inconvenience and plays a role in many surgical injuries. To further advance MIS technology, we developed a new type of laparoscopic camera that has a total length of less than 17 mm, greater than 4× optical zoom, and 100 times higher sensitivity than today's laparoscope allowing it to work under illumination as low as 300 lux. All these unique features are enabled by the technology of bioinspired fluidic lenses having a dynamic range over 100 diopters and being convertible between a convex and concave shape.

Tsai, Frank S.; Johnson, Daniel; Francis, Cameron S.; Cho, Sung Hwan; Qiao, Wen; Arianpour, Ashkan; Mintz, Yoav; Horgan, Santiago; Talamini, Mark; Lo, Yu-Hwa

2010-05-01

307

[Laparoscopic treatment of incisional hernia with Parietex mesh. Preliminary results and review of the literature].  

PubMed

Conventional surgery for incisional hernia carries a postoperative morbidity and recurrence rate of more than 12%. The aim of this study was to report our experience with the laparoscopic treatment of incisional hernia with the use of a composite mesh (Parietex, Sofradim, Celbio). The median duration of the operation was 135 minutes. In one patient peritonitis from small bowel perforation occurred on postoperative day 2 and required emergency surgery. The median postoperative hospital stay was 3 days. No complications were observed over a median follow-up period of 12 months. The goal of the laparoscopic treatment of incisional hernia is to decrease the incidence of local complications and the recurrence rate which are seen with traditional open surgery. To this should be added all the advantages of minimally invasive surgery in terms of decreased postoperative pain, length of hospital stay, and sick leave. PMID:15452994

Bonavina, Luigi; Abraham, Medhanie; Boati, Stefano; Bona, Davide

2004-01-01

308

[Factors influencing sexual satisfaction in women who have had a hysterectomy: a comparative group study].  

PubMed

This descriptive study was done to identify factors influencing sexual satisfaction in women who had had a hysterectomy and to compare these women who had not had a hysterectomy. The purpose was to contribute theoretical understanding on which to base nursing care planning. One group of subjects were 156 women who had had a hysterectomy, between one and 18 months post surgery, living with their spouse, having no complications, and menstruating before surgery. The other group of subjects were 282 healthy women who were living with their husbands and menstruating. The study tool consisted of 108 items including item concerning personal characteristics, characteristics related to the hysterectomy, husband's support, body image, emotions, attitude toward the sexual relationship, knowledge of sexuality, sexual behavior, and sexual satisfaction. Sexual satisfaction was measured by a tool based on Derogatis Sexual Function Inventory. The range of the internal level of the study tool was from .5208 to .9462. Data collection was done during the period from June 20 to Aug. 20, 1989. The same questionnaire was used of data collection for both groups, but a mail survey method was used for the women who had had a hysterectomy, and an interview method was used for the women who had not had a hysterectomy. Data analysis was done using frequency, ratio, mean and S.D. for the characteristics of the subjects and level of sexual satisfaction. t-test or ANOVA was used for the differences between the groups with regard to the general and hysterectomy related characteristics. The relationship between the score for sex life related factors and the level of sexual satisfaction was analyzed using the Pearson Correlation, and the influencing factors on sexual satisfaction were analyzed by stepwise multiple regression. The results of this study were as follows; 1. Mean age and income level were the only general characteristics for the two groups that were significantly different. The mean age, and income level of the group who had had a hysterectomy were 45 years, and 1,150,000 won respectively, and for those who had not had a hysterectomy, 41 years and 999,000 won. 2. There was no statistical difference of the sexual satisfaction score between the two groups. 3. There was differences in the factors influencing sexual satisfaction between the two groups. Factors influencing sexual satisfaction for the group who had had a hysterectomy were husband's support (R = .5793, P = .000) and the women's Knowledge of sexuality (R = .6670, P = .000) (total variance: 33.56).(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2290248

Chang, S B

1990-12-01

309

The first total laparoscopic pancreatoduodenectomy in Poland  

PubMed Central

We present a case of a 55-year-old female patient with pancreatic head cancer who was treated with total laparoscopic pylorus-preserving pancreatoduodenectomy (TLPD) on 13.12.2013. The procedure as well as the postoperative course was uncomplicated. The patient was mobilized on the day of surgery; a liquid diet was introduced on day 1 and a full hospital diet on day 2 postoperatively. Drains were removed on the 3rd day after the procedure. Length of hospital stay was 6 days. The final pathology report confirmed the diagnosis of cancer. According to our knowledge this is the first report on total laparoscopic pancreatoduodenectomy in Poland performed by an entirely Polish team of surgeons. In our opinion, TLPD is feasible and similarly to other laparoscopic operations may improve postoperative recovery. PMID:25337173

Budzynski, Andrzej; Zub-Pokrowiecka, Anna; Zychowicz, Anna; Wierdak, Mateusz; Matlok, Maciej; Zajac, Malgorzata

2014-01-01

310

Laparoscopic Resection of an Adrenal Schwannoma  

PubMed Central

Background and Objectives: Schwannomas are tumors originating from Schwann cells of the peripheral nerve sheath (neurilemma) of the neuroectoderm. Rarely, schwannomas can arise from the retroperitoneum and adrenal medulla. We describe a case of a 71-y-old woman who presented with an incidentally discovered adrenal tumor. Methods: Ultrasound and computed tomography scans revealed a lesion with solid and cystic areas originating from the left adrenal gland. The patient underwent complete laparoscopic resection of the tumor and the left adrenal gland. Results: Histopathological examination and immunohistochemical staining of the excised specimen revealed a benign schwannoma measuring 5.5×5×3.7 cm. To our knowledge, few other cases of laparoscopic resection of adrenal schwannomas have been reported. Conclusion: Because preoperative diagnosis of adrenal tumors is inconclusive, complete laparoscopic excision allows for definitive diagnosis with histological evaluation and represents the treatment of choice. PMID:23484583

Konstantinos, Toutouzas G.; Panagiotis, Kekis B.; Nikolaos, Michalopoulos V.; Ioannis, Flessas; Andreas, Manouras; Geogrios, Zografos

2012-01-01

311

Laparoscopic revolution in bariatric surgery  

PubMed Central

The history of bariatric surgery is investigational. Dedicated surgeons have continuously sought for an ideal procedure to relieve morbidly obese patients from their burden of comorbid conditions, reduced life expectancy and low quality of life. The ideal procedure must have low complication risk, both in short- and long term, as well as minimal impact on daily life. The revolution of laparoscopic techniques in bariatric surgery is described in this summary. Advances in minimal invasive techniques have contributed to reduced operative time, length of stay, and complications. The development in bariatric surgery has been exceptional, resulting in a dramatic increase of the number of procedures performed world wide during the last decades. Although, a complex bariatric procedure can be performed with operative mortality no greater than cholecystectomy, specific procedure-related complications and other drawbacks must be taken into account. The evolution of laparoscopy will be the legacy of the 21st century and at present, day-care surgery and further reduction of the operative trauma is in focus. The impressive effects on comorbid conditions have prompted the adoption of minimal invasive bariatric procedures into the field of metabolic surgery. PMID:25386062

Sundbom, Magnus

2014-01-01

312

Laparoscopic colectomy vs traditional colectomy for diverticulitis  

Microsoft Academic Search

Background  The aim of this study was to evaluate the outcome of patients undergoing laparoscopic colectomy for diverticulitis.\\u000a \\u000a \\u000a \\u000a Methods  Fourteen consecutive patients undergoing laparoscopic sigmoid colectomy (LSC) for diverticulitis were evaluated. Medical records\\u000a from a control group of 14 matched patients undergoing traditional open sigmoid colectomy (OSC) for diverticulitis were reviewed\\u000a for comparison.\\u000a \\u000a \\u000a \\u000a Results  Mean age, operative time, morbidity, and mortality of the

M. A. Liberman; E. H. Phillips; B. J. Carroll; M. Fallas; R. Rosenthal

1996-01-01

313

Laparoscopic Fertility Sparing Management of Cervical Cancer  

PubMed Central

Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

2014-01-01

314

Ectopic gallbladder revisited, laparoscopically: a case report  

PubMed Central

A case of the rare congenital anomaly ectopic gallbladder is presented. A 16-year-old girl suffered attacks of epigastric pain unrelated to eating. On abdominal ultrasonography, the gallbladder could not be found in its usual position. Endoscopic retrograde cholangiography demonstrated the gallbladder on the left side of the common duct and the cystic duct arising from the right hepatic duct. Laparoscopic cholecystectomy was done without complication. This appears to be the first reported case of laparoscopic removal of an ectopic gallbladder. The importance of preoperative cholangiography is emphasized for accurate diagnosis and preoperative location of the gallbladder. PMID:9416258

Chung, C.C.; Leung, K.L.; Lau, W.Y.; Li, Arthur K.C.

1997-01-01

315

Laparoscopic fertility sparing management of cervical cancer.  

PubMed

Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

2014-04-01

316

Single-port access in laparoscopic cholecystectomy  

Microsoft Academic Search

Background  Single-port access cholecystectomy is a new laparoscopic procedure using only one, transumbilical-placed port. The method\\u000a has been denominated by some authors as “scarless.” We report one of the initial clinical experiences in Europe with this\\u000a new technique.\\u000a \\u000a \\u000a \\u000a Methods  Fourteen patients underwent laparoscopic cholecystectomy using the ASC TriPort. In all cases, a small transumbilical incision\\u000a was used to insert two 5-mm rigid

Thomas E. Langwieler; Thomas Nimmesgern; Melanie Back

2009-01-01

317

Complications of laparoscopic antireflux surgery in childhood  

Microsoft Academic Search

Background: The aim of this study was to assess the complications associated with the laparoscopic treatment of gastroesophageal reflux\\u000a disease (GERD) in children.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: From March 1992 to March 1998, we used the laparoscopic approach to treat 289 children affected by gastroesophageal reflux\\u000a disease. The patients' ages ranged between 4 months and 17 years (median, 4.3 years), and their body

C. Esposito; P. Montupet; G. Amici; P. Desruelle

2000-01-01

318

Laparoscopic resection of pancreatic neuroendocrine tumors  

PubMed Central

Pancreatic neuroendocrine tumors (PNETs) are a rare heterogeneous group of endocrine neoplasms. Surgery remains the best curative option for this type of tumor. Over the past two decades, with the development of laparoscopic pancreatic surgery, an increasingly larger number of PNET resections are being performed by these minimally-invasive techniques. In this review article, the various laparoscopic surgical options for the excision of PNETs are discussed. In addition, a summary of the literature describing the outcome of these treatment modalities is presented. PMID:24803802

Al-Kurd, Abbas; Chapchay, Katya; Grozinsky-Glasberg, Simona; Mazeh, Haggi

2014-01-01

319

Laparoscopic repair of a Morgagni hernia  

PubMed Central

We report a case of laparoscopic repair of symptomatic Morgagni hernia (MH) in an adult. A tension-free closure of the defect was carried out using a polypropylene mesh. The recovery was quick and uneventful. Two years after surgery, the patient is doing well. A search of the English-language surgical literature revealed a total of 55 cases of laparoscopic repair of MH reported: 40 in adults and 15 in children. The various modalities of diagnosis, operative techniques, and disease presentation are discussed. PMID:21206651

Sherigar, J. M.; Dalal, A. D.; Patel, J. R.

2005-01-01

320

Laparoscopic total extraperitoneal repair of lumbar hernia  

PubMed Central

Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mesh fixation. A total extraperitoneal method of lumbar hernia repair by laparoscopic approach is feasible and may be an ideal option. PMID:22111086

Lim, Man Sup; Lee, Hae Wan; Yu, Chang Hee

2011-01-01

321

Resolving gastroesophageal reflux with laparoscopic fundoplication  

Microsoft Academic Search

Background: The purpose of this study was to evaluate the results of 138 cases of gastroesophageal reflux disease resolved laparoscopically\\u000a with the Rossetti modification of the Nissen fundoplication and to compare them with findings from other studies in an effort\\u000a to evaluate the procedure's ability to transfer from an academic setting to a community hospital setting.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: We performed laparoscopic

P. L. Leggett; R. Churchman-Winn; C. Ahn

1998-01-01

322

Development of a collapsible guard component for a novel surgical instrument  

E-print Network

The Endoblend is a novel surgical device for use in laparoscopic hysterectomy surgery. Laparoscopic hysterectomy surgery requires that the uterus be removed through a laparoscopic port. To achieve this, the Endoblend ...

Buckley, Darragh

2007-01-01

323

Archives of Sexual Behavior, Vol. 33, No. 1, February 2004, pp. 3142 ( C 2004) The Effects of Hysterectomy on Sexual Arousal in Women  

E-print Network

of Hysterectomy on Sexual Arousal in Women With a History of Benign Uterine Fibroids Cindy M. Meston, Ph.D.1 with a history of benign uterine fibroids who had (n = 15) or had not (n = 17) undergone hysterectomy supported. KEY WORDS: hysterectomy; uterine fibroids; sexual arousal; exercise; vaginal photoplethysmography

Meston, Cindy

324

Transmesocolic Approach for Left Side Laparoscopic Pyeloplasty: Comparison with Laterocolic Approach in the Initial Learning Period  

PubMed Central

Purpose To evaluate the outcome of transmesocolic (TMC) laparoscopic pyeloplasty compared with conventional laterocolic procedure for surgeons with limited experience. Materials and Methods We started laparoscopic pyeloplasty for ureteropelvic junction obstruction in 2009. Since then, 21 patients of left side disease have undergone this surgery in our institution. To access the left ureteropelvic junction, we used the conventional laterocolic approach in 9 patients, while the transmesocolic approach was used in the remaining 12 patients, and perioperative results and follow-up data were then compared. Results The mean operative time using the transmesocolic approach was significantly shorter than the conventional laterocolic approach (242 vs. 308 min, p=0.022). Furthermore, there was no complication or open conversion. Postoperative pain was significantly decreased in the TMC group (2.8 vs. 4.0 points, measured using the visual analogue scale on the first postoperative day, p=0.009). Postoperative complications were encountered in two patients. All patients were symptom-free after 1 year of follow-up, and radiologic success rates for each group were 92 and 89%, respectively. Conclusion Direct exposure of the ureteropelvic junction via the mesocolon saves time during the colon mobilization procedure. The approach is safe and feasible even for surgeons with limited experience, and has success rates similar to those of the conventional laterocolic approach. PMID:23225819

Han, Hyun Ho; Ham, Won Sik; Kim, Jang Hwan; Choi, Young Deuk; Han, Sang Won; Chung, Byung Ha

2013-01-01

325

Laparoscopic and Open Cholecystectomy in Surgical Training  

Microsoft Academic Search

Background: Open cholecystectomy (OC) may still be necessary in surgical training to perform safe conversions of laparoscopic cholecystectomy (LC). Our aim was to study the outcome of LCs and OCs performed by surgical trainees. Methods: All consecutive cholecystectomies (1,581 LCs and 984 OCs) were retrospectively analyzed from 1995 until 2008. Operative complications were compared between the cholecystectomies performed by 20

Satu Suuronen; Anu Koski; Pia Nordstrom; Pekka Miettinen; Hannu Paajanen

2010-01-01

326

Laparoscopic left colon resection for diverticular disease  

Microsoft Academic Search

Background: The aim of this study was to review our experience with laparoscopic sigmoid colectomy for diverticular disease. Methods: All patients presenting with acute or chronic diverticulitis, obstruction, abscess, or fistula were included. Symptomatic diverticular disease was the main surgical indication (95%). Results: Between March 1992 and August 1999 170 consecutive patients underwent surgery. Of these, 21 patients (12%) had

G. Trebuchet; D. Lechaux; J. L. Lecalve

2002-01-01

327

Significant weight loss after laparoscopic Nissen fundoplication  

Microsoft Academic Search

Background: Laparoscopic Nissen fundoplication (LNF) has evolved as a gold standard in antireflux surgery. However, the association between body weight and gastroesophageal reflux disease (GERD) is still unclear, and no data are available concerning the effect of fundoplication on body weight. We present the first report elucidating the impact of LNF on body weight in GERD patients with special emphasis

C. Neumayer; R. Ciovica; M. Gadenstätter; G. Erd; S. Leidl; S. Lehr; G. Schwab

2005-01-01

328

Laparoscopic urology: Past, present, and future  

Microsoft Academic Search

Laparoscopy has begun to have a significant impact on the management of urologic problems. Although initially limited to diagnostic pediatric problems, it has more recently been used to resolve myriad adult urologic conditions. Indeed, during the past year laparoscopic urology has moved well beyond the diagnosis of the undescended testicle and has been successfully used for pelvic lymphadenectomy, varicocelectomy, ureterolysis,

Ralph V. Clayman; Louis R. Kavoussi

1993-01-01

329

Laparoscopic Appendectomy in a Nigerian Teaching Hospital  

PubMed Central

Objective: Laparoscopic appendectomy in a setting where resources are poor is still controversial. This study evaluates the impact of laparoscopy on the early outcome of acute appendicitis in a developing country. Methods: All patients who underwent appendectomy from January 2010 through June 2011 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were recruited for this study. Results: Of the 139 patients with acute appendicitis within the study period, 83 (59.7%) had open appendectomy (OA), 19 (13.7%) whose clinical and radiological findings suggested complicated appendicitis at presentation had laparotomy, while 37 (26.6%) had laparoscopic procedures. In the laparoscopy group, initial diagnostic laparoscopy in 4 (10.8%) patients revealed a normal appendix along with other findings that precluded appendectomy. Laparoscopic appendectomy (LA) was then performed in 33 (23.7%) patients with 2 of these (6.1%) requiring conversion to open laparotomy. Mean time for the LA procedure was higher than that observed for OA (56.2 vs 38.9 min). Patients in the LA group had a shorter mean postoperative stay (1.8 vs 3.0). Wound infection occurred in 2 (6.5%) patients from the LA group and 8 (9.6%) from OA. Conclusion: Laparoscopic appendectomy reduced the rate of unnecessary appendectomy and postoperative hospital stay in our patients, potentially reducing crowding in our surgical wards. We advocate increased use of laparoscopy especially in young women. PMID:23484567

Alatise, Olusegun I.; Arowolo, Olukayode A.; Lawal, Oladejo O.

2012-01-01

330

Laparoscopic splenectomy for atraumatic splenic rupture.  

PubMed

A traumatic splenic rupture (ASR) is a rare clinical entity. Several underlying benign and malignant conditions have been described as a leading cause. We report on a case of ASR in a 41-year-old man treated with laparoscopic splenectomy. Considering ASR as a life-threatening condition, a prompt diagnosis can be life saving. PMID:21675627

Grossi, Ugo; Crucitti, Antonio; D'Amato, Gerardo; Mazzari, Andrea; Tomaiuolo, Pasquina M C; Cavicchioni, Camillo; Bellantone, Rocco

2011-01-01

331

Increased transperitoneal bacterial translocation in laparoscopic surgery  

Microsoft Academic Search

Background: The indications for laparoscopic surgery have expanded to include diseases possibly associated with peritonitis such as appendicitis, perforated peptic ulcers, and diverticulitis. The safety of carbon dioxide (CO 2) pneumoperitoneum in the presence of peritonitis has not been proved. Our previous investigations demonstrated increased bacteremia associated with CO 2 insufflation. In effort to clarify the relative effects of intraabdominal

M. C. Horattas; N. Haller; D. Ricchiutti

2003-01-01

332

Laparoscopic Treatment of Intrauterine Fallopian Tube Incarceration  

PubMed Central

Herniation of the pelvic structures into the uterine cavity (appendix vermiformis, small bowel, omentum, or fallopian tube) may occur after uterine perforation. In this paper, we describe one case of intrauterine fallopian tube incarceration treated by means of laparoscopic surgery. PMID:23738168

Kondo, William; Bruns, Rafael Frederico; Nicola, Marcelo Chemin; Ribeiro, Reitan; Trippia, Carlos Henrique; Zomer, Monica Tessmann

2013-01-01

333

Ambidexterity in laparoscopic surgical skills training.  

PubMed

Understanding the way in which specialized medical skills are acquired is critical for developing effective training curricula, as well as effective metrics and methodologies for assessing skill acquisition, proficiency, and retention. Currently, a need exists for novel, objective metrics to support training and assessment of specialized surgical skills, such as those involved in laparoscopy, and to support a deeper understanding of the way in which these skills are acquired and decay during periods of nonuse. Ambidexterity has been identified by expert surgeons as a critical factor in the achievement of laparoscopic psychomotor surgical skill proficiency; however, the current standardized training and assessment protocols do not measure or account for differential performance between the dominant and non-dominant hands. Two experiments compared performance with the left and right hands during training of laparoscopic psychomotor surgical skills using the Fundamentals of Laparoscopic Surgery (FLS) platform, examining the role of ambidexterity in skill acquisition and proficiency. The results of these investigations indicate that degree of ambidexterity in task performance increases with overall task performance improvement and may be related to achievement of task proficiency. Measures that account for degree of task-related ambidexterity may provide useful metrics for assessing laparoscopic surgical skill acquisition, proficiency, and decay. PMID:23400194

Skinner, Anna; Auner, Gregory; Meadors, Margaret; Sebrechts, Marc

2013-01-01

334

Laparoscopic adrenalectomy: pathologic features determine outcome  

PubMed Central

Introduction The differential outcomes of laparoscopic adrenalectomy are not well described. Therefore, we evaluated these outcomes in the 3 groups most often seen clinically: bilateral adrenalectomy for Cushing's disease (group 1), pheochromocytoma (group 2) and unilateral adrenalectomy for non-pheochromocytoma (group 3). Methods We reviewed a longitudinal database of 72 consecutive cases of laparoscopic adrenalectomy carried out between 1997 and 2001 at the Centre for Minimally Invasive Surgery, University of Toronto. Results Patients in group 1 tended to be older (median 49 yr) and heavier (median 87 kg). They had a longer operating time (median 255 min), more postoperative complications (15%) and a longer median postoperative stay (4 d). Patients in group 2 had intermediate outcomes: a median operating time of 198 minutes, complication rate of 8.3% and a median postoperative hospital stay of 3 days. However, they had more intraoperative blood loss (median 150 mL). Group 3 patients had the best outcomes with the shortest median operating time (125 min), least blood loss (median 50 mL), fewer complications (6%) and shortest hospital stay (median 2 d). Conclusions Although the outcomes of laparoscopic adrenalectomy are uniformly good, on the basis of the underlying pathologic characteristics, patients can be divided into groups that have different expected outcomes. Patients requiring a unilateral adrenalectomy except for pheochromocytoma have the best recorded outcomes. Surgeons transferring to laparoscopic adrenalectomy would benefit from selecting patients in this group during their learning curve. PMID:14577705

Poulin, Eric C.; Schlachta, Christopher M.; Burpee, Stephen E.; Pace, Kenneth T.; Mamazza, Joseph

2003-01-01

335

Parameter evaluation for virtual Laparoscopic simulation  

Microsoft Academic Search

Virtual Reality based surgical simulators have become quite common for training of surgeons for different surgical skills. Simulators have been widely used particularly in minimal invasive surgery. In this paper we find parameters that would be required to create a real time working simulation for exercises given in the Fundamentals of Laparoscopic Surgery curriculum. We use peg transfer exercise as

Shamyl Bin Mansoor; Zaheer Mukhtar; Muddassir Malik; Zohaib Amjad; Hammad Qureshi

2011-01-01

336

Augmented Reality Visualization for Laparoscopic Surgery  

E-print Network

ameliorate this problem, they still separate the camera from the physician's point of view and fail implementation of a three-dimensional visualization system to assist with laparoscopic surgi- cal procedures. Such a system can restore the physician's natural point of view and head motion parallax that are used

State, Andrei

337

Planned totally extraperitoneal laparoscopic Spigelian hernia repair.  

PubMed

A Spigelian hernia is a congenital defect in the tranversus aponeurosis fascia. Traditionally, an open anterior hernioplasty was used to repair these defects. Recently, laparoscopic approaches have been described. This report describes the first application of the totally extraperitoneal laparoscopic approach to a planned repair of a Spigelian hernia. The patient was a 62-year-old white female with a reducible left lower quadrant anterior abdominal wall bulge consistent with a Spigelian hernia. At the time of surgery, we exposed the posterior rectus fascia and modified our extraperitoneal inguinal hernia technique by passing the balloon dissector in a more lateral orientation. This created a unilateral preperitoneal space with adequate room for dissection and mesh fixation. The Spigelian defect was easily identified. Its preperitoneal fat contents were reduced, and a 5-mm laparoscopic tacking device was used to secure a piece of prolene mesh. The patient was discharged home with no complications. Placement of the mesh in the preperitoneal space avoids direct interaction of the mesh prosthesis and the intraperitoneal viscera. In conclusion, we find that a laparoscopic totally extraperitoneal approach is technically feasible and advantageous when a Spigelian hernia is diagnosed preoperatively. PMID:11967699

Tarnoff, M; Rosen, M; Brody, F

2002-02-01

338

Laparoscopic Versus Open Colorectal Surgery  

PubMed Central

Summary Background Data: Studies comparing the costs of colorectal resection by laparoscopic (LPS) and open approaches are small sized or not randomized. The main purpose of this study is to compare the hospital costs of LPS and open colorectal surgery in a large series of randomized patients. Methods: A total of 517 patients with colorectal disease were randomly assigned to LPS (n = 258) or open (n = 259) resection. The following costs were calculated: surgical instruments, operative room (OR) occupation, routine care, postoperative morbidity, and length of hospital stay (LOS). Follow-up for postoperative morbidity was carried out for 30 days after hospital discharge. Results: Operative time was 37 minutes longer in the LPS group. Overall morbidity rate was 18.2% (47 of 258) in the LPS versus 34.7% (90 of 259) in the open group (P = 0.0005). The mean LOS was 9.9 (2.6) days in the LPS group and 12.4 (3.9) days in the open group (P < 0.0001). The additional OR charge in the LPS group was €1171 per patient randomized (€864 due to surgical instruments and €307 due to longer time). The saving in the LPS group was €1046 per patient randomized (€401 due to shorter LOS and €645 due to the lower cost of postoperative complications). The net balance resulted in €125 extra cost per patient allocated to the LPS group. Conclusions: The present cost-benefit analysis showed a slight additional cost in the LPS group. The better postoperative short-term outcome in patients receiving LPS had a key role to nearly balance the operative room charges due to laparoscopy. PMID:16327499

Braga, Marco; Vignali, Andrea; Zuliani, Walter; Frasson, Matteo; Di Serio, Clelia; Di Carlo, Valerio

2005-01-01

339

Comparative study on postoperative effects of laparoscopic versus open ovariectomy in ferrets.  

E-print Network

??Objective- To compare the postoperative effects of laparoscopic versus open ovariectomy in ferrets. Study design- Randomized comparative trial Animals- Female ferrets (n=18) Methods- Laparoscopic ovariectomy… (more)

Pagter, W.P. de

2014-01-01

340

Qualifications of Physicians Performing Hysterectomy: The Study of Women's Health Across the Nation.  

PubMed

The objective of this study was to evaluate whether physicians performing hysterectomy on participants of the Study of Women's Health Across the Nation (SWAN) are adequately trained to perform this procedure. A multicenter longitudinal study of 3302 women aged 42 to 52 was conducted over 9 years of follow-up. Of the 238 women reporting hysterectomy within the United States, 165 were verified via medical record review. Information regarding training background and board certification status of the physicians performing these hysterectomies was obtained from the American Board of Medical Specialists. Complications of hysterectomy were abstracted from patients' medical records. Of the 165 physicians, 163 (98.8%) obtained board certification and 139 (84.2%) obtained their medical degrees in the United States. Ninety-eight percent of the physicians completed a residency in obstetrics and gynecology. Intra- and postoperative complications were exceedingly low. Physicians performing hysterectomies on participants of SWAN appear adequately trained to carry out this commonly performed procedure. PMID:20007906

Morelli, Sara S; Lian, Yinjuan; Schott, Laura L; Weiss, Gerson

2009-12-10

341

Postoperative Immunosuppression After Open and Laparoscopic Liver Resection: Assessment of Cellular Immune Function and Monocytic HLA-DR Expression  

PubMed Central

Background and Objectives: Major abdominal procedures are strongly associated with postoperative immunosuppression and subsequent increased patient morbidity. It is believed that laparoscopic surgery causes less depletion of the systemic immune function because of the reduced tissue trauma. Various cytokines and monocytic HLA-DR expression have been successfully implemented to assess postoperative immune function. The aim of our study was to show the difference in immunologic profiles after minimally invasive versus conventional liver resection. Methods: Ten animals underwent either laparoscopic or conventional open left lateral liver resection. Flow cytometric characteristics of HLA-DR expression on monocytes and lipopolysaccharide-stimulated cellular secretion of tumor necrosis factor ?, interferon ?, interleukin 6, and interleukin 8 were measured and analyzed in ex vivo whole blood samples. Intraoperative and postoperative clinical outcome parameters were also documented and evaluated. Results: All animals survived the procedures. Postoperative complications were fever (n = 3), wound infections (n = 2), and biloma (n = 1). Open surgery showed a morbidity rate of 80% compared with 40% after laparoscopic surgery. Laparoscopic liver resection showed no postoperative immunoparalysis. Major histocompatibility complex class II expression in this group was elevated, whereas the open surgery group showed decreased major histocompatibility complex class II expression on postoperative day 1. Postoperative secretion of tumor necrosis factor ?, interleukin 6, and interferon ? was lower in the open surgery group. Elevated transaminase levels after laparoscopy might have resulted from an ischemia/reperfusion injury caused by the capnoperitoneum. Conclusion: Major immunoparalysis depression was not observed in either group. Laparoscopic surgery shows a tendency to improve immunologic recovery after liver resection. PMID:24398205

Haacke, Nadine; Meisel, Christian; Unterwalder, Nadine; Fikatas, Panagiotis; Schmidt, Sven C.

2013-01-01

342

Day case laparoscopic nephrectomy: initial experience  

PubMed Central

Rationale: Laparoscopic nephrectomy tends to become the new gold standard surgical technique in a selected population (non–functioning kidney, localised renal cell carcinoma). Day surgery is a popular pathway of care and, procedures of ever–increasing complexity are being considered. Objective: The aim of the study was to report the postoperative complications of day case laparoscopic nephrectomy, according to the Clavien system, and, to assess the feasibility of the procedure performed as a day case. Material and Results: This study included all the patients considered for day case transperitoneal laparoscopic nephrectomy between May 2008 and November 2009. Sixteen consecutive patients were enrolled in this retrospective study. There were ten procedures on the left hand–side and six on the right hand–side. Age ranges from 22 to 77 years old. Male to female ratio was 9:7. The preoperative diagnosis was non–functioning kidney in 9 cases and kidney tumour in the other 7 cases. All but two patients have been discharged in the same day (87.5%). The readmission rate was of 12.5%. One wheel–chair bonded patient was readmitted four days after the procedure, because of adynamic ileus, and another one three days later because of wound infection. There were two grade I and one grade IV complications (Clavien system). The patient readmitted with grade IV complication, wheel–chair bonded because of cerebral palsy, was not a typical day surgery patient. Discussion: The vast majority of complications were minor and resulted in no residual disability. In our small series, the day case laparoscopic nephrectomy was feasible and safe. Abbreviations: day surgery (DS), laparoscopic nephrectomy (LN), American Society of Anesthesiology (ASA) PMID:21505573

Luscombe, CJ; Smith, I; Boddy, J; Mischianu, D; Golash, A

2011-01-01

343

Laparoscopic adrenalectomy – ten-year experience  

PubMed Central

Objectives The objective of the study is to summarize the authors’ 10-year experience with laparoscopic adrenalectomy and to analyze the intra- and postoperative complications of the procedure. Material and methods The records of 80 patients who had undergone laparoscopic adrenalectomy from January 2002 to January 2012 were reviewed retrospectively. There were 51 female and 29 male patients. The average age was 52. In 33 cases the right adrenal gland was affected, in 47 it was the left adrenal gland. Nineteen operations were performed with the retroperitoneal approach, in 61 a transperitoneal access was used. The average size of the tumor was 5 cm. The diagnosis was based on ultrasonography (USG) and computed tomography (CT). The biochemical tests were performed in all cases to assess hormonal activity of the tumor. Pheochromocytoma was diagnosed in 16 cases, Cushing syndrome in 3 cases, and Conn syndrome in 4 cases. All other tumors were hormonally inactive. Six patients were operated on because of adrenal metastases – from renal carcinoma in five cases and from lung carcinoma in one case. Results There were three open conversions. The mean operative time was 158 minutes. The mean hospital stay was 5.5 days Blood transfusion was necessary in three patients. Postoperative complications were observed in 11 patients (13.7%). Conclusions Laparoscopic adrenalectomy is a safe and effective procedure and should be considered the first – line treatment of benign adrenal masses. Our experience indicates that patients with adrenal metastases are suitable candidates for laparoscopic adrenalectomy, providing a skilled laparoscopic surgeon is involved in operation. PMID:24578932

Lewandowski, Jaros?aw; Panek, Wojciech; Tupikowski, Krzysztof; Dembowski, Janusz; Zdrojowy, Romuald

2012-01-01

344

[Laparoscopic repair of incisional and ventral hernia].  

PubMed

The application of laparoscopic principles to ventral or incisional hernia repair has recently been shown to be a safe and effective alternative to open procedures. In this study we analyzed our recent experience with laparoscopic incisional-ventral hernia repair. The outcomes of 75 consecutive patients (January 2002 to July 2006) who underwent laparoscopic repair for incisional-ventral hernia were reviewed. Patient's demographics, hernia parameters, and intraoperative and postoperative data were collected. Of the 75 patients, 44 were females and 31 males. Mean age was 59.1 yrs (range 29-80 yrs). Mean BMI was 25.9 (range 19.4-36.7). Twenty-one patients had primary ventral hernias while 54 patients had an incisional hernia. Fifty-three patients had a single defect and 22 patients multiple defects. In 45 cases the incisional hernia was a primary hernia; in 4 cases it was a first recurrence; in 2 cases a 2nd recurrence; and in 3 cases a 3rd recurrence. The mean defect size was 52,7 cm2 (range 4-432). Laparoscopic hernia repair was successfully performed in 71 cases (94.7%). The mean mesh size was 211 cm2 (range 63-694). Mean operating time was 101 min (range 50-220 min). The mean hospital stay was 4.7 days. The postoperative morbidity rate was 14%. After a mean follow-up of 24.6 months (range 7-56) the recurrence rate was 7% (5/71). Laparoscopic repair of incisional-ventral hernias seems to be safe and effective. Medium-term outcomes were promising with a relatively low rate of conversion to open surgery, a low complication rate and a low risk of recurrence. PMID:18709780

Antinori, Armando; Moschella, Francesca; Tomaiuolo, Pasquina M C; Crucitti, Antonio; La Greca, Antonio; Maci, Eliana; Magistrelli, Paolo

2008-01-01

345

Laparoscopic hernia repair: a preliminary report.  

PubMed

Advances in laparoscopic technique have provided the opportunity to perform preperitoneal herniorrhaphy and potentially avoid the morbidity associated with open techniques. From January 1991 to May 1992, two primary surgeons repaired 63 inguinal hernias (42 indirect, 20 direct, 1 femoral) on 48 patients using a standardized laparoscopic technique. The hernia defect was visualized laparoscopically, and the peritoneum anterior to the defect was incised. The hernia sac was dissected from the inguinal canal. The hernia defect was then loosely packed with rolled 1 x 6-inch polypropylene mesh (average number of rolls used was 3.4). A sheet of polypropylene mesh (average 5 x 8 cm) was then placed over the mesh rolls and the hernia defect and anchored with an endostapler. The peritoneum was closed over the mesh sheet with standard laparoscopic clips. There were 44 males and 4 females in the study group. The mean age was 55 years (range, 17-89 years). The mean follow-up was 5.8 months (range, 1-12 months). Thirty-three patients underwent unilateral hernia repair, and 15 patients underwent bilateral hernia repair. Clinically unsuspected contralateral hernias were identified at the time of laparoscopy in seven patients. The mean duration of surgery was 118 minutes (range, 80-165 minutes) for bilateral hernia repair, and 70 minutes (range, 45-100 minutes) for unilateral hernia repair. All patients with laparoscopic hernia repairs were treated on a same-day or less-than-24-hour in-hospital stay. Complications were designated as minor, moderate, or severe. There were 14 minor complications, which included subcutaneous hematomas at the trocar site, scrotal ecchymosis, groin swelling emphysema, and testicular asymmetry.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8476147

Sailors, D M; Layman, T S; Burns, R P; Chandler, K E; Russell, W L

1993-02-01

346

The laparoscopic transperitoneal approach for irreducible inguinal hernias: Perioperative outcome in four patients  

PubMed Central

BACKGROUND: Incarceration and strangulation are the most feared complications of inguinal hernia. Till date, incarcerated hernias have traditionally been treated by conventional open repair. Reports are now available for the feasibility of laparoscopic repair of incarcerated inguinal hernia. Here, we described our experience with the transperitoneal approach for incarcerated hernias. MATERIALS AND METHODS: Between January 2008 and May 2008, four patients were presented with a history of irreducible hernia, abdominal distention and vomiting. All the patients had right-sided inguinal hernia. Reductions of the hernia contents were not possible in any patient. The patients were treated on emergency basis with laparoscopic transabdominal preperitoneal hernia repair. Retrospective analyses of all the patients were done. RESULTS: Reduction of the bowel was achieved in all but one patient, who required the division of the internal ring on lateral side. Transperitoneal mesh repair was performed. No major complications were encountered. One patient developed seroma formation that was treated conservatively. CONCLUSION: Laparoscopic transperitoneal approach has the advantage of observation of the hernia content for a longer period of time. The division of the internal ring can be done under direct vision. Other intra-abdominal pathology and opposite side hernia can be diagnosed and treated at the same time.. PMID:19727375

Jagad, Rajan B; Shah, Jignesh; Patel, Gulabbhai R

2009-01-01

347

Robotic-assisted laparoscopic reconstructive surgery in the lower urinary tract.  

PubMed

Open surgery has long been the most common surgical approach for the correction of congenital anomalies of the lower urinary tract in children. With the continued development of minimally invasive surgery in adult urology, including endoscopic, conventional, and robot-assisted laparoscopic approaches, the indications for minimally invasive surgery have similarly expanded in the pediatric population. The most commonly performed robotic procedure in children has been pyeloplasty for ureteropelvic junction obstruction; the use of robotics in complex reconstructive surgery in the lower urinary tract has also been acceptable. In this review, we summarize recent viewpoints regarding robotic-assisted laparoscopic reconstructive surgeries in the lower urinary tract, such as ureteral reimplantation, appendicovesicostomy, and augmentation enterocystoplasty in the pediatric population, and critically summarize the current knowledge on outcomes in the literature. We also discuss our technique and the outcomes of robotic ureteral reimplantation. This review demonstrates that robotic-assisted laparoscopic reconstructive surgeries in the lower urinary tract are technically feasible and may achieve outcomes that are equalto those of open surgery, with reduced morbidity. PMID:23740381

Gundeti, Mohan S; Kojima, Yoshiyuki; Haga, Nobuhiro; Kiriluk, Kyle

2013-08-01

348

Hand-assisted laparoscopic donor nephrectomy minimizes warm ischemia  

Microsoft Academic Search

Objectives. Traditional open donor nephrectomy is associated with good donor outcomes and excellent allograft function. Laparoscopic donor nephrectomy may accomplish these same goals with less morbidity. We report our initial experience with hand-assisted laparoscopic living donor nephrectomy using a commercially available hand-assist device.Methods. Donor and allograft outcomes for the first 30 patients undergoing hand-assisted laparoscopic live donor nephrectomy in our

Kent Kercher; Douglas Dahl; Robert Harland; Robert Blute; Karen Gallagher; Demetrius Litwin

2001-01-01

349

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy  

Microsoft Academic Search

Background  Laparoscopic surgery during pregnancy is a challenging procedure that most surgeons are reluctant to perform. The objective of this study was to evaluate whether laparoscopic appendectomy and cholecystectomy is safe in pregnant women. The management of these situations remains controversial. We report a single center study describing the successful management of 16 patients during pregnancy.Methods  More than 3,356 laparoscopic procedures were

Nermin Halkic; Adrien A. Tempia-Caliera; Riadh Ksontini; Michel Suter; Jean-François Delaloye; Henri Vuilleumier

2006-01-01

350

Evaluation of immediate laparoscopic surgery for gynecologic disorders  

Microsoft Academic Search

The purpose of this study was to obtain information to aid in deciding the timing of immediate laparoscopic surgery for gynecological\\u000a disorders. We evaluated immediate laparoscopic surgery (within 12 h after admission) performed at our institution between\\u000a January 2005 and March 2010. Of the total 287 laparoscopic surgeries performed for patients with gynecological disorders during\\u000a this period, 70 (24.4%) were immediate

Haruhiko Kanasaki; Aki Oride; Kentaro Nakayama; Kohji Miyazaki

351

Intestinal Obstruction After Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair  

PubMed Central

Laparoscopic hernia repair is a frequently performed operation. Although it has many advantages over open inguinal hernia repair, laparoscopic surgery is not without complications. Small bowel obstruction is a complication unique to laparoscopic repair of inguinal hernias. It is reported following transabdominal preperitoneal repairs. We present a case of small bowel incarceration through a peritoneal defect after a totally extraperitoneal inguinal hernia repair. Techniques to avoid this complication are presented. The literature is reviewed. PMID:14974673

Rink, Joanne

2004-01-01

352

Double-blind trial of perioperative intravenous metronidazole prophylaxis for abdominal hysterectomy.  

PubMed Central

A double-blind trial of perioperative intravenous metronidazole treatment to prevent infections at the operative site and unexplained fever after abdominal hysterectomy was conducted in 106 patients. Metronidazole prophylaxis reduced the rate of recovery of anaerobes from vaginal swabs for several days and prolonged the high rate of vaginal carriage of enterococci and aerobic gram-negative bacilli following hysterectomy. Although the fever index, calculated from the duration of a temperature above 37.3 degrees C, was significantly lower in the metronidazole-treated group than in the placebo-treated group, the frequency of postoperative infections, the proportion of patients requiring antibiotic treatment and the average duration of hospital stay were similar in the two groups. These results do not support the reported value of perioperative metronidazole prophylaxis in patients undergoing abdominal hysterectomy. PMID:7093856

Vincelette, J.; Finkelstein, F.; Aoki, F. Y.; Ogilvie, R. I.; Richards, G. K.; Seymour, R. J.

1982-01-01

353

[Reinterventions in classic and laparoscopic surgery of biliary ducts].  

PubMed

The study suggests to make a comparative analysis between the complications happened after classic and laparoscopic surgery require a surgical reintervention. The study was realised in the Surgical Department of the Districtual Hospital Baia Mare between 27.04.1997-27.04.1999, which means the precursory year of beginning laparoscopic surgery and the first year with experience in laparoscopic surgery. The conclusions of this study prove that the number of reinterventions after laparoscopic surgery is less than after classic surgery of biliary ducts. PMID:14870552

Lese, M; Naghi, I; Pop, C

2000-01-01

354

Laparoscopic resection for rectal cancer: a case-matched study  

Microsoft Academic Search

Introduction  The field of laparoscopic rectal cancer surgery is expanding. We compare short-term and early oncological outcomes after laparoscopic\\u000a versus open resection in carefully matched rectal cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  All consecutive patients undergoing elective laparoscopic resection for rectal cancer were reviewed. Laparoscopic resections\\u000a were matched 1:1 to open resections by age, gender, American Society of Anesthesiologists class, body mass index, neoadjuvant\\u000a chemoradiation,

Andre da Luz Moreira; Isabella Mor; Daniel P. Geisler; Feza H. Remzi; Ravi P. Kiran

2011-01-01

355

A case of parasitic myoma 4 years after laparoscopic myomectomy.  

PubMed

We present a case of parasitic myoma complaining of abdominal pain, constipation, dyspareunia and dysmenorrhea 4 years after laparoscopic myomectomy. We performed laparoscopic myomectomy for multiple parasitic myomas. Three myomas were very firmly attached to bowel and mesentery. Parasitic myoma after laparoscopic surgery is very rare condition there are almost 35 cases in the literature. It is related with variable symptoms or can be asymptomatic. Laparoscopic surgeons should be aware of this situation, and further investigation should be made in case of suspicion. Surgery for parasitic myomas can be difficult in case of bowel and mesentery involvement and patient should be informed about the extensive surgery. PMID:25336821

Temizkan, Osman; Erenel, Hakan; Arici, Bulent; Asicioglu, Osman

2014-10-01

356

Construct Validity Testing of a Laparoscopic Surgical Simulator  

Microsoft Academic Search

BACKGROUND: Wepresentinitialdataontheconstruct,content,andfacevalidityoftheLAPMentor(Simbionix), virtual reality laparoscopic surgical simulator. STUDY DESIGN: Medical students (MS), residents and fellows (R\\/F), and experienced laparoscopic surgeons (ES), with 30 laparoscopic cases per year (ES 30) and those with 30 laparoscopic cases per year (ES 30), were tested on 9 basic skill tasks (SK) including manipulation of 0-degree and30-degreecameras(SK1,SK2),eye-handcoordination(SK3),clipping(SK4),graspingand clipping (SK5), two-handed maneuvers (SK6), cutting (SK7), fulguration

Elspeth M. McDougall; Federico A. Corica; John R. Boker; Leandro G. Sala; Gabriela Stoliar; James F. Borin; Frank T. Chu; Ralph V. Clayman

2006-01-01

357

Results of Laparoscopic Versus Open Abdominal and Incisional Hernia Repair  

PubMed Central

Background: Incisional hernia is a frequent complication of abdominal surgery. The object of this study was to confirm the safety, efficacy, and feasibility of laparoscopic treatment of abdominal wall defects. Methods: Fifty consecutive laparoscopic abdominal and incisional hernia repairs from September 2001 to May 2003 were compared with 50 open anterior repairs. Results: The 2 groups were not different for age, body mass index, or American Society of Anaesthesiologists scores. Mean operative time was 59 minutes for the laparoscopic group, 164.5 minutes for the open group. Mean hernia diameter was 10.6 cm for the laparoscopic group, 10.5 cm for the open group. Mean length of stay was 2.1 days for the laparoscopic group, 8.1 days for the open group. Complications occurred in 16% of the laparoscopic and 50% of open group. Median follow-up was 9.0 months for the laparoscopic group, 24.5 months for the open group. Recurrence rates were 2% for laparoscopic group and 0% for the open group. Conclusion: Results for laparoscopic abdominal and incisional hernia repair seem to be superior to results for open repair in terms of operative time, length of stay, wound infection, major complications, and overall hospital reimbursement. PMID:15984708

Magnone, Stefano; Erba, Luigi; Bertolini, Aimone; Croce, Enrico

2005-01-01

358

Lateral pedicle control during laparoscopic radical prostatectomy: Refined technique  

Microsoft Academic Search

ObjectivesTo report a technique of lateral pedicle control during laparoscopic radical prostatectomy that completely eliminates any form of electrocautery, ultrasonic thermal energy, clips, or bioadhesives.

Inderbir S. Gill; Osamu Ukimura; Mauricio Rubinstein; Antonio Finelli; Alireza Moinzadeh; Dinesh Singh; Jihad Kaouk; Tsuneharu Miki; Mihir Desai

2005-01-01

359

Laparoscopic Incidental Finding of Pneumatosis Intestinalis in Acute Appendicitis  

PubMed Central

Pneumatosis intestinalis (PI) is a rare condition where the gas trapped inside the bowel wall. It is commonly found as an incidental finding on routine abdominal imaging or scans. We present a case of incidental laparoscopic finding of pneumatosis intestinalis on a 32-year-old male, who underwent a laparoscopic appendectomy for an acute appendicitis. Laparoscopic appendectomy was performed and pneumatosis intestinalis managed conservatively. Patient did well and was discharged home. Management of PI depends on clinical presentation; asymptomatic PI can be managed adequately by treating underlying causes. We report a case of incidental laparoscopic finding of Pneumatosis intestinalis, which was adequately managed by treating underlying appendicitis. PMID:25221683

Mayooran, N.; Olu Shola, A.; Iqbal, N.

2014-01-01

360

Integrated interventions for improving negative emotions and stress reactions of young women receiving total hysterectomy.  

PubMed

50% of women had obvious abnormal emotions before hysterectomy and hysterectomy can cause strong mental stress reaction. This study was to investigate the impact of psychological health education based integrated interventions on the preoperative negative emotions and stress of patients younger than 45 years receiving total hysterectomy. Forty patients undergoing total hysterectomy were randomly divided into psychological intervention (PI) group and control group (n=20 per group). Patients in PI received peri-operative psychological intervention (supportive psychotherapy, health education, individual depth psychotherapy, family and society supportive care, education on anesthesia and surgery etc.); Interventions were not used in control group. Hamilton Anxiety Scale and Hamilton Depression Rating Scale were used to evaluate patients in two groups on admission (T1) and before surgery (T2; after interventions in PI group). Serum levels of cortisol and IL-6 were detected at T1, T2 and the second day after surgery (T3). Results showed that 1) Patients had obvious anxiety and depression symptoms before and after total hysterectomy. For patients in PI group, the Hamilton Anxiety Scale (HAMA) score decreased from 14.4±5.9 to 9.1±4.2 and the Hamilton Depressing Scale (HAMD) score from 17.8±3.5 to 9.4±6.8 after interventions; 2) In PI group, the serum cortisol was 13.4±3.9 ?g/dl at T2 and 14.2±4.8 ?g/dl at T3 which were significantly lower than that at T1 (16.6±4.0 ?g/dl) and that in the control group at T2 (13.4±3.9/15.5±4.3 ?g/dl, t=2.10, P<0.05). Thus, preoperative integrated intervention based on psychological health education can improve peri-operative negative emotions and psychological stress in young patients undergoing hysterectomy. PMID:24482729

Wang, Fen; Li, Chun-Bo; Li, Shenghua; Li, Quan

2014-01-01

361

Comparison of open and laparoscopic live donor nephrectomy.  

PubMed Central

OBJECTIVE: This study compares an initial group of patients undergoing laparoscopic live donor nephrectomy to a group of patients undergoing open donor nephrectomy to assess the efficacy, morbidity, and patient recovery after the laparoscopic technique. SUMMARY BACKGROUND DATA: Recent data have shown the technical feasibility of harvesting live renal allografts using a laparoscopic approach. However, comparison of donor recovery, morbidity, and short-term graft function to open donor nephrectomy has not been performed previously. METHODS: An initial series of patients undergoing laparoscopic live donor nephrectomy were compared to historic control subjects undergoing open donor nephrectomy. The groups were matched for age, gender, race, and comorbidity. Graft function, intraoperative variables, and clinical outcome of the two groups were compared. RESULTS: Laparoscopic donor nephrectomy was attempted in 70 patients and completed successfully in 94% of cases. Graft survival was 97% versus 98% (p = 0.6191), and immediate graft function occurred in 97% versus 100% in the laparoscopic and open groups, respectively (p = 0.4961). Blood loss, length of stay, parenteral narcotic requirements, resumption of diet, and return to normal activity were significantly less in the laparoscopic group. Mean warm ischemia time was 3 minutes after laparoscopic harvest. Morbidity was 14% in the laparoscopic group and 35% in the open group. There was no mortality in either group. CONCLUSIONS: Laparoscopic live donor nephrectomy can be performed with morbidity and mortality comparable to open donor nephrectomy, with substantial improvements in patient recovery after the laparoscopic approach. Initial graft survival and function rates are equal to those of open donor nephrectomy, but longer follow-up is necessary to confirm these observations. PMID:9351716

Flowers, J L; Jacobs, S; Cho, E; Morton, A; Rosenberger, W F; Evans, D; Imbembo, A L; Bartlett, S T

1997-01-01

362

Laparoscopic Resection of Symptomatic Gastric Diverticula  

PubMed Central

Gastric diverticula are rare and usually asymptomatic. This report, however, describes two examples of symptomatic gastric diverticula successfully treated by laparoscopic resection. Both patients were male and in their sixth decade of life. One patient was relatively healthy with no past medical history, whereas the other patient had chronic pain issues and at presentation was also undergoing evaluation for hyperaldosteronism. The patients presented with gastrointestinal symptoms, including nausea, emesis, abdominal pain, and change in bowel function. In both cases, a gastric diverticulum was identified by CT scan, and precise anatomic position was determined by upper endoscopy. After discussion with the treating teams, including a gastroenterologist and surgeon, surgical treatment and resection was elected. Successful laparoscopic removal was accomplished in both patients, and they were discharged home after tolerating liquid diets. Both patients reported resolution of their abdominal symptoms at follow-up. PMID:24680154

Zelisko, Andrea; Rodriguez, John; El-Hayek, Kevin

2014-01-01

363

Laparoscopic hand-assisted spleen autotransplantation  

Microsoft Academic Search

Background  Only recently has the spleen been perceived as an organ with a major immune function. This raised an interest in spleen salvage\\u000a after spleen trauma and pancreatic tail resection, for the treatment of hematologic disorders and inducement tolerance for\\u000a allogenic transplants. The purpose of this study was to evaluate the feasibility of a new technique for spleen transplantation:\\u000a laparoscopic spleen

L. Biertho; M. Gagner; A. Waage; W.-W. Kim; B. Jacob; B. Faife-Faife; N. Sekhar; G. DelGenio

2004-01-01

364

Laparoscopic extraperitoneal repair of inguinofemoral herniation.  

PubMed

This report describes my group's experience with repairing 100 direct and indirect inguinal hernias using a solely extraperitoneal, laparoscopic prosthetic procedure. No unusual complications were noted and all patients were discharged on the day of or the day following surgery and resumed normal activities within one week. The surgical technique is outlined, with attention given to general guidelines performing this minimally invasive repair procedure. PMID:8050020

McKernan, J B

1993-08-01

365

Laparoscopic fundoplication: 5-year follow-up.  

PubMed

There are few published reports on outcomes of 5 or more years following laparoscopic fundoplication. Gastroesophageal reflux disease (GERD) specific quality of life questionnaires (QOLRAD), short form health surveys (SF12), and queries regarding current medication use and long-term satisfaction were mailed to all patients who underwent laparoscopic fundoplication at our institution. Results are reported as mean +/- SEM. Seventy-six patients underwent laparoscopic fundoplication (63 Nissen, 13 Toupet) between November 1992 and December 1997. Fifty-two patients completed questionnaires (68%). Mean follow-up was 5.1 +/- 0.2 years (range, 4-9 years). Mean QOLRAD scores were 5.8 +/- 0.2, (scale 0-7, a higher score reflecting improved QOL), which is comparable to the general population (6.0 mean). SF-12 mental and physical scores were 46.6 +/- 1.7 and 34.2 +/- 1.6, respectively, versus 50.7 and 51.2 for the general population. Forty-seven patients (92%) would have the procedure again. Eleven (21%) remained on antisecretory medications (15% proton pump inhibitor and 6% H2 receptor antagonists). None of the 11 patients underwent 24-hour pH testing to document persistent acid exposure. Furthermore, postoperative symptoms of heartburn, dysphagia, and abdominal bloating were rated as none to mild in the majority of patients. Laparoscopic fundoplication is an effective long-term treatment for GERD, resulting in high patient satisfaction, improved quality of life, and elimination of antisecretory medicines in the majority of patients. PMID:15328802

Dassinger, M S; Torquati, A; Houston, H L; Holzman, M D; Sharp, K W; Richards, W O

2004-08-01

366

Single Incision Laparoscopic Ventral Hernia Repair  

PubMed Central

Background and Objectives: Laparoscopic ventral hernia repair (LVH) requires several skin incisions for trocar placement. We have developed a single incision approach to LVH repair. The technique was introduced in clinical practice to any consenting patients who were candidates for a standard multi-port laparoscopic hernia repair. A consecutive series of patients was then followed to evaluate feasibility. Methods: Over an 8-month period, 14 patients (9 females, 5 males) underwent LVH repair by an academic surgeon. One of 2 access methods was used in each patient through a single 1.5-cm to 2-cm skin incision. One technique utilized two 5-mm ports with a temporarily placed 11-mm port for mesh insertion. The second technique utilized the SILS port (Covidien, Norwalk, CT). Standard or roticulating laparoscopic instruments were used with both techniques. Results: Range (mean) BMI: 23 to 59 (38), Age: 26 to 73 years (53), Duration: 37 to 87 minutes (57), Defect size: 1cm to 8cm (2), 3 with Swiss-cheese defect hernias. The procedure was successfully performed in all patients. No conversions to a multiple-port approach or to an open procedure were necessary. There were no mortalities, major complications, or recurrences during the mean follow-up period of 4 weeks. Conclusion: Single incision ventral hernia repair is technically feasible, effective, and reproducible. The technique is easy to master, and safe for any patient who is a candidate for laparoscopic ventral hernia repair. Further data collection with long-term follow-up will be needed to ensure equivalent outcomes. There will be demand for this approach by patients for cosmetic reasons, and it may serve as a bridge to natural orifice techniques. PMID:21902968

Love, Katie M.

2011-01-01

367

Robot-assisted laparoscopic intestinal anastomosis  

Microsoft Academic Search

  Introduction: Robotic telemanipulation systems have been introduced recently to enhance the surgeon's dexterity and visualization\\u000a in videoscopic surgery in order to facilitate refined dissection, suturing, and knot tying. The aim of this study was to demonstrate\\u000a the technical feasibility of performing a safe and efficient robot-assisted handsewn laparoscopic intestinal anastomosis in\\u000a a pig model. Methods: Thirty intestinal anastomoses were performed

J. P. Ruurda; I. A. M. J. Broeders

2003-01-01

368

Technical Controversies in Laparoscopic Sleeve Gastrectomy  

Microsoft Academic Search

Laparoscopic sleeve gastrectomy is a recently developed technique for treating morbid obesity. Since it is a simple procedure,\\u000a many bariatric surgeons have adopted it in recent years with good results. However, there is still no standard procedure across\\u000a different surgical teams. We will discuss the more controversial aspects of the surgical technique: the size of the bougie,\\u000a the beginning of

Manuel Ferrer-Márquez; Ricardo Belda-Lozano; Manuel Ferrer-Ayza

369

Learning kinematic mappings in laparoscopic surgery  

Microsoft Academic Search

We devised an interactive environment in which subjects could perform simulated laparoscopic maneuvers, using either unconstrained movements or standard mechanical contact typical of a box-trainer. During training the virtual tool responded to the absolute position in space (Position-Based) or the orientation (Orientation-Based) of a hand-held sensor. Volunteers were further assigned to different sequences of target distances (Near-Far-Near or Far-Near-Far). Orientation-Based

Felix C. Huang; Carla M. Pugh; James L. Patton; Ferdinando A. Mussa-Ivaldi

2010-01-01

370

Laparoscopic Management of Complicated Urachal Remnants  

PubMed Central

Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We report 7 cases with complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue. We expected that this technique would be less invasive and have lower morbidity. We report on the feasibility of this approach, including efficacy and outcomes. Eight patients with a mean age of 36.5 years who had symptomatic urachal diseases underwent laparoscopic excision between July 2004 and July 2012. With the use of four ports, the urachal remnant was dissected transperitoneally and then removed via the umbilicus port. The clinical results of laparoscopic urachal remnant excision as a minimally invasive surgery, the perioperative records, and pathologic results were evaluated. There were no intraoperative or postoperative complications. Mean surgery time was 2.7 hours. Mean hospital stay was 14.6 days. The patients with bladder cuff resection had a long admission and Foley catheterization period (mean, 14.4 and 11 days). Pathological evaluations were 6 cases of infected urachal cysts, 1 case of infected urachal sinus, and 1 case of urachal adenocarcinoma. We found no postoperative complications including any symptom recurrence or voiding difficulty during a mean follow-up of 46.3 months. The perioperative surgical outcomes achieved infection control and symptomatic relief and additionally good cosmesis. Complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue seems to be a safe, effective, and better cosmetic alternative with the advantages of a minimally invasive approach. PMID:23678477

Jeong, Hee Jong; Han, Dong Youp

2013-01-01

371

Laparoscopic retrieval of an unusual foreign body  

PubMed Central

Ingestion of foreign body is a serious problem commonly encountered in our clinical practice. Most of them pass spontaneously, whereas in others endoscopic or surgical intervention is required because of complications or non-passage from the gastrointestinal tract. We present here a case of teaspoon ingestion, which did not pass spontaneously. Laparoscopic retrieval of teaspoon was done from mid jejunum after enterotomy and the patient recovered uneventfully. Right intervention at the right time is of paramount importance.

Shukla, Binay Kumar; Khullar, Rajesh; Sharma, Anil; Soni, Vandana; Baijal, Manish; Chowbey, Pradeep

2014-01-01

372

Postoperative Ascites of Unknown Origin following Laparoscopic Appendicectomy: An Unusual Complication of Laparoscopic Surgery  

PubMed Central

Postoperative ascites is a very rare complication of laparoscopic surgery. Significant iatrogenic injuries to the bowel, the urinary tract, and the lymphatic system should be excluded promptly to avoid devastating results for the patient. In some cases, in spite of investigating patients extensively, no definitive causative factor for the accumulation of fluid can be identified. In such cases, idiopathic allergic or inflammatory reaction of the peritoneum may be responsible for the development of ascites. We present a case of ascites of an unknown origin in a young female patient following a laparoscopic appendicectomy. PMID:24822146

Feretis, M.; Boyd-Carson, H.; Karim, A.

2014-01-01

373

Single incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC)—a matched pair analysis  

Microsoft Academic Search

Introduction  The aim of our study was to compare single incision laparoscopic cholecystectomy (SILC) and laparoscopic cholecystectomy (LC)\\u000a with respect to complications, operating time, postoperative pain, use of analgesics, length of stay, return to work, rate\\u000a of incisional hernia, and cosmetic outcome.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Sixty-seven patients underwent SILC. Of a cohort of 163 LC operated in the same time period, 67 patients were

Odo Gangl; Wolfgang Hofer; Florian Tomaselli; Thomas Sautner; Reinhold Függer

374

Laparoscopic excision of a cystic lymphangioma.  

PubMed

A 16-year-old female was evaluated for recurrent episodes of acute abdominal pain and distension. Initial abdominal radiographs were consistent with recurrent gastric volvulus. Following nasogastric tube decompression, reexamination revealed a mobile abdominal mass in the left upper quadrant. Contrast studies followed by computed tomography demonstrated a cyst measuring 9 X 7 X 6 cm with no obvious relationship to abdominal viscera. Laparoscopy was performed with a 10-mm port at the umbilicus and right upper quadrant,and a 5-mm port in the left lower quadrant. The cyst was excised from the mesentery of the proximal jejunum and placed in a laparoscopic sac. Controlled incision and drainage of the cyst within the sac facilitated its removal from the abdomen with neither enlargement of the trocar site nor intraabdominal spillage. To prevent recurrent gastric volvulus, a gastropexy was performed from the greater and lesser curvatures to the anterior abdominal wall. The histology was typical of a cystic lymphangioma. The patient was discharged on the third postoperative day without complication. Laparoscopic technique allowed the performance of both procedures without large incisions, This is the first reported laparoscopic excision of a cystic lymphangioma. PMID:8832938

Kenney, B; Smith, B; Bensoussan, A L

1996-03-01

375

Laparoscopic and robotic surgical training in urology.  

PubMed

The most important change in urology during the past decade was the development of minimally invasive surgery, particularly laparoscopy. However, the main drawback of laparoscopy is a steep learning curve, which results from the significant changes in the surgical environment. Although laparoscopy can provide important advantages for the patient, including decreased length of hospitalization, decreased analgesic requirement, and a shortened postoperative convalescence, one concern has been whether laparoscopic techniques should be learned solely in the operating room. For example, sports, music, and aviation are practiced before an actual performance is ever undertaken. In this review, the advantages and limitations of all available training modalities in minimally invasive surgery are described. Testing basic laparoscopic skills on inanimate models, becoming familiar with the principles of dissection and hemostasis on living animals, and studying surgical anatomy on cadavers should be considered as indispensable and complementary elements for laparoscopic training in the future. In addition, telementoring with the help of modern image processing and virtual reality eventually may become the basis of tomorrow's surgical instruction. PMID:12648430

Hoznek, András; Katz, Ran; Gettman, Matthew; Salomon, Laurent; Antiphon, Patrick; de la Taille, Alexandre; Yiou, René; Chopin, Dominique; Abbou, Clément-Claude

2003-04-01

376

Laparoscopic Splenectomy Using LigaSure  

PubMed Central

Background: Laparoscopic splenectomy (LS) has become the standard approach for most splenectomy cases. Bleeding is the main complication and cause for conversion. We present our experience with the LigaSure and discuss its advantage as a vessel sealing system in achieving safe vascular control. Method: Over a 3-year period, we performed 12 consecutive LS using LigaSure at a single center. A literature review of all the patients who had undergone laparoscopic splenectomy with of the LigaSure to achieve vascular control at the hilum was carried out, assessing its advantages and outcome. Results: Twelve LS were performed. Eleven of these patients had ITP, and one patient had sickle cell disease. The mean blood loss was 70mL (range, 50 to 460), and operating time was 126 minutes (range, 110 to 240). Two postoperative complications occurred: portal vein thrombosis in one case and subphrenic collection in the other. The literature review revealed 8 studies with 231 cases in which the LigaSure was used to perform laparoscopic splenectomy. A significant reduction in operating time (average 102 minutes) and intraabdominal blood loss (66mL) was observed with the LigaSure compared with endostaplers. Conclusion: The use of LigaSure and the semilateral position results in a gain of time and safety in addition to low intraoperative bleeding, need for transfusion, minimal complications and a low conversion rate. PMID:21605520

Kindy, Nayil Al; Chopra, Pradeep J.

2010-01-01

377

Giant gallstone performed by emergency laparoscopic cholecystectomy?  

PubMed Central

INTRODUCTION Gallstone disease is very common, but the gallstone bigger than 5 cm in diameter is very rare. It is very challenging to be removed by laparoscopic cholecystectomy (LC) and poses extra difficulty in emergency. PRESENTATION OF CASE A 70-year-old man complained of abdominal pain in the right upper quadrant with fever of 38 °C for two days. Abdominal ultrasound indicated acute cholecystitis and a single, extremely large gallstone (95 mm × 60 mm × 45 mm). Emergency laparoscopic cholecystectomy was performed successfully. DISCUSSION Gallstone over 5 cm in diameter is very rare. LC will be very difficult for these cases, especially for the emergency cases. Emergency laparoscopic cholecystectomy can be successfully performed with clear exposure of the anatomy of the Calot's triangle. To the best of our knowledge, such giant gallstone has been rarely reported. CONCLUSION We have proven that for the rare giant gallstone about 10 cm in size, LC is a feasible option if the anatomy of the Calot's triangle can be clearly exposed; otherwise, open cholecystectomy is a safe choice.

Xu, Xiequn; Hong, Tao; Zheng, Chaoji

2013-01-01

378

Laparoscopic Sleeve Gastrectomy: Our First 100 Patients  

PubMed Central

Background: Laparoscopic sleeve gastrectomy is becoming a popular procedure for the morbidly obese patient. Its utilization as a standalone procedure has good results with weight loss in short- and midterm reports. The aim of this study was to assess our technique and whether it warranted any modifications in the early postoperative period. Methods: Our first 100 consecutive patients undergoing laparoscopic sleeve gastrectomy were retrospectively reviewed. Data analysis was conducted at 3 and 6 months to assess the percentage of excess body weight loss and comorbidity status change. Results: The percentage of excess body weight loss at the 3- and 6-month marks was 34.2% and 49.1%, respectively. Comorbidities were also improved at the 3- and 6-month marks. Hypertension resolved in 38%, hyperlipidemia resolved in 19%, and diabetes in 46%. Complication rate during the first 6 months was 10%. Major complications included 2 patients with postoperative bleeding, 2 patients with acute renal failure from dehydration, and 1 postoperative bleeding patient who developed a gastric fistula. No surgical reintervention was required for any complication. Conclusion: Our technique is a safe method that is easily reproducible and does not require any modification. Laparoscopic sleeve gastrectomy is an excellent surgical option with a low complication rate. PMID:21605511

LeBlanc, Karl A.; Hausmann, Mark G.; Kleinpeter, Kenny; Allain, Brent W.; Romero, Roderick

2010-01-01

379

Mesh infections after laparoscopic inguinal hernia repair.  

PubMed

Several complications like hematoma and seroma have been reported after laparoscopic inguinal hernia repair (LH). Sepsis due to infection of the patch is an uncommon complication. In this retrospective trial, we evaluated three male patients who developed postoperative mesh infection after LH by transabdominal preperitoneal patch (TAPP) technique in two institutions. Diagnosis was confirmed by clinical symptoms, signs, ultrasonography, and computerized tomography (CT), and definitive treatment was provided by removing the mesh. In the first case, mesh infection occurred 10 months after laparoscopic left inguinal hernia repair with TAPP for recurrence. The infection manifested itself as an external fistula at the drain site. The mesh was removed laparoscopically due to persistent suppuration. In the second case, mesh infection occurred 3 months after transabdominal preperitoneal hernia repair on the left. The patch was removed because of the persistent suppuration despite repetitive drainage and lavage. In the third case, mesh infection occurred in 15 days after transabdominal preperitoneal hernia repair on the right. External drainage was performed under CT guidance, but suppuration could not be stopped. Thus the mesh was removed. In three cases, infection could not be stopped after diagnosis despite drainage and antibiotic coverage, and then it was decided to remove the mesh. The meshes were removed under general anesthesia for the first two cases and under local anesthesia for the third one. During the follow-up period, no recurrences were noted. The mesh infections of these three cases, resistant to conservative treatment methods, completely disappeared after mesh removal. PMID:9194276

Avtan, L; Avci, C; Bulut, T; Fourtanier, G

1997-06-01

380

Laparoscopic Repair of Incidentally Found Spigelian Hernia  

PubMed Central

Background and Objectives: A Spigelian hernia is a rare type of hernia that occurs through a defect in the anterior abdominal wall adjacent to the linea semilunaris. Estimation of its incidence has been reported as 0.12% of all abdominal wall hernias. Traditionally, the method of repair has been an open approach. Herein, we discuss a series of laparoscopic repairs. Methods: Case series and review of the literature. Cases: Three patients are presented. All were evaluated and taken to surgery initially for a different disease process, and all were incidentally found to have a spigelian hernia. These patients underwent laparoscopic repair of their hernias; 2 were repaired intraperitoneally and one was repaired totally extraperitoneally. Two patients initially underwent a mesh repair, while the third had an attempted primary repair. Conclusions: There is evidence that supports the use of laparoscopy for both diagnosis and repair of spigelian hernias. There are also reports of successful repairs both primarily and with mesh. In our experience with the preceding 3 patients, we found that laparoscopic repair of incidentally discovered spigelian hernias is a viable option, and we also found that implantation of mesh, when possible, resulted in satisfactory results and no recurrence. PMID:21902949

Nickloes, Todd; Mancini, Greg; Solla, Julio A.

2011-01-01

381

Laparoscopic fundoplication for gastroesophageal reflux disease  

PubMed Central

Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms and/or complications. Heartburn is the cardinal symptom, often associated with regurgitation. In patients with endoscopy-negative heartburn refractory to proton pump inhibitor (PPI) therapy and when the diagnosis of GERD is in question, direct reflux testing by impedance-pH monitoring is warranted. Laparoscopic fundoplication is the standard surgical treatment for GERD. It is highly effective in curing GERD with a 80% success rate at 20-year follow-up. The Nissen fundoplication, consisting of a total (360°) wrap, is the most commonly performed antireflux operation. To reduce postoperative dysphagia and gas bloating, partial fundoplications are also used, including the posterior (Toupet) fundoplication, and the anterior (Dor) fundoplication. Currently, there is consensus to advise laparoscopic fundoplication in PPI-responsive GERD only for those patients who develop untoward side-effects or complications from PPI therapy. PPI resistance is the real challenge in GERD. There is consensus that carefully selected GERD patients refractory to PPI therapy are eligible for laparoscopic fundoplication, provided that objective evidence of reflux as the cause of ongoing symptoms has been obtained. For this purpose, impedance-pH monitoring is regarded as the diagnostic gold standard. PMID:25339814

Frazzoni, Marzio; Piccoli, Micaela; Conigliaro, Rita; Frazzoni, Leonardo; Melotti, Gianluigi

2014-01-01

382

Response of serum cytokines in patients undergoing laparoscopic cholecystectomy  

Microsoft Academic Search

The clinical observation that a laparoscopic cholecystectomy is a minimally invasive operation has not been demonstrated on a biochemical basis. Interleukin-6, a known endogenous pyrogen and hepatocyte-stimulating protein, correlates with the significance of surgical trauma. Utilizing the IL-6 immunoassay, we studied this biochemical parameter of trauma to compare its response in laparoscopic vs open cholecystectomy. Sixteen patients who underwent only

J. M. Cho; A. J. LaPorta; J. R. Clark; M. J. Schofield; S. L. Hammond; P. L. Mallory II

1994-01-01

383

Laparoscopic surgery in women with endometrial cancer: the learning curve  

Microsoft Academic Search

Objective: The aim of this study was to assess the effect of increasing surgeons’s experience in the laparoscopic surgery of women with endometrial cancer (EC) on the surgical outcome of these patients. Study design: Data were obtained from a prospectively collected database of 108 patients two oncolaparoscopic centers in Czech Republic who underwent laparoscopically assisted surgical staging (LASS) from April

Zdenek Holub; Anton??n Jabor; Pavel Bartoš; Jan Hendl; Št?pán Urbánek

2003-01-01

384

Pilot Study on Laparoscopic Surgery in Port-Harcourt, Nigeria  

PubMed Central

Background: Video-laparoscopic surgery has long been practiced in western countries; however documented practice of this minimal access surgical technique are recently emanating from Nigeria. To the best of our knowledge, this is the first documented study on laparoscopic surgery from the Niger Delta region. Aim: To evaluate the feasibility of laparoscopy as a useful tool for management of common surgical abdominal conditions in our environment. Patients and Methods: This was a prospective outcome study of all consecutive surgical patients who had laparoscopic procedures in general and pediatric surgery units of our institution from August 2011 to December 2012. Data on patient's age, gender, indication for surgery, duration of hospital stay and outcome of surgery were collected and analyzed. Results: A total of 15 laparoscopic procedures were performed during this study period with age range of 2-65 years; mean: 32.27 ± 17.86 years. There were 11 males and four females. Six laparoscopic appendicectomies, one laparoscopy-assisted orchidopexy, five diagnostic laparoscopy ± biopsy, one laparoscopic trans-abdominal pre-peritoneal herniorrhaphy for bilateral indirect inguinal hernia and two laparoscopic adhesiolysis for small bowel obstruction were performed. All were successfully completed except one conversion (6.7%) for uncontrollable bleeding in an intra-abdominal tumor. Conclusion: The practice of laparoscopic surgery in our environment is feasible and safe despite the numerous, but surmountable challenges. There is the need for adequate training of the support staff and a dedicated theatre suite. PMID:24665198

Ray-Offor, E; Okoro, PE; Gbobo, I; Allison, AB

2014-01-01

385

Comparison of Laparoscopic and Open Surgery for Total Rectal Prolapse  

Microsoft Academic Search

Purpose. Total rectal prolapse is a devastating disorder causing constipation and anal incontinence. We compared open and laparoscopic surgical approaches in a limited series. Methods. The subjects of this study were 23 patients who underwent laparoscopic procedures (LP group) and 17 patients who underwent open procedures (OP group) for rectal prolapse. We assessed the preoperative colonic transit time, postoperative pain

Sezai Demirbas; M. Levhi Akin; Murat Kalemoglu; Ibrahim Ogün; Tuncay Çelenk

2005-01-01

386

Laparoscopic Myomectomy after Failure of Uterine Artery Embolization  

Microsoft Academic Search

A patient experienced continuing pain and growth of a broad-based pedunculated myoma 6 months after uterine artery embolization (UAE). A 7-cm myoma was found growing directly from the serosa of the fallopian tube and was removed laparoscopically. To our knowledge, this is the first report of laparoscopic myomectomy performed after failure of UAE. This case identifies one of the predictable

Nelson H. Stringer; April DeWhite; Julie Park; Anoosha Ghodsizadeh; Marjorie Edwards; Nakka V. A. Kumari; Erica A. Stringer

2001-01-01

387

Postgraduate Year Does Not Influence Operating Time in Laparoscopic Cholecystectomy  

Microsoft Academic Search

Background. Surgical resident education may contribute to increased operating time, thus increasing costs at teaching institutions. It is possible that junior residents, in particular, with less experience could contribute to longer operating times for laparoscopic cholecystectomy. We hypothesized that all general surgery residents, regardless of level of training and with proper supervision, could complete a laparoscopic cholecystectomy in a safe

William N. Wang; Michael G. Melkonian; Renee Marshall; Randy S. Haluck

2001-01-01

388

Laparoscopic Management of a Hydatid Cyst of the Adrenal Gland  

PubMed Central

Hydatid disease is endemic in parts of India, yet genitourinary involvement is rare. Laparoscopic management of such cases is uncommonly reported. We present a case of an adrenal hydatid and its management by laparoscopic aspiration, instillation of scolicidal solution, and partial excision of the cyst. PMID:25045450

Nanjappa, Bhuvanesh; Gowda, Kiran Krishne

2014-01-01

389

Learning laparoscopic surgery by imitation using robot trainer  

Microsoft Academic Search

Laparoscopic surgery requires rigorous training in order to overcome physical, spatial and visual constraints. We are developing a laparoscopic robot trainer. The robot trainer can learn the motion of the master surgeon when he is performing a virtual surgery, and drive the surgical tool by mimicking the learnt trajectory during training. This paper reports our investigation on robot learning using

Chee-Kong Chui; Chin-Boon Chng; Tao Yang; Rong Wen; Weimin Huang; Jimmy Liu; Yi Su; Stephen Chang

2011-01-01

390

Laparoscopic reoperations after failed and complicated antireflux operations  

Microsoft Academic Search

Nineteen patients underwent laparoscopic reoperations for failed or complicated antireflux operations from a total of 248 patients with gastroesophageal reflux disease who had been operated on by this approach. Sixteen had been submitted to open surgery and three to laparoscopic surgery over a period ranging from 5 days to 31 years before the study. Three patients had been submitted to

A. L. DePaula; K. Hashiba; M. Bafutto; C. A. Machado

1995-01-01

391

Laparoscopic partial nephrectomy with suture repair of the pelvicaliceal system  

Microsoft Academic Search

ObjectivesLaparoscopic partial nephrectomy is emerging as a viable minimally invasive nephron-sparing option for select patients with an exophytic renal tumor. With increasing experience, we are applying laparoscopic partial nephrectomy to tumors invading more deeply into the renal parenchyma, necessitating intentional caliceal entry to ensure an adequate margin of resection. In this prospective study, we assessed the safety and efficacy of

Mihir M Desai; Inderbir S Gill; Jihad H Kaouk; Surena F Matin; Andrew C Novick

2003-01-01

392

LAPAROSCOPIC ORCHIOPEXY: PROCEDURE OF CHOICE FOR THE NONPALPABLE TESTIS?  

Microsoft Academic Search

PurposeMultiple approaches exist for the management of the nonpalpable testis. With the use of diagnostic laparoscopy widely accepted in the setting of the nonpalpable testis we have found laparoscopic orchiopexy to be an efficient and logical extension. To evaluate its use we report our experience with laparoscopic orchiopexy to treat 44 nonpalpable testes in 36 patients.

BRUCE W. LINDGREN; ERIC C. DARBY; LOUIS FAIELLA; WILLIAM A. BROCK; EDWARD F. REDA; SELWYN B. LEVITT; ISRAEL FRANCO

1998-01-01

393

Laparoscopic Orchiopexy for the Intra-Abdominal Testis  

Microsoft Academic Search

Laparoscopic orchiopexy was performed in 3 patients with an intra-abdominal testis. The laparoscopic approach provides better exposure of the spermatic vessels and vas deferens, and is less traumatic compared to the open procedure. In 2 patients the spermatic vessels were dissected after incising the posterior peritoneum but in 1 a strip of peritoneum overlying the vessels was left to avoid

D. D. Gaur; D. K. Agarwal; K. C. Purohit; A. S. Darshane

1995-01-01

394

Grade Seven Consumer Convention.  

ERIC Educational Resources Information Center

Seventh-graders studied inflation and other economic consumer concepts at a consumer convention. Preactivities, workshop sign-up day, and the convention schedule are discussed. A chart of the workshop design is included. (SR)

Berndes, Katherine

1983-01-01

395

Interstitial Fluid Concentrations of Ceftriaxone (1 g i.v.) in the Subperitoneal Space after Hysterectomy  

Microsoft Academic Search

The ability of an antibiotic to penetrate into the extravascular site of infection is particularly important for a successful perioperative antibiotic prophylaxis and postoperative therapy of bacterial infection. We, therefore, measured interstitial fluid concentrations of ceftriaxone in the subperitoneal space following hysterectomy using Rubinstein’s disc method after intravenous administration of 1 g of ceftriaxone preoperatively. After removal of the uterus,

G. J. Gerstner; W. Kronich; D. Adam

1990-01-01

396

Arterial embolisation for persistent primary postpartum haemorrhage: before or after hysterectomy?  

PubMed

Arterial embolisation is a recognised treatment for postpartum haemorrhage (PPH). In this retrospective study, we evaluate its use in the management of persistent PPH. Records of all births during a 54 month period at a university hospital were analysed. Two sub-groups were identified. Group I (n= 5), underwent embolisation after hysterectomy and Group II (n= 4), had embolisation as a first-line theraphy without hysterectomy. Of 20,215 births, there were 636 cases of PPH (3.1%). Nine required embolisation to control bleeding (1.4%). Group I needed multiple surgical procedures, had a larger pre- and post-operative blood requirement (12-100, median 22 units, vs. 6-12, median 8.5 units), longer embolisation (33-93, median 54 minutes, vs 20-66, 47 minutes) with a larger radiation exposure (5194-9067, median 6301 dGy, vs. 269-3862, median 950 dGy), a longer intensive care stay (3-7, median four days vs. 0-1.5, median one day), and more complications, when compared with Group II. Three of four women from Group II resumed menstrual function. Embolisation prior to hysterectomy may be preferable to embolisation after hysterectomy for the control of PPH. PMID:15270943

Bloom, Allan I; Verstandig, Anthony; Gielchinsky, Yuval; Nadiari, Michel; Elchalal, Uri

2004-08-01

397

Loss of ovarian reserve after uterine artery embolization: A randomized comparison with hysterectomy  

Microsoft Academic Search

Background: Ovarian failure as a complication of uterine artery embolization (UAE) for symptomatic uterine fibroids has raised concerns about this new treatment modality. Methods: We investigated the occurrence of ovarian reserve reduction in a randomized trial comparing UAE and hysterectomy by measuring follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH). A total of 177 pre-menopausal women with menorrhagia due to

Wouter J. K. Hehenkamp; Nicole A. Volkers; Frank J. M. Broekmans; Jong de F. A; Axel P. N. Themmen; Erwin Birnie; Jim A. Reekers; Willem M. Ankum

2007-01-01

398

Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer  

Microsoft Academic Search

From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40

Andrew P. Soisson; John T. Soper; Daniel L. Clarke-Pearson; Andrew Berchuck; Gustavo Montana; William T. Creasman

1990-01-01

399

The Role of Laparoscopic-Assisted Myomectomy (LAM)  

PubMed Central

Laparoscopic myomectomy has recently gained wide acceptance. However, this procedure remains technically highly demanding and concerns have been raised regarding the prolonged time of anesthesia, increased blood loss, and possibly a higher risk of postoperative adhesion formation. Laparoscopic-assisted myomectomy (LAM) is advocated as a technique that may lessen these concerns regarding laparoscopic myomectomy while retaining the benefits of laparoscopic surgery, namely, short hospital stay, lower costs, and rapid recovery. By decreasing the technical demands, and thereby the operative time, LAM may be more widely offered to patients. In carefully selected cases, LAM is a safe and efficient alternative to both laparoscopic myomectomy and myomectomy by laparotomy. These cases include patients with numerous large or deep intramural myomas. LAM allows easier repair of the uterus and rapid morcellation of the myomas. In women who desire a future pregnancy, LAM may be a better approach because it allows meticulous suturing of the uterine defect in layers and thereby eliminates excessive electrocoagulation. PMID:11719974

Nezhat, Ceana H.; Nezhat, Farr.; Nezhat, Camran

2001-01-01

400

A new technical approach for extraperitoneal laparoscopic bladder diverticulectomy.  

PubMed

In this paper, the authors report on a new, modified laparoscopic technique to remove a large bladder diverticulum. A 26-year-old male with a urinary problem underwent an ultrasound, as well as intravenous urography and cystoscopy examinations, which showed a large bladder diverticulum. The diverticulum was operated upon laparoscopically. The extraperitoneal laparoscopic intervention was facilitated by balloon placed into the diverticulum. The new technique for the laparoscopic diverticulumectomy procedure was successful and the operating time was 140 minutes. There were no perioperative complications. In conclusion, the laparoscopic removal of the bladder diverticulum is a safe and minimally invasive intervention. The introduction of a balloon into the diverticulum makes the operation easier. PMID:17907983

Flasko, Tibor; Toth, Gyorgy; Benyo, Matyas; Farkas, Antal; Berczi, Csaba

2007-10-01

401

A laparoscopic intraperitoneal onlay mesh technique for the repair of an indirect inguinal hernia.  

PubMed Central

OBJECTIVE: This study was done (1) to determine whether congenital indirect inguinal hernias in male pigs could be repaired by placing a polypropylene mesh prosthesis over the defect intra-abdominally, (2) to measure the incidence of adhesions between intra-abdominal viscera and the prosthesis with and without the adhesion barrier oxidized regenerated cellulose, (3) to determine the incidence of other complications, and (4) to assess the effect on fertility. SUMMARY BACKGROUND DATA: Several techniques for laparoscopic inguinal herniorrhaphy are currently being evaluated to determine whether there are advantages over conventional inguinal herniorrhaphy. Perhaps the most controversial is the intraperitoneal onlay mesh procedure (IPOM). Its advantage is its simplicity (in that the repair is accomplished by placing a prosthesis over the hernia defect intra-abdominally, avoiding a groin dissection). Its disadvantage is the potential for complications because the prosthesis is in contact with the intra-abdominal viscera. METHODS: In male pigs, polypropylene mesh alone or polypropylene mesh plus the adhesion barrier oxidized regenerated cellulose (composite prosthesis) was fixed to the peritoneum surrounding the hernia defect. In phase 1 (6-week follow-up), two groups of 13 pigs each underwent herniorrhaphy at laparotomy or laparoscopy. In phase 2 (7.1-month follow-up), 21 pigs underwent laparoscopic herniorrhaphy. RESULTS: All IPOM herniorrhaphies were successful. The prostheses adhered most frequently to the bladder, followed by small bowel, peritoneum, and cord structures. Prosthetic erosion into these organs was not observed. Laparoscopically placed prostheses in phases 1 and 2 had significantly less surface covered by adhesions (13% +/- 13% and 19% +/- 27%, respectively) and a lower adhesion tenacity grade (1.5 +/- 0.9 and 1.3 +/- 1.1, respectively) than those placed at laparotomy (44% +/- 27% and 2.5 +/- 0.7, respectively; p < 0.01). In phase 1, a histologic evaluation of laparoscopically placed specimens demonstrated significantly thinner above-mesh fibrotic tissue compared with the prostheses implanted at laparotomy (p < 0.04). In either phase, the use of the adhesion barrier did not produce any histologic difference between the polypropylene alone and the composite prosthesis. Fertility studies were performed in phase 2 and showed no adverse effects caused by either prosthesis. CONCLUSIONS: This study demonstrated that the intraperitoneal placement of a polypropylene prosthesis was an effective technique for indirect inguinal herniorrhaphy in a pig. Furthermore, with laparotomy, the addition of oxidized regenerated cellulose significantly decreased the rate of adhesion formation to the prosthesis. However, oxidized regenerated cellulose would appear to have no value when used with a prosthesis placed laparoscopically. Images Figure 1. Figure 2. Figure 5. Figure 5. PMID:8129485

Fitzgibbons, R J; Salerno, G M; Filipi, C J; Hunter, W J; Watson, P

1994-01-01

402

Surgicel granuloma: unusual cause of "recurrent" mass lesion after laparoscopic nephron-sparing surgery for renal cell carcinoma.  

PubMed

We present the first clinical report of Surgicel granuloma after laparoscopic nephron-sparing surgery and present the characteristics of this radiological image mimicking local recurrence. A 47-year-old man underwent laparoscopic nephron-sparing surgery for left renal interpolar incidentaloma; Surgicel bolsters were used for hemostasis. Histological examination revealed conventional clear-cell renal cell carcinoma with negative surgical margins. Magnetic resonance imaging at 3 months revealed a 2.5-cm enhancing mass in the region of nephron-sparing surgery. Computed tomography-guided core biopsy revealed foreign-body granuloma. Serial magnetic resonance imaging showed a decrease in the size/enhancement of the lesion during 12 months. To conclude, Surgicel may invoke foreign-body reaction leading to formation of pseudotumor, which leads to diagnostic dilemma. PMID:20494418

Agarwal, Mayank M; Mandal, Arup K; Agarwal, Santosh; Lal, Anupam; Prakash, Mahesh; Mavuduru, Ravimohan; Singh, Shrawan K

2010-08-01

403

Laparo-endoscopic single-site left adrenalectomy using conventional ports and instruments  

PubMed Central

Laparo-endoscopic single-site adrenalectomy (LESS-A) is commonly performed using specialized access devices and/or instruments. We report a LESS-A in a 47-year-old woman with a left aldosteranoma via a subcostal approach utilizing conventional laparoscopic ports and instruments. The feasibility and cost-effectiveness of this approach are highlighted and the literature on the subject is reviewed. PMID:24833835

Bhandarkar, Deepraj S.; Mittal, Gaurav K.; Katara, Avinash N.; Behera, Ramya R.

2014-01-01

404

Spinal anesthesia for laparoscopic cholecystectomy: Thoracic vs. Lumbar Technique  

PubMed Central

Aims: In our group, after a study showing that spinal anesthesia is safe when compared with general anesthesia, spinal anesthesia has been the technique of choice for this procedure. This is a prospective study with all patients undergoing LC under spinal anesthesia in our department since 2007. Settings and Design: Prospective observational. Materials and Methods: From 2007 to 2011, 369 patients with symptoms of colelithiasis, laparoscopic cholecystectomy were operated under spinal anesthesia with pneumoperitoneum and low pressure CO2. We compared 15 mg of hyperbaric bupivacaine and lumbar puncture with 10 or 7.5 mg of hyperbaric bupivacaine thoracic puncture, all with 25 ?g fentanyl until the sensory level reached T3. Intraoperative parameters, post-operative pain, complications, recovery, patient satisfaction, and cost were compared between both groups. Statistical Analysis Used: Means were compared by ANOVA or Kruskal-Wallis test, the percentages of the Chi-square test or Fisher's exact test when appropriate. Time of motor and sensory block in spinal anesthesia group was compared by paired t test or Mann-Whitney test. Differences were considered significant when P ? 0.05, and for comparisons of mean pain visual scale, we employed the Bonferroni correction applied to be considered significant only with P ? 0.0125 Results: All procedures were completed under spinal anesthesia. The use of lidocaine 1% was successful in the prevention of shoulder pain in 329 (89%) patients. There were significant differences in time to reach T3, obtaining 15 mg > 10 mg = 7.5 mg. There is a positive correlation between the dose and the incidence of hypotension. The lowest doses gave a decrease of 52.2% in the incidence of hypotension. There was a positive correlation between the dose and duration of sensory and motor block. Sensory block was almost twice the motor block at all doses. With low doses, 60% of patients went from table to stretcher. Satisfaction occurred in 99% of patients. Conclusions: Laparoscopic cholecystectomy can be performed successfully under spinal anesthesia with low-pressure pneumoperitoneum of CO2. The use of thoracic puncture and low doses of hyperbaric bupivacaine provided better hemodynamic stability, less hypotension, and shorter duration of sensory and motor blockade than lumbar spinal anesthesia with conventional doses.

Imbelloni, Luiz Eduardo

2014-01-01

405

Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison  

SciTech Connect

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.

Hehenkamp, Wouter J. K. [Academic Medical Centre Amsterdam, Department of Gynaecology (Netherlands)], E-mail: w.j.k.hehenkamp@amc.uva.nl; Volkers, Nicole A. [Academic Medical Centre Amsterdam, Department of Radiology (Netherlands); Bartholomeus, Wouter [Academic Medical Centre Amsterdam, Faculty of Medicine (Netherlands); Blok, Sjoerd de [Onze Lieve Vrouwe Gasthuis, Amsterdam, Department of Gynaecology (Netherlands); Birnie, Erwin [Academic Medical Centre Amsterdam, Public Health Epidemiology (Netherlands); Reekers, Jim A. [Academic Medical Centre Amsterdam, Department of Radiology (Netherlands); Ankum, Willem M. [Academic Medical Centre Amsterdam, Department of Gynaecology (Netherlands)

2007-09-15

406

Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison  

PubMed Central

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE. PMID:17671809

Volkers, Nicole A.; Bartholomeus, Wouter; de Blok, Sjoerd; Birnie, Erwin; Reekers, Jim A.; Ankum, Willem M.

2007-01-01

407

Laparoscopic liver resection: lessons learnt after 100 cases.  

PubMed

OBJECTIVE. To share our institutional experience in laparoscopic liver resection and our learning curve after the first 100 cases of laparoscopic liver resection. DESIGN. Case series with internal comparison. SETTING. A regional hospital in Hong Kong. PATIENTS. Our institution started performing laparoscopic liver resection since 2006. All patients who underwent laparoscopic liver resections from March 2006 to October 2012 were identified in a prospectively collected database. The demographic data and operative outcomes of these patients were extracted, and results of the early (from March 2006 to May 2010) and late (from June 2010 to October 2012) study periods were compared. RESULTS. Between March 2006 and October 2012, 100 laparoscopic liver resections were performed for 98 patients in the Department of Surgery, Kwong Wah Hospital, Hong Kong. They were 69 (70%) males and 29 (30%) females, and the median age was 65 years. The final histological diagnoses were as follows: hepatocellular carcinoma (n=72), colorectal liver metastases (n=14), intrahepatic cholangiocarcinoma (n=4), and benign disease (n=10). There were more anatomical resections, major hepatectomies as well as resections of more anatomically challenging right-sided and posterosuperior lesions in the late versus the early period; however, operative outcomes remained comparable in both periods. CONCLUSION. Laparoscopic hepatectomies are feasible with growing experience. Bearing in mind the diversity in the level of operative techniques with various types of laparoscopic liver resections, more experience is needed to overcome the learning curve. PMID:24722724

Chan, F Km; Cheng, K C; Yeung, Y P

2014-10-01

408

Laparoscopic Management of a Cystic Duct Cyst  

PubMed Central

Background: Choledochal cysts are rare cystic dilatations of the biliary tree. Though their cause is uncertain, these cysts are usually referred for surgical resection because of their association with developing malignancy. Traditionally, choledochal cysts have been classified under 5 main types. Not included in this classification are cysts of the cystic duct, a condition that is even rarer, with only 14 cases reported in the literature to date. We describe one such rare case of a cyst of the cystic duct that we successfully treated via laparoscopic resection. Methods and Results: A 41-year-old male was found to have a biliary abnormality on a routine follow-up computed tomography (CT) scan for an unrelated medical condition. Further magnetic resonance cholangiopancreatography (MRCP) imaging identified a cystic dilation consistent with a Type II choledochal cyst. Laparoscopic resection was performed using a total of 5 trocars, at which time a cyst of the cystic duct was found instead of the expected Type II choledochal cyst. Intraoperative cholangiography was used as a surgical adjunct to confirm the anatomy, and resection of the cyst was completed without complications. Conclusions: Our case adds to the body of reports showing that cysts of the cystic duct, while extremely rare, do occur and need to be recognized. Given the preoperative similarity between cystic duct cysts and other choledochal cysts, proposal for a new “Type VI” category for choledochal cysts may be considered so that clinicians can be prepared for this variation. Once recognized, cysts of the cystic duct can be safely and effectively removed by laparoscopic excision, as we have demonstrated. PMID:19793491

Chan, Edward S.; Auyang, Edward D.

2009-01-01

409

Completely Intracorporeal Robotic-Assisted Laparoscopic Ileovesicostomy  

PubMed Central

We present a report of a completely intracorporeal robotic-assisted laparoscopic ileovesicostomy with long term follow-up. The patient was a 55-year-old man with paraplegia secondary to tropical spastic paresis resulting neurogenic bladder dysfunction. The procedure was performed using a da Vinci Surgical system (Intuitive Surgical, Sunnyvale, CA) and took 330 minutes with an estimated blood loss of 100?mL. The patient recovered without perioperative complications. He continues to have low pressure drainage without urethral incontinence over two years postoperatively. PMID:24600527

Dolat, MaryEllen T.; Wade, Greg; Grob, B. Mayer; Hampton, Lance J.; Klausner, Adam P.

2014-01-01

410

A comparison of open vs laparoscopic adrenalectomy  

Microsoft Academic Search

Background: To compare the outcome of patients who underwent laparoscopic transabdominal adrenalectomy (LA) with those who had open adrenalectomy\\u000a (OA).\\u000a \\u000a \\u000a \\u000a \\u000a Methods: A retrospective review of consecutive adrenalectomies performed by a single surgical team at a university hospital. Outcome\\u000a measurements were operative time, operative blood loss, procedure-related complications, postoperative stay, and return to\\u000a regular activity.\\u000a \\u000a \\u000a \\u000a \\u000a Results: Twenty-nine adrenalectomies were done in

D. C. MacGillivray; S. J. Shichman; F. A. Ferrer; C. D. Malchoff

1996-01-01

411

Laparoscopic vs open colectomy for sigmoid diverticulitis  

Microsoft Academic Search

Background: The aim of this prospective comparative study was to assess the outcome of laparoscopic and open colectomy for sigmoid diverticulitis\\u000a in patients aged ?75 years.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: From January 1993 to December 1998, all patients 75 years of age and older undergoing an elective colectomy for sigmoid diverticulitis\\u000a were included in the study. The patients were divided into the following

J.-J. Tuech; P. Pessaux; C. Rouge; N. Regenet; R. Bergamaschi; J.-P. Arnaud

2000-01-01

412

Micronutrient Deficiencies After Laparoscopic Gastric Bypass: Recommendations  

Microsoft Academic Search

Background  The aim of this study was to evaluate the changes of micronutrients in patients with morbid obesity after laparoscopic Roux-en-Y\\u000a gastric bypass surgery (LRYGBP).\\u000a \\u000a \\u000a \\u000a Methods  We retrospectively reviewed 121 patients diagnosed with morbid obesity who undertook LRYGBP and evaluated the serum iron (Fe),\\u000a calcium (Ca), zinc (Zn), selenium (Se), vitamin A (VitA), 25-hydroxy vitamin D3 (VitD), vitamin B12 (VitB12), and parathormone

Ke Gong; Michel Gagner; Alfons Pomp; Taghreed Almahmeed; Sergio J. Bardaro

2008-01-01

413

Laparoscopic Kasai portoenterostomy for biliary atresia.  

PubMed

Minimally invasive surgery requires mastery of complex skills and exhaustive knowledge of anatomic variations but the patient benefits from excellent cosmesis, less requirement for analgesia and respiratory support, and a reduced incidence of postoperative morbidity, such as bowel adhesions and incisional hernias. Laparoscopic portoenterostomy is being performed with encouraging results after the open extended portoenterostomy procedure currently performed was revised to more closely resemble the original procedure developed by Kasai in the 1950s. Thus, the risk for damage to micro bile ducts around the porta hepatis is minimized because deep suturing and extensive dissection are eliminated. PMID:23572285

Yamataka, Atsuyuki

2013-06-01

414

[Laparoscopic management of a congenital diaphragmatic hernia].  

PubMed

Morgagni diaphragmatic hernia is a birth defect whose presentation in adults is rare. Diagnosis is usually made as an incidental finding through image studies; infrequently, patients may present with symptoms such as dyspnea or retrosternal pain. Open surgical repair has been the preferred management method of symptomatic presentation. In this paper we present the case of a 42 year-old-male with symptoms of retrosternal pain and dyspnea. Diaphragmatic hernia diagnosis was made ??by CT and it was managed by laparoscopic repair of the diaphragmatic hernia. PMID:25275848

Núñez García, Edgar; Arriola Sánchez, Jorge; Sánchez Jauredini, Gabriel; Baley Spindel, Isaac

2014-01-01

415

Laparoscopic versus open incisional hernia repair  

Microsoft Academic Search

Background  Incisional hernia is a common complication of abdominal surgery, and it is often a source of morbidity and high costs for\\u000a health care. This is a case-control study to compare laparoscopic versus anterior-open incisional hernia repair.\\u000a \\u000a \\u000a \\u000a Methods  170 patients with incisional hernia were enrolled in this study between September 2001 and December 2004. Of these, 85 underwent\\u000a anterior-open repair (open group:

S. Olmi; A. Scaini; G. C. Cesana; L. Erba; E. Croce

2007-01-01

416

Rectal mesh exposure after laparoscopic sacrocolpopexy.  

PubMed

Herein we report the case of a 68-year-old woman who had rectal bleeding 13 days after laparoscopic sacrocolpopexy. Clinical examination and rectoscopy revealed rectal exposure of the posterior polyester mesh placed during the surgery. Endorectal surgery was performed to remove the exposed mesh and repair the rectal erosion. No further complications occurred during follow-up. Although vaginal erosions are a well-known complication of synthetic implants after surgery to repair pelvic organ prolapse, one must keep in mind the possibility of more uncommon types of mesh exposure. PMID:24075836

Ferry, Philippe; Sedille, Lucie; Roncheau, Valérie

2014-01-01

417

Parasitic leiomyomas after laparoscopic surgery with morcellation.  

PubMed

Parasitic leiomyomas after laparoscopic surgery with morcellation are a rare entity, and only a few small series and single case reports have been published in recent years. This was first known as a spontaneously occuring condition, but in recent years it has been observed more frequently as an iatrogenic condition after morcellation, and may occur several years after primary surgery. We present three patients diagnosed in an eight year period, representing an incidence of 0.12% after morcellation procedures in our department. The mechanisms leading to parasitic leiomyomas are discussed, as well as how we should minimize the risk of development of this rare condition. PMID:22574911

Leren, Vibeke; Langebrekke, Anton; Qvigstad, Erik

2012-10-01

418

Laparoscopic vs open appendectomy in overweight patients  

Microsoft Academic Search

Background  Laparoscopic appendectomy (LA) has been associated with a faster recovery and less postoperative pain than the open technique.\\u000a However, few data are available on the clinical outcome of LA in overweight patients.\\u000a \\u000a \\u000a \\u000a Methods  A group of 106 patients with a body mass index (BMI) > 26.4, representing the upper quintile of 500 prospectively randomized\\u000a patients, were included in the study. They

L. Enochsson; A. Hellberg; C. Rudberg; G. Fenyö; T. Gudbjartson; E. Kullman; I. Ringqvist; S. Sörensen; J. Wenner

2001-01-01

419

Robot assisted laparoscopic prostatectomy in 2013.  

PubMed

Robot assisted laparoscopic prostatectomy has surpassed open radical prostatectomy as the most common surgical approach for radical prostatectomy in the United States. In this article we briefly describe the evolution of this minimally invasive technique. The current diagnostic approaches of multiparametric magnetic resonance imaging and fusion biopsy used in preoperative workup of the patients are discussed, followed by a description of risk stratified a thermal nerve sparing approach with total anatomical reconstruction. Finally we present a critical appraisal of the published oncological, continence and potency outcomes. PMID:24101007

Ali, A; Nguyen, D P; Tewari, A

2013-10-01

420

Comparative studies on changes in C-reactive protein, serum cortisol, blood glucose and aspartate amino transferase level following left flank method and laparoscopic method of ovariohysterectomy in bitches  

Microsoft Academic Search

A study was carried in 12 bitches presented to Veterinary College Hospital, Bangalore, for elective ovariohysterectomy. They were divided into group A and group B, with six bitches each. Bitches of Group A were sterilized by conventional method of ovariohysterectomy by left flank approach, and Group B bitches were sterilized by laparoscopic method. Blood samples were collected at regular intervals

Lingappa Ranganath; Suthanthira Senthil; Selva Kumar

421

Preliminary experience of laparoscopic renal artery aneurysm clipping surgery.  

PubMed

Developments in endovascular therapy and laparoscopy have led to the expansion of minimally invasive surgical techniques in the treatment of renal artery aneurysm (RAA). In this study, we introduced a new surgical technique that combined the clipping technique widely used in neurosurgery with laparoscopic surgery to clip the aneurysm. RAA clipping was performed by retroperitoneal laparoscopy, and the procedures were completed with no conversions to open surgery. In addition, no perioperative complications were recorded. Our preliminary experience suggests that laparoscopic RAA clipping surgery is feasible and appears to be safe. Laparoscopic RAA clipping surgery has advantages of a simplified surgical process, short warm ischemia time, and excellent cosmetic results. PMID:24767974

Yan, Hao; Cui, Xin; Ou, Tongwen; Wang, Qi; Cui, Bo; Wu, Jiangtao

2014-08-01

422

Laparoscopic radical prostatectomy: a marketing or surgical strategy?  

PubMed

The aim of the present review is to compare the advantages and the disadvantages of radical perineal, retropubic and laparoscopic prostatectomy with a close look at the laparoscopic procedure, an operation which has gained much attention in the urological world over the last 3 years. Also reviewed are the motivations, in terms of real advantages for the patient and the needs of the urological 'market', that push the urologist towards using the laparoscopic technique instead of the radical retropubic or radical perineal prostatectomy. PMID:11371785

Gallucci, M; Vincenzoni, A

2001-05-01

423

Is Laparoscopic Resection Adequate in Patients with Neuroendocrine Pancreatic Tumors?  

Microsoft Academic Search

Since the first reports with laparoscopic resection of islet cell tumors in 1996, the experience worldwide is still limited,\\u000a with only short-term outcomes available. Some have suggested that a malignant tumor is a contraindication to laparoscopic\\u000a resection.\\u000a \\u000a \\u000a Aim The aim of this study was to evaluate the feasibility, safety, and long-term outcome of the laparoscopic approach in patients\\u000a with functioning,

Laureano Fernández-Cruz; Laia Blanco; Rebeca Cosa; Héctor Rendón

2008-01-01

424

Laparoscopic orchiopexy without division of the spermatic vessels  

Microsoft Academic Search

Background: Several surgical procedures have been described for the management of nonpalpable testis. Following a vast experience with\\u000a a complete laparoscopic two-stage Fowler-Stephens procedure, we report our experience with laparoscopic orchiopexy performed\\u000a without dividing the spermatic vessels.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: Over a 24-month period, 70 boys with nonpalpable testes (72 overall) underwent laparoscopic diagnostic exploration. Twenty\\u000a patients (27.8%) of this series who

C. Esposito; G. Vallone; A. Settimi; M. A. Gonzalez Sabin; G. Amici; T. Cusano

2000-01-01

425

Decomposing Composing Conventions.  

ERIC Educational Resources Information Center

Recent research has invited critiques of the authoritative descriptions of composing found in many rhetoric textbooks. The concept of "convention" may be especially useful in rethinking the teleological basis of these textbook descriptions. Conventions found in composition textbooks need to be unmasked as arbitrary concepts which serve to…

Beers, Terry

426

Vienna convention is adopted  

Microsoft Academic Search

On March 22, 1985, a conference of plenipotentiaries sponsored by the United Nations Environment Programme (UNEP) and by the Austrian government adopted the Vienna Convention for the Preservation of the Ozone Layer. This paper discusses the problems caused by the reduction of the ozone layer, the value of the ozone convention, and the problems that must be overcome if the

Sand

1985-01-01

427

Laparoscopic Splenectomy for Isolated Splenic Sarcoidosis  

PubMed Central

Introduction: Sarcoidosis is an inflammatory disease with an unknown etiology. The pulmonary interstitium is mainly involved, with noncaseating granulomas and lymphadenopathy. It is a multisystemic disease, and the differential diagnosis should include infectious, neoplastic, and autoimmune diseases to prevent inappropriate treatment and unnecessary surgery. Abdominal disease without evidence of pulmonary abnormalities on chest radiography in sarcoidosis can be found in approximately 25% to 38% of cases. The approach to isolated splenic nodules in a patient with nonspecific abdominal symptoms should be focused on exclusion of malignancies and infections, and may require computed tomography, magnetic resonance imaging, and positron emission tomography–computed tomography imaging; scintigraphy; bone marrow biopsy; breast and genital examinations; and endoscopies. This report documents a rare case of isolated granulomatous disease of the spleen that was diagnosed and treated laparoscopically. Case: A 29-year-old woman presented with nonspecific complaints such as nausea, vomiting, and epigastric discomfort. Further laboratory test results were normal. Abdominal ultrasonography, computed tomography, and magnetic resonance imaging revealed multiple splenic lesions. Additional examination findings were negative for occult neoplasia or infectious disease. Laparoscopic splenectomy was performed as a diagnostic procedure, without complications, and the final diagnosis was sarcoidosis. Conclusion: Isolated splenic sarcoidosis is a rare manifestation of extrapulmonary disease. The final diagnosis may be achieved only by histology, requiring biopsy or splenectomy. Minimally invasive surgery is a safe and efficient method for diseases of the spleen and should be the first option when feasible. The patient did well; however, further monitoring is required to diagnose recurrence. PMID:24680162

Tempes, Bruna Cogo; Lambert, Bruna Franco; Trindade, Eduardo Neubarth; Trindade, Manoel Roberto Maciel

2014-01-01

428

Teaching instrument: a laparoscopic training model.  

PubMed

A laparoscopic training model with female surface anatomy has been developed. This training model is made of a plastic boutique-showing model that is equivalent to normal-size female anatomy from the neck to the upper thigh. Four holes were made on the model's abdominal wall as puncture-sites to enter the cavity, the first is 80-mm diameter at the umbilical area, and the other three 38-mm diameter holes are located on both sides of the lower abdomen and suprapubic area. The umbilical hole can be covered with a simulated abdominal wall made from 6.5-mm insulation sheet, fixed to the model using a rubber band. The other three puncture-sites were plugged with a flexible rubber diaphragm as working ports. When used as video-laparoscopy, the auto-focus camcorder is used as a telescope and is connected to a regular television set as a monitor. This model can be used for training of abdominal entry by Veress needle or trocar, laparoscopic tubal ligation (LTL), and video-eye-hand co-ordination. This model has been a training medium in our Department for 1 year and was included in the OSCE for the Board Examination of the Royal Thai College of Obstetricians and Gynecologists in the year 2000 to assess the process of Veress needle insertion. PMID:11853305

Tintara, H; Choobun, T

2001-11-01

429

Laparoscopic surgical staging of early ovarian cancer.  

PubMed

Since its advent in the early 1990s, laparoscopic surgical staging for early ovarian cancer has been explored as an option with the potential to offer women equivalent cancer control and survival as provided by laparotomy but with the clear benefits of minimally invasive surgery. A limited but expanding body of literature suggests aggressive surgical staging can be performed with equivalent tissue assessment compared with laparotomy. Given the lack of randomized, controlled trials, the risks and benefits of such a procedure remain ambiguous. This review summarizes the current body of literature regarding the role of laparoscopy in upfront surgical staging of ovarian cancer. This review presents the history, rationale, and established benefits and risks of utilizing this approach in women who present with malignancy that appears confined to the ovary. Although retrospective data confirm the feasibility, safety, and efficacy of laparoscopic staging of early ovarian cancer, more prospective data will be required to confirm equivalent survival in a patient population that has the potential to be cured. PMID:22229064

Weber, Sarah; McCann, Christopher K; Boruta, David M; Schorge, John O; Growdon, Whitfield B

2011-01-01

430

Laparoscopic Surgical Staging of Early Ovarian Cancer  

PubMed Central

Since its advent in the early 1990s, laparoscopic surgical staging for early ovarian cancer has been explored as an option with the potential to offer women equivalent cancer control and survival as provided by laparotomy but with the clear benefits of minimally invasive surgery. A limited but expanding body of literature suggests aggressive surgical staging can be performed with equivalent tissue assessment compared with laparotomy. Given the lack of randomized, controlled trials, the risks and benefits of such a procedure remain ambiguous. This review summarizes the current body of literature regarding the role of laparoscopy in upfront surgical staging of ovarian cancer. This review presents the history, rationale, and established benefits and risks of utilizing this approach in women who present with malignancy that appears confined to the ovary. Although retrospective data confirm the feasibility, safety, and efficacy of laparoscopic staging of early ovarian cancer, more prospective data will be required to confirm equivalent survival in a patient population that has the potential to be cured. PMID:22229064

Weber, Sarah; McCann, Christopher K; Boruta, David M; Schorge, John O; Growdon, Whitfield B

2011-01-01

431

Robot-assisted laparoscopic colorectal surgery.  

PubMed

Colorectal cancer is one of the most common malignancies seen in developed countries. Its current treatment is based on a multidisciplinary approach entailing surgery, chemotherapy and radiotherapy. Surgery can be performed with open and minimal invasive methods. Single incision laparoscopic surgery (SILS), natural orifice transluminal endoscopic surgery (NOTES) and robot assisted laparoscopic surgery (RALS) are the final points to be reached in minimally invasive surgery. The first robotic colorectal surgical intervention was performed in 2001 after getting the FDA approval for the da Vinci surgical system in intraabdominal surgery, and since then, its use in this field gradually increased. Compared to open surgery, the advantage and sup