These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Hysterectomy - laparoscopic - discharge  

MedlinePLUS

Supracervical hysterectomy - discharge; Removal of the uterus - discharge; Laparoscopic hysterectomy - discharge; Total laparoscopic hysterectomy - discharge; TLH - discharge; Laparoscopic supracervical hysterectomy - discharge

2

Laparoscopic Hysterectomy  

PubMed

Retrospective analysis of 200 laparoscopic hysterectomies performed from June 1991 to July 31, 1995, showed the main indications to be symptomatic uterine fibroids, advanced endometriosis, chronic pelvic inflammatory disease, and endometrial hyperplasia with atypia. Some women had more than one indication, and pathology reports contained more than one diagnosis. Three cases were converted to abdominal procedures. Operating room time was under 2 hours in general, and blood loss was around 120 ml. Most of the initial cases were performed with endostapling. This technique was changed in favor of bipolar and unipolar coagulation and suturing. Laparoscopic hysterectomy is a safe, superior technique that should be an integral part of gynecologic practice. PMID:9074095

Charles

1996-08-01

3

Laparoscopic vaginal vault closure with conventional straight instruments in single-port access total laparoscopic hysterectomy  

PubMed Central

Objective Laparoscopic vaginal vault closure with conventional straight instruments is the final barrier to single-port access total laparoscopic hysterectomy (SPA-TLH). The aim of this study is to find out the safer, easier, simpler, faster, and even cheaper way to overcome it. Methods Vaginal vault suturing techniques of 152 consecutive single-port access total laparoscopic hysterectomy cases performed by the author in Gangnam CHA Hospital, CHA University from October 1, 2003 to June 30, 2012, were retrospectively analysed with medical records and DVDs. Results Of 152 patients who were attempted SPA-TLH, 119 patients (78%) were finished their operations without conversion to multi-port laparoscopy or laparotomy. Of women with successful SPA-TLH, 8 cases (7%) were closed their vaginal vaults vaginally (median, 20 minutes; range, 15-44 minutes), and 111 cases (93%) laparoscopically (median, 44 minutes; range, 13-56 minutes). Laparoscopic vault closure techniques were continuous suture (4 cases, 3%; median, 36 minutes; range, 30-45 minutes), interrupted sutures using knot-pusher (7 cases, 6%; median, 52 minutes; range, 48-56 minutes) Endo Stitch suture (2 cases, 2%; median, 32 minutes; range, 13-50 minutes), continuous vault closure using percutaneous sling sutures (PCSS) (92 cases, 77%; median, 40 minutes; range, 19-56 minutes), and continuous vault closure without PCSS (6 cases, 5%; median, 23 minutes; range, 16-31 minutes). Conclusion Laparoscopic vault closure using PCSS in SPA-TLH only with conventional straight instruments is the best way to overcome the barrier and the short-cut to shorten the learning curve to date. PMID:24396818

Park, Daehyun; Kim, Juyoung; Jun, Hye Sun; Jeong, Hyangjin

2013-01-01

4

Cost effectiveness analysis of laparoscopic hysterectomy compared with standard hysterectomy: results from a randomised trial  

Microsoft Academic Search

Objective To assess the cost effectiveness of laparoscopic hysterectomy compared with conventional hysterectomy (abdominal or vaginal). Design Cost effectiveness analysis based on two parallel trials: laparoscopic (n = 324) compared with vaginal hysterectomy (n = 163); and laparoscopic (n = 573) compared with abdominal hysterectomy (n = 286). Participants 1346 women requiring a hysterectomy for reasons other than malignancy. Main

Mark Sculpher; Andrea Manca; Jason Abbott; Jayne Fountain; Su Mason; Ray Garry

2004-01-01

5

Is laparoscopic hysterectomy a waste of time?  

Microsoft Academic Search

SummaryLaparoscopic hysterectomy (LH) is a way to avoid laparotomy. However, there is evidence that most women treated by abdominal hysterectomy are suitable for vaginal surgery. To test this hypothesis, and to determine the relative merits of laparoscopic and vaginal hysterectomy (VH) and the best technique for LH, we prospectively studied 98 women who had relative contraindications for vaginal surgery by

R. E Richardson; N Bournas; A. L Magos

1995-01-01

6

Metabolic and inflammatory responses after laparoscopic and abdominal hysterectomy  

Microsoft Academic Search

OBJECTIVE: Our purpose was to quantify and compare the metabolic and inflammatory changes after laparoscopic and abdominal hysterectomy.STUDY DESIGN: Forty-four patients with no major medical disease requiring abdominal hysterectomy for benign disorders were randomly assigned to have laparoscopic hysterectomy (n = 20) and abdominal hysterectomy (n = 24). Venous blood and 24-hour urine samples were collected the day before and

Pong Mo Yuen; Tony W. L. Mak; So Fan Yim; Warwick D. Ngan Kee; Christopher W. K. Lam; Michael S. Rogers; Allan M. Z. Chang

1998-01-01

7

Total Laparoscopic Hysterectomy for Large Uterus  

PubMed Central

Aim: In this review, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uteri weighing more than 500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number and location of the myomas. Design: Retrospective review (Canadian Task Force Classification II-1) Setting: Dedicated high volume Gynecological laparoscopy centre. Patients: 173 women with symptomatic myomas who underwent total laparoscopic hysterectomy at our center. There were no exclusion criteria based on the size number or location of myomas. Intervention: TLH and modifications of performing the surgery by ligating the uterine arteries prior, myomectomy followed by hysterectomy, direct morcellation after uterine artery ligation. Results: 72% of patients had previous normal vaginal delivery and 28% had previous cesarean section. Average clinical size of the uterus was 18 weeks (10, 32). The average weight of the specimen was 700 grams (500, 2240). The average duration of surgery was 107 min (40, 300) and the average blood loss was 228 ml (10, 3200). Conclusion: Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. PMID:22442509

Sinha, Rakesh; Sundaram, Meenakshi; Lakhotia, Smita; Mahajan, Chaitali; Manaktala, Gayatri; Shah, Parul

2009-01-01

8

Laparoscopic Supracervical Hysterectomy Compared With Abdominal, Vaginal, and Laparoscopic Vaginal Hysterectomy in a Primary Care Hospital Setting  

PubMed Central

Objective: This study compares the operative parameters of laparoscopic supracervical hysterectomy, laparoscopically assisted vaginal hysterectomy, total vaginal hysterectomy, and total abdominal hysterectomy in patients in a small suburban medical center. Methods: This investigation is a Canadian Classification II-2. It was performed in a 238 bed not-for-profit community general hospital. Charts of 117 patients were reviewed. These patients had undergone the following procedures: laparoscopic supracervical hysterectomy, laparoscopically assisted vaginal hysterectomy, total vaginal hysterectomy, total abdominal hysterectomy; questionnaires completed by the patients were reviewed. All patients had hysterectomies performed by members of the Ob/Gyn department of Alamance Regional Medical Center. Comparisons of intraoperative and postoperative events were made in those patients who consented to the study and who returned their questionnaires. Parameters compared were patient age, weight, preoperative diagnosis, operative time, operative complications, blood loss, uterine weight, length of stay, postoperative complications, return to hospital, return to work, resumption of intercourse, dyspareunia, and bowel or bladder problems. Results: Patient demographics and outcomes are similar. Laparoscopic supracervical hysterectomy showed lower morbidity and quicker return to normal function, but most findings did not reach statistical significance. Conclusion: The results support the conclusion that the patients in each arm of the study are similar. The operative parameters show a longer operating time for the laparoscopic procedures than for total abdominal hysterectomy and total vaginal hysterectomy, respectively. The other indicators of morbidity show slight advantages of laparoscopic supracervical hysterectomy in blood loss, length of stay, and resumption of normal activities. PMID:16121874

2005-01-01

9

Retained myoma after laparoscopic supracervical hysterectomy with morcellation  

Microsoft Academic Search

Laparoscopic myomectomy and, more recently, laparoscopic supracervical hysterectomy are practical alternatives to traditional surgical management of uterine fibroids. With the advent of mechanical morcellation these procedures are now much more feasible. A 6-cm fibroid was lost at the time of laparoscopic-assisted supracervical hysterectomy and caused persistent, severe abdominal pain over the next 3 weeks. The fibroid was lodged in the

Francis L. Hutchins; Elizabeth M. Reinoehl

1998-01-01

10

Two-port total laparoscopic hysterectomy with a multichannel port.  

PubMed

Total laparoscopic hysterectomy (TLH) is often performed in many countries. TLH has been shown to involve shorter hospital stays, as well as less bleeding and postoperative pain, than conventional abdominal hysterectomy. The skin incision for the laparoscopy is smaller than that of the laparotomy, but multiple incisions may decrease the cosmetic satisfaction of patients. The multiple puncture sites also increase the cost of trocars and trocar-associated complications, such as bleeding, hernias, and wound infection. Therefore, in this paper we introduce a two-port TLH technique with a multichannel port employing the transumbilical one-port technique performed by Ryu et al. To perform a two-port TLH, the ancillary 5-mm trocar was inserted at the left iliac fossa under laparoscopic view. The inserted umbilical trocar was removed and the skin incision was extended about 1.5 cm. An Alexis wound retractor XS (Applied Medical) was inserted through the extended umbilical wound. The wrist portion of a 6 (1/2) rubber glove covered the wound retractor, and two trocars were inserted into the fingers of the glove and ligated with rubber bands. A 5- or 10-mm laparoscope and atraumatic forceps were inserted through the umbilical port. TLH was performed in the usual manner. This two-port method would be cost-effective considering the conventional laparoscopic instruments. The development of multichannel trocars and minimized laparoscopic devices may confer less invasive operative techniques that also cause less scarring. PMID:19243267

Yi, Sang Wook; Park, Han Moie; Lee, Sang Soo; Park, Sun Min; Lee, Hyun Mee; Sohn, Woo Seok

2009-04-01

11

Laparoscopic Hysterectomy with Automatic Stapling Devices  

PubMed Central

Purpose: To evaluate outcomes including operating time, blood loss, length of stay (LOS), return to work and complications of laparoscopic hysterectomy performed with automatic stapling devices. Methods: Between 6/11/91 and 11/23/95, 127 laparoscopic hysterectomies were performed with automatic stapling devices. On an average, 6 firings with the stapler were done per case. Postoperative telephone survey and retrospective review of records were done. Results: Data averages for operating time, blood loss, LOS and return to work, respectively, were 90 minutes, 190 cc's, 1.1 day and 2 weeks. Significant complications included delayed postoperative bleeding in 4 patients, all of which occurred within the first 35 cases. One was controlled laparoscopically and 3 others required exploratory laparotomies. Since certain precautionary measures as described were taken, hemorrhagic complications were eliminated. Conclusions: Laparoscopic hysterectomy can be performed safely and effectively with automatic stapling devices in properly selected patients. A potential hazard inherent with this technique includes intraoperative and postoperative bleeding from the staple lines, the incidence of which can be minimized by taking certain precautionary measures such as the use of white cartridges only and bipolar desiccation of staple lines when indicated. PMID:9876650

Tabb, Reese

1997-01-01

12

Laparoscopic supracervical hysterectomy with a new disposable morcellator  

Microsoft Academic Search

Laparoscopic supracervical hysterectomy (LSH) can be performed more easily with a powered morcellator for removal of the uterus. Available laparoscopic morcellators are expensive and may be difficult to use, but a new, powered, disposable instrument was developed (Diva; FemRx, Sunnyvale, CA) to morcellate the entire uterus for easy removal through a 15-mm cannula. Twelve consecutive women for whom subtotal hysterectomy

Arnold J. Kresch; Thomas L. Lyons; Andrea B. Westland; Wendy K. Winer; George M. Savage

1998-01-01

13

Recurrence of uterine tissue residues after laparoscopic hysterectomy or myomectomy.  

PubMed Central

Objective: To report a new complication after laparoscopic surgery i.e recurrence of endometrium and leiomyoma fragments from uterine tissue residues after laparoscopic hysterectomy or laparoscopic myomectomy. Methods: This study was carried out on three patients with the recurrence of endometrium or leiomyoma fragments from tissue residues after laparoscopic hysterectomy or laparoscopic myomectomy in the First Affiliated Hospital, Yangtze University, China. We also explored the possible reasons and corresponding preventative strategies. Results: Small residues of endometrium and leiomyoma fragments could implant into normal tissue anywhere in the peritoneal cavity after laparoscopic myomectomy or laparoscopic hysterectomy. Conclusion: These cases emphasize the importance of removing every single fragment to prevent the recurrence of endometrium and leiomyoma from tissue residues. PMID:25225541

Yi, Cunjian; Li, Li; Wang, Xiaowen; Liu, Xiangqiong

2014-01-01

14

Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy  

PubMed Central

Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

2011-01-01

15

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

16

Laparoscopic-assisted vaginal hysterectomy vs abdominal hysterectomy for benign disease: a meta-analysis of randomized controlled trials  

Microsoft Academic Search

The objective of this meta-analysis was to assess whether laparoscopic-assisted vaginal hysterectomy achieves better clinical results compared with abdominal hysterectomy. Medline (PubMed), EMBASE, Web of Science, ProQuest, Cochrane Library and China Biological Medicine Database were searched to identify randomized controlled trials that compared laparoscopic-assisted vaginal hysterectomy with abdominal hysterectomy. Twenty-three trials were studied and the analysis was performed using Review

Yue-xiong Yi; Wei Zhang; Qi Zhou; Wan-ru Guo; Yu Su

17

Laparoscopic supracervical hysterectomy with a new disposable morcellator.  

PubMed

Laparoscopic supracervical hysterectomy (LSH) can be performed more easily with a powered morcellator for removal of the uterus. Available laparoscopic morcellators are expensive and may be difficult to use, but a new, powered, disposable instrument was developed (Diva; FemRx, Sunnyvale, CA) to morcellate the entire uterus for easy removal through a 15-mm cannula. Twelve consecutive women for whom subtotal hysterectomy was indicated underwent LSH by standard laparoscopic protocol and were monitored postoperatively for a minimum of 1 month. In the current trend of "less is more," LSH is an emerging option for less extensive hysterectomies and can be made more cost and time effective with a single-use powered morcellator. PMID:9564073

Kresch, A J; Lyons, T L; Westland, A B; Winer, W K; Savage, G M

1998-05-01

18

Single-Port Access Laparoscopic Hysterectomy: A New Dimension of Minimally Invasive Surgery  

PubMed Central

The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach. PMID:22442528

Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

2011-01-01

19

Clinical observation of laparoscopic radical hysterectomy for cervical cancer  

PubMed Central

To evaluate safety, feasibility and the improvement of surgical method of laparoscopic extensive hysterectomy and pelvic lymph node dissection in patients with early-stage cervical cancer. Clinical data were prospectively collected from patients with IA2-IIA cervical cancer who underwent laparoscopic extensive hysterectomy (n1=22) and laparotomy (n2=23) in Department of Obstetrics and Gynecology in the Subei People’s Hospital from June 2010 to August 2013. The successful rates in two groups of operation were 100%. Blood loss, postoperative hospital stay, complication rate, postoperative recovery of gastrointestinal tract and bladder function of the laparoscopy group of the laparoscopic group were all better than those of the laparotomy group, and there were significant differences (all P < 0.05). But in the laparoscopy group, the operative time was longer than the laparotomy group with statistical significance (P < 0.05). There was no statistically significant difference in the number of excised lymph nodes and the duration time of postoperative urinary catheterization between the two groups (P > 0.05). Laparoscopic extensive hysterectomy and pelvic lymph node dissection can fully meet the requirement of laparotomy. It has the properties of minor trauma and rapid recovery. The clinical efficacy is superior to laparotomy surgery. The results indicated laparoscopic is an ideal method for the treatment of early cervical cancer. PMID:24995098

Yin, Xiang-Hua; Wang, Zhong-Qin; Yang, Shi-Zhang; Jia, Hong-Yan; Shi, Min

2014-01-01

20

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

21

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

PubMed

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; Hauser, Nik

2010-09-01

22

Total laparoscopic hysterectomy of very enlarged uterus (3030 g): case report and review of the literature  

PubMed Central

Fibromatosis is the most frequent benign uterine pathology of fertile women, rarely causing anomalous enlargement of the uterus. Traditionally the surgical treatment has been abdominal hysterectomy. However, development of minimally invasive techniques has led to major safeness of the laparoscopic route. We report a case of total laparoscopic hysterectomy performed on a uterus weighting more than 3,000 g and present a review of the literature about the laparoscopic approach to very enlarged uteri. PMID:25097706

Roviglione, Giovanni; Pesci, Anna; Quintana, Sara; Bruni, Francesco; Clarizia, Roberto

2014-01-01

23

Total laparoscopic hysterectomy of very enlarged uterus (3030 g): case report and review of the literature.  

PubMed

Fibromatosis is the most frequent benign uterine pathology of fertile women, rarely causing anomalous enlargement of the uterus. Traditionally the surgical treatment has been abdominal hysterectomy. However, development of minimally invasive techniques has led to major safeness of the laparoscopic route. We report a case of total laparoscopic hysterectomy performed on a uterus weighting more than 3,000 g and present a review of the literature about the laparoscopic approach to very enlarged uteri. PMID:25097706

Ceccaroni, Marcello; Roviglione, Giovanni; Pesci, Anna; Quintana, Sara; Bruni, Francesco; Clarizia, Roberto

2014-06-01

24

What Determines the Need to Morcellate the Uterus during Total Laparoscopic Hysterectomy?  

Microsoft Academic Search

Study ObjectiveTo identify factors associated with the need to perform uterine morcellation during total laparoscopic hysterectomy (TLH). A secondary aim was to establish new cut-offs based on uterine weight for the probability of morcellation.

George Condous; Tommaso Bignardi; Dalya Alhamdan; Ben Van Calster; Sabine Van Huffel; Dirk Timmerman; Alan Lam

2009-01-01

25

Robot-assisted total laparoscopic hysterectomy in obese and morbidly obese women  

Microsoft Academic Search

Total laparoscopic hysterectomy (TLH) in obese patients is challenging. We sought to evaluate whether total laparoscopic hysterectomies\\u000a using the da Vinci robotic system in obese patients, in comparison with non-obese patients, is a reasonable surgical approach.\\u000a One-hundred consecutive robot-assisted TLHs were performed over a 17-month period. Obesity was not a contraindication to robotic\\u000a surgery, assuming adequate respiratory function to tolerate

Sonia A. Rebeles; Howard G. Muntz; Carrie Wieneke-Broghammer; Emily S. Vason; Kathryn F. McGonigle

2009-01-01

26

Recurrence of unclassifiable uterine cancer after modified laparoscopic hysterectomy with morcellation  

Microsoft Academic Search

In a premenopausal patient with a 1-year history of abnormal bleeding laparoscopic supracervical hysterectomy in combination with vaginal intrafascial cylindriform enucleation of the cervix was performed. Histologic evaluation of the morcellated uterus was unremarkable. Five months later the patient was diagnosed with a pelvic mass consistent with an undifferentiated adenocarcinoma. Retrospective evaluation of the cored and morcellated hysterectomy specimen showed

Achim Schneider

1997-01-01

27

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

28

Endometrial Stromal Sarcoma Diagnosed after Uterine Morcellation in Laparoscopic Supracervical Hysterectomy  

Microsoft Academic Search

Endometrial stromal sarcoma is a rare uterine cancer with no reliable method for preoperative diagnosis. A 30-year-old parous woman underwent laparoscopic supracervical hysterectomy because of a leiomyoma. The uterus was removed from the abdominal cavity with an electric morcellator with a spinning blade. The pathology report revealed low-grade endometrial stromal sarcoma. Two months after the initial surgery, a second laparoscopic

Carl Della Badia; Homa Karini

2010-01-01

29

Low COST surgery setting for one-operational port laparoscopic hysterectomy surgery with ordinary laparoscopic instruments: preliminary results  

PubMed Central

Background Hysterectomy dates back to 120BC and is the second most commonly performed gynecological surgery in the world. Cosmetic demands and the necessity of rapid return to work have contributed to the minimally invasive laparoscopic approach for hysterectomy. The majority of reports describe the use of three or four incisions to perform the surgery (two or three for manipulation and one for optics). Methods This work describes our experience with using only two ports for 11 patients who underwent video-laparoscopic hysterectomy surgery. One port was used for the optical system, and the second was used for manipulation. Early and late surgery complications, as well as the time to return to work and daily activities, were assessed. Results The mean age of the patients was 41.4 years old (range 16 to 52 years) and the mean uterine weight was 133.54 g, ranging from 35 g and 291 g. The operative time ranged from 30 to 60 minutes (average 46.4 minutes) and the hospital stay ranged between 24 and 48 hrs. No intraoperative complications occurred, and no early or late postoperative complications were recorded. Patients reported minimal pain during the first 24–48 hrs in the hospital. Patients returned to their daily activities within seven days after surgery. Clinical care follow-up continued until the 40th postoperative day. Conclusion The laparoscopic hysterectomy technique with a single port for manipulation is a feasible procedure when the uterine weight is not greater than 400 mg with little postoperative pain. The patients had an early return-to-work and daily activities and a better cosmetic outcome. These preliminary data led us to make the one-operative port laparoscopic hysterectomy the procedure of choice for patients with a low uterine weight. PMID:24088385

2013-01-01

30

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

31

Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: pilot data and comparison to laparotomy  

Microsoft Academic Search

ObjectivesThe aim of this study was to describe the feasibility and outcome of total laparoscopic radical hysterectomy with pelvic lymphadenectomy for stage I cervical cancer using the argon-beam coagulator.

Nadeem R Abu-Rustum; Mary L Gemignani; Kathleen Moore; Yukio Sonoda; Ennapadam Venkatraman; Carol Brown; Elizabeth Poynor; Dennis S Chi; Richard R Barakat

2003-01-01

32

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

33

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

34

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

35

Ovarian remnant syndrome after laparoscopic hysterectomy and bilateral salpingo-oophorectomy for severe pelvic endometriosis.  

PubMed

Ovarian remnant syndrome is a rare complication of total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSO). Ovarian enlargement and dense periovarian adhesions are the predisposing factors. Recurrent ovarian remnant syndrome was associated with recurrence of symptomatic endometriosis in a woman who underwent laparoscopic supracervical hysterectomy and BSO for severe endometriosis and extensive pelvic adhesions. After primary surgery she required five additional procedures for complete resection of all ovarian remnants. Definitive surgery for advanced endometriosis with extensive periovarian adhesions may be complicated by ovarian remnant syndrome and reactivation of the disease. Careful retroperitoneal resection of all ovarian tissue is of paramount importance in preventing the syndrome. This, however, may be a limitation of laparoscopic surgery. The choice between laparoscopy and laparotomy in such cases should be individualized and based on the degree of surgical difficulty and the surgeon's level of experience. PMID:9050667

Rana, N; Rotman, C; Hasson, H M; Redwine, D B; Dmowski, W P

1996-05-01

36

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

37

Laparoscopic Hysterectomy of Large Uteri With Uterine Artery Coagulation at Its Origin  

PubMed Central

Background: To argue the usefulness for performing total laparoscopic hysterectomy with primary uterine artery coagulation at its origin for a series of women presenting with an enlarged benign uterus. Method: Eighteen women having undergone the procedure consecutively during a period of 17 months were studied retrospectively. The inclusion criteria were an enlarged benign uterus weighing more than 280 g, managed by total laparoscopic hysterectomy with primary uterine artery coagulation at its origin. Results: Patient median values (range) for age, body mass index, and parity were respectively 47.5 years (range, 38 to 53), 25 kg/m2 (range, 19.3 to 34.9), and 2 (range, 0 to 3). The median value for uterine weight (range) was 540 g (range, 280 to 1,015), and the median duration for the surgical procedure was 185 minutes (range, 90 to 260), the longest procedures being due to associated deep endometriosis resection and extensive adhesions. The duration of the intervention was not significantly correlated with uterine size (correlation coefficient r=-0.15, P=0.56), and no intra- or postoperative complications were recorded. Conclusion: The selective coagulation of the uterine artery at its origin is a reproducible technique that allows total laparoscopic hysterectomy in enlarged uteri. This procedure avoids unexpected intraoperative hemorrhage requiring conversion to the abdominal route and provides optimal protection for the ureter. PMID:18402735

Zanati, Joel; Friederich, Ludovic; Resch, Benoit; Lena, Eric; Marpeau, Loic

2008-01-01

38

Hysterectomy - vaginal - discharge  

MedlinePLUS

Vaginal hysterectomy - discharge; Laparoscopically assisted vaginal hysterectomy - discharge; LAVH - discharge ... you are unable to urinate. You have a discharge from your vagina that has a bad odor. ...

39

Does previous abdominal surgery effect the feasibility of total laparoscopic hysterectomy?  

PubMed Central

Objective: The primary aim of this study is to evaluate the effects of previous abdominal surgery on the feasibility of performing and the safety of total laparoscopic hysterectomy (TLH). Material and Methods: In this retrospective study, we analysed 62 laparoscopic hysterectomies which were performed at our institute between February 2011 and January 2013. We chose to perform laparoscopic surgery for all patients, including those who had previously undergone abdominal surgery. The patients were classified into two groups: Group 1 included patients with a history of abdominal surgery (n=24) and Group 2 included patients without a history of abdominal surgery (n=38). Results: The operating period was compared in both groups: 184.43±51.0 min. for Group 1 and 195.41±64.1 min. for Group 2 (p=0.471). Postoperative hospital stay and blood loss was also compared. There was just 1 conversion from TLH to a laparotomy in both groups. None of the patients in Group 1 needed a blood transfusion, whereas 1 in Group 2 did. Conclusion: We found that operation time, postoperative hospital stay, blood loss, rate of operative complications or conversion rate to open surgery between patients with and without a history of abdominal surgery were comparable. Therefore, it appears that a history of abdominal surgery does not adversely affect the safety of TLH. PMID:24592078

Çelik, Cem; Abal?, Remzi; Ta?demir, Nicel; Aksu, Erson; Akku?, Didem; Gül, Abdülaziz

2013-01-01

40

Fiber Optical Improvements for a Device Used in Laparoscopic Hysterectomy Surgery  

NASA Astrophysics Data System (ADS)

Hysterectomy removes uterus from patients suffering different pathologies. One of the most common techniques for performing it is the laparoscopically-assisted vaginal hysterectomy (LAVH). In the final stage of the procedure, surgeons face the need to unambiguously identify the vaginal cuff before uterus removal. The aim of this research is to adapt a local source of illumination to a polymer cup-like device adapted to a stainless steel shaft that surgeons nowadays use to manipulate the uterus in LAVH. Our proposal consists in implementing a set of optical fiber illuminators along the border of the cup-like device to illuminate the exact vaginal cupola, using an external light source. We present experimental results concerning temperature increases in quasi adiabatic conditions in cow meat under different light intensity illumination.

Hernández Garcia, Ricardo; Vázquez Mercado, Liliana; García-Torales, G.; Flores, Jorge L.; Barcena-Soto, Maximiliano; Casillas Santana, Norberto; Casillas Santana, Juan Manuel

2006-09-01

41

Laparoscopic hysterectomy with manual morcellation of the uterus: an original technique that permits the safe and quick removal of a large uterus.  

PubMed

We present an original technique to rapidly extract a large uterus during laparoscopic hysterectomy. Manually morcellating the uterus is a safe and effective technique that overcomes the technical difficulties associated with traditional electrical morcellators. PMID:21752759

Serur, Eli; Lakhi, Nisha

2011-06-01

42

Recurrences After Conventional Anterior and Laparoscopic Inguinal Hernia Repair  

PubMed Central

Objective To study the long-term recurrence rate and other complications after conventional and laparoscopic inguinal hernia repair. Summary Background Data Reliable long-term follow-up of patients with inguinal hernias treated by laparoscopic repair techniques is lacking. Methods The authors performed a randomized, multicenter trial in which 487 patients with inguinal hernia were treated by totally extraperitoneal laparoscopic repair and 507 patients were treated by conventional anterior hernia repair. Patients were followed and examined for recurrence and chronic inguinal pain 2, 3, and 5 years after surgery. Risk factors for recurrence and chronic inguinal pain were assessed. Results Patients who underwent conventional repair had a high risk for recurrence compared to patients who underwent laparoscopic repair. Risk factors for recurrence were operative time and type of conventional repair. Predictive independent risk factors for chronic inguinal pain were conventional repair (Bassini repairs and non-bassini repairs), inguinal pain before surgery, and perioperative lesion of the ilioinguinal nerve. Conclusions Patients with inguinal hernia who undergo laparoscopic repair have fewer recurrences and less chronic inguinal pain than those who undergo conventional open repair. The Bassini repair produces unacceptably high recurrence rates. PMID:12496541

Liem, Mike S. L.; van Duyn, Eino B.; van der Graaf, Yolanda; van Vroonhoven, Theo J. M. V.

2003-01-01

43

Primary ovarian adenocarcinoma developing in ovarian remnant tissue ten years after laparoscopic hysterectomy and bilateral salpingo-oophorectomy for endometriosis.  

PubMed

Ovarian remnant syndrome is a rare but known complication of bilateral salpingo-oophorectomy associated or not with hysterectomy. This complication is frequently related to a history of multiple surgery, pelvic inflammatory disease, or endometriosis. Here we report the eighth documented case of a primary ovarian adenocarcinoma developing in an ovarian remnant but, to our knowledge, the first case to occur after laparoscopic hysterectomy and bilateral salpingo-oophorectomy. We discuss the management of pelvic masses suspected of malignancy after bilateral salpingo-oophorectomy and the possible role of endometriosis in the development of malignancy in ovarian remnant syndrome. PMID:17980339

Donnez, Olivier; Squifflet, Jean; Marbaix, Etienne; Jadoul, Pascale; Donnez, Jacques

2007-01-01

44

Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy: initial experience with a novel surgical approach to uterovaginal prolapse.  

PubMed

The objective of this retrospective study was to evaluate the feasibility, safety, and efficacy of a new laparoscopic technique for the treatment of uterovaginal prolapse using a transcervical access port to minimize the laparoscopic incision. From February 2008 through August 2010, symptomatic pelvic organ prolapse in 43 patients was evaluated and surgically treated using this novel procedure. Preoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q), and complex urodynamic testing with prolapse reduction to evaluate for symptomatic or occult stress urinary incontinence. The surgical procedure consisted of laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy with anterior and posterior mesh extension. Concomitant procedures were performed as indicated. All procedures were completed laparoscopically using only 5-mm abdominal port sites, with no intraoperative complications. Patients were followed up postoperatively for pelvic examination and POP-Q at 6 weeks, 6 months, and 12 months. The median (interquartile range) preoperative POP-Q values for point Aa was 0 (-1.0 to 1.0), and for point C was -1.0 (-3.0 to 2.0). Postoperatively, median points Aa and C were significantly improved at 6 weeks, 6 months, and 12 months (all p < .001). One patient was found to have a mesh/suture exposure from the sacrocervicopexy, which was managed conservatively without surgery. We conclude that laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy is a safe and feasible surgical approach to treatment of uterovaginal prolapse, with excellent anatomic results at 6 weeks, 6 months, and 12 months. Potential advantages of the procedure include minimizing laparoscopic port site size, decreasing the rate of mesh exposure compared with other published data, and reducing the rate of postoperative cyclic bleeding in premenopausal women by removing the cervical core. Longer follow-up is needed to determine the durability and potential long-term sequelae of the procedure. PMID:23084680

Rosenblatt, Peter L; Apostolis, Costas A; Hacker, Michele R; DiSciullo, Anthony

2012-01-01

45

Laparoscopic Supracervical Hysterectomy With Transcervical Morcellation and Sacrocervicopexy: Initial Experience With a Novel Surgical Approach to Uterovaginal Prolapse  

PubMed Central

The objective of this retrospective study was to evaluate the feasibility, safety, and efficacy of a new laparoscopic technique for the treatment of uterovaginal prolapse using a transcervical access port to minimize the laparoscopic incision. From February 2008 through August 2010, symptomatic pelvic organ prolapse in 43 patients was evaluated and surgically treated using this novel procedure. Preoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q), and complex urodynamic testing with prolapse reduction to evaluate for symptomatic or occult stress urinary incontinence. The surgical procedure consisted of laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy with anterior and posterior mesh extension. Concomitant procedures were performed as indicated. All procedures were completed laparoscopically using only 5-mm abdominal port sites, with no intraoperative complications. Patients were followed up postoperatively for pelvic examination and POP-Q at 6 weeks, 6 months, and 12 months. The median (interquartile range) preoperative POP-Q values for point Aa was 0 (?1.0 to 1.0), and for point C was ?1.0 (?3.0 to 2.0). Postoperatively, median points Aa and C were significantly improved at 6 weeks, 6 months, and 12 months (all p < .001). One patient was found to have a mesh/suture exposure from the sacrocervicopexy, which was managed conservatively without surgery. We conclude that laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy is a safe and feasible surgical approach to treatment of uterovaginal prolapse, with excellent anatomic results at 6 weeks, 6 months, and 12 months. Potential advantages of the procedure include minimizing laparoscopic port site size, decreasing the rate of mesh exposure compared with other published data, and reducing the rate of postoperative cyclic bleeding in premenopausal women by removing the cervical core. Longer follow-up is needed to determine the durability and potential long-term sequelae of the procedure. PMID:23084680

Rosenblatt, Peter L.; Apostolis, Costas A.; Hacker, Michele R.; DiSciullo, Anthony

2013-01-01

46

Hysterectomy  

MedlinePLUS

... cuts in the belly, in order to perform robotic surgery You and your doctor will decide which ... through the vagina using a laparoscope or after robotic surgery. When a larger surgical cut (incision) in ...

47

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

48

A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy.  

PubMed

Pregabalin has anticonvulsant, antihyperalgesic, and anxiolytic properties. In this study we evaluated the control of pain after perioperative administration of pregabalin 300 or 600 mg, compared with diazepam 10mg. Altogether 91 women scheduled for laparoscopic hysterectomy were randomized to receive diazepam 10mg (D10), pregabalin 150 mg (P300) or 300 mg (P600) for premedication, and the dose was repeated after 12h, except for the D10 group, in which the patients received placebo. Up until the 1st postoperative morning, analgesia was provided by oxycodone using patient controlled analgesia. The visual analogue scale scores for pain and side effects, and the amounts of the analgesics were recorded for three days after surgery. The doses of oxycodone during hours 0-12 after surgery were similar in the three groups, whereas the dose of oxycodone during hours 12-24 after surgery was smaller in the P600 group than in the P300 group (0.09 vs. 0.16 mg kg(-1); P=0.025). The total dose of oxycodone (0-24h after surgery) was smaller in the P600 group than in the D10 group (0.34 vs. 0.45 mg kg(-1); P=0.046). The incidence of dizziness (70% vs. 35%; P=0.012), blurred vision (63% vs. 14%; P=0.002) and headache (31% vs. 7%; P=0.041) were higher in the P600 group than in the D10 group. In conclusion, perioperative administration of pregabalin 600 mg decreases oxycodone consumption compared with diazepam 10mg, but is associated with an increased incidence of adverse effects. PMID:17507163

Jokela, Ritva; Ahonen, Jouni; Tallgren, Minna; Haanpää, Maija; Korttila, Kari

2008-01-01

49

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; Ça?lar, Mete; Alt?nta?, Ra?it; Dilbaz, Serdar; Yildiz, Pinar; Kumru, Selahattin; Üstün, Yusuf

2013-01-01

50

Calculating the true cost of robotic hysterectomy.  

PubMed

Although robotic hysterectomy does not produce significantly better outcomes than laparoscopic hysterectomy, hospitals may feel pressure from patients and clinicians to use the robotic procedure. Hospitals that opt for robotic hysterectomy over laparoscopic hysterectomy face not only higher variable costs, but also an opportunity cost in the form of lost surgical capacity. Estimating the opportunity cost of performing robotic hysterectomy provides crucial data for hospital executives in deciding whether to invest in the procedure. PMID:25145035

Tiwari, Vikram

2014-08-01

51

A randomized comparison of gasless laparoscopic appendectomy and conventional laparoscopic appendectomy  

PubMed Central

Introduction The purpose of this study was to compare the clinical outcomes and cost effectiveness of the gasless laparoscopic appendectomy (GLA) and conventional laparoscopic appendectomy (LA). Methods From Aug 2010 to Feb 2012, 100 patients with a clinical diagnosis of acute appendicitis in Shanghai Tongji hospital were included in the study and randomly divided into the LA and GLA groups, fifty in the GLA group and 50 in the LA group. The two groups were comparable in age, gender, body mass index, symptom duration, ASA score, and white blood cell count. Results The mean surgical duration was 70.6?±?30.8 min in the GLA group and 62.6?±?22.0 min in the LA group (P?=?0.138). The total conversion rate was 8% in the GLA group, while no conversions occurred in the LA group. Postoperative complications did not significantly differ between the two groups. Fentanyl consumption was decreased significantly in the GLA group (P?=?0.019) postoperatively. The length of the total hospital stay was 4.36?±?1.74 days in the GLA group compared with 5.68?±?4.44 days in the LA group (P?=?0.053). There was a significant decrease in the total hospital cost when the GLA group was compared with the LA group (6659?±?1782 vs. 9056?±?2680 Yuan, respectively, P?conventional LA are comparable in terms of operative duration, complications, and total hospital stay. The obvious advantage of GLA is the significantly reduced hospital cost. The demand for postoperative analgesics may also decrease following GLA. In conclusion, GLA is a safe and feasible procedure in selected patients. Trial registration Chinese Clinical Trial Register ChiCTR-TRC-10001203. PMID:24401566

2014-01-01

52

Single-incision laparoscopic appendectomy vs conventional laparoscopic appendectomy: Systematic review and meta-analysis  

PubMed Central

AIM: To assess the differences in clinical benefits and disadvantages of single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA). METHODS: The Cochrane Library, MEDLINE, Embase, Science Citation Index Expanded, and Chinese Biomedical Literature Database were electronically searched up through January 2013 to identify randomized controlled trails (RCTs) comparing SILA with CLA. Data was extracted from eligible studies to evaluate the pooled outcome effects for the total of 1068 patients. The meta-analysis was performed using Review Manager 5.2.0. For dichotomous data and continuous data, the risk ratio (RR) and the mean difference (MD) were calculated, respectively, with 95%CI for both. For continuous outcomes with different measurement scales in different RCTs, the standardized mean difference (SMD) was calculated with 95%CI. Sensitivity and subgroup analyses were performed when necessary. RESULTS: Six RCTs were identified that compared SILA (n = 535) with CLA (n = 533). Five RCTs had a high risk of bias and one RCT had a low risk of bias. SILA was associated with longer operative time (MD = 5.68, 95%CI: 3.91-7.46, P < 0.00001), higher conversion rate (RR = 5.14, 95%CI: 1.25-21.10, P = 0.03) and better cosmetic satisfaction score (MD = 0.52, 95%CI: 0.30-0.73, P < 0.00001) compared with CLA. No significant differences were found for total complications (RR = 1.15, 95%CI: 0.76-1.75, P = 0.51), drain insertion (RR = 0.72, 95%CI: 0.41-1.25, P = 0.24), or length of hospital stay (SMD = 0.04, 95%CI: -0.08-0.16, P = 0.57). Because there was not enough data among the analyzed RCTs, postoperative pain was not calculated. CONCLUSION: The benefit of SILA is cosmetic satisfaction, while the disadvantages of SILA are longer operative time and higher conversion rate. PMID:23964153

Cai, Yu-Long; Xiong, Xian-Ze; Wu, Si-Jia; Cheng, Yao; Lu, Jiong; Zhang, Jie; Lin, Yi-Xin; Cheng, Nan-Sheng

2013-01-01

53

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

54

Antiemetic effect of propofol administered at the end of surgery in laparoscopic assisted vaginal hysterectomy  

PubMed Central

Background Postoperative nausea and vomiting (PONV) commonly occur after general anesthesia, especially in women. In this study, we evaluated the antiemetic efficacy of propofol administered at the end of surgery in highly susceptible patients undergoing a laparoscopy-assisted vaginal hysterectomy. Methods A total of 107 women undergoing a laparoscopy-assisted vaginal hysterectomy under general anesthesia were enrolled for this prospective, double-blind, randomized study. Fifteen minutes before the end of surgery, all patients received 50 µg fentanyl and 1 of following 3 doses; 0.5 mg/kg of propofol (propofol 0.5 group), 1 mg/kg of propofol (propofol 1.0 group), and normal saline (control group). All patients received intravenous patient-controlled analgesia (PCA). Emergence time, a visual analog scale for pain and nausea, duration of postanesthesia care unit (PACU) stay, and frequency of antiemetic use were recorded at 0-2, 2-24, and 24-48 hours postoperatively. Results The incidence of nausea significantly lower in the propofol 0.5 and propofol 1.0 groups than in the control group (12.1 vs 14.7 vs 40%). During the first postoperative 2 hours, antiemetics were less frequently administered in the propofol 0.5 and propofol 1.0 groups than in the control group (3.0 vs 5.9 vs 22.5%). Emergence time was slightly longer in the propofol 0.5 and propofol 1.0 groups than in the control group, but there was no significant difference in PACU stay time was observed between the 3 groups. Conclusions The results of this study suggest that low-dose propofol administration at the end of surgery may effectively reduce the incidence of PONV within 2 hours postoperatively in highly susceptible women undergoing a laparoscopiy-assisted vaginal hysterectomy and receiving opioid-based PCA. PMID:24729843

Kim, Eu-Gene; Kang, Hyoseok; Choi, Juyoun; Lee, Hyun Jeong

2014-01-01

55

Prospective randomized study of stress and immune response after laparoscopic vs conventional colonic resection  

Microsoft Academic Search

Methods: In order to evaluate the stress and immunological response to laparoscopic and conventional colon resection we operated on\\u000a male Wistar rats (350–380 g), performing either laparoscopic (n= 15) or open colon resection (n= 15). A third group (n= 10) underwent anesthesia only. Immediately before and after surgery as well as 1 and 7 days postoperatively a 1 ml sample

C. Kuntz; A. Wunsch; F. Bay; J. Windeler; F. Glaser; C. Herfarth

1998-01-01

56

Single port laparoscopic appendectomy in children using glove port and conventional rigid instruments  

PubMed Central

Purpose To further improve the advantages of minimally invasive surgery, single port laparoscopic techniques continue to be developed. We report our initial experience with single port laparoscopic appendectomy (SPLA) in children and compare its outcomes to those of conventional laparoscopic appendectomy (CLA). Methods Clinical data were prospectively collected for SPLA cases performed at Chung-Ang University Hospital by a single surgeon between March 2011 and December 2011, including operative time, perioperative complications, conversion rate, and length of hospital stay. Each case of SPLA was performed using conventional laparoscopic instruments through Glove port placed into the single umbilical incision. To compare outcomes, a retrospective review was performed for those patients who underwent CLA between March 2010 and December 2010. Results Thirty-one patients underwent SPLA and 114 patients underwent CLA. Mean age (10.5 years vs. 11.1 years, P = 0.43), weight (48.2 kg vs. 42.9 kg, P = 0.27), and operation time (41.8 minutes vs. 37.9 minutes, P = 0.190) were comparable between both groups. Mean hospital stay was longer for CLA group (2.6 days vs. 3.7 days, P = 0.013). There was no conversion to conventional laparoscopic surgery in SPLA group. In CLA group, there were nine complications (7.9%) with 3 cases of postoperative ileuses and 6 cases wound problems. There was one complication (3.2%) of umbilical surgical site infection in SPLA group (P = 0.325). Conclusion The results of this study demonstrated that SPLA using conventional laparoscopic instruments is technically feasible and safe in children. SPLA using conventional laparoscopic instruments might be popularized by eliminating the need for specially designed instruments. PMID:24761405

Choi, Yoo Shin; Kim, Beom Gyu; Cha, Seong-Jae; Park, Joong-Min; Chang, In Taik

2014-01-01

57

Single-incision laparoscopic appendectomy is comparable to conventional laparoscopic and laparotomic appendectomy: our single center single surgeon experience  

PubMed Central

Summary Several studies have demonstrated the clinical and technical benefits of the laparoscopic surgery for complicated and uncomplicated appendicitis. Our retrospective study included 12 patient who underwent SILS appendectomy (SILS-A), 14 who received conventional laparoscopic surgery (VL-A), and 12 who received laparotomic appendectomy (O-A); performed in all cases by the same surgeon (C.F.). The aim of this study was the comparison between this three different surgical techniques on same features: post operative leukocytosis, post operative pain, need abdominal drainage, esthetic viewpoint, incidence of complication, hospital stay. The results showed no significant differences between SILS-A and VLS-A, while an evident improvement shows versus O-A, even though not statistically significative. SILS was more effective in decreasing the risk of postoperative wound infection. PMID:24091177

CECI, F.; ORSINI, S.; TUDISCO, A.; AVALLONE, M.; AIUTI, F.; DI GIROLAMO, V.; STEFANELLI, F.; DE ANGELIS, F.; MARTELLUCCI, A.; COSTANTINO, A.; DI GRAZIA, C.; NICODEMI, S.; CIPRIANI, B.; NAPOLEONI, A.; MOSILLO, R.; CORELLI, S.; CASCIARO, G.; SPAZIANI, E.; STAGNITTI, F.

2013-01-01

58

Palliative stoma creation: comparison of laparoscopic vs conventional procedures  

Microsoft Academic Search

Background  The creation of a stoma is an established therapeutic concept for the palliation of non-resectable rectal carcinomas and advanced\\u000a tumours infiltrating the pelvis.\\u000a \\u000a \\u000a \\u000a Materials and methods  In two prospective country-wide multicentre studies, each conducted over a similar period of time, the peri-operative course\\u000a and postoperative short-term outcomes of laparoscopic vs laparotomy-based stoma construction were compared.\\u000a \\u000a \\u000a \\u000a Results  A total of 90 patients underwent

H. Scheidbach; H. Ptok; D. Schubert; D. Kose; O. Hügel; I. Gastinger; F. Köckerling; H. Lippert

2009-01-01

59

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; Hallerbäck, Bengt; Glise, Hans; Anesten, Bengt; Smedberg, Sam; Román, Jonas

1999-01-01

60

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

61

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

62

Living kidney donation: a comparison of laparoscopic and conventional open operations  

PubMed Central

Laparoscopic donor nephrectomy has the potential to lessen the burden placed on live kidney donors. This study describes the first British comparison of donor morbidity and recovery following conventional open donor nephrectomy (ODN) and laparoscopic donor nephrectomy (LDN). An initial series of LDN (n=20) was compared to a historical control group of ODN (n=34). Laparoscopic operations were performed via a transperitoneal approach, the kidney being removed through a 6–12 cm Pfannensteil incision. Open operations were performed using a retroperitoneal flank approach with resection of the 12th rib. Postoperatively, donors were managed with a patient controlled analgesia system. LDN was associated with shorter mean (SD) inpatient stay (6 (2) v 4 (1) days; p=0.0001) and lower parenteral narcotic requirements (morphine 179 (108) v 67 (54) mg; p=0.0001). Laparoscopic donors started driving their cars sooner (2 (1.5) v 6 (4) weeks; p=0.0001) and returned to work more quickly (5 (3) v 12 (6) weeks; p=0.0001) than open nephrectomy donors. There were no differences in recipient serum creatinine levels at three months post-transplant but two recipients of transplant kidneys retrieved laparoscopically (10%) developed ureteric obstruction, whereas this complication did not occur after ODN (p=0.13). LDN is associated with less postoperative pain and a substantial improvement in donor recovery times. It is not yet clear whether or not the outcome of the recipient kidney transplants are the same after ODN and LDN and much more experience is required before the place of this new technique can be defined. PMID:11884697

Waller, J; Hiley, A; Mullin, E; Veitch, P; Nicholson, M

2002-01-01

63

Laparoscopic Supracervical Hysterectomy  

MedlinePLUS Videos and Cool Tools

... for control of my PCOS. That's polycystic ovarian syndrome. Would I be a good candidate for this ... with dysfunctional bleeding because of your polycystic ovarian syndrome, this would be an option. But generally, if ...

64

Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis  

PubMed Central

Background Laparoscopic surgery has become the standard for treating appendicitis. The cosmetic benefits of using single-incision laparoscopy are well known, but its duration, complications and time to recovery have not been well documented. We compared 2 laparoscopic approaches for treating appendicitis and evaluated postoperative pain, complications and time to full recovery. Methods We retrospectively reviewed the cases of consecutive patients with appendicitis and compared those who underwent conventional laparoscopic appendectomy (CLA) performed using 3 incisions and those who underwent single-incision laparoscopic appendectomy (SILA). During SILA, the single port was prepared to increase visibility of the operative site. Results Our analysis included 688 consecutive patients: 618 who underwent CLA and 70 who underwent SILA. Postsurgical complications occurred more frequently in the CLA than the SILA group (18.1% v. 7.1%, p = 0.018). Patients who underwent SILA returned to oral feeding sooner than those who underwent CLA (median 12 h v. 22 h, p < 0.001). These between-group differences remained significant after controlling for other factors. Direct comparison of only nonperforated cases, which was determined by pathological examination, revealed that SILA was significantly longer than CLA (60 min v. 50 min, p < 0.001). Patients who underwent SILA had longer in-hospital stays than those who underwent CLA (72 v. 55 h, p < 0.001); however, they had significantly fewer complications (3.0% v. 14.4%, p = 0.006). Conclusion In addition to its cosmetic advantages, SILA led to rapid recovery and no increase in postsurgical pain or complications. PMID:24869622

Liang, Hung-Hua; Hung, Chin-Sheng; Wang, Weu; Tam, Ka-Wai; Chang, Chun-Chao; Liu, Hui-Hsiung; Yen, Ko-Li; Wei, Po-Li

2014-01-01

65

Patient-reported satisfaction and cosmesis outcomes following laparoscopic adrenalectomy: Laparoendoscopic single-site adrenalectomy vs. conventional laparoscopic adrenalectomy  

PubMed Central

Introduction: We evaluate patient-reported satisfaction and cosmesis of laparoendoscopic single-site adrenalectomy (LESS-A) in comparison with that of conventional laparoscopic adrenalectomy (CLA). Methods: A total of 19 and 104 patients who respectively underwent LESS-A and CLA between May 1996 and June 2011 were included in the study. Questionnaires inquiring about scar pain (0: not painful, 10: very painful), satisfaction (0: not satisfied, 10: very satisfied) and cosmesis (0: very unsightly, 10: very beautiful) on the basis of a visual analogue scale were sent to patients postoperatively. Results: The respondents consisted of 11 and 54 patients who underwent LESS-A and CLA, respectively. There was no significant inter-group difference in age, sex, affected side or body mass index. No significant differences were observed in operative time or estimated blood loss. There were also no significant differences in pain (0.67 vs. 0.57, p = 0.393), satisfaction (8.92 vs. 8.46, p = 0.453), or cosmesis score (8.58 vs. 8.00, p = 0.487) between the LESS-A and CLA groups overall. In female patients, the satisfaction score was significantly higher in the LESS-A group than in the CLA group (10.0 vs. 8.72, p = 0.049). In young patients (<50 years old), the satisfaction score was also significantly higher in the LESS-A group than in the CLA group (9.17 vs. 6.38, p = 0.036). Conclusions: Young patients and female patients who had received LESS-A adrenal surgery were more satisfied with the scar outcomes than were the young patients and female patients who had received CLA. We suggest that this patient subset most values the cosmetic benefits of LESS-A. PMID:24454596

Inoue, Shogo; Ikeda, Kenichiro; Kobayashi, Kanao; Kajiwara, Mitsuru; Teishima, Jun; Matsubara, Akio

2014-01-01

66

Quality of laparoscopic radical hysterectomy in developing countries: a comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia  

PubMed Central

Objective To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. Methods Records of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología–Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. Results There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m2 vs. 28.7 kg/m2, P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated blood loss (200 mL vs. 79 mL, P<0.001), longer median operative time (328.5 min vs. 235 min, P<0.001), and longer postoperative hospital stay (2 days vs. 1 day, P<0.001). Conclusions Surgical and oncologic outcomes of laparoscopic radical hysterectomy were not worse at a cancer center in a developing country than at a large comprehensive cancer center in the United States. These results support consideration of developing countries for inclusion in collaborations for prospective surgical studies. PMID:22261300

Pareja, Rene; Nick, Alpa M.; Schmeler, Kathleen M.; Frumovitz, Michael; Soliman, Pamela T.; Buitrago, Carlos A; Borrero, Mauricio; Angel, Gonzalo; dos Reis, Ricardo; Ramirez, Pedro T.

2014-01-01

67

Prospective Observational Study of Single-Site Multiport Per-umbilical Laparoscopic Endosurgery versus Conventional Multiport Laparoscopic Cholecystectomy: Critical Appraisal of a Unique Umbilical Approach  

PubMed Central

Purpose. This prospective observational study compares an innovative approach of Single-Site Multi-Port Per-umbilical Laparoscopic Endo-surgery (SSMPPLE) cholecystectomy with the gold standard—Conventional Multi-port Laparoscopic Cholecystectomy (CMLC)—to assess the feasibility and efficacy of the former. Methods. In all, 646 patients were studied. SSMPPLE cholecystectomy utilized three ports inserted through three independent mini-incisions at the umbilicus. Only the day-to-day rigid laparoscopic instruments were used in all cases. The SSMPPLE cholecystectomy group had 320 patients and the CMLC group had 326 patients. The outcomes were statistically compared. Results. SSMPPLE cholecystectomy had average operative time of 43.8?min and blood loss of 9.4?mL. Their duration of hospitalization was 1.3 days (range, 1–5). Six patients (1.9%) of this group were converted to CMLC. Eleven patients had controlled gallbladder perforations at dissection. The Visual Analogue Scores for pain on postoperative days 0 and 7, the operative time, and the scar grades were significantly better for SSMPPLE than CMLC. However, umbilical sepsis and seroma outcomes were similar. We had no bile-duct injuries or port-site hernias in this study. Conclusion. SSMPPLE cholecystectomy approach complies with the principles of laparoscopic triangulation; it seems feasible and safe method of minimally invasive cholecystectomy. Overall, it has a potential to emerge as an economically viable alternative to single-port surgery. PMID:24876955

Jategaonkar, Priyadarshan Anand; Yadav, Sudeep Pradeep

2014-01-01

68

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?o?lu, Sümeyra Nergiz; Alt?nkaya, Sündüz Özlem; Küçük, Mert; Yüksel, Hasan; Demircan-Sezer, Selda

2014-01-01

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

Comparision of modified and conventional delta-shaped gastroduodenostomy in totally laparoscopic surgery  

PubMed Central

AIM: To evaluate the safety and feasibility of a modified delta-shaped gastroduodenostomy (DSG) in totally laparoscopic distal gastrectomy (TLDG). METHODS: We performed a case-control study enrolling 63 patients with distal gastric cancer (GC) undergoing TLDG with a DSG from January 2013 to June 2013. Twenty-two patients underwent a conventional DSG (Con-Group), whereas the other 41 patients underwent a modified version of the DSG (Mod-Group). The modified procedure required only the instruments of the surgeon and assistant to complete the involution of the common stab incision and to completely resect the duodenal cutting edge, resulting in an anastomosis with an inverted T-shaped appearance. The clinicopathological characteristics, surgical outcomes, anastomosis time and complications of the two groups were retrospectively analyzed using a prospectively maintained comprehensive database. RESULTS: DSG procedures were successfully completed in all of the patients with histologically complete (R0) resections, and none of these patients required conversion to open surgery. The clinicopathological characteristics of the two groups were similar. There were no significant differences between the groups in the operative time, intraoperative blood loss, extension of the lymph node (LN) dissection and number of dissected LNs (150.8 ± 21.6 min vs 143.4 ± 23.4 min, P = 0.225 for the operative time; 26.8 ± 11.3 min vs 30.6 ± 14.8 mL, P = 0.157 for the intraoperative blood loss; 4/18 vs 3/38, P = 0.375 for the extension of the LN dissection; and 43.9 ± 13.4 vs 39.5 ± 11.5 per case, P = 0.151 for the number of dissected LNs). The anastomosis time, however, was significantly shorter in the Mod-Group than in the Con-Group (13.9 ± 2.8 min vs 23.9 ± 5.6 min, P = 0.000). The postoperative outcomes, including the times to out-of-bed activities, first flatus, resumption of soft diet and postoperative hospital stay, as well as the anastomosis size, did not differ significantly (1.9 ± 0.6 d vs 2.3 ± 1.5 d, P = 0.228 for the time to out-of-bed activities; 3.2 ± 0.9 d vs 3.5 ± 1.3 d, P = 0.295 for the first flatus time; 7.5 ± 0.8 d vs 8.1 ± 4.3 d, P = 0.489 for the resumption of a soft diet time; 14.3 ± 10.6 d vs 11.5 ± 4.9 d, P = 0.148 for the postoperative hospital stay; and 30.5 ± 3.6 mm vs 30.1 ± 4.0 mm, P = 0.730 for the anastomosis size). One patient with minor anastomotic leakage in the Con-Group was managed conservatively; no other patients experienced any complications around the anastomosis. The operative complication rates were similar in the Con- and Mod-Groups (9.1% vs 7.3%, P = 1.000). CONCLUSION: The modified DSG, an alternative reconstruction in TLDG for GC, is technically safe and feasible, with a simpler process that reduces the anastomosis time. PMID:25132765

Huang, Chang-Ming; Lin, Mi; Lin, Jian-Xian; Zheng, Chao-Hui; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lu, Jun

2014-01-01

71

Routes of hysterectomy in women with benign uterine disease in the Vancouver Coastal Health and Providence Health Care regions: a retrospective cohort analysis  

PubMed Central

Background Minimally invasive hysterectomies performed vaginally or laparoscopically are associated with decreased perioperative morbidity. We examined temporal trends and patient and hospital factors associated with the routes of hysterectomy used in the Vancouver Coastal Health and Providence Health Care regions in British Columbia. Methods We performed a retrospective cohort study of all women who had an elective hysterectomy for a benign indication between 2007 and 2011 in 8 hospitals in the region. Logistic regression modeling with mixed effects was used to estimate adjusted odds ratios and 95% confidence intervals for patient and hospital characteristics associated with the route of hysterectomy. Results The study involved 4372 women who underwent abdominal (52.3%), vaginal (25.5%) or laparoscopic (22.3%) hysterectomy. From 2007 to 2011, the number of abdominal hysterectomies performed decreased from 58.4% to 47.7%, the number of vaginal hysterectomies performed decreased from 27.5% to 21.1% and the number of laparoscopic hysterectomies performed increased from 14.2% to 31.2% (p < 0.001 for all trends). Patient factors associated with laparoscopic versus abdominal hysterectomy included young age, pain or prolapse indication, absence of fibroid indication, absence of concurrent gynecologic procedure, rural residence and lower socioeconomic status. Patient factors associated with vaginal hysterectomy included older age, prolapse indication and concurrent procedure for prolapse. Hospital location and size were not significantly associated with vaginal hysterectomy, but urban hospital location was associated with laparoscopic hysterectomy. Interpretation The proportion of minimally invasive hysterectomies is increasing and represents approximately half of all hysterectomies performed in the Vancouver Coastal Health and Providence Health Care regions. Vaginal hysterectomies are associated with patient characteristics, whereas laparoscopic hysterectomies are associated with patient and hospital characteristics. PMID:25485254

Lisonkova, Sarka; Allaire, Catherine; Williams, Christina; Yong, Paul; Joseph, K.S.

2014-01-01

72

Physical and Mental Workload in Single-Incision Laparoscopic Surgery and Conventional Laparoscopy.  

PubMed

Objectives. The aim of the present study is to evaluate mental workload and fatigue in fingers, hand, arm, shoulder in single-incision laparoscopic surgery (SILS) and multiport laparoscopy. Methods. Volunteers performed chosen tasks by standard laparoscopy and SILS. Time to complete tasks and finger and hand strength were evaluated. Lateral, tripod, and pulp pinch strengths were measured. Hand dexterity was determined by pegboard. Electromyography recordings were taken from biceps and deltoid muscles of both extremities. The main outcome measurement was median frequency (MF) slope. NASA-TLX was used for mental workload. Results. Time to complete laparoscopic tasks were longer in the SILS group (P < .05). Decrease of strength in fingers and hand were similar in SILS and standard laparoscopy. Pegboard time was increased in both hands after SILS (P < .05). MF slope of biceps muscle and deltoid muscle in SILS was far away from the reference slope. MF slope of biceps muscle and deltoid muscle in standard laparoscopy was close to reference slope, indicating there was more fatigue in biceps and deltoid muscles of both upper extremities in SILS group. NASA-TLX score was 73 ± 13.3 and 42 ± 19.5 in SILS and multiport laparoscopy, respectively (P < .01). Mental demand, physical demand, temporal demand, performance, effort, and frustration were, respectively, scored 10.7 ± 3.8, 11.7 ± 3.5, 12.2 ± 2.7, 11 ± 3, 13.6 ± 2.7, and 13.5 ± 2.8 in SILS and 6.3 ± 3.1, 6.6 ± 3.3, 7.3 ± 3.3, 7.1 ± 4.1, 7.9 ± 3.9, and 6.6 ± 3.8 in standard laparoscopy (P < .01). Conclusions. SILS is mentally and physically demanding, particularly on arms and shoulders. Fatigue of big muscles, effort, and frustration were major challenges of SILS. Ergonomic intervention of instruments are needed to decrease mental and physical workload. PMID:25380604

Koca, Dilek; Y?ld?z, Sedat; Soyupek, Feray; Günyeli, Ilker; Erdemoglu, Ebru; Soyupek, Sedat; Erdemoglu, Evrim

2014-11-01

73

Laparoscopic treatment of ureteral obstruction secondary to ovarian remnant syndrome.  

PubMed

A case is presented in which an ovarian remnant following total abdominal hysterectomy and bilateral salpingo-oophorectomy resulted in unilateral ureteral obstruction. The obstructing tissue was excised laparoscopically with simultaneous ureteroscopic monitoring. PMID:8455251

Klutke, J; Kavoussi, L R; Albala, D M; Clayman, R V

1993-04-01

74

Cost-effectiveness of extraperitoneal laparoscopic inguinal hernia repair: a randomized comparison with conventional herniorrhaphy. Coala trial group.  

PubMed Central

OBJECTIVE: To determine the cost-effectiveness of laparoscopic inguinal hernia repair. SUMMARY BACKGROUND DATA: Laparoscopic inguinal hernia repair seems superior to open techniques with respect to short-term results. An issue yet to be studied in depth remains the cost-effectiveness of the procedure. As part of a multicenter randomized study in which >1000 patients were included, a cost-effectiveness analysis from a societal point of view was performed. METHODS: After informed consent, all resource costs, both in and outside the hospital, for patients between August 1994 and July 1995 were recorded prospectively. Actual costs were calculated in a standardized fashion according to international guidelines. The main measures used for the evaluation of inguinal hernia repair were the number of averted recurrences and quality of life measured with the Short Form 36 questionnaire. RESULTS: Resource costs were recorded for 273 patients, 139 in the open and 134 in the laparoscopic group. Both groups were comparable at baseline. Average total hospital costs were Dfl 1384.91 (standard deviation: Dfl 440.15) for the open repair group and Dfl 2417.24 (standard deviation: Dfl 577.10) for laparoscopic repair, including a disposable kit of Dfl 676. Societal costs, including costs for days of sick leave, were lower for the laparoscopic repair and offset the hospital costs by Dfl 780.83 (75.6%), leaving the laparoscopic repair Dfl 251.50 more expensive (Dfl 4665 versus Dfl 4916.50). At present, the recurrence rate is 2.6% lower after laparoscopic repair. Thus, 38 laparoscopic repairs, costing an additional Dfl 9,557, prevent the occurrence of one recurrent hernia. Quality of life was better after laparoscopic repair. CONCLUSION: A better quality of life in the recovery period and the possibility of replacing parts of the disposable kit with reusable instruments may result in the laparoscopic repair becoming dominantly better--that is, less expensive and more effective from a societal perspective. PMID:9409566

Liem, M S; Halsema, J A; van der Graaf, Y; Schrijvers, A J; van Vroonhoven, T J

1997-01-01

75

Retained uterine fundus after vaginal hysterectomy.  

PubMed

We report a case of retained uterine fundus after vaginal hysterectomy that was subsequently removed at laparoscopy. The patient had undergone vaginal hysterectomy 8 years previously and came to our hospital with abdominal pain. Examination revealed a supravesical mass. Laparoscopy was performed and showed the uterine fundus with its cornual attachments. The mass was excised and sent for histopathologic analysis, which confirmed that it was uterine tissue. Retained uterine tissue or myoma tissue has been reported, usually after morcellation. However, to our knowledge, our case is only the second reported case of retained fundus after complete vaginal hysterectomy. Because of adhesions, it is possible that the uterus was not completely removed. In such cases, laparoscopic assistance is extremely useful. PMID:20129338

Sinha, Rakesh; Lakhotia, Smita; Sundaram, Meenakshi; Manaktala, Gayatri; Shah, Parul; Mahajan, Chaitali

2010-01-01

76

Comparison of hand-assisted laparoscopic surgery and conventional laparotomy for colorectal cancer: Interim results from a single institution  

PubMed Central

The present study aimed to compare the results of hand-assisted laparoscopic surgery (HALS) and conventional laparotomy (CL) at a single institution in Japan. Of the 212 patients with stage I/II/III colorectal cancer who received a curative resection, 98 patients underwent HALS and 114 patients underwent CL. The clinical background and post-operative management did not differ between the two groups. There were no significant differences in the 3-year relapse-free and 3-year overall survival rates between the HALS and CL groups for the patients in any stage. Blood loss during surgery was 250.1 and 135.5 ml (mean and median; the same hereafter) in stage I patients receiving HALS versus 608.2 and 315.5 ml in stage I CL patients (P=0.006), while it was 277.6 and 146 ml in stage II patients receiving HALS versus 548.6 and 347 ml in stage II CL patients (P=0.004). Post-operative hospital stay was recorded at 16.8 and 15 days in stage III patients receiving HALS versus 23.1 and 21 days in stage III CL patients (P=0.001). There were no significant differences in the operating time or complications between the two groups. These results indicate that the survival rate was comparable for HALS and CL, while HALS caused less surgical stress and achieved a better cosmetic outcome. The results of the final analysis of this cohort are awaited. PMID:25013477

TAJIMA, TAKAYUKI; MUKAI, MASAYA; YAMAZAKI, MASASHI; HIGAMI, SHIGEO; YAMAMOTO, SOUICHIROU; HASEGAWA, SAYURI; NOMURA, EIJI; SADAHIRO, SOTARO; YASUDA, SEIEI; MAKUUCHI, HIROYASU

2014-01-01

77

Fallopian Tube Prolapse after Hysterectomy: A Systematic Review  

PubMed Central

Background Prolapse of the fallopian tube into the vaginal vault is a rarely reported complication that may occur after hysterectomy. Clinicians can miss the diagnosis of this disregarded complication when dealing with post-hysterectomy vaginal bleeding. Objectives We performed a systematic review in order to describe the clinical presentation, therapeutic management and outcome of fallopian tube prolapse occurring after hysterectomy. Search Strategy A systematic search of MEDLINE and EMBASE references from January 1980 to December 2010 was performed. We included articles that reported cases of fallopian tube prolapse after hysterectomy. Data from eligible studies were independently extracted onto standardized forms by two reviewers. Results Twenty-eight articles including 51 cases of fallopian tube prolapse after hysterectomy were included in this systematic review. Clinical presentations included abdominal pain, dyspareunia, post- coital bleeding, and/or vaginal discharge. Two cases were asymptomatic and diagnosed at routine checkup. The surgical management reported comprised partial or total salpingectomy, with vaginal repair in some cases combined with oophorectomy using different approaches (vaginal approach, combined vaginal-laparoscopic approach, laparoscopic approach, or laparotomy). Six patients were initially treated by silver nitrate application without success. Conclusions This systematic review provided a precise summary of the clinical characteristics and treatment of patients presenting with fallopian tube prolapse following hysterectomy published in the past 30 years. We anticipate that these results will help inform current investigations and treatment. PMID:24116117

Ouldamer, Lobna; Caille, Agnčs; Body, Gilles

2013-01-01

78

Laparoscopic surgery in endometriosis.  

PubMed

Endometriosis (the presence of endometrial glands and stroma outside of the uterine cavity) is a common gynecologic problem affecting 10% of women in the general population, 40% of women with infertility and 60% of women with chronic pelvic pain. Laparoscopy has revolutionized management of women with endometriosis. Diagnosis of endometriosis depends on visualization of endometriotic lesions and histologic confirmation. Endometriotic implants have a multitude of appearances: powder burns, red, blue-black, yellow, white, clear vesicular and peritoneal windows. Diagnostic laparoscopy is often combined with operative procedures to treat manifestations and symptoms of endometriosis. This often includes removal or laser vaporization of endometriotic implants, lysis of adhesions, restoration of normal anatomy and removal or fulguration of ovarian endometriomas (conservative surgery). Severe incapacitating endometriosis, recurrent endometriosis following conservative surgery and symptomatic endometriosis in women not desiring more children is often treated by laparoscopic unilateral or bilateral salpingo-oophorectomy or laparoscopically-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (radical surgery). Endometriosis affecting the appendix, ureters, bladder wall and rectosigmoid colon could be treated with laparoscopic appendectomy, excision of endometriotic implants or laparoscopic colectomy and anastomosis, respectively. Hydrodis-section and use of CO2 super pulsed laser aid in removal of adherent endometriotic implants without damage to normal underlying structures. Robotic-assisted laparoscopic surgery promises to provide advantages in the management of women with severe endometriosis secondary to 3-dimensional visualization, decreasing surgeon's fatigue and hand tremors and improving surgical precision. PMID:18560348

Eltabbakh, G H; Bower, N A

2008-08-01

79

Minimally Invasive Hysterectomies—A Survey on Attitudes and Barriers among Practicing Gynecologists  

PubMed Central

Study Objective To explore attitudes and hysterectomy practices among gynecologists in the United States and to identify potential barriers to offering minimally invasive hysterectomies. Design Mixed-mode (online and on-paper) survey of a random sample of 1500 practicing obstetrician-gynecologists. Setting Nationwide survey in the United States. Participants Nonretired obstetrician-gynecologists identified through a physician list from the American Medical Association. Interventions Postal and online survey. Measurements & Main Results We received a response from 376 physicians (25.8% response rate). The average age of respondents was 47.9 years, and 87% were generalists. Participants performed on average 4 surgical cases per week and 32 hysterectomies per year, most of which were abdominal hysterectomies. When asked for preferred mode of access for themselves or their spouse, 55.5% chose vaginal hysterectomy (VH), 40.6% chose laparoscopic hysterectomy (LH), and 8% chose abdominal hysterectomy (AH). Younger physicians (<40) and high surgical volume physicians were significantly more likely to chose a laparoscopic approach and identified significantly fewer barriers for performing LH. The main barriers to performing VH were technical difficulty, potential for complications, and caseload of VH. The main barriers for performing LH were training during residency, technical difficulty, personal surgical experience and operating time. The majority of gynecologists wanted to decrease their AH rates and increase their LH rates. The most significant identified contraindications to VH were prior laparotomy, a uterus larger than 12 weeks, narrow introitus, adnexal mass, and minimal uterine descent. Conclusions While a large majority of gynecologists would prefer a VH or LH for themselves or their spouse, AH remains the most common hysterectomy method in the United States. A generation gap appears to be brewing with younger gynecologist more in favor of the laparoscopic approach. More emphasis should be placed on training gynecologists in performing minimally invasive hysterectomies, given their desire to change their surgical mode of access. PMID:20226403

Einarsson, Jon I.; Matteson, Kristen A.; Schulkin, Jay; Chavan, Niraj R.; Sangi-Haghpeykar, Haleh

2011-01-01

80

[Laparoscopic appendectomy].  

PubMed

The authors report their experience of 6 cases of appendicectomy using a laparoscopic route of which 5 were performed under local anesthesia and 1 under general anesthesia. The results indicate that this new technique is easy to perform and as rapid and safe as the traditional operation. The possibility of using local anesthesia, the lack of complications when operating on obese patients, the lower incidence of wound infections and rapid postoperative mobilisation all argue in favour of this alternative approach to conventional open surgery. PMID:7603611

Vadalŕ, G; Mangiameli, A; Altamore, S; Roveccio, S; Scalia, A; L'Anfusa, G

1995-03-01

81

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

82

Virtual reality in laparoscopic surgery.  

PubMed

Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery. PMID:15747974

Uranüs, Selman; Yanik, Mustafa; Bretthauer, Georg

2004-01-01

83

Laparoscopic Radical Trachelectomy  

PubMed Central

Introduction: The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported. Case Description: We report the first case of a laparoscopic radical trachelectomy performed in a developing country. The patient is a nulligravid, 30-y-old female with stage IB1 adenocarcinoma of the cervix who desired future fertility. She underwent a laparoscopic radical trachelectomy and bilateral pelvic lymph node dissection. The operative time was 340 min, and the estimated blood loss was 100mL. There were no intraoperative or postoperative complications. The final pathology showed no evidence of residual disease, and all pelvic lymph nodes were negative. At 20 mo of follow-up, the patient is having regular menses but has not yet attempted to become pregnant. There is no evidence of recurrence. Conclusion: Laparoscopic radical trachelectomy with pelvic lymphadenectomy in a young woman who desires future fertility may also be an alternative technique in the treatment of early cervical cancer in developing countries. PMID:23318085

Rendón, Gabriel J.; Ramirez, Pedro T.; Frumovitz, Michael; Schmeler, Kathleen M.

2012-01-01

84

Evidence for reduced traumatization during laparoscopic versus conventional cholecystectomy: Different changes in histamine levels related to special phases of operation  

Microsoft Academic Search

The role of histamine in injury due to trauma or surgical treatment is more than doubtful after more than 70 years of investigation. A comparison of histamine released during conventional versus minimal invasive surgery seems especially useful to elucidate the role of histamine in such important events of the daily clinical life.

R. Lindlar; U. Schäfer; W. Lorenz; J. Sattler; D. Schröder; W. Krack

1992-01-01

85

Laparoscopic Treatment of Ovarian Retention Pathology  

PubMed

We define ovarian retention pathology as the complications (cystic, degenerative, adhesions, endometriosis, pain, etc.) attributed to ovaries deliberately retained at the time of hysterectomy. We established a protocol for laparoscopy in these women. During 14 laparoscopic procedures for ovarian retention pathology, only one intraoperative complication occurred, a small bowel injury requiring minilaparotomy. One woman required repeat surgery for ovarian remnant syndrome. Published experience with laparotomy suggests that significant injuries to or resections of bowel, bladder, or ureters can occur, but the limited experience with laparoscopic surgery has not shown significant complications. PMID:9074105

Dionisi; Dionisi; Dionisi

1996-08-01

86

Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus  

PubMed Central

BACKGROUND: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. MATERIALS AND METHODS: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. RESULTS: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4), robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007) and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044) compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. CONCLUSIONS: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions. PMID:25598606

Chiu, Li-Hsuan; Chen, Ching-Hui; Tu, Pei-Chia; Chang, Ching-Wen; Yen, Yuan-Kuei; Liu, Wei-Min

2015-01-01

87

Laparoscopic enterocystoplasty  

Microsoft Academic Search

Objectives. To report the initial clinical experience with laparoscopic augmentation enterocystoplasty using the ileum, sigmoid, or right colon.Methods. Three patients with functionally reduced bladder capacities due to neurogenic causes underwent laparoscopic enterocystoplasty: ileocystoplasty (n = 1), sigmoidocystoplasty (n = 1), and cystoplasty with cecum and proximal ascending colon (n = 1). In the last patient, a continent, catheterizable, ileal conduit

Inderbir S Gill; Raymond R Rackley; Anoop M Meraney; Peter W Marcello; Gyung Tak Sung

2000-01-01

88

SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy.  

PubMed

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

89

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

90

Appraisal of laparoscopic cholecystectomy.  

PubMed Central

This paper reports the experience of three general surgeons performing 304 laparoscopic cholecystectomies in three private hospitals between October 1989 and November 1990. Laparoscopic cholecystectomy boasts two major advantages over the conventional procedure: the remarkable reduction in postoperative pain and economic benefit, largely due to the patient's early return to work. Revealing a complication rate of 2% and no deaths, this study has shown that this procedure can offer patients these advantages with a medical risk no greater than that accompanying conventional cholecystectomy. Patient safety must be paramount, and it is the responsibility of the surgical community to ensure that all surgeons receive the highest quality training and that the technique is applied appropriately. Images Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 7. PMID:1828140

Graves, H A; Ballinger, J F; Anderson, W J

1991-01-01

91

Laparoscopic colectomy.  

PubMed Central

Fifty-one laparoscopic colectomies were attempted at two institutions. The clinical results and methods are presented. Seven cases (14%) were converted to facilitated procedures, and four cases (8%) were converted to "open." Cases of cancer, diverticulitis, endometriosis, regional enteritis, villous adenomas, and sessile polyps were operated. Right, transverse, left, low anterior, and abdominoperineal colectomies were performed. Colotomies and wedge resections were also performed. Laparoscopic suturing was required in five cases of incomplete anastomosis by circular stapler (18%). Suturing was required in all right, transverse colectomies and colotomies. Operative time averaged 2.3 hours. Hospitalization averaged 4.6 days. Four patients had complications (8%), and one 95-year-old died of pneumonia (2%). Laparoscopic colectomies can be performed safely, but require two-handed laparoscopic coordination, as well as suturing and knot-tying skills. Images FIG. 2. FIG. 3. PMID:1466626

Phillips, E H; Franklin, M; Carroll, B J; Fallas, M J; Ramos, R; Rosenthal, D

1992-01-01

92

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

93

D-light for laparoscopic fluorescence diagnosis  

NASA Astrophysics Data System (ADS)

To evaluate the role of ALA induced fluorescence diagnosis in laparoscopic surgery, we induced peritoneal carcinosis in rats by multilocular intraabdominal tumorcell implantation (CC531). The animals were photosensitized by intraabdominal ALA lavage. Laparoscopy was performed with both, conventional white and then blue light (D-Light, KARL STORZ Germany) excitation. Laparoscopy with conventional white light showed peritoneal carcinoma foci from 0.1 to 2 cm in diameter. All macroscopically visible tumors (n equals 142) were fluorescence positive after laparoscopic blue light excitation. In addition, 30 laparoscopic not visible (white light) tumors showed fluorescence and were histologically confirmed as colon carcinoma metastases. We conclude that only ALA induced laparoscopic fluorescence detection after blue light excitation is the adequate method to detect the entire extent of the intraabdominal tumor spread. Fluorescence laparoscopy is essential for laparoscopic staging of colorectal cancer because of a higher rate of cancer foci detection.

Gahlen, Johannes; Laubach, Hans-Heinrich; Stern, Josef; Pressmar, Jochen; Pietschmann, Mathias; Herfarth, Christian

1999-07-01

94

Abdominal hysterectomy for the enlarged myomatous uterus compared with vaginal hysterectomy with morcellation  

Microsoft Academic Search

ObjectiveThe purpose of this study was to compare intraoperative and postoperative complications of abdominal hysterectomy for the enlarged, myomatous uterus with vaginal hysterectomy with morcellation.

Susan M Taylor; Audrey A Romero; Dorothy N Kammerer-Doak; Clifford Qualls; Rebecca G Rogers

2003-01-01

95

Transvaginal evisceration after laparoscopic adrenalectomy in neurofibromatosis  

PubMed Central

Transvaginal evisceration is a rare complication of hysterectomy. We describe this event following adrenalectomy for pheochromocytoma in a patient affected by neurofibromatosis. This is the first case reported in the literature following laparoscopic surgery. Prompt emergency intestinal reduction and vaginal cuff repair is required to prevent ischemia of the eviscerated bowel. Pneumoperitoneum, passage of stools, or an unknown connective tissue dysplasia due to genetic abnormalities might have contributed to this unpredictable event. The general surgeon must be aware of this rare but challenging gynecological complication. PMID:20606805

Vettoretto, Nereo; Balestra, Luca; Taglietti, Lucio; Giovanetti, Maurizio

2010-01-01

96

Laparoscopic robotic total gastrectomy  

PubMed Central

Minimally invasive gastrectomy has become the standard of care in many centers in Asia but remains unpopular in Europe. The aim of this article is to present the technique of laparoscopic robot-assisted total gastrectomy. The presented case involved a 66-year-old female patient with an advanced gastric cancer on the lesser curvature of the stomach. The laparoscopic part of the procedure involved opening the lesser sac, mobilization of the greater curvature and transection of the duodenum. A robot was used for the D2 lymphadenectomy and creation of the anastomosis. In summary, we have found that during a total gastrectomy for advanced gastric cancer a successful oncological resection can be achieved using a minimally invasive approach. We have also found that by combining conventional laparoscopy with robotic assistance we could overcome the technical difficulties with regards to lymph node dissection and anastomosis.

Witkiewicz, Wojciech

2014-01-01

97

[Laparoscopic splenectomy].  

PubMed

From 1995 to 1998, 14 patients have been treated with laparoscopic splenectomy. Seven patients had immune thrombocytopenic purpura (ITP), six hereditary spherocytosis and one chronic myelomonocytic leukaemia with trombocytopenia. 12 of the patients had normal or nearly normal sized spleen. Median duration of surgery was 156 minutes and the median postoperative hospital stay four days. All operations were completed laparoscopically. Three patients had postoperative fever without any sign of infection, one developed urinary retention and one was readmitted with pneumonia. The patient with chronic myelomonocytic leukaemia died 15 days postoperatively from an intracerebral bleeding. Two patients suffer from relapse of trombocytopenia, one is treated with steroids. Laparoscopic splenectomy can be performed safely in patients with normal sized spleen with all the advantages of minimal access surgery. However, problems related to identification of accessory spleens and splenectomy in patients with splenomegali, should be further evaluated. PMID:10327847

Glomsaker, T; Faerden, A E; Reiertsen, O; Edwin, B; Rosseland, A R

1999-04-10

98

Radical Hysterectomy: A comparison of surgical approaches after adoption of robotic surgery in gynecologic oncology  

PubMed Central

Objective To compare intra-operative, postoperative and pathologic outcomes of three surgical approaches to radical hysterectomy and bilateral pelvic lymph node dissection over a three year time period during which all three approaches were used. Methods We reviewed all patients who underwent radical hysterectomy with pelvic lymph node dissection between 1/2007 and 11/2010. Comparison was made between robotic, laparoscopic and open procedures in regard to surgical times, complication rates, and pathologic findings. Results A total of 95 radical hysterectomy procedures were performed during the study period: 30 open (RAH), 31 laparoscopic (LRH) and 34 robotic (RRH). There were no differences in age, body mass index or other demographic factors between the groups. Operative time was significantly shorter in the RAH compared to LRH and RRH (265 vs 338 vs 328 min, p=0.002). Estimated blood loss was significantly lower in LRH and RRH compared with RAH (100 vs 100 vs 350 mL, p<0.001). Thirteen (24%) of RAH required blood transfusion. Conversion rates were higher in the LRH (16%) compared to RRH (3%) although not significant (p=0.10). Median length of stay was significantly shorter in RRH (1 days) vs LRH or RAH (2 vs 4 days, p<0.01). Pathologic findings were similar among all groups. Conclusion Minimally invasive surgery has made a significant impact on patients undergoing radical hysterectomy including decrease in blood loss and transfusion rates however; operative times were significantly longer compared to open radical hysterectomy. Our findings suggest that the robotic approach may have the added benefit of even shorter length of stay compared to traditional laparoscopy. PMID:21872911

Soliman, Pamela T.; Frumovitz, Michael; Sun, Charlotte C.; dos Reis, Ricardo; Schmeler, Kathleen M.; Nick, Alpa M.; Westin, Shannon N.; Brown, Jubilee; Levenback, Charles F.; Ramirez, Pedro T.

2014-01-01

99

Laparoscopic management of colorectal endometriosis  

Microsoft Academic Search

Background: In the past, intestinal endometriosis diagnosed at laparoscopy has generally required conversion to conventional surgery.\\u000a The purpose of this study was to describe the laparoscopic management of colorectal endometriosis at a tertiary referral center.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: From November 1994 to March 1998, 509 consecutive patients with endometriosis requiring laparoscopic intervention were prospectively\\u000a evaluated. Those with colorectal involvement were analyzed for

B. L. Jerby; H. Kessler; T. Falcone; J. W. Milsom

1999-01-01

100

Laparoscopic live-donor nephrectomy.  

PubMed

Laparoscopic nephrectomy with ablative intent has been performed clinically. The current study aimed to determine whether a physiologically and anatomically intact kidney suitable for transplantation could be harvested laparoscopically. Three weeks after an ablative laparoscopic right nephrectomy, 15 pigs were divided into two groups: the study group (n = 10) underwent a laparoscopic live-donor left nephrectomy of the solitary kidney and conventional autotransplantation; the control group (n = 5) underwent an open live-donor left nephrectomy of the solitary kidney and conventional autotransplantation. All study kidneys underwent laparoscopic in situ hypothermic perfusion. The mean length of the left renal artery and vein were similar in the study and control groups: 3.1 cm and 3.4 cm, respectively, in the study group compared with 2.5 cm and 3.8 cm, respectively, in the control group (P = 0.5). No intraoperative renal vascular injuries or postoperative ureteral complications were noted in either group. Renal histopathologic examination immediately after live-donor nephrectomy and at 1 month post-transplant showed similar findings in the two groups. The mean serum creatinine at 7 and 30 days postoperatively was not significantly different: 2.1 mg/dL and 1.6 mg/dL, respectively, in the study group and 1.7 mg/dL, and 1.4 mg/dL, respectively, in the control group (P = 0.4). We conclude that laparoscopic live-donor nephrectomy can be performed safely and reproducibly in the porcine model. PMID:8061673

Gill, I S; Carbone, J M; Clayman, R V; Fadden, P A; Stone, M A; Lucas, B A; McRoberts, J W

1994-04-01

101

Laparoscopic oophorectomy.  

PubMed

Laparoscopic oophorectomy is one of the most controversial and challenging areas of endoscopic surgery. Judicious preoperative evaluation along with careful patient selection can reduce the risk of operating on an unsuspected ovarian malignancy. Appropriate patient consent and planning should be obtained before the procedure, in case an ovarian neoplasia should be encountered. Although endoscopic pelvic biopsy, treatment and staging has been reported recently, the standard of care still appears to be by a laparoscopy. The removal of benign cystic teratomas of all sizes can be handled laparoscopically with the assistance of a retrieval bag or pouch. Reports of endoscopic treatment of ovarian remnant syndrome, androgen insensitivity syndrome, and even prophylactic oophorectomy are appearing in the literature. They have major benefits to patients including reduced cost, decreased hospitalization and time away from work, and with similar or lower complication rates compared with other modes of treatment. Pelviscopy or operative laparoscopy is gaining in popularity and acceptance as our experience and training improves. PMID:7578970

Russell, J B

1995-08-01

102

Hematocele After Laparoscopic Appendectomy  

PubMed Central

Background: Laparoscopic appendectomy is one of the most common laparoscopic surgeries performed. We report an unusual complication of hematocele after laparoscopic appendectomy. Case Description: A 48-y-old male presented with swelling and discomfort in his right scrotum 11 d after he underwent laparoscopic appendectomy for acute appendicitis. Before the surgery, he had no scrotal swelling or inguinal hernia. PMID:23484582

Bhullar, Jasneet Singh; Subhas, Gokulakrishna; Mittal, Vijay K.

2012-01-01

103

Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery  

PubMed Central

BACKGROUND: Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS) has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH). PATIENTS AND METHODS: From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure™ (Covidien-Valleylab. Boulder. USA), Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.). RESULTS: Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min) and the mean estimated blood loss was 57 ml (range: 25-150 ml). The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days). Pathology identified three benign and four malignant liver tumours with clear margins. CONCLUSION: SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach. PMID:24501503

Claude, Tayar; Daren, Subar; Chady, Salloum; Alexandre, Malek; Alexis, Laurent; Daniel, Azoulay

2014-01-01

104

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

105

Laparoscopic versus Open Appendectomy: Between Evidence and Common Sense  

Microsoft Academic Search

Background: Laparoscopic surgery has been proposed to have diagnostic and therapeutic advantages over conventional surgery. The purpose of this article is to present a recently completed Cochrane review on laparoscopic surgery for suspected appendicitis on the background of daily surgical practice and the developments in the last decade. Methods: Within the Cochrane review, various medical databases (Medline, Embase, Cochrane, SciSearch)

Ernst Eypasch; Stefan Sauerland; Rolf Lefering; Edmund A. M. Neugebauer

2002-01-01

106

Laparoscopic pancreaticoduodenectomy  

PubMed Central

Laparoscopic pancreaticoduodenectomy (LPD) is one of the most complex operations in general surgery. With the development and maturation of surgical technology, more and more of such surgeries have been reported each year. Five LPDs have been performed in our department in the past year. We have achieved very satisfying clinical results with very few complications. The average operation takes 6.5 hours, which is significantly shorter compared to prior operations. In addition, the average hospitalization time was significantly shortened. Here we present a case report on one of the LPDs. PMID:25568867

Zhou, Xinhua; Ying, Dongjian; Zheng, Siming

2014-01-01

107

Recurrence of endometriosis after hysterectomy  

PubMed Central

Aim: Persistent or recurrent pain after hysterectomy is one of the most frustrating clinical scenarios in benign gynaecology. We attempt to review the current evidence regarding the recurrence of pelvic pain after hysterectomy for endometriosis. The impact of ovarian conservation, type of hysterectomy and the extent of surgical excision were analysed. Methods: Peer reviewed published manuscripts in the English language in the period between 1980 and 2014 were reviewed using Pubmed and science direct regarding the incidence, causes and recurrence of endometriosis. Results: Sixty-seven articles were identified. Incomplete excision of endometriosis is the most predominant reason in the literature for the recurrence of endometriosis, and the type of Hysterectomy affects the recurrent symptoms mainly by impacting the extent of excision of the lesion. Ovarian cyst drainage is associated with the highest rate of ovarian cyst reformation within three to six months after surgery. The use of hormone replacement therapy is associated with recurrence of pelvic pain in 3.5% of cases. No studies addressed the recurrence of endometriosis after standard vs robotic assisted hysterectomy. Conclusion: A high recurrence rate of 62% is reported in advanced stages of endometriosis in which the ovaries were conserved. Ovarian conservation carries a 6 fold risk of recurrent pain and 8 folds risk of reoperation. The decision has to be weighed taking into consideration the patient’s age and the impact of early menopause on her life style. The recurrence of endometriosis symptoms and pelvic pain are directly correlated to the surgical precision and removal of peritoneal and deeply infiltrated disease. Surgical effort should always aim to eradicate the endometriotic lesions completely to keep the risk of recurrence as low as possible. PMID:25593697

Rizk, B.; Fischer, A.S.; Lotfy, H.A.; Turki, R.; Zahed, H.A.; Malik, R.; Holliday, C.P.; Glass, A.; Fishel, H.; Soliman, M.Y.; Herrera, D.

2014-01-01

108

Fertility-Preserving Management of a Uterine Arteriovenous Malformation: A Case Report of Uterine Artery Embolization (UAE) Followed by Laparoscopic Resection.  

PubMed

Herein is presented a fertility-preserving approach in the management of a uterine arteriovenous malformation (AVM) resistant to endovascular management. The patient had a documented AVM and underwent 2 uterine artery embolization procedures, with subsequent recurrence of symptoms. Doppler ultrasound demonstrated recanalization of the AVM. Ultimately, laparoscopic resection of the AVM was performed after laparoscopic ligation of the uterine arteries. Postoperatively, the patient has remained asymptomatic. Laparoscopic resection of a uterine AVM may offer a fertility-preserving alternative to hysterectomy in patients in whom endovascular management has failed. PMID:25117839

Patton, Elizabeth W; Moy, Irene; Milad, Magdy P; Vogezang, Robert

2015-01-01

109

How to increase the proportion of hysterectomies performed vaginally  

Microsoft Academic Search

Objectives: The main purpose of our study was to identify the patient characteristics of women undergoing hysterectomy and to estimate the proportion of hysterectomies that could be done vaginally by recognized surgical techniques. Study Design: The records of 500 women who underwent hysterectomy were reviewed. The characteristics of patients without an absolute contraindication to vaginal hysterectomy were analyzed. Results: Overall,

Anthony Davies; Enrico Vizza; Nikolaos Bournas; Hugh O’Connor; Adam Magos

1998-01-01

110

[Laparoscopic-assisted colectomy].  

PubMed

After gaining experience in laparoscopic cholecystectomy, laparoscopic appendectomy and other laparoscopic procedures, we decided to perform laparoscopic-assisted colectomy. During July 1992 to February 1993 we performed 14 such procedures. Ages ranged from 46-83 years (mean, 68). In all cases the indication for surgery was neoplasm of the colon. 8 of the tumors were located in the right colon and 6 in the sigmoid. Procedures performed were laparoscopic-assisted right hemicolectomy with a biofragmentable anastomotic ring or laparoscopic-assisted sigmoidectomy with end-to-end anastomosis. In 1 operation we combined laparoscopic cholecystectomy with laparoscopic right hemicolectomy. Operation time varied from 90-130 min (mean, 100 min). In our opinion the procedure is as radical as standard laparotomy with the number of lymph nodes per specimen ranging from 4-10 (mean, 7); the surgical margins were free of tumor in all cases. There was less pain in the postoperative period than with the standard procedure and the average time from operation to discharge was 7 days (range, 5-9). Complications included 1 fatality due to postoperative myocardial infarction, and 1 case of duodenal perforation which was sutured during the operation. We conclude that laparoscopic-assisted right hemicolectomy and laparoscopic sigmoidectomy are feasible for carcinoma, and that recovery is quicker and with less pain. However, we need a larger series and long-term follow-up to conclude whether the laparoscopic assisted technic is an adequate operation in cases of cancer. PMID:8144081

Walfisch, S; Twena, M; Avinoah, E; Charuzi, I

1994-01-16

111

Laparoscopic repair of recurrent lateral enterocele and rectocele.  

PubMed

It is difficult to determine what types of procedures should be attempted in patients who have recurrent prolapse. We present a case of recurrent lateral enterocele and rectocele after the patient had undergone multiple surgeries for pelvic organ prolapse (POP), including a vaginal hysterectomy, bladder-neck suspension, anterior colporrhaphy, site-specific rectocele repair, apical mesh implant, iliococcygeus vault suspension, and transobturator suburethral sling procedure. With recurrence, the patient underwent robot-assisted laparoscopic sacral colpopexy, tension-free vaginal tape transobturator sling insertion, rectocele repair, and perineorrhaphy with cystoscopy. She then presented with defecatory outlet obstruction and constipation and subsequently was treated with a stapled transanal rectal resection. The patient returned with continued defecatory dysfunction and a recurrent lateral enterocele and rectocele. The recurrence was treated laparoscopically using a lightweight polypropylene mesh. The postoperative period was uneventful. Two years later, the patient reported decreased defecatory symptoms and no further symptomatic prolapse. PMID:25224146

Solomon, Ellen R; Muffly, Tyler M; Hull, Tracy; Paraiso, Marie Fidela R

2015-01-01

112

[Urologic complications after radical hysterectomy].  

PubMed

From 1981-1984, in cases of the carcinoma of the cervix uteri, 174 radical abdominal and 29 radical vaginal hysterectomies were performed. Prior the surgery, there were 6.4% of pathologic urograms in the patients. After it, applying the Wertheim method, temporary hydronephrosis was recorded in 32.5%, lasting hydronephrosis in 9.8%, and fistulas in 2.5% of patients. Lasting complications developed also several year following the treatment. Subsequent surgery due to urologic complications included 19 patients having been treated by a combined therapy, surgery and radiation. More complications were observed after combined therapy applied in 58.6% of cases. PMID:2640270

Lukanovic, A; Rakar, S

1989-01-01

113

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

114

Laparoscopic creation of stomas  

Microsoft Academic Search

Background: Some indications for laparoscopic bowel surgery are still controversial. However, the use of laparoscopic techniques for\\u000a the treatment of benign disorders is less often challenged. Moreover, the morbidity of nonresectional procedures is less than\\u000a that encountered with resectional cases. Therefore, stoma creation seems ideally suited to laparoscopy. The aim of our study\\u000a was to assess the outcome of laparoscopic

L. Oliveira; P. Reissman; J. Nogueras; S. D. Wexner

1997-01-01

115

[Is hysterectomy nowadays an obsolete procedure?].  

PubMed

After the general morbidity reduction at the beginning of the century and the routine use of prophylactic antibiotics, a hysterectomy was generously, sometimes to generously indicated in the middle of the 20th century. This might be one of the major reasons why the procedure got a bad reputation. Furthermore, in the last decade, several new treatments for benign uterine pathologies have been developed which can be proposed to the patients instead of performing a hysterectomy. Therefore, the question might be asked, if nowadays there are still some indications for a hysterectomy or if the procedure is obsolete. PMID:25447087

Mueller, Michael D

2014-12-01

116

[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

117

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

118

Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer  

Microsoft Academic Search

Background  Laparoscopic gastrectomy is a widely accepted procedure for treating early gastric cancers. This procedure is less invasive\\u000a than conventional open approaches, and the oncologic outcomes are comparable. Single-incision laparoscopic surgery, developed\\u000a to reduce the invasiveness of traditional laparoscopy, is applied to various abdominal surgical procedures. However, its application\\u000a to laparoscopic gastrectomy for the treatment of gastric cancer has not been

Takeshi Omori; Tsukasa Oyama; Hiroki Akamatsu; Masayuki Tori; Shigeyuki Ueshima; Toshirou Nishida

2011-01-01

119

Laparoscopic intestinal stomas  

Microsoft Academic Search

PURPOSE: We report our early experiences with laparoscopic intestinal stomas, describing the indications, the surgical techniques, and the complications of this new procedure. METHODS: The medical records of the 17 patients who had successfully undergone laparoscopic intestinal diversion at The University of Texas M. D. Anderson Cancer Center were reviewed. RESULTS: The mean follow-up of this group has been 24.3

George M. Fuhrman; David M. Ota

1994-01-01

120

Single Incision Laparoscopic Myomectomy  

PubMed Central

Single port laparoscopic surgery (SPLS), also called SILS is the natural extension of multi-incisional laparoscopic surgery, in the quest for reduction of traumatic insult and residual scarring to the patient. Today with the evolution of newer instruments, bidirectional self-retaining sutures, and surgical experience we are able to perform many surgeries in gynecology. PMID:22442539

Ramesh, B; Vidyashankar, Madhuri; Bharathi, BV

2011-01-01

121

Evaluation of a novel laparoscopic camera for characterization of renal ischemia in a porcine model using digital light processing (DLP) hyperspectral imaging  

NASA Astrophysics Data System (ADS)

Digital light processing hyperspectral imaging (DLP® HSI) was adapted for use during laparoscopic surgery by coupling a conventional laparoscopic light guide with a DLP-based Agile Light source (OL 490, Optronic Laboratories, Orlando, FL), incorporating a 0° laparoscope, and a customized digital CCD camera (DVC, Austin, TX). The system was used to characterize renal ischemia in a porcine model.

Olweny, Ephrem O.; Tan, Yung K.; Faddegon, Stephen; Jackson, Neil; Wehner, Eleanor F.; Best, Sara L.; Park, Samuel K.; Thapa, Abhas; Cadeddu, Jeffrey A.; Zuzak, Karel J.

2012-03-01

122

42 CFR 441.255 - Sterilization by hysterectomy.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Sterilization by hysterectomy. 441.255 Section 441...AND LIMITS APPLICABLE TO SPECIFIC SERVICES Sterilizations § 441.255 Sterilization by hysterectomy. (a) FFP is not...

2010-10-01

123

42 CFR 50.207 - Sterilization by hysterectomy.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Sterilization by hysterectomy. 50.207...POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted...Planning Projects § 50.207 Sterilization by hysterectomy....

2010-10-01

124

Route of hysterectomy: an evidence-based approach.  

PubMed

The number of hysterectomies performed has long been a concern; now the appropriateness of the surgical method is under more careful scrutiny. What is the clinically appropriate route and method for hysterectomy in a given patient? To ensure that each patient receives the best possible care at reasonable costs, physicians must closely examine recent data comparing surgical approaches to hysterectomy. So, what is the most evidence-based approach for hysterectomy? PMID:24351441

Kovac, S Robert

2014-03-01

125

An "all 5-mm ports" selective approach to laparoscopic cholecystectomy, appendectomy, and anti-reflux surgery.  

PubMed

Laparoscopic appendectomy, cholecystectomy, or anti-reflux procedures are conventionally performed with the use of one and often two 10/12-mm ports. While needlescopic or micropuncture laparoscopic procedures reduce postoperative pain, they invariably involve the use of one 10/12-mm port and the instruments applied have their ergo-dynamic shortcomings. Between September 2002 and March 2003, we have attempted an "all 5-mm ports" approach in 49 laparoscopic procedures, which included 18 of 59 laparoscopic cholecystectomies (31%), 26 diagnostic laparoscopies for suspected appendicitis (of which we proceeded to a laparoscopic appendectomy in 17 patients), and in the last 5 of 9 laparoscopic Nissen fundoplications. Conversion of one of the 5-mm ports to a 10-mm port was required in 5 of the 18 (28%) laparoscopic cholecystectomies and in 6 of the 17 (35%) laparoscopic appendectomies to facilitate organ retrieval in patients with large gallstones (>5 mm in diameter) and in obese patients with fatty mesoappendix. There were no conversions to open surgery. No significant differences in the operating time between the laparoscopic procedures performed by the all 5-mm ports approach or the conventional approach were observed. No intraoperative or postoperative complications occurred in this series. The "all 5-mm ports" approach to laparoscopic cholecystectomy and appendectomy in selected patients and to laparoscopic fundoplication appears feasible and safe. A randomised comparison between this approach and the conventional laparoscopic approach to elective cholecystectomy and fundoplication in which two of the ports employed are of the 10-mm diameter is warranted. PMID:15471020

El-Dhuwaib, Yesar; Hamade, Ayman M; Issa, M Eyad; Balbisi, Basel M; Abid, Ghalib; Ammori, Basil J

2004-06-01

126

Hysterectomy  

MedlinePLUS

... either side of the uterus, that contain the eggs released at ovulation and that produce hormones. Uterine Prolapse: A condition in which the uterus drops down into the vagina. Uterus: A muscular organ ...

127

Hysterectomy  

MedlinePLUS Videos and Cool Tools

... for your specific condition. ©1995-2009, The Patient Education Institute, Inc. www.X-Plain.com og010104 Last ... for your specific condition. ©1995-2009, The Patient Education Institute, Inc. www.X-Plain.com og010104 Last ...

128

Hysterectomy  

MedlinePLUS

... depression, including feelings of sadness, a loss of interest in food or things you once enjoyed, or less energy, that last ... depression, including feelings of sadness, a loss of interest in food or things you once enjoyed, or less energy, that last ...

129

Hysterectomy  

MedlinePLUS

... to treat conditions that affect the uterus: • Uterine fibroids • Endometriosis • Pelvic support problems (such as uterine prolapse ) • ... egg travels from the ovary to the uterus. Fibroids: Benign (noncancerous) growths that form in the muscle ...

130

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

131

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

132

Laparoscopic Presacral Neurectomy Versus Neurotomy with the Argon Beam Coagulator  

PubMed

Presacral neurectomy is effective treatment for dysmenorrhea and midline pelvic pain. The purpose of this paper is to report the benefits of the argon beam coagulator (ABC) used laparoscopically to perform a presacral neurotomy compared with conventional techniques for presacral neurectomy. In 51 patients undergoing laparoscopic presacral neurectomy, 34 were performed using the ABC only without dissection or excision, and 17 underwent presacral neurectomy by conventional methods. Postoperative pain reduction was the same in both groups, 77% versus 73%, with average anesthesia time 64 minutes for the ABC neurotomy versus 92 minutes with conventional techniques. One major vascular complication requiring immediate laparotomy occurred in the ABC group. When properly applied laparoscopically, the ABC is an effective tool to rapidly coagulate and separate the presacral nerves with minimal smoke, excellent visualization and no retroperitoneal dissection. PMID:9073717

McTavish; Daniell; Lalonde

1994-08-01

133

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

134

Towards laparoscopic tissue aspiration.  

PubMed

The soft tissue aspiration experiment has been further developed for application during laparoscopic surgery. The new setup has been tested and validated under lab-conditions and came then to in vivo operation. It is to our knowledge the first time ever a mechanical experiment has been performed under laparoscopic conditions on the human, which enables determining corresponding constitutive model equations. As most important results, the feasibility of laparoscopic tissue aspiration has been demonstrated and, based on an ad hoc parameter for the tissue stiffness, the liver and the stomach gave significantly different responses. Furthermore, the determined constitutive behavior for one healthy human liver was in line with results obtained from tissue aspiration during open surgery. Eventually, laparoscopic tissue aspiration might qualify as minimally invasive testing method for tactile feedback systems. The presented results are preliminary and more research is required. PMID:23876854

Hollenstein, Marc; Bugnard, Guillaume; Joos, Renzo; Kropf, Saskia; Villiger, Peter; Mazza, Edoardo

2013-12-01

135

Robotic single-site combined cholecystectomy and hysterectomy: Advantages and limits  

PubMed Central

INTRODUCTION Robotic single-site surgery (RSS) represents the latest innovation for clinical use of single incision surgery. Several applications have been reported in urology, general surgery and gynecology with potential application in benign cases as well as in oncology. PRESENTATION OF CASE To further explore potential applications of RSS, we present the first case reported in the literature of combined cholecystectomy and total hysterectomy using the da Vinci Si single-port platform (Intuitive Surgical Inc., Sunnyvale, CA). DISCUSSION A critical description of the procedure with potential advantages and limitations of the current platform for combined surgical procedure is provided. CONCLUSION Robotics may facilitate the widespread diffusion of single incision surgery, overcoming current laparoscopic and LESS limitations. However, the available robotic platform still has technical features that will limit its uptake amongst surgeons and further technological development is needed for a wider diffusion of single incision surgery. PMID:25460464

Pluchino, Nicola; Buchs, Nicolas C.; Drakopoulos, Panagiotis; Wenger, Jean Marie; Morel, Philippe; Dällenbach, Patrick

2014-01-01

136

Laparoscopic Partial Nephrectomy  

Microsoft Academic Search

\\u000a Laparoscopic partial nephrectomy is an excellent management option for small, superficial renal masses. With experience, larger\\u000a and deeper tumors can be addressed as well. Intermediate-term follow-up (3- and 5-year) suggests cancer control similar to\\u000a that of open surgery. The benefit of laparoscopy over open surgery is a briefer and less intense convalescence. The disadvantage\\u000a of laparoscopic partial nephrectomy, at least

137

Laparoscopic infrared imaging.  

PubMed

A system was developed to determine the potential role of infrared imaging as a tool for localizing anatomic structures and assessing tissue viability during laparoscopic surgical procedures. A camera system sensitive to emitted energy in the midinfrared range (3-5 micron) was incorporated into a two-channel visible laparoscope. Laparoscopic cholecystectomy, dissection of the ureter, and assessment of bowel perfusion were performed in a porcine model with the aid of this infrared imaging system. Inexperienced laparoscopists were asked to localize and differentiate structures before dissection using the visible system and then using the infrared system. Assessment of bowel perfusion was also conducted using each system. Infrared imaging proved to be useful in differentiating between blood vessels and other anatomic structures. Differentiation of the cystic duct and arteries and transperitoneal localization of the ureter were successful in all instances using the infrared system when use of the visible system had failed. This system also permitted assessment of bowel perfusion during laparoscopic occlusion of mesenteric vessels. These initial studies demonstrate that infrared imaging may improve the differentiation and localization of anatomic structures and allow assessment of physiologic parameters such as perfusion not previously attainable with visible laparoscopic techniques. It may thus potentially be a powerful adjunct to laparoscopic surgery. PMID:9373300

Roberts, W W; Dinkel, T A; Schulam, P G; Bonnell, L; Kavoussi, L R

1997-12-01

138

[Nephrectomy - pro laparoscopic].  

PubMed

Laparoscopic radical nephrectomy (LRN) is considered as a standard of care for T2 renal masses and T1 tumors not treatable by nephron-sparing surgery. It can be performed transperitoneally, retroperitoneoscopic or hand-assisted. However, the morbidity after laparoscopic nephrectomy has been shown to be lower than the open procedure and patients seem to benefit from early mobilization, less pain medication, shorter hospital stays and an earlier return to normal daily activities. Furthermore, the extent of perioperative activation of the systemic stress response appears to be less during laparoscopic procedures. This has been shown to have evidently beneficial clinical impact on patient's recovery; however, its importance for the oncologic prognosis is somewhat unclear. In addition, the progression-free and overall tumor-specific survival rates for laparoscopic nephrectomy are equivalent to those for open surgery. The experiences with robot-assistance for laparoscopic nephrectomy reported so far show no significant advantages over traditional laparoscopic nephrectomy. However, the problem of high costs of acquisition and operation of robots still remains unsolved. For the future, prospective studies are needed in order to compare the functional and oncological outcomes and cost-effectiveness of different methods of radical nephrectomy. PMID:22526177

Hoda, M R; Fornara, P

2012-05-01

139

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

140

Fibroid after hysterectomy: a diagnostic dilemma.  

PubMed

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

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

2014-07-01

141

Endoluminal release of ureteral ligature after hysterectomy.  

PubMed

Iatrogenic ureteral injury is a well-recognized complication of abdominal total hysterectomy. We report a case of a 57-year-old female who underwent abdominal total hysterectomy for a uterine myoma and experienced severe right flank pain postoperatively. The imaging study displayed an obstruction of the right distal ureter. Under ureteroscopy, an extraluminal ligature was released with a holmium:yttrium-aluminum-garnet laser. The stenotic segment was immediately relieved. Two months later, the intravenous urogram illustrated patency of the distal ureter with regression of right hydronephrosis. There was no recurrent hydronephrosis during 1 year of follow-up. PMID:25241286

Wang, Chih-Jen; Lin, Victor Chia-Hsiang; Huang, Ching-Yu

2014-09-17

142

Endoscopic removal of intravesical polypropylene suture with plasmakinetic resection after abdominal hysterectomy  

PubMed Central

INTRODUCTION Intravesical foreign substances such as mesh or suture are among the rare reasons of recurrent urinary tract infections. Anti-incontinence and prolapsus procedures are associated with mesh/suture extrusion into the bladder, however, this complication is uncommon with abdominal hysterectomy. PRESENTATION OF CASE A 61-year-old female, obese patient admitted to our clinic with recurrent urinary tract infections and voiding symptoms which were worsened after abdominal hysterectomy. Radiological evaluation revealed an intravesical foreign material within the bladder. The cytoscopy was performed and a polypropylene suture which was inserted from dome, passed through the base and exited from the dome of bladder during abdominal hysterectomy. Transurethral plasmakinetic resection of superficial layer of urothelium between suture entrance and exit sites was performed and suture was removed from the bladder. DISCUSSION Urogynecological procedures are associated with the increased risk of urethral or ureteral injury, intravesical mesh or suture erosion and fistulae formation. Many different techniques including open, laparoscopic and transvaginal approaches were described for the removal of intravesical mesh/suture extrusion in the literature. Transurethral approach with its minimally invasive and safe nature was used to remove suture in this patient. This technique with the use of plasmakinetic energy has the advantage of decreased risk of bleeding and urothelial injury when compared to monopolar cautery. It also avoids the need for open or extensive surgery which may have a high rate of complications. CONCLUSION Transurethral resection is the treatment of choice for the removal of intravesical foreign substances. Use of plasmakinetic energy will decrease the risk of complications and avoid the need for open interventions. PMID:25437667

Küçükdurmaz, Faruk; Can, Selman; Barut, Osman

2014-01-01

143

Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States.  

PubMed

The healthcare sector is a driver of economic growth in the U.S., with spending on healthcare in 2012 reaching $2.8 trillion, or 17% of the U.S. gross domestic product, but it is also a significant source of emissions that adversely impact environmental and public health. The current state of the healthcare industry offers significant opportunities for environmental efficiency improvements, potentially leading to reductions in costs, resource use, and waste without compromising patient care. However, limited research exists that can provide quantitative, sustainable solutions. The operating room is the most resource-intensive area of a hospital, and surgery is therefore an important focal point to understand healthcare-related emissions. Hybrid life cycle assessment (LCA) was used to quantify environmental emissions from four different surgical approaches (abdominal, vaginal, laparoscopic, and robotic) used in the second most common major procedure for women in the U.S., the hysterectomy. Data were collected from 62 cases of hysterectomy. Life cycle assessment results show that major sources of environmental emissions include the production of disposable materials and single-use surgical devices, energy used for heating, ventilation, and air conditioning, and anesthetic gases. By scientifically evaluating emissions, the healthcare industry can strategically optimize its transition to a more sustainable system. PMID:25517602

Thiel, Cassandra L; Eckelman, Matthew; Guido, Richard; Huddleston, Matthew; Landis, Amy E; Sherman, Jodi; Shrake, Scott O; Copley-Woods, Noe; Bilec, Melissa M

2015-02-01

144

Abdominal Cavity and Laparoscopic Surgery  

NSDL National Science Digital Library

For students interested in studying biomechanical engineering, especially in the field of surgery, this lesson serves as an anatomy and physiology primer of the abdominopelvic cavity. Students are introduced to the abdominopelvic cavityâa region of the body that is the focus of laparoscopic surgeryâas well as the benefits and drawbacks of laparoscopic surgery. Understanding the abdominopelvic environment and laparoscopic surgery is critical for biomechanical engineers who design laparoscopic surgical tools.

Integrated Teaching And Learning Program

145

Sexual function after hysterectomy and myomectomy.  

PubMed

Sexual function after hysterectomy and myomectomy is a controversial topic and influenced by several factors. With regard to hysterectomy, there is not a consensus whether the removal of the cervix will modify sexual function after surgery, and patients who choose to preserve their cervix should be counseled about the possibility of continued vaginal bleeding and the need for continued pap smear surveillance after surgery. In most studies, hysterectomy has been found to improve sexual function because usually patients have symptoms that indicated the surgery, such as abnormal uterine bleeding and pelvic pain, and as these symptoms cease, they report an improvement in their sexual life. In regards to myomectomy, literature is scarce, however few studies have shown an improvement in sexual function due to the same reasons as hysterectomy. For purposes of research, it is important to standardize sexual questionnaires when performing studies about this outcome. It is also important to emphasize that during discussion of your patient, sexual outcomes should be addressed and that the surgeon should consider all patients' personal, religious, and cultural background during the decision-making process because it will minimize patient's disappointment if she develops a negative response after surgery. PMID:25433152

Brito, Luiz Gustavo Oliveira; Pouwels, Nieck Sebastiaan Alexander; Einarsson, Jon Ivar

2014-11-01

146

Complete laparoscopic resection of the rectum using natural orifice specimen extraction  

PubMed Central

AIM: To investigate how complete laparoscopic anterior resection with natural orifice specimen extraction (NOSE), as a novel minimally invasive surgery, compares to conventional laparoscopic surgery. METHODS: Twenty patients who underwent complete laparoscopic anterior resection with NOSE and 50 patients who underwent laparoscopic assisted anterior resection by the conventional method between 2011 and 2012 were studied. Selection for complete laparoscopic anterior resection with NOSE was decided on the basis of tumor size, localization of the tumor, and body mass index. Outcomes related to surgery, including operation time, postoperative wound pain, hospital stay after surgery, the number of totally dissected lymph nodes, postoperative complications (suture failure and wound infection), and anal function, were reviewed retrospectively. Anal function was assessed at 3 and 6 mo after surgery using the Wexner fecal incontinence scoring system. RESULTS: Complete laparoscopic resection with NOSE was performed to completion in all 20 patients. There was no patient emergency that required conversion to conventional laparoscopic surgery or open surgery. The comparison between complete laparoscopic resection with NOSE and conventional laparoscopic surgery showed no significant differences in the maximal diameter of the tumor, number of totally dissected lymph nodes, bleeding volume, mean operation time, time to start of oral ingestion, postoperative hospital stay, and postoperative complications. On the other hand, with regard to pain after epidural anesthesia, the total usage of analgesia in this novel surgical technique was 1.85 ± 1.8 times, whereas it was 5.89 ± 2.86 in conventional laparoscopic surgery (P < 0.001). The postoperative pain period was 1.9 ± 1.9 d in this novel surgical technique, whereas it was 3.43 ± 1.41 d in conventional laparoscopic surgery (P < 0.004). In complete laparoscopic surgery with NOSE, the mean postoperative follow-up period was 20 mo (range: 12-30 mo). Neither local recurrence nor remote metastasis was observed during the follow-up period. CONCLUSION: Complete laparoscopic anterior resection using NOSE does not require any incision and has excellent cosmetic properties, with mitigated postoperative pain. PMID:25469041

Hisada, Masayuki; Katsumata, Kenji; Ishizaki, Tetsuo; Enomoto, Masanobu; Matsudo, Takaaki; Kasuya, Kazuhiko; Tsuchida, Akihiko

2014-01-01

147

Laparoscopic surgery in weightlessness  

NASA Technical Reports Server (NTRS)

BACKGROUND: Performing a surgical procedure in weightlessness has been shown not to be any more difficult than in a 1g environment if the requirements for the restraint of the patient, operator, and surgical hardware are observed. The feasibility of performing a laparoscopic surgical procedure in weightlessness, however, has been questionable. Concerns have included the impaired visualization from the lack of gravitational retraction of the bowel and from floating debris such as blood. METHODS: In this project, laparoscopic surgery was performed on a porcine animal model in the weightlessness of parabolic flight. RESULTS: Visualization was unaffected due to the tethering of the bowel by the elastic mesentery and the strong tendency for debris and blood to adhere to the abdominal wall due to surface tension forces. CONCLUSIONS: There are advantages to performing a laparoscopic instead of an open surgical procedure in a weightless environment. These will become important as the laparoscopic support hardware is miniaturized from its present form, as laparoscopic technology becomes more advanced, and as more surgically capable crew medical officers are present in future long-duration space-exploration missions.

Campbell, M. R.; Billica, R. D.; Jennings, R.; Johnston, S. 3rd

1996-01-01

148

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

149

Laparoscopic donor nephrectomy.  

PubMed

Living donor nephrectomy has been developed and promoted as a method to address the shortfall in kidneys available for transplantation. The classical method to procure a kidney from a living donor is the open donor nephrectomy performed through a flank lumbotomy incision. However, this classical method has negative short- and long-term side effects for the donor. These disincentives are a drawback for possible donors to donate a kidney. Therefore, transplant surgeons were stimulated to develop new and less invasive techniques. In this review several new open and laparoscopic techniques are described. Compared with open donor nephrectomy, laparoscopic donor nephrectomy has shown superior results in terms of postoperative pain, cosmetics, convalescence, and return to normal daily activities. No significant differences exist between the two approaches in terms of complication rates, cost-effectiveness and graft function. Nowadays, laparoscopic donor nephrectomy has become the preferred method for procuring kidney grafts of living donors in many centres. PMID:20508268

Minnee, R C; Idu, M M

2010-05-01

150

Emergency peripartum hysterectomy: experience at a community teaching hospital  

Microsoft Academic Search

OBJECTIVES:To estimate the incidence, indications, risk factors, and complications associated with emergency peripartum hysterectomy at a community-based academic medical center.METHODS:We analyzed retrospectively 47 of 48 cases of emergency peripartum hysterectomy performed at Winthrop-University Hospital from 1991 to 1997. Emergency peripartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatment less than 24 hours after delivery. Fisher exact

Elana S Kastner; Reinaldo Figueroa; David Garry; Dev Maulik

2002-01-01

151

[Hysterectomy: indications and advantages of the vaginal route in Mali].  

PubMed

The purpose of this report was to determine the frequency of hysterectomy and describe its indications and outcomes. A retrospective, descriptive study related to active hysterectomy of was conducted at the reference health centre of commune V in Bamako, Mali from January 1st, 2004 to December 31st, 2008. All hysterectomy patients with complete medical files were included. A total of 172 files were identified including 152 that were complete. Hysterectomy accounted for 1.38% of all interventions during the study period. The procedure was carried out in emergency in 0.14% and electively in 13.39%. Mean patient age was 47.9 +/- 11.7 years; 89 patients were older than 45 years. The indications for hysterectomy were complicated uterine fibroids in 82 patients, genital prolapse in 44, adenomyosis in 10, obstetrical hysterectomy in 13 and cervical dysplasia in 3. The abdominal route was used in 100 patients (65.8%) and the vaginal rout in 52 (34.2%). The duration of the procedure and hospital stay was longer after hysterectomy by the abdominal (p<0.05). Perioperative complications were observed in 17% of patients after abdominal hysterectomy versus 7.69% after vaginal hysterectomy. Two maternal deaths due to hemorrhagic shock were observed after obstetrical hysterectomy. Hysterectomy is a frequent intervention that is not without complication risks. Choice of route depends on the indication and skill of the operator. Although endoscopic surgery is still difficult to perform in developing countries, development of vaginal hysterectomy is necessary to reduce perioperative complications. PMID:22393643

Traoré, M; Togo, A; Traoré, Y; Dembélé, B T; Diakité, I; Traoré, S O; Traoré, O M; Coulibaly, A; Keita, S I; Diabaté, A

2011-12-01

152

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

PubMed

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

153

Laparoscopic Reoperation for Early Complications of Laparoscopic Gastric Bypass  

Microsoft Academic Search

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a popular operation for morbid obesity.Early complications can\\u000a be treated successfully with a laparoscopic approach.We reviewed our experience with laparoscopic re-exploration in the early\\u000a postoperative period. Methods: The initial 85 patients who underwent LRYGBP by two surgeons at a training hospital were reviewed.\\u000a All patients who required re-exploration within the first 60 days

Pavlos K. Papasavas; Michael S. O'Mara; Robert F. Quinlin; Julie Maurer; Philip F. Caushaj; Daniel J. Gagné

2002-01-01

154

Multiresolution foveated laparoscope with high resolvability.  

PubMed

A key limitation of the state-of-the-art laparoscopes for minimally invasive surgery is the tradeoff between the field of view and spatial resolution in a single-view camera system. As such, surgical procedures are usually performed at a zoomed-in view, which limits the surgeon's ability to see much outside the immediate focus of interest and causes a situational awareness challenge. We proposed a multiresolution foveated laparoscope (MRFL) aiming to address this limitation. The MRFL is able to simultaneously capture wide-angle overview and high-resolution images in real time; it can scan and engage the high-resolution images to any subregion of the entire surgical field in analogy to the fovea of human eye. The MRFL is able to render equivalently 10 million pixel resolution with a low data bandwidth requirement. The system has a large working distance (WD) from 80 to 180 mm. The spatial resolvability is about 45 ?m in the object space at an 80 mm WD, while the resolvability of a conventional laparoscope is about 250 ?m at a typically 50 mm surgical distance. PMID:23811873

Qin, Yi; Hua, Hong; Nguyen, Mike

2013-07-01

155

Laparoscopic Splenectomy for Malignant Diseases  

Microsoft Academic Search

\\u000a Since Delaitre and Maignien [1] reported the first laparoscopic splenectomy in 1991, the utility of laparoscopic splenectomy\\u000a in the treatment of hematologic diseases such as hereditary spherocytosis, immune thrombocytopenic purpura, and autoimmune\\u000a hemolytic anemia has been well established. Thousands of cases in the surgical literature have documented laparoscopic splenectomy\\u000a as safe and effective in the management of these benign hematologic

R. Matthew Walsh; B. Todd Heniford

156

A ‘critical view’ on a classical pitfall in laparoscopic cholecystectomy!  

PubMed Central

INTRODUCTION Laparoscopic cholecystectomy is the most common laparoscopic surgery performed by general surgeons. Although being a routine procedure, classical pitfalls shall be regarded, as misperception of intraoperative anatomy is one of the leading causes of bile duct injuries. The “critical view of safety” in laparoscopic cholecystectomy serves the unequivocal identification of the cystic duct before transection. The aim of this manuscript is to discuss classical pitfalls and bile duct injury avoiding strategies in laparoscopic cholecystectomy, by presenting an interesting case report. PRESENTATION OF CASE A 71-year-old patient, who previously suffered from a biliary pancreatitis underwent laparoscopic cholecystectomy after ERCP with stone extraction. The intraoperative situs showed a shrunken gallbladder. After placement of four trocars, the gall bladder was grasped in the usual way at the fundus and pulled in the right upper abdomen. Following the dissection of the triangle of Calot, a “critical view of safety” was established. As dissection continued, it however soon became clear that instead of the cystic duct, the common bile duct had been dissected. In order to create an overview, the gallbladder was thereafter mobilized fundus first and further preparation resumed carefully to expose the cystic duct and the common bile duct. Consecutively the operation could be completed in the usual way. DISCUSSION Despite permanent increase in learning curves and new approaches in laparoscopic techniques, bile duct injuries still remain twice as frequent as in the conventional open approach. In the case presented, transection of the common bile duct was prevented through critical examination of the present anatomy. The “critical view of safety” certainly offers not a full protection to avoid biliary lesions, but may lead to a significant risk minimization when consistently implemented. CONCLUSION A sufficient mobilization of the gallbladder from its bed is essential in performing a critical view in laparoscopic cholecystectomy. PMID:25437680

Dziodzio, Tomasz; Weiss, Sascha; Sucher, Robert; Pratschke, Johann; Biebl, Matthias

2014-01-01

157

The Investigation of Laparoscopic Instrument Movement Control and Learning Effect  

PubMed Central

Laparoscopic surgery avoids large incisions for intra-abdominal operations as required in conventional open surgery. Whereas the patient benefits from laparoscopic techniques, the surgeon encounters new difficulties that were not present during open surgery procedures. However, limited literature has been published in the essential movement characteristics such as magnification, amplitude, and angle. For this reason, the present study aims to investigate the essential movement characteristics of instrument manipulation via Fitts' task and to develop an instrument movement time predicting model. Ten right-handed subjects made discrete Fitts' pointing tasks using a laparoscopic trainer. The experimental results showed that there were significant differences between the three factors in movement time and in throughput. However, no significant differences were observed in the improvement rate for movement time and throughput between these three factors. As expected, the movement time was rather variable and affected markedly by direction to target. The conventional Fitts' law model was extended by incorporating a directional parameter into the model. The extended model was shown to better fit the data than the conventional model. These findings pointed to a design direction for the laparoscopic surgery training program, and the predictive model can be used to establish standards in the training procedure. PMID:23984348

Lin, Chiuhsiang Joe

2013-01-01

158

Study on an infrared endoscope for energized laparoscopic method  

NASA Astrophysics Data System (ADS)

An infrared endoscopic system has been developed to investigate thermal spread and collateral damage during energized laparoscopic surgery, the system consists of an infrared endoscope and a thermal camera (3-5 ?m) with combined thermal sensitivity of 0.05°C. The system performance was evaluated in live animals with electrosurgical devices to monitor intraoperative thermal changes. During activation periods, the peak temperature of the jaws averaged 100.5 ± 5.8 ° with a thermal spread of 3.0 ± 0.9 mm. For laparoscopic dissections of the esophagus-gastric junction with the 10 mm Atlas, the maximum jaw temperature was 105.2 ± 2.1 ° with a bigger thermal spread of 11.5 ± 7.2 mm). The study has confirmed that infrared endoscopy is a very useful tool adjunct to conventional endoscopy, which may improve the safety of energized laparoscopic dissections.

Chen, Minghui; Song, Chengli

2014-11-01

159

Laparoscopic closure of perforated gastro-duodenal ulcer: 15 years’ experience in our centre  

PubMed Central

Introduction The objective of the study is to share the results and development findings on the laparoscopic closure technique applied in our centre during a 15-year period (1998–2012). Aim To compare statistically the standard parameters (hospitalization, duration of operation) versus conventional surgery, and at the same time we compared mainly morbidity and mortality. Material and methods During the period under review we operated on a total of 259 patients, 115 (44.4%) of them laparoscopically, and 144 (55.6%) of them conventionally. The sample was divided into two groups: patients with ASA physical status classification system 1–3, and patients with ASA 4–5. Results The results favour laparoscopy within the group with ASA 1–3 in terms of several parameters, namely: duration of hospitalization – 7.7 days in the case of laparoscopic intervention, vs. 10.6 days for conventional surgery (p < 0.05); and duration of operation – 61 min vs. 85.1 min respectively (p < 0.05). Total morbidity was 27.5% in the case of patients with conventional surgery, vs. 10.9% with laparoscopic intervention (p < 0.05). The sample of patients with ASA 4–5 suffered a high mortality of 82.7%. Conclusions Laparoscopic closure of perforated ulcer is a safe therapeutic method, as confirmed by the results of many other studies around the world, which in many aspects favour the laparoscopic technique.

Vá?a, Juraj; Babiš, Boris

2014-01-01

160

Prospective Trial of Aggressive Postoperative Bowel Stimulation Following Radical Hysterectomy  

Microsoft Academic Search

Introduction. Postoperative traditional feeding protocols are not based on scientific studies, but rather on anecdotal evidence. We present the first prospective trial of aggressive postoperative bowel stimulation following radical hysterectomy in an attempt to determine its effect on the length of hospital stay.Methods. Twenty consecutive patients undergoing radical hysterectomy were entered onto a prospective trial of aggressive postoperative bowel stimulation,

James Fanning; Sandia Yu-Brekke

1999-01-01

161

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

162

Single port laparoscopic right hemicolectomy for ileocolic intussusception  

PubMed Central

A 36-year-old male was admitted with right lower abdominal pain and diarrhea for more than 3 mo. Colonoscopy and a barium enema study revealed a submucosal tumor over the cecum, but computed tomography showed an ileal lipoma. There was no definitive diagnosis preoperatively, but ileocolic intussusception was noted during surgery. Single port laparoscopic radical right hemicolectomy was performed because intra-operative reduction failed. The histological diagnosis of the resected tumor was lipoma. Single port laparoscopic surgery has recently been proven to be safe and feasible. There are advantages compared with conventional laparoscopic surgery, such as smaller incision wounds, fewer port site complications, and easier conversion. However, there are some drawbacks which need to be overcome, such as difficulties in triangulation and instrument clashing. If there are no contraindications to laparoscopy, single port laparoscopic surgery can be performed safely and should be considered for diagnosis and treatment of intussusception in adults. Here, we report the first case of ileocolic intussusception successfully treated by single port laparoscopic surgery. PMID:23538552

Chen, Jia-Hui; Wu, Jhe-Syun

2013-01-01

163

Laparoscopic Adjustable Gastric Banding  

Microsoft Academic Search

. We introduced open adjustable silicone gastric banding (ASGB) for treatment of morbid obesity in our institution\\u000a in 1991. It was done in a prospective study comparing ASGB with vertical banded gastroplasty (VBG) with regard to weight loss.\\u000a After 200 cases of open ASGB and 210 VBG procedures and the encouraging weight loss results, we started laparoscopic placement\\u000a of the

Mitiku Belachew; Marc Legrand; Vernon Vincent; Michel Lismonde; Nicole Le Docte; Veronique Deschamps

1998-01-01

164

Laparoscopic specimen retrieval bags.  

PubMed

Specimen retrieval bags have long been used in laparoscopic gynecologic surgery for contained removal of adnexal cysts and masses. More recently, the concerns regarding spread of malignant cells during mechanical morcellation of myoma have led to an additional use of specimen retrieval bags for contained "in-bag" morcellation. This review will discuss the indications for use retrieval bags in gynecologic endoscopy, and describe the different specimen bags available to date. PMID:25368466

Smorgick, Noam

2014-10-01

165

Systemic Inflammatory Response after Laparoscopic and Open Application of Adjustable Banding for Morbidly Obese Patients  

Microsoft Academic Search

Background: Surgical injury induces a systemic inflammatory metabolic-endocrine response that is proportional to the severity\\u000a of the surgical stress. Compared with the conventional open method, laparoscopic surgery is mini-invasive and has decreased\\u000a postoperative pain and length of hospitalization. The aim of this study was to investigate the systemic inflammatory response,\\u000a after laparoscopic and open stoma-adjustable silicone band application, which is

Kagan Zengin; Mustafa Taskin; Nevin Sakoglu; Ziya Salihoglu; Sener Demiroluk; Hafize Uzun

2002-01-01

166

Adequacy of laparoscopic oophorectomy.  

PubMed

Ovarian remnant syndrome occurs infrequently after oophorectomy, yet when present it can contribute greatly to pelvic discomfort. The syndrome may be difficult to diagnose, identify surgically, and treat without intraoperative or postoperative complications developing. Recently, laparoscopic oophorectomy has been performed with increasing frequency. We assessed the outcome after laparoscopic removal of both ovaries or the sole remaining ovary in 27 premenopausal women. No intraoperative or postoperative complications were identified, and no patients have experienced symptoms consistent with ovarian remnant syndrome. All women had a marked rise in serum follicle-stimulating hormone (FSH) levels (81 to 72+/-5 mIU/ml), and luteinizing hormone (LH) levels (8+/-1 to 37+/-3 mIU/ml) after oophorectomy, and all but one had FSH levels 40 mIU/ml or above. Thirteen women had gonadotropin levels measured after 4 weeks of hormone replacement therapy; all had reductions in FSH levels, but 10 had elevations of their LH levels. These findings indicate that ovarian remnant syndrome occurs infrequently after laparoscopic oophorectomy. In addition, the data suggest a different, nonovarian regulation of gonadotropin secretion. PMID:9050455

Johns, D A; Diamond, M P

1993-11-01

167

Laparoscopic inguinal hernia repair.  

PubMed

Between March 1991 and May 1994, 444 laparoscopic inguinal hernia repairs were undertaken in 375 patients: 386 transperitoneal and 58 extraperitoneal. During a follow-up period of 20.5 months (range 1-38) there have been three recurrences at 6, 7 and 12 months, all direct and all after transperitoneal repair. A total of 52 patients were treated as a day case (< 6 h), 317 patients spent less than 24 h in hospital and four patients were discharged on the second postoperative day. Operating time for transperitoneal hernia repair was 27 min (range 10-68) and extraperitoneal repair, 29 min (range 11-48). Short-term complications occurred in 18 patients: six haematomas, four seromas, one urinary retention and seven suffered persistent groin pain. Six patients have had neuralgia, three have had mesh removed and three further patients had individual clips removed from within the inguinal canal. There have been two adhesive small bowel obstructions. The first occurred 2 months after laparoscopic surgery and required laparotomy; the second occurred 2 years after surgery and had laparoscopic division of an adhesive band to a pelvic staple. There was one infected lymphocoele treated percutaneously. PMID:7741670

Fielding, G A

1995-05-01

168

Comparison between single and three portal laparoscopic splenectomy in dogs  

PubMed Central

Background Single incision laparoscopic surgery (SILS) is a newly growing technique to replace a more invasive conventional multiple portal laparoscopic surgery. The objective of this study was to compare single (SILS) with three portal (Conventional) laparoscopic splenectomy in dogs. Mongrel dogs (n?=?18), weighting 15?±?3?kg, were selected for this study (n?=?12 SILS; n?=?6 conventional). The area from xiphoid to pubis was prepared under aseptic conditions in dorsal recumbency with the head down and tilted 30 degree in the right lateral position. Pneumoperitoneum was established by CO2 using an automatic high flow pressure until achieving 12?mm Hg. Instrumentation used consisted of curved flexible-tip 5?mm Maryland forceps and ultracision harmonic scalpel for sealing and cutting of the vessels and splenic attachments. Results All dogs recovered uneventfully. The splenectomy procedure using SILS and conventional methods were significantly different in the respective operative time (29.1?±?1.65 vs. 42.0?+?2.69?min) and the length of the surgical scar (51.6?±?1.34?mm vs. 72.0?±?1.63?mm; P?Conventional) for splenectomy in dog. PMID:22963734

2012-01-01

169

Laparoscopically guided bilateral pelvic lymphadenectomy  

NASA Astrophysics Data System (ADS)

Pelvic node dissection has gained widespread acceptance as the final staging procedure in patients with normal acid phospatase and bone scan free of metastatic disease prior to definitive therapy for cure. However, the procedure has had a high morbidity (20-34%) and a major economic impact on the patient due to lengthy hospitalization and recuperative time. The development of laparoscopic biopsy techniques suggests that the need for open surgical lymphadenectomy may be reduced by a laparoscopically performed lymphadenectomy. The goal of this report is to investigate the possibility of laparoscopic pelvic lymphadenectomy in an animal model. Our interest in laparoscopy is based on the ability of this technique to permit tissue removal without the need for major incisions. In laparoscopic cholecystectomy and laparoscopic appendectomy, the surgical procedure is essentially unaltered. The diseased organ is removed and there is no need for a large abdominal incision.

Gershman, Alex; Danoff, Dudley; Chandra, Mudjianto; Grundfest, Warren S.

1991-07-01

170

Visual enhancement of laparoscopic nephrectomies using the 3-CCD camera  

NASA Astrophysics Data System (ADS)

Many surgical techniques are currently shifting from the more conventional, open approach towards minimally invasive laparoscopic procedures. Laparoscopy results in smaller incisions, potentially leading to less postoperative pain and more rapid recoveries . One key disadvantage of laparoscopic surgery is the loss of three-dimensional assessment of organs and tissue perfusion. Advances in laparoscopic technology include high-definition monitors for improved visualization and upgraded single charge coupled device (CCD) detectors to 3-CCD cameras, to provide a larger, more sensitive color palette to increase the perception of detail. In this discussion, we further advance existing laparoscopic technology to create greater enhancement of images obtained during radical and partial nephrectomies in which the assessment of tissue perfusion is crucial but limited with current 3-CCD cameras. By separating the signals received by each CCD in the 3-CCD camera and by introducing a straight forward algorithm, rapid differentiation of renal vessels and perfusion is accomplished and could be performed real time. The newly acquired images are overlaid onto conventional images for reference and comparison. This affords the surgeon the ability to accurately detect changes in tissue oxygenation despite inherent limitations of the visible light image. Such additional capability should impact procedures in which visual assessment of organ vitality is critical.

Crane, Nicole J.; Kansal, Neil S.; Dhanani, Nadeem; Alemozaffar, Mehrdad; Kirk, Allan D.; Pinto, Peter A.; Elster, Eric A.; Huffman, Scott W.; Levin, Ira W.

2006-02-01

171

Trends in laparoscopic and robotic surgery among gynecologic oncologists: A survey update  

PubMed Central

Objectives To assess the use of traditional and robotic assisted laparoscopy by Society of Gynecologic Oncology (SGO) members and to compare the results with those of our published survey in 2004. Methods Surveys were mailed to SGO members, and anonymous responses were collected by mail or through a web site. Data were analyzed and compared with those of our previous survey. In addition, we gathered information on the effect of robotic assisted surgery on the management of gynecologic malignancies. Results Three hundred eighty-eight (46%) of 850 SGO members responded to the survey. Three hundred fifty-two (91%) indicated that they performed laparoscopic surgery in their practice (compared with 84% in the 2004 survey). The three most common laparoscopic procedures were laparoscopic hysterectomy and staging for uterine cancer (43%), diagnostic laparoscopy for adnexal masses (39%), and prophylactic bilateral oophorectomy for high-risk women (11%). Although 76% of respondents had received either limited or no laparoscopic training during their fellowship, 78% now believe that maximum or much emphasis should be placed on laparoscopic training (55% in the 2004 survey). Twenty-four percent of respondents indicated that they performed robotic assisted surgery, with 66% indicating that they planned to increase their use of the procedure in the next year. Conclusions We found an overall increase in the use of and perceived indications for minimally invasive surgery in gynecologic oncology among SGO members. Endometrial cancer staging has become an accepted indication for laparoscopy. In addition, most respondents were planning on increasing their use of robotic assisted surgery in the next year. PMID:19138793

Mabrouk, Mohamed; Frumovitz, Michael; Greer, Marilyn; Sharma, Sheena; Schmeler, Kathleen M.; Soliman, Pamela T.; Ramirez, Pedro T.

2014-01-01

172

Shared decision making and informed consent for hysterectomy.  

PubMed

This article provides an overview of the components of the informed consent process for surgery including the components specific to hysterectomy. Shared decision making and informed consent for hysterectomy rely on a mutual understanding by the patient and surgeon of the goals, risks, benefits, and alternatives as well as the choice of hysterectomy technique. The importance of a patient-centered approach is emphasized with an explanation of several communication methods and resources for decision aids that will help to ensure that patients have a good understanding of the items listed above and are able to provide informed consent. PMID:24145363

Ogburn, Tony

2014-03-01

173

Ruptured Spleen Following Laparoscopic Cholecystectomy  

PubMed Central

Background: Laparoscopic cholecystectomy is generally a safe and well-accepted procedure. However, in a small percentage of patients, it is associated with complications, such as bleeding and injury to the bile duct and other viscera. Splenic injury as a result of laparoscopic surgery has been reported only in the context of direct trauma, for example due to retraction in hand-assisted urologic surgery. To date, there have been no reported cases of patients requiring splenectomy following laparoscopic cholecystectomy. We report an unusual case of ruptured spleen presenting less than 28 days following “uncomplicated” laparoscopic cholecystectomy. Results: A 52-year-old female presented to our Accident and Emergency department 3 weeks following “uncomplicated” laparoscopic cholecystectomy, complaining of severe left upper quadrant pain radiating to the left shoulder tip. Clinical examination revealed a patient in hypovolemic shock, with localized left upper quadrant peritonism. Abdominal computed tomography supported a diagnosis of splenic rupture, and the patient required an emergency splenectomy. Discussion: Splenic injury rarely complicates laparoscopic cholecystectomy. We postulate that either congenital or posttraumatic adhesions of the parietal peritoneum to the spleen may have caused the capsule to tear away from the spleen when the pneumoperitoneum was established, resulting in subcapsular hematoma and subsequent rupture in this patient. Videoscopic assessment of the spleen at the end of laparoscopic cholecystectomy might be a worthwhile exercise to aid early recognition and management in such cases. PMID:17651581

Leff, Daniel; Nortley, Mei; Melly, Lucy

2007-01-01

174

Laparoscopic partial splenectomy  

Microsoft Academic Search

Background  The immunologic function of the spleen and its important role in immune defense has led to splenic-preserving surgery. This\\u000a study aimed to evaluate whether laparoscopic partial splenectomy is safe.\\u000a \\u000a \\u000a \\u000a Methods  Data on consecutive patients presenting with localized benign or malignant disease of the spleen were included in a prospective\\u000a database. The surgical technique consisted of six steps: patient positioning and trocar

S. Uranues; D. Grossman; L. Ludwig; R. Bergamaschi

2007-01-01

175

Stereoscopic visualization of laparoscope image using depth information from 3D model.  

PubMed

Laparoscopic surgery is indispensable from the current surgical procedures. It uses an endoscope system of camera and light source, and surgical instruments which pass through the small incisions on the abdomen of the patients undergoing laparoscopic surgery. Conventional laparoscope (endoscope) systems produce 2D colored video images which do not provide surgeons an actual depth perception of the scene. In this work, the problem was formulated as synthesizing a stereo image of the monocular (conventional) laparoscope image by incorporating into them the depth information from a 3D CT model. Various algorithms of the computer vision including the algorithms for the feature detection, matching and tracking in the video frames, and for the reconstruction of 3D shape from shading in the 2D laparoscope image were combined for making the system. The current method was applied to the laparoscope video at the rate of up to 5 frames per second to visualize its stereo video. A correlation was investigated between the depth maps calculated with our method with those from the shape from shading algorithm. The correlation coefficients between the depth maps were within the range of 0.70-0.95 (P<0.05). A t-test was used for the statistical analysis. PMID:24444752

Kumar, Atul; Wang, Yen-Yu; Wu, Ching-Jen; Liu, Kai-Che; Wu, Hurng-Sheng

2014-03-01

176

Exposure of surgeons to extremely low-frequency magnetic fields during laparoscopic and robotic surgeries.  

PubMed

The development of new medical electronic devices and equipment has increased the use of electrical apparatuses in surgery. Many studies have reported the association of long-term exposure to extremely low-frequency magnetic fields (ELF-MFs) with diseases or cancer. Robotic surgery has emerged as an alternative tool to overcome the disadvantages of conventional laparoscopic surgery. However, there has been no report regarding how much ELF-MF surgeons are exposed to during laparoscopic and robotic surgeries. In this observational study, we aimed to measure and compare the ELF-MFs that surgeons are exposed to during laparoscopic and robotic surgery.The intensities of the ELF-MFs surgeons are exposed to were measured every 4 seconds for 20 cases of laparoscopic surgery and 20 cases of robotic surgery using portable ELF-MF measuring devices with logging capability.The mean ELF-MF exposures were 0.6?±?0.1?mG for laparoscopic surgeries and 0.3?±?0.0?mG for robotic surgeries (significantly lower with P?conventional laparoscopic surgery were lower than 2?mG, which is the most stringent level considered safe in many studies. However, we should not overlook the effects of long-term ELF-MF exposure during many surgeries in the course of a surgeon's career. PMID:25674758

Park, Jee Soo; Chung, Jai Won; Kim, Nam Kyu; Cho, Min Soo; Kang, Chang Moo; Choi, Soo Beom; Kim, Deok Won

2015-02-01

177

Ruptured ectopic pregnancy presenting 3 years after supracervical hysterectomy.  

PubMed

An ectopic pregnancy after a hysterectomy is a rare event, with about 40 reported cases since it was first identified by Wendeler in 1895. There are even fewer cases reported of an ectopic pregnancy occurring years after a hysterectomy has been performed. This case illustrates the sonographic and computed tomographic (CT) findings in the setting of abdominal pain in a woman of childbearing age and highlights the need to obtain a urine pregnancy test as part of the workup for abdominal pain in women, even if a history of a hysterectomy has been given. Many providers may automatically exclude an ectopic pregnancy as a possibility in the aforementioned clinical scenario if the patient has a history of a hysterectomy. Such automatic exclusion may result in life-threatening consequences. PMID:18577674

Babikian, Sarkis; Thoma, David C; Berkey, Bryan D

2008-07-01

178

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

179

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

PubMed

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

2014-11-01

180

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. PMID:25210690

Lee, Taek-Gu

2014-01-01

181

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

182

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

183

Laparoscopic versus open stoma creation for fecal diversion  

Microsoft Academic Search

:   This study compared the results for laparoscopic and conventional laparotomy techniques of intestinal stoma creation. All\\u000a patients who underwent only fecal diversion without any other abdominal procedures were included. Neither prior laparotomy,\\u000a inflammatory bowel diseases, nor recurrent or metastatic carcinoma were absolut contraindications. Parameters evaluated included\\u000a age, indications, previous abdominal surgery, operative time, time until stoma function, and the

A. J. Iroatulam; F. M. Potenti; L. Oliveira; A. J. Pikarsky; S. D. Wexner

2000-01-01

184

Sentinel node detection in a patient with recurrent endometrial cancer initially treated by hysterectomy and radiotherapy.  

PubMed

This is the first article reporting sentinel node identification in a patient with endometrial cancer recurring in the vagina. A 79-year-old woman presented with a midvaginal recurrence of a stage IB, grade II endometroid carcinoma that had been treated 3 years earlier by a total abdominal hysterectomy, bilateral salpingoophorectomy, and pelvic lymph node sampling, followed by adjuvant brachytherapy to the vaginal vault. A staging examination under anesthetic was performed. Preoperatively, 60-MBq technetium-labeled nannocolloid was injected in the mucosa at 3, 6, 9, and 12 o'clock just adjacent to the tumor recurrence. Three sentinel nodes were detected, respectively, in the left obturator fossa (two) and the right external iliac region, using a laparoscopic probe (Navigator) and removed for pathological assessment. As they proved to be negative, the patient underwent a total vaginectomy, parametrectomy with pelvic lymphadenectomy. The tumor was completely removed, and all lymph nodes proved to be negative. The accuracy of sentinel node identification in patients with recurrent gynecological tumors needs further evaluation. This unique case shows that sentinel node detection is possible after previous radiotherapy and surgery and hopes to stimulate further research in this field. PMID:15304164

Van Dam, P; Sonnemans, H; Van Dam, P-J; Smet, D; Verkinderen, L; Dirix, L Y

2004-01-01

185

Laparoscopic resection of presacral schwannomas.  

PubMed

Presacral tumors are particularly rare in the adult. Schwannomas are neurogenic neoplasms, rarely occurring in the retroperitoneum and the pelvis. Presented herein are the cases of 2 female patients with chronic pelvic pain who were discovered to have presacral schwannomas and were managed laparoscopically. Laparoscopy is a safe and efficient option in approaching benign pelvic tumors and might offer the advantage of better visualization of structures due to the magnification of laparoscopic view, especially in narrow anatomic spaces. PMID:16215494

Konstantinidis, Konstantinos; Theodoropoulos, George E; Sambalis, George; Georgiou, Michael; Vorias, Michael; Anastassakou, Kornelia; Mpontozoglou, Nikolaos

2005-09-01

186

Laparoscopic Surgery for Ulcerative Colitis  

PubMed Central

Laparoscopic techniques have become increasingly used in the treatment of ulcerative colitis: in experienced hands, they are safe and feasible. Recovery advantages have not been consistently demonstrated and functional results have been comparable to open surgery. Other possible benefits and costs issues have also been inconsistent. Further investigation on the role of laparoscopic surgery for ulcerative colitis with larger populations and longer follow-up with a focus on recovery parameters, quality of life, and costs are needed. PMID:22131895

Stocchi, Luca

2010-01-01

187

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

188

The morcellator knife: a new laparoscopic instrument for supracervical hysterectomy and morcellation  

Microsoft Academic Search

Background: Cutting the cervix, morcellation, and extraction of the uterus and myomata remain major problems in endoscopic surgery. We developed an efficient, safe, reusable, and inexpensive instrument to cut the cervix and morcellate the uterus and myomata: the morcellator knife.Instrument: The morcellator knife is a classic lancet with an interchangeable blade, transformed into an endoscopic instrument that can be inserted

P De Grandi; E Chardonnens; S Gerber

2000-01-01

189

Techniques in laparoscopic donor nephrectomy.  

PubMed

What's known on the subject? and What does the study add? Innovations in laparoscopic surgery have provided transplant surgeons with a range of techniques as well as a vast array of minimally invasive instruments. Whilst randomized control trials have compared open and laparoscopic donor nephrectomy, there is a paucity of high quality data comparing different laparoscopic approaches. This article summarizes the main techniques of laparoscopic donor nephrectomy currently in use and reviews the evidence available for each. In addition, controversial aspects of donor nephrectomy are examined, including the technological advances applicable to this operation. Increasing numbers of living donor kidney transplants are being performed worldwide, and the majority of donor operations are now laparoscopic. Transperitoneal 'pure' and hand-assisted laparoscopic donor nephrectomy are the two most commonly performed procedures, although retroperitoneal approaches are advocated by some centres. Controversy persists with respect to the technical aspects of donor nephrectomy, including both the approach and the method of ligation of the hilar vessels. More recently, robot-assisted, laparo-endoscopic single site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) -assisted donor nephrectomy have also been performed, further increasing the number of options available, but creating uncertainty as to the ideal approach. PMID:22489654

Banga, Neal; Nicol, David

2012-11-01

190

Laparoscopic Renal Cryosurgery: The Northwestern Experience  

Microsoft Academic Search

PurposeLaparoscopic renal cryosurgery provides a minimally invasive alternative for the treatment of small renal lesions of undefined malignant potential. We report on our series of patients treated with laparoscopic renal cryosurgery.

ROBERT B. NADLER; SAMUEL C. KIM; JONATHAN N. RUBENSTEIN; RONALD L. YAP; STEVEN C. CAMPBELL

2003-01-01

191

Development of a laparoscope with multi-resolution foveation capability for minimally invasive surgery  

NASA Astrophysics Data System (ADS)

Laparoscope is the essential tool for minimally invasive surgery (MIS) within the abdominal cavity. However, the focal length of a conventional laparoscope is fixed. Therefore, it suffers from the tradeoff between field of view (FOV) and spatial resolution. In order to obtain large optical magnification to see more details, a conventional laparoscope is usually designed with a small working distance, typically less than 50mm. Such a small working distance limits the field of coverage, which causes the situational awareness challenge during the laparoscopic surgery. We developed a multi-resolution foveated laparoscope (MRFL) aiming to address this limitation. The MRFL was designed to support a large working distance range from 80mm to 180mm. It is able to simultaneously provide both wide-angle overview and high-resolution image of the surgical field in real time within a fully integrated system. The high-resolution imaging probe can automatically scan and engage to any subfield of the wide-angle view. During the surgery, MRFL does not need to move; therefore it can reduce the instruments conflicts. The FOV of the wide-angle imaging probe is 80° and that of the high-resolution imaging probe is 26.6°. The maximum resolution is about 45um in the object space at an 80mm working distance, which is about 5 times as good as a conventional laparoscope at a 50mm working distance. The prototype can realize an equivalent 10 million-pixel resolution by using only two HD cameras because of its foveation capability. It saves the bandwidth and improves the frame rate compared to the use of a super resolution camera. It has great potential to aid safety and accuracy of the laparoscopic surgery.

Qin, Yi; Hua, Hong; Nguyen, Mike

2013-03-01

192

Laparoscopic port closure.  

PubMed

Formation of a post-operative trocar site hernia (TSH) is a serious complication of laparoscopic surgery with an incidence of 1.5%-1.8%, and may necessitate emergent surgical correction in the case of bowel strangulation. Many contributing factors increase the risk of this complication, and various surgical devices have been developed to help prevent post-operative TSH formation. Bladeless trocars with radially expanding technology have been shown to decrease the incidence of post-operative TSH. Various port site closure devices are also available on the market, which assist in closing the fascia, thus decreasing the risk of this complication. In this article, we will review the use of these devices and their potential to reduce post-operative TSH formation. PMID:24700212

Mikhail, Emad; Hart, Stuart

2014-03-01

193

Laparoscopic partial splenic resection.  

PubMed

Twenty domestic pigs with an average weight of 30 kg were subjected to laparoscopic partial splenic resection with the aim of determining the feasibility, reliability, and safety of this procedure. Unlike the human spleen, the pig spleen is perpendicular to the body's long axis, and it is long and slender. The parenchyma was severed through the middle third, where the organ is thickest. An 18-mm trocar with a 60-mm Endopath linear cutter was used for the resection. The tissue was removed with a 33-mm trocar. The operation was successfully concluded in all animals. No capsule tears occurred as a result of applying the stapler. Optimal hemostasis was achieved on the resected edges in all animals. Although these findings cannot be extended to human surgery without reservations, we suggest that diagnostic partial resection and minor cyst resections are ideal initial indications for this minimally invasive approach. PMID:7773460

Uranüs, S; Pfeifer, J; Schauer, C; Kronberger, L; Rabl, H; Ranftl, G; Hauser, H; Bahadori, K

1995-04-01

194

Laparoscopic ventral hernia repair.  

PubMed

Ventral hernias, whether naturally occurring or the result of previous surgery, comprise one of the most common problems confronting general surgeons. As many as 25% of laparotomy incisions develop a hernia over long-term follow-up, which is a difficult problem with many treatment algorithms. Laparoscopic ventral hernia repair has improved over the last decade and has proven to be an effective treatment option. With fewer wound complications and low recurrence rates, it is a useful tool in the surgeon's armamentarium. Care should be taken regarding patient selection, operative technique, and mesh size to ensure adequate repair of the hernia, thereby preventing recurrence at a later date. The first attempt at a hernia repair has the highest chance of long-term success, so it is important that the surgeon take all the factors into mind before proceeding with operative repair. PMID:21424876

Melvin, W Scott; Renton, David

2011-07-01

195

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.

196

Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria  

PubMed Central

Introduction Emergency peripartum hysterectomy, a maker of severe maternal morbidity and near miss mortality is an inevitable surgical intervention to save a woman's life when uncontrollable obstetric haemorrhage complicates delivery. This study was conducted in order to determine the incidence, types, indications and maternal complications of emergency peripartum hysterectomy at the University of Uyo Teaching Hospital, Uyo, Nigeria. Methods The case records of all women who underwent emergency peripartum hysterectomy between 1st January 2004 and 31st December 2011 were studied. Results There were 12,298 deliveries during the study period and 28 emergency peripartum hysterectomies were performed resulting in a rate of 0.2% or 1 in 439 deliveries. The modal age group of the patients was 26-30 years (35.7%), majority were of low parity (64.4%), while 17.9% attained tertiary level education. Half of the patients (50.0%) were unbooked while 14.3% were antenatal clinic defaulters. Extensive uterine rupture (67.8%) was the most common indication for emergency hysterectomy distantly followed by uterine atony with uncontrollable haemorrhage (17.9%). Subtotal abdominal hysterectomy was performed in 92.8% of the cases. The case fatality rate was 14.3% while the perinatal mortality rate was 64.3%. Conclusion Emergency peripartum hysterectomy is not uncommonly performed in our centre and extensive uterine rupture from prolonged obstructed labour is the most common indication. In addition, it is associated with significant maternal and perinatal mortality. There is need to enlighten women in our communities on the benefits of ANC and hospital delivery as well as the dangers of delivering without skilled attendance. Government should consider enacting legislation to discourage people or organisations who operate unlicensed maternity homes in our environment. PMID:24147186

Abasiattai, Aniekan Monday; Umoiyoho, Aniefiok Jackson; Utuk, Ntiense Maurice; Inyang-Etoh, Emmanuel Columba; Asuquo, Otobong Peter

2013-01-01

197

Transumbilical single port laparoscopic appendectomy using basic equipment: a comparison with the three ports method  

PubMed Central

Purpose Single port laparoscopic surgery is a rapidly evolving laparoscopic surgical approach. We report a comparison of transumbilical single port laparoscopic appendectomy (TUSPLA) and conventional laparoscopic appendectomy (CLA) in a Korean military hospital. Methods This single-center retrospective study of 63 patients who received laparoscopic appendectomy was conducted between May 2011 and October 2011. Nineteen patients received TUSPLA and 44 patients received CLA. Clinical outcomes such as operation time, hospital stay, postoperative pain, diet, and postoperative complication were reviewed. Results There were no statistically significant differences between TUSPLA and CLA patients, respectively, in operation time (58.9 minutes vs. 52.3 minutes, P = 0.262), duration of hospitalization (10.2 days vs. 10.6 days, P = 0.782), mean visual analogue scale score (2.6 vs. 2.5, P = 0.894), and return to diet (1.6 days vs. 1.7 days, P = 0.776). There were two cases (10.5%) of short-term complications in the TUSPLA group and four cases (9.1%) of short-term complications in the CLA group. All patients were fully recovered at discharge. Conclusion TUSPLA is a feasible alternative for CLA. When a glove port is used, no special instruments are needed. Thus, it can be performed in a hospital equipped with basic laparoscopic surgical instruments. PMID:23091793

Lee, Jun Suh; Choi, Young Il; Lim, Sung Ho

2012-01-01

198

Safety and Efficacy of Single Incision Laparoscopic Surgery for Total Extraperitoneal Inguinal Hernia Repair  

PubMed Central

Almost 20 years after the first laparoscopic inguinal hernia repair was performed, single incision laparoscopic surgery (SILS™) is set to revolutionize minimally invasive surgery. However, the loss of triangulation must be overcome before the technique can be popularized. This study reports the first 100 laparoscopic total extraperitoneal hernia repairs using a single incision. The study cohort comprised 68 patients with a mean age of 44 (range, 18 to 83): 36 unilateral and 32 bilateral hernias. Twelve patients also underwent umbilical hernia repair with the Ventralex patch requiring no additional incisions. A 2.5-cm to 3-cm crescentic incision within the confines of the umbilicus was performed. Standard dissecting instruments and 52-cm/5.5-mm/300 laparoscope were used. Operation times were 50 minutes for unilateral and 80 minutes for bilateral. There was one conversion to conventional 3-port laparoscopic repair and none to open surgery. Outpatient surgery was achieved in all (except one). Analgesic requirements were minimal: 8 Dextropropoxyphene tablets (range, 0 to 20). There were no intraoperative or postoperative complications with a high patient satisfaction score. Single-incision laparoscopic hernia repair is safe and efficient simply by modifying dissection techniques (so-called “inline” and “vertical”). Comparable success can be obtained while negating the risks of bowel and vascular injuries from sharp trocars and achieving improved cosmetic results. PMID:21902942

2011-01-01

199

[Laparoscopic surgery in day surgery].  

PubMed

Since ten years laparoscopic techniques have been employed as alternatives of many established open procedures in gynecologic, abdominal and finally urologic surgery. Laparoscopic techniques show significant advantages compared to open surgery, such as less hospitalization, reduced need of analgesic drugs, quick return to daily activities and far a better cosmetic results. Laparoscopic surgery has been advocated for urologic, uro-gynecologic and andrologic diseases. Since 1983 one-day surgery was proposed for only a few gynecologic and abdominal procedures and only recently for laparoscopic renal biopsy and abdominal testis evaluation. In these preliminary experiences the conditions for a correct management of laparoscopic one-day surgery have been clearly pointed out: 1. correct surgical indication; 2. through knowledge of surgical technique; 3. duration of the procedure less than 90 minutes; 4. correct anesthesia. Technique of anesthesia must be adapted to the surgical procedure required, its duration and the physical features of the patient. General anesthesia is usually preferred for either longer and more complex procedures or when a higher abdominal insufflation pressure is needed. Spinal or local anesthesia are preferred for simpler procedures or when only one trocar is required. At date only few urologic procedures seem to be suitable to one-day laparoscopic surgery. 1) Varicocele: although laparoscopic varicocelectomy in one-day surgery has never been reported previously, it can be performed in a short time, only 3 trocars are needed and insufflation pressure can be maintained within 15 mm Hg. 2) Renal biopsy and marsupialization of renal cysts. These are usually managed percutaneously but in some particular indications procedures under direct vision should be preferable. Both are short-lasting and only superficial general anesthesia is required; as surgical access is retroperitoneal only two trocars are sufficient; at date only renal biopsies have previously been reported. 3) Diagnostic procedures on abdominal testis. The procedure is brief only superficial general anesthesia is needed and only one trocar is required. Conclusions. One-day laparoscopic surgery will require in the future a more and more strict cooperation between urologists and anesthetists in order to tailor the correct anesthesiological and laparoscopic technique to the procedure required and the features of the patient. PMID:9707775

Micali, S; Bitelli, M; Torelli, F; Valitutti, M; Micali, F

1998-06-01

200

Peripartum hysterectomy in a tertiary hospital in Western Sydney.  

PubMed

The aim of this study was to review the incidence, indication, management and complications of peripartum hysterectomy (PH) in a tertiary level hospital over a decade. A retrospective review of all cases of PH performed at Westmead Hospital, Western Sydney, 2003-2012, was undertaken. PH was defined as hysterectomy performed after 20 weeks' gestation or any time after delivery but within 6 weeks' postpartum ( Awan et al. 2011 ). There were 56 cases of peripartum hysterectomy of 46,177 births, a rate of 1.22 per 1,000 births. The most common indication for PH was morbid adherence of the placenta (58.2%) followed by uterine atony. Having a history of both caesarean section and placenta praevia is highly associated with a morbidly adherent placenta in the index pregnancy (p = 0.002). The most common complication was coagulopathy followed by febrile illness and urinary tract injury. Our data showed previous caesarean section and placenta praevia to be associated with abnormal placentation, the leading indication for PH. Since there is an association between a planned caesarean hysterectomy and reduced amount of estimated blood loss and blood transfused, the knowledge of placentation and adequate preoperative planning and consideration for elective hysterectomy could be beneficial. The morbidity associated with PH is considerable. PMID:25264917

Shamsa, A; Harris, A; Anpalagan, A

2014-09-29

201

McCarus Cosmetic Hysterectomy™ - a patient-centric approach.  

PubMed

As patients are diagnosed with a health condition that requires a hysterectomy, surgical recommendations are generally discussed. Surgical options for a variety of procedures have expanded greatly in the past decade because of the development of innovations including, but not limited to, robots, advanced bipolar energy systems, HD cameras, single-site access systems, minilaparoscopic instruments, and novel uterine manipulators. These advances allow the surgeon to consider an expanded variety of procedures that may not only improve patient outcomes but also accommodate patient preferences. However, inherent bias directly related to the surgeon's specific view may influence decisions limiting hysterectomy options offered to patients. As general gynecological surgeons, we are not only empowered but also obligated to provide patients with expanded hysterectomy options that fit the indications and clinical needs of our patients. - Cosmetic minimally invasive surgery improved cosmesis compared with standard trocars. - Cosmetic minimally invasive surgery needs no skin or fascial closure. - McCarus Cosmetic Hysterectomy™ affords benefits of minimally invasive surgery. - Cosmetic minimally invasive surgery represents the next evolution in minimally invasive surgery. - Cosmetic minimally invasive surgery allows expansion of hysterectomy options for benign disease. PMID:23686798

McCarus, Steven D

2013-09-01

202

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

203

Fibroids, Infertility and Laparoscopic Myomectomy  

PubMed Central

Objective: To review the literature and summarize the available evidence about the relationship of fibroids with infertility and to review the role of laparoscopic myomectomy in infertility. Materials and Methods: Medline, PubMed, and Cochrane Databases were searched for articles published between 1980 and 2010. Results: Fertility outcomes are decreased in women with submucosal fibroids, and myomectomy is of value. Subserosal fibroids do not affect fertility outcomes, and removal may not confer benefit. Intramural fibroids appear to decrease fertility, but the results of therapy are unclear. Although pregnancy rates for women with leiomyomata, managed endoscopically, are similar to those after laparotomy, there is a risk of uterine rupture. The risk is essentially unknown. Finally, the risk of recurrence seems higher after laparoscopic myomectomy compared to laparotomy. Conclusions: Laparoscopic myomectomy, when performed by an experienced surgeon, can be considered a safe technique, with an extremely low failure rate and good results in terms of the outcome of pregnancy. PMID:22442534

Desai, Pankaj; Patel, Purvi

2011-01-01

204

Intraoperative laparoscopic sonography for improved preoperative sonographic pathologic characterization of adnexal masses.  

PubMed

This study compares the diagnostic accuracy of laparoscopic sonography and transvaginal sonography in the evaluation of adnexal masses. Fifty-eight women underwent transvaginal sonography, which showed 69 adnexal masses, and laparoscopic ultrasonography, which showed 68 adnexal lesions. Conventional gray-scale ultrasonography (using transvaginal sonography and laparoscopic ultrasonography) was performed with morphologic characterization of internal architecture, followed by color Doppler imaging with spectral Doppler analysis where possible. A specific diagnosis was obtained with transvaginal sonography and laparoscopic ultrasonography based on a combination of imaging features. The specific diagnosis obtained with each imaging modality was compared with the final histologic diagnosis as the gold standard in 57 patients with 68 adnexal masses who underwent cystectomy or oophorectomy. The ability of laparoscopic sonography to detect the contralateral ovary and any residual ovarian tissue in the presence of a mass was also compared with transvaginal sonography. The accuracy of laparoscopic ultrasonography in the characterization of adnexal masses was 83.8% and that of transvaginal sonography was 73.5% (P < 0.05). Laparoscopic sonography showed greater morphologic detail than that obtained with transvaginal sonography, allowed more precise and specific characterization of adnexal masses, and detected additional adnexal lesions not evident on preoperative transvaginal sonography. Laparoscopic ultrasonography showed the contralateral ovary in 86.2% of patients, compared with 81.0% using transvaginal sonography (P = 0.51). In addition, laparoscopic ultrasonography was able to demonstrate the presence of residual ovarian tissue in the side affected pathologically in 76.5% of patients compared with 59.4% using transvaginal sonography (P < 0.005). Laparoscopic sonography allows more precise morphologic characterization of internal architecture and histologic diagnosis of adnexal lesions, but it is as yet unable to increase the diagnostic accuracy of borderline or malignant lesions, possibly due to the small sample size. Laparoscopic sonography is superior to transvaginal sonography in the evaluation of residual ovarian tissue in the side affected pathologically, which may help in surgical planning between cystectomy and oophorectomy, and also in the identification of the contralateral ovary, which may potentially increase the detection of bilateral pathologic conditions. PMID:9440109

Yang, W T; Yuen, P M; Ho, S S; Leung, T N; Metreweli, C

1998-01-01

205

Laparoscopic reversal of Hartmann's procedure.  

PubMed

Reestablishing continuity after a Hartmann's procedure is considered a major surgical procedure with high morbidity/mortality. The aim of this study was to assess the short-/long-term outcome of laparoscopic restoration of bowel continuity after HP. A prospectively collected database of colorectal laparoscopic procedures (>800) performed between June 2005 and June 2013 was used to identify 20 consecutive patients who had undergone laparoscopic reversal of Hartmann's procedure (LHR). Median age was 65.4. Ten patients (50 %) had undergone surgery for perforated diverticulitis, 3 (15 %) for cancer, and 7 (35 %) for other reasons (volvulus, posttraumatic perforation, and sigmoid perforation from foreign body). Previous HP had been performed laparoscopically in only 3 patients. Median operative time was 162.5 min. All the procedures were completed laparoscopically. Intraoperative complication rate was nil. Post-operative mortality and morbidity were respectively 0 and 10 % (1 pneumonia, 1 bowel obstruction from post-anastomotic stenosis which required resection and redo of the anastomosis). Median time to first flatus was 3 days, to normal diet 5 days. Median hospital stay was 9 days without readmissions. We followed up the patients for a median of 44 months: when asked, all 20 (100 %) said they would undergo the operation (LHR) again; 3 (15 %) had been re-operated of laparoscopic mesh repair for incisional hernia. When performed by experienced surgeons, LHR is a feasible, safe, reproducible operation, which allows early return of bowel function, early discharge and fast return to work for the patient. It has a low morbidity rate. PMID:25262377

Fiscon, Valentino; Portale, Giuseppe; Mazzeo, Antonio; Migliorini, Giovanni; Frigo, Flavio

2014-12-01

206

Two-port laparoscopic appendectomy as transition to laparoendoscopic single site surgery  

PubMed Central

BACKGROUND: According to the precepts of reduced surgical trauma and better cosmesis, an intermediate laparoscopic appendectomy technique between the conventional three-trocar procedure and Laparoendoscopic Single Site Surgery (LESS) was performed, based on literature review and experience of the surgical team. PATIENTS AND METHODS: Patients with early stage acute appendicitis and a favourable anatomical presentation were selected. The procedure was performed with two ports: A 10 mm trocar at the umbilicus site for laparoscope and a 5 mm one just above the pubic bone for grasper. The appendix was secured by external wire traction through a right iliac fossa puncture with 14-gauge intravenous catheter. RESULTS: From August 2009 to December 2012, we performed 42 cases; two required conversion to a conventional laparoscopic technique. There were no complications in the remaining, no wound infections and a mean operation time of 64.5 minutes. CONCLUSION: The use of two-port laparoscopic appendectomy can act as a LESS intermediate step procedure, without loss of instrumental triangulation and maintenance of appropriate counter-traction. This technique can be used as an alternative to the three-port laparoscopic procedure in patients with initial presentation of appendicitis and a favourable anatomical position. PMID:24501505

Olijnyk, José Gustavo; Pretto, Guilherme Gonçalves; da Costa Filho, Omero Pereira; Machado, Fernando Koboldt; Silva Chalub, Sidney Raimundo; Cavazzola, Leandro Totti

2014-01-01

207

Effects of jazz on postoperative pain and stress in patients undergoing elective hysterectomy.  

PubMed

Context • Anesthesiologists use various medications to provide surgical patients with pain relief in the postoperative period. Other modalities, such as music, could be used in conjunction with opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and lower heart rate and blood pressure. Our hypothesis was that patients listening to jazz in a postanesthesia care unit (PACU) would have lower heart rates and blood pressures and reduced pain and anxiety. Objective • The study objective was to determine if listening to jazz music in the PACU, when compared to wearing noise-canceling headphones with no music playing, would decrease heart rate, blood pressure, pain, or anxiety in patients undergoing a hysterectomy. Design • The research design was a prospective, randomized study. Setting • The study was conducted in the PACU at the Penn State Hershey Medical Center in Hershey, PA, USA. Participants • A total of 56 patients, aged 18-75 y, who were categorized as status 1 or 2 according to the American Society of Anesthesiologists (ASA) Physical Status Classification System, and who were undergoing elective laparoscopic or abdominal hysterectomies, were enrolled in the study. Intervention • Patients were randomly assigned either to listen to jazz music where the beats per min (BPM) was <100 (experimental group, n = 28) or to wear noise-canceling headphones (control group, n = 28) for 30 min while in the PACU after their surgery. Outcome Measures • Heart rate was the primary outcome, and secondary outcomes included systolic and diastolic blood pressure, an anxiety score, and a pain score. All outcome measures were initially recorded at baseline upon the patient's arrival in the PACU. Heart rate and blood pressure were recorded postoperatively every 5 min for the initial 30 min that a patient was in the PACU. Pain was checked every 10 min during the 30-min period; anxiety was checked at 30 min. Results • Heart rates of patients in the noise-cancellation group were significantly lower when compared with baseline (P < .05), at all time points. For patients in the jazz group, heart rates were significantly lower at 15, 20, 25, and 30 min when compared with baseline. The pain scores were significantly lower (P < .05) in the noise-cancellation group compared with the jazz group at 10 min into the recovery period. Conclusion • Overall, the results showed that patients responded not only to music but also to silence in the PACU. Using music and/or noise reduction could decrease opioid administration, promote relaxation, and improve patient satisfaction. PMID:25607117

Rafer, Lorenzo; Austin, Flower; Frey, Jessica; Mulvey, Christie; Vaida, Sonia; Prozesky, Jansie

2015-01-01

208

All-Cause Cost Differences Between Robotic, Vaginal, and Abdominal Hysterectomy  

PubMed Central

Objective To compare the all-cause costs of vaginal and abdominal hysterectomy with robotically assisted hysterectomy. Methods We identified all cases of robotically assisted hysterectomy, with or without bilateral salpingo-oophorectomy, treated at Mayo Clinic (Rochester, Minnesota) from January 1, 2007, through December 31, 2009. Cases were propensity score–matched (1:1) to cases of vaginal and abdominal hysterectomy, selected randomly from the 3 preceding years (before acquisition of the robotic surgical system). All-cause costs were abstracted through the sixth postoperative week from the Olmsted County Healthcare Expenditure and Utilization Database and compared between cohorts with a generalized linear modeling framework. Predicted costs were estimated with the recycled predictions method. Costs of operative complications also were compared. Results Predicted mean cost of robotically assisted hysterectomy was $2,253 more than that of vaginal hysterectomy ($13,619 vs $11,366; P<.001), although costs of complications were not significantly different. The predicted mean costs of robotically assisted vs abdominal hysterectomy were similar ($14,679 vs $15,588; P=.35), and the costs of complications were not significantly different. Conclusions Overall, vaginal hysterectomy was less costly than robotically assisted hysterectomy. Abdominal hysterectomy and robotically assisted hysterectomy had similar costs. PMID:24402586

Woelk, Joshua L.; Borah, Bijan J.; Trabuco, Emanuel C.; Gebhart, John B.

2015-01-01

209

Laparoscopic Surgery for Rectal Cancer  

PubMed Central

Laparoscopic surgery for rectal cancer is much more challenging than that for colon cancer because of the confined space within the pelvis. Further, because of the tumor's location in the pelvis, maintenance of resection margins is of greater concern. Nonrandomized studies by groups experienced in laparoscopic surgery have shown both that it produces short-term outcomes equivalent to those for open surgery and that it can be performed safely from an oncologic perspective. Nonsurgical complications appear to be fewer, but conversion to open surgery may become a real issue. This review summarizes these findings by addressing technical considerations, early outcomes, late outcomes, costs, and complications. PMID:21373245

Indar, Adrian; Efron, Jonathan

2009-01-01

210

Laparoscopic ultrasound and gastric cancer  

NASA Astrophysics Data System (ADS)

The management of gastrointestinal malignancies continues to evolve with the latest available therapeutic and diagnostic modalities. There are currently two driving forces in the management of these cancers: the benefits of minimally invasive surgery so thoroughly demonstrated by laparoscopic surgery, and the shift toward neoadjuvant chemotherapy for upper gastrointestinal cancers. In order to match the appropriate treatment to the disease, accurate staging is imperative. No technological advances have combined these two needs as much as laparascopic ultrasound to evaluate the liver and peritoneal cavity. We present a concise review of the latest application of laparoscopic ultrasound in management of gastrointestinal malignancy.

Dixon, T. Michael; Vu, Huan

2001-05-01

211

The laparoscopic learning curve.  

PubMed

To characterize the learning curve for laparoscopic cholecystectomy, we compared the first 47 cases (group A), which were performed by two senior attending surgeons who assisted each other when the procedure was introduced into clinical practice (1990-1991), with the first 46 cases (group R) performed by two surgical chief residents who were assisted by members of the teaching faculty in 1992-1993. The patient groups were comparable in terms of age, sex, and anesthetic class, but pathologically proven acute cholecystitis was more common in group R (33% vs. 9%; p < 0.005). To analyze operative procedures and outcomes, we compared operative time, frequency of successful operative cholangiography (attempted in all cases), frequency of conversion to open cholecystectomy, major complication rate, and days of postoperative stay for all patients and for those without complications. Of these parameters, only operative time for nonacute cases differed significantly between the groups (144 min for group A vs. 114 min for group R; p < 0.05). Complications in group A included one ductal injury and one case of postoperative pancreatitis; group R had one ductal injury and two cases of postoperative bleeding. We conclude that (a) the learning curve has similar structure for senior surgeons and resident trainees; and (b) the resident learning curve is not hazardous when teaching assistants are trained in the procedure, which has implications for safe instruction and proctoring of residents and staff. PMID:8611992

Lekawa, M; Shapiro, S J; Gordon, L A; Rothbart, J; Hiatt, J R

1995-12-01

212

Trends in Hysterectomy for Genital Prolapse: Rural Experience  

PubMed Central

The present study was conducted to investigate the trends of vaginal hysterectomy for genital prolapse in last 20 years by analyzing case records of affected women. During the analysis period, 4831 women underwent hysterectomy; records of 4223 (87.5%) were available. Of these, 911 (21.6%), 2.7% of 34,080 gynecological admissions, had vaginal hysterectomy for genital prolapse (study subjects). Eighty percent women who had vaginal hysterectomy for genital prolapse were over 40 years of age; however, most of these women had had the disorder for years before they presented. Only 4 (0.4%) women had not given birth, 874 (96%) women had had two or more births, and 383 (42%) had had 5 or more births. Having given birth was the major factor responsible for genital prolapse. In all, 94.2% of women presented with something coming out of the vagina.” Some women presented with abnormal vaginal bleeding or pain in abdomen as the chief complaint although they had had uterovaginal prolapse for years. There was no mortality and morbidity decreased over the years. There has been no change in the rate of vaginal hysterectomy for genital prolapse over the years. Surgical morbidity decreased trend, possibly because of the preoperative, intraoperative, and postoperative precautions taken, especially preoperative treatment of urinary and genital tract infection. Attempts need to be made to have safe births and a healthy life style so as to prevent genital prolapse and in case it occurs, therapy to prevent progression so that major interventions like hysterectomy are averted. Meticulous preoperative evaluation and planned therapy help in reducing surgical morbidity, if surgery becomes essential. PMID:24453514

Chhabra, Shakuntala; Ramteke, Manjiri; Mehta, Sonali; Bhole, Nisha; Yadav, Yojna

2013-01-01

213

21 CFR 884.1720 - Gynecologic laparoscope and accessories.  

Code of Federal Regulations, 2010 CFR

...Devices § 884.1720 Gynecologic laparoscope and accessories...Identification. A gynecologic laparoscope is...perform diagnostic and surgical procedures on the female genital... (2) Class I for gynecologic laparoscope...

2010-04-01

214

[Laparoscopic colo-rectal surgery].  

PubMed

Laparoscopic colorectal surgery was less invasive for patients although it was difficult to perform complete resection of colon combined with regional lymph node. The skillful manner of the laparoscopic surgery was required for the surgical team. The laparoscopic equipments, in order to perform curative dissection of mesenterium and intermediate lymph node, such as Ultrasonic-aspiration surgical unit (USU) or Harmonic scalpel laparoscopic coagulation shears (LCS), were useful for safer dissection of D2 regional lymph node. Meticulous manner of grasping forceps and special dissectors was made sufficient lymph node dissection. The reconstruction of extracorporeal anastomotic technique by hand or valtrac (biofragmentable anastomosis ring) were safer manner for anastomosis after resection of the right side colon. Reconstruction by double stapling technique of linear stapler and circular stapler was admired for anastomosis for left side colonic and rectal surgery. We had safely performed locar resection in 3, partial resection with Do dissection in 2, with D1 dissection in 14, with D2 dissection in 21 and right and left hemicolectomy in 1 each. PMID:8965357

Hayashi, K; Munakata, Y

1996-05-01

215

Adjuvant chemotherapy for endometrial cancer after hysterectomy  

PubMed Central

Background Endometrial adenocarcinoma (womb cancer) is a malignant growth of the lining (endometrium) of the womb (uterus). It is distinct from sarcomas (tumours of the uterine muscle). Survival depends the risk of microscopic metastases after surgery. Adjuvant (postoperative) chemotherapy improves survival from some other adenocarcinomas, and there is evidence that endometrial cancer is sensitive to cytotoxic therapy. This systematic review examines the effect of chemotherapy on survival after hysterectomy for endometrial cancer. Objectives To assess efficacy of adjuvant (postoperative) chemotherapy for endometrial cancer. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2010, Issue 3), MEDLINE and EMBASE up to August 2010, registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. Selection criteria Randomised controlled trials (RCTs) comparing adjuvant chemotherapy with any other adjuvant treatment or no other treatment. Data collection and analysis We used a random-effects meta-analysis to assess hazard ratios (HR) for overall and progression-free survival and risk ratios (RR) to compare death rates and site of initial relapse. Main results Five RCTs compared no additional treatment with additional chemotherapy after hysterectomy and radiotherapy. Four trials compared platinum based combination chemotherapy directly with radiotherapy. Indiscriminate pooling of survival data from 2197 women shows a significant overall survival advantage from adjuvant chemotherapy (RR (95% CI) = 0.88 (0.79 to 0.99)). Sensitivity analysis focused on trials of modern platinum based chemotherapy regimens and found the relative risk of death to be 0.85 ((0.76 to 0.96); number needed to treat for an additional beneficial outcome (NNT) = 25; absolute risk reduction = 4% (1% to 8%)). The HR for overall survival is 0.74 (0.64 to 0.89), significantly favouring the addition of postoperative platinum based chemotherapy. The HR for progression-free survival is 0.75 (0.64 to 0.89). This means that chemotherapy reduces the risk of being dead at any censorship by a quarter. Chemotherapy reduces the risk of developing the first recurrence outside the pelvis (RR = 0.79 (0.68 to 0.92), 5% absolute risk reduction; NNT = 20). The analysis of pelvic recurrence rates is underpowered but the trend suggests that chemotherapy may be less effective than radiotherapy in a direct comparison (RR = 1.28 (0.97 to 1.68)) but it may have added value when used with radiotherapy (RR = 0.48 (0.20 to 1.18)). Authors’ conclusions Postoperative platinum based chemotherapy is associated with a small benefit in progression-free survival and overall survival irrespective of radiotherapy treatment. It reduces the risk of developing a metastasis, could be an alternative to radiotherapy and has added value when used with radiotherapy. PMID:21975736

Johnson, Nick; Bryant, Andrew; Miles, Tracie; Hogberg, Thomas; Cornes, Paul

2014-01-01

216

Efficacy and safety of reuse of disposable laparoscopic instruments in laparoscopic cholecystectomy: a prospective randomized study  

Microsoft Academic Search

Background The aim of this prospective randomized study was to investigate the efficacy and safety of the reuse of disposable laparoscopic instruments (DLI) in laparoscopic cholecystectomy. Methods A total of 125 consecutive patients with symptomatic cholelithiasis were randomly assigned to undergo laparoscopic cholecystectomy with single-use DLI (group 1, n = 62) or DLI that were reused (group 2, n =

T. Colak; G. Ersoz; T. Akca; A. Kanik; S. Aydin

2004-01-01

217

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

218

Surgery  

MedlinePLUS

... Minimally invasive hysterectomy (laparoscopic-assisted vaginal hysterectomy and robotic total laparoscopic hysterectomy): the uterus and cervix are ... vagina with the assistance of a laparoscope or robotic device (a small tubelike viewing instrument) that is ...

219

Laparoscopic pericystectomy for liver hydatid cysts  

Microsoft Academic Search

  Background: The laparoscopic approach for managing of liver echinococcosis is a controversial issue because of scarce experience\\u000a worldwide. The aim of this report is to describe the technical details of our laparoscopic method and present our results.\\u000a Methods: Consecutive cases of liver echinococcosis managed by laparoscopic surgery are reported. Thoracic x-ray and abdominal\\u000a ultrasound had been performed previously. The following

C. Manterola; O. Fernández; S. Muńoz; M. Vial; H. Losada; R. Carrasco; N. Bello; M. Barroso

2002-01-01

220

A Comparative Study of Single-Port Laparoscopic Surgery Versus Robotic-Assisted Laparoscopic Surgery for Rectal Cancer.  

PubMed

Introduction. Conventional laparoscopic surgery is the treatment of choice for many abdominal procedures. To further reduce surgical trauma, new minimal invasive procedures such as single-port laparoscopic surgery (SPLS) and robotic assisted laparoscopic surgery (RALS) have emerged. The aim of this study was to compare the early results of SPLS versus RALS in the treatment of rectal cancer. Methods. We performed a retrospective analysis of prospectively collected data on patients who had undergone SPLS (n = 36) or RALS (n = 56) in the period between 2010 and 2012. Operative and short-term oncological outcomes were compared. Results. The RALS group had fewer patients with low rectal cancer and more patients with mid-rectal tumors (P = .017) and also a higher rate of intraoperative complications (14.3% vs 0%, P = .021). The rate of postoperative complications did not differ (P = .62). There were no differences in circumferential resection margins, distal resection margins, or completeness of the mesorectal fascia. The RALS group had a larger number of median harvested lymph nodes (27 vs 13, P = .001). The SPLS group had fewer late complications (P = .025). There were no locoregional recurrences in either of the groups. There was no difference in median follow-up time between groups (P = .58). Conclusion. Both SPLS and RALS may have a role in rectal surgery. The short-term oncological outcomes were similar, although RALS harvested more lymph nodes than the SPLS procedure. However, SPLS seems to be safer with regard to intraoperative and late postoperative complications. PMID:25377216

Levic, Katarina; Donatsky, Anders Meller; Bulut, Orhan; Rosenberg, Jacob

2014-11-01

221

Contraindications and complications of laparoscopic cholecystectomy.  

PubMed

Laparoscopic cholecystectomy is a commonly performed procedure for the removal of symptomatic gallstones. Compared with open cholecystectomy, laparoscopic cholecystectomy is associated with less postoperative pain, earlier discharge from the hospital and a more rapid recovery. However, there are specific contraindications to the procedure, including empyema of the gallbladder, gangrenous cholecystitis, coagulopathy, portal hypertension and peritonitis. Complications from laparoscopic cholecystectomy include common duct injury, bleeding, bile leakage and wound infection. An understanding of these issues allows the family physician to more appropriately select patients for laparoscopic removal of the gallbladder. PMID:7977000

Rappaport, W D; Gordon, P; Warneke, J A; Neal, D; Hunter, G C

1994-12-01

222

Laparoscopic pouch surgery in ulcerative colitis  

PubMed Central

Laparoscopic restorative proctocolectomy is a complex procedure with a steep learning curve. It has been proven to be safe and feasible with outcomes comparable to those of open surgery if performed in experienced centers. Published evidence in favor of laparoscopic approach is mainly from small case series and data from randomized controlled trials are currently awaited. This article reviews and analyzes the existing literature on laparoscopic ileoanal pouch surgery in light of the available evidence, demonstrating safety and efficacy of the laparoscopic approach and potential short-term benefits. Technical aspects and future directions in the minimally invasive approach to restorative proctocolectomy are also discussed. PMID:24714253

Hemandas, Anil K.; Jenkins, John T.

2012-01-01

223

Laparoscopic fundoplication in infants and children  

Microsoft Academic Search

Background: Laparoscopic fundoplication is a new method for treating gastroesophageal reflux in children. We present 160 children with\\u000a gastroesophageal reflux treated by laparoscopic fundoplication.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: Patients underwent either a laparoscopic Nissen or Toupet fundoplication. Many patients also required gastrostomies and gastric\\u000a outlet procedures.\\u000a \\u000a \\u000a \\u000a \\u000a Results: Twelve patients (7.5%) were converted to open fundoplication. Laparoscopic gastrostomies were placed in 112 patients (75.7%)

J. J. Meehan; K. E. Georgeson

1996-01-01

224

Single-incision laparoscopic pyloromyotomy: initial experience  

Microsoft Academic Search

Background  Laparoscopic pyloromyotomy has become the standard treatment for hypertrophic pyloric stenosis. Single-incision laparoscopic\\u000a surgery is an emerging operative approach that utilizes the umbilical scar to hide the surgical incision.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  To describe our initial experience with single-incision laparoscopic pyloromyotomy in 15 infants.\\u000a \\u000a \\u000a \\u000a Materials and methods  Laparoscopic pyloromyotomy was performed through a single skin incision in the umbilicus, using a 4-mm 30° endoscope

Oliver J. Muensterer; Obinna O. Adibe; Carrol M. Harmon; Albert Chong; Erik N. Hansen; Donna Bartle; Keith E. Georgeson

2010-01-01

225

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

226

Laparoscopic assisted right hemicolectomy with Valtrac BAR (Biofragmentable Anastomotic Ring) ileotransverse anastomosis.  

PubMed

Laparoscopic techniques have been employed in a group of medically compromised patients requiring right hemicolectomy, permitting a shorter and lower placed abdominal incision than may have been expected with a conventional surgical approach. In eight patients requiring right hemicolectomy, full mobilization of the right colon from the caecum to the proximal transverse colon was performed laparoscopically. Resection and anastomosis then proceeded through a small right-sided transverse abdominal incision. End to end ileotransverse anastomosis was performed in each instance employing the Valtrac BAR (Biofragmentable Anastomotic Ring) compressive anastomotic technique. The average operating time was 133 min. There was no mortality, but one patient developed pulmonary complications and three developed minor wound infections. An additional three patients developed urinary tract infections. There were no anastomotic complications. The average postoperative stay was 10 days. This study has indicated that laparoscopic techniques can be successfully applied to large bowel surgery, and may be of benefit to high risk patients. PMID:8498919

Polglase, A L; Skinner, S A; Johnson, W R

1993-06-01

227

Efficacy of Laparoscopic Sacrocervicopexy for Apical Support of Pelvic Organ Prolapse  

PubMed Central

Background and Objectives: To evaluate the efficacy of laparoscopic sacrocervicopexy for apical support in sexually active patients with pelvic organ prolapse. Methods: One-hundred thirty-five women with symptomatic prolapse of the central compartment (Pelvic Organ Prolapse Quantitative [POP-Q] stage 2) underwent laparoscopic sacrocervicopexy. The operating physicians used synthetic mesh to attach the anterior endopelvic fascia to the anterior longitudinal ligament of the sacral promontory with subtotal hysterectomy. Anterior and posterior colporrhaphy was performed when necessary. The patients returned for follow-up examinations 1 month after surgery and then over subsequent years. On follow-up a physician evaluated each patient for the recurrence of genital prolapse and for recurrent or de novo development of urinary or bowel symptoms. We define “surgical failure” as any grade of recurrent prolapse of stage II or more of the POP-Q test. Patients also gave feedback about their satisfaction with the procedure. Results: The mean follow-up period was 33 months. The success rate was 98.4% for the central compartment, 94.2% for the anterior compartment, and 99.2% for the posterior compartment. Postoperatively, the percentage of asymptomatic patients (51.6%) increased significantly (P < .01), and we observed a statistically significant reduction (P < .05) of urinary urge incontinence, recurrent cystitis, pelvic pain, dyspareunia, and discomfort. The present study showed 70.5% of patients stated they were very satisfied with the operation and 18.8% stated high satisfaction. Conclusion: Laparoscopic sacrocervicopexy is an effective option for sexually active women with pelvic organ prolapse. PMID:23925017

Rosati, Maurizio; Bracale, Umberto; Pignata, Giusto; Azioni, Guglielmo

2013-01-01

228

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

Díaz-Güemes Martín-Portugués, Idoia; Hernández-Hurtado, Laura; Usón-Casaús, Jesús; Sánchez-Hurtado, Miguel Angel; Sánchez-Margallo, Francisco Miguel

2013-01-01

229

Vaginal Access Minimally Invasive Surgery (VAMIS): A New Approach to Hysterectomy.  

PubMed

Vaginal hysterectomy is the original natural orifice operation. Although one of the most common gynecologic operations performed, the surgical approach has not changed significantly during the past century. This article describes a new approach to hysterectomy using vaginal access minimally invasive surgery (VAMIS). VAMIS hysterectomy is successfully performed on a cadaveric model. The step-by-step description of the surgical technique is depicted with video supplement. PMID:25432882

Atallah, Sam; Martin-Perez, Beatriz; Albert, Matthew; Schoonyoung, Henry; Quinteros, Francisco; Hunter, Lawna; Larach, Sergio

2014-11-27

230

A randomised trial comparing endometrial resection and abdominal hysterectomy for the treatment of menorrhagia  

Microsoft Academic Search

OBJECTIVE--To determine the advantages and disadvantages of endometrial resection and abdominal hysterectomy for the surgical treatment of women with menorrhagia. DESIGN--Randomised study of two treatment groups with a minimum follow up of nine months. SETTING--Royal Berkshire Hospital, Reading. SUBJECTS--51 of 78 menorrhagic women without pelvic pathology who were on the waiting list for abdominal hysterectomy. TREATMENT--Endometrial resection or abdominal hysterectomy

M J Gannon; E M Holt; J Fairbank; M Fitzgerald; M A Milne; A M Crystal; J O Greenhalf

1991-01-01

231

Laparoscopic approach to retrorectal cyst.  

PubMed

Retrorectal cysts are rare benign lesions in the presacral space which are frequently diagnosed in middle-aged females. We report here our experience with two symptomatic female patients who were diagnosed as having a retrorectal cyst and managed using a laparoscopic approach. The two patients were misdiagnosed as having an ovarian cystic lesion after abdominal ultrasonography. Computer tomograghy (CT) scan was mandatory to establish the diagnosis. The trocar port site was the same in both patients. An additional left oophorectomy was done for a coexisting ovarian cystic lesion in one patient in the same setting. There was no postoperative morbidity or mortality and the two patients were discharged on the 5th and 6th post operative days, respectively. Our cases show that laparoscopic management of retrorectal cysts is a safe approach. It reduces surgical trauma and offers an excellent tool for perfect visualization of the deep structures in the presacral space. PMID:19030218

Gunkova, Petra; Martinek, Lubomir; Dostalik, Jan; Gunka, Igor; Vavra, Petr; Mazur, Miloslav

2008-11-14

232

Complications of Laparoscopic Donor Nephrectomy  

Microsoft Academic Search

\\u000a “Laparoscopic donor nephrectomy is a unique surgical procedure due to the fact that the surgeon is operating on a healthy\\u000a individual in order to benefit another patient he or she is unlikely managing, with a potential for complications ensuing\\u000a in both the donor and the recipient patients. Overall surgical technique, anatomic considerations, and perioperative management\\u000a remain important for minimizing the

Alexei Wedmid; Michael A. Palese

233

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

234

Understanding and optimizing laparoscopic videosystems.  

PubMed

As tactile feedback and degree of freedom for instrument movement are restricted in laparoscopic surgery, the video image plays the most crucial role in giving the surgeon information about the performance of the operation. The development of small, reliable, high-resolution imaging systems is essential for the surgeon's acquisition detailed information about the tissues being manipulated. Image quality depends on each component of the laparoscopic imaging unit. In this context, it is crucial for the surgeon to have an understanding of how the video signal is formed, transmitted, and displayed. Moreover, the surgeon also needs to have an idea about the basic principles and specifications of the surgical video systems (i.e. charge-coupled device (CCD) camera, monitors, and digitizers). This knowledge is essential for choosing pieces of equipment and knowing how to assemble them into a functional operating suite. The aim of this review is to provide the surgeon with the basics of video signaling, and to familiarize him or her with the technical principles of the surgical video systems. An insight into the future of laparoscopic video systems also is made, and practical tips for improving image quality and troubleshooting are given throughout the article. PMID:11443427

Berber, E; Siperstein, A E

2001-08-01

235

Review. Laparoscopic appendicectomy: current status.  

PubMed Central

Laparoscopic appendicectomy (LA), has failed to gain unequivocal acceptance by the general surgical community as an alternative to open appendicectomy (OA). This is because the early postoperative recovery leading to quicker hospital discharge, which led to the worldwide acceptance of laparoscopic cholecystectomy, has not been universally seen with LA. Moreover, in the majority of the published series of LAs, there seems to be a trend towards an increased incidence of intra-abdominal abscesses. However, laparoscopy is superior to the 'watch and wait' policy where the diagnosis of appendicitis is questionable. Furthermore, since a large incision can be avoided by using the LA technique in obese patients, the incidence of postoperative morbidity can be reduced considerably. Nevertheless, before endorsing routine and widespread use of LA, it is essential that this technique is critically evaluated in well-designed, controlled, randomised trials, showing clearly the major benefits to the patient in terms of quicker hospital discharge, reduced postoperative pain, decreased wound infection and early return to full activities. Laparoscopic appendicectomy will never replace all open appendicectomies, but should become an alternative in certain groups of patients. PMID:9422862

Memon, M. A.

1997-01-01

236

Laparoscopic colorectal cancer surgery for palliation  

Microsoft Academic Search

PURPOSE: The aim of this study was to review our experience with laparoscopic colorectal cancer surgery for palliative purposes and to assess its safety and efficacy. METHODS: This was a prospective analysis of 30 patients with incurable colorectal cancer considered for laparoscopic surgery for palliative purposes. RESULTS: Resection of a single segment of the bowel was performed in 15 patients

Jeffrey W. Milsom; Seon Hahn Kim; Katherine A. Hammerhofer; Victor W. Fazio

2000-01-01

237

Laparoscopic vs. open abdominoperineal resection for cancer  

Microsoft Academic Search

PURPOSE: The aim of this study was to compare the safety and efficacy of laparoscopic abdominoperineal resection and open abdominoperineal resection for cancer. METHODS: Records of 194 patients who underwent laparoscopic abdominoperineal resection (42 patients) or open abdominoperineal resection (152 patients) at three institutions between 1991 and 1997 were reviewed. Follow-up was through office charts, American College of Surgeons cancer

James W. Fleshman; Steven D. Wexner; Mehran Anvari; Jean-Francois LaTulippe; Elisa H. Birnbaum; Ira J. Kodner; Thomas E. Read; Juan J. Nogueras; Eric G. Weiss

1999-01-01

238

Laparoscopic Adrenal Surgery for Neuroblastomas in Children  

Microsoft Academic Search

PurposeThe role of laparoscopy in children with neuroblastomas has not been fully defined. The laparoscopic approach to the adrenal gland is already largely used in adults and a few cases have been reported in children. We report the experience of a single surgical team center with laparoscopic adrenal surgery for neuroblastomas in children.

P. De LAGAUSIE; D. BERREBI; J. MICHON; P. PHILIPPE-CHOMETTE; A. EL GHONEIMI; C. GAREL; H. BRISSE; M. PEUCHMAUR; Y. AIGRAIN

2003-01-01

239

Laparoscopically assisted vaginal resection of rectovaginal endometriosis  

Microsoft Academic Search

Background: We wanted to establish a technique of laparoscopically assisted radical vaginal surgery for deep endometriosis of the rectovaginal septum with extensive rectal involvement.Technique: The procedure is started by vaginally excising the involved area which is left on the rectum, followed by bilateral dissection of the pararectal and retrorectal spaces. Para- and retrosigmoido-rectal spaces are developed laparoscopically along the coccygeosacral

Marc Possover; Herbert Diebolder; Karin Plaul; Achim Schneider

2000-01-01

240

Laparoscopic correction of right transverse colostomy prolapse.  

PubMed

Colostomy prolapse is a frequently seen complication of transverse colostomy. In one child with recurrent stoma prolapse, we performed a loop-to-loop fixation and peritoneal tethering laparoscopically. No prolapse had recurred at follow-up. Laparoscopic repair of transverse colostomy prolapse seems to be a less invasive method than other techniques. PMID:23879415

Gundogdu, Gokhan; Topuz, Ufuk; Umutoglu, Tarik

2013-08-01

241

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

242

Pure laparoscopic hepatectomy as repeat surgery and repeat hepatectomy  

PubMed Central

AIM: To assess clinical outcomes of laparoscopic hepatectomy (LH) in patients with a history of upper abdominal surgery and repeat hepatectomy. METHODS: This study compared the perioperative courses of patients receiving LH at our institution that had or had not previously undergone upper abdominal surgery. Of the 80 patients who underwent LH, 22 had prior abdominal surgeries, including hepatectomy (n = 12), pancreatectomy (n = 3), cholecystectomy and common bile duct excision (n = 1), splenectomy (n = 1), total gastrectomy (n = 1), colectomy with the involvement of transverse colon (n = 3), and extended hysterectomy with extensive lymph-node dissection up to the upper abdomen (n = 1). Clinical indicators including operating time, blood loss, hospital stay, and morbidity were compared among the groups. RESULTS: Eighteen of the 22 patients who had undergone previous surgery had severe adhesions in the area around the liver. However, there were no conversions to laparotomy in this group. In the 58 patients without a history of upper abdominal surgery, the median operative time was 301 min and blood loss was 150 mL. In patients with upper abdominal surgical history or repeat hepatectomy, the operative times were 351 and 301 min, and blood loss was 100 and 50 mL, respectively. The median postoperative stay was 17, 13 and 12 d for patients with no history of upper abdominal surgery, patients with a history, and patients with repeat hepatectomy, respectively. There were five cases with complications in the group with no surgical history, compared to only one case in the group with a prior history. There were no statistically significant differences in the perioperative results between the groups with and without upper abdominal surgical history, or with repeat hepatectomy. CONCLUSION: LH is feasible and safe in patients with a history of upper abdominal surgery or repeat hepatectomy. PMID:25624731

Isetani, Masashi; Morise, Zenichi; Kawabe, Norihiko; Tomishige, Hirokazu; Nagata, Hidetoshi; Kawase, Jin; Arakawa, Satoshi

2015-01-01

243

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

244

Intravesical stone formation several years after hysterectomy: a case report  

PubMed Central

Introduction Most bladder stones develop in patients with bladder outlet obstruction. Intravesical stone formation after surgery outside the urinary bladder is rare. Case presentation A 54-year-old Taiwanese woman with lower urinary tract symptoms following a hysterectomy 14 years ago presented to our hospital. The intravesical calculus had developed from non-absorbable sutures and hung on the dome of the urinary bladder. The stone and residuum of the suture were retrieved by performing an endoscopic procedure. Conclusions The presence of an intravesical stone should be suspected in patients with a history of hysterectomy who have symptoms in the lower urinary tract. A hanging stone on the dome of the urinary bladder implies that suture materials migrate into the urinary bladder. The complication can be prevented by the routine use of absorbable material and double-checking with cystoscopy. PMID:24088263

2013-01-01

245

First experience on laparoscopic near-infrared fluorescence imaging of hepatic uveal melanoma metastases using indocyanine green.  

PubMed

Background. Uveal melanoma is the most common primary intraocular tumor in adults, and up to 50% of patients will develop liver metastases. Complete surgical resection of these metastases can improve 5-year survival, but only a few patients are eligible for radical surgical treatment. The aim of this study was to introduce a near-infrared (NIR) fluorescence laparoscope during minimally invasive surgery for intraoperative identification of uveal melanoma hepatic metastases and to use it to provide guidance during resection. Methods. Three patients diagnosed with one solitary liver metastasis from uveal melanoma are presented. Patients received 10 mg indocyanine green (ICG) intravenously 24 hours before surgery. A NIR fluorescence laparoscope was used to detect malignant liver lesions. Results. In all 3 patients, laparoscopic NIR fluorescence imaging using ICG successfully identified uveal melanoma metastases. In 2 patients, multiple additional lesions were identified by inspection and NIR fluorescence imaging, which were not identified by preoperative conventional imaging. In one patient, one additional lesion, not identified by computed tomography, magnetic resonance imaging, laparoscopic ultrasonography, and inspection, was observed with NIR fluorescence imaging only. Importantly, NIR fluorescence imaging provided guidance during resection of these metastases. Conclusions. We describe the successful use of laparoscopic identification and resection of uveal melanoma liver metastases using NIR fluorescence imaging and ICG. This procedure is minimally invasive and should be used as complementary to conventional techniques for the detection and resection of liver metastases. PMID:24902685

Tummers, Quirijn R J G; Verbeek, Floris P R; Prevoo, Hendrica A J M; Braat, Andries E; Baeten, Coen I M; Frangioni, John V; van de Velde, Cornelis J H; Vahrmeijer, Alexander L

2015-02-01

246

Is cirrhosis a contraindication to laparoscopic cholecystectomy?  

PubMed

Laparoscopic cholecystectomy is the gold standard treatment for the vast majority of patients with symptomatic cholelithiasis. Although cirrhotic patients are twice as likely to develop gallstones as compared with noncirrhotic patients, cirrhosis has historically been considered a relative, if not absolute, contraindication to laparoscopic cholecystectomy. More recently a number of authors have reported on the safety of laparoscopic cholecystectomy in cirrhotic patients. We reviewed our patients retrospectively and assessed the safety of laparoscopic cholecystectomy in cirrhotic patients as compared with noncirrhotics at a large liver transplant center. A retrospective longitudinal cohort study was conducted of all laparoscopic cholecystectomies performed by our surgical group between August 2002 and April 2011. Of 63 patients undergoing laparoscopic cholecystectomy, 32 (51%) were cirrhotic. Of the 30 for whom a Child score could be calculated, 11 (34%) were Child A, 14 (44%) were Child B, and five (16%) were Child C. The morbidity rate was 33 per cent and mortality rate was 2 per cent. Length of stay, conversion rates, 30-day readmission rates, and morbidity and mortality rates were not significantly different between the cirrhotic and noncirrhotic groups. There was a trend toward higher complication rates in Child C cirrhotics. Our results indicate that laparoscopic cholecystectomy can be performed with acceptable morbidity and mortality in carefully selected cirrhotic patients. PMID:25569066

McGillicuddy, John W; Villar, Juan José E; Rohan, Vinayak S; Bazaz, Sapna; Taber, David J; Pilch, Nicole A; Baliga, Prabhakar K; Chavin, Kenneth D

2015-01-01

247

Influence of hysterectomy on the fibrinolytic activity of plasma of women with intact ovarian function.  

PubMed

Hysterectomies are frequently required operations in gynecology. Several studies have reported an association between premenopausal hysterectomy and the risk of cardiovascular diseases. However, the pathophysiological linkages between these two conditions have not been elucidated. In recent years it has been shown that a decrease in plasma fibrinolytic activity is associated with increased risk of thrombosis. Furthermore, it has been known that the uterus is a very finbrinolytic active organ. In the present study we investigated the hypothesis that hysterectomy may lead to a decrease in plasma fibrinolytic activity, and thereby increase the risk for thromboembolic diseases. Fibrinolytic parameters of plasma were investigated in 26 women before and 6 weeks after premenopausal hysterectomy. Euglobulin lysis time (ELT), a global measure of plasma fibrinolytic activity, and the levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI-1) were not different before and after hysterectomy. The ELT difference before and after venous occlusion, which is a good indicator for the risk of thrombosis, was also not significantly changed after hysterectomy. Estradiol-17 beta, progesterone, LH, FSH and sex hormone binding globulin displayed no significant changes after hysterectomy. Furthermore, the hormone measurements also indicated that the women were premenopausal. There were no correlations between the hormone values and fibrinolytic parameters. These data indicate that premenopausal hysterectomy does not lead to changes in plasma fibrinolytic activity. PMID:7781859

Schubring, C; Grulich-Henn, J; Bauer, S; Gips, H; Müller-Berghaus, G

1995-03-01

248

A Qualitative Study of Women's Decisions Not to Have a Hysterectomy  

ERIC Educational Resources Information Center

In focusing on individual and physician demographics and system characteristics that lead to hysterectomy rate variations, researchers overlook the impact of culturally mediated meanings women assign to their bodies, hysterectomy, and other treatments. In this study I sought to provide a fuller description of this decision-making process by…

Fredericks, Erin

2013-01-01

249

Single-Port Access Subtotal Hysterectomy with Transcervical Morcellation: A Pilot Study  

Microsoft Academic Search

We evaluated the feasibility, safety, and operative outcome of management of myomas and adenomyosis using single-port access subtotal hysterectomy with transcervical morcellation using a wound retractor and a surgical glove. We conclude the single-port access subtotal hysterectomy is safe and effective and results in almost no visible scar. With more experience and advanced instruments, this surgical procedure can offer a

Gun Yoon; Tae-Joong Kim; Yoo-Young Lee; Chul-Jung Kim; Chel Hun Choi; Jeong-Won Lee; Byoung-Gie Kim; Duk-Soo Bae

2010-01-01

250

Laparoscopic Cholecystectomy in Cirrhotic Patients  

PubMed Central

Background and Objectives: Gallstones are twice as common in cirrhotic patients as in the general population. Although laparoscopic cholecystectomy (LC) has become the gold standard for symptomatic gallstones, cirrhosis has been considered an absolute or relative contraindication. Many authors have reported on the safety of LC in cirrhotic patients. We reviewed our patients retrospectively and assessed the safety of LC in cirrhotic patients at a tertiary care hospital in Pakistan. Methods: From January 2003 to December 2005, a retrospective study was conducted at SU IV, Liaquat University of Medical & Health Sciences Jamshoro. All the cirrhotic patients with Child-Pugh class A and B cirrhosis undergoing LC were included in the study. Cirrhosis was diagnosed based on clinical, biochemical, ultrasonography, and intraoperative findings of the nodular liver and histopathological study. Results: Of 250 patients undergoing laparoscopic cholecystectomy, 20 (12.5%) were cirrhotic. Of these 20, 12 (60%) were Childs group A and 8 (40%) were group B. Thirty percent were hepatitis B positive, and 70% were hepatitis C positive. Preoperative diagnosis of cirrhosis was possible in 80% of cases, and 20% were diagnosed during surgery. Morbidity rate was 15% and mortality rate was 0%. Two patients developed postoperative ascites, and mean hospital stay was 2.8±0.1 days. Of the 20 cases, 2 (10%) were converted to open cholecystectomy. The mean operation time was 70.2±32.54 minutes. Conclusion: Laparoscopic cholecystectomy is an effective and safe treatment for symptomatic gallstone disease in select patients with Child-Pugh A and B cirrhosis. The advantages over open cholecystectomy are the lower morbidity rate and reduced hospital stay. PMID:20202403

Muneer, Ambreen

2009-01-01

251

Laparoscopic approach to Meckel's diverticulum  

PubMed Central

AIM: To retrospective review the laparoscopic management of Meckel Diverticulum (MD) in two Italian Pediatric Surgery Centers. METHODS: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted (TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years (range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was established based on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients’ demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and analyzed. RESULTS: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min (range 40-115 min). No major surgical complications were recorded. The median hospital stay was 5-7 d (range 4-13 d). All patients are asymptomatic at a median follow up of 4, 5 years (range 10 mo-10 years). CONCLUSION: Trans-umbilical laparoscopic-assisted Meckel’s diverticulectomy is safe and effective in the treatment of MD, with excellent results. PMID:25009390

Papparella, Alfonso; Nino, Fabiano; Noviello, Carmine; Marte, Antonio; Parmeggiani, Pio; Martino, Ascanio; Cobellis, Giovanni

2014-01-01

252

[Value of intraoperative laparoscopic cholangiography].  

PubMed

Discussion about the necessity of intraoperative cholangiography restarted when laparoscopic cholecystectomy was established. The value of cholangiography was examined in a prospectively randomized study of one hundred patients. We could show that the routinely performed intraoperative cholangiography represents a careful, secure and sensitive method for the detection of common bile duct stones. As it is not very time consuming nor linked to high costs we believe it to be unrenouncible. It allows a detailed anatomic presentation and may be combined with ERCP for definitive treatment of bile duct stones. PMID:9206908

Tusek, D; Hufschmidt, M; Raguse, T

1997-01-01

253

[LAPAROSCOPIC SURGERY IN DIGESTIVE SYSTEM  

PubMed

The principal procedures of digestive surgery to be made by laparoscopy are mentioned. Some of them (Cholecystectomy, Fundoplication, highly selective Vagotomy, some diagnosis procedures, etc.) are perfectly consolidated, and they are the chosen procedures for they have passed the test of time and experience.However, some other procedures are still a controversial topic, and it is expected that in the near future they will be defined, according to results.Some indications are emerging as for example the Laparoscopic Staging of certain digestive cancers. lf its feasibility and efficacy is demonstrated, it will be a new tool with which the doctor in change will count with for his patients' benefit. PMID:12271342

De Vinatea, José

1998-01-01

254

Laparoscopic repair of complicated umbilical hernia with Strattice Laparoscopic™ reconstructive tissue matrix  

PubMed Central

INTRODUCTION Complex hernias continue to present a challenge. Surgical techniques for repair are carefully considered to reduce risk for complications. Laparoscopic repairs improve postoperative infection rates, and placement of biologic mesh decreases mesh infection rates. However, laparoscopic repairs using biologic mesh is generally challenging due to difficulty with maneuverability. PRESENTATION OF CASE We present a case of a complex ventral hernia that was laparoscopically repaired using a new FDA cleared laparoscopic biologic graft. The patient had multiple comorbidities, including obesity, hepatitis C, endocarditis secondary to IV drug use, tobacco smoking, bilateral inguinal hernia, and recurrent umbilical hernia. The recurrent hernia was larger, irreducible, and discolored compared to original defect. The patient underwent laparoscopic repair with primary closure and reinforcement with Strattice™ Tissue Matrix Laparoscopic (LifeCell Corporation, Branchburg, NJ). At nine months postoperative, the patient had no evidence of recurrence, infection, or chronic pain, demonstrating early success from the surgical management. DISCUSSION Presence of multiple comorbidities and incarcerated recurrent hernia increase risk for complications during and/or after hernia repair. Considering these factors, laparoscopic repair with Strattice Laparoscopic and defect closure was a reasonable technique for repair. CONCLUSION Laparoscopic suture repair reinforced with biologic dermal tissue matrix was successfully performed during a complex hernia repair. PMID:25437666

Tsuda, Shawn

2014-01-01

255

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

256

Laparoscopic Heminephrectomy of a Horseshoe Kidney  

PubMed Central

Minimally invasive surgery has revolutionized surgery for urologic disorders, and laparoscopic procedures have become widely available for several different ablative and reconstructive operations. Laparoscopic heminephrectomy in patients with horseshoe kidney can be a technically challenging procedure due to aberrant vessels, functional parenchyma in the isthmus, and abnormal location. We report the management of a case of symptomatic nonfunctioning left moiety of a horseshoe kidney with emphasis on its surgical technique combined with a review of the literature. Laparoscopic heminephrectomy is a feasible option in the surgical management of benign and malignant conditions of the horseshoe kidney and can be performed safely using a transperitoneal or a retroperitoneal approach. PMID:21985738

Khan, Atif; Myatt, Andrew; Palit, Victor

2011-01-01

257

Laparoscopic excision of a retrorectal schwannoma.  

PubMed

Retrorectal tumors are uncommon and are usually managed by open surgical excision. Recent advances in laparoscopic techniques have led to the use of laparoscopy for a variety of problems in colorectal surgery, including the excision of retrorectal tumours. This case report, which describes the laparoscopic excision of a benign schwannoma arising from the second sacral nerve root, highlights the benefits of accurate preoperative diagnosis with MR imaging and the advantages of a laparoscopic approach while pointing out principles that should be adhered to when using this approach. The tumour was successfully resected without neural compromise and with a prompt and full postoperative recovery. PMID:20454822

Rao, M; Sagar, P; Duff, S; Hulme-Moir, M; Brayshaw, I

2010-12-01

258

Single-Incision Laparoscopic Intraperitoneal Onlay Mesh Repair for the Treatment of Multiple Recurrent Inguinal Hernias  

PubMed Central

Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, “chopsticks” and “inline” dissection, 5.5 mm/52 cm/30° angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM. PMID:25392643

Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne

2014-01-01

259

Laparoscopic Liver Mobilization: Tricks of the Trade to Avoid Complications  

PubMed Central

Laparoscopic liver resection is gaining popularity because of the availability of new laparoscopic instruments and advanced techniques. Laparoscopic liver mobilization is not only necessary for pure laparoscopic liver resection but also for laparoscopy-assisted hepatectomy. Laparoscopy-assisted hepatectomy significantly reduces the length of the laparotomy incision, and it is a good educational transition to the more advanced laparoscopic liver resection. Laparoscopic liver mobilization is a simple and easy procedure if surgeons know what challenges to expect. Here, the technique of liver mobilization is summarized, along with those challenges. PMID:25370795

Ikoma, Naruhiko; Oshima, Go; Kitagawa, Yuko

2015-01-01

260

Laparoscopic liver mobilization: tricks of the trade to avoid complications.  

PubMed

Laparoscopic liver resection is gaining popularity because of the availability of new laparoscopic instruments and advanced techniques. Laparoscopic liver mobilization is not only necessary for pure laparoscopic liver resection but also for laparoscopy-assisted hepatectomy. Laparoscopy-assisted hepatectomy significantly reduces the length of the laparotomy incision, and it is a good educational transition to the more advanced laparoscopic liver resection. Laparoscopic liver mobilization is a simple and easy procedure if surgeons know what challenges to expect. Here, the technique of liver mobilization is summarized, along with those challenges. PMID:25370795

Ikoma, Naruhiko; Itano, Osamu; Oshima, Go; Kitagawa, Yuko

2015-02-01

261

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

262

Laparoscopically assisted transhiatal esophagectomy with esophagogastroplasty for post-corrosive esophageal stricture treatment in children  

Microsoft Academic Search

A tight post-corrosive esophageal stricture in a child poses significant surgical challenges. Many studies have described\\u000a minimally invasive esophagectomy in adults, but very few reports have described this technique in children. Minimally invasive\\u000a esophagectomy represents a new alternative to conventional open esophagectomy. This retrospective study evaluated the safety\\u000a and efficacy of laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive

Rafik Shalaby; Abdelmonaem Shams; Soliman Mohamed Soliman; Abelhady Samaha; Hossam Abdelrazek Ibrahim

2007-01-01

263

Laparoscopic female sterilisation by a single port through monitor--a better alternative.  

PubMed

Female sterilisation by tubal occlusion method by laparocator is most widely used and accepted technique of all family planning measures all over the world. After the development of laparoscopic surgery in all faculties of surgery by monitor, now laparoscopic female sterilisation has been developed to do under monitor control by two ports--one for laparoscope and second for ring applicator. But the technique has been modified using single port with monitor through laparocator in which camera is fitted on the eye piece of laparocator (the same laparocator which is commonly used in camps without monitor since a long time in India). In this study over a period of about 2 years, a total 2011 cases were operated upon. In this study, I used camera and monitor through a single port by laparocator to visualise as well as to apply ring on fallopian tubes. The result is excellent and is a better alternative to conventional laparoscopic sterilisation and double puncture technique through camera--which give two scars and an extra assistant is required. However, there was no failure and the strain on surgeon's eye was minimum. Single port is much easier, safe, equally effective and better acceptable method. PMID:22187798

Sewta, Rajender Singh

2011-04-01

264

Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic.  

PubMed Central

OBJECTIVE: The authors provide an assessment of mechanisms leading to hernia recurrence after laparoscopic and traditional preperitoneal herniorrhaphy to allow surgeons using either technique to achieve better results. SUMMARY BACKGROUND DATA: The laparoscopic and traditional preperitoneal approaches to hernia repair are analogous in principle and outcome and have experienced a similar evolution over different time frames. The recurrence rate after preperitoneal herniorrhaphy should be low (< 2%) to be considered a viable alternative to the most successful methods of conventional herniorrhaphy. METHODS: Experienced surgeons supply specifics regarding the mechanisms of recurrence and technical measures to avoid hernia recurrence when using the preperitoneal prosthetic repair. Videotapes of laparoscopic herniorrhaphy in 13 patients who subsequently experienced a recurrence also are used to determine technical causes of recurrence. RESULTS: Factors leading to recurrence include surgeon inexperience, inadequate dissection, insufficient prosthesis size, insufficient prosthesis overlap of hernia defects, improper fixation, prosthesis folding or twisting, missed hernias, or mesh lifting secondary to hematoma formation. CONCLUSIONS: The predominant factor in successful preperitoneal hernia repair is adequate dissection with complete exposure and coverage of all potential groin hernia sites. Hematoma mesh lifting and inadequate lateral inferior and medial inferior mesh fixation represent the most common causes of recurrence for surgeons experienced in traditional or laparoscopic preperitoneal hernia repair. PMID:9114802

Lowham, A S; Filipi, C J; Fitzgibbons, R J; Stoppa, R; Wantz, G E; Felix, E L; Crafton, W B

1997-01-01

265

Laparoscopic repair of parastomal hernias: early results  

Microsoft Academic Search

Background: Open repair of parastomal hernias is associated with high rates of morbidity and recurrence. Laparoscopic repair with mesh has been described, and good results have been reported in small case series with short-term follow-up. The purpose of this study was to review our institution’s experience with the laparoscopic repair of parastomal hernias. Methods: Nine patients with symptomatic parastomal hernias

B. Safadi

2004-01-01

266

Laparoscopic excision of a retrorectal schwannoma  

Microsoft Academic Search

Retrorectal tumors are uncommon and are usually managed by open surgical excision. Recent advances in laparoscopic techniques\\u000a have led to the use of laparoscopy for a variety of problems in colorectal surgery, including the excision of retrorectal\\u000a tumours. This case report, which describes the laparoscopic excision of a benign schwannoma arising from the second sacral\\u000a nerve root, highlights the benefits

M. Rao; P. Sagar; S. Duff; M. Hulme-Moir; I. Brayshaw

2010-01-01

267

Laparoscopic renal cryoablation in 32 patients  

Microsoft Academic Search

Objectives. Laparoscopic renal cryoablation is a developmental minimally invasive nephron-sparing treatment alternative for highly select patients with small renal tumors. We present our evolving experience with this procedure.Methods. Thirty-two patients (34 tumors) with a mean tumor size of 2.3 cm on preoperative computed tomography underwent laparoscopic renal cryoablation. As dictated by the tumor location, cryoablation was performed by either the

Inderbir S Gill; Andrew C Novick; Anoop M Meraney; Roland N Chen; Michael G Hobart; Gyung Tak Sung; Jonathan Hale; Dana K Schweizer; Erick M Remer

2000-01-01

268

Laparoscopic Approaches to Pancreatic Endocrine Tumors  

Microsoft Academic Search

\\u000a Pancreatic endocrine tumors (PETs) are rare. Resection is the only curative treatment [1, 2]. A brief overview of the pathophysiology\\u000a and classification of PETs along with epidemiology and survival data is presented. The role of various diagnostic imaging\\u000a modalities is discussed and appropriate patient selection is presented as a guide. Laparoscopic and hand-assisted laparoscopic\\u000a (HALS) approaches to distal pancreatectomy, with

John B. Martinie; Stephen M. Smeaton

269

Massive left hemothorax following laparoscopic pyeloplasty.  

PubMed

Laparoscopic pyeloplasty is viable standard minimally invasive alternative to open pyeloplasty for the treatment of ureteropelvic junction obstruction. Intrathoracic bleeding is an extremely rare complication after laparoscopic urological surgery, but it should be suspected and promptly diagnosed in case of worsening hemodynamic status and respiratory parameters during the intra or post-operative course. We report a case of hemothorax complicating an otherwise uneventful LP in an 18-year-old girl. PMID:25378831

Rao, Manjula; D'Souza, Nischith; Khan, Altaf; Rahiman, Mujeebu

2014-10-01

270

[Large simple liver cyst treated laparoscopically].  

PubMed

Simple liver cysts of various sizes are present in 1% of the population. Most are found incidentally and require no treatment. However, in a few the cyst is symptomatic and requires surgery: celiotomy and unroofing of the cyst. A 64-year-old woman with a symptomatic, simple cyst of the liver underwent laparoscopic surgery. After an uneventful course she was discharged on the 3rd postoperative day. Simple liver cysts can be safely treated by laparoscopic surgery. PMID:8138207

Lazauskas, T; Greif, F; Michowitz, M; Lelcuk, S

1994-01-01

271

Laparoscopic Colorectal Surgery in Obese Patients  

Microsoft Academic Search

Background: The aim of the study was to the evaluate results of laparoscopic colorectal surgery in obese patients. Methods:\\u000a All patients who underwent elective laparoscopic colorectal surgery from January 1993 to December 2003 were included in the\\u000a study. BMI >30 was used as an objective obesity criterion. The evaluated parameters included BMI, age, sex, diagnosis and\\u000a associated diseases, American Society

Jan Dostalík; Lubomír Martínek; Petr Vávra; Petr Andel; Igor Gunka; Petra Gunková

2005-01-01

272

Laparoscopic liver resection of benign liver tumors  

Microsoft Academic Search

  Objective: The objective of this study was to assess the feasibility, safety, and outcome of laparoscopic liver resection\\u000a for benign liver tumors in a multicenter setting. Background: Despite restrictive, tailored indications for resection in benign\\u000a liver tumors, an increasing number of articles have been published concerning laparoscopic liver resection of these tumors.\\u000a Methods: A retrospective study was performed in 18

B. Descottes; D. Glineur; F. Lachachi; D. Valleix; J. Paineau; A. Hamy; M. Morino; H. Bismuth; D. Castaing; E. Savier; P. Honore; O. Detry; M. Legrand; J. S. Azagra; M. Goergen; M. Ceuterick; J. Marescaux; D. Mutter; B. Hemptinne; R. Troisi; J. Weerts; B. Dallemagne; C. Jehaes; M. Gelin; V. Donckier; R. Aerts; B. Topal; C. Bertrand; B. Mansvelt; L. Krunckelsven; D. Herman; M. Kint; E. Totte; R. Schockmel; J. F. Gigot

2003-01-01

273

[Relaparoscopy as an alternative to laparotomy for laparoscopic complications].  

PubMed

In the field of visceral surgery, complications requiring reintervention following laparoscopy are currently most likely to be approached with conventional laparotomy. However, relaparoscopy has the theoretical advantage of maintaining the reduced morbidity allowed by the first procedure. Essential to the success of relaparoscopy is a clear understanding of the various specific complications. Should the surgeon decide on relaparoscopy, then prompt action is of central importance. Following laparoscopic cholecystectomy, it is fundamentally technically possible through renewed laparoscopy to treat not only subhepatic abscesses but also smaller lesions of the bile duct, for example from the gall bladder fossa. Revision of complications following fundoplication is technically very demanding and should be performed only by those most experienced in the techniques of laparoscopy. In contrast to interventional drainage, relaparoscopy of abscesses following laparoscopic appendectomy has the theoretical advantage of allowing recognition and treatment of the causes, for example in the case of appendicular stump insufficiency. Relapses very shortly after endoscopic surgery of inguinal herniae result from erroneous technique and may be corrected endoscopically in most cases. Complications following colon surgery have so far been dealt with using open surgery for technical reasons and also for patient safety. Given the uncertainty in the literature, patient safety must be paramount, when deciding on which technique is best to employ, particularly in cases of haemorrhage. PMID:17036247

Leister, I; Becker, H

2006-11-01

274

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

275

Pure Laparoscopic and Robot-Assisted Laparoscopic Reconstructive Surgery in Congenital Megaureter: A Single Institution Experience  

PubMed Central

To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150–220) and 187 (range: 170–205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10–30) and 28.75 (range: 15–20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4–6) and 5.75 (range: 5–6) d, respectively, and the indwelling catheter time was 6.33 (range: 4–8) d and 7 (range: 7–7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7–8) d and 8 (range: 7–10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter. PMID:24924420

Zhang, Peng; Gao, Jiangping; Dong, Jun; Chen, Guangfu; Xu, Axiang; Ma, Xin; Li, Hongzhao; Shi, Lixin

2014-01-01

276

Laparoscopic intracorporeal distal rectal transection with the CONTOUR(®) device.  

PubMed

Laparoscopic rectal resection is considered technically more demanding than laparoscopic colectomy. Rectal transection is a challenging part of laparoscopic low anterior rectal resection and restorative proctocolectomy. We describe our technique for laparoscopic rectal transection with a curved cutter, a device initially designed for open surgery, combined with the use of a ring-mounted sterile drape that allows maintenance of sufficient intra-abdominal gas pressure in a series of 34 patients. PMID:22426929

Alevizos, L; Lirici, M M

2012-10-01

277

A newly developed morcellator creates a new dimension in minimally invasive surgery  

Microsoft Academic Search

We compared the efficiency and safety of a newly developed morcellator with a conventional device for minimally invasive supracervical hysterectomy. The prospective, randomized parallel-group study was set in a department of obstetrics and gynecology within an Academic Teaching Hospital. Patients included 48 women; 20 treated with an existing laparoscopic morcellator (Group 1); 28 treated with newly developed laparoscopic morcellator (Group

S. Brucker; E. Solomayer; W. Zubke; S. Sawalhe; A. Wattiez; D. Wallwiener

2007-01-01

278

Cutaneous Metastasis Following Laparoscopic Pelvic Lymphadenectomy for Prostatic Carcinoma  

Microsoft Academic Search

A case of implantation metastasis in the abdominal wall following transabdominal laparoscopic pelvic lymphadenectomy is reported. A cutaneous nodule was palpated at 1 of the laparoscopic ports 6 months after laparoscopic lymphadenectomy in a 66-year-old patient with stage T3pN1M0, grade 2 adenocarcinoma of the prostate. Aspiration cytology confirmed metastatic adenocarcinoma.

Chr H. Bangma; W. J. Kirkels; S. Chadha; F. H. Schroder

1995-01-01

279

Minireview on laparoscopic hepatobiliary and pancreatic surgery  

PubMed Central

The first laparoscopic cholecystectomy was performed in the mid-1980s. Since then, laparoscopic surgery has continued to gain prominence in numerous fields, and has, in some fields, replaced open surgery as the preferred operative technique. The role of laparoscopy in staging cancer is controversial, with regards to gallbladder carcinoma, pancreatic carcinoma, hepatocellular carcinoma and liver metastasis from colorectal carcinoma, laparoscopy in conjunction with intraoperative ultrasound has prevented nontherapeutic operations, and facilitated therapeutic operations. Laparoscopic cholecystectomy is the preferred option in the management of gallbladder disease. Meta-analyses comparing laparoscopic to open distal pancreatectomy show that laparoscopic pancreatectomy is safe and efficacious in the management of benign and malignant disease, and have better patient outcomes. A pancreaticoduodenectomy is a more complex operation and the laparoscopic technique is not feasible for this operation at this time. Robotic assisted pancreaticoduodenectomy has been tried with limited success at this time, but with continuing advancement in this field, this operation would eventually be feasible. Liver resection remains to be the best management for hepatocellular carcinoma, cholangiocarcinoma and colorectal liver metastases. Systematic reviews and meta-analyses have shown that laparoscopic liver resections result in patients with equal or less blood loss and shorter hospital stays, as compared to open surgery. With improving equipment and technique, and the incorporation of robotic surgery, minimally invasive liver resection operative times will improve and be more efficacious. With the incorporation of robotic surgery into hepatobiliary surgery, donor hepatectomies have also been completed with success. The management of benign and malignant disease with minimally invasive hepatobiliary and pancreatic surgery is safe and efficacious. PMID:24634709

Tan-Tam, Clara; Chung, Stephen W

2014-01-01

280

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. PMID:25419372

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

2014-01-01

281

Comparison of Surgical Skills in Laparoscopic and Robotic Tasks Between Experienced Surgeons and Novices in Laparoscopic Surgery: An Experimental Study  

PubMed Central

Purpose Robotic surgery is known to provide an improved technical ability as compared to laparoscopic surgery. We aimed to compare the efficiency of surgical skills by performing the same experimental tasks using both laparoscopic and robotic systems in an attempt to determine if a robotic system has an advantage over laparoscopic system. Methods Twenty participants without any robotic experience, 10 laparoscopic novices (LN: medical students) and 10 laparoscopically-experienced surgeons (LE: surgical trainees and fellows), performed 3 laparoscopic and robotic training-box-based tasks. This entire set of tasks was performed twice. Results Compared with LN, LEs showed significantly better performances in all laparoscopic tasks and in robotic task 3 during the 2 trials. Within the LN group, better performances were shown in all robotic tasks compared with the same laparoscopic tasks. However, in the LE group, compared with the same laparoscopic tasks, significantly better performance was seen only in robotic task 1. When we compared the 2 sets of trials, in the second trial, LN showed better performances in laparoscopic task 2 and robotic task 3; LE showed significantly better performance only in robotic task 3. Conclusion Robotic surgery had better performance than laparoscopic surgery in all tasks during the two trials. However, these results were more noticeable for LN. These results suggest that robotic surgery can be easily learned without laparoscopic experience because of its technical advantages. However, further experimental trials are needed to investigate the advantages of robotic surgery in more detail. PMID:24851216

Kim, Hye Jin; Park, Jun Seok; Park, Soo Yeun

2014-01-01

282

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

283

Laparoscopic trocar port site endometriosis: a case report and brief literature review.  

PubMed

Endometriosis is defined as the presence of ectopic endometrial tissue outside the lining of the uterine cavity. It occurs most commonly in pelvic sites such as ovaries, cul-de-sac, and fallopian tubes but also can be found associated with the lungs, bowel, ureter, brain, and abdominal wall. Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. Although many cases of scar endometriosis have been reported after a cesarean section, some cases of scar endometriosis have been reported after an episiotomy, hysterectomy, appendectomy, and laparoscopic trocar port tracts. To our knowledge, 14 case reports related to trocar site endometriosis have been published in the English language literature to date. Herein, we present the case of a 20-year-old woman (who had been previously operated on for left ovarian endometrioma 1.5 years ago by laparoscopy) with the complaint of a painful mass at the periumbilical trocar site with cyclic pattern. Consequently, although rare, if a painful mass in the surgical scar, such as the trocar site, is found in women of reproductive age with a history of pelvic or obstetric surgery, the physician should consider endometriosis. PMID:23102079

Emre, Arif; Akbulut, Sami; Yilmaz, Mehmet; Bozdag, Zehra

2012-01-01

284

Laparoscopic Management of Complex Crohn's Disease  

PubMed Central

Background: Although the technical feasibility of laparoscopic management of Crohn's disease has been described, it remains of limited perceived usefulness in the management of surgically complex Crohn's. Successful management of such disease by using minimal access techniques is described. Patients and Methods: Seventeen patients underwent laparoscopically assisted procedures to address clinically complex disease. Goals of the laparoscopic phase included mobilization of pertinent structures, localization of disease, and precise selection of incision location. Clinical situations encountered included fistulas, multiple-or long-segment disease, abscesses, and reoperative management. Results: Conversion to completely open procedures was not necessary in any case. Operative time was longer in complex Crohn's disease than in concurrently managed patients who underwent laparoscopic ileal/cecal resection for limited disease (244±18 vs 127±5 minutes, P<0.05). Management of long-segment or multi-segment disease was associated with the longest operative times (292±36 minutes). Length of hospitalization was also longer than after management of limited ileal disease (7.1±1.4 vs 4.5±0.4 days). Major complications occurred in 18%. Conclusions: Laparoscopic techniques can be applied to complex Crohn's disease with effective disease management. In patients who may require multiple procedures, maintenance of abdominal wall integrity should be of significant value. PMID:12856841

Kavic, Stephen M.

2003-01-01

285

Laparoscopic Resection of Retroperitoneal Neural Tumors  

PubMed Central

Purpose Retroperitoneal neural tumor (RNT) is rarely excised laparoscopically, and the laparoscopic management of RNT remains controversial. We herein report 4 cases of laparoscopic excision of RNT that resulted in diverse clinical outcomes. Patients and Methods Between August 2005 and January 2011, we performed laparoscopic excision of RNT in 4 patients. The mean tumor size was 4.5 cm. The mean operative time was 297 minutes and the mean amount of blood loss was 55 ml. The surgeries were uneventful, with no operative complications or evidence of intra-abdominal bleeding. However, 2 patients required reoperation for delayed hemorrhage and urinoma formation, respectively. Results The postoperative pathological diagnoses were schwannoma in 3 patients and ganglioneuroblastoma in 1 patient. All patients were well with no signs of peripheral neuropathy or radiculopathy, and CT and/or 18F-FDG PET/CT performed during follow-up indicated no evidence of disease. Conclusions Obtaining extensive preoperative knowledge of the source neural and vascular anatomy of the tumor is important for the surgical planning of laparoscopic resection of RNT. When a great deal of care is taken to divide the tumor and the source nerves and vital vessels, safe execution of RNT can be achieved for minimal postoperative mortality and morbidity. PMID:24917756

Nozaki, Tetsuo; Kato, Tomonori; Morii, Akihiro; Fuse, Hideki

2013-01-01

286

Laparoscopic use of laser and monopolar electrocautery  

NASA Astrophysics Data System (ADS)

Most general surgeons are familiar with monopolar electrocautery, but few are equally comfortable with laser dissection and coagulation. At courses across the country, surgeons are being introduced to laparoscopy and laser use in one and two day courses, and are certified from that day forward as laser laparoscopists. Some surgeons are told that laser and electrosurgery may be equally acceptable techniques for performance of laparoscopic surgery, but that a surgeon may double his patient volume by advertising 'laser laparoscopic cholecystectomy.' The sale of certain lasers has skyrocketed on the basis of such hype. The only surprise is that laparoscopic cholecystectomy complications occurring in this country seem to be more closely related to the laparoscopic access and visualization than to the choice of laser of electrocautery as the preferred instrument for thermal dissection. The purpose of this article is to: 1) Discuss the physics and tissue effects of electrosurgery and laser; 2) compare the design and safety of electrosurgical and laser delivery systems; and 3) present available data comparing laser and electrocautery application in laparoscopic cholecystectomy.

Hunter, John G.

1991-07-01

287

Bimanual haptic workstation for laparoscopic surgery simulation.  

PubMed

Realistic laparoscopic surgical simulators will require real-time graphic imaging and tactile feedback. Our research objective is to develop a cost-effective haptic workstation for the simulation of laparoscopic procedures for training and treatment planning. The physical station consists of a custom-built frame into which laparoscopic trocars and surgical tools may be attached/inserted and which are continuously adjustable to various positions and orientations to simulate multiple laparoscopic surgical approaches. Instruments inserted through the trocars are attached to end effectors of two haptic devices and interfaced to a high speed PC with fast graphics capability. The haptic device transduces 3D motion of the two manually operated surgical instruments into slave maneuvers in virtual space. The slave instrument tips probe the simulated organ. Simulations currently in progress include: 1) Surface-only renderings, deformation, and haptic interactions with elements in the gall gladder surgical field; 2) Voxel-based simulations of the bulk manipulation of tissue; 3) laparoscopic herniorrhaphy. This system provides force feed-forward from the grasped tools to the contact tissue in virtual space, with deformation of the tissue by the virtual probe, and force feedback from the deformed tissue to the operator's hands. PMID:11317725

Devarajan, V; Scott, D; Jones, D; Rege, R; Eberhart, R; Lindahl, C; Tanguy, P; Fernandez, R

2001-01-01

288

Visual search behaviour during laparoscopic cadaveric procedures  

NASA Astrophysics Data System (ADS)

Laparoscopic surgery provides a very complex example of medical image interpretation. The task entails: visually examining a display that portrays the laparoscopic procedure from a varying viewpoint; eye-hand coordination; complex 3D interpretation of the 2D display imagery; efficient and safe usage of appropriate surgical tools, as well as other factors. Training in laparoscopic surgery typically entails practice using surgical simulators. Another approach is to use cadavers. Viewing previously recorded laparoscopic operations is also a viable additional approach and to examine this a study was undertaken to determine what differences exist between where surgeons look during actual operations and where they look when simply viewing the same pre-recorded operations. It was hypothesised that there would be differences related to the different experimental conditions; however the relative nature of such differences was unknown. The visual search behaviour of two experienced surgeons was recorded as they performed three types of laparoscopic operations on a cadaver. The operations were also digitally recorded. Subsequently they viewed the recording of their operations, again whilst their eye movements were monitored. Differences were found in various eye movement parameters when the two surgeons performed the operations and where they looked when they simply watched the recordings of the operations. It is argued that this reflects the different perceptual motor skills pertinent to the different situations. The relevance of this for surgical training is explored.

Dong, Leng; Chen, Yan; Gale, Alastair G.; Rees, Benjamin; Maxwell-Armstrong, Charles

2014-03-01

289

Complications of diverticular disease: surgical laparoscopic treatment  

PubMed Central

Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of our study was to evaluate the outcome of laparoscopic colon resection in patients with diverticulitis and with complications like colon-vescical fistula, peridiverticular abscess, perforation or stricture. All patients underwent laparoscopic colectomy within 8 years period. Main data recorded were age, sex, return of bowel function, operation time, duration of hospital stay, ASA score, body mass index (BMI), early and late complications. During the study period, 33 colon resections were performed for diverticulitis and complications of diverticulitis. We performed 5 associated procedures. We had 2 postoperative complications; 1 of these required a redo operation with laparotomy for anastomotic leak and 3 patients required conversion from laparoscopic to open colectomy. The most common reasons for conversion were related to the inflammatory process with a severe adhesion syndrome. Mean operative time was 229 minutes, and average postoperative hospital stay was 9,8 days. Laparoscopic surgery for complications of diverticular disease is safe, effective and feasible. Laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis in our institution. PMID:24979103

ANANIA, G.; VEDANA, L.; SANTINI, M.; SCAGLIARINI, L.; GIACCARI, S.; RESTA, G.; CAVALLESCO, G.

2014-01-01

290

Laparoscopic removal of a huge gastric trichobezoar in a patient with trichotillomania.  

PubMed

Gastric bezoars are rare, and are commonly observed in female children with mental or emotional disorders. Large bezoars may not be suitable for endoscopic extraction and are conventionally removed at laparotomy. We present a 19-year-old girl who had trichotillomania with a symptomatic abdominal mass that represented a 17-cm gastric trichobezoar. This was removed laparoscopically through a gastrotomy in a water-impervious bag and was extracted piecemeal through a 4-cm extension of one of the port wounds. The bezoar weighed 720 g. She was discharged home on the third postoperative day and remains symptom-free at 12-month follow-up. Laparoscopic removal of large gastric trichobezoars is feasible and appears safe. PMID:17581466

Shami, Samer B; Jararaa, Ayatallah A M; Hamade, Ayman; Ammori, Basil J

2007-06-01

291

[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

292

Initial experience with laparoscopic-assisted transvaginal cholecystectomy: a hybrid approach to natural orifice surgery.  

PubMed

Minimally invasive surgery is designed to provide a friendlier surgical therapy, in terms of faster recovery times, improved cosmetic results, and reduced postoperative pain. In recent years, a new genre for exploring the abdominal cavity without incisions has been developed. Incisionless surgery is considered the next frontier in minimally invasive surgery. The idea is to use natural orifices as the entry point to the abdomen, by using an endoscope through a transgastric, transvaginal, transvesical, or transcolonic access; hence, it is called as natural orifice transluminal endoscopic surgery (NOTES). We report our first case of laparoscopic-assisted transvaginal cholecystectomy. We support that NOTES can provide benefits in terms of reduced pain, faster recovery, and better cosmetic results compared with conventional laparoscopic surgery. PMID:20187522

Rudiman, Reno; Wiradisuria, Errawan

2009-01-01

293

Laparoscopic Repair of a Posttraumatic Left-Sided Diaphragmatic Hernia Complicated by Strangulation and Colon Obstruction  

PubMed Central

Background: Posttraumatic diaphragmatic hernias (PDH) are serious complications of blunt and penetrating abdominal or thoracic trauma. Traditional thoracic or abdominal operations are usually performed in these cases. Methods: We present 2 cases of posttraumatic left-sided diaphragmatic hernia complicated by strangulation and colon obstruction. Both cases were successfully treated with laparoscopy. Results: We found that laparoscopy is a safe, successful, and gentle procedure not only for diagnosis but also for treatment of complicated PDH. Strangulation and colon obstruction were not contraindications to performing laparoscopic procedures. The postoperative course and long-term follow-up (range, 12 to 30 months) were uneventful and short. We expect the same good long-term results after laparoscopic repair as after open conventional surgery. Conclusion: We recommend the use a minimally invasive approach to treat posttraumatic diaphragmatic hernia complicated by strangulation and colon obstruction in hemodynamically stable patients. PMID:21333198

Protsenko, A.V.; Globin, A.V.

2010-01-01

294

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

295

Laparoscopic cholecystostomy for acute acalculous cholecystitis.  

PubMed

Acute acalculous cholecystitis (AAC) can occur in up to 18% of severely injured patients. Diagnosis is made by positive ultrasound findings of gallbladder sludge, hydrox, and wall thickening. There may also be recent-onset jaundice, positive ultrasound induced Murphy's sign, and unexplained sepsis. Mortality can be as high as 50%. Laparoscopic confirmation was obtained in six ICU trauma patients when omentum was drawn up over a distended gallbladder. Laparoscopic cholecystectomy (LC) was done by first directly decompressing the gallbladder through the fundus. This trocar was replaced by a 16 French Foley catheter passed through an Endoloop into the gallbladder and secured by tightening the loop around a cuff of gallbladder. Sepsis resolved in all cases. Only one required subsequent laparoscopic cholecystectomy. LC has a low morbidity and may be life saving during the early stages of AAC. It is not indicated in gangrene or perforation of the gallbladder. PMID:8662413

Yang, H K; Hodgson, W J

1996-06-01

296

Laparoscopic resection of a retroperitoneal pelvic schwannoma  

PubMed Central

Schwannomas are rarely located in the pelvis. A 54-year-old woman was found incidentally to have a tumor in the abdomen. Abdominal computed tomography and magnetic resonance imaging revealed a well-defined, heterogeneous tumor, 5 cm in diameter, in the pelvic cavity. With a diagnosis of a mesenteric tumor, a laparoscopic procedure was performed. Intra-operatively, an elastic tumor was identified in the pelvis adjacent to the right internal iliac vein and ureter. The tumor was dissected free from adjacent structures using Liga-Sure and blunt maneuvers. A complete laparoscopic excision was performed. Histopathological examination revealed a benign schwannoma. The patient had an uneventful post-operative course, and was discharged on the fourth post-operative day. Laparoscopic treatment is useful and feasible for retroperitoneal pelvic schwannoma, with minimal invasiveness and an early post-operative recovery. Thus, this procedure may be the first-choice surgical procedure for retroperitoneal pelvic schwannomas. PMID:24876325

Okuyama, Takashi; Tagaya, Nobumi; Saito, Kazuyuki; Takahashi, Shuhei; Shibusawa, Hiroyuki; Oya, Masatoshi

2014-01-01

297

The first total laparoscopic pancreatoduodenectomy in Poland.  

PubMed

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 3(rd) 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

Budzy?ski, Andrzej; Zub-Pokrowiecka, Anna; Zychowicz, Anna; P?dziwiatr, Micha?; Wierdak, Mateusz; Mat?ok, Maciej; Zaj?c, Ma?gorzata

2014-09-01

298

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

Budzy?ski, Andrzej; Zub-Pokrowiecka, Anna; Zychowicz, Anna; Wierdak, Mateusz; Mat?ok, Maciej; Zaj?c, Ma?gorzata

2014-01-01

299

Diagnostic laparoscopic biopsy for intraabdominal tumors.  

PubMed

Improvements in imaging technology have resulted in an increase in the incidental detection of intraabdominal tumors. Diagnostic computed tomography (CT)- and ultrasound (US)-guided biopsy, while minimally invasive, often provides specimens that are insufficient for histological evaluation. Moreover, it can be difficult to perform because the location and size of the tumor. In such cases, laparoscopic biopsy is useful because it is less invasive than laparotomy, but more reliable than imaging-guided biopsy, to obtain a sufficient specimen, regardless of the location and size of the tumor. We report a series of seven patients who underwent laparoscopic biopsy of intraabdominal tumors of unknown origin. There were no cases of conversion to laparotomy and all patients were able to resume oral intake on postoperative day 1. There were no intraoperative or postoperative complications. Thus, laparoscopic biopsy for a tumor of unknown origin is useful and minimally invasive. PMID:25212568

Sakamoto, Yasuo; Karashima, Ryuichi; Ida, Satoshi; Imamura, Yu; Iwagami, Shiro; Baba, Yoshifumi; Miyamoto, Yuji; Yoshida, Naoya; Baba, Hideo

2015-03-01

300

[Laparoscopic and general surgery guided by open interventional magnetic resonance].  

PubMed

Interventional magnetic resonance (IMR) machines have produced unique opportunity for image-guided surgery. The open configuration design and fast pulse sequence allow virtual real time intraoperative scanning to monitor the progress of a procedure, with new images produced every 1.5 sec. This may give greater appreciation of anatomy, especially deep to the 2-dimensional laparoscopic image, and hence increase safety, reduce procedure magnitude and increase confidence in tumour resection surgery. The aim of this paper was to investigate the feasibility of performing IMR-image-guided general surgery, especially in neoplastic and laparoscopic field, reporting a single center -- St. Mary's Hospital (London, UK) -- experience. Procedures were carried out in a Signa 0.5 T General Elettric SP10 Interventional MR (General Electric Medical Systems, Milwaukee, WI, USA) with magnet-compatible instruments (titanium alloy instruments, plastic retractors and ultrasonic driven scalpel) and under general anesthesia. There were performed 10 excision biopsies of palpable benign breast tumors (on female patients), 3 excisions of skin sarcoma (dermatofibrosarcoma protuberans), 1 right hemicolectomy and 2 laparoscopic cholecystectomies. The breast lesions were localized with pre- and postcontrast (intravenous gadolinium DPTA) sagittal and axial fast multiplanar spoiled gradient recalled conventional Signa sequences; preoperative real time fast gradient recalled sequences were also obtained using the flashpoint tracking device. During right hemicolectomy intraoperative single shot fast spin echo (SSFSE) and fast spoiled gradient recalled (FSPGR) imaging of right colon were performed after installation of 150 cc of water or 1% gadolinium solution, respectively, through a Foley catheter; imaging was also obtained in an attempt to identify mesenteric lymph nodes intraoperatively. Concerning laparoscopic procedures, magnetic devices (insufflator, light source) were positioned outside scan room, the tubing and light head being passed through penetration panels. Intraoperative MR-cholangiography was performed using fast spin echo (SSFSE) techniques with minimal intensity projection 3-dimensional reconstruction. About skin sarcomas, 2 of them were skin recurrences of previously surgically treated sarcomas (all of them received preoperative biopsy) and the extent of the lesion was then determined using short tau inversion recovery (STIR) sequence. The skin was closed in each case without need for any plastic reconstruction. The breast lesions were visualized with both Signa and real-time imaging and all enhanced with contrast: 2 (20%) were visualized only after contrast enhancement; intraoperative real time imaging clearly demonstrated a resection margin in all cases. Maximum dimensions of breast specimens (range 8-50 mm, median 24.5 mm) were not significantly different from those measured by Signa (p>0.17, Student's paired t-test) or real time images (p>0.4): also there was no significant difference in lesion size between Signa and real time images (p>0.25). All postprocedure scans clearly demonstrated complete excision. The extent of the tumor at MR imaging was greater in each case than suggested by clinical examination. Adequate resection margins were planned using STIR sequences. Histological examination confirmed clear surgical margins of at least 1 cm in each case. During right hemicolectomy, both intraoperative SSFSE and FSPGR contrast imaging revealed the lesion and details of the colonic surface; imaging of the lymph node draining right colon was only partially successful, due to movement artifact. Concerning laparoscopic procedures, both FSE and SSFSE techniques produced reasonable images of the gallbladder and intrahepatic ducts, but the FSE imaging was of poor quality due to respiration artifact; however, SSFSE allowed visualization of the gallbladder and part of the common bile duct. About skin sarcomas, the extent of the tumor at MR imaging was greater in each case than suggested by clinical examination and in each case the com

Lauro, A; Gould, S W T; Cirocchi, R; Giustozzi, G; Darzi, A

2004-10-01

301

Two-port laparoscopic adnexal surgery with a multichannel port using a wound retractor: is it safe and minimally scarring?  

PubMed

This study aimed to explore and evaluate the feasibility and safety of laparoscopic adnexal surgery using a two-port technique with a multichannel port, using a wound retractor, as previously reported. A series of patients undergoing two-port laparoscopy for a benign pelvic mass were enrolled in this study. To perform two-port laparoscopic surgery, the ancillary 5-mm trocar was inserted at the left iliac fossa under laparoscopic view after umbilical trocar insertion. The inserted umbilical trocar was removed and the skin incision was extended about 1.5 cm with index-finger-passable width. An Alexis wound retractor XS (Applied Medical, Santa Rancha Margarita, CA) was inserted through the umbilical wound. Two trocars were inserted into two fingers of a no. 6 surgical rubber glove and ligated with rubber bands. The wrist portion of the rubber glove covered the wound retractor, and the edge of the wound retractor was clamped with three Babcock clamps to prevent carbon-dioxide gas leakage. Both a 10-mm laparoscope and atraumatic forceps were inserted through the umbilical multichannel port. Laparoscopic adnexal surgery was performed in the usual manner. A total of 19 patients were enrolled. The operative procedures were adnexectomy (n = 8), myomectomy (n = 1), and ovarian cystectomy and/or salpingectomy (n = 10). There were no operative complications, conversion to laparotomy, or additional trocar insertions. The mean operation time was 81.3 +/- 28.7 min. The pathologic diagnosis were mature cystic teratoma (n = 6), benign cyst (n = 4), endometrial cyst (n = 3), serous cystadenoma (n = 3), mucinous cystadenoma (n = 1), leiomyoma (n = 1), and tubo-ovarian abscess (n = 1). The mean postoperative hospital stay was 4.0 +/- 1.3 days. This two-port method seems to be safe and needs no additional cost from the use of the conventional laparoscopic instruments. It is also cosmetically effective and highly appreciated by patients, leaving minimal abdominal scarring. PMID:19694570

Yi, Sang-Wook

2009-12-01

302

Ergonomic problems associated with laparoscopic surgery  

Microsoft Academic Search

Background: The Society of American Gastrointestinal Endoscopic Surgeons (SAGES) Task Force on Ergonomics conducted a subjective and\\u000a objective assessment of ergonomic problems associated with laparoscopic instrument use. The goal was to assess the prevalence,\\u000a causes, and consequences of operational difficulties associated with the use of laparoscopic instruments.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: A questionnaire was distributed asking respondents to rate the frequency with which

R. Berguer; D. L. Forkey; W. D. Smith

1999-01-01

303

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

304

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

305

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

306

Laparoscopic management of acute small bowel obstruction  

Microsoft Academic Search

Background: The use of laparoscopy has expanded to include the management of acute abdomen. This study describes the author's experience\\u000a with laparoscopic management of acute small bowel obstruction.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: From February 1994 through March 1998, 19 patients underwent laparoscopic intervention for acute small bowel obstruction.\\u000a Their clinical data were analyzed to evaluate the outcome.\\u000a \\u000a \\u000a \\u000a \\u000a Results: A total of 19 patients

A. A. Al-Mulhim

2000-01-01

307

Oncologic implications of laparoscopic and open surgery.  

PubMed

Although instrumental manipulation and mechanical tumor cell spillage seem to play the major role in port-site metastases from laparoscopic cancer surgery, minimally invasive procedures are used more and more in the resection of malignancies. However, port-site metastases also have been reported after resection of colon cancer in International Union Against Cancer (UICC) stage I [2, 14]. Therefore, changes in the peritoneal environment during laparoscopy also might influence intra- and extraperitoneal tumor growth during laparoscopy and pneumoperitoneum. Different results of experimental studies presented at the Third International Conference for Laparoscopic Surgery are analyzed and discussed. PMID:11928024

Jacobi, C A; Bonjer, H J; Puttick, M I; O'Sullivan, R; Lee, S W; Schwalbach, P; Tomita, H; Kim, Z G; Hewett, P; Wittich, P; Fleshman, J W; Paraskeva, P; Gessman, T; Neuhaus, S J; Wildbrett, P; Reymond, M A; Gutt, C; Whelan, R I

2002-03-01

308

Laparoscopic gastrostomy as an adjunctive procedure to laparoscopic fundoplication in children  

Microsoft Academic Search

.   Infants and children requiring fundoplication for gastroesophageal reflux frequently have significant associated medical\\u000a problems necessitating placement of a gastrostomy at the time of fundoplication. This article reviews the techniques, complications,\\u000a and results of 141 laparoscopic Stamm gastrostomies performed in conjunction with laparoscopic fundoplication in infants and\\u000a children. The three techniques employed were the T-fastener technique (63\\/141) which is best

L. K. Sampson; K. E. Georgeson; D. C. Winters

1996-01-01

309

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

310

Laparoscopic intrauterine insemination in the bitch  

Microsoft Academic Search

A technique for laparoscopic intrauterine insemination in bitches is described. During natural estrus, 5 beagle bitches were inseminated and S others were naturally mated (control group) twice at a 48-h interval on Days 3 and S (n = 4) or Days 4 and 6 (n = 6) after the increase in plasma progesterone considered to be indicative of the day

L. D. M. Silva; K. Onclin; F. Snaps; J. Verstegen

1995-01-01

311

Laparoscopic repair of strangulated Morgagni hernia  

Microsoft Academic Search

A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used.

Michael D Kelly

2007-01-01

312

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

313

Laparoscopic treatment of post renal transplant lymphoceles  

Microsoft Academic Search

Background: Traditionally, a post transplant lymphocele (PTL) is drained by widely opening the wall connecting the lymphocele cavity to the intraperitoneal space via laparotomy. We hypothesize that laparoscopic techniques can be effectively used for the treatment of PTL. Methods: Patients requiring intervention for PTL between 1993 and 2002 were identified via a retrospective review. Results of drainage via laparotomy and

S. H. Bailey; M. C. Mone; J. M. Holman; E. W. Nelson

2003-01-01

314

Laparoscopic repair of strangulated Morgagni hernia  

PubMed Central

A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used. PMID:17935621

Kelly, Michael D

2007-01-01

315

Laparoscopic surgery: A pioneer's point of view.  

PubMed

For a surgeon who performed some of the first laparoscopic cholecystectomies, laparoscopic surgery is undoubtedly the main revolution in the last decade of this century. It is impossible not to be fascinated by the extraordinary changes introduced in our profession in less than 10 years. However, looking back in history, one realizes that laparoscopy is but one of those leaps forward that have always punctuated the evolution of our profession. Since the last century we have witnessed the advent of painless surgery, infectionless surgery, reconstructive surgery, microsurgery, surgery under extracorporeal circulation, organ replacement, and so on. We are in the time of scarless surgery, with no lengthy postoperative handicap. Maybe tomorrow will see surgery performed by remote-controlled robots and surgery at the molecule level. The laparoscopic revolution is particularly important because for the first time surgery no longer involves any physical contact between the surgeon's hand and the patient. Let us hope that this will not lead to total absence of a human relationship in the surgical operation. To avoid this possibility we must remain resolutely involved in the development of laparoscopic surgery; we must keep our minds open to the future advances of science and technology and integrate them in our operative procedures. PMID:10415213

Périssat, J

1999-08-01

316

Pediatric laparoscopic appendectomy for acute appendicitis  

Microsoft Academic Search

Background: The benefit of laparoscopy in the treatment of pediatric acute appendicitis continues to be controversial, particularly as it relates to operative time and costs. Methods: We reviewed the charts of 200 children who underwent appendectomy for acute appendicitis concurrently over 35 months at a large teaching children’s hospital. Results: Laparoscopic ( n = 106) and open ( n =

A. H. Vernon; K. E. Georgeson; C. M. Harmon

2004-01-01

317

A preliminary comparison of a consecutive series of open versus laparoscopic abdomino-perineal resection for rectal adenocarcinoma  

Microsoft Academic Search

.  \\u000a Aim: To compare a consecutive series of patients who underwent laparoscopic abdomino-perineal resection (LAPR) versus conventional\\u000a open abdomino-perineal resection (CAPR). Material and Methods: Sixteen patients (8 females) and 11 patients (4 females) underwent LAPR and CAPR respectively. Results: The median operative time was 110 (65 – 210) mins and 100 (80 – 185) mins for LAPR and CAPR respectively

F. Seow-Choen; K. W. Eu; Y. H. Ho; A. F. P. K. Leong

1997-01-01

318

Laparoscopic surgery for colorectal cancer in China: an overview  

PubMed Central

Since its introduction into China in 2001, laparoscopic techniques have been extensively used for the surgical management of colorectal cancer during the last two decades in China. Like all the pioneers of the technique, Chinese gastrointestinal surgeons claim that laparoscopic surgery for colorectal cancer led to faster recovery, shorter hospital stay and more rapid return to daily activities respect to open surgery while offering the same functional and oncological results. There has been booming interest in laparoscopic surgery for colorectal cancer since 2006 in China. The last decade has witnessed national growth in the application of laparoscopic surgery for colorectal cancer and yielded a significant amount of scientific data to support its clinical merits and advantages. However, few prospective randomized controlled trials have investigated the benefits of laparoscopic surgery for colorectal cancer in China. In this article, we make an overview of the current data and state of the art of laparoscopic surgery for colorectal cancer in China. PMID:25663960

Jin, Ketao; Wang, Jun; Lan, Huanrong; Zhang, Ruili

2014-01-01

319

Laparoscopic-assisted continent stoma procedures: our new standard  

Microsoft Academic Search

Objectives. To compare standard surgery to laparoscopic-assisted surgery for the creation of continent stomas. Creation of an antegrade continent enema (ACE) and\\/or continent urinary (CU) stoma using the appendix may require a generous midline incision. A laparoscopic-assisted technique to reduce morbidity and improve cosmesis has been described for urologic reconstruction.Methods. Between February 1996 and November 1998, 11 laparoscopic-assisted ACE and\\/or

Jeffrey A Cadeddu; Steven G Docimo

1999-01-01

320

Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication  

Microsoft Academic Search

Laparoscopic Nissen fundoplication has been applied with increasing frequency in the treatment of gastroesophageal reflux\\u000a disease. The aim of this study was to determine the variahles that predict outcome of laparoscopic Nissen fundoplication.\\u000a A multivariate analysis was performed on data from 199 consecutive patients undergoing laparoscopic Nissen fundoplication.\\u000a Variables included age, sex, body mass index, primary symptoms, clinical response to

Guilherme M. R. Campos; Jeffrey H. Peters; Tom R. DeMeester; Stefan Öberg; Peter F. Crookes; Silvia Tan; Steven R. DeMeester; Jeffrey A. Hagen; Cedric G. Bremner

1999-01-01

321

Four zoom lens design for 3D laparoscope by using liquid lens  

NASA Astrophysics Data System (ADS)

Laparoscopic lens module that is capable of zooming is presented. The lens module has a high magnification and a high resolution such as four zoom and 2M pixels full HD image. The lens module consists of two lens sets to get 3-D images. Each lens module has several lenses less than conventional laparoscope but has 8 lenses and two liquid lenses. The total length of module is 19 mm long and the diameter is less than 5 mm. The separated distance of two lens center is 5 mm and two lens modules are inserted into the 11mm diameter laparoscope. The lens module is designed by Code V™ by using the 2M pixels CMOS sensor that the pixel size is 1.75 ?m. The merit of this fluidic lens design is being convertible between a convex and concave shape. The effective focal length of zoom-out and zoom-in modes is 3.24 mm and 12.94 mm respectively. The modulation transfer function of zoom-out and zoom-in modes is 40% and 30% at 140 lp/mm frequency. We have a diffraction of element at near stop to improve image resolution. Also the resolution of zoom-in mode is improved by using liquid iris. The F-number of a two modes is 4.4 and 5.8 and the optical distortion is 10% and 0.5%. It is expected that the z-direction resolution by this laparoscope is less than 2 mm

Lee, Seungwan; Choi, Minseog; Lee, Eunsung; Jung, Kyu-Dong; Chang, Jong-Hyeon; Kim, Woonbae

2012-10-01

322

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

323

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

324

Laparoscopic Surgery for Kidney Orthotopic Transplant in the Pig Model  

PubMed Central

Background and Objectives: Laparoscopic surgery has rapidly expanded in surgical practice with well-accepted benefits of minimal incision, less analgesia, better cosmetics, and quick recovery. The surgical technique for kidney transplantation has remained unchanged since the first successful kidney transplant in the 1950s. Over the past decade, there were only a few case reports of kidney transplantation by laparoscopic or robotic surgery. Therefore, the aim of this study is to develop a laparoscopic technique for kidney transplantation at the region of the native kidney. Methods: After initial development of the laparoscopic technique for kidney transplant in cadaveric pigs, 5 live pigs (Sus scrofa, weighing 45–50 kg) underwent laparoscopic kidney transplant under general anesthesia. First, laparoscopic donor nephrectomy was performed, and then the kidney was perfused and preserved with cold Ross solution. The orthotopic auto-transplant was subsequently performed using the laparoscopic technique. The blood flow of the kidney graft was assessed using Doppler ultrasonography, and urine output was monitored. Results: The laparoscopic kidney transplant was successful in 4 live pigs. Immediate urine output was observed in 3 pigs. The blood flow in the kidney was adequate, as determined using Doppler ultrasonography. Conclusion: It has been shown that laparoscopic kidney orthotopic transplant is feasible and safe in the pig model. Immediate kidney graft function can be achieved. A further study will be considered to identify the potential surgical morbidity and mortality after recovery in a pig model before translating the technique to clinical human kidney transplantation. PMID:23743384

Musk, Gabby C.; Mou, Lingjun; Waneck, Gerald L.; Delriviere, Luc

2013-01-01

325

[Laparoscopic surgery of perforated duodenal and gastric ulcers].  

PubMed

During the period of 13 months, the authors have operated on seven patients with perforated gastroduodenal ulcers. All surgeries were completely performed by the laparoscopic method. The laparoscopic suture of perforated ulcers was performed with lavage and only in one case it involved omentoplasty. The healing process was free of any complications in all patients. The advantage of laparoscopic operations of perforated ulcers resides in fast convalescence and in the fast restoration of working abilities. This method is appropriate in cases when the surgeon performing laparoscopic surgeries has sufficient experience in coincidence with the treatment of perforated ulcers. PMID:9721467

Ferencík, O; Tutka, S; Sabol, V; Lycius, M; Jalcovík, M; Cierny, A; Stepienová, A

1998-06-01

326

Surgical outcomes of robotic-assisted surgical staging for endometrial cancer are equivalent to traditional laparoscopic staging at a minimally invasive surgical center  

PubMed Central

Objective To compare peri- and post-operative complications and outcomes of robotic-assisted surgical staging with traditional laparoscopic surgical staging for women with endometrial cancer. Methods A retrospective chart review of cases of women undergoing minimally invasive total hysterectomy and pelvic and para-aortic lymphadenectomy by a robotic-assisted approach or traditional laparoscopic approach was conducted. Major intraoperative complications, including vascular injury, enterotomy, cystotomy, or conversion to laparotomy, were measured. Secondary outcomes including operative time, blood loss, transfusion rate, number of lymph nodes retrieved, and the length of hospitalization were also measured. Results 275 cases were identified–102 patients with robotic-assisted staging and 173 patients with traditional laparoscopic staging. There was no significant difference in the rate of major complications between groups (p=0.13). The mean operative time was longer in cases of robotic-assisted staging (237 min vs. 178 min, p<0.0001); however, blood loss was significantly lower (109 ml vs. 187 ml, p<0.0001). The mean number of lymph nodes retrieved were similar between groups (p=0.32). There were no significant differences in the time to discharge, re-admission, or re-operation rates between the two groups. Conclusion Robotic-assisted surgery is an acceptable alternative to laparoscopy for minimally invasive staging of endometrial cancer. In addition to the improved ease of operation, visualization, and range of motion of the robotic instruments, robotic surgery results in a lower mean blood loss, although longer operative time. More data are needed to determine if the rates of urinary tract injuries and other surgical complications can be reduced with the use of robotic surgery. PMID:20144471

Cardenas-Goicoechea, Joel; Adams, Sarah; Bhat, Suneel B.; Randall, Thomas C.

2010-01-01

327

Modified approach for extraperitoneal laparoscopic staging for locally advanced cervical cancer.  

PubMed

Describe a modified approach to the technique for staging laparoscopic extraperitoneal aortic and common iliac lymph node dissection for locally advanced cervical cancer.Retrospective, nonrandomized clinical study. (Canadian Task Force classification II-2), setting in an acute-care, teaching hospital. Thirty-six patients with locally advanced cervical cancer underwent laparoscopic surgical staging via extraperitoneal approach with the conventional or the modified technique from August 2001 through September 2004. Clinical outcomes in 23 patients who were operated on with the conventional technique using index finger for first trocar entrance; 12 patients with the modified technique using direct trocar entrance, were compared. One patient was excluded due to peritoneal carcinomatosis. Technique, baseline characteristics, histopathologic variables and surgical outcome were measured. There were no significant differences in patients basal characteristics on comparative analysis between conventional and modified technique. With our proposed modified technique, we obtained a reduced surgical procedure duration and blood loss. The proposed modified surgical technique offers some advantages, is an easier approach because the parietal pelvic peritoneum is elastic and this helps to avoid its disruption at time of trocar insertion, size of incision is shorter, we achieved no CO2 leak through the trocar orifice, and wound suture is fast and simple. PMID:18365538

Gil-Moreno, A; Maffuz, A; Díaz-Feijoo, B; Puig, O; Martínez-Palones, J M; Pérez, A; García, A; Xercavins, J

2007-12-01

328

Bowel function and irritable bowel symptoms after hysterectomy and cholecystectomy--a population based study.  

PubMed Central

Because unsubstantiated beliefs link hysterectomy and cholecystectomy with bowel function, this study examined all the women who had had these operations in a defined population (79 and 37 respectively, out of 1058) with respect to bowel habits, irritable bowel syndrome symptoms, and whole gut transit time calculated from records of three defecations. Compared with unoperated controls, women after hysterectomy were more likely to consider themselves constipated; they also strained more and admitted more often to bloating and feelings of incomplete evacuation. Their stools tended to be lumpier and, in women over 50 years, transit time was longer. When women treated by cholecystectomy were compared with women having newly discovered, asymptomatic gall stones, they more often described defecation as urgent but had no other detectable differences. In conclusion symptomatic constipation is frequent in women after hysterectomy; after cholecystectomy, bowel habit is not consistently changed but the rectum seems to be more irritable. PMID:8174964

Heaton, K W; Parker, D; Cripps, H

1993-01-01

329

Plasma progesterone in reindeer in relation to ovariectomy and hysterectomy.  

PubMed

Four semi-domesticated reindeer were ovariectomized and 3 both ovariectomized and hysterectomized, 30-70 days before expected parturition. Anaesthesia with etorphine/propyonylphenthiazine was followed by an increase in the plasma concentration of progesterone of peripheral blood. The concentration of progesterone returned to pre-anaesthetic values before ovariectomy. Ovariectomy did not result in any substantial change in the plasma progesterone concentration within an observation period of 35-120 min. Hysterectomy was followed by a marked decrease in peripheral plasma progesterone within 60 min. The progesterone concentration in ovarian venous blood was slightly higher than the jugular venous blood in 1 animal and 150 and 400 times higher in the 2 other animals examined. Thus, despite lack of marked changes of progesterone in jugular venous blood upon ovariectomy, it is concluded that the ovaries are a major production site of progesterone in pregnant reindeer. The progesterone in uterine venous blood was close to that in the jugular vein in 1 animal, and slightly higher in 2 others. This observation, and the maintenance of pregnancy in spite of ovariectomy in 2 out of 4 animals, point to the foeto-placental unit as an additional source of progesterone production. PMID:2399871

Sjaastad, O V; Blom, A K; Austad, R; Oen, E O

1990-01-01

330

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

331

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

332

Tubal ligation, hysterectomy and epithelial ovarian cancer in the New England Case-Control Study.  

PubMed

Previous studies have observed that tubal ligation and hysterectomy are associated with a decreased risk of ovarian cancer; however, little is known about whether these associations vary by surgical characteristics, individual characteristics or tumor histology. We used logistic regression to examine tubal ligation, simple hysterectomy and hysterectomy with unilateral oophorectomy in relation to risk of epithelial ovarian cancer in the New England Case-Control Study. Our primary analysis included 2,265 cases and 2,333 controls. Overall, tubal ligation was associated with a lower risk of epithelial ovarian cancer [odds ratio (OR) = 0.82, 95% confidence interval (CI): 0.68-0.97], especially for endometrioid tumors (OR = 0.45, 95% CI: 0.29-0.69). The inverse association between tubal ligation and ovarian cancer risk was stronger for women who had undergone the procedure at the time of last delivery (OR = 0.60, 95% CI: 0.42-0.84) rather than at a later time (OR = 0.93, 95% CI: 0.75-1.15). Overall, simple hysterectomy was not associated with ovarian cancer risk (OR: 1.09, 95% CI: 0.83-1.42), although it was associated with a nonsignificant decreased risk of ovarian cancer among women who underwent the procedure at age 45 or older (RR: 0.64, 95% CI: 0.40-1.02) or within the last 10 years (OR = 0.65, 95% CI: 0.38-1.13). Overall, women who had a hysterectomy with a unilateral oophorectomy had significantly lower risk of ovarian cancer (OR = 0.65, 95% CI: 0.45-0.94). In summary, tubal ligation and hysterectomy with unilateral oophorectomy were inversely associated with ovarian cancer risk in a large population-based case-control study. Additional research is necessary to understand the potential biologic mechanisms by which these procedures may reduce ovarian cancer risk. PMID:23650079

Rice, Megan S; Murphy, Megan A; Vitonis, Allison F; Cramer, Daniel W; Titus, Linda J; Tworoger, Shelley S; Terry, Kathryn L

2013-11-15

333

Laparoscopic resection of a giant exophytic liver haemangioma with the laparoscopic Habib 4× radiofrequency device.  

PubMed

Haemangiomas are the most common solitary benign neoplasm of the liver with an incidence ranging from 5% to 20%. Although usually small and asymptomatic, they may reach considerable proportions and rarely give rise to life-threatening complications. Surgical intervention is required for incapacitating symptoms, established complications, and diagnostic uncertainty. The resection of haemangiomas demands meticulous surgical technique, owing to their high vascularity and the concomitant risk of intra-operative haemorrhage. Laparoscopic resection of giant haemangiomas is even more challenging, and has only been reported twice. We here report the case of a giant 10 cm liver haemangioma which was successfully resected laparoscopically using the laparoscopic HabibTM 4×, a bipolar radiofrequency device, without clamping major vessels and with minimal blood loss. Transfusion of blood or blood products was not required. The patient had an uneventful recovery and was asymptomatic at 7-mo follow-up. PMID:23293733

Acharya, Metesh; Panagiotopoulos, Nikolaos; Bhaskaran, Premjithlal; Kyriakides, Charis; Pai, Madhava; Habib, Nagy

2012-08-27

334

Laparoscopic resection of a giant exophytic liver haemangioma with the laparoscopic Habib 4× radiofrequency device  

PubMed Central

Haemangiomas are the most common solitary benign neoplasm of the liver with an incidence ranging from 5% to 20%. Although usually small and asymptomatic, they may reach considerable proportions and rarely give rise to life-threatening complications. Surgical intervention is required for incapacitating symptoms, established complications, and diagnostic uncertainty. The resection of haemangiomas demands meticulous surgical technique, owing to their high vascularity and the concomitant risk of intra-operative haemorrhage. Laparoscopic resection of giant haemangiomas is even more challenging, and has only been reported twice. We here report the case of a giant 10 cm liver haemangioma which was successfully resected laparoscopically using the laparoscopic HabibTM 4×, a bipolar radiofrequency device, without clamping major vessels and with minimal blood loss. Transfusion of blood or blood products was not required. The patient had an uneventful recovery and was asymptomatic at 7-mo follow-up. PMID:23293733

Acharya, Metesh; Panagiotopoulos, Nikolaos; Bhaskaran, Premjithlal; Kyriakides, Charis; Pai, Madhava; Habib, Nagy

2012-01-01

335

[Conversions and reinterventions in laparoscopic cholecystectomy].  

PubMed

From the introduction of the laparoscopy in our clinic, more and more of the cholecystectomies, reaching over 50% are done by this technique. Based upon the accumulation of an already important experience, the paper tries to analyze the situations in which, during or after laparoscopic cholecystectomy, intraoperative conversions (deliberate or of necessity) or reinterventions were necessary. We present a global view of the number of these cases and also (an in detail) analysis of the causes the imposed such decisions and of the solutions adopted. The percentages of 5.55 conversions and 1.49 reinterventions seem reasonable and acceptable in comparison with the initial results published by some experience surgeons in the field of laparoscopic surgery. PMID:9854865

Dragomirescu, C; Li?escu, M; Iordache, N; Turcu, F; Pento, V; Iorgulescu, R; Cop?escu, C; Vizeteu, R; Munteanu, R

1998-01-01

336

Laparoscopic cholecystectomy using 2-mm instruments.  

PubMed

Today, laparoscopic cholecystectomy is the method of choice for treatment of symptomatic gallbladder disorders. It minimizes effects of the operation that are independent of the gallbladder, such as trauma to the abdominal wall and other soft tissue. The surgical wounds were even smaller when 2-mm trocars were used. Laparoscopic cholecystectomy using 2-mm instruments was performed in a consecutive series of 14 patients with symptomatic gallstones. The procedure was completed in 12 cases, with conversion to open surgery in two cases. Intraoperative cholangiography was always performed. The postoperative course was always uneventful. The cosmetic effect was highly satisfactory. The procedure using 2-mm instruments could be indicated in selected patients with uncomplicated gallstone disease. PMID:9820716

Uranüs, S; Peng, Z; Kronberger, L; Pfeifer, J; Salehi, B

1998-10-01

337

Laparoscopic hernia repair--the best option?  

PubMed

For 100 years the Bassini-type repair for inguinal hernia was the standard method. The Lichtenstein "tension free" mesh repair replaced it on the grounds of much lower recurrence rates, < 5% vs approximately 15%. However, open procedures all have significant long-term discomfort rates of up to 53%. Laparoscopic repair has become a genuine option in the last 15 years and offers low recurrence (< 1%) and minimal long-term discomfort. However, it has not been widely taken up. There is a common misconception that it takes longer to perform, has more complications and is much more expensive. None of these caveats stand up under objective scrutiny. It is time that laparoscopic repair became the method of choice for most elective inguinal hernia repairs. PMID:18557141

Wall, M L; Cherian, Th; Lotz, J C

2008-01-01

338

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

339

Laparoscopic surgical concepts of morbid obesity  

Microsoft Academic Search

Background According to the WHO, obesity and obesity with associated morbidity constitute a chronic, multi-factorial condition requiring treatment. Conservative treatment has been shown in long-term studies to be ineffective in morbid obesity. Surgical treatments break down into restrictive, malabsorptive, combined restrictive and malabsorptive or motility-reducing procedures. Method and results Laparoscopic implantation of an adjustable gastric band is an efficient restrictive

K. Miller; E. Hell

2003-01-01

340

Is a Drain Required after Laparoscopic Cholecystectomy?  

PubMed Central

Objective: Whether drains should be routinely used after laparoscopic cholecystectomy is still debated. We aimed to retrospectively evaluate the benefits of drain use after laparoscopic cholecystectomy for non-acute and non-inflamed gallbladders. Materials and Methods: Two hundred and fifty patients (mean age, 47±13.8 years; 200 females and 50 males) who underwent laparoscopic cholecystectomy for cholestasis were included in the study. The medical files of the patients were examined retrospectively to obtain data on patient demographics, cholecystitis attacks, complications during the operation, whether a drain was placed in the biliary tract during the operation, etc. The volume of the fluid collection detected in the subhepatic area by ultrasonography on the first postoperative day was recorded. Results: Drains were placed in 51 patients (20.4%). The mean duration of drain placement was 3.1±1.9 (range 1–16) days. Fluid collection was detected in the gallbladder area in 67 patients (26.8%). The mean volume of collected fluid was 8.8±5.2 mL. There were no significant effects of age, gender, and previous cholecystitis attacks on the presence or volume of the fluid collection (P>0.05 for all). With regard to the relationship between fluid collection and drains, 52 of 199 (26.1%) patients without drains had postoperative fluid collection, compared to 15 of 51 (29.4%) patients with drains (P>0.05). Conclusion: In conclusion, there is no relationship between the presence of a drain after laparoscopic cholecystectomy and the presence of postoperative fluid collection. Thus, in patients without complications, it is not necessary to place a drain to prevent fluid collection.

Gurer, Ahmet; Dumlu, Ersin Gurkan; Dikili, Erol; Kiyak, Gulten; Ozlem, Nuraydin

2013-01-01

341

Laparoscopic appendectomy for mucocele of the appendix  

PubMed Central

Mucocele of the appendix is an aseptic dilatation secondary to obstruction. The preoperative clinical diagnosis of appendiceal mucoceles can therefore be difficult because of this lack of clinical symptomotology. Surgical excision is the treatment of choice in benign mucocele. We report a case presenting to the surgeons where initial clinical findings and investigations suggested a cyst in the right adnexa. Diagnostic laparoscopy revealed mucocele of the appendix and laparoscopic appendicectomy was done. PMID:24678230

Singh, Manish Kumar; Kumar, Mani Kant; Singh, Ramanuj

2014-01-01

342

Laparoscopic versus Open Appendectomy: Time to Decide  

Microsoft Academic Search

.   Although widely practiced, laparoscopic appendectomy (LA) has not met with universal approval. Several controlled trials\\u000a have been conducted, some in favor, others not. The goal of this review was to ascertain (1) if laparoscopy was capable of\\u000a improving the diagnostic and therapeutic difficulties encountered during open appendectomy (OA) and (2) if the introduction\\u000a of laparoscopy in the overall management

Abe Fingerhut; Bertrand Millat; Fredéric Borrie

1999-01-01

343

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

344

Comparison of comorbidity resolution and improvement between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding  

Microsoft Academic Search

Background  This study aimed to compare the rates for resolution and improvement of common comorbidities between laparoscopic sleeve gastrectomy\\u000a (LSG) and laparoscopic adjustable gastric banding. The comorbid conditions included were type 2 diabetes mellitus (DM), hypertension\\u000a (HTN), hyperlipidemias (LPD), degenerative joint disease (DJD), gastroesophageal reflux disease (GERD), obstructive sleep\\u000a apnea (OSA), and asthma.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective chart review of the patients who

Juan J. Omana; Scott Q. Nguyen; Daniel Herron; Subhash Kini

2010-01-01

345

Laparoscopic fundoplication for gastroesophageal reflux disease.  

PubMed

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

2014-10-21

346

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

347

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

348

Laparoscopic-assisted colostomy closure after Hartmann's procedure  

Microsoft Academic Search

PURPOSE: The aim of the study was to review our experience with colostomy closure after Hartmann's procedure and the possible impact of laparoscopic colostomy closure. METHODS: A retrospective review of hospital stay after colostomy closure by laparotomy in the last four years was conducted. A chart review of patients undergoing laparoscopic colostomy closure after Hartmann's procedure since the introduction of

J. L. Sosa; Danny Sleeman; Ivan Puente; Mark G. McKenney; Rene Hartmann

1994-01-01

349

Iatrogenic diaphragmatic hernia due to laparoscopic gastric banding  

Microsoft Academic Search

A patient developed a huge diaphragmatic hernia following laparoscopic gastric banding. Almost the entire stomach was incarcerated within the left chest. Segmental necrosis of the greater curvature of the stomach necessitated partial gastrectomy. The postoperative course was uneventful. The etiology, diagnosis and treatment of this previously undescribed complication of laparoscopic gastric banding are addressed in relation to the present case.

Oleg Dukhno; Jochanan Peiser; Isaac Levy; Amnon Ovnat

2006-01-01

350

Effect of laparoscopic abdominal surgery on splanchnic circulation: Historical developments  

PubMed Central

With the developments in medical technology and increased surgical experience, advanced laparoscopic surgical procedures are performed successfully. Laparoscopic abdominal surgery is one of the best examples of advanced laparoscopic surgery (LS). Today, laparoscopic abdominal surgery in general surgery clinics is the basis of all abdominal surgical interventions. Laparoscopic abdominal surgery is associated with systemic and splanchnic hemodynamic alterations. Inadequate splanchnic perfusion in critically ill patients is associated with increased morbidity and mortality. The underlying pathophysiological mechanisms are still not well understood. With experience and with an increase in the number and diversity of the resulting data, the pathophysiology of laparoscopic abdominal surgery is now better understood. The normal physiology and pathophysiology of local and systemic effects of laparoscopic abdominal surgery is extremely important for safe and effective LS. Future research projects should focus on the interplay between the physiological regulatory mechanisms in the splanchnic circulation (SC), organs, and diseases. In this review, we discuss the effects of laparoscopic abdominal surgery on the SC. PMID:25561784

Hatipoglu, Sinan; Akbulut, Sami; Hatipoglu, Filiz; Abdullayev, Ruslan

2014-01-01

351

Laparoscopic Surgical Robot for Remote In Vivo Training Brian Allena  

E-print Network

of laparoscopic surgery learning show that the rate of technical complications only stabilize after 80 to 100 Department of Surgery, University of California at Los Angeles, 200 UCLA Medical Plaza, Los Angeles, CA in advanced laparoscopic techniques. The Laparobot allows a student to practice surgery on a remotely located

Faloutsos, Petros

352

STUDY PROTOCOL Open Access Open versus laparoscopically-assisted  

E-print Network

to the reduced postoperative trauma. We hypothesise that the laparoscopic abdominal approach (laparoscopic rate due to the reduced surgical trauma. Methods/Design: The MIRO trial is an open, controlled. Secondary objectives are to assess the overall 30-day morbidity, 30-day mortality, 30-day pulmonary

Paris-Sud XI, Université de

353

Robotic and Laparoscopic Surgery for Treatment of Colorectal Diseases  

Microsoft Academic Search

PURPOSE In the last ten years, several robotic systems have been developed to overcome the loss of the three-dimensional view and dexterity characteristic of laparoscopic surgery. The aim of this study was to compare the traditional laparoscopic approach and robotic techniques in the treatment of colorectal diseases. METHODS The study compares a consecutive series of patients treated surgically for colorectal

Annibale D’Annibale; Emilio Morpurgo; Valentino Fiscon; Paolo Trevisan; Gianna Sovernigo; Camillo Orsini; Daniela Guidolin

2004-01-01

354

Automatic guidance of an assistant robot in laparoscopic surgery  

Microsoft Academic Search

A robotic arm which automatically guides the camera in the laparoscopic surgery is presented. The goal of this work is to generate adequate camera control strategies to track the working scene during a surgical procedure. The system is based on the computer vision analysis of the laparoscopic image that allows the surgeon to identify the scene's relevant point from the

A. Casals; J. Amat; E. Laporte

1996-01-01

355

Laparoscopic radical prostatectomy: review and assessment of an emerging technique  

Microsoft Academic Search

Background: Several recent reports have affirmed the feasibility of the laparoscopic approach for radical prostatectomy. In this review, we discuss the morbidities associated with this technique and compare outcomes and convalescence withstandard open radical prostatectomy. Methods: We reviewed all currently published data on laparoscopic radical prostatectomy and our series of 45 robotic-assisted radical prostatectomies and compared them to several landmark

J. B. Basillote; T. E. Ahlering; D. W. Skarecky; D. I. Lee; R. V. Clayman

2004-01-01

356

Laparoscopic repair of paraesophageal hiatus hernia in infancy  

PubMed Central

Paraesophageal hiatus hernia (PEHH) is an uncommon type of diaphragmatic hernia in the pediatric age group. Two patients aged 5-months and 8-months presented with respiratory symptoms and underwent a laparoscopic repair. Preoperative assessment included chest x-ray and CT scan. We suggest that laparoscopic repair of PEHH in infants is safe and preferred mode of the treatment. PMID:20011498

Kundal, Anjani Kumar; Zargar, Noor Ullah; Krishna, Anurag

2008-01-01

357

Laparoscopic nephrectomy in the markedly obese living renal donor  

Microsoft Academic Search

Objectives. To determine whether laparoscopic living donor nephrectomy is safe and efficacious in markedly obese renal donors.Methods. From 1996 to 1999, 431 laparoscopic living donor nephrectomies were performed. The markedly obese group consisted of 41 patients with a body mass index (BMI) greater than 35. Forty-one controls with a BMI less than 30 were matched to the obese donors by

Stephen C Jacobs; Eugene Cho; Brian J Dunkin; Stephen T Bartlett; John L Flowers; Bruce Jarrell

2000-01-01

358

Laparoscopic Liver Resection for Malignant Liver Tumors  

PubMed Central

Objective To assess the feasibility, safety, and outcome of laparoscopic liver resection for malignant liver tumors. Summary Background Data The precise role of laparoscopy in resection of liver malignancies (hepatocellular carcinoma [HCC] and liver metastases) remains controversial despite an increasing number of publications reporting laparoscopic resection of benign liver tumors. Methods A retrospective study was performed in 11 surgical centers in Europe regarding their experience with laparoscopic resection of liver malignancies. Detailed questionnaires were sent to each surgeon focusing on patient characteristics, clinical data, type and characteristics of the tumor, technical details of the operation, and early and late clinical outcome. All patients had radiologic investigations at follow-up to exclude disease recurrence. Results From February 1994 to December 2000, 37 patients with malignant liver tumors were included in this study. Ten patients had HCC, including 9 with cirrhotic liver, and 27 patients had liver metastases. The mean tumor size was 3.3 cm, and 89% of the tumors were located in the left lobe or in the anterior segments of the right liver. Liver procedures included 12 wedge resections, 9 segmentectomies, 14 bisegmentectomies (including 13 left lateral segmentectomies), and 2 major hepatectomies. The transfusion rate, the use of pedicular clamping, the conversion rate (13.5% in the whole series), and the complication rate were significantly greater in patients with HCC. There were no deaths. Postoperative complications occurred in eight patients (22%). The surgical margin was less than 1 cm in 30% of the patients. During a mean follow-up of 14 months, the 2-year disease-free survival was 44% for patients with HCC and 53% for patients having hepatic metastases from colorectal cancer. No port-site metastases were observed during follow-up. Conclusions In patients with small malignant tumors, located in the left lateral segments or in the anterior segments of the right liver, laparoscopic resection is feasible and safe. The complication rate is low, except in patients with HCC on cirrhotic liver. By using laparoscopic ultrasound, a 1-cm free surgical margin should be routinely obtained. The late outcome needs to be evaluated in expert centers. PMID:12131090

Gigot, Jean-François; Glineur, David; Santiago Azagra, Juan; Goergen, Martine; Ceuterick, Marc; Morino, Mario; Etienne, José; Marescaux, Jacques; Mutter, Didier; van Krunckelsven, Ludo; Descottes, Bernard; Valleix, Dominique; Lachachi, François; Bertrand, Claude; Mansvelt, Baudouin; Hubens, Guy; Saey, Jean-Pierre; Schockmel, Romain

2002-01-01

359

Laparoscopic Appendectomy with a Single Incision in a Single Institute  

PubMed Central

Purpose The laparoscopic appendectomy has become popular for the treatment of acute appendicitis. A single-incision laparoscopic appendectomy offers better cosmesis. We present the results of single-incision laparoscopic appendectomies in our hospital as initial experience. Methods A single-incision laparoscopic appendectomy was performed in 75 patients at The Catholic University of Korea, Bucheon St. Mary's hospital. The operating time, operation type, hospital stay, surgical morbidities, and body mass index were compared. Results This retrospective study revealed equal operation times in both the suppurative and the perforated appendicitis group. There was an increase in the hospital stay in the perforated appendicitis group. The postoperative complication rate was 4%, and the median operation time was 58.55 ± 31.79 minutes. Conclusion The single-incision laparoscopic appendectomy was easy and safe procedure for treating acute appendicitis. There were no differences in degree of inflammation and body mass index. PMID:21152227

Lee, Jin A; Sung, Ki Young; Lee, Jun Hyun

2010-01-01

360

Reduced port laparoscopic gastrectomy: A review, techniques, and perspective.  

PubMed

Reduced port laparoscopic surgery has been used increasingly. It is a concept that has grown out of the various efforts aimed at minimally invasive surgery, with SILS being the ultimate reduced port technique. Reduced port laparoscopic surgery has been used to perform sleeve gastrectomy in bariatric surgery and excision of benign gastric submucosal tumor, applications that generally do not require lymph node dissection or complicated reconstruction. It can be done safely, result in a permanent cure, and offer good cosmetic outcomes. Reduced port laparoscopic surgery for gastric cancer has a short history, and its usefulness has not yet been fully established. This review describes the present situation and challenges faced as well as standardized procedures and the future prospects of reduced port laparoscopic gastrectomy for gastric cancer, which my team performs almost daily. These aspects of reduced port laparoscopic surgery are presented in light of the literature. PMID:25496345

Inaki, Noriyuki

2015-02-01

361

Secrets of safe laparoscopic surgery: Anaesthetic and surgical considerations  

PubMed Central

In recent years, laparoscopic surgery has gained popularity in clinical practice. The key element in laparoscopic surgery is creation of pneumoperitoneum and carbon dioxide is commonly used for insufflation. This pneumoperitoneum perils the normal cardiopulmonary system to a considerable extent. Every laparoscopic surgeon should understand the consequences of pneumoperitoneum; so that its untoward effects can be averted. Pneumoperitoneum increases pressure on diaphragm, leading to its cephalic displacement and thereby decreasing venous return, which can be aggravated by the position of patient during surgery. There is no absolute contraindication of laparoscopic surgery, though we can anticipate some problems in conditions like obesity, pregnancy and previous abdominal surgery. This review discusses some aspects of the pathophysiology of carbon dioxide induced pneumoperitoneum, its consequences as well as strategies to counteract them. Also, we propose certain guidelines for safe laparoscopic surgery. PMID:21120064

Srivastava, Arati; Niranjan, Ashutosh

2010-01-01

362

Conventions for quantum pseudocode  

SciTech Connect

A few conventions for thinking about and writing quantum pseudocode are proposed. The conventions can be used for presenting any quantum algorithm down to the lowest level and are consistent with a quantum random access machine (QRAM) model for quantum computing. In principle a formal version of quantum pseudocode could be used in a future extension of a conventional language.

Knill, E.

1996-06-01

363

Simulation System for Training in Laparoscopic Surgery  

NASA Technical Reports Server (NTRS)

A computer-based simulation system creates a visual and haptic virtual environment for training a medical practitioner in laparoscopic surgery. Heretofore, it has been common practice to perform training in partial laparoscopic surgical procedures by use of a laparoscopic training box that encloses a pair of laparoscopic tools, objects to be manipulated by the tools, and an endoscopic video camera. However, the surgical procedures simulated by use of a training box are usually poor imitations of the actual ones. The present computer-based system improves training by presenting a more realistic simulated environment to the trainee. The system includes a computer monitor that displays a real-time image of the affected interior region of the patient, showing laparoscopic instruments interacting with organs and tissues, as would be viewed by use of an endoscopic video camera and displayed to a surgeon during a laparoscopic operation. The system also includes laparoscopic tools that the trainee manipulates while observing the image on the computer monitor (see figure). The instrumentation on the tools consists of (1) position and orientation sensors that provide input data for the simulation and (2) actuators that provide force feedback to simulate the contact forces between the tools and tissues. The simulation software includes components that model the geometries of surgical tools, components that model the geometries and physical behaviors of soft tissues, and components that detect collisions between them. Using the measured positions and orientations of the tools, the software detects whether they are in contact with tissues. In the event of contact, the deformations of the tissues and contact forces are computed by use of the geometric and physical models. The image on the computer screen shows tissues deformed accordingly, while the actuators apply the corresponding forces to the distal ends of the tools. For the purpose of demonstration, the system has been set up to simulate the insertion of a flexible catheter in a bile duct. [As thus configured, the system can also be used to simulate other endoscopic procedures (e.g., bronchoscopy and colonoscopy) that include the insertion of flexible tubes into flexible ducts.] A hybrid approach has been followed in developing the software for real-time simulation of the visual and haptic interactions (1) between forceps and the catheter, (2) between the forceps and the duct, and (3) between the catheter and the duct. The deformations of the duct are simulated by finite-element and modalanalysis procedures, using only the most significant vibration modes of the duct for computing deformations and interaction forces. The catheter is modeled as a set of virtual particles uniformly distributed along the center line of the catheter and connected to each other via linear and torsional springs and damping elements. The interactions between the forceps and the duct as well as the catheter are simulated by use of a ray-based haptic-interaction- simulating technique in which the forceps are modeled as connected line segments.

Basdogan, Cagatay; Ho, Chih-Hao

2003-01-01

364

Are Concerns Over Right Laparoscopic Donor Nephrectomy Unwarranted?  

PubMed Central

Objective To examine the ability of several large, experienced transplantation centers to perform right-sided laparoscopic donor nephrectomy safely with equivalent long-term renal allograft function. Summary Background Data Early reports noted a higher incidence of renal vein thrombosis and eventual graft loss. However, exclusion of right-sided donors would deprive a significant proportion of donors a laparoscopically harvested graft. Methods A retrospective review was performed among 97 patients from seven centers performing right-sided laparoscopic donor nephrectomy. Surgical and postoperative demographic factors were evaluated. Complications were identified and long-term renal allograft function was compared with historical left-sided laparoscopic donor nephrectomy cohorts. Results Right laparoscopic donor nephrectomy was performed for varying reasons, including multiple left renal arteries or veins, smaller right kidney, or cystic right renal mass. Mean surgical time was 235.0 ± 66.7 minutes, with a mean blood loss of 139 ± 165.8 mL. Conversion was required in three patients secondary to bleeding or anatomical anomalies. Mean warm ischemic time was limited at 238 ± 112 seconds. Return to diet was achieved on average after 7.5 ± 2.3 hours, with mean discharge at 54.6 ± 22.8 hours. Two grafts were lost during the early experience of these centers to renal vein thrombosis. Both surgical and postoperative complications were limited, with few long-term adverse effects. Mean serum creatinine levels were higher than open and left laparoscopic donor nephrectomy on postoperative day 1, but at all remaining intervals the right laparoscopic donors had equivalent creatinine values. Conclusions These results confirm that right laparoscopic donor nephrectomy provides similar patient benefits, including early return to diet and discharge. Long-term creatinine values were no higher than in traditional open donor or left laparoscopic donor cohorts. These results establish that early concerns about high thrombosis rates are not supported by a multiinstitutional review of laparoscopic right donor nephrectomies. PMID:11323503

Buell, Joseph F.; Edye, Michael; Johnson, Mark; Li, Christine; Koffron, Alan; Cho, Eugene; Kuo, Paul; Johnson, Lynt; Hanaway, Michael; Potter, Steven R.; Bruce, David S.; Cronin, David C.; Newell, Kenneth A.; Leventhal, Joseph; Jacobs, Stephen; Woodle, E. Steve; Bartlett, Stephen T.; Flowers, John L.

2001-01-01

365

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

366

Simple laparoscopic nephrectomy assisted by transvaginal NOTES and using standard laparoscopic instruments  

Microsoft Academic Search

Introduction: Natural orifice transluminal endoscopic surgery (NOTES™) is an emerging technology that allows for performing surgical procedures without use of abdominal incisions. There are however limitations in equipment available for mimicking traditional surgery. Our objective was to report our experience with the transvaginal NOTES nephrectomy technique using standard laparoscopic instruments. Materials and Methods: Two female patients aged 23 and 26

Octavio A. Castillo; Ivar Vidal-Mora; Rodrigo Campos; Alejandro Fonerón; Miguel Feria-Flores; Reinaldo Gómeza; Francisco Sepúlvedaa

367

Schistosomiasis japonica identified by laparoscopic and colonoscopic examination.  

PubMed

A 45-year-old Philippine woman who came from Mindanao Island was admitted to our hospital with a complaint of epigastric discomfort. Abdominal ultrasonography and computed tomography demonstrated a network pattern and linear calcification in the liver. Laparoscopic examination showed numerous yellowish, small speckles over the liver surface. The liver surface was separated into many small blocks by groove-like depressions, demonstrating a so-called tortoise shell pattern. Conventional colonoscopy and narrow-band imaging showed irregular areas of yellowish mucosa, and diminished vascular network and increased irregular microvessels extending from the descending colon to the rectum. Liver biopsy showed many Schistosoma japonicum eggs in Glisson's capsule and colon biopsy showed many S. japonicum eggs in the submucosal layer. These findings established a diagnosis of schistosomiasis japonica. The present case is imported schistosomiasis japonica. Even though new cases have not occurred recently in Japan, we should remain aware of schistosomiasis japonica for patients who came from foreign epidemic areas. PMID:20447208

Hosho, Keiko; Ikebuchi, Yuichiro; Ueki, Masaru; Nakamura, Keiko; Yashima, Kazuo; Maeda, Naoto; Koda, Masahiko; Murawaki, Yoshikazu; Suou, Takeaki; Inoue, Masayuki

2010-04-01

368

Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Tube Placement  

PubMed Central

Background: Percutaneous endoscopic gastrostomy (PEG) is the most common way of placing a feeding tube. Sometimes PEG cannot be used to safely place a feeding tube, most commonly secondary to an inability to transilluminate the abdominal wall. Whereas open gastrostomy was previously necessary in such cases, laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) is a viable option and is reviewed here. Methods: All patients referred for surgical feeding tube placement after unsuccessful PEG were considered for LAPEG. A diagnostic laparoscopy was performed to identify the reason for the failed PEG attempt. Additional ports were placed as needed for the retraction of organs and lysis of adhesions. The stomach was visualized, and the PEG was placed. Results: Eight patients who underwent an unsuccessful PEG were taken to the operating room for LAPEG. All patients had successful LAPEG placement. No postoperative complications occurred. The most common reason identified for failed PEG attempt was adhesions followed by overlying organs. Average OR time was 32 minutes. Conclusion: When conventional PEG placement is not possible, LAPEG placement should be considered as a time efficient, minimally invasive alternative to open gastrostomy. PMID:20529530

Salcone, Mark; Neff, Marc

2010-01-01

369

Predictive factors from cold knife conization for residual cervical intraepithelial neoplasia in subsequent hysterectomy  

Microsoft Academic Search

OBJECTIVE: The optimal management of cervical intraepithelial neoplasia after cold knife conization remains controversial. Reliable predictors of residual dysplasia in the cervix after cold knife conization have not been consistently identified. This study was initiated to examine the accuracy of the traditional factors used to predict residual dysplasia in hysterectomy specimens after cold knife conization.STUDY DESIGN: A retrospective 10-year chart

Barbara C. Moore; Robert V. Higgins; Sherry L. Laurent; Marie-Claire Marroum; Patricia Bellitt

1995-01-01

370

Placenta percreta managed by transverse uterine fundal incision with retrograde cesarean hysterectomy: a novel surgical approach  

PubMed Central

Key Clinical Message Placenta percreta (with bladder invasion) is a rare obstetric condition with the risk of massive intraoperative hemorrhage. In these cases, the combination of a transverse uterine fundal incision and retrograde cesarean hysterectomy could be useful to minimize maternal hemorrhage and avoid severe bladder injury. PMID:25548627

Matsuzaki, Shinya; Yoshino, Kiyoshi; Kumasawa, Keiichi; Satou, Noriko; Mimura, Kazuya; Kanagawa, Takeshi; Ueda, Yutaka; Kimura, Tadashi

2014-01-01

371

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

372

[The capacities of ultrasound study and magnetic resonance imaging of small pelvic masses after hysterectomy].  

PubMed

The purpose of the study was to develop the ultrasound study (USS) and magnetic resonance imaging (MRI) semiotics of small pelvic masses after hysterectomy, to comprehensively use USS and MRI for the diagnosis of these masses, and to define indications for MRI. One hundred and seventy-five female patients with small pelvic masses after hysterectomy were examined. For the specification of the pattern of small pelvic masses and their differential diagnosis, USS and MRI were carried out in 175 and 72 patients, respectively. Four groups of the masses were identified; of them there were tumor-like masses of the uterine appendages in 67 (38.2%) patients, ovarian tumors in 31 (17.7%), other additional masses of the small pelvis in 27 (15.4%), and a mixed variant of its masses in 50 (28.5%). The findings suggest that it is reasonable to concurrently use USS and MRI in the diagnosis of small pelvic masses following hysterectomy for the specification of their pattern and their differential diagnosis. The benefit of MRI is that information images of the basic structures of the small pelvis can be obtained in patients with a marked commissural process after hysterectomy in the absence of limitations in large mass sizes. Practical guidelines were proposed to comprehensively use USS and MRI for the diagnosis of small pelvic pathology. PMID:23214029

Boldyreva, O G; Briukhanov, A V

2012-01-01

373

Factors Related to Hysterectomy in Women with Physical and Mobility Disabilities  

ERIC Educational Resources Information Center

This paper aims to identify self-report data for hysterectomy prevalence and to explore its correlated factors among women with physical and mobility disabilities in Taiwan. This paper was part of a larger study, "Survey on Preventive Health Utilizations of People with Physical and Mobility Disability in Taiwan," which is a cross-sectional survey…

Lin, Lan-Ping; Hsieh, Molly; Chen, Si-Fan; Wu, Chia-Ling; Hsu, Shang-Wei; Lin, Jin-Ding

2012-01-01

374

Comparison of vaginal and abdominal hysterectomy:A prospective non-randomized trial  

PubMed Central

Objective: To compare outcomes of vaginal and abdominal hysterectomy procedures in women with benign gynaecological diseases. Methods: This was a prospective study of outcomes of consecutive patients who underwent total vaginal hysterectomy (VH) or abdominal hysterectomy (AH) for benign gynaecological diseases. Patient characteristics before, during, and after the operations were reviewed. Patients were followed up for three months to evaluate postoperative complications. Results: This study included a total of 313 patients. 143 patients underwent AH and 170 patients underwent VH. Baseline characteristics were similar between the two groups. There were no intraoperative complications in either group. Operation time, intraoperative blood loss, first postoperative flatus time, time to out-of-bed activity, mean maximum postoperative body temperature, and duration of fever were all significantly shorter and less severe in the VH group compared with the AH group. In addition, vaginal length in the VH group was significantly shorter than in the AH group. Conclusions: Vaginal hysterectomy has advantages over AH in the treatment of benign gynaecological diseases, providing greater efficacy and safety with minimal invasiveness. PMID:25097536

Chen, Bing; Ren, Dong-Ping; Li, Jing-Xuan; Li, Chun-Dong

2014-01-01

375

Early experience with single-incision laparoscopic surgery for the placement of a gastrostomy in a 10-year-old girl: a case report  

PubMed Central

Introduction Access procedures for alimentation have been performed both endoscopically and surgically. In patients in whom endoscopic gastrostomy feeding tubes cannot be placed, single-incision laparoscopic surgery gastrostomy is an alternative method. This minimally invasive approach is a new technique performed through a single umbilical incision and without the need for additional laparoscopic ports. Case presentation In this article we present a case of single-incision laparoscopic surgery gastrostomy performed with conventional laparoscopic instruments in a 10-year-old girl of Caucasian ethnicity who was not a candidate for a percutaneous endoscopic gastrostomy tube because of esophageal varices due to her advanced-stage cystic fibrosis with liver cirrhosis and portal hypertension. She also had an umbilical hernia, which was repaired during the same procedure through the same incision. Access and pneumoperitoneum were obtained through the umbilicus with the single-incision laparoscopic surgery port. The selected site for the feeding tube in the stomach was exteriorized through this incision and a feeding tube was placed. The stomach was returned into the abdomen. The fascial defect, and thus also the hernia, was repaired, and the 2cm umbilical incision was closed with endocutaneous sutures. The total operative time was 25 minutes. Our patient’s intra-operative and post-operative course was uneventful. We were able to use the feeding tube on the first post-operative day with good intestinal function. Our patient and her parents were pleased with the cosmetic result. Conclusions The single-incision laparoscopic surgery procedure seems to be a less invasive alternative to open placement of gastrostomy. This approach has the possible advantages of reduced post-operative pain, faster return to normal function, reduced port site complications, improved cosmesis and better patient satisfaction. PMID:23130674

2012-01-01

376

Laparoscopic gastrectomies for cancer: The ACOI-IHTSC national guidelines.  

PubMed

Guidelines for laparoscopy and cancer of stomach have been outlined by several scientific societies: The main recommendation being that laparoscopy should be used only by surgeons already highly skilled in gastric surgery. The laparoscopic approach to gastric cancer surgery has become more and more frequent in most Italian centers. On behalf of the Guideline Committee of the Italian Society of Hospital Surgeons and the Italian Hi-Tech Surgical Club, a panel of experts analyzed the highest evidence of all scientific papers focusing on laparoscopic gastrectomies for cancer and published from 2003 to 2011, and drew these national guidelines. Laparoscopic gastrectomy may be considered as a safe procedure with better short-term and comparable long-term results. compared to open gastrectomy (Grade A). There is a general agreement that a laparoscopic approach to the treatment of gastric cancer should be chosen only by surgeons already highly skilled in gastric surgery and other advanced laparoscopic interventions. Furthermore, the first procedures should be carried out during a tutoring program. Diagnostic laparoscopy is strongly recommended as the first step of laparoscopic as well as laparotomic gastrectomies (Grade B). Additional randomized controlled trials (RCT) that compare and investigate the long-term oncological outcomes of laparoscopic assisted gastrectomy are required. PMID:22793780

Bracale, Umberto; Pignata, Giusto; Lirici, Marco Maria; Hüscher, Cristiano Gs; Pugliese, Raffaele; Sgroi, Giovanni; Romano, Giovanni; Spinoglio, Giuseppe; Gualtierotti, Monica; Maglione, Valeria; Azagra, Santiago; Kanehira, Eiji; Kim, Jun Gi; Song, Kyo Young

2012-09-01

377

Outcomes of laparoscopic versus open splenectomy  

PubMed Central

Purpose Laparoscopic techniques have gained wide clinical acceptance in surgical practice today. The laparoscopic approach has been established as the technique of choice for elective splenectomies performed on normal sized spleens. The purpose of this study was to evaluate the outcome of patients undergoing laparoscopic splenectomy (LS) at the TOBB University of Economics and Technology (ETU) Hospital and Kecioren Training and Research Hospital. Methods One hundred and thirty-five patients underwent splenectomy between January 2000 and July 2010. For comparison, the records of 130 patients undergoing splenectomy were evaluated for age, gender, hospital stay, time to start of diet, conversion rate, operation time and wound infection. Results Mean operation time means the time interval between surgeon commencing operation to end of operation. Mean operation time in patients treated by LS was 132 minutes and 121 minutes in open splenectomy (OS). Mean hospital stay was 5.65 days in patients undergoing LS and starting of diet was 1.21 days. In patients treated by OS, mean hospital stay was 9.17 days, starting of diet was 2.37 days. Four patients were converted to open surgery. Conversion rate was 6.4 percent. In the early post operative period (within 10 days of surgery) 9.2%, LS group had lower incidences of wound infection rate after surgery than OS group (4.8%, 7.4%, respectively; P = 0.06). Conclusion LS is a safe and effective alternative to OS for treatment of splenic diseases in patients of all ages. PMID:23323234

Bulus, Hakan; Mahmoud, Hatim; Altun, Hasan; Karayalcin, Kaan

2013-01-01

378

Stentless laparoscopic pyeloplasty: A single center experience  

PubMed Central

Aim: To assess the effectiveness of laparoscopic stentless pyeloplasty for congenital ureteropelvic junction obstruction. Materials and Methods: This was a prospective comparative study conducted over a period of 5 years. The study included 35 cases of primary ureteropelvic junction obstruction (UPJO) with mean age of 29.5 years, divided in two groups- Group A (stent-less, 18 patients) and Group B (stented, 17 patients). Follow up ranged from one to 4years (mean 2 years). Transperitoneal laparoscopic Anderson- Hyene's pyeloplasty was standard for both the groups. Perioperative and postoperative complications were prospectively collected and analyzed by Statistical Package for Social Sciences (SPSS) 17 version using Pearson chi square test. Results: Both the groups were comparable with respect to preoperative differential renal function (DRF) and time required for maximum activity in minutes (tmax.min). Average post operative DRF was significantly higher than preoperative DRF in both the groups. Average tmax was significantly lower after pyeloplasty than pre operative tmax. Mean operative time, mean duration of urethral catheter, and mean duration of drain removal were comparable in both the groups. However bothersome irritative lower urinary tract symptoms (LUTS) and hematuria were significantly more in group B patients (P < 0.0001 and <0.013 respectively). Conclusion: In experienced hands, laparoscopic stentless pyeloplasty is as effective method for treating UPJO as its stented counterpart. It is cost effective, avoids stent-related morbidity, and could be performed without compromising the success rate. However, more randomized studies are needed to evaluate the safety of stentless pyeloplasty. PMID:25125891

Khawaja, Abdul Rouf; Dar, Tanveer Iqbal; Bashir, Farzana; Sharma, Ajay; Tyagi, Vipin; Bazaz, Mohammad Sajid

2014-01-01

379

Superior staging of liver tumors with laparoscopy and laparoscopic ultrasound.  

PubMed Central

OBJECTIVE. The authors describe the technique of staging laparoscopy with laparoscopic contact ultrasonography in the preoperative assessment of patients with liver tumors, and assess its impact on the selection of patients for hepatic resection with curative intent. SUMMARY BACKGROUND DATA. Laparoscopy may be useful in the selection of patients with a variety of intra-abdominal malignancies for operative intervention. Laparoscopic ultrasonography is a new technique that combines the principles of high resolution intraoperative contact ultrasound with those of the laparoscopic examination, and thus, allows the laparoscopist to perform detailed assessment of the liver. METHODS. This study analyzes a cohort of 50 consecutive patients who were diagnosed as having potentially resectable liver tumors, and in whom staging laparoscopy was successfully undertaken. Laparoscopic ultrasonography was performed in 43 patients, and the impact of the ensuing findings on the decision to proceed to operative assessment of resectability is examined. The resectability rate in those patients assessed laparoscopically and subsequently submitted to laparotomy is compared with a preceding group of patients in whom no laparoscopic assessment was performed. RESULTS. Laparoscopy demonstrated factors precluding curative resection in 23 patients (46%). Laparoscopic ultrasonography identified liver tumors not visible during laparoscopy in 14 patients (33%), and provided staging information in addition to that derived from laparoscopy alone in 18/43 patients (42%). The resectability rate was significantly higher among those patients undergoing laparoscopic staging (93%) compared with those in whom operative assessment was undertaken without laparoscopy (58%). CONCLUSIONS. Staging laparoscopy with laparoscopic ultrasonography optimizes patient selection for liver resection with curative intent. Images Figure 1. Figure 2. PMID:7986136

John, T G; Greig, J D; Crosbie, J L; Miles, W F; Garden, O J

1994-01-01

380

Completely intracorporeal robotic-assisted laparoscopic ileovesicostomy.  

PubMed

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

381

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

382

Laparoscopic cholecystectomy in situs inversus totalis.  

PubMed

Situs inversus totalis is a rare condition where the organs in the body is placed in the opposite side. When such patient presents with the diseases of the intra abdominal organs the diagnosis is challenging and the operative procedure to be performed will be difficult. This may require the anticipation of variations in anatomy, ergonomic changes required during surgery and mastery over the operative skills in reversed anatomy. Cholelithiasis in situs inversus totalis is one such situation. Herein we report a case of situs inversus totalis who underwent successful laparoscopic cholecystectomy for symptomatic gallbladder calculi. PMID:25177601

Mn, Raghuveer; S, Mahesh Shetty; Bb, Sunil Kumar

2014-07-01

383

Laparoscopic Cholecystectomy in Situs Inversus Totalis  

PubMed Central

Situs inversus totalis is a rare condition where the organs in the body is placed in the opposite side. When such patient presents with the diseases of the intra abdominal organs the diagnosis is challenging and the operative procedure to be performed will be difficult. This may require the anticipation of variations in anatomy, ergonomic changes required during surgery and mastery over the operative skills in reversed anatomy. Cholelithiasis in situs inversus totalis is one such situation. Herein we report a case of situs inversus totalis who underwent successful laparoscopic cholecystectomy for symptomatic gallbladder calculi. PMID:25177601

S, Mahesh Shetty; BB, Sunil Kumar

2014-01-01

384

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

385

Single incision laparoscopic surgery in Canadian children  

PubMed Central

Summary As minimally invasive surgery progresses, there have been attempts to modify the technique to minimize both the number and visibility of incisions. These newer techniques are known by multiple acronyms, including single incision laparoscopic surgery (SILS). The SILS technique has gained popularity in the United States, particularly owing to its perceived improved cosmesis. The SILS technique has been primarily used in adults, and the number of pediatric publications on the topic is underwhelming. We have begun to evaluate SILS at our centre to determine its applicability in both a Canadian and pediatric practice, and this commentary discusses our initial application of the procedure. PMID:24869605

Botkin, Colin; Keijzer, Richard; Milbrandt, Kris

2014-01-01

386

Robotic-assisted laparoscopic mesh sacrocolpopexy  

PubMed Central

The current ‘gold standard’ surgical repair for apical prolapse is the abdominal mesh sacrocolpopexy. Use of a robotic-assisted laparoscopic surgical approach has been demonstrated to be feasible as a minimally invasive approach and is gaining popularity amongst pelvic floor reconstructive surgeons. Although outcome data for robotic-assisted sacrocolpopexy (RASC) is only just emerging, several small series have demonstrated anatomic and functional outcomes, as well as complication rates, comparable to those reported for open surgery. The primary advantages thus far for RASC over open surgery include decreased blood loss and shorter hospital stay. PMID:21789075

Gilleran, Jason P.; Johnson, Matthew; Hundley, Andrew

2010-01-01

387

Laparoscopic approach for rectosigmoidian resection in children.  

PubMed

Abdominoperineal approach for rectosigmoidian resection,first imagined and performed in 1948 by Orwar Swenson,was the surgical technique that opened the pathway in the treatment of congenital megacolon (1). B. Duhamel (1956) and F. Soave (1964) intended to correct the postoperative complications appeared after the Duhamel technique and proposed surgical procedures that keep the aganglionic rectum in transit (2,3). In 1994 K. Bax reproduces the Duhamel procedure using laparoscopic approach (4). K.Georgeson, in 1995, reproduced the Swenson technique for rectosigmoidian resection using minimal invasive surgery (5).Today, this approach represents the most frequently used procedure for the radical treatment of congenital megacolon. PMID:24524481

Oancea, M; Vatra, L; Kadar, A; Cop?escu, C

2014-01-01

388

Laparoscopic-assisted anorectal pull-through.  

PubMed

Posterior sagittal anorectoplasty (PSARP) is the procedure most commonly employed to repair high and intermediate anorectal malformations. Many patients repaired by PSARP subsequently require bowel management to avoid the physiologic and social problems associated with fecal incontinence. Laparoscopic assisted anorectal pull-through (LAARP) is a recently developed technique which positions the neorectum accurately inside the sphincter complex without dividing any of these muscles. Some physiologic measurements after LAARP indicate that outcomes are at least equivalent to PSARP. Long-term outcomes have not been reported after LAARP. PMID:17933669

Georgeson, Keith

2007-11-01

389

Perioperative tumor localization for laparoscopic colorectal surgery  

Microsoft Academic Search

Background: Because of the inability to palpate colonic tumors during laparoscopy, their location must be precisely identified before\\u000a resection is undertaken.\\u000a \\u000a \\u000a \\u000a \\u000a Method: A retrospective study was performed of 58 patients in order to be able to describe our methods of tumor localization for\\u000a laparoscopic colorectal operations and to review their effectiveness.\\u000a \\u000a \\u000a \\u000a \\u000a Results: In all patients, the entire colon was examined

S. H. Kim; J. W. Milsom; J. M. Church; K. A. Ludwig; A. Garcia-Ruiz; J. Okuda; V. W. Fazio

1997-01-01

390

Tumor Localization for Laparoscopic Colorectal Surgery  

Microsoft Academic Search

Background  Because palpating colonic tumors during laparoscopy is impossible, the precise location of a tumor must be identified before\\u000a operation. The aim of this study was to evaluate the accuracy of various diagnostic methods that are used to localize colorectal\\u000a tumors and to propose an adequate localization protocol for laparoscopic colorectal surgery.\\u000a \\u000a \\u000a \\u000a Methods  A total of 310 patients underwent laparoscopy-assisted colectomy between

Yong Beom Cho; Woo Yong Lee; Hae Ran Yun; Won Suk Lee; Seong Hyeon Yun; Ho-Kyung Chun

2007-01-01

391

Giant Bauhin valve adenoma and laparoscopically assisted colonoscopic polypectomy  

PubMed Central

Nowadays colonoscopic polypectomy has become a routine procedure, which is performed daily. Almost every colorectal benign tumor can be removed endoscopically, although there are some problematic adenomas which are either large in size or difficult to approach. In the past two decades laparoscopically assisted colonoscopic polypectomy has become established in the endoscopic world, which reduced the need of operations for those patients with lesions that are large or hard to approach. The first laparoscopically monitored colonoscopic polypectomy was performed by Franklin in 1991, and reported publicly in 1993. We present a case report of a patient who was diagnosed with Bauhin valve giant adenoma and underwent laparoscopically assisted polypectomy. PMID:25337179

Mikalauskas, Saulius; Žeromskas, Paulius; Strupas, K?stutis

2014-01-01

392

Laparoscopic appendectomy for perforated appendicitis: a comparison with open appendectomy  

Microsoft Academic Search

Background  The role of laparoscopic appendectomy for perforated appendicitis remains controversial. This study aimed to compare laparoscopic\\u000a and open appendectomy outcomes for children with perforated appendicitis.\\u000a \\u000a \\u000a \\u000a Methods  Over a 36-month period, 111 children with perforated appendicitis were analyzed in a retrospective review. These children\\u000a were treated with either laparoscopic (n = 59) or open appendectomy. The primary outcome measures were operative time,

A. Yagmurlu; A. Vernon; D. C. Barnhart; K. E. Georgeson; C. M. Harmon

2006-01-01

393

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

394

Specimen processing during laparoscopic renal surgery: a review of techniques and technologies  

PubMed Central

Laparoscopic surgery has well-defined benefits for patients and has become accepted over time as a standard access strategy for the management of benign and malignant urologic diseases. Unlike in open surgery, the surgeon is often faced with the additional challenges of specimen retrieval and extraction at the end of laparoscopic extirpative procedures. This final step often requires significant laparoscopic skill to entrap and safely extract the laparoscopic specimens. Failure to apply safe exit steps at the end of a laparoscopic procedure may lead to significant morbidity. The aim of this review is to explore the different techniques and technologies available for laparoscopic kidney retrieval, entrapment and safe extraction.

Binsaleh, Saleh

2014-01-01

395

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

396

conventional delivery? (ie  

E-print Network

Is this a new programme proposal? Is the programme for conventional delivery? (ie not blended? (subject and SCQF level) Where is the programme being delivered? Is the programme for conventional delivery, it is a modification Does modification involve changes to/additions of: Modes of Study Locations of Study Language

Painter, Kevin

397

Single-incision laparoscopic colorectal surgery for cancer: State of art  

PubMed Central

A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of “scarless” surgery. Although NOTES may seem not fully suitable or safe for advanced procedures, such as colectomies, SIL is currently regarded as the next major advance in the progress of minimally invasive surgical approaches to colorectal disease that is more feasible in generalized use. The small incision through the umbilicus allows surgeons to use familiar standard laparoscopic instruments and thus, perform even complex procedures which require extraction of large surgical specimens or intestinal anastomosis. The cosmetic result from SIL is also better because the only incision is made through the umbilicus which can hide the wound effectively after operation. However, SIL raises a number of specific new challenges compared with the laparoscopic conventional approach. A reduced capacity for triangulation, the repeated conflicts between the shafts of the instruments and the difficulties to achieve a correct exposure of the operative field are the most claimed issues. The use therefore of this new approach for complex colorectal procedures might understandingly be viewed as difficult to implement, especially for oncologic cases. PMID:24876729

Cianchi, Fabio; Staderini, Fabio; Badii, Benedetta

2014-01-01

398

Characterization of a near-infrared laparoscopic hyperspectral imaging system for minimally invasive surgery.  

PubMed

We developed and characterized a new imaging platform for minimally invasive surgical venues, specifically a system to help guide laparoscopic surgeons to visualize biliary anatomy. This platform is a novel combination of a near-infrared hyperspectral imaging system coupled with a conventional surgical laparoscope. Intraoperative tissues are illuminated by optical fibers arranged in a ring around a center-mounted relay lens collecting back-reflected light from tissues to the hyperspectral imaging system. The system consists of a focal plane array (FPA) and a liquid crystal tunable filter, which is continuously tunable in the near-infrared spectral range of 650-1100 nm with the capability of passing light with a mean bandwidth of 6.95 nm, and the FPA is a high-sensitivity back-illuminated, deep depleted charge-coupled device. Placing a standard resolution target 5.1 cm from the distal end of the laparoscope, a typical intraoperative working distance, produced a 7.6-cm-diameter field of view with an optimal spatial resolution of 0.24 mm. In addition, the system's spatial and spectral resolution and its wavelength tuning accuracy are characterized. The spectroscopic images are formatted into a three-dimensional hyperspectral image cube and processed using principle component analysis. The processed images provide contrast based on measured spectra associated with chemically different anatomical structures helping identify the main molecular chromophores inherent to each tissue. The principal component images were found to image swine gallbladder and biliary structures from surrounding tissues, in real time, during cholecystectomy surgery. Furthermore, it is shown that surgeons can interrogate selected image subregions for their molecular composition identifying biliary anatomy during surgery and before any invasive action is undertaken. PMID:17492839

Zuzak, Karel J; Naik, Sabira C; Alexandrakis, George; Hawkins, Doyle; Behbehani, Khosrow; Livingston, Edward H

2007-06-15

399

The safety and efficacy of minimal-flow desflurane anesthesia during prolonged laparoscopic surgery  

PubMed Central

Background Minimal-flow anesthesia can meet the demands of a modern society that is more sensitive to environmental protection and economic burdens. This study compared the safety and efficacy of minimal-flow desflurane anesthesia with conventional high-flow desflurane anesthesia for prolonged laparoscopic surgery. Methods Forty-six male patients (ASA physical status II or III) undergoing laparoscopic urologic surgery for more than 6 hours were randomly divided into two groups: the high-flow (HF) group and the minimal-flow (MF) group. The HF group was continuously administered a fresh gas flow of 4 L/min. In the MF group, a fresh gas flow of 4 L/min was administered for the first 20 minutes and was thereafter lowered to 0.5 L/min. Inspiratory and expiratory desflurane concentrations, respiratory variables, and hemodynamic variables were continuously monitored during administration of anesthesia. Measurements of carboxyhemoglobin (COHb) concentration and arterial blood gas analysis were performed every 2 hours during anesthesia. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and creatinine were measured on the first and second day after the surgery. Results Demographic data and duration of anesthesia were not different between the two groups. Significant differences were not observed between the two groups in terms of hemodynamic variables, respiratory variables, and inspiratory and expiratory desflurane concentrations. Inspiratory O2 concentration was maintained lower in the MF group than in the HF group (43-53% vs. 53-59%; P < 0.05). Compared with the HF group, COHb concentrations was higher (P < 0.05), but not increased from the baseline value in the MF group. Serum AST, ALT, BUN, and creatinine were not significantly different between the two groups. Conclusions In prolonged laparoscopic surgery, no significant differences were found in safety and efficacy between minimal-flow and high-flow desflurane anesthesia. PMID:23277809

Park, Sang Yoong; Jang, Jung Hoon; Bae, Jae Young; Choi, So Ron

2012-01-01

400

Pilot study of salvage laparoscopic prostatectomy for the treatment of recurrent prostate cancer  

PubMed Central

OBJECTIVE To evaluate feasibility, safety and oncological efficacy of salvage laparoscopic radical prostatectomy for pathology-proven biochemical recurrence after primary radiation therapy or cryotherapy for prostate cancer. MATERIALS AND METHODS This retrospective pilot study examined 15 patients from 2004 to 2010 with biochemical recurrence after external beam radiation therapy (n = 8), brachytherapy (n = 6) or cryotherapy (n = 1). Patients were treated with salvage laparoscopic radical prostatectomy (11 conventional, four robotic-assisted) with bilateral pelvic dissection. RESULTS Median duration of surgery was 235 min. None of the following occurred: conversion to open surgery, transfusion, urethrovesical stenosis or perioperative or postoperative mortality. One patient presented with a rectal injury, repaired using uninterrupted sutures and a colostomy. One patient had anastomotic leak treated with prolonged Foley catheterization. Pathological stage was pT2a in three, pT2b in three, pT3a in four, pT3b in three and pT4 in two patients; two patients had nodal metastasis. Within an 8-month median follow-up, 11 patients were disease-free and three had persistent postoperative prostate-specific antigen (PSA) elevation; the remaining patient experienced PSA recurrence after 21 months. Seven patients achieved continence (no pads) by 8.4 months (median), one patient manifested severe incontinence corrected by implanting an artificial sphincter, and seven patients with a 12.6-month mean follow-up continued to need one or two pads per day. Erectile dysfunction was present in five patients before surgery and in 14 patients after surgery. CONCLUSIONS Salvage laparoscopic radical prostatectomy seems to offer a safe therapeutic alternative for patients failing primary radiation or cryotherapy. However, larger studies with longer-term data are required. PMID:21166755

Ahallal, Youness; Shariat, Shahrokh F.; Chade, Daher C.; Mazzola, Clarisse; Reuter, Victor E.; Sandhu, Jaspreet S.; Laudone, Vincent P.; Touijer, Karim A.; Guillonneau, Bertrand D.

2014-01-01

401

Remains of the day: Biliary complications related to single-port laparoscopic cholecystectomy  

PubMed Central

AIM: To assesse the rate of bile duct injuries (BDI) and overall biliary complications during single-port laparoscopic cholecystectomy (SPLC) compared to conventional laparoscopic cholecystectomy (CLC). METHODS: SPLC has recently been proposed as an innovative surgical approach for gallbladder surgery. So far, its safety with respect to bile duct injuries has not been specifically evaluated. A systematic review of the literature published between January 1990 and November 2012 was performed. Randomized controlled trials (RCT) comparing SPLC versus CLC reporting BDI rate and overall biliary complications were included. The quality of RCT was assessed using the Jadad score. Analysis was made by performing a meta-analysis, using Review Manager 5.2. This study was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. A retrospective study including all retrospective reports on SPLC was also performed alongside. RESULTS: From 496 publications, 11 RCT including 898 patients were selected for meta-analysis. No studies were rated as high quality (Jadad score ? 4). Operative indications included benign gallbladder disease operated in an elective setting in all studies, excluding all emergency cases and acute cholecystitis. The median follow-up was 1 mo (range 0.03-18 mo). The incidence of BDI was 0.4% for SPLC and 0% for CLC; the difference was not statistically different (P = 0.36). The incidence of overall biliary complication was 1.6% for SPLC and 0.5% for CLC, the difference did not reached statistically significance (P = 0.21, 95%CI: 0.66-15). Sixty non-randomized trials including 3599 patients were also analysed. The incidence of BDI reported then was 0.7%. CONCLUSION: The safety of SPLC cannot be assumed, based on the current evidence. Hence, this new technology cannot be recommended as standard technique for laparoscopic cholecystectomy. PMID:24574757

Allemann, Pierre; Demartines, Nicolas; Schäfer, Markus

2014-01-01

402

Development of blood vessel search system using near-infrared light for laparoscopic surgery  

NASA Astrophysics Data System (ADS)

Our objective of this study is to develop a miniature and high accuracy automatic 3D blood vessel searching system, which will be introduced in the laparoscopic operation with the minimally invasive surgery. Now, the conventional optical system used in the laparoscopic surgery has many difficulties of blood vessel imaging and detection, because the peripheral bio-tissue located around the blood vessel disturbs the light wave propagation, disperses and refracts. Consequently, only unclear image is obtained. We develop a new blood vessel detecting system by using Near-Infrared (NIR) light, two CMOS camera modules and a comprehensive image processing technique, which is implemented in the laparoscope pipe with 25mm in diameter. We adopt the stereo method for the searching system to determine 3D blood vessel location. The blood vessel visualization system adopts hemoglobin's absorption characteristics of the NIR light, which has high permeability for the bio-tissue and absorbency for the hemoglobin. A sharpening process is employed to improve the image quality of original ones, through the LoG filter and the un-sharp-mask processing. 2D location of the blood vessel is calculated from luminance distribution of the image and its depth is calculated by the stereo method. A validity of our blood vessel visualization and 3D detecting system was examined through the comparison with the imaging and detecting the results of organization phantoms, which embedded at known depths under the surface. Experimental results of depth obtained by our detecting system showed good agreements with the given depths, and the availability of this system is confirmed.

Narita, K.; Nakamachi, E.; Morita, Y.; Hagiwara, A.

2013-09-01

403

Laparoscopic (endoscopic) radical prostatectomy: techniques and results  

NASA Astrophysics Data System (ADS)

Laparoscopic radical prostatectomy (LRP) is a relatively new technique for treating organ-confined prostate cancer. Recent progress of laparoscopic/endoscopic techniques allow to perform these complex oncological procedure. Since the first description of LRP in the early 1990s the technique has undergone significant technical modifications. Two operation routes were mainly used: the transperitoneal LRP and the extraperitoneal endoscopic radical prostatectomy (EERPE). Here we review the surgical techniques of both operation routes, and highlight results, outcome and complications. The transperitoneal LRP and the EERPE can be used successfully and reproducibly, giving results comparable with those from the open retropubic procedure. Despite many advantages, transperitoneal LRP is associated with potential intraperitoneal complications. The technical improvements of the EERPE completely obviates these complications. The available data are encouraging and promising, but long-term oncological results will define the definitive role of these new techniques. We truly believe that minimally invasive surgery in treating localized prostate cancer has a bright future and that these techniques will continue to be developed.

Nelius, Thomas; de Riese, Werner T. W.; Reiher, Frank; Lindenmeir, Tobias; Filleur, Stephanie; Allhoff, Ernst P.

2005-04-01

404

Laparoscopic Treatment of Cesarean Scar Ectopic Pregnancy.  

PubMed

Background: An ectopic pregnancy within a Cesarean scar represents a rare type of extrauterine pregnancy in which the fertilized egg nidates in the myometrium of the uterine wall within a scar left from a previous Cesarean delivery. An unrecognized growing Cesarian scar pregnancy may result in uterine rupture, uncontrollable metrorrhagia, and bleeding into the abdominal cavity; therefore, early diagnosis and therapy are necessary to prevent the development of severe complications. Case: A 34-year-old woman after a previous Cesarean delivery presented with amenorrhoa of 7 weeks' duration. Transvaginal ultrasonography revealed an ectopic pregnancy in the Cesarean scar, and a laparoscopic removal of the gestational sac was performed with no complications. Results: Three months later, another laparoscopy with chromopertubation showed no signs of penetration in the suture, both the Fallopian tubes being bilaterally passable. The patient was advised that she could try to achieve pregnancy through spontaneous conception, after which monitoring of the gestational development and a careful assessment of the nidation site would be needed. Conclusions: Laparoscopic surgical management of a viable ectopic pregnancy is technically simple, and is followed by a good recovery. (J GYNECOL SURG 30:309). PMID:25336858

Hude?ek, Robert; Felsingerová, Zuzana; Felsinger, Michal; Jandakova, Eva

2014-10-01

405

Diffuse reflectance measurement tool for laparoscopic surgery  

NASA Astrophysics Data System (ADS)

Continuous-wave diffuse reflectance or Near Infrared Spectroscopy (NIRS) offers the possibility to perform a preliminary screening of tissue for ischemia or other tissue anomalies. A tool for intracavity NIRS measurements during laparoscopic surgery, developed within the framework of the FP7-IP ARAKNES (Array of Robots Augmenting the KiNematics of Endoluminal Surgery) project, is described. It consists of a probe, that is located on the tip of an appropriately shaped laparoscopic manipulator and then applied to the tissue. Such a probe employs an array of incoherent semiconductor light sources (LEDs) frequency-multiplexed on a single detector using a lock-in technique. The resulting overall tool structure is simple and compact, and allows efficient coupling of the emitted light towards the tissue. The tool has high responsivity and enables fast and accurate measurements. A dataset gathered from in-vivo tissue is presented. The performance both indicates direct applicability of the tool to significant surgical issues (ischemia detection), and clearly indicates the possibility of further miniaturizing the probe head towards catheterized approaches.

Giardini, Mario E.; Klemm, Annett B.; Di Falco, Andrea; Krauss, Thomas F.

2010-04-01

406

Right liver necrosis: complication of laparoscopic cholecystectomy.  

PubMed

Although bile duct injuries are common among the complications of laparoscopic cholecystectomy, hepatic vascular injuries are not well described. Between January 1990 to December 1999, 83 patients with bile duct injuries have been referred to our clinic. Two of them had liver necrosis due to hepatic arterial occlusion. These two women had laparoscopic cholecystectomy for symptomatic cholelithiasis in district hospitals 4 and 15 days prior to their referral to our clinic. Serum aspartate aminotransferase and alanine aminotransferase levels were found to be 30 to 40-fold higher than normal levels. Ultrasonography, computed tomography and Doppler sonography showed necrosis in the right liver lobe and no flow in the right hepatic artery. Patients were also complicated with liver abscess and biliary peritonitis, respectively. Emergency right hepatectomy was performed in both cases and one of them needed Roux-Y-hepaticojejunostomy (to the left hepatic duct). One patient died of peritonitis in the postoperative period. The other one has no problem in her third postoperative year. The earliest and the simplest method for diagnosis or ruling out hepatic arterial occlusion is detecting the blood biochemistry and Doppler ultrasonography. In some cases emergency hepatectomy can be necessary. Postoperative complications should be expected higher than elective cases. PMID:11813609

Kayaalp, C; Nessar, G; Kaman, S; Akoglu, M

2001-01-01

407

The Laparoscopic Approach to Paraesophageal Hernia Repair  

PubMed Central

Laparoscopic paraesophageal hernia repair continues to be one of the most challenging procedures facing the minimally invasive surgeon. A thorough understanding of the tenets of the operation and advanced skills in minimally invasive laparoscopy are needed for long-term freedom from symptomatic and anatomic recurrence. These include complete reduction of the hernia sac from the mediastinum back into the abdomen with careful preservation of the integrity of muscle and peritoneal lining of the crura, aggressive and complete mobilization of the esophagus to the level of the inferior pulmonary vein, clear identification of the gastroesophageal junction to allow accurate assessment of the intraabdominal esophageal length and use of Collis gastroplasty when esophageal lengthening is required for a tension-free intraabdominal repair. Liberal mobilization of the phrenosplenic and phrenogastric attachments substantially increases the mobility of the left limb of the crura, allowing for a tension-free primary closure in a large percentage of patients. The following describes our current approach to laparoscopic paraesophageal hernia repair following a decade of refinement in a high-volume center. PMID:22160778

Nason, Katie S.; Levy, Ryan M.; Witteman, Bart P.L.; Luketich, James D.

2014-01-01

408

Rectal arteriovenous fistula resected laparoscopically after laparoscopic sigmoidectomy: a case report.  

PubMed

We report a very rare case of rectal arteriovenous fistula following sigmoidectomy and discuss this case in the context of the existing literature. In April 2011, the patient, a man in his 60s, underwent laparoscopic sigmoidectomy with lymph node dissection for sigmoid colon cancer. Beginning in February 2012, he experienced frequent diarrhea. Abdominal contrast-enhanced CT revealed local thickening of the rectal wall and rectal arteriovenous fistula near the anastomosis site. Rectitis from the rectal arteriovenous fistula was diagnosed. No improvement was seen with conservative treatment. Therefore, surgical resection was performed laparoscopically and the site of the lesion was confirmed by intraoperative angiography. The arteriovenous fistula was identified and resected. Postoperatively, diarrhea symptoms resolved, and improvement in rectal wall thickening was seen on abdominal CT. No recurrence has been seen as of 1 year postoperatively. PMID:24450345

Ushigome, Hajime; Hayakawa, Tetsushi; Morimoto, Mamoru; Kitagami, Hidehiko; Tanaka, Moritsugu

2014-01-01

409

Clinical results with acridine orange using a novel confocal laparoscope  

NASA Astrophysics Data System (ADS)

We previously reported on the development of a multi-spectral confocal laparoscope for clinical imaging. In this paper we present current results using the system to image ovaries with a new laparoscope design using the contrast agent acridine orange. This new laparoscope integrates computer controlled systems for focus, depth scans, and localized contrast agent delivery. Precise axial position control is accomplished with tiny stepper motors integrated inside the laparoscope handle. Ergonomic handle controls allow for data acquisition, deliver of contrast agents, and adjustment of imaging depth during procedures by the surgeon. We have approval to use acridine orange in our clinical trials to image ovaries in vivo during oophorectomies. We present in vivo results using both acridine orange and fluorescein as the topically administered contrast agent.

Tanbakuchi, Anthony A.; Rouse, Andrew R.; Hatch, Kenneth D.; Gmitro, Arthur F.

2009-02-01

410

Laparoscopic Spigelian Hernia Repair: A Series of 40 Patients.  

PubMed

Spigelian hernias are a rare abdominal wall hernia. The aim of this study was to assess the efficacy and outcomes of patients who underwent a laparoscopic spigelian hernia repair. A retrospective study was performed reviewing all patients who had a laparoscopic spigelian hernia repair. We assessed the success of the procedure including conversion rates, postoperative morbidities, and recurrence rates. Forty patents had a laparoscopic repair. Two thirds (n=25) had an intraperitoneal repair. There was no conversion to open repair. Four patients had postoperative morbidities. At 6-month follow-up all patients were pain free, with 1 recurrence. There is considerable evidence supporting the opinion that laparoscopic repair offers excellent outcomes. This report is the largest series to date, and we advocate that this approach should become the standard of care. PMID:25383942

Kelly, Michael E; Courtney, Danielle; McDermott, Frank D; Heeney, Anna; Maguire, Donal; Geoghegan, Justin G; Winter, Des C

2014-11-01

411

Laparoscopic gastric surgery for cancer: Where do we stand?  

PubMed Central

Gastric cancer poses a significant public health problem, especially in the Far East, due to its high incidence in these areas. Surgical treatment and guidelines have been markedly different in the West, but nowadays this debate is apparently coming to an end. Laparoscopic surgery has been employed in the surgical treatment of gastric cancer for two decades now, but with controversies about the extent of resection and lymphadenectomy. Despite these difficulties, the apparent advantages of the laparoscopic approach helped its implementation in early stage and distal gastric cancer, with an increase on the uptake for distal gastrectomy for more advanced disease and total gastrectomy. Nevertheless, there is no conclusive evidence about the laparoscopic approach yet. In this review article we present and analyse the current status of laparoscopic surgery in the treatment of gastric cancer. PMID:25339815

Antonakis, Pantelis T; Ashrafian, Hutan; Isla, Alberto Martinez

2014-01-01

412

Diagnosis and management of atypical mycobacterial infection after laparoscopic surgery.  

PubMed

Atypical mycobacterial infections at the laparoscopic port site are a frequent problem encountered in patients undergoing laparoscopic surgery. In this study we concentrate on the clinical diagnosis, management and prevention of this problem. In this series we assess 19 patients presenting with port hole infections after laparoscopic surgery and were treated with a combination of oral clarithromycin and ciprofloxacin. Seven patients who had persistent nodules were given injections of amikacin directly into the infection foci along with standard oral therapy. Most of the patients treated with standard oral therapy for 28 days showed recovery. The patients with persistent nodules 4 weeks after completion of therapy were treated with injections of amikacin directly into the nodule which lead to resolution of symptoms. For prevention of infection, proper sterilization and storage of instruments is recommended. Laparoscopic port hole infections is a preventable problem and can also be treated by nonsurgical method. PMID:22131651

Chaudhuri, Sumit; Sarkar, Debojyoti; Mukerji, Reshmi

2010-12-01

413

Appendicitis with psoas abscess successfully treated by laparoscopic surgery.  

PubMed

Although acute appendicitis is a common disease, retroperitoneal abscesses are rarely observed. Here, we report a case consisting of a psoas abscess and cutaneous fistula caused by appendicitis. The patient was a 56-year-old male who was introduced to our institution due to an intractable right psoas abscess. Imaging tests had been performed over the previous 3 years; however, clinicians could not find the origin of the abscess and failed to resolve the problem. A successful operation was performed via a laparoscopic approach, and 17 mo have passed without recurrence. The advantage of laparoscopic surgery is well understood in cases of appendicitis with abscesses. However, the indication for laparoscopic approach is not clear for retroperitoneal abscesses. From our experience, we can conclude that appendicitis with retroperitoneal abscesses can be managed and treated using a laparoscopic approach. PMID:25009411

Otowa, Yasunori; Sumi, Yasuo; Kanaji, Shingo; Kanemitsu, Kiyonori; Yamashita, Kimihiro; Imanishi, Tatsuya; Nakamura, Tetsu; Suzuki, Satoshi; Tanaka, Kenichi; Kakeji, Yoshihiro

2014-07-01

414

Appendicitis with psoas abscess successfully treated by laparoscopic surgery  

PubMed Central

Although acute appendicitis is a common disease, retroperitoneal abscesses are rarely observed. Here, we report a case consisting of a psoas abscess and cutaneous fistula caused by appendicitis. The patient was a 56-year-old male who was introduced to our institution due to an intractable right psoas abscess. Imaging tests had been performed over the previous 3 years; however, clinicians could not find the origin of the abscess and failed to resolve the problem. A successful operation was performed via a laparoscopic approach, and 17 mo have passed without recurrence. The advantage of laparoscopic surgery is well understood in cases of appendicitis with abscesses. However, the indication for laparoscopic approach is not clear for retroperitoneal abscesses. From our experience, we can conclude that appendicitis with retroperitoneal abscesses can be managed and treated using a laparoscopic approach. PMID:25009411

Otowa, Yasunori; Sumi, Yasuo; Kanaji, Shingo; Kanemitsu, Kiyonori; Yamashita, Kimihiro; Imanishi, Tatsuya; Nakamura, Tetsu; Suzuki, Satoshi; Tanaka, Kenichi; Kakeji, Yoshihiro

2014-01-01

415

Comparison of Laparoscopic Anterior Discoid Resection and Laparoscopic Low Anterior Resection of Deep Infiltrating Rectosigmoid Endometriosis  

PubMed Central

Objective: To compare laparoscopic anterior discoid resection (ADR) with low anterior resection (LAR). Methods: This is a retrospective review of a cohort (Canadian Task Force classification II-2) of patients undergoing laparoscopic ADR or LAR at a university hospital. Chart review and telephone questionnaires were conducted to examine long-term outcomes. Preoperative and operative findings, short- and long-term outcomes were compared. SF-12 quality of life scores, need for further interventions, and overall satisfaction were also compared. Results: Twenty-two patients underwent laparoscopic ADR (n=8) or LAR (n=14) for rectosigmoid endometriosis between January 2001 and December 2009. Mean follow-up time was 41.26 months (range, 14 to 70). Patients undergoing laparoscopic ADR had significantly less blood loss and shorter operative time and hospital stay. Patients who required LAR had a significantly higher rate of mucosal involvement (61.5% v. 0%). No statistically significant difference was found in the size, depth of invasion, location of lesions, or operative complications. Fifty percent of the LAR group had several lesions as opposed to 12.5% of the ADR group. Median age was significantly higher in patients who required LAR (39) than in patients who required ADR (32). Three patients in the LAR group (21.4%) had anastomotic strictures; 2 required dilation. The ADR group had consistently higher increments of improvement in bowel symptoms and dyspareunia. Overall satisfaction rate with the procedures was 93.3%. SF-12 scores were comparable between the 2 groups. Conclusion: ADR compared with LAR is associated with decreased operative time, blood loss, and hospital stay and a lower rate of anastomotic strictures. Other outcomes and satisfaction rates are comparable between the 2 procedures. PMID:21985719

Guido, Richard; Ramanathan, Ramesh; Mansuria, Suketu; Lee, Ted

2011-01-01

416

Stoma creation for fecal diversion: is the laparoscopic technique appropriate?  

Microsoft Academic Search

This study assessed the results of laparoscopic stoma creation for fecal diversion. All patients who underwent elective laparoscopic\\u000a stoma creation as the sole procedure were evaluated prospectively. Univariate analysis was performed to determine whether\\u000a previous abdominal surgery, age, gender, body mass index, indication, or surgeons' experience has an effect on the outcome.\\u000a Between November 1992 and May 1998, 42 patients

O. Schwandner; T. H. K. Schiedeck; H.-P. Bruch

1998-01-01

417

Surgical technology and the ergonomics of laparoscopic instruments  

Microsoft Academic Search

.   Laparoscopic surgery provides patients with less painful surgery and a more rapid recovery, while requiring that surgeons\\u000a work harder and in a more remote manner from the operating field. Cost-containment pressures on surgeons demand efficient\\u000a surgery, whereas the increased technological complexity and sometimes poorly adapted equipment have led to increased complaints\\u000a of surgeon fatigue and discomfort during laparoscopic surgery.

R. Berguer

1998-01-01

418

Outcomes of Conversion of Laparoscopic Colorectal Surgery to Open Surgery  

PubMed Central

Objectives: There is limited data regarding the outcomes of patients who undergo conversion to open surgery during a laparoscopic operation in colorectal resection. We sought to identify the outcomes of such patients. Methods: The NIS (National Inpatient Sample) database was used to identify patients who had conversion from laparoscopic to open colorectal surgery during the 2009 to 2012 period. Multivariate regression analysis was performed to identify risk-adjusted outcomes of conversion to open surgery. Results: We sampled 776 007 patients who underwent colorectal resection. 337 732 (43.5%) of the patients had laparoscopic resection. Of these, 48 265 procedures (14.3%) were converted to open surgery. The mortality of converted patients was increased, when compared with successfully completed laparoscopic operations, but was still lower than that of open procedures (0.6% vs. 1.4% vs. 3.9%, respectively; adjusted odds ratio [AOR], 1.61 and 0.58, respectively; P < .01). The most common laparoscopic colorectal procedure was right colectomy (41.2%). The lowest rate of conversion is seen with right colectomy while proctectomy had the highest rate of conversion (31.2% vs. 12.9%, AOR, 2.81, P < .01). Postsurgical complications including intra-abdominal abscess (AOR, 2.64), prolonged ileus (AOR, 1.50), and wound infection (AOR, 2.38) were higher in procedures requiring conversion (P < .01). Conclusions: Conversion of laparoscopic to open colorectal resection occurs in 14.3% of cases. Compared with patients who had laparoscopic operations, patients who had conversion to open surgery had a higher mortality, higher overall morbidity, longer length of hospitalization, and increased hospital charges. The lowest conversion rate was in right colectomy and the highest was in proctectomy procedures. Wound infection in converted procedures is higher than in laparoscopic and open procedures.

Moghadamyeghaneh, Zhobin; Masoomi, Hossein; Mills, Steven D.; Carmichael, Joseph C.; Pigazzi, Alessio; Nguyen, Ninh T.

2014-01-01

419

Robotic-Assisted Versus Laparoscopic Colectomy: Cost and Clinical Outcomes  

PubMed Central

Background and Objectives: Laparoscopic colectomies, with and without robotic assistance, are performed to treat both benign and malignant colonic disease. This study compared clinical and economic outcomes for laparoscopic colectomy procedures with and without robotic assistance. Methods: Patients aged ?18 years having primary inpatient laparoscopic colectomy procedures (cecectomy, right hemicolectomy, left hemicolectomy, and sigmoidectomy) identified by International Classification of Diseases, Ninth Edition procedure codes performed between 2009 and the second quarter of 2011 from the Premier Hospital Database were studied. Patients were matched to a control cohort using propensity scores for disease, comorbidities, and hospital characteristics and were matched 1:1 for specific colectomy procedure. The outcomes of interest were hospital cost of laparoscopic robotic-assisted colectomy compared with traditional laparoscopic colectomy, surgery time, adverse events, and length of stay. Results: Of 25 758 laparoscopic colectomies identified, 98% were performed without robotic assistance and 2% were performed with robotic assistance. After matching, 1066 patients remained, 533 in each group. Lengths of stay were not significantly different between the matched cohorts, nor were rates of major, minor, and/or surgical complications. Inpatient procedures with robotic assistance were significantly more costly than those without robotic assistance ($17 445 vs $15 448, P = .001). Operative times were significantly longer for robotic-assisted procedures (4.37 hours vs 3.34 hours, P < .001). Conclusion: Segmental colectomies can be performed safely by either laparoscopic or robotic-assisted methods. Increased per-case hospital costs for robotic-assisted procedures and prolonged operative times suggest that further investigation is warranted when considering robotic technology for routine laparoscopic colectomies. PMID:24960484

Davis, Bradley R.; Yoo, Andrew C.; Moore, Matt

2014-01-01

420

Late Presentation of a Diaphragmatic Hernia Following Laparoscopic Gastric Banding  

Microsoft Academic Search

Laparoscopic gastric banding is an established and increasingly popular surgical treatment for morbid obesity. Iatrogenic\\u000a diaphragmatic injury can complicate upper abdominal and esophageal surgery. We describe here the case of a patient who had\\u000a undergone revisional surgery to replace a laparoscopic band, who presented acutely, years following surgery, with breathlessness\\u000a and abdominal pain. CT of the chest and abdomen demonstrated

Stephen Boyce; Raj Burgul; Florentine Pepin; Chris Shearer

2008-01-01

421

Laparoscopic resection of a jejunal mesenteric pseudocyst: case report  

PubMed Central

Mesenteric cysts are rare and can occur at any age. They can manifest with abdominal pain or compressive mass effect. The exact etiology is unknown. Ultrasonography, computed tomography and laparoscopy are used in diagnosing mesenteric cysts. Laparoscopic excision of a mesenteric cyst is possible and should be considered as the treatment of choice. We present a case of mesenteric pseudocyst of small bowel treated by laparoscopic excision. PMID:25644729

RESTA, G.; TARTARINI, D.; FABBRI, N.; BIANCHINI, E.; ANANIA, G.

2014-01-01

422

Mediastinal Seroma Post Laparoscopic Repair of Type IV Paraesophageal Hernia  

PubMed Central

Laparoscopic repair of paraesophageal hernia is safe and feasible and can provide comparable results for patients with type IV paraesophageal hernia. We report a rare case of mediastinal seroma in an 80-year-old gentleman who had a giant type IV paraesophageal hernia and was eventually admitted to our hospital for elective laparoscopic repair and recovered very well after surgery with resolution of the atelectatic lungs and air-fluid collection in his chest. PMID:21727737

Alnassar, Sami A.

2011-01-01

423

The carbon footprint of laparoscopic surgery: should we offset?  

Microsoft Academic Search

The aim of this study was to estimate the effect that the expansion of laparoscopic surgery has had on global warming. Laparoscopic\\u000a procedures performed in a hospital over a 10-year period were analysed. The number of CO2 cylinders (size C) used over a 2.5-year period and the “carbon footprint” of each cylinder was calculated. There was a fourfold\\u000a increase of

A. D. Gilliam; B. Davidson; J. Guest

2008-01-01