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1

[Minimally invasive laparoscopic hysterectomy: Pelosi's single puncture technique].  

PubMed

The purposes of this paper were to determine the indications, feasibility, outcome, complications and costs of laparoscopic hysterectomy utilizing the Pelosi single umbilical puncture technique and to introduce in Latinoamérica this minimally invasive and inexpensive alternative of laparoscopic hysterectomy. Ours results suggest that laparoscopic hysterectomy using a single umbilical puncture approach is a safe, inexpensive and effective alternative when compared with other techniques of laparoscopic hysterectomy. PMID:7569152

Pelosi, M A; Ortega, I

1994-01-01

2

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.

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

2009-01-01

3

Same-day discharge after laparoscopic hysterectomy.  

PubMed

The benefits of laparoscopic hysterectomy are well documented and include less postoperative pain, shorter hospital stay and faster recovery. The objective of this study was to assess the feasibility of laparoscopic hysterectomy as an outpatient procedure. A total of 26 women regarded eligible for an accelerated approach were included. The mean duration of the operation was 40 min (range 23-60 min), with a blood loss of 50 mL (range 10-200 mL). Twenty-three left the hospital the same day (88%). One woman required overnight hospitalization because of a port hematoma, while two stayed for reasons unrelated to the surgery. Three other women were referred with minor problems to an urgent clinic appointment within the first month. Overall, the women were satisfied with the procedure, with a mean rating of 9 of 10 possible points. Thus, outpatient laparoscopic hysterectomy appeared to be safe and well accepted by selected patients. PMID:22924755

Lassen, Pernille Danneskiold; Moeller-Larsen, Hedvig; DE Nully, Pia

2012-10-17

4

Experience in laparoscopic hysterectomy: analysis of three hundred cases.  

PubMed

A personal experience with 300 cases of laparoscopic hysterectomy was analysed and its merits and demerits were discussed. The demographic features, indications, feasibility, complications, operating time, blood loss, hospital stay, cost effectiveness and its outcome were reviewed. The indications were uterine fibroid (40%), adenomyosis, dysfunctional uterine bleeding and pelvic inflammatory disease (36%), fibroid uterus with endometriosis (17.5%), postmenopausal bleeding (3%), ovarian neoplasm (2.1%) and fibroid uterus with ovarian cyst (1.4%). Two uterine malignancies and one case of potentially malignant ovarian neoplasm, were also encountered in our series. Assessibility score of above 20 was present in 55%. Haemorrhage was prevented intraoperatively by securing the large pedicles with electrocoagulation as well as large titanium clips (LT-400). Retrograde ureteric catheterisation was not necessary. Overall morbidity was present only in 10.62%. Intraoperative bladder injury was encountered in 1%, urinary fistula in 0.66%, primary and secondary haemorrhage in 0.33% respectively, and minor febrile morbidity in 4.66%. Conversion to conventional abdominal hysterectomy occurred in 0.66% of the cases. The average operating time was 141.99 +/- 31.678 min, the estimated blood loss was 237.07 +/- 76.76 ml and average hospitalisation was 3.37 +/- 0.66 days. The cost of laparoscopic hysterectomy was found similar to abdominal hysterectomy. Higher operating fee, operating theatre and anaesthesia charges did not affect the overall cost of laparoscopic hysterectomy because of shorter hospital stay. It is concluded that laparoscopic hysterectomy has definite role in gynaecological surgery. PMID:8924000

Mehra, S; Bokaria, R; Gujral, A; Bhat, V; Hotchandani, M

1996-09-01

5

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

6

[Laparoscopic hysterectomy--brief history, frequency, indications and contraindications].  

PubMed

Hysterectomy is the most common gynecological operation after Caesarean section and the laparoscopic access to uterus removal is one of the contemporary methods showing slow but steady growth in time. In reference to indications and contraindications for laparoscopic hysterectomy, the following directions emerge as controversial: malignant gynecological tumors, uterus size, and high body mass index. Laparoscopic hysterectomy can be taken into consideration at the first stage of endometrial, cervical and ovarian cancer. If there is doubt about an uterus sarcoma and a laparoscopic access is accomplished, a conversion to abdominal hysterectomy must be done. Obesity and big uteri are not a contrarindication for that minimally-invasive access. Today, laparoscopic hysterectomy is a reasonable alternative to total abdominal and vaginal hysterectomy. PMID:23234025

Tomov, S; Gorchev, G; Tzvetkov, Ch; Tanchev, L; Iliev, S

2012-01-01

7

Hysterectomy  

MedlinePLUS

... the laparoscope is used to guide the procedure. In a robot-assisted laparoscopic hysterectomy, the surgeon uses a robot attached to the instruments to assist in the surgery. What are the risks associated with ...

8

Incidence of cyclical bleeding after laparoscopic supracervical hysterectomy  

Microsoft Academic Search

Study objectiveThe aim of the study was to estimate the incidence of cyclical bleeding after laparoscopic supracervical hysterectomy (LSH) when the uterus is amputated at or below the level of internal cervical os.

Ali Ghomi; Jeff Hantes; E. C. Lotze

2005-01-01

9

Laparoscopic radical hysterectomy (type III) with aortic and pelvic lymphadenectomy  

Microsoft Academic Search

OBJECTIVE: The purpose of this study was to incorporate a wide range of operative laparoscopic techniques to complete a type III radical hysterectomy with aortic and pelvic lymphadenectomy. STUDY DESIGN: A type III radical hysterectomy with bilateral aortic and pelvic lymph node dissection was separated into eight component parts: (1) right and left aortic lymphadenectomy, (2) right and left pelvic

Nick M. Spirtos; John B. Schlaerth; Ronald E. Kimball; Victoria M. Leiphart; Samuel C. Ballon

1996-01-01

10

Costs and Outcomes of Abdominal, Vaginal, Laparoscopic and Robotic Hysterectomies  

PubMed Central

Background and Objectives: To estimate the incidence of operative complications and compare operative cost and overall cost of different methods of benign hysterectomy including abdominal, vaginal, laparoscopic, and robotic techniques. Methods: We performed a retrospective cohort analysis (Canadian Task Force classification II-2) of all patients who underwent a hysterectomy for benign reasons in 2009 at a single urban academic tertiary care center using the ?2 test and Student t test. A multivariate regression analysis was also performed for predictors of costs. Cost data were gathered from the hospital's billing system; the remainder of data was extracted from patient's medical records. Results: In 2009, 688 patients underwent a benign hysterectomy; 185 (26.9%) hysterectomies were abdominal, 135 (19.6%) vaginal, 352 (51.5%) laparoscopic, and 14 (2.0%) robotic. The rate of intraoperative complication was 1.7% for abdominal, 0.8% for vaginal, 0.3% for laparoscopic, and 0 for robotic. Mean total patient costs were $43,622 for abdominal, $31,934 for vaginal, $38,312 for laparoscopic, and $49,526 for robotic hysterectomies. Costs were significantly influenced by method of hysterectomy, operative time, and length of stay. Conclusion: Though complication rates did not vary significantly among minimally invasive methods of hysterectomy, patient costs were significantly influenced by the method of hysterectomy.

Jonsdottir, Gudrun M.; Jorgensen, Selena; Shah, Neel; Einarsson, Jon I.

2012-01-01

11

Postoperative Patient Satisfaction After Laparoscopic Supracervical Hysterectomy  

PubMed Central

Background and Objectives: The aim of this study was to evaluate postoperative patient satisfaction in women after laparoscopic supracervical hysterectomy (LASH). Methods: A retrospective study by a mailed questionnaire among 2334 women who underwent hysterectomy via LASH at the MIC-Klinik, Berlin, between 1998 and 2004 was conducted. Indications for LASH were uterus myomatosus, adenomyosis uteri, disorders of bleeding, and genital descensus. The LASH operation technique was standardized and remained consistent throughout the observation period. Pearson's test for metric variables, Spearman's rank correlation test for ordinal data, Mann-Whitney U test, and Kruskal-Wallis test were used. Results: Of the 2334 questionnaires mailed, 1553 were returned and 1431 (61.3%) of those could be analyzed. Almost 94% (93.9%) of the women were highly satisfied with the outcome, 5.6% reported medium satisfaction, and 0.5% were not satisfied. There was no significant difference in patient satisfaction with regard to the different indication for LASH. Conclusion: This study demonstrates high postoperative patient satisfaction after LASH. The rate of highly satisfied women might be increased by carefully choosing the right indications for LASH and improving operation techniques. This is important for widening acceptance of this innovative new operation standard.

Gardanis, Konstantinos; Bojahr, Bernd; de Wilde, Rudy Leon

2013-01-01

12

Comparative Effectiveness of Robotic Versus Laparoscopic Hysterectomy for Endometrial Cancer  

PubMed Central

Purpose Use of robotics in oncologic surgery is increasing; however, reports of safety and efficacy are from highly experienced surgeons and centers. We performed a population-based analysis to compare laparoscopic hysterectomy and robotic hysterectomy for endometrial cancer. Patients and Methods The Perspective database was used to identify women who underwent a minimally invasive hysterectomy for endometrial cancer from 2008 to 2010. Morbidity, mortality, and cost were evaluated using multivariable logistic and linear regression models. Results We identified 2,464 women, including 1,027 (41.7%) who underwent laparoscopic hysterectomy and 1,437 (58.3%) who underwent robotic hysterectomy. Women treated at larger hospitals, nonteaching hospitals, and centers outside of the northeast were more likely to undergo a robotic hysterectomy procedure, whereas black women, those without insurance, and women in rural areas were less likely to undergo a robotic hysterectomy procedure (P < .05 for all). The overall complication rate was 9.8% for laparoscopic hysterectomy versus 8.1% for robotic hysterectomy (P = .13). The adjusted odds ratio (OR) for any morbidity for robotic hysterectomy was 0.76 (95% CI, 0.56 to 1.03). After adjusting for patient, surgeon, and hospital characteristics, there were no significant differences in the rates of intraoperative complications (OR, 0.68; 95% CI, 0.42 to 1.08), surgical site complications (OR, 1.49; 95% CI, 0.81 to 2.73), medical complications (OR, 0.64; 95% CI, 0.40 to 1.01), or prolonged hospitalization (OR, 0.85; 95% CI, 0.64 to 1.14) between the procedures. The mean cost for robotic hysterectomy was $10,618 versus $8,996 for laparoscopic hysterectomy (P < .001). In a multivariable model, robotic hysterectomy was significantly more costly ($1,291; 95% CI, $985 to $1,597). Conclusion Despite claims of decreased complications with robotic hysterectomy, we found similar morbidity but increased cost compared with laparoscopic hysterectomy. Comparative long-term efficacy data are needed to justify its widespread use.

Wright, Jason D.; Burke, William M.; Wilde, Elizabeth T.; Lewin, Sharyn N.; Charles, Abigail S.; Kim, Jin Hee; Goldman, Noah; Neugut, Alfred I.; Herzog, Thomas J.; Hershman, Dawn L.

2012-01-01

13

A laparoscopic bipolar cutting forceps can assist in a case of difficult vaginal hysterectomy.  

PubMed

A vaginal approach to hysterectomy can become challenging when visualization is limited by poor or absent uterine descent, obesity, or other factors that make an approach to the uterine pedicles difficult. When factors occur that make application or visualization of conventional vaginal instruments difficult, using an instrument designed for laparoscopic application, with its thin, elongated shape, may permit continuation of a vaginal approach. In such a case, a Gyrus bipolar laparoscopic cutting forceps was used for coagulation and transection of the uterine pedicles during a vaginal hysterectomy. This represents a way to expand on traditional techniques for completion of difficult vaginal hysterectomy, which may be used concurrently. Surgical techniques that more easily and safely permit completion of hysterectomy by the vaginal approach can improve outcomes for all. PMID:16825076

Fenton, Bradford W; Hutchings, Tim; Flora, Robert F; Fanning, James

14

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

15

Total Laparoscopic Hysterectomy: Our 5-Year Experience (1998-2002)  

PubMed Central

Purpose: To review our experience performing total laparoscopic hysterectomy since we first introduced this procedure in 1998. Methods: A retrospective cohort study was performed for patients undergoing total laparoscopic hysterectomy at Ochsner Clinic Foundation from February 1998 through December 2002. Rates of complications, successful completion, length of hospital stay, readmission, and reoperation were determined for this period. Results: Among 511 patients who underwent attempted total laparoscopic hysterectomy, 487 procedures (95.3%) were completed by laparoscopy. The major intraoperative complication rate was 3.9%, and the major postoperative complication rate was 4.7%. No significant differences were seen in the intraoperative and postoperative complication rates of patients who were morbidly obese (body mass index ?30 kg/m2), patients with enlarged uteri (?300 g), or patients who underwent concomitant procedures (unilateral or bilateral salpingo-oophorectomy and lysis of adhesions). The readmission rate was 4.1%, and the reoperation rate was 2%. None of the variables studied, including age, medical problems, morbid obesity, concomitant procedures, or enlarged uterus, were found to have an association with readmission or reoperation rates. Conclusions: Total laparoscopic hysterectomy can be performed successfully in most patients with benign indications. Morbidity is comparable to that of other types of hysterectomies, and this technique may be a more reasonable approach under some circumstances.

Bonilla, David J.; Mains, Lindsay; Rice, Janet; Crawford, Benjamin

2010-01-01

16

Laparoscopic hysterectomy using a computer-enhanced surgical robot  

Microsoft Academic Search

Objective  The objective of this study was to describe the technique of laparoscopic hysterectomy using a computer-enhanced robotic surgical\\u000a system.\\u000a \\u000a \\u000a \\u000a Methods  Eleven patients underwent laparoscopic hysterectomy and bilateral salpingo-oophorectomy using a computer-enhanced surgical\\u000a robot. Four trocars were used: one for the camera, two for the robotic arms controlled by the operating surgeon from the surgeon’s\\u000a console, and an additional port for use

C. Diaz-Arrastia; C. Jurnalov; G. Gomez; C. Townsend

2002-01-01

17

Vaginal-Assisted Laparoscopic Radical Hysterectomy: Rationale, Technique, Results  

PubMed Central

Objective: Total laparoscopic radical hysterectomy (TLRH) makes it difficult to resect adequate vaginal cuff according to tumor size and to avoid tumor spread after opening the vagina. Laparoscopic-assisted radical vaginal hysterectomy (LARVH) is associated with higher risk for urologic complications. Methods: The vaginal-assisted laparoscopic radical hysterectomy (VALRH) technique comprises 3 steps: (1) comprehensive laparoscopic staging, (2) creation of a tumor-adapted vaginal cuff, and (3) laparoscopic transsection of parametria. We retrospectively analyzed data of 122 patients who underwent VALRH for early stage cervical cancer (n=110) or stage II endometrial cancer (n=12) between January 2007 and December 2009 at Charité University Berlin. Results: All patients underwent VALRH without conversion. Mean operating time was 300 minutes, and mean blood loss was 123cc. On average, 36 lymph nodes were harvested. Intra- and postoperative complication rates were 0% and 13.1%, respectively. Resection was in sound margins in all patients. After median follow-up of 19 months, disease-free survival and overall survival for all 110 cervical cancer patients was 94% and 98%, and for the subgroup of patients (n=90) with tumors ?pT1b1 N0 V0 L0/1 R0, 97% and 98%, respectively. Conclusion: VALRH is a valid alternative to abdominal radical hysterectomy and LARVH in patients with early-stage cervical cancer and endometrial cancer stage II with minimal intraoperative complications and identical oncologic outcomes.

Gottschalk, Elisabeth; Lanowska, Malgorzata; Chiantera, Vito; Marnitz, Simone; Schneider, Achim; Brink-Spalink, Verena; Hasenbein, Kati

2011-01-01

18

Comparison of Two Bipolar Systems in Laparoscopic Hysterectomy  

PubMed Central

Objective: To compare the efficacy of 2 bipolar systems during total laparoscopic hysterectomy (TLH): the pulsed bipolar system (PlasmaKinetic; Olympus, Japan) vs. conventional bipolar electrosurgery (Kleppinger bipolar forceps; Richard Wolf Instruments, Vernon Hills, IL). Methods: We retrospectively reviewed medical records of 80 women who underwent TLH for benign gynecologic disease between 2009 and 2010. Forty women received TLH using the conventional bipolar system and another 40 using the pulsed bipolar system. The clinical outcomes and complications were compared between the 2 groups. Results: No significant differences between the 2 groups were observed in terms of age, body mass index, and hospital stay. However, the blood loss was greater (515.3 ± 41.2mL vs. 467.9 ± 33.4mL, P < .05) and the operation time was longer (173.4 ± 33.4min vs. 157.3 ± 21.3min, P < .05) in the conventional group. Additionally, the uterine weight was lighter in the conventional group (218.5 ± 23.4g vs. 299.4 ± 41.1g, P < .05). None of the surgeries were required to be converted to laparotomy. No significant differences were found in intraoperative or postoperative complications between the groups. Conclusion: The pulsed bipolar system has some advantages over the conventional system, and therefore, may offer an alternative option for patients undergoing TLH.

Cho, Hye-Yon; Choi, Kong-Ju; Lee, Young-Lan; Chang, Kylie Hae-Jin; Kim, Hong-Bae

2012-01-01

19

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

Microsoft Academic Search

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

Michael L. Nimaroff; Michael Dimino; Susan Maloney

1996-01-01

20

Comparison of laparoscopic and abdominal hysterectomy in terms of quality of life: A systematic review  

Microsoft Academic Search

The objective of this study was to investigate the randomized studies reporting on quality of life after laparoscopic hysterectomy as compared to abdominal hysterectomy.A systematic qualitative review was performed on published studies identified by the databases PubMed and EMBASE, as well as cross-references. Randomized clinical trials on laparoscopic versus abdominal hysterectomy were assessed for the methods in which studies reported

Kirsten B. Kluivers; Neil P. Johnson; Patrick Chien; Mark E. Vierhout; Marlies Y. Bongers; Ben W. J. Mol

2008-01-01

21

Total laparoscopic hysterectomy with obliterated anterior cul-de-sac  

PubMed Central

Endometriosis may in severe cases lead to obliteration of the anterior and/or posterior cul-de-sacs in the female pelvis. The anterior cul-de-sac is generally less commonly affected. This type of cases usually presents a challenge for the operating surgeon, whether via open route or through laparoscopy. In this paper, we present an illustrative case and explain our technique for dealing with a scarred and totally obliterated anterior cul-de-sac because of endometriosis during total laparoscopic hysterectomy.

Walid, M. Sami; Heaton, Richard L.

2010-01-01

22

Laparoscopically assisted repair of vaginal evisceration after hysterectomy.  

PubMed

Vaginal evisceration is a rare condition most commonly associated with previous vaginal surgery. It usually presents with vaginal bleeding, lower abdominal pain and a protruding mass, and requires immediate assessment and surgical management to salvage the prolapsed bowel. Any delay in the treatment may result in bowel ischaemia and perforation which is associated with higher morbidity and mortality. We report a case of spontaneous vaginal evisceration during defaecation in a 56-year-old postmenopausal women 11 months post hysterectomy. This case highlights the benefits of a combined laparoscopic and transvaginal approach in the successful management of this surgical emergency. PMID:23667228

Nikolopoulos, Ioannis; Khan, Hasan; Janakan, Gnananandan; Kerwat, Rajab

2013-05-09

23

Factors Determining Conversion to Laparotomy in Patients Undergoing Total Laparoscopic Hysterectomy  

Microsoft Academic Search

Aims: To identify the risk factors determining conversion to laparotomy during total laparoscopic hysterectomy (TLH) for benign diseases. Methods: We retrospectively reviewed medical records of 288 patients that underwent TLH during the first 2 years of performing TLH at Kang-Nam Sacred Heart Hospital. Twenty-three cases were converted to laparotomy. We compared patient characteristics, indications for hysterectomy, operation time, estimated blood

Sung-Ho Park; Hye-Yon Cho; Hong-Bae Kim

2011-01-01

24

Incidence of Lower Urinary Tract Injury at the Time of Total Laparoscopic Hysterectomy  

PubMed Central

Objectives: To determine the incidence of and risk factors for injury to the lower urinary tract during total laparoscopic hysterectomy. Methods: All patients who underwent total laparoscopic hysterectomy for benign disease from January 1, 2002 to December 31, 2005, at an academic medical center are included. Subjects undergoing laparoscopic-assisted vaginal hysterectomy, supracervical hysterectomy, or hysterectomy for malignancy were excluded. Intraoperative cystoscopy with intravenous indigo carmine was routinely performed. Relevant data were abstracted to determine the incidence of lower urinary tract injury, predictors of injury, and postoperative complications. Results: Total laparoscopic hysterectomy was performed in 126 consecutive subjects. Two (1.6%) cystotomies were noted and repaired before cystoscopy was performed. Two (1.6%) additional cystotomies were detected during cystos-copy. Absent ureteral spill of indigo carmine was detected in 2 subjects: 1 (0.8%) with previously unknown renal disease and 1 (0.8%) with ureteral obstruction that was relieved with subsequent suture removal. Only 40% (2/5) of injuries were recognized without the use of cystoscopy with indigo car-mine. The overall incidence of injury to the lower urinary tract was 4.0%. No subjects required postoperative intervention to the lower urinary tract within the 6-week perioperative period. Performing a ureterolysis was associated with an increased rate (odds ratio 8.7, 95%CI, 1.2-170, P=0.024) of lower urinary tract injury. Conclusion: Surgeons should consider performing cystoscopy with intravenous indigo carmine dye at the time of total laparoscopic hysterectomy.

Chiung, Chi; Chen, Grace; Roberts, Soldrea L.; Paraiso, Marie Fidela R.; Falcone, Tommaso

2007-01-01

25

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.

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

2007-01-01

26

A Case of Delayed Diagnosis of Bilateral Ureteral and Bladder Injury after Laparoscopic Hysterectomy: An Unusual Complication  

PubMed Central

The incidence of ureteral and bladder lesions after laparoscopic hysterectomy is the most encountered urinary complication in gynaecological surgery. We report the unusual case of 42-year-old woman who had a delayed diagnosis of bilateral ureteral injury associated with bladder lesion and loose of vaginal suture after undergoing laparoscopic hysterectomy for uterine adenomyosis.

Goris-Gbenou, Maximilien C.; Arfi, Nicolas; Mitach, Abdel; Rashed, Sheer; Lopez, Jean-Gabriel

2012-01-01

27

Laparoscopic Hysterectomy in the Treatment of Endometrial Cancer: A Systematic Review  

Microsoft Academic Search

We sought to compare the safety and efficacy of laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy and open surgery in women with endometrial cancer. A systematic review of the literature was undertaken. Bibliographic searches of the Health Technology Assessment, National Health Service Economic Evaluation, DARE, Cochrane Database of Systematic Reviews, MEDLINE, Embase, Pascal Biomed, and Cinahl databases were

Susana Granado de la Orden; M. Mercedes Reza; Juan A. Blasco; Elena Andradas; Daniel Callejo; Tirso Pérez

2008-01-01

28

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.

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

2009-01-01

29

Comparison of Perioperative Outcomes of Total Laparoscopic and Robotically Assisted Hysterectomy for Benign Pathology during Introduction of a Robotic Program  

PubMed Central

Study Objective. Prospectively compare outcomes of robotically assisted and laparoscopic hysterectomy in the process of implementing a new robotic program. Design. Prospectively comparative observational nonrandomized study. Design Classification. II-1. Setting. Tertiary caregiver university hospital. Patients. Data collected consecutively 24 months, 34 patients underwent laparoscopic hysterectomy, 25 patients underwent robotic hysterectomy, and 11 patients underwent vaginal hysterectomy at our institution. Interventions. Outcomes of robotically assisted, laparoscopic, and vaginal complex hysterectomies performed by a single surgeon for noncancerous indications. Measurements and Main Results. Operative times were 208.3 ± 59.01 minutes for laparoscopic, 286.2 ± 82.87 minutes for robotic, and 163.5 ± 61.89 minutes for vaginal (P < .0001). Estimated blood loss for patients undergoing laparoscopic surgery was 242.7 ± 211.37?cc, 137.4 ± 107.50?cc for robotic surgery, and 243.2 ± 127.52?cc for vaginal surgery (P = 0.05). The mean length of stay ranged from 1.8 to 2.3 days for the 3 methods. Association was significant for uterine weight (P = 0.0043) among surgery methods. Conclusion. Robotically assisted hysterectomy is feasible with low morbidity, a shorter hospital stay, and less blood loss. This suggests that robotic assistance facilitates a minimally invasive approach for patients with larger uterine size even during implementing a new robotic program.

Kilic, Gokhan Sami; Moore, Gradie; Elbatanony, Ayman; Radecki, Carmen; Phelps, John Y.; Borahay, Mostafa A.

2011-01-01

30

Does size matter? The effect of uterine weight on robot-assisted total laparoscopic hysterectomy outcomes  

Microsoft Academic Search

The objective of this study was to determine whether uterine weight affects the surgical outcomes of robot-assisted total\\u000a laparoscopic hysterectomy (RH) procedures. The design of this study is retrospective cohort study. The classification of the\\u000a study design is level II-2 evidence. The study setting is the Henry Ford Health System’s Community Teaching Hospitals. One-hundred\\u000a and thirty-five patients underwent RH for

Mona E. OradyA; A. Karim Nawfal; Ganesa Wegienka

31

The Outcome of Laparoscopic Radical Hysterectomy and Lymphadenectomy for Cervical Cancer: A Prospective Analysis of 295 Patients  

Microsoft Academic Search

Objectives  Cervical carcinoma is likely to become one of the most important indications for laparoscopic radical surgery. The laparoscopic\\u000a technique combines the benefits of a minimally invasive approach with established surgical principles. In our institution,\\u000a the laparoscopic radical hysterectomy and transperitoneal approach for lymphadenectomy have become the standard techniques\\u000a for invasive cervical cancer. We report the indications, techniques, results, and oncological

Yong Chen; Huichen Xu; Yuyan Li; Dan Wang; Junnan Li; Jizhao Yuan; Zhiqing Liang

2008-01-01

32

Supracervical Hysterectomy  

Microsoft Academic Search

Objective: This guideline reviews the evidence relating to the potential benefits of the vaginal hysterectomy (VH) and supracervical hysterectomy (SCH) versus total abdominal hysterectomy (TAH) with respect to postoperative sexual function, urinary function, and peri- and postoperative complications. Laparoscopic options are not included in this guideline.

Sari Kives; Guylaine Lefebvre; Wendy Wolfman; Catherine Allaire; Alaa Awadalla; Nathalie Leroux; Montreal QC; Frank Potestio; David Rittenberg; Halifax NS; Renée Soucy; Chandler QC; Sukhbir Singh

2010-01-01

33

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

34

Comparison of laparoscopic versus conventional open surgical staging procedure for endometrial cancer  

PubMed Central

Objective The aim of this study was to compare the surgical outcomes of laparoscopic surgery and conventional laparotomy for endometrial cancer. Methods A total of 104 consecutive patients were non-randomly assigned to either laparoscopic surgery or laparotomy. All patients underwent comprehensive surgical staging procedures including total hysterectomy, bilateral salpingo-oophorectomy, and pelvic/para-aortic lymphadenectomy. The safety, morbidity, and survival rates of the two groups were compared, and the data was retrospectively analyzed. Results Thirty-four patients received laparoscopic surgery and 70 underwent laparotomy. Operation time for the laparoscopic procedure was 227.0±28.8 minutes, which showed significant difference from the 208.1±46.4 minutes (p=0.032) of the laparotomy group. The estimated blood loss of patients undergoing laparoscopic surgery was 230.3±92.4 mL. This was significantly less than that of the laparotomy group (301.9±156.3 mL, p=0.015). The laparoscopic group had an average of 20.8 pelvic and 9.1 para-aortic nodes retrieved, as compared to 17.2 pelvic and 8.5 para-aortic nodes retrieved in the laparotomy group. There was no significant difference (p=0.062, p=0.554). The mean hospitalization duration was significantly greater in the laparotomy group than the laparoscopic group (23.3 and 16.4 days, p<0.001). The incidence of postoperative complications was 15.7% and 11.8% in the laparotomy and laparoscopic groups respectively. No statistically significant difference was found between the two groups in the survival rate. Conclusion Laparoscopic surgical staging operation is a safe and effective therapeutic procedure for management of endometrial cancer with an acceptable morbidity compared to the laparotomic approach, and is characterized by far less blood loss and shorter postoperative hospitalization.

Kong, Tae Wook; Lee, Kyung Mi; Cheong, Ji Yoon; Kim, Woo Young; Yoo, Seung-Chul; Yoon, Jong-Hyuck; Chang, Ki-Hong; Ryu, Hee-Sug

2010-01-01

35

Prospective comparison of laparoscopic uterine artery occlusion plus myomectomy with classic intrafascial supracervical hysterectomy for symptomatic fibroid treatment: differences in post-operative quality-of-life measures  

Microsoft Academic Search

ObjectiveProspective comparison of laparoscopic uterine artery occlusion plus myomectomy (LUAO+M) with classic intrafascial supracervical hysterectomy (CISH) for symptomatic fibroid treatment, regarding differences in post-operative quality-of-life measures.

Mingmin Liu; Zhongping Cheng; Yu Zhu; Hong Dai; Liping Hu; Lizhen Xu

2011-01-01

36

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

37

A Critical Comparison of Robotic Versus Conventional Laparoscopic Splenectomies  

Microsoft Academic Search

The benefit of robotic systems for general surgery is a matter of debate. We compare our initial series of robotic splenectomies\\u000a with our first series of conventional laparoscopic ones. A retrospective analysis of the first six robotic versus the first\\u000a six conventional laparoscopic splenectomies is presented. Patients were matched with regard to age, bodymass index, ASA score,\\u000a and preoperative platelet

Johannes Bodner; Reinhold Kafka-Ritsch; Paolo Lucciarini; John H. Fish III; Thomas Schmid

2005-01-01

38

A critical comparison of robotic versus conventional laparoscopic splenectomies.  

PubMed

The benefit of robotic systems for general surgery is a matter of debate. We compare our initial series of robotic splenectomies with our first series of conventional laparoscopic ones. A retrospective analysis of the first six robotic versus the first six conventional laparoscopic splenectomies is presented. Patients were matched with regard to age, body-mass index, ASA score, and preoperative platelet levels. All procedures were performed by a single surgeon. Size and weight of the resected specimens were comparable in both groups. Median overall operating time was 154 (range, 115-292) min for the robotic and 127 (range, 95-174) min for the laparoscopic group. No complications occurred. There were no open conversions. The median postoperative hospital stay was 7 (robotic group) and 6 (laparoscopic group) days. Median average costs were 6927 dollars for the robotic procedure versus $4084 for the conventional laparoscopic procedure (p < 0.05). Minimally invasive splenectomies are feasible using either conventional laparoscopic techniques or the da Vinci robotic system. In this analysis, procedures performed with the da Vinci robotic system resulted in prolonged overall operative time and significantly higher procedural costs. The use of a robotic system for laparoscopic splenectomy offers, at this stage, no relevant benefit and thus is not justified. PMID:15981042

Bodner, Johannes; Kafka-Ritsch, Reinhold; Lucciarini, Paolo; Fish, John H; Schmid, Thomas

2005-08-01

39

Laparoscopic hysterectomy in the treatment of endometrial cancer: a systematic review.  

PubMed

We sought to compare the safety and efficacy of laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy and open surgery in women with endometrial cancer. A systematic review of the literature was undertaken. Bibliographic searches of the Health Technology Assessment, National Health Service Economic Evaluation, DARE, Cochrane Database of Systematic Reviews, MEDLINE, Embase, Pascal Biomed, and Cinahl databases were made. This study sought to include systematic reviews, health technology assessment reports, and randomized clinical trials comparing laparoscopic surgery (LS) with open surgery for the treatment of endometrial cancer. The quality of the included studies was assessed using a clinical trial checklist. The clinical studies finally included were 4 randomized clinical trials. The short-term results described show that LS offers advantages with respect to postoperative recovery, including reduced bleeding, a need for fewer days of intravenous fluid therapy, and a reduced need for pain killers. In addition, intraoperative and postoperative complications were fewer among those who underwent LS in all the studies consulted. The mean hospital stay of those who underwent LS was 3 to 4 days shorter, and they returned to normal activity sooner. The number of lymph glands resected was the same with both techniques. The LS was associated with a better quality of life after surgery. With respect to long-term results, no significant differences were found in relation to overall, disease-free or cause-specific survival, according to 1 study. The short-term results of LS are equivalent or better than those achieved with open surgery, whereas the long-term results obtained by both seems equivalent but more studies are needed assessing this outcome. PMID:18602044

de la Orden, Susana Granado; Reza, M Mercedes; Blasco, Juan A; Andradas, Elena; Callejo, Daniel; Pérez, Tirso

40

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

Microsoft Academic Search

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

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

2009-01-01

41

Laparoscopic hysterectomy with or without pelvic lymphadenectomy or sampling in a high-risk series of patients with endometrial cancer  

PubMed Central

Background The purpose of the study was to determine the outcome of all patients with endometrial adenocarcinoma cancer treated by laparoscopic hysterectomy at our institution, many of whom were high-risk for surgery. Methods Data was collected by a retrospective search of the case notes and Electronic Patient Records of the thirty eight patients who underwent laparoscopic hysterectomy for endometrial cancer at our institutions. Results The median body mass index was 30 (range 19–67). Comorbidities were present in 76% (29 patients); 40% (15 patients) had a single comorbid condition, whilst 18% (7 patients) had two, and a further 18% (7 patients) had more than two. Lymphadenectomy was performed in 45% (17 patients), and lymph node sampling in 21% (8 patients). Median operating time was 210 minutes (range 70–360 minutes). Median estimated blood loss was 200 ml (range 50–1000 ml). There were no intraoperative complications. Post-operative complications were seen in 21% (2 major, 6 minor). Blood transfusion was required in 5% (2 patients). The median stay was 4 post-operative nights (range 1–25 nights). In those patients undergoing lymphadenectomy, the mean number of nodes taken was fifteen (range 8–26 nodes). The pathological staging was FIGO stage I 76% (29 patients), stage II 8% (3 patients), stage III 16% (6 patients). The pathological grade was G1 31% (16 patients), G2 45% (17 patients), G3 24% (8 patients). Conclusion Laparoscopic hysterectomy can be safely carried out in patients at high risk for surgery, with no compromise in terms of outcomes, whilst providing all the benefits inherent in minimal access surgery.

Willis, Susan F; Barton, Desmond; Ind, Thomas EJ

2006-01-01

42

Laparoscopic radical prostatectomy: Conventional and robotic  

Microsoft Academic Search

By 2015, prostate cancer will become the most commonly diagnosed cancer in men. Radical prostatectomy reduces disease-specific mortality in patients with localized prostate cancer; however, the invasiveness of surgery and its resultant side effects cause many men to seek other treatments. In 2000, laparoscopic radical prostatectomy emerged as a minimally invasive alternative to open surgery; it has been refined recently

Mani Menon; Alok Shrivastava; Ashutosh Tewari

2005-01-01

43

A technique to deal with severe adhesions between the uterus and bladder or rectum in laparoscopic-assisted vaginal hysterectomy.  

PubMed

Severe adhesions between uterus and bladder or rectum, especially caused by endometriosis and multiple cesarean sections, remain a great challenge to surgeons in laparoscopic-assisted vaginal hysterectomy. Dense adhesions and anatomic variations cause difficulty in dissecting tissue planes, significant bleeding, lengthy operative time, and visceral injuries, especially an unrecognized thermal injury leading to late-onset fistulae or abscess. A modified technique, the combination of vaginal and laparoscopic approach with assistance of a Deaver retractor, is introduced in this article, which can achieve several advantages, including easily and safely dissecting tissue planes as close to the edge of adhesions as possible, avoidance of bladder or rectum injuries, less bleeding, shortened operative time, and minimized possibility of conversion to exploratory laparotomy if the surgeon is experienced in this technique. PMID:17980338

Cho, Fu-Nan

44

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

PubMed Central

Background Traditionally standard treatment for patients with early stage endometrial cancer (EC) is total abdominal hysterectomy and bilateral salpingo oophorectomy (TAH+BSO) with or without lymph node dissection through a vertical midline incision. While TAH is an accepted effective treatment, it is highly invasive, visibly scarring and associated with morbidity. An alternative treatment is the same operation by laparoscopy. Though in several studies total laparoscopic hysterectomy (TLH+ BSO) seems a safe and feasible alternative approach in early stage endometrial cancer patients, there are no randomized data available yet. Furthermore, a randomized controlled trial with surgeons trained in laparoscopy is warranted in order to implement this technique in a safe manner. The aim of this study is to compare the treatment related morbidity, cost-effectiveness and quality of life in early stage endometrial cancer patients treated by laparoscopy versus the standard open approach. Methods A multi centre randomized clinical phase 3 trial, including 5 university hospitals and 15 regional hospitals in the Netherlands. Only gynecologists trained in performing a TLH are allowed to participate. Inclusion criteria: Patients with a clinical stage I endometrioid adenocarcinoma or complex atypical hyperplasia are randomized in a 2:1 allocation to receive TLH or TAH. The main outcome measure is the rate of major complications, as assessed by an independent clinical review board. In total, 275 patients are required to have 80% power at ?-0.05 to detect a significant difference of 15% complication rate. Secondary outcome measures are 1) costs and cost-effectiveness, 2) minor complications, and 3) quality of life. All data from this multi center study are reported using case record forms. Data regarding quality of life, pain, body Image, sexuality and additional homecare are assessed with self reported questionnaires. Discussion A randomized multi center study in early stage endometrial cancer patients with inclusion criteria for patients and surgeons is designed and ongoing. Results will be presented at the end of 2009. Trial Registration Dutch trial register number NTR821.

2009-01-01

45

Abrupt formation of a right atrium thrombus detected by transesophageal echocardiography during laparoscopic assisted vaginal hysterectomy and spontaneous resolution during thromboembolectomy -A case report-  

PubMed Central

Intraoperative formation and management of a thrombus in right atrium has been reported occasionally. Nevertheless, it is rare that a right atrial thrombus with unstable hemodynamic changes detected by transesophageal echocardiography is resolved spontaneously. We report upon the 44-year-old woman, who had a right atrial thrombus detected by transesophageal echocardiography during laparoscopic assisted vaginal hysterectomy and resolved during thromboembolectomy.

Chu, Byung-Kwan; Han, Ilyong; Shin, Chee-Mahn; Kim, Young-Jae; Cheong, Soon Ho; Lee, Kun Moo; Lim, Se Hun; Lee, Jeong Han; Kim, Myoung-Hun; Kim, Hyo-Joong

2012-01-01

46

Turkey’s experience of robotic-assisted laparoscopic hysterectomy: a series of 25 consecutive cases  

Microsoft Academic Search

Purpose  To present the outcomes of the first 25 robotic-assisted hysterectomies from Turkey.\\u000a \\u000a \\u000a \\u000a Method  A total of 25 patients who underwent robotic-assisted hysterectomy (RAH) for benign conditions were included in the study.\\u000a Patients’ demographics, surgical procedures, operative and postoperative complications, hospital stay, conversion to laparotomy,\\u000a time data including all operative times, uterus weight and estimated blood loss (EBL) were recorded. All hysterectomies

Ahmet GocmenFatih; Fatih ?anl?kan; Mustafa Gazi Uçar

2010-01-01

47

Laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): an implementation study in 1,952 patients with an analysis of risk factors for conversion to laparotomy and complications, and of procedure-specific re-operations.  

PubMed

PURPOSE: To compare laparoscopic supracervical hysterectomy (LSH) with total laparoscopic hysterectomy (TLH) with regard to relevant surgical parameters and risk factors of conversion to laparotomy and complications. METHODS: This prospective, open, single-center, interventional study included women with benign gynecologic disease who underwent standardized LSH or TLH. The techniques were compared for conversion rate and mean operating time, hemoglobin drop, hospital stay, and complication rates using descriptive statistics and standard non-parametric statistical tests. Risk factors of conversion and complications were identified by logistic regression analysis. RESULTS: During January 2003 to December 2010, 1,952 women [mean age (SD): 47.5 (7.2) years] underwent LSH [1,658 (84.9 %)] or TLH [294 (15.1 %)], mostly (>70 %) for uterine fibroids. Significant differences in surgical parameters were observed for conversion rate (LSH/TLH: 2.6/6.5 %), mean operating time [87 (34)/103 (36) min], hemoglobin drop [1.3 (0.8)/1.6 (1.0) g/dL], and hospital stay [4.3 (1.5)/4.9 (2.8) days]. Overall intraoperative (0.2/0.7 %) and long-term (>6 weeks) post-operative (0.8/1.7 %) complication rates did not differ significantly, but the short-term LSH complication rate was significantly lower (0.6 vs. 4.8 %). Spotting (LSH, 0.2 %) and vaginal cuff dehiscence (TLH, 0.7 %) were long-term method-specific complications. Logistic regression showed that uterine weight and extensive adhesiolysis were significant factors for conversion while previous surgery, age, and BMI were not. Major risk factors of short-term complications were age, procedure (LSH/TLH), and extensive adhesions. CONCLUSIONS: Both procedures proved effective and were well tolerated. LSH performed better than TLH regarding most outcome measures. LSH is associated with very low rates of re-operation and spotting. PMID:23775263

Wallwiener, Markus; Taran, Florin-Andrei; Rothmund, Ralf; Kasperkowiak, Adam; Auwärter, Gabriel; Ganz, Antje; Kraemer, Bernhard; Abele, Harald; Schönfisch, Birgitt; Isaacson, Keith B; Brucker, Sara Yvonne

2013-06-18

48

Pain after laparoscopic appendectomy: a comparison of transumbilical single-port and conventional laparoscopic surgery  

PubMed Central

Purpose Conventional laparoscopic appendectomy is performed using three ports, and single-port appendectomy is an attractive alternative in order to improve cosmesis. The aim of this study was to compare pain after transumbilical single-port laparoscopic appendectomy (SA) with pain after conventional three-port laparoscopic appendectomy (TA). Methods From April to September 2011, 50 consecutive patients underwent laparoscopic appendectomy for simple appendicitis without gangrene or perforation. Patients who had undergone appendectomy with a drainage procedure were excluded. The type of surgery was chosen based on patient preference after written informed consent was obtained. The primary endpoint was postoperative pain evaluated by the visual analogue scale score and postoperative analgesic use. Operative time, recovery of bowel function, and length of hospital stay were secondary outcome measures. Results SA using a SILS port (Covidien) was performed in 17 patients. The other 33 patients underwent TA. Pain scores in the 24 hours after surgery were higher in patients who underwent SA (P = 0.009). The change in postoperative pain score over time was significantly different between the two groups (P = 0.021). SA patients received more total doses of analgesics (nonsteroidal anti-inflammatory drugs) in the 24 hours following surgery, but the difference was not statistically significant. The median operative time was longer for SA (P < 0.001). Conclusion Laparoscopic surgeons should be concerned about longer operation times and higher immediate postoperative pain scores in patients who undergo SA.

Kim, Hyung Ook; Lee, Sung Ryol; Son, Byung Ho; Park, Yong Lai; Shin, Jun Ho; Kim, Hungdai; Han, Won Kon

2012-01-01

49

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

50

A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.  

PubMed

We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route. PMID:23919862

Agnaeber, K; Bodalal, Z

2013-08-01

51

Sun beams on hysterectomies  

Microsoft Academic Search

Are hysterectomies still necessary in 2010 and why and how should they be performed? As every now and then a critical evaluation\\u000a of routine surgical procedure is necessary, there it is: This review follows the “Perspectives on laparoscopic hysterectomy”\\u000a by Michelle Nisolle (Gynecol Surg 7:105–107, 2010). Hysterectomies performed in the field of obstetrics and gynaecology until the nineteenth century had

Liselotte Mettler; Wael Sammur; Thoralf Schollmeyer

52

Hysterectomies. Where are the indications?  

PubMed

This article reviews the major reasons for hysterectomies and critiques some of the alternative practices, such as medical therapy to shrink fibroids, and new surgical techniques, such as laparoscopic-assisted hysterectomies. Perhaps in response to the increased attention and the new procedures and drugs that allow more conservative management, the rate of hysterectomies has actually decreased. PMID:7936552

Ravnikar, V A; Chen, E

1994-06-01

53

Hysterectomy outcomes in patients with similar indications  

Microsoft Academic Search

Objective: To investigate the cost advantages and complication rates associated with surgical routes of uncomplicated hysterectomies in which uteri weigh less than 280 g and benign diseases are confined to the uterus.Methods: Data were collected prospectively from 1988 to 1993 from 4609 consecutive women who had hysterectomies at a single institution. Women who had abdominal hysterectomies, laparoscopically assisted vaginal hysterectomies,

S. Robert Kovac

2000-01-01

54

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

Microsoft Academic Search

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

J R Waller; A L Hiley; E J Mullin; P S Veitch; M L Nicholson

2002-01-01

55

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

PubMed Central

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

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

2009-01-01

56

Laparoscopic-Assisted Vaginal Hysterectomy (LAVH) 9/90 - 9/93: Data from 253 Cases  

PubMed

After our first LAVH in September of 1990, we performed a prospective clinical trial. All women referred for abdominal hysterectomy were given the option of LAVH. A total of 253 patients met the strict criteria prohibiting vaginal hysterectomy. Those criteria utilized included obesity, uterus> 12-14 week size, pelvic pathology, prior pelvic surgery, pelvic adhesions, and lack of pelvic relaxation. All patients were consented for LAVH with potential complications including infection, anesthesia accidents, and hemorrhage listed on the release of liability. Also included in the release of liability was the potential for laparotomy. A combination of techniques were used, and procedures were performed mainly at a tertiary hospital center by attending and resident physicians. Surgery in 248 (98%) patients was completed via LAVH. Mean operating room time was 135 minutes (65-140 min range). Mean hospital stay was 1.2 days (1-5 day range). Mean recovery time was 2.5 weeks (2-6 week range). Mean EBL was 350 ml (100-1250 ml range). PMID:9073776

Woodland

1994-08-01

57

Laparoscopic Repair of Perforated peptic ulcers versus conventional open surgery  

Microsoft Academic Search

Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery causes great controversy regarding the choice of procedure for perforated duodenal ulcer. In this study the safety and efficacy of laparoscopic surgery was evaluated, different types of procedures were described and early outcomes in comparison with open surgery were assessed. In addition

Nita Zaji

2007-01-01

58

Optimal pain management in total abdominal hysterectomy.  

PubMed

Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk of deep vein thrombosis, faster recovery, and reduced cost of care. Although many therapeutic modalities are available for pain management, the optimal combination in managing postoperative pain in total abdominal hysterectomy is controversial. The objective of this study was to review the literature to formulate optimal, evidence-based preoperative, intraoperative, and postoperative pain management for women undergoing total abdominal hysterectomy. Using the OVID platform, we searched in MEDLINE and PubMed using MeSH terms postoperative pain and total abdominal hysterectomy for published articles from 1960 to the present; we found 545 studies. We screened and included only randomized clinical trials, publications in English, human studies, and abdominal hysterectomy for noncancerous indications. We excluded 456 studies that reported on animal studies; laparoscopic, vaginal, supracervical, or robotic hysterectomy; pharmacokinetic studies; primary outcome other than pain management; and chronic pain management. Studies with inadequate power, poor methodology, or inconclusive results were further excluded from this review. Thus, 89 studies constituted the cohort for our article. Pain control remains complex given variables such as age, anxiety, and extent of surgery. In general, regimens should be tailored to the needs of the individual patient, taking into account medical, psychological, and physical condition. A multimodality approach is better than conventional, single-agent narcotic in achieving optimal pain management. After reading this article, the reader should be able to understand various modalities that can be considered for preoperative, intraoperative, and postoperative pain management in total abdominal hysterectomy. Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After completing this CME activity, physicians should be better able to understand various modalities that can be considered for preoperative, intraoperative, and postoperative pain management in total abdominal hysterectomy. PMID:23945838

Azari, Laleh; Santoso, Joseph T; Osborne, Shelby E

2013-03-01

59

Total Laparoscopic Hysterectomy: Evaluation of an Evidence-Based Educational Strategy Using a Novel Simulated Suture and Knot-Tying Challenge, the "Holiotomy"  

PubMed Central

Objective. The purpose of this study was to evaluate perceptions of skills and practice patterns of gynecologists attending a course on total laparoscopic hysterectomy (TLH). This course employed extensive use of pelvic trainer boxes to accomplish the Holiotomy Challenge. The “Holiotomy Challenge” entailed suturing two plastic pieces with six figure-of-N sutures tied with four square knots each. Methods. A survey was administered before the course and 3 months later. Data were analyzed by paired t-tests, McNemar's Chi Squares, and ANCOVAs with significance set P < .05. Results. At baseline, 216 surgeons and at 3 months 102 surgeons returned the survey. Surgeons' self-perceptions of their skills significantly increased from 6.24 to 7.28. Their reports of their surgical practice at home revealed significantly increased rates of minimally invasive procedures, from 42% to 54%. Significantly more surgeons reported having the ability to close the vagina, or a small cystotomy or enterotomy. Participation in the cadaver lab and presence of their practice partner did not impact these rates. Conclusions. A comprehensive course employing laparoscopic surgical simulation focused on basic surgical skills essential to TLH has a positive impact on attendees' self-rated skill level and rate of laparoscopic approaches. Many had begun performing TLH after the course.

O'Hanlan, Katherine A.; Beingesser, Kelli R.; Dibble, Suzanne L.

2012-01-01

60

Comparison of the effect of laparoscopic and conventional pyloric surgery on gastric emptying in dogs.  

PubMed

The effect of a laparoscopic approach and pyloric surgery on canine gastrointestinal activity, particularly gastric emptying time, is not well understood. The purpose of this study was to compare the effect of laparoscopic and conventional pyloric surgery, in Ramstedt pyloromyotomy and Heineke-Mikulicz pyloroplasty, on complete gastric emptying time in 20 clinically normal dogs. Dogs were divided into four groups of five animals: dogs with laparoscopic Ramstedt pyloromyotomy, conventional Ramstedt pyloromyotomy, or laparoscopic Heineke-Mikulicz pyloroplasty, and the conventional Heineke-Mikulicz pyloroplasty group. Gastric emptying time using barium sulfate mixed with dry kibble dog food was measured fluoroscopically before and 1 month after surgery. Gastric emptying of solids was significantly enhanced in the pyloroplasty groups in the postoperative period compared with preoperative emptying. Just as after conventional pyloromyotomy, gastric emptying time after laparoscopic pyloromyotomy was not statistically different as compared with preoperative values. This study indicates that the fluoroscopic test meal is a valuable tool for defining complete gastric emptying time in normal dogs. We conclude that pyloromyotomy was less effective in decreasing complete gastric emptying time than Heineke-Mikulicz pyloroplasty in normal dogs. The possibility of decreasing complete gastric emptying time by laparoscopic surgery suggests a potential clinical application for this technique in small animals. PMID:15693561

Sánchez-Margallo, Francisco M; Ezquerra-Calvo, Luis J; Soria-Gálvez, Federico; Usón-Gargallo, Jesús

61

Laparoscopic ventral incisional hernia repair: A more effective alternative to conventional repair of recurrent incisional hernia  

Microsoft Academic Search

Conventional repair of recurrent ventral incisional hernia is associated with a higher recurrence rate (30%-50%) than repair\\u000a of primary incisional hernia (11%-20%). Laparoscopic incisional hernia repair (LIHR) can significantly reduce the recurrence\\u000a rate of primary hernia to less than 5%. In this study, we evaluate the efficacy of repairing recurrent incisional hernia laparoscopically.\\u000a One-hundred and seventy consecutive patients undergoing LIHR

Rodrick D. McKinlay; Adrian Park

2004-01-01

62

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.

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

2013-01-01

63

Changing the route of hysterectomy into a minimal invasive approach.  

PubMed

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

2013-05-21

64

Hysterectomy - laparoscopic - discharge  

MedlinePLUS

... warm to touch, or has thick, yellow, or green drainage. Your pain medicine is not helping your pain. It is hard to breathe. You have a cough that does not go away. You cannot drink or eat. You have ...

65

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis  

PubMed Central

Purpose For the treatment of acute appendicitis, a conventional laparoscopic appendectomy (LA) has been widely performed. Recently, the use of single incision laparoscopic surgery (SILS) is increasing because it is believed to have advantages over conventional laparoscopic surgery. In this study, we compared SILS and a conventional LA. Methods We analyzed the 217 patients who received laparoscopy-assisted appendectomies between August 2010 and April 2012 at Inje University Sanggye Paik Hospital. One hundred-twelve patients underwent SILS, and 105 patients underwent LA. For the two groups, we compared the operation times, postoperative laboratory results, postoperative pain, hospital stay, and postoperative complications. Results The patients' demographics, including body mass index, were not significantly different between the two groups. There were 6 perforated appendicitis cases in the SILS group and 5 cases in the LA group. The mean operative time in the SILS group was 65.88 ± 22.74 minutes whereas that in the LA group was 61.70 ± 22.27 minutes (P = 0.276). There were no significant differences in the mean hospital stays, use of nonsteroidal antiinflammatory drugs, and wound infections between the two groups. Conclusion Postoperative pain, complications and hospital stay showed no statistically significant differences between the SILS and the LA groups. However, our SILS method uses a single trocar and two latex tubes, so cost savings and reduced interference during surgery are expected.

Kang, Jungwoo; Gwak, Geumhee; Park, Inseok; Cho, Hyunjin; Yang, Keunho; Kim, Ki Whan; Han, Sehwan; Kim, Hong-Joo; Kim, Young-Duck

2012-01-01

66

The Feasibility of Societal Cost Equivalence between Robotic Hysterectomy and Alternate Hysterectomy Methods for Endometrial Cancer  

PubMed Central

Objectives. We assess whether it is feasible for robotic hysterectomy for endometrial cancer to be less expensive to society than traditional laparoscopic hysterectomy or abdominal hysterectomy. Methods. We performed a retrospective cohort analysis of patient characteristics, operative times, complications, and hospital charges from all (n = 234) endometrial cancer patients who underwent hysterectomy in 2009 at our hospital. Per patient costs of each hysterectomy method were examined from the societal perspective. Sensitivity analysis and Monte Carlo simulation were performed using a cost-minimization model. Results. 40 (17.1%) of hysterectomies for endometrial cancer were robotic, 91 (38.9%), were abdominal, and 103 (44.0%) were laparoscopic. 96.3% of the variation in operative cost between patients was predicted by operative time (R = 0.963, P < 0.01). Mean operative time for robotic hysterectomy was significantly longer than other methods (P < 0.01). Abdominal hysterectomy was consistently the most expensive while the traditional laparoscopic approach was consistently least expensive. The threshold in operative time that makes robotic hysterectomy cost equivalent to the abdominal approach is within the range of our experience. Conclusion. It is feasible for robotic hysterectomy to be less expensive than abdominal hysterectomy, but unlikely for robotic hysterectomy to be less expensive than traditional laparoscopy.

Shah, Neel T.; Wright, Kelly N.; Jonsdottir, Gudrun M.; Jorgensen, Selena; Einarsson, Jon I.; Muto, Michael G.

2011-01-01

67

Conventional Pneumoperitoneum Compared with Abdominal Wall Lift for Laparoscopic Cholecystectomy  

Microsoft Academic Search

Summary We have compared, in a randomized study, con- ventional carbon dioxide pneumoperitoneum with abdominal wall lift in 25 patients undergoing laparoscopic cholecystectomy. Intra-abdominal pressure (IAP) (11 (SD 2) mm Hg vs 2.7 (9) mm Hg) (P ? 0.01) and total amount of carbon dioxide used (40 (23) litre vs 9 (7) litre) (P ? 0.001) were significantly less with

L. LINDGREN; A.-M. KOIVUSALO; I. KELLOKUMPU; Michele Joseph

1996-01-01

68

Laparoendoscopic single-site versus conventional transperitoneal laparoscopic pyeloplasty: A prospective randomized study.  

PubMed

OBJECTIVES: To evaluate the potential benefits of laparoendoscopic single-site pyeloplasty over conventional laparoscopic pyeloplasty. METHODS: Between October 2009 and January 2012, 39 patients were enrolled in a prospective study and randomized to undergo a laparoendoscopic single-site pyeloplasty (n?=?19) or conventional laparoscopic pyeloplasty (n?=?20). The outcomes in the two groups were compared by using Mann-Whitney U-test and ?(2) -test, and considering a P-value less than 0.05 as statistically significant. RESULTS: There was no difference in blood loss (55.67?±?6.71 vs 45.84?±?5.22?mL, P?=?0.60), transfusion rates (0% for both) and hospitalization time (2.12?±?0.23 vs 2.06?±?0.34 days, P?=?0.72) between the laparoendoscopic single-site pyeloplasty and conventional laparoscopic pyeloplasty groups. The time to return to normal activities was shorter (8.65?±?1.25 vs 11.53?±?1.28 days, P?=?0.01), and median operative time (195.21?±?12.15 vs 145.62?±?15.34?min, P?=?0.001) was longer in the laparoendoscopic single-site pyeloplasty group compared with the conventional laparoscopic pyeloplasty group. No significant intraoperative or postoperative complications occurred in either group. Compared with conventional laparoscopic pyeloplasty, laparoendoscopic single-site pyeloplasty yielded better cosmetic results and patient satisfaction. The mean follow-up period was 19.7 months (4-28 months). The success rate was 95% in both the groups. Both the visual analog scale and the postoperative use of analgesics were significantly lower in patients who underwent laparoendoscopic single-site pyeloplasty. CONCLUSIONS: Our findings suggest that laparoendoscopic single-site pyeloplasty can offer faster recovery and higher patient satisfaction than conventional laparoscopic pyeloplasty. Thus, this novel technique promises to become the treatment of choice in minimally-invasive management of ureteropelvic junction obstruction. PMID:23441754

Tugcu, Volkan; Ilbey, Yusuf Ozlem; Sonmezay, Erkan; Aras, Bekir; Tasci, Ali Ihsan

2013-02-26

69

Retroperitoneal Laparoendoscopic Single-Site Ureterolithotomy: A Comparison with Conventional Laparoscopic Surgery  

PubMed Central

Abstract Background and Purpose Laparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to compare the feasibility and outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral stones. Patients and Methods From June 2010 to May 2011, LESS ureterolithotomy through the retroperitoneal approach was performed in 10 patients (the LESS group). Another 15 patients who underwent conventional retroperitoneal laparoscopic ureterolithotomy (the conventional laparoscopic group) by the same surgeon were involved and compared. The operative time, complications, and surgical outcomes were evaluated. Results All the operations were completed successfully, without conversion to conventional laparoscopic or open surgeries. The operative time of the LESS group and of the conventional laparoscopic group were 132.7±16.3 and 128.1±20.1 minutes, respectively (P=0.782). The estimated blood loss were 30.7±5.9 vs 28.0±4.5?mL (P=0.620). Duration of analgesia postoperatively was 2.0±0.8 vs 3.5±0.5 days (P=0.005). All targeted stones were successfully extracted without major complications. Postoperative urine leakage was noted in one patient in each group. Cosmetic results were superior in the LESS group according to both the study nurse's and the patients' assessments (8.5 vs 5.3; P=0.012, and 8.3 vs 5.6; P=0.025, respectively). All patients showed no obstructions or stricture formations on postoperative follow-up. Conclusions In experienced hands, LESS for ureterolithotomy through the retroperitoneal approach is feasible and can acquire outcomes equal to those of conventional multiport laparoscopic surgery. Prospective long-term follow-up studies with a larger number of patients are needed to further evaluate its benefits.

Liu, Xiaopeng; Huang, Huaiqiu; Wu, Jieying; Huang, Wentao; Cai, Songwang; Li, Xiaojuan; Ye, Chunwei; Zhu, Baoyi; Cai, Yi; Gao, Xin

2012-01-01

70

Laparoscopy-assisted vaginal hysterectomy compared with abdominal hysterectomy.  

PubMed Central

The first 150 consecutive laparoscopic vaginal hysterectomy (LVH) cases done by Creighton University faculty members at Mercy Hospital, Council Bluffs, Iowa and at St Joseph Hospital, Omaha, Nebraska were compared with 194 abdominal hysterectomies (AHs) for benign or noninvasive disease. The results indicate that LVH can be accomplished with low morbidity, low length of stay, and with less patient discomfort than experienced by patients who undergo AH.

Garcia-Padial, J.; Osborne, N.; Sotolongo, J.; Ferrer, N.

1995-01-01

71

A Comparison of Laparoscopic and Abdominal Radical Parametrectomy for Cervical or Vaginal Apex Carcinoma and Stage II Endometrial Cancer After Hysterectomy  

PubMed Central

Background and Objective: Radical parametrectomy (RP), performed either abdominally (ARP) or laparoscopically (LRP), is a viable alternative to radiotherapy in treating invasive cervical cancer, vaginal apex cancer, and endometrial cancer that is more advanced than initially suspected after hysterectomy. We carried out a comparative study on intra- and postoperative parameters between the two performed by similarly experienced surgeons. Methods: Forty consecutive patients indicative for RP were reviewed: 22 and 18 underwent ARP and LRP, respectively. Information was collected on demographics, indications for initial and this surgery, tumor characteristics, intra- and postoperative parameters, and complications. The lengths of resected parametrial and vaginal tissues were measured. Results: Compared with ARP, LRP resulted in shorter operative time (200 vs 239 min), less blood loss (627.8 vs 929.5 mL), shorter hospital stay (16.8 vs 19.9 days), and removal of more pelvic lymph nodes (27.4 ± 5.9 vs 23.1 ± 7.1). Although it was not attempted in ARP to remove lymph nodes in the deep obturator space, it was attempted in LRP and one positive node was found. In the ARP cohort there was one case of injury to the small intestine during surgery, whereas in LRP there was one instance of lower urologic fistula after surgery. Conclusion: LRP is superior to ARP in terms of shorter operative time, less blood loss, and shorter hospital stay while still maintaining the completeness of the procedure. It can be safely performed in the hands of experienced surgeons for cervical or vaginal apex carcinoma and stage II endometrial cancer after hysterectomy.

Jiang, Hongyuan; Qu, Lianxi; Hua, Keqin; Xu, Huan; Guo, Sun-Wei

2013-01-01

72

A prospective study comparing operative time in conventional laparoscopic and robotically assisted Thal semifundoplication in children  

Microsoft Academic Search

BackgroundIt is not clear if robotically assisted surgery (providing articulating instruments, 3-dimensional vision, intuitive ergonomics) performed in pediatric patients offers the same advantages over conventional surgery as in adult patients. In the laboratory setting, robots require less time to perform certain tasks. Accordingly, we tested the hypothesis that the time required to perform a robotically assisted laparoscopic Thal semifundoplication is

Mark Lehnert; Bernd Richter; Peter A. Beyer; Klaus Heller

2006-01-01

73

Reassessing Hysterectomy  

PubMed Central

Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications for which there are other effective alternatives. Observational studies are increasingly highlighting the effects of hysterectomy and concomitant oophorectomy on a variety of long-term health outcomes including fracture risk, pelvic floor dysfunction, all-cause mortality, cardiovascular disease, and neurologic function. Individualizing therapy and discussing appropriate alternatives to hysterectomy is an important responsibility for all health care providers.

Stewart, Elizabeth A.; Shuster, Lynne T.; Rocca, Walter A.

2013-01-01

74

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

PubMed Central

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

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

2013-01-01

75

Robotic versus conventional laparoscopic pyeloplasty: A single surgeon concurrent cohort review  

PubMed Central

Introduction: The increasing availability of robotic devices has led to an increase in their use for procedures such as pyeloplasty, which have been conventionally performed laparoscopically or through open surgery. We perform both laparoscopic and robotic-assisted pyeloplasty routinely and have compared these techniques in a set of concurrent cohorts, operated by the same surgeon. Materials and Methods: A chart review was performed of all cases of Robot-assisted laparoscopic pyeloplasty (RALP) and conventional laparoscopic pyeloplasty (CLP) performed by a single surgeon, from September 2006 to July 2010. The choice of procedure depended upon the availability of the robot on the given day. A lateral transperitoneal approach was used in all cases. All anastomoses were stented antegrade. A diuretic renogram was obtained in all patients between six to twelve weeks after stent removal. Success was defined as a resolution of symptoms with non-obstructive outflow on the renogram. Results: Thirty patients underwent 31 laparoscopic pyeloplasties (20 RALPs and 11 CLPs), with one patient undergoing bilateral simultaneous robotic procedures. The robotic procedures were superior in terms of shorter operating time by 20 minutes on an average. Furthermore, 35% of the robotic procedures were performed in under 90 minutes, while the minimum time taken for laparoscopy was 110 minutes. All procedures in both cohorts were successful with no complications in either group. The surgeon recorded subjective ergonomic benefits with the use of the robot. Conclusions: Robotic assistance helps decrease the operative time for laparoscopic pyeloplasty. It seems ergonomically superior for the surgeon, allowing multiple procedures in the same list. These may be important benefits in busy centers.

Kumar, Rajeev; Nayak, Brusabhanu

2013-01-01

76

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

Microsoft Academic Search

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

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

2009-01-01

77

Single-Fulcrum Laparoscopic Cholecystectomy in Uncomplicated Gallbladder Diseases: A Retrospective Comparative Analysis with Conventional Laparoscopic Cholecystectomy  

PubMed Central

Purpose Single-fulcrum laparoscopic cholecystectomy (SFLC) is a variant type of single incision and multi-port technique that does not use specialized one-port devices or articulating instruments. We retrospectively compared perioperative outcomes of SFLC with those of conventional laparoscopic cholecystectomy (CLC). Materials and Methods Between March 2009 and December 2010, SFLC was performed in 130 patients. Among them, 105 patients with uncomplicated gallbladder disease (no inflammation or no clinical symptoms) and another 105 patients who underwent CLC were selected for this study. Results There was no open conversion. In comparison with CLC, SFLC was performed more often in young (46.4±12.2 years vs. 52.5±13.6 years, p=0.001) female patients (80/25 vs. 62/43, p=0.008). The total operation time was longer in SFLC (56.7±14.1 min vs. 47.5±17.1 min, p<0.001), but pain scores immediately after operation and at discharge time were lower for SFLC than for CLC (3.1±1.3 vs. 4.0±1.9, p<0.001, 2.0±0.9 vs. 2.4±0.8, p=0.002). Total cost was lower for SFLC than for CLC (US $ 1801±289.9 vs. US $ 2003±617.4, p=0.004). There were no differences in hospital stay or complication rates. Conclusion SFLC showed greater technical feasibility and cost benefits in treating uncomplicated benign gallbladder disease than CLC.

Hwang, Ho Kyoung; Choi, Sung Hoon; Lee, Woo Jung

2013-01-01

78

Short and long-term results after laparoscopic vs conventional colon resection in a tumor-bearing small animal model  

Microsoft Academic Search

Background: We designed a study to evaluate the short- and long-term outcome of laparoscopic vs conventional colonic resection in a tumor-bearing\\u000a small animal model.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: We operated on male BD X rats (260–300 g), performing either laparoscopic (n= 9) or open colon resection (n= 9) in order to evaluate stress and immunological response to laparoscopic vs conventional colon resection. A

C. Kuntz; A. Wunsch; R. Rosch; F. Autschbach; J. Windeler; C. Herfarth

2000-01-01

79

Single incision laparoscopic surgery ovarian cystectomy in large benign ovarian cysts using conventional instruments  

PubMed Central

We describe a technique for the management of large benign ovarian cysts by single incision laparoscopic surgery (SILS) through the umbilicus. The paucity of intra-abdominal working space in large ovarian cysts poses a technical challenge. Moreover, difficult convergence of operating instruments and competition for operating space outside the abdomen during the SILS makes the procedure quite demanding, especially with the conventional instruments. The concept of providing traction by taking sutures from the abdominal wall, as done in SILS laparoscopic cholecystectomy, was applied for SILS cystectomy in large ovarian cysts. Two sutures taken through the abdominal wall and then through the cyst wall provide excellent traction and “hang” the cyst from the abdominal wall, making it convenient to dissect and operate. This technique demonstrates that SILS ovarian cystectomy is feasible, safe and technically unchallenging even in large benign ovarian cysts.

Garg, Pankaj; Misra, Swapna; Thakur, Jai Deep; Song, Jeremy

2011-01-01

80

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

Microsoft Academic Search

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

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

2001-01-01

81

A comparison of transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy: from the diagnosis to the hospital cost  

PubMed Central

Purpose Recently many cases of appendectomy have been conducted by single-incision laparoscopic technique. The aim of this study is to figure out the benefits of transumbilical single-port laparoscopic appendectomy (TULA) compared with conventional three-port laparoscopic appendectomy (CTLA). Methods From 2010 to 2012, 89 patients who were diagnosed as acute appendicitis and then underwent laparoscopic appendectomy a single surgeon were enrolled in this study and with their medical records were reviewed retrospectively. Cases of complicated appendicitis confirmed on imaging tools and patients over 3 points on the American Society of Anesthesia score were excluded. Results Among the total of 89 patients, there were 51 patients in the TULA group and 38 patients in the CTLA group. The visual analogue scale (VAS) of postoperative day (POD) #1 was higher in the TULA group than in the CTLA group (P = 0.048). The operative time and other variables had no statistical significances (P > 0.05). Conclusion Despite the insufficiency of instruments and the difficulty of handling, TULA was not worse in operative time, VAS after POD #2, and the total operative cost than CTLA. And, if there are no disadvantages of TULA, TULA may be suitable in substituting three-port laparoscopic surgery and could be considered as one field of natural orifice transluminal endoscopic surgery with the improvement and development of the instruments and revised studies.

Baik, Seung Min; Hong, Kyung Sook

2013-01-01

82

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

Microsoft Academic Search

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

James B. Unger

1999-01-01

83

Laparoscopic radiofrequency ablation of liver tumors: comparison of MR guidance versus conventional laparoscopic ultrasound for needle positioning in a phantom model.  

PubMed

Laparoscopic radiofrequency ablation (LapRFA) is an established procedure for liver tumors in patients who are unsuitable for resection. A novel technique of magnetic resonance (MR) guided needle positioning during LapRFA was developed and compared to conventional ultrasound (US) guidance in a phantom model. MR-guided procedures were conducted in a 1.0 tesla high field open MR using an MR compatible endoscope and camera. The ultrasound-guided procedure was performed with a clinically established laparoscopy setup and a 2D laparoscopic US probe. During both techniques an identical monopolar non-ferromagnetic RFA needle and a silicon-based phantom model were applied. Finally needle positioning was performed by two surgeons and one interventionalist. Time to needle placement and number of trials were recorded and statistically analyzed. MR-guided needle positioning under laparoscopic control was technically feasible. Average time to correct needle placement was 2' 6? in the LapUS group and 1' 54? in the MR group. The number of trials was 3.2 in the LapUS group and 2.6 in the MR group. Image quality was assessed by all participants. MR images showed a better tissue to tumor contrast and allowed an improved orientation due to multiplanar visualization. MR-guided laparoscopic RFA is a promising technique offering multiplanar needle positioning with high soft tissue contrast with immediate therapy control. In a phantom model it showed comparable results regarding needle positioning to the established technique of laparoscopic US guidance. PMID:21082902

Chopra, Sascha S; Schmidt, Sven C; Wiltberger, Georg; Denecke, Timm; Streitparth, Florian; Seebauer, Christian; Teichgräber, Ulf; Schumacher, Gudio; Eisele, Robert M

2010-11-17

84

Laparoscopic Surgery Recording as an Adjunct to Conventional Modalities of Teaching Gross Anatomy  

PubMed Central

Objectives: In order to increase their effectiveness, methods of teaching morphological sciences need to be revised to incorporate the recent technological advances made in the field of medicine. Teaching human structure with conventional methods of prosections using dissected cadaveric specimen alone quite often fails to prepare students adequately for their clinical training. A learner-oriented method, incorporating three dimensional spatial anatomy and more closely mirroring the clinical setting, is required. Methods: With these challenges in mind, a 30-minute slow-paced video recording of a cholecystectomy performed laproscopically on a 45 year-old lady was adapted to supplement the conventional teaching of anatomy of the abdomen and pelvis. This study was carried out in October 2010. Results: The subjects of this study were 84 students in a first year preclinical MD course in human structure at the private Oman Medical College. Their feedback was obtained via questionnaire and revealed that the video presentation helped the students to realise the significance of the anatomical details learnt during the human structure course. Conclusion: Recordings of laparoscopic surgeries are an effective preclinical anatomy teaching resource in student-centred learning. They also help the students to appreciate the clinical relevance of gross anatomy and enhance their motivation to learn.

Kumar, Pananghat A.; Norrish, Mark; Heming, Thomas

2011-01-01

85

Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma. Analysis on 65 patients operated on by conventional or robot-assisted minimal access procedures  

Microsoft Academic Search

AimsDespite laparoscopic surgery for gastric cancer has gained worldwide acceptance, long term results and survival are seldom reported. This study was designed to assess long term outcomes after laparoscopic gastrectomy with D2 dissection. The short term results of conventional and robot-assisted minimally invasive procedures were also examined.

R. Pugliese; D. Maggioni; F. Sansonna; G. C. Ferrari; A. Forgione; A. Costanzi; C. Magistro; J. Pauna; S. Di Lernia; D. Citterio; C. Brambilla

2009-01-01

86

Cosmesis and body image after single-port laparoscopic or conventional laparoscopic cholecystectomy: a multicenter double blinded randomised controlled trial (SPOCC-trial)  

PubMed Central

Background Emerging attempts have been made to reduce operative trauma and improve cosmetic results of laparoscopic cholecystectomy. There is a trend towards minimizing the number of incisions such as natural transluminal endoscopic surgery (NOTES) and single-port laparoscopic cholecystectomy (SPLC). Many retrospective case series propose excellent cosmesis and reduced pain in SPLC. As the latter has been confirmed in a randomized controlled trial, patient's satisfaction on cosmesis is still controversially debated. Methods/Design The SPOCC trial is a prospective, multi-center, double blinded, randomized controlled study comparing SPLC with 4-port conventional laparoscopic cholecystectomy (4PLC) in elective surgery. The hypothesis and primary objective is that patients undergoing SPLC will have a better outcome in cosmesis and body image 12 weeks after surgery. This primary endpoint is assessed using a validated 8-item multiple choice type questionnaire on cosmesis and body image. The secondary endpoint has three entities: the quality of life 12 weeks after surgery assessed by the validated Short-Form-36 Health Survey questionnaire, postoperative pain assessed by a visual analogue scale and the use of analgesics. Operative time, surgeon's experience with SPLC and 4PLC, use of additional ports, conversion to 4PLC or open cholecystectomy, length of stay, costs, time of work as well as intra- and postoperative complications are further aspects of the secondary endpoint. Patients are randomly assigned either to SPLC or to 4PLC. Patients as well as treating physicians, nurses and assessors are blinded until the 7th postoperative day. Sample size calculation performed by estimating a difference of cosmesis of 20% (alpha = 0.05 and beta = 0.90, drop out rate of 10%) resulted in a number of 55 randomized patients per arm. Discussion The SPOCC-trial is a prospective, multi-center, double-blind, randomized controlled study to assess cosmesis and body image after SPLC. Trial registration (clinicaltrial.gov): NCT 01278472

2011-01-01

87

Vaginal cuff dehiscence with adnexal mass evisceration after abdominal hysterectomy  

PubMed Central

INTRODUCTION More commonly, a vaginal cuff dehiscence is a complication of robotic or laparoscopic hysterectomy while dehiscence is less commonly observed following total abdominal or vaginal hysterectomies. PRESENTATION OF CASE Three years after an uncomplicated total abdominal hysterectomy for fibroid uterus, a 50 year old female with a known, large adnexal mass presented with vaginal cuff dehiscence and prolapse of the adnexal mass through the vaginal cuff. DISCUSSION We discuss surgical risk factors including route of hysterectomy, method of colpotomy and vaginal cuff closure as contributing factors for vaginal cuff dehiscence in our patient. CONCLUSION Any large pelvic mass that may potentially exert pressure necrosis on the vaginal cuff, even remote from hysterectomy may result a vaginal cuff dehiscence. Emergent surgical intervention is warranted.

Nguyen, My-Linh T.; Anyikam, Adanna L.; Paolucci, Michele

2013-01-01

88

A surgical window to access the obliterated posterior cul-de-sac at vaginal hysterectomy  

Microsoft Academic Search

ObjectiveTo perform vaginal hysterectomy and adnexectomy without laparoscopic assistance in women with ovarian endometriosis by accessing the posterior cul-de-sac via the posterior uterocervical–broad ligament space.

Shirish S. Sheth

2009-01-01

89

Laparoscopic Para-aortic and Pelvic Lymphadenectomy: Experience with 150 Patients and Review of the Literature  

Microsoft Academic Search

Objective.The clinical usefulness of laparoscopic pelvic and para-aortic lymphadenectomy for staging and therapy of gynecological cancer was analyzed prospectively.Method.Laparoscopic para-aortic and pelvic lymphadenectomy was performed in 150 patients with cervical (n= 96), endometrial (n= 41), or ovarian cancer (n= 13). Lymphadenectomy was combined with laparoscopically assisted vaginal radical hysterectomy in 70 patients, with laparoscopically assisted vaginal hysterectomy and\\/or bilateral salpingo-oophorectomy

Marc Possover; Norman Krause; Karin Plaul; Rosemarie Kühne-Heid; Achim Schneider

1998-01-01

90

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.

Ouldamer, Lobna; Caille, Agnes; Body, Gilles

2013-01-01

91

[Management of myoma: what is the place for hysterectomy and how to perform it?].  

PubMed

Hysterectomy is the most effective treatment for symptomatic myoma with no possible recurrence. Hysterectomy for myoma is associated with a high rate of patient satisfaction (95%). Quality of life is globally improved by hysterectomy, as is sexuality with less pelvic pain, asthenia, urinary symptoms and impaired mental health. Vaginal and laparoscopic routes should be preferred to diminish blood loss, hospital stay and postoperative pain. Patients with hysterectomy are at twice as much risk of requiring surgical treatment for incontinence later on. Stress urinary incontinence must be looked for during the preoperative history-taking. PMID:23582149

Giraudet, Géraldine; Niro, Julien; Lucot, Jean-Philippe; Panel, Pierre

2013-04-10

92

[Peripartal hysterectomy - review].  

PubMed

Peripartal hysterectomy is one of the life - threatening procedures needed to be performed in an urgent situation. Women at highest risk of peripartal hysterectomy are multiparas, women who had a caesarian delivery in either previous or present pregnancy or women who had an abnormal placentation. This report presents the basic issues and brief review of the major indications of peripartal hysterectomy. It also compares the effectiveness of the selected types of operation. PMID:22779724

Pálová, E; Borovsky, M

2012-06-01

93

Autostereoscopic three-dimensional viewer evaluation through comparison with conventional interfaces in laparoscopic surgery.  

PubMed

In the near future, it is likely that 3-dimensional (3D) surgical endoscopes will replace current 2D imaging systems given the rapid spreading of stereoscopy in the consumer market. In this evaluation study, an emerging technology, the autostereoscopic monitor, is compared with the visualization systems mainly used in laparoscopic surgery: a binocular visor, technically equivalent from the viewer's point of view to the da Vinci 3D console, and a standard 2D monitor. A total of 16 physicians with no experience in 3D interfaces performed 5 different tasks, and the execution time and accuracy of the tasks were evaluated. Moreover, subjective preferences were recorded to qualitatively evaluate the different technologies at the end of each trial. This study demonstrated that the autostereoscopic display is equally effective as the binocular visor for both low- and high-complexity tasks and that it guarantees better performance in terms of execution time than the standard 2D monitor. Moreover, an unconventional task, included to provide the same conditions to the surgeons regardless of their experience, was performed 22% faster when using the autostereoscopic monitor than the binocular visor. However, the final questionnaires demonstrated that 60% of participants preferred the user-friendliness of the binocular visor. These results are greatly heartening because autostereoscopic technology is still in its early stages and offers potential improvement. As a consequence, the authors expect that the increasing interest in autostereoscopy could improve its friendliness in the future and allow the technology to be widely accepted in surgery. PMID:21742655

Silvestri, Michele; Simi, Massimiliano; Cavallotti, Carmela; Vatteroni, Monica; Ferrari, Vincenzo; Freschi, Cinzia; Valdastri, Pietro; Menciassi, Arianna; Dario, Paolo

2011-07-07

94

Loss of intestine during stoma closure: an experimental model comparing laparoscopic and conventional techniques  

Microsoft Academic Search

Purpose  This study compared laparoscopy-assisted stoma closure (Lap) with conventional closure (Co) to assess loss of intestine.\\u000a \\u000a \\u000a \\u000a Methods  Ileostomies (loop L; single S) were performed 5 cm proximal to the ileocecal junction through a right lower quadrant incision\\u000a in forty 11-week-old Lewis rats (L = 20, S = 20). Stoma closure was performed 60 days later using laparoscopy (Lap) or conventional\\u000a closure (Co) in 10 rats each, to

Go Miyano; Satoko Ichikawa; Yoshifumi Kato; Tadaharu Okazaki; Atsuyuki Yamataka

2010-01-01

95

Robotic Hysterectomy Strategies in the Morbidly Obese Patient  

PubMed Central

Background and Objectives: The purpose of this study was to present strategies for performing computer-enhanced telesurgery in the morbidly obese patient. Methods: This was a prospective, institutional review board-approved, descriptive feasibility study (Canadian Task Force classification II-2) conducted at a university-affiliated hospital. Twelve class III morbidly obese women with a body mass index of 40 kg/m2 or greater were selected to undergo robotic-assisted total laparoscopic hysterectomy. Robotic-assisted total laparoscopic hysterectomy, classified as type IVE, with complete detachment of the cardinal-uterosacral ligament complex, unilateral or bilateral, with entry into the vagina was performed. Results: The median estimated blood loss was 146.3 mL (range, 15–550 mL), the mean length of stay in the hospital was 25.3 hours (range, 23–48 hours), and the complication rate was 0%. The rate of conversion to laparotomy was 8%. The median surgical time was 109.6 minutes (range, 99–145 minutes). Conclusion: Robotic-assisted total laparoscopic hysterectomy can be a safe and effective method of performing hysterectomies in select morbidly obese patients, allowing them the opportunity to undergo minimally invasive surgery without increased perioperative complications.

2013-01-01

96

Medical effectiveness and safety of conventional compared to laparoscopic incisional hernia repair: A systematic review  

Microsoft Academic Search

Background  Incisional hernias are a common complication following abdominal surgery and represent about 80% of all ventral hernia. In\\u000a uncomplicated postoperative follow-up they develop in about 11% of cases and in up to 23% of cases with wound infections or\\u000a other forms of wound complications. While conventional mesh repair has been the standard of care in the past, the use of

Falk Müller-Riemenschneider; Stephanie Roll; Meik Friedrich; Juergen Zieren; Thomas Reinhold; J.-Matthias Graf von der Schulenburg; Wolfgang Greiner; Stefan N. Willich

2007-01-01

97

Extended experience in the use of laparoscopic ultrasound to detect pelvic nodal metastasis in patients with cervical carcinoma  

Microsoft Academic Search

Objective. To evaluate the use of laparoscopic ultrasound (USG) to detect pelvic nodal metastasis in patients with early stage cervical carcinoma.Methods. Laparoscopic USG was used to search for pelvic lymph node metastasis in stage Ia2 to IIa cervical carcinoma patients before radical hysterectomy. Suspicious lymph nodes identified by laparoscopic USG were removed laparoscopically for pathological confirmation by frozen section. If

T. H Cheung; W. K Lo; M. Y Yu; W. T Yang; S Ho

2004-01-01

98

Minilaparotomy cholecystectomy with ultrasonic dissection versus conventional laparoscopic cholecystectomy: a randomized multicenter study.  

PubMed

Abstract Objective. Cholecystectomy by minilaparotomy (MC) or by laparoscopy (LC) has been shown to have equal results of both early and late recovery. Although, the ultrasonic dissection (UsD) technique has seen used in LC, the technique is rarely used in MC. Material and methods. Initially, 88 patients with uncomplicated symptomatic gallstones were randomized into MC with UsD (n = 44) or conventional LC (n = 44) over a 2-year period (2010-2012). The two groups were similar in terms of age and American Society of Anesthesiologists (ASA) physical status score. Results. Both groups were similar in terms of the operative time and the time in the operation theatre, the success of day-surgery and satisfaction with the procedure. The MC group had significantly less postoperative pain than the LC group, p = 0.002, and the MC group used less analgesics doses during the first 24 h: 2.8 (1.2) doses vs. 3.8 (1.4) doses, p = 0.003. The convalescence needed was 3 days shorter in the MC group, 7 (3) days, than that in the LC-group, 10 (8) days, p = 0.024. In the MC group 4 patients and in the LC group 11 (p = 0.046) required more than 14 days of sick leave. In the MC group there was one and in the LC group two conversions to open surgery. Conclusion. The patients in the MC group had less early postoperative pain and had a shorter convalescence than the patients in the LC group. PMID:23971855

Harju, Jukka; Juvonen, Petri; Kokki, Hannu; Remes, Veikko; Scheinin, Tom; Eskelinen, Matti

2013-08-26

99

[Post hysterectomy vaginal vault prolapse: diagnosis prevention and treatment].  

PubMed

Post-hysterectomy vaginal vault prolapse is a common disorder which generally manifests as a protrusion of the vagina through the genital hiatus, sometimes accompanied by urinary and gastrointestinal symptoms as well as sexual dysfunction. Risk factors for this condition include vaginal deliveries, obesity and previous hysterectomy, although genetic predisposition leading to reduced connective tissue and muscle strength may also play a role. Surgical correction of this disorder can be performed through either the abdominal or transvaginal approaches. Two prospective randomized trials have compared these approaches demonstrating better anatomic success rates for the abdominal approach as opposed to faster recovery and lower morbidity for the transvaginal approach. Laparoscopic and other transvaginal minimal access techniques for vaginal vault suspension have recently been advocated utilizing synthetic or biological adjuvant grafts. These techniques have been associated with high success rates albeit substantial graft complications such as erosion, contraction and dyspareunia. Suspension of the vaginal apex to the uterosacral ligaments (McCall culdoplasty) or to the sacrospinous ligaments at the time of vaginal hysterectomy is the mainstay for prevention of post hysterectomy vaginal vault prolapse. Our knowledge of the pathophysiology of post hysterectomy vaginal vault prolapse is quickly being refined, leading to more efficient surgical therapies for prevention and treatment of this disorder. PMID:18770962

Segev, Yakir; Auslander, Ron; Lavie, Ofer; Lissak, Arie; Abramov, Yoram

2008-05-01

100

Total and subtotal abdominal hysterectomy.  

PubMed

Hysterectomy is one of the most frequently performed operations in the world, accounting for 500,000-600,000 procedures annually in the USA; the abdominal route for hysterectomy is the preferred route in 60-80% of these operations. Although the number of total abdominal hysterectomies performed annually has decreased, the number of subtotal abdominal hysterectomies increased by >400%. The major indications for abdominal hysterectomy include abnormal uterine bleeding, myomata uteri, adenomyosis, endometriosis, neoplasia, and chronic salpingitis. The basis for selection for subtotal versus total hysterectomy has little in the way of factual data to support it and may actually present some significant disadvantages, such as continued menstruation and cervical prolapse. The detailed technique for performing intrafascial abdominal hysterectomy relies heavily on precise knowledge of pelvic anatomy and compulsive detail to tissue handling. The consistent and correct usage of prophylactic antimicrobials, measures to prevent thromboemboli, and procedures to avoid urinary retention are key to the overall success of the surgery. PMID:15985251

Baggish, Michael S

2005-02-05

101

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

Microsoft Academic Search

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

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

2007-01-01

102

Efficacy of the subcostal transversus abdominis plane block in laparoscopic cholecystectomy: Comparison with conventional port-site infiltration  

PubMed Central

Background: Pain experienced following laparoscopic cholecystectomy is largely contributed by the anterior abdominal wall incisions. This study investigated whether subcostal transversus abdominis (STA) block was superior to traditional port-site infiltration of local anesthetic in reducing postoperative pain, opioid consumption, and time for recovery. Materials and Methods: Forty-three patients presenting for day case laparoscopic cholecystectomy were randomly allocated to receive either an ultrasound-guided STA block (n = 21) or port-site infiltration of local anesthetic (n = 22). Visual analog pain scores were measured at 1 and 4 h postoperatively to assess pain severity, and opioid requirement was measured in recovery and up to 8 h postoperatively. The time to discharge from recovery was recorded. Results: STA block resulted in a significant reduction in serial visual pain analog score values and significantly reduced the fentanyl requirement in recovery by >35% compared to the group that received local port-site infiltration (median 0.9 vs. 1.5 ?cg/kg). Furthermore, STA block was associated with nearly a 50% reduction in overall 8-h equivalent morphine consumption (median 10 mg vs. 19 mg). In addition, STA block significantly reduced median time to discharge from recovery from 110 to 65 min. Conclusion: The results suggest that STA block provides superior postoperative analgesia and reduces opioid requirement following laparoscopic cholecystectomy. It may also improve theater efficiency by reducing time to discharge from the recovery unit.

Tolchard, S; Davies, R; Martindale, S

2012-01-01

103

Management of intravascular leiomyomatosis: laparoscopic surgery for ordinary uterine fibroids led to an extraordinary finding.  

PubMed

An unexpected diagnosis of intravascular leiomyomatosis was made during a laparoscopic procedure. As the extent of the disease was unknown, the initial procedure was limited to laparoscopic hysterectomy and salpingo-oophorectomy. Postoperative computed tomography imaging demonstrated intravascular leiomyomatosis extending into the suprarenal inferior vena cava. The patient underwent exploratory laparotomy to excise residual tumor. PMID:23454251

Lakhi, Nisha; Serur, Eli; Chi, Dennis S

2013-02-27

104

Endometrial dye instillation: a novel approach to histopathologic evaluation of morcellated hysterectomy specimens.  

PubMed

The purpose of this prospective pilot case study was to determine whether instillation of trypan blue dye into the uterine cavity before laparoscopic hysterectomy and morcellation aids in gross identification of endometrium. The most common commercially available trypan blue stain, VisionBlue was used in this study. Instillation was performed at the beginning of the procedure using an embryo transfer catheter. A sterile solution of trypan blue, 0.5 mL, was instilled transcervically into the uterine cavities in 12 patients before laparoscopic hysterectomy with uterine morcellation. The morcellated specimens were sent for routine gross pathologic and histologic examination. It was concluded that intrauterine instillation of trypan blue stained the endometrium, thus aiding the pathologist in identification of the endometrium in morcellated uterine specimens. PMID:23714746

Tam, Teresa; Harkins, Gerald; Caldwell, Trevor; Zaino, Richard; Hazard, Danielle

2013-05-25

105

Laparo-endoscopic single-site surgery hysterectomy using robotic lightweight endoscope assistants  

Microsoft Academic Search

Current laparoscopic and robotic hysterectomy techniques require three to five small incisions in the abdominal wall. Each\\u000a additional port contributes an additional risk for port site complications. Because of these risks, and in an effort to improve\\u000a cosmesis, surgery through a single incision is being explored. New versatile robot devices can provide a less cumbersome and\\u000a less expensive alternative to

Sarah Kane; Kevin J. Stepp

2010-01-01

106

Robotic-assisted laparoscopic pyeloplasty: a pilot study  

Microsoft Academic Search

Objectives. Robotic technology has been employed to manipulate the laparoscope during urologic procedures. However, to our knowledge, robotic technology has not been previously applied to actually perform the urologic laparoscopic procedure. The objective of this study was to determine the feasibility and efficacy of performing robotic-assisted laparoscopic pyeloplasty and compare it with conventional laparoscopic pyeloplasty in an acute porcine model.Methods.

Gyung Tak Sung; Inderbir S Gill; Thomas H. S Hsu

1999-01-01

107

Safe Laparoscopic Removal of a 3200 Gram Fibroid Uterus  

PubMed Central

Background and Objectives: Hysterectomy using minimally invasive techniques yields fewer complications, less blood loss, and quicker recovery time compared with traditional abdominal hysterectomy. Despite these advantages, >65% of all hysterectomies in the United States are still performed using traditional laparotomy, and many clinicians still exclude patients with a history of prior abdominal surgery, significant obesity, or a large fibroid uterus from these procedures. Among physicians skilled in minimally invasive surgery, the prior largest uteri removed included a 2421g uterus removed vaginally, and a 2418g uterus removed via hand-assisted laparoscopic hysterectomy. Methods: We performed a laparoscopic-assisted hysterectomy on a significantly obese 50-year-old woman with a 3200g uterus. The patient required a 2-day hospital stay and recovered unremarkably. The patient was able to return to work within one week and quickly returned to activities of daily life. Conclusion: In the hands of experienced minimally invasive surgeons, laparotomy can be avoided in almost all instances of hysterectomy for benign disease.

Marchand, Gregory J.

2010-01-01

108

Telerobotics in laparoscopic general surgery  

Microsoft Academic Search

Summary  BACKGROUND: Telerobotic systems are considered to further improve laparoscopic surgery. They may have some advantages over conventional laparoscopic instruments such as increase in the degree of freedom and 3-D vision. On the other hand, loss of tactile sensitivity and enormous costs are limiting features of these devices. Currently, 2 systems are in use, the Da Vinciand the Zeussystem. METHODS: Our

C. Wullstein; M. Golling; W. O. Bechstein

2004-01-01

109

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

110

Laparoscopic vs robotic-assisted surgery for endometrial carcinoma in a centre with long laparoscopic experience.  

PubMed

Surgical outcomes and costs of laparoscopic and robotic hysterectomy for the treatment of endometrial carcinoma were compared in a centre with lengthy experience with laparoscopic surgery. The robotic cohort (n = 67) had a longer operative time than the laparoscopic cohort (n = 150) (p < 0.0001). Lymph node yields were similar for both surgical modalities, but the median of estimated blood loss was lower in the robotic group (50 ml vs 100 ml; p < 0.0001). The proportion of patients with hospital stay > 2 days and rate of overall complications were similar in both groups. Operative costs were (Euros) €1,680 and €3,860 for the laparoscopic and robotic procedure, respectively. We conclude that robotic technology is feasible but does not provide short-term benefits for the treatment of endometrial carcinoma in a centre where laparoscopy has been established as the standardised minimally invasive surgical method. PMID:24127963

Turunen, H; Pakarinen, P; Sjöberg, J; Loukovaara, M

2013-10-01

111

Laparoscopic Total Mesorectum Excision  

PubMed Central

The main controversy of colon-rectal laparoscopic surgery comes from its use as a cancer treatment. Two points deserve special attention: the incidence of portsite tumor implantation and the possibility of performing radical cancer surgery, such as total mesorectum excision. Once these points are addressed, the laparoscopic approach will be used routinely to treat rectal cancer. To clarify these points, 32 patients with cancer of the lower rectum participated in a special protocol that included preoperative radiotherapy and laparoscopic total mesorectum excision. All data were recorded. At the same time, all data recorded from the experience of a multicenter laparoscopic group (Brazilian Colorectal Laparoscopic Surgeons – 130 patients with tumor of the lower rectum) were analyzed and compared with the data provided by our patients. Analysis of the results suggests that a laparoscopic approach allows the same effective resection as that of conventional surgery and that preoperative irradiation does not influence the incidence of intraoperative complications. The extent of lymph nodal excision is similar to that obtained with open surgery, with an average of 12.3 lymph nodes dissected per specimen. The rate of local recurrence was 3.12%. No port site implantation of tumor was noted in this series of patients with cancer of the lower rectum.

Quilici, F.A.; Cordeiro, F.; Reis, J.A.; Kagohara, O.; Simoes Neto, J.

2002-01-01

112

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.

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

2013-01-01

113

Laparoscopic colorectal resection for diverticulitis.  

PubMed

This study evaluated outcome in patients undergoing laparoscopically assisted sigmoid resection for diverticular disease. A total of 29 consecutive patients were treated surgically for colonic diverticulitis; in 27 of these laparoscopy was performed. The review of medical records from a control group of 34 patients undergoing open resection were used for comparison. The conversion rate was 7.5%. Using the laparoscopic technique the duration of surgery was longer (165 vs. 121 min, P < 0.05), blood loss less (182 vs. 352 ml, P < 0.05), and subsequent blood transfusion less (0 vs. 61%). The incidence of complications following laparoscopic resection was lower (two anastomotic leakages, two wound infections) than in the conventional group. Convalescence in the laparoscopic group was more rapid and hospital stay shorter (7.9 vs. 14.3 days, P < 0.05). In the laparoscopic group patients expressed less pain at rest and in motion. The cost of the laparoscopically assisted procedure was less than that of conventional resection (7185 vs. 8975 DM). In this series laparoscopically assisted sigmoid resection for diverticulitis proved safe. Recovery was faster, hospital stay was shorter, and patients expressed less pain than in conventional open surgery. PMID:9548100

Köhler, L; Rixen, D; Troidl, H

1998-01-01

114

[Pyeloplasty: pro laparoscopic].  

PubMed

With increasing experience and availability of the da Vinci® robotic surgery system there has been an extension of the indications from initially exclusively ablative interventions, such as nephrectomy and radical prostatectomy to reconstructive interventions, such as pyeloplasty, bladder augmentation and urinary diversion. Laparocopic pyeloplasty has been established for both adults and children, with results comparable to the open procedure. In comparison the conventional laparoscopic procedure is little cost-intensive and therefore widely used. The available literature has to be analysed to find advantages for the cost-intensive, robot-assisted laparoscopic pyeloplasty from which patients can profit. PMID:22526175

Bader, P

2012-05-01

115

Laparoscopic and open incisional hernia repair: A comparison study  

Microsoft Academic Search

Background: Techniques for performing laparoscopic incisional hernia repair have been described and some advantages over conventional open repair reported. However, most reported series of laparoscopic incisional hernia procedures are small, and only one has included a comparison with open repairs. Methods: From December 1993 to January 1998, we prospectively collected operative and outcome data on 56 consecutive laparoscopic prosthetic repairs

Adrian Park; Daniel W. Birch; Peter Lovrics

1998-01-01

116

Hysterectomy  

MedlinePLUS

... disease if the ovaries are removed before menopause Estrogen replacement therapy can help decrease the risk of heart disease ... a decreased sex drive. Your doctor may recommend estrogen replacement therapy .

117

Laparoscopic anatomical hepatic resection  

Microsoft Academic Search

.   Four patients underwent a laparoscopic left hepatic resection for solid tumor, two for metastasis from colonic cancer, and\\u000a two for focal nodular hyperplasia (final diagnosis). The procedure was performed according to the rules of conventional hepatic\\u000a surgery and cancer surgery. No blood transfusion was necessary. No surgical complication occurred. In malignant disease, laparoscopy\\u000a allows a good staging and the

G. Samama; L. Chiche; J. L. Bréfort; Y. Le Roux

1998-01-01

118

Laparoscopic adrenal surgery  

Microsoft Academic Search

Summary.   Minimally invasive adrenalectomy is now an accepted alternative to conventional adrenalectomy. As in open surgery, several\\u000a different endoscopic approaches to the adrenal glands have been described. In principle, one must distinguish between the\\u000a laparoscopic and the retroperitoneoscopic access. All adrenal tumors – pheochromocytomas included – except adrenal carcinomas\\u000a can be removed endoscopically. However, the use of these techniques is

C. Nies; E. Möbius; M. Rothmund

1997-01-01

119

Pap Smear: Still Necessary after Hysterectomy?  

MedlinePLUS

... an important screening test for early diagnosis of cervical cancer. If you had a partial hysterectomy — when the ... and you're not at high risk of cervical cancer. If you're unsure whether you still need ...

120

Laparoscopic gastrostomy in children.  

PubMed

During a 30-month period, 28 children aged 6 months-15 years underwent fashioning of a laparoscopic gastrostomy. Indications for operation included: feeding difficulties and failure to thrive in neurologically impaired children (13); chronic renal failure (9); and others (6). There were 17 conventional tube and 11 button gastrostomies. Twelve children had insertion of a gastrostomy alone; the others underwent a concomitant laparoscopic Nissen fundoplication (NFP). The average operation time for gastrostomy alone was 65 min (range 35-104) and for gastrostomy plus NFP 155 min (range 130-246). There were no specific laparoscopic complications. Two patients who required large volumes of eternal drugs and peritoneal dialysis from the 1st post-operative day developed minor external leaks from their stomas. It appears that laparoscopy provides for safe and precise positioning of any standard balloon or button gastrostomy. It is a particularly attractive technique for use in patients already undergoing a laparoscopic fundoplication and those in whom other minimally invasive techniques are contraindicated or fail. PMID:9238116

Humphrey, G M; Najmaldin, A

1997-09-01

121

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

122

[Laparoscopic nephron sparing surgery. Initial experience].  

PubMed

We present our initial experience in laparoscopic nephron sparing surgery. It's a technically advanced procedure requiring considerable minimally invasive expertise. This technique is particularly attractive compared to an open conventional procedure with its larger incision and associated morbidity. PMID:17711165

Aguilera Bazán, A; Alonso y Gregorio, S; Pérez Utrilla, M; Cansino Alcalde, J R; Cisneros Ledo, J; De la Peña Barthel, J

2007-05-01

123

Breastfeeding following emergency peripartum hysterectomy.  

PubMed

Emergency peripartum hysterectomy (EPH) is usually performed in cases of intractable obstetric hemorrhage unresponsive to conservative treatment. EPH is associated with a high incidence of maternal morbidity and mortality. Most of these women do not have the opportunity to even start breastfeeding. We report a case where breastfeeding was attempted after EPH. The mother spent 6 days in the intensive care unit and suffered several medical and surgical complications. On day 7 she was reunited with her baby. One month later, a diagnosis of post-traumatic stress disorder was made. Breastfeeding became very important, with the patient frequently expressing that this was the most healing aspect in her recovery from the traumatic EPH. At 3 months, five daily feeds were supplemented with formula. Breastfeeding, principally nocturnal, continued 6 months after childbirth, with the baby being weaned at 7 months. Women who undergo EPH need psychological support. The option of breastfeeding should be considered even days or weeks after the surgical intervention as it can be a healing experience for some women who are grieving the loss of their fertility. Professional specialized breastfeeding support should be offered in these cases, and the possibility of reuniting mother and infant even when the mother is in the intensive care unit should be considered. PMID:22148927

Olza-Fernández, Ibone; García-Murillo, Lourdes; Palanca-Maresca, Inmaculada

2011-12-07

124

42 CFR 50.207 - Sterilization by hysterectomy.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Sterilization by hysterectomy. 50.207...POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted...Planning Projects § 50.207 Sterilization by hysterectomy....

2009-10-01

125

42 CFR 441.255 - Sterilization by hysterectomy.  

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Sterilization by hysterectomy. 441.255 Section 441...AND LIMITS APPLICABLE TO SPECIFIC SERVICES Sterilizations § 441.255 Sterilization by hysterectomy. (a) FFP is not...

2009-10-01

126

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

127

Hysterectomy Decision: Assessment of Outcomes. (Includes Executive Summary).  

National Technical Information Service (NTIS)

The Maine Women's Health Study assessed the outcomes of hysterectomy and nonsurgical treatment for common noncancerous gynecological conditions. The study was a prospective cohort study of 798 women ages 25 to 50 years undergoing hysterectomy for any nonc...

B. A. Miller

1992-01-01

128

Advantages of nerve-sparing intrastromal total abdominal hysterectomy  

PubMed Central

Background The purpose of the prospective study was to evaluate the effect of the nerve-sparing intrastromal abdominal hysterectomy bilateral salpingo-oophorectomy (ISTAH-BSO) on intraoperative, and postoperative complications namely blood loss and length of hospital stay. Methods Forty female patients were allocated by a block randomization method into a study group and a control group. The study group consisted of 20 patients who underwent ISTAH-BSO over a 2-year period. The control group included 20 patients who underwent conventional hysterectomy by the same surgeon during the same time frame. Both groups were followed for outcomes of interest, which included length of hospital stay, blood loss, and surgical complications. The participants in both groups were as similar as possible with respect to all known or unknown factors that might affect the study outcome. Results Postoperative hemoglobin levels were higher in the study group (blood loss 1.0 g/dL versus 1.4 g/dL in control group). Average hospital stay was significantly shorter in the study group (2.7 days versus 3.15 days in the control group, P = 0.028). No significant complications such as urinary fistula, vaginal vault prolapse, blood transfusion, or postoperative infections were identified in the study group. Conclusion The nerve-sparing ISTAH-BSO procedure described in this study has the potential to reduce length of hospital stay after abdominal hysterectomy by reducing blood loss and postoperative complications. Follow-up observations suggest that urinary function and sexual satisfaction are also preserved. Since this research, 175 cases have been performed, with an average of 5 years of follow-up. The outcomes of these cases have been reported as similar.

Samimi, Daryoosh; Allam, Afdal; Devereaux, Robert; Han, William; Monroe, Mark

2013-01-01

129

Guidelines to determine the route of oophorectomy with hysterectomy  

Microsoft Academic Search

OBJECTIVES: Our purpose was to determine whether there is adequate visibility and access for transvaginal oophorectomy in most patients and the success rate of the transvaginal approach. The final goal was to establish objective guidelines for choosing the route of oophorectomy with hysterectomy. STUDY DESIGN: Patients underwent laparoscopy-assisted vaginal hysterectomy (n = 91) or vaginal hysterectomy (n = 875). Ovarian

S. Robert Kovac; Stephen H. Cruikshank

1996-01-01

130

The hysterectomy story in the United Kingdom.  

PubMed

Gynaecologists in India should be deeply concerned by the message broadcast on the BBC by Jill McGivering (6(th) February 2013) in which she suggested that hysterectomy is abused in India, with the overwhelming number of women being subjected to the operation unnecessarily. Their counterparts in the UK should be no more complacent because although the hysterectomy rates have fallen over the years, yet there is widely and wildly varying rates between regions, hospitals and individual gynaecologists. Until research can be undertaken to establish what the true rates of hysterectomy should be, clear simple guidelines could go a long way to ensuring that women are not subjected to an operation they do not need, while those who would benefit are not denied an intervention that can improve their quality of life. PMID:23833533

Mukhopadhaya, Neela; Manyonda, I T

2013-01-01

131

The hysterectomy story in the United Kingdom  

PubMed Central

Gynaecologists in India should be deeply concerned by the message broadcast on the BBC by Jill McGivering (6th February 2013) in which she suggested that hysterectomy is abused in India, with the overwhelming number of women being subjected to the operation unnecessarily. Their counterparts in the UK should be no more complacent because although the hysterectomy rates have fallen over the years, yet there is widely and wildly varying rates between regions, hospitals and individual gynaecologists. Until research can be undertaken to establish what the true rates of hysterectomy should be, clear simple guidelines could go a long way to ensuring that women are not subjected to an operation they do not need, while those who would benefit are not denied an intervention that can improve their quality of life.

Mukhopadhaya, Neela; Manyonda, I. T.

2013-01-01

132

Laparoscopic-guided transversus abdominis plane block for colorectal surgery.  

PubMed

The transversus abdominis plane block has been used as a component of postoperative analgesia after hysterectomy and open abdominal surgery. This block involves the injection of anesthetic between the internal oblique and transversus abdominis muscles. We demonstrate an improved method by the use of laparoscopic guidance for transversus abdominis plane blocks.Transversus abdominis plane blocks are performed at the conclusion of an elective laparoscopic procedure by an experienced colorectal surgeon. With the use of direct visualization with a laparoscope, a Braun Stimuplex A insulated needle is passed through the skin at the level of the midaxillary line, midway between the iliac crest and the costal margin. The needle is inserted further until 2 distinct "pops" are felt, indicating the correct needle position between the internal oblique and transversus abdominis muscle. The laparoscope confirms a bulge, which signifies the injectate covered by the transversus abdominis muscle. The procedure is performed at a second injection site on the same side and bilaterally.The transversus abdominis plane block is useful as an adjunct to reduce postoperative analgesia in patients undergoing laparoscopic colorectal surgery. Our method for transversus abdominis plane blocks with the use of laparoscopy is easily performed at the conclusion of any laparoscopic procedure. Prospective randomized trials are necessary to assess the significance of these blocks in postoperative pain control, length of stay, and cost benefit. PMID:23392158

Favuzza, Joanne; Delaney, Conor P

2013-03-01

133

An unusual late sequel to hysterectomy.  

PubMed Central

A case is reported of a large infected foreign body granuloma associated with a retained non-opaque swab presenting 9 years after hysterectomy. An abdominal radiography and whole body computed tomography (CT) scanning demonstrated gas collections in a large abdominal mass. The case underlines the necessity for using radioopaque swabs in all surgical operations. Images Fig. 1 Fig. 2 Fig. 3

Hertzanu, Y.; Hurwitz, J.

1983-01-01

134

Laparoscopic vessel sealing technologies.  

PubMed

Laparoscopic vessel sealing devices have revolutionized modern laparoscopy. These devices fall into 2 major categories: advanced bipolar and ultrasonic instruments. The range of tissue effects available with these technologies is more limited than with conventional monopolar electrosurgery; however, both advanced bipolar and ultrasonic devices efficiently seal vessels (?7-mm and ?5-mm diameter, respectively), and most also have built-in tissue transection capabilities. These technologies have been the subject of a range of comparative studies on their relative advantages and disadvantages, and, to date, neither advanced bipolar or ultrasonic devices has been proven to be superior. PMID:23659750

Lyons, Stephen D; Law, Kenneth S K

135

Feasibility of Robotic-assisted Laparoscopic Pancreaticojejunostomy  

Microsoft Academic Search

Background: Robotic technology has been employed and developed in the laparo- scopic gastrointestinal procedures recently. We have undertaken a study using robotic instrumentation and voice-controlled camera guidance to determine the feasibility and the efficacy of performing robotic-assisted laparoscopic pancreaticojejuno- stomy and compare it with conventional laparoscopic pancreaticojejunostomy in acute porcine models. Methods: Using the robotic surgical system, we performed robotic-assisted

S. Fukuyama; K. Shibuya; T. Abe; S. Egawa; M. Sunamura; K. Takeda; M. Gagner; S. Matsuno

136

Robotically assisted laparoscopic microsurgical uterine horn anastomosis  

Microsoft Academic Search

Objective: To evaluate the feasibility, safety, and sterility issues with regard to the use of a robotic device to perform uterine horn anastomosis in a live porcine model.Design: Prospective animal study.Setting: Landrace-Yorkshire pigs in a conventional laboratory setting.Intervention(s): Six female pigs underwent laparoscopic bipolar electrocoagulation of the distal uterine horns. Two weeks later, the uterine horns were reanastomosed laparoscopically with

Harout Margossian; Antonio Garcia-Ruiz; Tommaso Falcone; Jeffrey M Goldberg; Marjan Attaran; Michel Gagner

1998-01-01

137

[Laparoscopic adrenalectomy].  

PubMed

The authors performed three left and one right sided laparoscopic adrenalectomies between 3rd April and 8th August 1997. The indication of surgery was hormonally active cortical adenoma of about 2 cm size in three cases, a 6 cm large hormonally inactive tumour in one case respectively. For the operation on the left side three, on the right side four trocars with 11 mm diameter was used. The duration of the operations was between 115 and 220 min. The patients left one the second or third postoperative day, no complication was observed. The authors' opinion based on both literature data and their own experience is that laparoscopic approach to adrenalectomies is the method of choice today. PMID:9702083

Horányi, J; Tihanyi, T; Darvas, K; Rácz, K; Fütö, L

1998-07-12

138

[Laparoscopic splenectomy].  

PubMed

To date more than 400 laparoscopic splenectomies have been reported in the literature. The main indications for the procedure are benign haematological diseases, in particular idiopathic thrombocytopenic purpura. Laparoscopic splenectomy to treat malignant illnesses is rare and is usually restricted to small or only moderately enlarged spleens. Technically, the lateral abdominal approach with the patient in a right decubitus position has the advantage over the anterior approach in the supine patient of permitting better access to the organ. Under the force of gravity the stomach and intestines drop out of the operating field, and the splenic ligaments are placed under tension. This facilitates dissection with the harmonic scalpel and safe divisioning of the hilar vessels using the linear stapler. The individual steps of the procedure are described in detail. PMID:9586193

Reck, T; Köckerling, F; Scheuerlein, H; Hohenberger, W

1998-01-01

139

Laparoscopic Instrumentation  

Microsoft Academic Search

\\u000a Laparoscopic instrumentation continues to evolve towards smaller, more reliable, and better ergonomic devices, with a larger\\u000a variety of choices. Since the first edition of this textbook, subtle improvements are readily apparent in existing devices\\u000a as first-generation instruments progress towards later-generation models. New technology exists to allow procedures to be\\u000a performed with fewer complications. Combined with refinements in techniques, new and

Patrick S. Lowry

140

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.

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

2012-01-01

141

Training for laparoscopic surgery  

Microsoft Academic Search

Laparoscopic cholecystectomy has rapidly become the procedure of choice for most patients with symptomatic gallbladder disease. Laparoscopic surgery, however, has not been a required component of most general surgery training programs. The demonstrated efficacy of laparoscopic surgery dictates that this discipline be rapidly incorporated into residency programs. Laparoscopic cholecystectomy and other surgical endoscopic procedures have been an integral part of

Karl A. Zucker; Robert W. Bailey; Scott M. Graham; William Scovil; Anthony L. Imbembo

1993-01-01

142

Antifogging effects of a socket-type device with the superhydrophilic, titanium dioxide–coated glass for the laparoscope  

Microsoft Academic Search

Background  Lens fogging during laparoscopic surgery extensively deteriorates operative field visibility and may provoke serious complications.\\u000a \\u000a \\u000a \\u000a Methods  A simulation model study was conducted using a conventional laparoscope, a conventional laparoscope plus heating (100C, 10\\u000a s), a conventional laparoscope plus surfactant, and a conventional laparoscope plus both a titanium dioxide (TiO2)-coated glass (with ?15 h of preoperative ultraviolet irradiation) and a water supply.

T. Ohdaira; H. Nagai; S. Kayano; H. Kazuhito

2007-01-01

143

Laparoscopic Repair for Perforated Peptic Ulcer  

PubMed Central

Objective To compare the results of open versus laparoscopic repair for perforated peptic ulcers. Summary Background Data Omental patch repair with peritoneal lavage is the mainstay of treatment for perforated peptic ulcers in many institutions. Laparoscopic repair has been used to treat perforated peptic ulcers since 1990, but few randomized studies have been carried out to compare open versus laparoscopic procedures. Methods From January 1994 to June 1997, 130 patients with a clinical diagnosis of perforated peptic ulcer were randomly assigned to undergo either open or laparoscopic omental patch repair. Patients were excluded for a history of upper abdominal surgery, concomitant evidence of bleeding from the ulcer, or gastric outlet obstruction. Patients with clinically sealed-off perforations without signs of peritonitis or sepsis were treated without surgery. Laparoscopic repair would be converted to an open procedure for technical difficulties, nonjuxtapyloric gastric ulcers, or perforations larger than 10 mm. A Gast- rografin meal was performed 48 to 72 hours after surgery to document sealing of the perforation. The primary end-point was perioperative parenteral analgesic requirement. Secondary endpoints were operative time, postoperative pain score, length of postoperative hospital stay, complications and deaths, and the date of return to normal daily activities. Results Nine patients with a surgical diagnosis other than perforated peptic ulcer were excluded; 121 patients entered the final analysis. There were 98 male and 23 female patients recruited, ages 16 to 89 years. The two groups were comparable in age, sex, site and size of perforations, and American Society of Anesthesiology classification. There were nine conversions in the laparoscopic group. After surgery, patients in the laparoscopic group required significantly less parenteral analgesics than those who underwent open repair, and the visual analog pain scores in days 1 and 3 after surgery were significantly lower in the laparoscopic group as well. Laparoscopic repair required significantly less time to complete than open repair. The median postoperative stay was 6 days in the laparoscopic group versus 7 days in the open group. There were fewer chest infections in the laparoscopic group. There were two intraabdominal collections in the laparoscopic group. One patient in the laparoscopic group and three patients in the open group died after surgery. Conclusions Laparoscopic repair of perforated peptic ulcer is a safe and reliable procedure. It was associated with a shorter operating time, less postoperative pain, reduced chest complications, a shorter postoperative hospital stay, and earlier return to normal daily activities than the conventional open repair.

Siu, Wing T.; Leong, Heng T.; Law, Bonita K. B.; Chau, Chun H.; Li, Anthony C. N.; Fung, Kai H.; Tai, Yuk P.; Li, Michael K. W.

2002-01-01

144

[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

145

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

146

Subtotal hysterectomy in modern gynecology: A decision analysis  

Microsoft Academic Search

OBJECTIVE: Our purpose was to compare the risks and benefits of subtotal (supracervical) hysterectomy with those of total hysterectomy in women at low risk for cervical cancer.STUDY DESIGN: A decision analysis was performed. Baseline probabilities for operative and postoperative morbidity, mortality, and long-term quality of life were established for subtotal and total hysterectomy.RESULTS: Operative complication rates and ranges for total

James R. Scott; Howard T. Sharp; Mark K. Dodson; Peggy A. Norton; Homer R. Warner

1997-01-01

147

Pragmatic Narratives of Hysterectomy Among Australian Women  

Microsoft Academic Search

Drawing on a qualitative study based on in-depth interviews with 30 rural and urban Australian women, we analyze their experiences\\u000a of a hysterectomy for conditions other than cancer. Women were recruited via advertisements in community newspapers and the\\u000a network sampling technique. The study aimed to identify the personal, social and medical factors that influenced their decision\\u000a to undergo surgery and

Milica Markovic; Lenore Manderson; Narelle Warren

2008-01-01

148

Acute Cholecystitis: Video-Laparoscopic Versus Traditional Treatment  

PubMed Central

It has been shown that a video-laparoscopic approach is the preferred method for treatment of cholecystitis. However, when we consider acute cholecystitis, many questions must be answered. The aim of this study is to compare video-laparoscopic and conventional surgery in the management of acute cholecystitis.

Azaro Filho, Euler M.; Galvao-Neto, Manoel P.; Fortes, Marcos F.; Souza, Elias L.Q.; Alcantara, Rogerio S.M; Ettinger, Joao E.M.T.M.; Regis, Adrian B.; Sousa, Manoela M.; do Carmo, Vinicio M.; Santana, Pedro A.; Fahel, Edvaldo

2001-01-01

149

The Role of Tactile Feedback in Laparoscopic Surgery  

Microsoft Academic Search

Abstract Two experiments aiming at comparing palpation with gloved fingers, conventional laparoscopic instruments and a laparoscopic instrument with a sensor array attached to its end effector are described. The sensor array provides the surgeon with visually presented tactile information. 15 subjects were asked to discriminate hardness and size of objects (rubber balls hidden in pig's intestine) with the 3 palpation

MV Ottermo; M Øvstedal; Ø Stavdahl; Y Yavuz; TA Johansen; R Mårvik; Cybernetics Odd; Bragstads Plass

2006-01-01

150

Elective abdominal hysterectomy in Nigerian Jehovah's Witnesses.  

PubMed

In a retrospective study at a university hospital, the perioperative morbidity associated with elective total abdominal hysterectomy in 23 Jehovah's Witnesses was compared with that of 46 non-Witness controls. The mean operative blood loss was significantly less, the procedure was lengthier and the average postoperative hospital stay was longer in the study than in the control group. Febrile morbidity was insignificantly more frequent among the study group (OR: 2.05, CI: 0.61-6.88) and there was no significant difference between the overall morbidity experienced by patients in both groups (study: 43.5% versus control: 39.1%; P = 0.73). The perioperative morbidity associated with elective abdominal hysterectomy in patients unwilling to accept blood transfusion does not justify the denial of this important gynaecological surgery when indicated. Gynaecologists in poor resource settings should consciously aim at providing 'bloodless' care for all their patients undergoing abdominal hysterectomy as this may translate to reduced blood loss and decreased need for blood transfusion. PMID:16147614

Oladapo, O T

2004-09-01

151

[Comparison of laparoscopic and open splenectomy].  

PubMed

Introduction: Conventional operative techniques are gradually being replaced by minimally invasive surgical methods in the surgery of the spleen. We summarized our 10-year-experience after the introduction of laparoscopic splenectomy at the University of Szeged, Department of Surgery, comparing open and minimally invasive techniques. Material and method: Between 1st January 2002 and 1st December 2011 we performed 141 splenectomies of which 17 were acute operations. Of the 124 elective procedures 54 were laparoscopic and 70 open operations. In 40 cases (open procedures) splenectomy was part of multivisceral surgery which were excluded from the analysis. In this retrospective analysis a comparison of laparoscopic and open elective technique was carried out. Results: Average operating time of laparoscopic procedures was slightly longer than that of open technique (133 vs. 122 minutes, p = 0.074). After the learning period, duration of laparoscopic procedures became shorter (first five years: 147 min., second five years: 118 min, p = 0.003), larger spleens were removed (220 vs. 450 grams, p = 0.063) and conversion rate became lower. In cases of laparoscopic procedures fewer reoperations needed to be performed (1.5% vs. 6%, p = 0.718), bowel motility recovered earlier (2 vs. 3 days, p = 0.002) and hospital stay was shorter (5 vs. 8 days, p ? 0.001). Conclusion: Our study proves that laparoscopic splenectomy is a safe method with many advantages. Our results correlate with data of international publications. PMID:23428723

Nyilas, Aron; Paszt, Attila; Simonka, Zsolt; Abrahám, Szabolcs; Pál, Tamás; Lázár, György

2013-02-01

152

Breast cancer risk and hysterectomy status: the Multiethnic Cohort Study  

PubMed Central

Objective The main objective was to examine the association between simple hysterectomy (without bilateral oophorectomy) and breast cancer risk. Because hysterectomy prevalence varies by ethnicity, the secondary objective was to examine whether inclusion of women with hysterectomies affects the estimates of breast cancer risk by ethnicity. Methods The Multiethnic Cohort Study was assembled in 1993-6 and included 68,065 women from Hawaii and Los Angeles aged 45-75 years without missing information or bilateral oophorectomy. Hysterectomy status was self-reported. After 7.7 years median follow-up, 1,862 cases of invasive breast cancer were identified. Proportional hazards models were used to estimate relative risks (RR) while controlling for known risk factors. Results Prevalence of simple hysterectomy varied from 12 to 29% among the ethnic groups (White, African American, Native Hawaiian, Japanese American, and Latina). Overall, hysterectomy was not associated with breast cancer risk (RR=0.98). Although the RRs were nonsignificantly elevated by 15% in White women and nonsignificantly reduced by 15% in Latinas of non-US origin, the variation by ethnicity was not significant (pinteraction=0.48). The breast cancer risk associated with ethnicity was very similar when estimated with and without women with hysterectomies. Conclusions This study suggests that simple hysterectomy status does not alter breast cancer risk. Therefore, inclusion of women with simple hysterectomies does not substantially change estimated risk of breast cancer by ethnicity.

Woolcott, Christy G.; Maskarinec, Gertraud; Pike, Malcolm C.; Henderson, Brian E.; Wilkens, Lynne R.; Kolonel, Laurence N.

2009-01-01

153

Laparoscopic Appendectomy: Why It Should Be Done  

PubMed Central

Objective: Notwithstanding its widely perceived advantages, laparoscopic appendectomy has not yet met with universal acceptance. The aim of the present work is to illustrate retrospectively the results of a case-control experience with laparoscopic versus open appendectomy carried out at our institution. Methods: Between January 1993 and November 2000, 555 patients (M:F = 210:345; mean age 25.2±15 years) underwent emergency or urgent appendectomy, or both. Of them, 322 (52%) were operated on laparoscopically, and 233 (48%) were treated via conventional surgery, according to the presence of a well-trained surgical team. Results: The laparoscopic group conversion rate was 3.1% (10/322) and was mainly due to the presence of dense intraabdominal adhesions. Major intraoperative complications ranged as high as 0.3% (1/322) and 0%, respectively, in the laparoscopic and conventional groups (P=ns). Major postoperative complications were 1.6% (5/312) vs 0.8% (2/243), respectively (P=ns). Postoperative mortality was 0.3% (1/312) and 0.4% (1/243) in the laparoscopic and conventional subsets of patients. Reinterventions were 0.9% (3/322) in the laparoscopic patients versus nil in the open group (P=ns). Minor postoperative complications were observed in 0.6% (2/312) and 6.5% (16/243) of patients, respectively, in the laparoscopy and open surgery groups, and consisted mainly of wound infections (P=0.001). Flatus passage and hospitalization were significantly more rapid among the laparoscopic patients. The greater diagnostic accuracy of laparoscopy allowed the diagnosis of concurrent diseases in 12% (30/254) versus 1.5% (3/199) of patients with histology proven appendicitis treated via laparoscopy versus laparotomy (P<0.01). Similarly, among those patients without gross or microscopic evidence of appendicitis, or both gross and microscopic evidence, concurrent diseases were detected in 57.3% (39/68) of laparoscopic patients versus 8.8% (3/34) in the conventional ones (P<0.01). Conclusion: Even if limited by its retrospective nature, the present experience shows that laparoscopic appendectomy is as safe and effective as conventional surgery, has a higher diagnostic yield, causes less trauma, and offers a more rapid postoperative recovery. Such features make laparoscopy a challenging alternative to laparotomy in premenopausal women referred for urgent abdominal or pelvic surgery, or both.

De Simone, Paolo; Michelet, Ivan; Bedin, Natalino

2003-01-01

154

Nintendo Wii video-gaming ability predicts laparoscopic skill  

Microsoft Academic Search

Background  Studies using conventional consoles have suggested a possible link between video-gaming and laparoscopic skill. The authors\\u000a hypothesized that the Nintendo Wii, with its motion-sensing interface, would provide a better model for laparoscopic tasks.\\u000a This study investigated the relationship between Nintendo Wii skill, prior gaming experience, and laparoscopic skill.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In this study, 20 participants who had minimal experience with either laparoscopic

Shiraz Badurdeen; Omar Abdul-Samad; Giles Story; Clare Wilson; Sue Down; Adrian Harris

2010-01-01

155

Class III Nerve-sparing Radical Hysterectomy Versus Standard Class III Radical Hysterectomy: An Observational Study  

Microsoft Academic Search

Background  The purpose of this observational study was to evaluate disease-free survival, overall survival, local recurrence rate, and\\u000a morbidities in patients submitted to class III nerve-sparing radical hysterectomy (NSRH) compared with standard radical hysterectomy\\u000a (RH) in cervical cancer (CC). This was a comparative study in the context of multimodal therapies.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  We investigated patients with CC admitted to the National

Antonino Ditto; Fabio Martinelli; Flavia Mattana; Claudio Reato; Eugenio Solima; Marialuisa Carcangiu; Edward Haeusler; Luigi Mariani; Francesco Raspagliesi

156

Sexual Outcomes and Satisfaction with Hysterectomy: Influence of Patient Education  

PubMed Central

Introduction Many women experience improved sexual function after hysterectomy. However, a sizeable minority of women report worsened sexual function after the surgery, and concerns about the effect of surgery on sexual function are common among women planning to undergo hysterectomy. Aim The present study examined the role of education about the potential sexual consequences of hysterectomy in predicting self-reported outcomes and satisfaction with the procedure. Methods We conducted a cross-sectional survey of 204 women who had undergone simple hysterectomy in the preceding 3–12 months. Participants volunteered in response to a Web-based advertisement. Main Outcome Measures Participants indicated their current sexual function using the Female Sexual Function Index (FSFI), and reported positive and negative sexual outcomes experienced after hysterectomy using a checklist. Participants also completed questionnaire items regarding satisfaction with hysterectomy and education from their physicians about sexual risks and benefits prior to surgery. Results Current sexual function scores were related to self-reports of positive and negative sexual outcomes following hysterectomy and overall satisfaction with hysterectomy. Education from a physician about possible adverse sexual outcomes was largely unrelated to self-reports of having experienced those outcomes. However, education about possible negative sexual outcomes predicted overall satisfaction with hysterectomy when controlling for self-reports of positive and negative sexual outcomes. Conclusion Education about potential negative sexual outcomes after surgery may enhance satisfaction with hysterectomy, independent of whether negative sexual outcomes were experienced. Including a discussion of potential sexual changes after surgery may enhance the benefits of presurgical counseling prior to hysterectomy.

Bradford, Andrea; Meston, Cindy

2010-01-01

157

Recent results of laparoscopic surgery in inflammatory bowel disease  

PubMed Central

Inflammatory bowel diseases are an ideal indication for the laparoscopic surgical approach as they are basically benign diseases not requiring lymphadenectomy and extended mesenteric excision; well-established surgical procedures are available for the conventional approach. Inflammatory alterations and fragility of the bowel and mesentery, however, may demand a high level of laparoscopic experience. A broad spectrum of operations from the rather easy enterostomy formation for anal Crohn’s disease (CD) to restorative proctocolectomies for ulcerative colitis (UC) may be managed laparoscopically. The current evidence base for the use of laparoscopic techniques in the surgical therapy of inflammatory bowel diseases is presented. CD limited to the terminal ileum has become a common indication for laparoscopic surgical therapy. In severe anal CD, laparoscopic stoma formation is a standard procedure with low morbidity and short operative time. Studies comparing conventional and laparoscopic bowel resections, have found shorter times to first postoperative bowel movements and shorter hospital stays as well as lower complication rates in favour of the laparoscopic approach. Even complicated cases with previous surgery, abscess formation and enteric fistulas may be operated on laparoscopically with a low morbidity. In UC, restorative proctocolectomy is the standard procedure in elective surgery. The demanding laparoscopic approach is increasingly used, however, mainly in major centers; its feasibility has been proven in various studies. An increased body mass index and acute inflammation of the bowel may be relative contraindications. Short and long-term outcomes like quality of life seem to be equivalent for open and laparoscopic surgery. Multiple studies have proven that the laparoscopic approach to CD and UC is a safe and successful alternative for selected patients. The appropriate selection criteria are still under investigation. Technical considerations are playing an important role for the complexity of both diseases.

Kessler, Hermann; Mudter, Jonas; Hohenberger, Werner

2011-01-01

158

Robotic single-port transumbilical total hysterectomy: a pilot study  

PubMed Central

Objective To evaluate the feasibility of robotic single-port transumbilical total hysterectomy using a home-made surgical glove port system. Methods We retrospectively reviewed the medical records of patients who underwent robotic single-port transumbilical total hysterectomy between January 2010 and July 2010. All surgical procedures were performed through a single 3-4-cm umbilical incision, with a multi-channel system consisting of a wound retractor, a surgical glove, and two 10/12-mm and two 8 mm trocars. Results Seven patients were treated with robotic single-port transumbilical total hysterectomy. Procedures included total hysterectomy due to benign gynecological disease (n=5), extra-fascial hysterectomy due to carcinoma in situ of the cervix (n=1), and radical hysterectomy due to cervical cancer IB1 (n=1). The median total operative time was 109 minutes (range, 105 to 311 minutes), the median blood loss was 100 mL (range, 10 to 750 mL), and the median weight of the resected uteri was 200 g (range, 40 to 310 g). One benign case was converted to 3-port robotic surgery due to severe pelvic adhesions, and no post-operative complications occurred. Conclusion Robotic single-port transumbilical total hysterectomy is technically feasible in selected patients with gynecological disease. Robotics may enhance surgical skills during single-port transumbilical hysterectomy, especially in patients with gynecologic cancers.

Nam, Eun Ji; Kim, Sang Wun; Lee, Maria; Yim, Ga Won; Paek, Ji Heum; Lee, San Hui; Kim, Sunghoon; Kim, Jae Hoon; Kim, Jae Wook

2011-01-01

159

Cholecystogastric fistula: laparoscopic repair.  

PubMed

We describe a patient with a cholecystogastric fistula treated by the laparoscopic approach. The use of intracorporeal suturing allows laparoscopic management of cholecystogastric fistulae without the need for an endoscopic transecting stapler. PMID:11525375

Prasad, A; Kapur, R

2001-08-01

160

Surgeon volume and outcomes in benign hysterectomy.  

PubMed

Annual surgeon case volume has been linked to patient outcome in a variety of surgical fields, although limited data focus on gynecologic surgery performed by general gynecologists. Herein we review the literature addressing the associations between intraoperative injury, postoperative morbidity, and resource use among surgeons performing a low vs high volume of hysterectomies. Although study design and populations differ, individual and composite morbidity outcomes consistently favored high-volume surgeons. Given the growing emphasis on competency-based evaluation in surgery, gynecology departments may soon consider volume requirements a component of privileging. PMID:23622760

Doll, Kemi M; Milad, Magdy P; Gossett, Dana R

2013-04-23

161

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

PubMed Central

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

Hall, R E; Cohen, M M

1994-01-01

162

Randomized Clinical Trial of Laparoscopic Versus Open Repair of the Perforated Peptic Ulcer: The LAMA Trial  

Microsoft Academic Search

Background  Laparoscopic surgery has become popular during the last decade, mainly because it is associated with fewer postoperative complications\\u000a than the conventional open approach. It remains unclear, however, if this benefit is observed after laparoscopic correction\\u000a of perforated peptic ulcer (PPU). The goal of the present study was to evaluate whether laparoscopic closure of a PPU is as\\u000a safe as conventional

Mariëtta J. O. E. Bertleff; Jens A. Halm; Willem A. Bemelman; Arie C. van der Ham; Erwin van der Harst; Hok I. Oei; J. F. Smulders; E. W. Steyerberg; Johan F. Lange

2009-01-01

163

Challenges of Laparoscopic Surgery  

NSDL National Science Digital Library

Students teams use a laparoscopic surgical trainer to perform simple laparoscopic surgery tasks (dissections, sutures) using laparoscopic tools. Just like in the operating room, where the purpose is to perform surgery carefully and quickly to minimize patient trauma, students' surgery time and mistakes are observed and recorded to quantify their performances. They learn about the engineering component of surgery.

Integrated Teaching And Learning Program

164

Psychological meaning of a woman with a hysterectomy among Mexican physicians and women  

Microsoft Academic Search

The psychological meaning of women who have had a hysterectomy, and attitudes toward them, were explored in 121 Mexican gynecologists, 155 women who had undergone a hysterectomy, and 115 women who had not had a hysterectomy. The surveys were completed between January and May, 2011. Both groups of women defined a woman who had had a hysterectomy using words with

Maria Luisa Marván; Rosa Lilia Catillo-López; Yamilet Ehrenzweig; Pedro Palacios

2012-01-01

165

Sexual Functioning Following Elective Hysterectomy: The Role of Surgical and Psychosocial Variables  

Microsoft Academic Search

In this article, two studies were conducted to investigate the surgical and psychosocial correlates of women's post-hysterectomy sexual functioning. In Study 1, sexual functioning was measured in an online convenience sample of 65 women who had undergone elective hysterectomy. Results suggested that most women experienced improved sexual functioning after their hysterectomy. Women who underwent hysterectomy to treat endometriosis reported less

Zoë D. Peterson; Jeffrey M. Rothenberg; Susan Bilbrey; Julia R. Heiman

2010-01-01

166

Cholelithoptysis: An unusual complication of laparoscopic cholecystectomy  

Microsoft Academic Search

Laparoscopic cholecystectomy is emerging as a preferred surgical method in the treatment of cholecystitis. Decreased morbidity and mortality rates make this an attractive altenative to conventional cholecystectomy. Recently, specific complications including bile duct transection, biloma formation, and liver lacerations have been reported. We report here, however, an unusual case of intraoperative spillage of stones into the introperitoneal cavity. Subsequent erosion

Jill Thompson; Etta Pisano; David Warshauer

1995-01-01

167

A Prospective Study of Weight Gain after Premenopausal Hysterectomy  

PubMed Central

Abstract Purpose Many women who have had hysterectomies have the perception that they gained weight after surgery that cannot be attributed to changes in diet or physical activity. The purpose of this analysis was to assess weight gain in premenopausal women in the first year after hysterectomy compared with a control group of women with intact uteri and ovaries. Methods As part of a prospective cohort study designed to assess the risk for ovarian failure after premenopausal hysterectomy, weight was measured at baseline and 1-year follow-up in 236 women undergoing hysterectomy and 392 control women. Changes in measured weight and reported weight were assessed. Unconditional logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for weight gains of >10 pounds. Results Women with hysterectomies weighed more and had a higher mean body mass index (BMI) than control women at baseline. Mean weight gain was 1.36?kg (?3 pounds) for women with hysterectomies vs. 0.61?kg (?1.3 pounds) for control women (p?=?0.07). Weight gain of >10 pounds occurred in 23% of women with hysterectomies compared with 15% of control women (multivariable OR?=?1.61, 95% CI 1.04?=?2.48). Conclusions Women undergoing hysterectomies appear to be at higher risk for weight gain in the first year after surgery. Heavier women and women who have had weight fluctuations throughout adulthood may be at greater risk for postsurgical weight gain, suggesting that lifestyle interventions to maintain or lose weight may be particularly helpful for these women in the months following hysterectomy.

Schildkraut, Joellen M.; Iversen, Edwin S.; Myers, Evan R.; Gradison, Margaret; Warren-White, Nicolette; Wang, Frances

2009-01-01

168

Combined preoperative angiography with transient uterine artery embolization makes laparoscopic surgery for massive myomatous uteri a reasonable option: case reports.  

PubMed

Herein are reported perioperative outcomes in 2 women who underwent laparoscopic myomectomy and hysterectomy to treat massive leiomyomas. Although we counseled the patients about the high risk of conversion to laparotomy, we would not have attempted the laparoscopic approach without a preoperative angiogram and transient uterine artery embolization. Preoperative angiography and selective embolization enable identification of an aberrant parasitic blood supply and minimization of intraoperative bleeding. In the appropriate hands, these tools make a minimally invasive surgical approach possible even for the largest myomatous specimens. PMID:22546425

Hawa, Nadim; Robinson, James; Chahine, Britton Elizabeth

169

Laparoscopic Doppler Technology in Laparoscopic Renal Surgery  

PubMed Central

Background and Objectives: Laparoscopic Doppler technology has previously been reported to help identify vasculature during laparoscopy. Recently, we published our initial experience with this technology during laparoscopic radical nephrectomy, laparoscopic nephroureterectomy, laparoscopic partial nephrectomy, and robotic-assisted laparoscopic pyeloplasty. We now present a prospective, pilot evaluation of the Doppler probe for these procedures. Methods: A laparoscopic Doppler probe was used in the above laparoscopic renal surgeries in 50 patients. Anatomic findings, Doppler survey time, dissection time, operative time, estimated blood loss, changes in management, subjective time saved/utility, technical difficulties, clinical complications, and ease of use were prospectively recorded. Results: Mean Doppler survey time was 1.77 minutes. Mean hilar dissection time was 9.25 minutes. Eight accessory vessels were not seen on preoperative imaging in 7 patients (17%). In 3 cases of RALP, Doppler rectified preoperative imaging in detecting a crossing vessel. The probe altered management in 16% of patients, subjectively saved time in 78% of patients, and had 100% concordance with dissection. There were no complications but 2 technical failures. Conclusion: The probe is quick, safe, easy to use, and has perfect concordance with surgical dissection. Randomized comparison with and without Doppler assistance is necessary to confirm the utility of this technology.

Perlmutter, Mark A.; Hyams, Elias S.

2009-01-01

170

Transanal polypectomy using single incision laparoscopic instruments.  

PubMed

Transanal excision of rectal polyps with laparoscopic instrumentation and a single incision laparoscopic port is a novel technique that uses technology originally developed for abdominal procedures from the natural orifice of the rectum. Transanal endoscopic microsurgery (TEM) is a well established surgical approach for certain benign or early malignant lesions of the rectum, under specific indications. Our technique is a hybrid technique of transanal surgery, a reasonable method for polyp resection without the need of the sophisticated and expensive instrumentation of TEM which can be applied whenever endoscopic or conventional transanal surgical removal is not feasible. PMID:21528096

Dardamanis, Dimitrios; Theodorou, Dimitrios; Theodoropoulos, George; Larentzakis, Andreas; Natoudi, Maria; Doulami, Georgia; Zoumpouli, Christina; Markogiannakis, Haridimos; Katsaragakis, Stylianos; Zografos, George C

2011-04-27

171

Robot-assisted laparoscopic pancreatic surgery  

Microsoft Academic Search

Background  In the field of gastroenterological surgery, laparoscopic surgery has advanced remarkably, and now accounts for most gastrointestinal\\u000a operations. This paper outlines the current status of and future perspectives on robot-assisted laparoscopic pancreatectomy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A review of the literature and authors’ experience was undertaken.\\u000a \\u000a \\u000a \\u000a Results  The da Vinci Surgical System is a robot for assisting laparoscopy and is safer than conventional endoscopes, thanks

Akihiko Horiguchi; Ichiro Uyama; Masahiro Ito; Shin Ishihara; Yukio Asano; Toshiyuki Yamamoto; Yoshinori Ishida; Shuichi Miyakawa

2011-01-01

172

Laparoscopic Approaches to Colonic Malignancy  

Microsoft Academic Search

\\u000a The last two decades have witnessed the surge and success of laparoscopic approaches in several surgical arenas. Laparoscopic\\u000a cholecystectomy, laparoscopic solid organ surgery, and laparoscopic gastric bypass have become the standard of care. Adoption\\u000a of laparoscopic colectomy has remained low until the middle of this decade and is approaching 10% for benign disease [1].\\u000a \\u000a \\u000a Concerns over the appropriateness of laparoscopic

Juliane Bingener; Heidi Nelson

173

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

174

42 CFR 50.207 - Sterilization by hysterectomy.  

Code of Federal Regulations, 2010 CFR

...HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted Family Planning Projects § 50.207 Sterilization by hysterectomy. (a) Programs or projects to which this subpart...

2010-10-01

175

A novel method for training residents in robotic hysterectomy  

Microsoft Academic Search

Standard surgeon training for robotic hysterectomy currently includes the use of a porcine lab to gain experience using the\\u000a daVinci Surgical System. Residents in obstetrics\\/gynecology are taught using a novel dry lab which mimics the tasks specific\\u000a to a robotic hysterectomy. This technique may ultimately aid in the credentialing of gynecologic surgeons, obviating the need\\u000a for the porcine lab. A

Michael A. FinanMichael; Michael E. Clark; Rodney P. Rocconi

2010-01-01

176

Robotic radical hysterectomy: comparison of outcomes and cost  

Microsoft Academic Search

Operative and peri-operative outcomes, complications, and cost for radical hysterectomy for cervical cancer with negative\\u000a sentinel nodes have been compared for robotics and laparotomy. Forty patients underwent radical hysterectomy with\\/out bilateral\\u000a salpingo-oophorectomy, for early-stage cervical cancer. All cases were performed by one of two surgeons, at a single institution\\u000a (16 robotic, 24 laparotomy). The data for the robotic group were

Darron Halliday; Susie Lau; Zvi Vaknin; Claire Deland; Mark Levental; Elizabeth McNamara; Raphael Gotlieb; Rebecca Kaufer; Jeffrey How; Eva Cohen; Walter H. Gotlieb

2010-01-01

177

Successful Embolization of an Ovarian Artery Pseudoaneurysm Complicating Obstetric Hysterectomy  

SciTech Connect

Transcatheter arterial embolization is becoming the therapy of choice for controlling obstetric hemorrhage, affording the ability to control persistent bleeding from pelvic vessels while avoiding the morbidity of surgical exploration. The clinicians are left with little choice if pelvic hemorrhage continues after hysterectomy and ligation of anterior division of both internal iliac arteries. We present one such case of intractable post-obstetric hysterectomy hemorrhage in which an ovarian artery pseudoaneurysm was diagnosed angiographically and successfully embolized, highlighting the role of transcatheter embolization.

Rathod, Krantikumar R, E-mail: krantikumarrathod@hotmail.com; Deshmukh, Hemant L; Asrani, Ashwin [Seth G.S. Medical College and K.E.M. Hospital, Department of Radiology (India); Salvi, Vinita S; Prabhu, Santoshi [Seth G.S. Medical College and K.E.M. Hospital, Department of Obstetrics and Gynaecology (India)

2005-01-15

178

Laparoscopic proctectomy: oncologic considerations.  

PubMed

The role of laparoscopic proctectomy in rectal cancer has not clearly been defined. Publications on long-term outcomes after laparoscopic proctectomy is lacking and there is a wide variation of practice patterns of rectal cancer management. Current data supports the feasibility of laparoscopic proctectomy for rectal cancer but due to surgeon, patient and tumor related factors open technique may be favored. Current series suggest that laparoscopic proctectomy can be performed with similar oncologic adequacy with regards to, circumferential resection margin, distal margin, local recurrence and quality of life. Ongoing trials will provide evidence clarifying the role of laparoscopic proctectomy in rectal cancer. Until then, high-level laparoscopic skills and meticulous preoperative evaluation of both patient and tumor can identify appropriate candidates. PMID:22678308

Asgeirsson, Theodor; Delaney, Conor P

2012-06-01

179

Factors associated with hysterectomy among women in Australia.  

PubMed

This study was to identify hysterectomy prevalence across urban, rural and remote areas of Australia and across states, to separate geographic variation from the effect of sociodemographic influences, and also to compare the quality of life of women who have and have not had hysterectomy. Data were collected from 14,072 women aged 45-50 years participating in the baseline survey of the Australian Longitudinal Study on Women's Health. The estimated prevalence of hysterectomy was 22%. Factors significantly associated with hysterectomy included living in a rural or remote area, state of residence, having private health insurance, lower levels of education, being married and having more than two children, having had other gynaecological and non-gynaecological surgical procedures, and more visits to general practitioners. Compared with women who had not had hysterectomy, women who had had hysterectomy had significantly poorer physical and mental health as measured by the SF-36 quality of life profile (adjusted mean PCS=45.7 vs 49.3, p<0.0001; adjusted mean MCS=46.9 vs 48.2, p<0.0001). PMID:11027955

Byles, J E; Mishra, G; Schofield, M

2000-12-01

180

[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

181

Laparoscopic herniorrhaphy in children  

Microsoft Academic Search

  Background: We report our clinical experience with 403 inguinal hernias in 279 children. They were treated via a purely laparoscopic\\u000a approach using 2-mm instruments, obviating the need for a groin incision. Methods: Laparoscopic herniorrhaphy was performed\\u000a in children ages 4 days to 15 years. A 5-mm laparoscope was inserted through the umbilicus, and two 2-mm needle holders were\\u000a inserted through

C. M. Gorsler; F. Schier

2003-01-01

182

Laparoscopic reconstructive urology  

PubMed Central

Objective: Laparoscopic reconstructive urology is undergoing rapid change. We review the current status of laparoscopic reconstructive urology, with particular respect to pyeloplasty and reconstructive ureteric surgery. Methods: An extensive Medline search of reconstructive laparoscopic procedures was undertaken. The initial reports and large series reports of a range of procedures was examined and summarised. The most commonly practised procedure within this remit is laparoscopic pyeloplasty. Several series of over 100 patients have been published. Success rates average over 90% for laparoscopic pyeloplasty with a low complication rate. Much less common laparoscopic reconstructive urological procedures include ureteric re-implantation, Boari flap, urinary diversion and transuretero-ureterostomy. The results of these are encouraging. Conclusions: Laparoscopic pyeloplasty may be safely performed by either the transperitoneal or retroperitoneal routes with excellent results. It should be considered the “gold standard” for the management of UPJ obstruction, especially in those patients with significant hydronephrosis, renal impairment or a crossing vessel. Laparoscopic ureteric reimplantation, Boari flap, urinary diversion and transuretero-ureterostomy have been performed by experienced laparoscopic urologists with encouraging results.

Murphy, Declan; Challacombe, Ben; Rane, Abhay

2005-01-01

183

Laparoscopic transperitoneal pyeloplasty.  

PubMed

Laparoscopic pyeloplasty is a first-line option for the management of ureteropelvic junction obstruction. It has a greater success rate than endopyelotomy and is associated with a shorter and less intense convalescence than open surgical pyeloplasty. The technique is well established and reproducible, although the procedure is more difficult in certain situations, such as after a previous pyeloplasty. Because laparoscopic suturing is needed, it is considered an advanced laparoscopic procedure. Suturing devices can facilitate suturing, but they are not optimal for all repairs. This article and the accompanying video summarize the preoperative, intraoperative, and postoperative considerations for laparoscopic pyeloplasty. PMID:21235382

Wolf, J Stuart

2011-01-15

184

Single incision laparoscopic colorectal resection: Our experience  

PubMed Central

BACKGROUND: A prospective case series of single incision multiport laparoscopic colorectal resections for malignancy using conventional laparoscopic trocars and instruments is described. MATERIALS AND METHODS: Eleven patients (seven men and four women) with colonic or rectal pathology underwent single incision multiport laparoscopic colectomy/rectal resection from July till December 2010. Four trocars were placed in a single transumblical incision. The bowel was mobilized laparoscopically and vessels controlled intracorporeally with either intra or extracorporeal anastomosis. RESULTS: Three patients had carcinoma in the caecum, one in the hepatic flexure, two in the rectosigmoid, one in the descending colon, two in the rectum and two had ulcerative pancolitis (one with high grade dysplasia and another with carcinoma rectum). There was no conversion to standard multiport laparoscopy or open surgery. The median age was 52 years (range 24-78 years). The average operating time was 130 min (range 90-210 min). The average incision length was 3.2 cm (2.5-4.0 cm). There were no postoperative complications. The average length of stay was 4.5 days (range 3-8 days). Histopathology showed adequate proximal and distal resection margins with an average lymph node yield of 25 nodes (range 16-30 nodes). CONCLUSION: Single incision multiport laparoscopic colorectal surgery for malignancy is feasible without extra cost or specialized ports/instrumentation. It does not compromise the oncological radicality of resection. Short-term results are encouraging. Long-term results are awaited.

Palanivelu, Chinnusamy; Vij, Anirudh; Rajapandian, Subbiya; Palanivelu, Praveenraj; Parthasarathi, Ramakrishnan; Vaithiswaran, Velyoudam; Palanisamy, Senthilnathan

2012-01-01

185

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

PubMed Central

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

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

2013-01-01

186

Laparoscopic treatment of recurrent inguinal hernia in children  

Microsoft Academic Search

The authors report their experience with the laparoscopic treatment of recurrent inguinal hernia in children. Between April\\u000a 1993 and January 1998, 225 boys aged 8 months to 14 years (mean 4.4 years) were treated laparoscopically for a hydrocele,\\u000a spermatic-cord cyst, or hernia. Ten boys had recurrent inguinal hernias after conventional surgery, in one case bilateral.\\u000a The technique requires 3 trocars:

Ciro Esposito; Philippe Montupet

1998-01-01

187

Peritoneal transforming growth factor beta-1 expression during prolonged laparoscopic procedures  

Microsoft Academic Search

BACKGROUND: Laparoscopic surgery may affect peritoneal physiology. Short-term laparoscopic surgery does not affect peritoneal transforming growth factor beta (TGF-b1) expression. The current study was conducted to evaluate the hypothesis that prolonged laparoscopic surgery may affect peritoneal TGF-b1 expression. STUDY DESIGN: In the first study, 24 patients scheduled for a right colonic resection were enrolled in the trial. Twelve underwent conventional

Mare M. A. Lensvelt; Walter J. A. Brokelman; Marie-Louise Ivarsson; Peter Falk; Michel M. P. J. Reijnen

2010-01-01

188

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.

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

2013-01-01

189

Laparoscopic total abdominal colectomy  

Microsoft Academic Search

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

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

1992-01-01

190

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.

2012-02-01

191

Introduction of laparoscopic sacral colpopexy to a fellowship training program.  

PubMed

INTRODUCTION AND HYPOTHESIS: Minimally invasive sacral colpopexy has increased over the past decade, with many senior physicians adopting this new skill set. However, skill acquisition at an academic institution in the presence of postgraduate learners is not well described. This manuscript outlines the introduction of laparoscopic sacral colpopexy to an academic urogynecology service that was not performing minimally invasive sacral colpopexies, and it also defines a surgical learning curve. METHODS: The first 180 laparoscopic sacral colpopexies done by four attending urogynecologists from January 2009 to December 2011 were retrospectively analyzed. The primary outcome was operative time. Secondary outcomes included conversion to laparotomy, estimated blood loss, and intra- and postoperative complications. Linear regression was used to analyze trends in operative times. Fisher's exact test compared surgical complications and counts of categorical variables. RESULTS: Mean total operative time was 250?±?52 min (range 146-452) with hysterectomy and 222?±?45 (range 146-353) for sacral colpopexy alone. When compared with the first ten cases performed by each surgeon, operative times in subsequent groups decreased significantly, with a 6-16.3 % reduction in overall times. There was no significant difference in the rate of overall complications regardless of the number of prior procedures performed (p?=?0.262). CONCLUSIONS: Introduction of laparoscopic sacral colpopexy in a training program is safe and efficient. Reduction in operative time is similar to published learning curves in teaching and nonteaching settings. Introducing this technique does not add additional surgical risk as these skills are acquired. PMID:23549650

Kantartzis, Kelly; Sutkin, Gary; Winger, Dan; Wang, Li; Shepherd, Jonathan

2013-04-01

192

Laparoscopic entry and exit.  

PubMed

Minimal access surgery has emerged as an acceptable means of performing therapeutic and diagnostic surgical procedures. Although the gynecologist has utilized the laparoscope for several decades, only recently has laparoscopic surgery gained increased acceptance in the general surgical and urologic community. The number of laparoscopic procedures being performed routinely is now extensive and growing rapidly. It appears that the critical step in performing laparoscopic surgery is the establishment of pneumoperitoneum and the placement of the trocars. This initial part of the procedure when performed properly ensures safe and reliable access allowing the procedure to commence. Difficulties with this part of the procedure may preclude the operative procedure and more importantly may result in potentially severe injuries. Therefore a detailed discussion of the method of performing laparoscopic entry and exit will provide the urologist with the essentials to perform safe and successful laparoscopy. PMID:8239733

Oshinsky, G S; Badlani, G H; Smith, A D

1993-09-01

193

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

2013-05-17

194

Cross-sectionally derived hysterectomy prevalence for correcting uterine and ovarian cancer incidence rates and probabilities  

Microsoft Academic Search

PURPOSE: This paper presents a cross-sectional method for deriving age-specific hysterectomy prevalence. The influence of hysterectomy prevalence on uterine and ovarian cancer incidence rates and probabilities is illustrated.METHODS: Hysterectomy prevalence estimates are derived from cross-sectional data using a life table method. Analysis is based on hysterectomy data from the Utah Hospital Discharge Data Base and cancer cases recorded by the

RM Merrill; JL Lyon; C Wiggins

2000-01-01

195

A continuous series of 96 laparoscopic inguinal hernia repairs in children by a new technique  

Microsoft Academic Search

Background: The aim of this study was evaluate a novel technique of laparoscopic hernia repair in children. Methods: Eighty two consecutive patients aged ‡2 years old were operated on for hernia repair using a laparoscopic technique that reproduced every step of the conventional open procedure. Technical details and clinical results are reported. Results: Ninety six sacs were divided in 82

F. Becmeur; P. Philippe; A. Lemandat-Schultz; R. Moog; S. Grandadam; A. Lieber; D. Toledano

2004-01-01

196

Laparoscopic inguinal herniorrhaphy in children: A three-center experience with 933 repairs  

Microsoft Academic Search

Background\\/Purpose: Laparoscopic inguinal herniorrhaphy has been introduced recently as an alternative to conventional open repair in children. This study was undertaken to evaluate the safety, efficacy, and reproducibility of this minimally invasive approach. Methods: A total of 933 laparoscopic inguinal herniorrhaphies were performed on 666 children (597 boys and 69 girls), ranging in age from 3 weeks to 14 years

Felix Schier; Philippe Montupet; Ciro Esposito

2002-01-01

197

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

198

ORIGINAL RESEARCH—WOMEN'S SEXUAL HEALTH Sexual Outcomes and Satisfaction with Hysterectomy: Influence of Patient Education  

Microsoft Academic Search

Introduction. Many women experience improved sexual function after hysterectomy. However, a sizeable minority of women report worsened sexual function after the surgery, and concerns about the effect of surgery on sexual function are common among women planning to undergo hysterectomy. Aim. The present study examined the role of education about the potential sexual consequences of hysterectomy in predicting self-reported outcomes

Andrea Bradford; Cindy Meston

199

Ten years experience of caesarean and postpartum hysterectomy in a teaching hospital in Hong Kong  

Microsoft Academic Search

Objective: To review 10 years' experience of obstetric hysterectomy in a university teaching hospital. Study Design: A retrospective study of all cases of caesarean or postpartum hysterectomy between 1984–1994. Demographic data and clinical details including indications for operation, nature of surgical management and complications were analysed. Results: The incidence of obstetric hysterectomy was 1 in 1420 deliveries. Overall, 0.32% of

W. C. Lau; Hedy Y. M. Fung; Michael S. Rogers

1997-01-01

200

Vaginal route: a gynaecological route for much more than hysterectomy.  

PubMed

Vaginal hysterectomy is the method of choice for gynaecologists who carry out hysterectomies. Undertaking this procedure regularly will enhance the gynaecologist's level of skill and enable conditions such as ovarian cysts, broad ligament fibroids and other adnexal pathology to be dealt with vaginally during hysterectomy surgery without abdominal invasion. It is also important as the vaginal route allows access to the posterior cul-de-sac, which can facilitate surgery or offer an alternative route to achieving the desired outcome. In this chapter, we look at the main indications for vaginal surgery, and also at other conditions in which vaginal surgery may be suitable (e.g. benign and malignant conditions). We believe that gynaecologists who include vaginal surgery in their armamentarium are better equipped to serve their patients. PMID:21349773

Sheth, Shirish S; Paghdiwalla, Kurush P; Hajari, Anju R

2011-02-23

201

Bile duct injury during laparoscopic cholecystectomy: risk of procedure or professional negligence?  

PubMed

Laparoscopic cholecystectomy introduced in the late eighties has now become the gold standard and has taken the place of conventional cholecystectomy. Bile duct injury during cholecystectomy is an iatrogenic, but rare catastrophe associated with significant morbidity and mortality. The incidence of bile duct injuries during laparoscopic cholecystectomy is 0.1-0.42%. We have presented a patient who underwent laparoscopic cholecystectomy which got complicated with bile duct injury grade four. The complication was recognized three weeks later. A remediation of complications was performed in a reference center with full involvement of the primary surgeon. Key words: laparoscopic cholecystectomy, bile duct injury, professional negligence. PMID:23892871

Denjali?, Amir; Skiljo, Hasan; Be?uli?, Hakija; Jusi?, Aldin; Avdagi?, Nesina; Oru?, Mirza

2013-08-01

202

The role of tactile feedback in laparoscopic surgery.  

PubMed

Two experiments aiming at comparing palpation with gloved fingers, conventional laparoscopic instruments, and a laparoscopic instrument with a sensor array attached to its end effector are described. The sensor array provides the surgeon with visually presented tactile information. Fifteen subjects were asked to discriminate hardness and size of objects (rubber balls hidden in pig's intestine) with the 3 palpation methods. The experiments showed that the gloved fingers are better at differentiating hardness and size compared with conventional laparoscopic instruments and the instrument with sensor. There was no significant difference between conventional instruments and the instrument with sensor, although the results showed a higher average score with the instrument with sensor. This indicates that visual presentation may not be an ideal way of presenting tactile information. It also indicates that the presence of the array does not make the task more difficult. PMID:17277655

Ottermo, Maria V; Ovstedal, Marit; Langø, Thomas; Stavdahl, Oyvind; Yavuz, Yunus; Johansen, Tor A; Mårvik, Ronald

2006-12-01

203

Emergency peripartum hysterectomy in a tertiary Istanbul hospital  

Microsoft Academic Search

Objective  To evaluate the incidence, risk factors, indications, outcomes and complications of emergency peripartum hysterectomy performed\\u000a after cesarean and vaginal deliveries.\\u000a \\u000a \\u000a \\u000a Method(s)  We analyzed retrospectively 28 cases of emergency peripartum hysterectomy operations performed between February 2001 and February\\u000a 2007 at the Istanbul Goztepe Training and Research Hospital, which is a teaching hospital operating under the Turkish Ministry\\u000a of Health. The indications, risk

Furkan Kayabasoglu; Kadir Guzin; Serkan Aydogdu; Selen Sezginsoy; Lale Turkgeldi; Gunes Gunduz

2008-01-01

204

Laparoscopic lateral pancreaticojejunostomy  

Microsoft Academic Search

Background  Lateral pancreaticojejunostomy is considered as the standard surgery for chronic pancreatitis. Yet there are very few reports\\u000a of this procedure being done laparoscopically. We present our experience with laparoscopic lateral pancreaticojejunostomy\\u000a till date and describe our technique.\\u000a \\u000a \\u000a \\u000a Material and method  Since 1997, we have done 12 laparoscopic lateral pancreatojejunostomies. There were 9 females and 3 males and the average\\u000a age was

C. Palanivelu; R. Shetty; K. Jani; P. S. Rajan; K. Sendhilkumar; R. Parthasarthi; V. Malladi

2006-01-01

205

Laparoscopic Duhamel procedure  

Microsoft Academic Search

Background: Between February 1995 and June 1998, 30 laparoscopic Duhamel pull-through procedures were performed in our department.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: Our main aim was to prove the feasibility of the laparoscopic abdominal Duhamel procedure for different localizations of\\u000a Hirschsprung disease. We used one camera port and three working ports. The sigmoid colon and posterior rectum were mobilized\\u000a laparoscopically. A standard posterior colo-anal

P. de Lagausie; D. Berrebi; G. Geib; G. Sebag; Y. Aigrain

1999-01-01

206

Laparoscopic and minimally invasive resection of malignant colorectal disease.  

PubMed

Minimally invasive surgery for colorectal cancer is a burgeoning field of general surgery. Randomized controlled trials have assessed short-term patient-oriented and long-term oncologic outcomes for laparoscopic resection. These trials have demonstrated that the laparoscopic approach is equivalent to open surgery with a shorter hospital stay. Laparoscopic resection also may result in improved short-term patient-oriented outcomes and equivalent oncologic resections versus the open approach. Transanal excision of select rectal cancer using endoscopic microsurgery is promising and robotic-assisted laparoscopic surgery is an emerging modality. The efficacy of minimally invasive treatment for rectal cancer compared with conventional approaches will be clarified further in randomized controlled trials. PMID:18790154

Koopmann, Matthew C; Heise, Charles P

2008-10-01

207

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

2013-06-19

208

Laparoscopic transabdominal lateral adrenalectomy.  

PubMed

Laparoscopic adrenalectomy is a mainstay of operative options for adrenal tumors and allows surgeons to perform adrenalectomies with less morbidity, less post-operative pain, and shorter hospital stays. The literature has demonstrated its efficacy to be equal to open adrenalectomy in most cases. With regard to malignant primary and metastatic lesions, controversy still remains, however, consideration of a laparoscopic approach for smaller, well circumscribed and non-invasive lesions is reasonable. During any laparoscopic resection, when there is doubt about the ability to safely remove the lesion with an intact capsule, conversion to an open approach should be considered. The primary goal of a safe and complete oncologic resection cannot be compromised. For most benign lesions, laparoscopic approaches are safe and feasible and conversion to an open approach is necessary only for lesions where size limits the ability of a minimally invasive resection. PMID:22933307

Bickenbach, Kai A; Strong, Vivian E

2012-08-29

209

Laparoscopic pancreatic resections.  

PubMed

The last decade has seen an increase in the application of minimally invasive surgical procedures to the management of pancreatic disease. Laparoscopic pancreatic surgery is an advanced laparoscopic procedure with a significant learning curve. It should be considered only by surgeons with extensive experience in open pancreatic surgery who possess advanced laparoscopic 'skills. Early reports suggest that laparoscopic pancreatic surgery can be accomplished with acceptable morbidity and mortality for the resection of small benign and low-grade malignant lesions in the body and tail of the pancreas and for the internal drainage of pancreatic pseudocysts. Its role in the management of lesions in the head, neck, and uncinate process of the pancreas is yet to be determined. PMID:19845171

Nakeeb, Attila

2009-01-01

210

Laparoscopic Inguinal Hernia Repair  

MedlinePLUS

... inguinal hernia repairs are performed using a small telescope known as a laparoscope. If your surgeon has ... in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). If may offer a ...

211

Minimally invasive (laparoscopic) surgery  

Microsoft Academic Search

  Minimally invasive (laparoscopic) surgery became a major part of general surgery with the introduction of laparoscopic cholecystectomy\\u000a in the late 1980s. This was the culmination of the development of instruments and techniques by many physicians; Kelling developing\\u000a pneumoperitoneum, Zollikofer using carbon dioxide, Kalk designing a lens system and the dual-trochar technique, Veress using\\u000a the Veress needle to create pneumoperitoneum, Hasson

H. S. Himal

2002-01-01

212

Laparoscopic refundoplication in children  

Microsoft Academic Search

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

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

2000-01-01

213

Laparoscopic adrenalectomy for cancer.  

PubMed

Laparoscopic procedures are preferred by surgeons and patients alike because of decreased pain, reduced perioperative morbidity, and an earlier return to self-reliance. During the last decade, laparoscopic adrenalectomy has become the technique most commonly used for the removal of benign adrenal tumors. The indications for laparoscopy in malignant adrenal tumors remains controversial, because oncologic resections have not been reproducible compared with open techniques. PMID:23158088

Creamer, Jennifer; Matthews, Brent D

2013-01-01

214

Self-reported bladder function five years post-hysterectomy.  

PubMed

We have examined the contribution of hysterectomy, compared with less invasive surgery, for dysfunctional uterine bleeding (DUB) on the prevalence of bladder problems five years after surgery. We report a prospective cohort study of over 25,000 women treated for benign cause menorrhagia by three types of surgery - transcervical endometrial resection/ablation and hysterectomy with or without bilateral oophorectomy. Postal questionnaires were sent five years after surgery investigating satisfaction with surgery and bladder function. When adjusted for confounders the odds of severe urinary incontinence (OR = 1.59, CI 95%, 1.35 - 1.87), urinary frequency (1.23 (1.04 - 1.45)), and nocturia (1.19, (1.03 - 1.38)) - were increased for women who had a hysterectomy compared with endometrial ablation. Hysterectomy with bilateral oophorectomy was not as strongly associated with severe bladder problems. Women who had the LAVH were most likely to report severe urinary incontinence (2.02, CI 95% 1.32 - 3.07), but not severe frequency or nocturia. PMID:16183583

McPherson, K; Herbert, A; Judge, A; Clarke, A; Bridgman, S; Maresh, M; Overton, C

2005-07-01

215

Robotic Repair of Complex Vesicouterine Fistula with and without Hysterectomy  

Microsoft Academic Search

Objective: To present robotic repair of vesicouterine fistulae (VUF) with and without hysterectomy in 3 cases and to discuss the technique with its outcome. Methods: Three patients were diagnosed with VUF, of whom 2 had a prior history of multiple cesarean sections and 1 had obstructed labor. Preoperative diagnosis of VUF was based on classic history, cystoscopy and imaging studies.

Ashok K. Hemal; Nitin Sharma; Satyadip Mukherjee

2009-01-01

216

Endometrial cryoablation with ultrasound visualization in women undergoing hysterectomy  

Microsoft Academic Search

Study ObjectivesTo evaluate tissue effects of cryosurgical endometrial ablation in women just before hysterectomy, characterize ultrasound monitoring of freezing, determine the feasibility of a new probe-angling procedure, and assess the safety profile by monitoring serosal surface temperatures.

John D. Dobak; John Willems; Rebecca Howard; Cheryl Shea; Duane E. Townsend

2000-01-01

217

Robot-Assisted Laparoscopic Pyeloplasty  

Microsoft Academic Search

\\u000a Laparoscopic pyeloplasty offers the success of open surgery with the benefit of decreased postoperative pain and decreased\\u000a length of stay. Its use, however, is limited by the steep learning curve required for proficient laparoscopic skills. The\\u000a introduction of robotic assistance shortens the laparoscopic learning curve and may allow increased use of laparoscopy in\\u000a performing pediatric laparoscopic pyeloplasty. This chapter describes

Chad R. Tracy; Craig A. Peters

218

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

219

Laparoscopic Versus Open Appendectomy  

PubMed Central

Summary Background Data: The value of laparoscopy in appendicitis is not established. Studies suffer from multiple limitations. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a prospective randomized double blind study. Methods: Two hundred forty-seven patients were analyzed following either laparoscopic or open appendectomy. A standardized wound dressing was applied blinding both patients and independent data collectors. Surgical technique was standardized among 4 surgeons. The main outcome measures were postoperative complications. Secondary outcome measures included evaluation of pain and activity scores at base line preoperatively and on every postoperative day, as well as resumption of diet and length of stay. Activity scores and quality of life were assessed on short-term follow-up. Results: There was no mortality. The overall complication rate was similar in both groups (18.5% versus 17% in the laparoscopic and open groups respectively), but some early complications in the laparoscopic group required a reoperation. Operating time was significantly longer in the laparoscopic group (80 minutes versus 60 minutes; P = 0.000) while there was no difference in the pain scores and medications, resumption of diet, length of stay, or activity scores. At 2 weeks, there was no difference in the activity or pain scores, but physical health and general scores on the short-form 36 (SF36) quality of life assessment forms were significantly better in the laparoscopic group. Appendectomy for acute or complicated (perforated and gangrenous) appendicitis had similar complication rates, regardless of the technique (P = 0.181). Conclusions: Unlike other minimally invasive procedures, laparoscopic appendectomy did not offer a significant advantage over open appendectomy in all studied parameters except quality of life scores at 2 weeks. It also took longer to perform. The choice of the procedure should be based on surgeon or patient preference.

Katkhouda, Namir; Mason, Rodney J.; Towfigh, Shirin; Gevorgyan, Anna; Essani, Rahila

2005-01-01

220

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

Microsoft Academic Search

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

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

1998-01-01

221

Anaesthetic management of Wolff-Parkinson-White syndrome for hysterectomy  

PubMed Central

Wolff–Parkinson–White syndrome (WPW) is an uncommon cardiac disorder having an aberrant pathway between atria and ventricles. We are reporting a known case of WPW syndrome for hysterectomy under combined spinal epidural anaesthesia. Management of the present case is an important pearl to revisit management of WPW syndrome. The perioperative management should be tailored according to the nature of surgery and the clinical presentation of the patient.

Sahu, Sandeep; Karna, Sunaina Tejpal; Karna, Amit; Lata, Indu; Kapoor, Deepa

2011-01-01

222

Hysterectomies in Nigerians: histopathological analysis of cases seen in Ile-Ife.  

PubMed

To review retrospectively hysterectomy specimens sent to the histopathological department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria in order to document the histopathological findings and relate these with the age of patients. The records of patients with hysterectomy specimens sent to the histopathological laboratory within a period of 10 years were studied. Some of the histological slides were reviewed. The diagnosis of uterovaginal prolapse was based on clinical as well as pathological findings. Three hundred and thirty hysterectomy specimens seen over the study period of 10 years were studied. Women aged 40-49 years accounted for the highest number of cases, Hysterectomy was most often performed for leiomyoma (48%). followed by uterovaginal prolapse (17%). In women over the age of 70 years hysterectomy was most often performed for uterovaginal prolapse. Complication of pregnancy still accounted for a high percentage of hysterectomy (11%) Most were ante-partum and post partum haemorrhages as well as septic abortion in young women Ten of the specimens were normal both grossly and microscopically. Six of these were removed for suspected leiomyoma. The peak age incidence for women with leiomyoma who had hysterectomy corresponds with the overall peak age for women who had Hysterectomy. Leiomyoma was the commonest finding in hysterectomy specimens. However, clinicians should ensure that the condition is accurately diagnosed in all cases to avoid removal of a normal uterus. PMID:11487782

Adelusola, K A; Ogunniyi, S O

2001-03-01

223

Recent advances in laparoscopic surgery.  

PubMed

Laparoscopic surgery has been widely adopted and new technical innovation, procedures and evidence based knowledge are persistently emerging. This review documents recent major advancements in laparoscopic surgery. A PubMed search was made in order to identify recent advances in this field. We reviewed the recent data on randomized trials in this field as well as papers of systematic review. Laparoscopic cholecystectomy is the most frequently performed procedure, followed by laparoscopic bariatric surgery. Although bile duct injuries are relatively uncommon (0.15%-0.6%), intraoperative cholangiography still plays a role in reducing the cost of litigation. Laparoscopic bariatric surgery is the most commonly performed laparoscopic gastrointestinal surgery in the USA, and laparoscopic Nissen fundoplication is the treatment of choice for intractable gastroesophageal reflux disease. Recent randomized trials have demonstrated that laparoscopic gastric and colorectal cancer resection are safe and oncologically correct procedures. Laparoscopic surgery has also been widely developed in hepatic, pancreatic, gynecological and urological surgery. Recently, SILS and robotic surgery have penetrated all specialties of abdominal surgery. However, evidence-based medicine has failed to show major advantages in SILS, and the disadvantage of robotic surgery is the high costs related to purchase and maintenance of technology. Laparoscopic surgery has become well developed in recent decades and is the choice of treatment in abdominal surgery. Recently developed SILS techniques and robotic surgery are promising but their benefits remain to be determined. PMID:23126424

Lee, Wei-Jei; Chan, Chien-Pin; Wang, Bing-Yen

2012-11-06

224

[Laparoscopic evaluation of reproductive organs in women treated for infertility].  

PubMed

The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubular inpatency was found. The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility. PMID:8112628

Popiela, A; Kasiak, J; Heimrath, T; Cis?o, M

1993-11-01

225

Laparoscopic incisional hernia repair: evaluation of effectiveness and experiences  

Microsoft Academic Search

Introduction  Incisional hernia is the most frequent postoperative complication following abdominal surgery and is a common and costly source\\u000a of morbidity. Conventional mesh repair is the standard treatment today, but the use of laparoscopic incisional hernia repair\\u000a (LIHR) seems to be a good alternative. We performed a retrospective analysis comparing open incisional hernia repair with\\u000a the laparoscopic approach.\\u000a \\u000a \\u000a \\u000a Methods  Between June 2004

A. Wolter; C. Rudroff; S. Sauerland; M. M. Heiss

2009-01-01

226

Laparoscopic colonic procedures  

Microsoft Academic Search

With the advent and general acceptance of laparoscopy as a means of surgically treating intraabdominal disease processes, procedures on organs other than the gallbladder and female genital tract have slowly evolved. After developing basic techniques in an animal model, a clinical series (n=19) of laparoscopic procedures for a variety of colonic lesions was undertaken and is herein presented. It included

Morris E. Franklin; Raul Ramos; Daniel Rosenthal; William Schuessler

1993-01-01

227

[Laparoscopic appendectomy. Our experience].  

PubMed

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

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

228

Laparoscopic inguinal hernioplasty  

Microsoft Academic Search

Laparoscopic hernioplasty was performed in a prospective fashion in 100 inguinal hernias in 66 patients. When available, a self-expanding prosthesis of Mersilene, strengthened with a cross- or star-shaped wire of Nitinol, was used without fixation (group B, 43 hernias).

Jacques M. Himpens

1993-01-01

229

Telesurgical Laparoscopic Radical Prostatectomy  

Microsoft Academic Search

Introduction: Telepresence surgery offers theoretically to overcome two main problems of laparoscopic surgery, i.e. the limitation to only four degrees of freedom and the lack of stereovision. Since 1998, telesurgical minimally invasive procedures have been performed with the da Vinci system mainly for cardiac bypass surgery. Clinical experience in urology is still very limited. We want to present our initial

Jens Rassweiler; Thomas Frede; Othmar Seemann; Christian Stock; Ludger Sentker

2001-01-01

230

Pediatric Laparoscopic Dismembered Pyeloplasty  

Microsoft Academic Search

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

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

1995-01-01

231

Laparoscopic surgery in pregnancy  

Microsoft Academic Search

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

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

1995-01-01

232

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

233

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

PubMed Central

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

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

2013-01-01

234

Laparoscopic pyeloplasty: status and review of literature.  

PubMed

The ideal treatment for ureteropelvic junction (UPJ) obstruction should have the highest success rate, enable treatment of all types of obstruction, allow removal coexisting renal stones, and be minimally invasive. Open pyeloplasty offers all these features except the last (minimal invasiveness), whereas endourology techniques guarantee only the last one. Different techniques of pyeloplasty can be applied laparoscopically, although the best results are seen with dismembered pyeloplasty (Anderson-Hynes technique). Various methods of tissue approximation have been devised to avoid the difficult-to-master, time-consuming conventional suturing technique. Laparoscopic (antegrade) stenting is preferred by some surgeons, but we consider retrograde stenting is superior, as this rules out the presence of associated distal-ureteral obstruction. The transperitoneal approach has the advantages of a larger working space and readily identifiable anatomic landmarks. However, access to the renal pelvis requires considerable mobilization and retraction of the overlying loops of bowel. The retroperitoneal approach has the perceived disadvantage of a somewhat limited working space and absence of readily identifiable intra-abdominal anatomic structures such as the liver and spleen. However, the retroperitoneal approach has the advantage of greater familiarity, better detection of crossing vessels, direct and rapid access to the UPJ, and less risk of ileus. The robot-assisted technique has made suturing easier and may allow expansion of advanced laparoscopic procedures to surgeons without expertise in advanced laparoscopic surgery. The optimal length of follow-up after pyeloplasty is still unclear. Although most failures occur within the first 2 years, failures continue to appear after 5 and 10 years. PMID:17705747

El-Shazly, M A; Moon, D A; Eden, C G

2007-07-01

235

HYSTERECTOMY IS ASSOCIATED WITH LARGE ARTERY STIFFENING IN ESTROGEN-DEFICIENT POSTMENOPAUSAL WOMEN  

PubMed Central

Objective Hysterectomy, with or without oophorectomy is associated with increased cardiovascular disease (CVD) risk due, in part, to an adverse CVD risk factor profile. Large artery stiffening, a biomarker of vascular aging, increases the risk for CVD. We determined whether hysterectomy with or without bilateral oophorectomy (BLO) is associated with arterial stiffening in healthy postmenopausal women. Methods We conducted a cross-sectional study including estrogen-deficient postmenopausal women who had a hysterectomy with ovarian preservation (N= 24; 59±1 year, mean±SE) or with BLO (N=21; 58±2 year), and had no hysterectomy/no BLO (N=58; 58±1 year). Arterial stiffness (arterial compliance and beta stiffness index) was measured by ultrasonography of the carotid artery. Results Carotid artery compliance was lower in women with hysterectomy alone and in women with hysterectomy with BLO compared to women with no hysterectomy (0.66±0.03 and 0.71±0.06 versus 0.89±0.03 mm2/mmHg×10?1, respectively, both P<0.05). There were no differences in traditional CVD risk factors (i.e., adiposity, blood pressure and fasted lipids and lipoproteins, glucose and insulin) between the groups. After adjustment for age, menopause duration, prior menopausal hormone therapy duration, parity, waist-to-hip ratio, systolic blood pressure and sex-hormone binding globulin, hysterectomy status remained a significant predictor of arterial compliance. Conclusions These results indicate that hysterectomy status (with or without BLO) is associated with greater arterial stiffening in estrogen-deficient postmenopausal women. The greater arterial stiffening with hysterectomy was not related to an adverse CVD risk profile. Large artery stiffening may be an important mechanism by which hysterectomy increases the risk of CVD in postmenopausal women.

Gavin, Kathleen M.; Jankowski, Catherine; Kohrt, Wendy M.; Stauffer, Brian L.; Seals, Douglas R.; Moreau, Kerrie L.

2012-01-01

236

Laparoscopic repair of gastroesophageal reflux disease. Toupet partial fundoplication versus Nissen fundoplication.  

PubMed

This report describes our preliminary experience with two surgical laparoscopic fundoplication procedures, the Nissen technique and the Toupet operation, in which the fundal wrap is reduced from 360 degrees to 180-200 degrees. Fourteen patients with symptomatic gastroesophageal reflux disease who were refractory to pharmacologic and medical therapy underwent a laparoscopic Nissen fundoplication; in an additional 14 patients, we performed a laparoscopic Toupet partial fundoplication. Our laparoscopic approach to the two procedures does not differ significantly from the traditional open methods and the effectiveness of the laparoscopic fundoplication procedures appears similar to that of the same conventional techniques. Oral feedings can be resumed on the first postoperative day and patients typically are discharged on the second day after surgery. Operative time for performing the Toupet procedure averaged just approximately 1.6 h and was shorter than that for the Nissen fundoplication, due to the use of a stapler to secure the fundal wrap. Confirming earlier observations, the laparoscopic Toupet 180-200 degrees fundoplication was associated with a lower incidence of postoperative digestive complications, such as dysphagia, than was the laparoscopic Nissen operation. The laparoscopic fundoplication approach offers the advantages of clear visualization, adequate dissection and precise repair, along with the benefits associated with endoscopic surgery: diminished postoperative pain and discomfort, reduced hospitalization, and quicker return to normal activities. Our experience indicates that the Toupet fundoplication may be preferable to the Nissen technique for many patients requiring surgical treatment of their reflux disease. PMID:7992149

McKernan, J B

1994-08-01

237

Laparoscopic Management of Large Myomas  

PubMed Central

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

Sinha, Rakesh; Sundaram, Meenakshi

2009-01-01

238

Experience and efficacy of a bipolar vessel sealing system for radical abdominal hysterectomy.  

PubMed

The present study evaluated the efficacy of an electrosurgical bipolar vessel sealing system for radical abdominal hysterectomy (RAH). A total of 85 consecutive patients who underwent RAH with pelvic lymphadenectomy for cervical cancer or endometrial cancer were analyzed; in 18 patients, the LigaSure system (Valleylab, Boulder, Colo) was used to secure the vascular pedicles, and in the remaining 67 patients, clamps were used, and the pedicles suture ligated. Compared with the conventional suture group, the patients in the LigaSure group had a significantly shorter operation time (mean, LigaSure 242.8 +/- 36.1 minutes vs conventional, 349.1 +/- 82.6) minutes; P < 0.001) and lower blood loss (mean, 583.1 +/- 287.6 mL vs 999.0 +/- 524.2 mL; P < 0.005). Only 1 (0.06%) of the 18 patients in the LigaSure group was transfused, whereas 27 (40.2%) of the 67 patients in the conventional suture group were transfused. Because transfusion requirements may be affected by the surgeon's bias, we compared blood loss among untransfused patients and found that the LigaSure group still had significantly lower blood loss than the conventional suture group (mean, 550.9 +/- 233.1 mL vs 745.49.0 +/- 230.4 mL; P < 0.01). Hemoglobin level reduction after surgery in untransfused patients was significantly lower in the LigaSure group than in the conventional suture group (mean, 2.31 +/- 2.22 mg/dL vs 3.22 +/- 1.11 mg/dL; P < 0.05). These findings indicate that the LigaSure vessel sealing system is useful to reduce blood loss and shorten operating time at RAH. PMID:19955955

Kyo, Satoru; Mizumoto, Yasunari; Takakura, Masahiro; Hashimoto, Manabu; Mori, Noriko; Ikoma, Tomomi; Nakamura, Mitsuhiro; Inoue, Masaki

2009-12-01

239

Laparoscopic radical and partial cystectomy  

PubMed Central

Radical cystectomy remains the standard treatment for muscle invasive organ confined bladder carcinoma. Laparoscopic radical cystoprostatectomy (LRC) is an advanced laparoscopic procedure that places significant demands on the patient and the surgeon alike. It is a prolonged procedure which includes several technical steps and requires highly developed laparoscopic skills including intra-corporeal suturing. Here we review the development of the technique, the indications, complications and outcomes. We also examine the potential benefits of robotic-assisted LRC and explore the indications and technique of laparoscopic partial cystectomy.

Challacombe, Ben J.; Rose, Kristen; Dasgupta, Prokar

2005-01-01

240

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

PubMed

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

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

2004-12-01

241

[Technical aspects of laparoscopic robot-assisted pyeloplasty].  

PubMed

From 2000, the robot-assisted laparoscopic approach has been developed for the management of ureteropelvic junction obstruction (UJO) with equivalent outcomes to conventional laparoscopic access regarding functional results. This system has simplified the suturing and has improved the precision of operative technique. The main surgical steps of the transperitoneal laparoscopic robot-assisted pyeloplasty are as follows: four or five port arrangement; initial dissection and early identification of the ureteropelvic junction; renal pelvis section; transection of the ureter and preparation of a spatula; continuous posterior suture; confection of a handle racket suture; placement of a double J stent; ending of the anastomosis. Outcomes after robotic and pure laparoscopic pyeloplasties are equivalent nowadays. Despite the financial cost, it seems easier and technically feasible and accessible for surgeons accustomed to the laparoscopic techniques and even beginners to learn the robotic technique if the system is available in their institution with success rate (radiologic and clinical) almost similar with those obtain with open techniques. PMID:19800549

Ferhi, K; Rouprêt, M; Rode, J; Misraï, V; Lebeau, T; Richard, F; Vaessen, C

2009-05-17

242

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.

Chen, Jia-Hui; Wu, Jhe-Syun

2013-01-01

243

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease  

PubMed Central

Pure laparoscopic hepatectomy is a less invasive procedure than conventional open hepatectomy for the resection of hepatic lesions. Increases in experiences with the technique, in combination with advances in technology, have promoted the popularity of pure laparoscopic hepatectomy. However, indications for usage and potential contraindications of the procedure remain unresolved. The characteristics and specific advantages of the procedure, especially for hepatocellular carcinoma (HCC) patients with chronic liver diseases, are reviewed and discussed in this paper. For cirrhotic patients with liver tumors, pure laparoscopic hepatectomy minimizes destruction of the collateral blood and lymphatic flow from laparotomy and mobilization, and mesenchymal injury from compression. Therefore, pure laparoscopic hepatectomy has the specific advantage of minimal postoperative ascites production that leads to lowering the risk of disturbance in water or electrolyte balance and hypoproteinemia. It minimizes complications that routinely trigger postoperative serious liver failure. Under adequate patient positioning and port arrangement, the partial resection of the liver in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated in pure laparoscopic surgery by providing good vision and manipulation in the small operative field. Furthermore, the features of reduced post-operative adhesion, good vision, and manipulation within the small area between the adhesions make this procedure safer in the context of repeat hepatectomy procedures. These improved features are especially advantageous for patients with liver cirrhosis and multicentric and/or metachronous HCCs.

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

2013-01-01

244

Laparoscopic intracorporal colorectal sutured anastomosis using the Radius Surgical System in a phantom model  

Microsoft Academic Search

Background  The Radius Surgical System (RSS) is a manipulator with additional degrees of freedom to enhance the dexterity of laparoscopic\\u000a suturing. Our aim was to determine the feasibility and potentially added value of laparoscopic intracorporal sutured colorectal\\u000a anastomosis (RSS) compared with suturing with conventional laparoscopic instruments (CLI).\\u000a \\u000a \\u000a \\u000a Methods  A total of 72 colorectal anastomoses and 30 single sutures using RSS and CLI

J. R. Torres Bermudez; G. Buess; M. Waseda; I. Gacek; F. Becerra Garcia; G. A. Manukyan; N. Inaky

2009-01-01

245

The Effects of Hysterectomy on Sexual Arousal in Women with a History of Benign Uterine Fibroids  

Microsoft Academic Search

Research indicates hysterectomy surgery may adversely affect the pelvic autonomic nerves and autonomic mechanisms are integral to the sexual arousal response in women. This study explored the possibility that women who undergo hysterectomy may experience an impaired vasocongestive response to erotic stimulation. Thirty-two women with a history of benign uterine fibroids who had (n = 15) or had not (n

Cindy M. Meston

2004-01-01

246

Intraoperative blood salvage in abdominal simple total hysterectomy for uterine myoma  

Microsoft Academic Search

Objective: To investigate the safety and usefulness of salvage-type autologous blood transfusion for abdominal simple total hysterectomy for uterine myoma. Methods: Forty patients with uterine myoma diagnosed histologically were treated by abdominal simple total hysterectomy using an intraoperative blood salvage apparatus. Bacterial contamination in the processed blood was studied. Results: Homologous blood transfusion was unnecessary. There was a positive relationship

T Yamada; A Ikeda; Yu Okamoto; Yo Okamoto; T Kanda; M Ueki

1997-01-01

247

Robotic Versus Abdominal Hysterectomy for Very Large Uteri  

PubMed Central

Background and Objectives: We sought to examine the outcomes of patients with myomatous uteri weighing >1000 g who underwent hysterectomy by one of two modalities, either with a robotic system or by laparotomy. Methods: All patients who underwent robotic hysterectomy for uteri weighing >1000 g at our institution between May 2007 and January 2011 were identified, and a retrospective chart review was performed. These patients were matched to a laparotomy control group by body mass index and uterine weight, and the postoperative outcomes in both groups were analyzed and compared. Results: Sixty patients with uteri weighing >1000 g underwent hysterectomy, 30 with the robotic system and 30 by laparotomy. The median body mass index was 31.8 kg/m2 (range, 18.5–56.3 kg/m2) and the median uterine weight was 1259 g (range, 1000–3543 g) in the robotic group versus 30.2 kg/m2 (range, 18–48 kg/m2) and 1509 g (range, 1000–3570 g), respectively, in the laparotomy group (P = .31). The median operating time was 255 minutes (range, 180–372 minutes) in the robotic group versus 150 minutes (range, 100–285 minutes) in the laparotomy group (P < .001). There were no conversions to laparotomy. In both groups the operative time was not increased with increasing specimen weight. The median blood loss was 150 mL in the robotic group versus 425 mL in the laparotomy group. Of 30 patients in the robotic group, 23 (76.6%) were discharged from the hospital on postoperative day 1. The median hospital stay for the robotic group was 1 day, and for the laparotomy group, it was 2.5 days (P < .01). Conclusion: Robotic surgeries for very large myomatous uteri are feasible and have minimal morbidity even in morbidly obese patients. The robotic surgery requires a longer operative time but results in a shorter hospital stay and decreased intraoperative blood loss.

Gallo, Taryn; Silasi, Michelle; Menderes, Gulden; Azodi, Masoud

2013-01-01

248

Laparoscopic adrenal cyst resection.  

PubMed

Two patients with left adrenal cysts underwent laparoscopic resection. In one case an adrenal origin of the cyst was suspected. In the other case the cyst was thought to be renal in origin. Both patients were female, ages 16 and 40 years. Operative time was 150 and 160 minutes. Blood loss was 50 and 30 mL. One patient received 14 mg of morphine and 60 mg of ketorolac. The other patient did not require any parenteral analgesics. Hospital stay was 1 day for both patients. Return to normal activity occurred at 15 and 7 days postoperatively, respectively. Histology in both cases revealed benign adrenal cysts. Our experience supports the laparoscopic approach for resection of adrenal cysts. PMID:9892002

Williams, J F; Wolf, J S

1998-12-01

249

Whether robot-assisted laparoscopic fundoplication is better for gastroesophageal reflux disease in adults: a systematic review and meta-analysis  

Microsoft Academic Search

Background  Although laparoscopic fundoplication is an effective, minimally invasive surgical technique for gastroesophageal reflux disease\\u000a (GERD) that failed to be treated with medicine, with wide implementation its technical limitations have become increasingly\\u000a clear. Recently, robot-assisted laparoscopic fundoplication (RALF) was considered a new approach that makes up for the deficiency\\u000a of conventional laparoscopic fundoplication (CLF). This systematic review aimed to assess the

Jun MiYingxin; Yingxin Kang; Xiao Chen; Bingjun Wang; Zhiping Wang

2010-01-01

250

Laparoscopic radical prostatectomy  

Microsoft Academic Search

The radical prostatectomy has been modified over the years. With the introduction to the modern operating room of robots and\\u000a other tools has come the latest modification: the laparoscopic radical prostatectomy (LRP), first described almost 10 years\\u000a ago. In the past 2 years, the technique of LRP has been made standard, reproducible, and efficient. The LRP virtually eliminates\\u000a the physical

Arnon Krongrad

2000-01-01

251

Robotic laparoscopic fundoplication  

Microsoft Academic Search

Opinion statement  Gastroesophageal reflux disease is a very common disorder, and both medical and surgical treatments have shown outstanding\\u000a results. Whereas proton pump inhibitors are the mainstay of treatment, laparoscopic fundoplication has become a very attractive\\u000a alternative due to its efficacy and low morbidity. There are defined patient categories that may benefit more from laparoscopy\\u000a than medical therapy, but a conclusive

Dimitrios Stefanidis; James R. Korndorffer; Daniel J. Scott

2005-01-01

252

Total Laparoscopic Pancreaticoduodenectomy  

PubMed Central

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

Kamyab, Armin

2013-01-01

253

[Experimental laparoscopic renal autograft].  

PubMed

Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased. The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vascular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed. PMID:15046477

Aguilera Bazán, A; Murillo, S; Benito de la Víbora, J; Cisneros Ledo, J; de la Peña Barthel, J

2004-01-01

254

Laparoscopic bariatric surgery  

Microsoft Academic Search

Laparoscopy has meant profound changes for the field of bariatric surgery. Bariatric operations, which are technically difficult\\u000a because of the patient population, were not performed laparoscopically until the last 5 years of the 20th century. The years\\u000a 1998 to 2003, herein defined as the Bariatric Revolution, saw profound changes in the way bariartric surgery was practiced.\\u000a Major changes in patient

B. Schirmer; Stephen H. Watts

2006-01-01

255

Hysterectomy and predictors for opioid prescription in a chronic pain clinic sample  

PubMed Central

Objectives To describe the prevalence of hysterectomy for women aged 18-45 seeking treatment at a chronic pain clinic, to describe patient characteristics (pain intensity, age, smoking status, hormone replacement status, and psychosocial factors) based on opioid and hysterectomy status, and to determine whether hysterectomy status predicted receipt of opioid prescription. Design Retrospective cross-sectional chart review. Participants Total 323 new female patients aged 18-45 who completed the Brief Pain Inventory-Short Form at initial evaluation at a chronic pain clinic during a 12-month period (July 2008- June 2009). Measures Data were collected from the Brief Pain Inventory and medical charts. Variables included opioid prescription, average pain intensity, pain type, age, hysterectomy status, smoking status, and pain-related dysfunction across domains measured by the Brief Pain Inventory. The association of opioid prescription with hysterectomy and other factors were determined by logistic regression. Results Prevalence of hysterectomy was 28.8%. Average pain intensity was not associated with either hysterectomy or opioid prescription status. However, hysterectomy and high levels of pain-related dysfunction were significantly and independently associated with opioid prescription after adjusting for age and pain intensity. More than 85% of women with hysterectomy and high pain-related dysfunction had opioid prescription. Conclusions Hysterectomy may confer risk for pain-related dysfunction and opioid prescription in women 45 and younger. More research is needed to understand (1) how patient characteristics influence prescribing patterns; and (2) the specific medical risks and consequences of chronic opioid therapy in this population.

Darnall, Beth; Li, Hong

2010-01-01

256

Complications of laparoscopic colorectal surgery  

Microsoft Academic Search

PURPOSE: The aim of this study was to test if the techniques learned during our early learning experience have proved to be effective in reducing the complications specifically related to the laparoscopic technique of colorectal surgery. METHODS: From October 1991 until July 1996, 195 laparoscopic operations were performed on the colon and the rectum. These data were divided into “early”

Sergio W. Larach; Sanjiv K. Patankar; Andrea Ferrara; Paul R. Williamson; Santiago E. Perozo; Alan S. Lord

1997-01-01

257

Choice of Laparoscopic Exposure Method  

Microsoft Academic Search

Presently, with few exceptions, carbon dioxide is the gas used for laparoscopic procedures in humans. CO2 is colorless, noncombustible, odorless, and inexpensive, and, because of its high solubility, is the least dangerous gas should a gas embolism occur during a laparoscopic procedure. Interestingly, several of the major drawbacks associated with the use of CO2 gas, namely, hypercarbia, acidosis, and other

Christopher A. Jacobi; C. Braumann

258

Laparoscopic surgery complications: Postoperative peritonitis  

PubMed Central

Introduction: Complications within laparoscopic surgery, similar to classic surgery are inevitable and require immediate actions both to diminish intraoperative risks and to choose the appropriate therapeutic attitude. Peritonitis and hemorrhagic incidents are both part of the complications aspect of laparoscopic surgery. Fortunately, the incidence is limited, thus excluding the rejection of celioscopic methods. Patient’s risks and benefits are to be analyzed carefully prior recommending laparoscopic surgery. Materials and methods: This study presents a statistical analysis of peritonitis consecutive to laparoscopic surgery, experience of „Sf. Ioan” Emergency Hospital, Bucharest, and Department of Surgery (2000-2010). Results:There were 180 (0,96%) complicated situations requiring reinterventions, from a total of 18676 laparoscopic procedures. 106 cases (0,56%) represented different grades of postoperative peritonitis. Most frequently, there were consecutive laparoscopic appendicectomia and colecistectomia. During the last decade, few severe cases of peritonitis followed laparoscopic bariatric surgical procedures. Conclusions: This study reflects the possibility of unfavorable evolution of postoperative peritonitis comparing with hemorrhagic incidents within laparoscopic surgery.

Draghici, L; Draghici, I; Ungureanu, A; Copaescu, C; Popescu, M; Dragomirescu, C

2012-01-01

259

Laparoscopic radical prostatectomy: preliminary results  

Microsoft Academic Search

Objectives. To evaluate our preliminary experience with laparoscopic radical prostatectomy. The indications for laparoscopy are currently being extended to complex oncologic procedures.Methods. Forty-three men underwent laparoscopic radical prostatectomy. We used five trocars. The surgical technique replicates the steps of traditional retropubic prostatectomy, except that the rectoprostatic cleavage plane is developed transperitoneally at the beginning of the procedure. In the first

C. C Abbou; L Salomon; A Hoznek; P Antiphon; A Cicco; F Saint; W Alame; J Bellot; D. K Chopin

2000-01-01

260

Laparoscopic Repair of Ureteral Transection  

Microsoft Academic Search

Injury to the ureter is a possible complication of laparoscopic surgery. Traditionally, it is repaired by laparotomy. During laparoscopic surgery for bilateral ovarian remnants in a 29-year-old woman, the left ureter was transected. The ureter was repaired by primary end-to-end anastomosis by laparoscopy. The patient recovered uneventfully, and postoperative intravenous puelogram confirmed the repair to be intact.

Paul K. Tulikangas; Jeffrey M. Goldberg; Inderbir S. Gill

2000-01-01

261

Laparoscopic Excision of an Infected \\  

Microsoft Academic Search

Primary retroperitoneal pseudocysts are rare entities. Though laparoscopic approach has been described in their treatment, open surgical excision is still the mainstay of treatment for these lesions. We present a case of infected retroperitoneal pseudocyst and its successful laparoscopic excision. The patient was an 80-year old female. Contrast enhanced CT scan of the abdomen and ultrasonography confirmed a large retroperitoneal

Chinnusamy Palanivelu; Muthukumaran Rangarajan; Rangaswamy Senthilkumar; Madhupalayam Velusamy Madhankumar; Shankar Annapoorni

262

Hysterectomy for Obese Women with Endometrial Cancer: Laparoscopy or Laparotomy?  

Microsoft Academic Search

Objective. The aim of this study was to investigate the feasibility and safety of laparoscopic management of obese women with early stage endometrial cancer and to compare the surgical outcome, cost, hospital stay, recall of postoperative pain control, time to return to full activity and to work, and overall satisfaction among these women and those managed by laparotomy.Methods. We conducted

Gamal H. Eltabbakh; Mousa I. Shamonki; Joanne M. Moody; Lynda Lee Garafano

2000-01-01

263

Short Hospital Stay after Laparoscopic Colorectal Surgery without Fast Track  

PubMed Central

Purpose. Short hospital stay and equal or reduced complication rates have been demonstrated after fast track open colonic surgery. However, fast track principles of perioperative care can be difficult to implement and often require increased nursing staff because of more concentrated nursing tasks during the shorter hospital stay. Specific data on nursing requirements after laparoscopic surgery are lacking. The purpose of the study was to evaluate the effect of operative technique (open versus laparoscopic operation), but without changing nurse staffing or principles for peri- or postoperative care, that is, without implementing fast track principles, on length of stay after colorectal resection for cancer. Methods. Records of all patients operated for colorectal cancer from November 2004 to December 2008 in our department were reviewed. No specific patients were selected for laparoscopic repair, which was solely dependent on the presence of two specific surgeons at the same time. Thus, the patients were not selected for laparoscopic repair based on patient-related factors, but only on the simultaneous presence of two specific surgeons on the day of the operation. Results. Of a total of 540 included patients, 213 (39%) were operated by a laparoscopic approach. The median hospital stay for patients with a primary anastomosis was significantly shorter after laparoscopic than after conventional open surgery (5 versus 8 days, P < 0.001) while there was no difference in patients receiving a stoma (10 versus 10 days, ns), with no changes in the perioperative care regimens. Furthermore there were significant lower blood loss (50 versus 200?mL, P < 0.001) and lower complication rate (21% versus 32%, P = 0.006) in the laparoscopic group. Conclusion. Implementing laparoscopic colorectal surgery in our department resulted in shorter hospital stay without using fast track principles for peri- and postoperative care in patients not receiving a stoma during the operation. Consequently, we aimed to reduce hospitalisation without increasing cost in nursing staff per hospital bed. Length of stay was not reduced in patients receiving a stoma pointing at this group for specific intervention in the future. Furthermore, the complication rate was reduced in the laparoscopic group.

Burgdorf, Stefan K.; Rosenberg, Jacob

2012-01-01

264

[Open and laparoscopic adrenalectomy. 10 years review].  

PubMed

We present a 10 years open adrenalectomy review in our Service and the beginning of laparoscopic adrenalectomy in the last year as a part of the retroperitoneal laparoscopic program at the Hospital Universitario La Paz . The first laparoscopic adrenalectomy was done after 21 retroperitoneal laparoscopic surgeries. Our initial experience has been so good that we have reduced the contraindications for this technique and we have increased the number of laparoscopic surgery cases. PMID:17253071

Aguilera Bazán, A; Pérez Utrilla, M; Alonso y Gregorio, S; Cansino Alcaide, R; Cisneros Ledo, J; De la Peña Barthel, J

265

The role of male partners in women's decision making regarding hysterectomy.  

PubMed

Although hysterectomy is a frequently performed surgical procedure, little is known about how women make decisions regarding hysterectomy. This report details the women's perceptions of male partners' knowledge and attitudes about hysterectomy and the role women expect or allow men to play in their decision-making process. Seventeen focus groups were conducted with a total of 82 African American and Caucasian women aged 30-65 years in two coastal counties of South Carolina. Transcripts were coded and analyzed using the nonnumerical unstructured data indexing searching and theory building (QSR NUD*IST) software program. Results indicate that women perceive men to be not well informed or knowledgeable about hysterectomy, to be concerned about the quality of sexual relations after hysterectomy, and, in some cases, to be neutral about hysterectomy. African American women reported that men hold more negative perceptions about hysterectomized women. Caucasian women stressed men's inability to understand what a woman is going through and men's concern with the hysterectomy's effect on their own egos. Nonhysterectomized women felt that men would be more bothered by a surgical procedure that left more visible effects (such as mastectomy). These women defined a limited role for men in their decision making regarding hysterectomy, consisting of discussion and offering of support/sympathy, but they reserved the actual decision for themselves. In a few instances, women accorded men a role in the hysterectomy decision based on a religious interpretation of marriage. Intervention programs are recommended that target women and their partners together, using hysterectomized women and their partners as peer educators. PMID:10714745

Richter, D L; McKeown, R E; Corwin, S J; Rheaume, C; Fraser, J

2000-01-01

266

Laparoscopic Total Mesorectal Excision  

PubMed Central

Objective To analyze total mesorectal excision (TME) for rectal cancer by the laparoscopic approach during a prospective nonrandomized trial. Summary Background Data Improved local control and survival rates in the treatment of rectal cancer have been reported after TME. Methods The authors conducted a prospective consecutive series of 100 laparoscopic TMEs for low and mid-rectal tumors. All patients had a sphincter-saving procedure. Case selection, surgical technique, and clinical and oncologic results were reviewed. Results The distal limit of rectal neoplasm was on average 6.1 (range 3–12) cm from the anal verge. The mean operative time was 250 (range 110–540) minutes. The conversion rate was 12%. Excluding the patient who stayed 104 days after a severe fistula and reoperation, the mean postoperative stay was 12.05 (range 5–53) days. The 30-day mortality was 2% and the overall postoperative morbidity was 36%, including 17 anastomotic leaks. Of 87 malignant cases, 70 (80.4%) had a minimum follow-up of 12 months, with a median follow-up of 45.7 (range 12–72) months. During this period 18.5% (13/70) died of cancer and 8.5% (6/70) are alive with metastatic disease. The port-site metastasis rate was 1.4% (1/70): a rectal cancer stage IV presented with a parietal recurrence at 17 months after surgery. The locoregional pelvic recurrence rate was 4.2% (3/70): three rectal cancers stage III at 19, 13, and 7 postoperative months. Conclusions Laparoscopic TME is a feasible but technically demanding procedure (12% conversion rate). This series confirms the safety of the procedure, while oncologic results are at present comparable to the open published series with the limitation of a short follow-up period. Further studies and possibly randomized series will be necessary to evaluate long-term clinical outcome in cancer patients.

Morino, Mario; Parini, Umberto; Giraudo, Giuseppe; Salval, Micky; Brachet Contul, Riccardo; Garrone, Corrado

2003-01-01

267

[Outcome of Burch retropubic urethropexy and the effect of concomitant abdominal hysterectomy].  

PubMed

A prospective follow-up stady was performed to evaluate the effect of Burch colposuspension alone and a concomitant abdominal hysterectomy with Burch colposuspension. Twenty seven women underwent Burch colposuspension and 34 women colposuspension with abdomina hysterectomy. Subjective outcame was assessed with questionaire at 4 weeks, 6 months and 1 year. In the 1 year follow-up 81,4% were subjectively cured or improved in the Burch group and 76,4% in the hysterectomy group. No statistically significant difference in the frequency of any subgroup of complications was found. PMID:16989152

Argirovi?, R; Liki?, I; Kadija, S; Milenkovi?, V; Ili?-Mosti?, T; Arsenijevi?, Lj

2006-01-01

268

Laparoscopic tailored Nissen fundoplication  

Microsoft Academic Search

Background  It is difficult sometimes to determine the suture points for proper Nissen fundoplication under laparoscopy. We introduce\\u000a a new procedure to define the suture points in Laparoscopic Nissen fundoplication (LNF).\\u000a \\u000a \\u000a \\u000a \\u000a Surgical technique  After dissection of the hiatus and mobilization of the fundus, the circumference of the esophagus c is measured at a point 2-cm cranial from the esophagogastric junction over the

Shinya Asami; Takashi Ishikawa; Shinichiro Kubo; Takayuki Iwamoto; Shinichiro Watanabe; Hitoshi Kin

2010-01-01

269

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

270

Laparoscopic splenectomy for ITP  

Microsoft Academic Search

Background: A comparison of safety, efficacy, and cost of laparoscopic splenectomy (LS) vs open splenectomy (OS) for idiopathic thrombocytopenic\\u000a purpura (ITP) was performed.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: The records of 49 consecutive patients who underwent splenectomy for ITP (31 LS and 18 OS) at a large metropolitan teaching\\u000a hospital between 3\\/91 and 8\\/95 were reviewed. Morbidity, mortality, hospital stay, operative time, blood loss,

R. L. Friedman; M. J. Fallas; B. J. Carroll; J. R. Hiatt; E. H. Phillips

1996-01-01

271

Umbilical incision laparoscopic surgery with one assist port for an elderly patient with recurrent sigmoid volvulus.  

PubMed

Single-port access laparoscopic surgery has recently emerged as a method to improve morbidity and cosmetic benefit of conventional laparoscopic surgery. Herein, we report the experience of transumbilical incision laparoscopic sigmoidectomy with one assist port in a 71-year-old man who had developed recurrent sigmoid volvulus in these several years since his first visit to the hospital. The patient presented abdominal distension and severe constipation. A plain x-ray film and CT of the abdomen showed grossly distended sigmoid colon loops and stenosis of recto-sigmoid colon. Sigmoid volvulus associated with megacolon was diagnosed and emergence endoscopic decompression was performed. After his condition improved, transumbilical incision laparoscopic sigmoidectomy was carried out as the minimally invasive approach, due to the several risk of patient such as aging and pulmonary disorder. Postoperative course was uneventful and on postoperative visit to the hospital he reported resolution of abdominal distension. PMID:23235104

Matsuoka, Tasuku; Osawa, Naoshi; Yoh, Taiho; Hirakawa, Kosei

2012-12-12

272

Laparoscopic Cholecystectomy in Cirrhotics  

PubMed Central

Background and Objectives: Due to the concern of risk of intra- and postoperative complications and associated morbidity, cirrhosis of the liver is often considered a contraindication for laparoscopic cholecystectomy (LC). This article intends to review the literature and underline the various approaches to dealing with this technically challenging procedure. Methods: A Medline search of major articles in the English literature on LC in cirrhotic patients over a 16-y period from 1994 to 2011 was reviewed and the findings analyzed. A total of 1310 cases were identified. Results: Most the patients who underwent LC were in Child-Pugh class A, followed by Child-Pugh classes B and C, respectively. The overall conversion rate was 4.58%, and morbidity was 17% and mortality 0.45%. Among the patients who died, most were in Child-Pugh class C, with a small number in classes B and A. The cause of death included, postoperative bleeding, liver failure, sepsis, duodenal perforation, and myocardial infarction. A meta-analysis of 400 patients in the literature, comparing outcomes of patients undergoing LC with and without cirrhosis, revealed higher conversion rate, longer operative time, higher bleeding complications, and overall increased morbidity in patients with cirrhosis. Safe LC was facilitated by measures that included the use of ultrasonic shears and other hemostatic measures and using subtotal cholecystectomy in patients with difficult hilum and gallbladder bed. Conclusions: Laparoscopic cholecystectomy can be safely performed in cirrhotic patients, within Child-Pugh classes A and B, with acceptable morbidity and conversion rate.

2012-01-01

273

Transvaginal laparoscopic donor nephrectomy.  

PubMed

Laparoscopic donor nephrectomy (LDN) has numerous advantages over open donor nephrectomy. The cosmetic issues and pain that arise due to the 5 to 6-cm incisions on the abdominal wall in LDN have led to transvaginal laparoscopic donor nephrectomy (TVLDN). Between May and August 2012, we performed seven donor nephrectomies via a transvaginal approach. The mean age of the donors was 53.0 ± 9.52 years. The mean operative time was 97.29 ± 39.47 minutes and mean warm ischemia time, 220.71 ± 55.49 seconds. Donors were mobilized, began oral intake at 8 hours postoperative, and were all discharged within the first 24 hours. Except one dose of analgesic applied immediately after the operation, no additional medication was required. No infectious complications were encountered in any recipient. TVLDN may be a good alternative for female donors. Compared with LDN, TVLDN has benefits of less postoperative pain, faster recovery, shorter hospital stay, and excellent cosmetic results. PMID:23622577

Ero?lu, A; ?ener, C; Tabandeh, B; Tilif, S; Okçuo?lu Kad?o?lu, Z; Kaçar, S

2013-04-01

274

Laparoscopic pancreatic surgery for islet cell tumors of the pancreas.  

PubMed

The experience with laparoscopic pancreatic surgery (LPS) in general, and pancreatic islet cell tumors (ICTs) in particular, is still limited. Because insulinoma is the most prevalent tumor and is mostly benign, single, and curable with surgical excision, it comprises most of the cases. Our experience with 17 cases (10 insulinomas, 2 gastrinomas, 1 nesidioblastoma, 4 nonfunctioning tumors) and those recorded in the literature (93 cases) show that laparoscopic surgery for small, solitary benign islet cell tumors located in the body and tail is feasible and safe and can result in rapid postoperative recuperation and a complication rate comparable or lower than that achieved with open surgery. It duplicates the success rate seen with conventional surgery regarding intraoperative localization and cure of disease. The main morbidity continues to be the occurrence of a fistula (18%), most often after enucleation, but the clinical course is benign in most instances. Preoperative imaging studies are required for localization, and the combined use of biphasic helical computed tomography and endoscopic ultrasonography (US) seems to be cost-effective. The use of laparoscopic US is an integral part of the laparoscopic procedure, and the information achieved is valuable for both confirming localization and decision making concerning the most appropriate surgical procedure. In cases of distal pancreatectomy, splenic salvage, preferably with preservation of splenic vessels, is feasible albeit more demanding and can be achieved in most cases. PMID:15517485

Assalia, Ahmad; Gagner, Michel

2004-11-04

275

Objective skill evaluation for laparoscopic training based on motion analysis.  

PubMed

Performing laparoscopic surgery requires several skills, which have never been required for conventional open surgery. Surgeons experience difficulties in learning and mastering these techniques. Various training methods and metrics have been developed to assess and improve surgeon's operative abilities. While these training metrics are currently widely being used, skill evaluation methods are still far from being objective in the regular laparoscopic skill education. This study proposes a methodology of defining a processing model that objectively evaluates surgical movement performance in the routine laparoscopic training course. Our approach is based on the analysis of kinematic data describing the movements of surgeon's upper limbs. An ultraminiaturized wearable motion capture system (Waseda Bioinstrumentation system WB-3), therefore, has been developed to measure and analyze these movements. The data processing model was trained by using the subjects' motion features acquired from the WB-3 system and further validated to classify the expertise levels of the subjects with different laparoscopic experience. Experimental results show that the proposed methodology can be efficiently used both for quantitative assessment of surgical movement performance, and for the discrimination between expert surgeons and novices. PMID:23204271

Lin, Zhuohua; Uemura, Munenori; Zecca, Massimiliano; Sessa, Salvatore; Ishii, Hiroyuki; Tomikawa, Morimasa; Hashizume, Makoto; Takanishi, Atsuo

2012-11-29

276

LAPAROSCOPIC HEMINEPHROURETERECTOMY IN PEDIATRIC PATIENTS  

Microsoft Academic Search

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

Gunter Janetschek; Jorg Seibold; Christian Radmayr; Georg Bartsch

1997-01-01

277

Laparoscopic repair of parapubic hernia.  

PubMed

Since the introduction of laparoscopic cholecystectomy in the late 1980s, video technology has continued to find new applications in the field of general surgery. Laparoscopic inguinal herniorrhaphy is touted by many to provide a minimally invasive approach to the most commonly performed general surgical procedure, possibly with a lower incidence of recurrence. Additionally, laparoscopic repair of an incisional hernia with synthetic mesh allows a tension-free procedure while potentially reducing the risk of complications such as wound and mesh infections by avoiding the use of large abdominal wall incisions through old surgical scars. The parapubic hernia is a rare form of incisional hernia resulting from the detachment of muscular attachments to the pubic bone. It is a diagnostic and therapeutic challenge that is often misdiagnosed and mismanaged. We have found the laparoscopic approach to the parapubic hernia to be a superior method of managing this often challenging condition. PMID:11695979

Hirasa, T; Pickleman, J; Shayani, V

2001-11-01

278

Laparoscopic colorectal resection for diverticulitis  

Microsoft Academic Search

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

L. Köhler; D. Rixen; H. Troidl

1998-01-01

279

Robotic-Assisted Laparoscopic Pyeloplasty  

Microsoft Academic Search

Robotic-assisted laparoscopic pyeloplasty (RALP) is an elegant, minimally invasive reconstructive procedure to treat UPJ obstruction.\\u000a The technique is discussed here in detail. Some selected patients can be discharged within 18 hours. Some series over five\\u000a years report success rates of between 95 and 100%. The benefits over laparoscopic pyeloplasty are arguable and need to carefully\\u000a be measured against the increased

Declan G. Murphy; Jamie Kearsley; Anthony J. Costello

280

Rhabdomyolysis after Laparoscopic Bariatric Surgery  

Microsoft Academic Search

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

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

2004-01-01

281

Laparoscopic-assisted colon resection  

Microsoft Academic Search

The popularity and success of laparoscopic biliary tract surgery have persuaded surgeons to explore other applications for\\u000a rigid endoscopic surgery. From July 1990 to February 1993 a total of 65 patients (mean age 57 years; range 41–82) underwent\\u000a attempted laparoscopic colon resection. Indications for surgical intervention included cancer (39), adenomatous polyps (14),\\u000a diverticulosis (10), stricture (1), and foreign-body perforation (1).

K. A. Zucker; D. E. Pitcher; D. T. Martin; R. S. Ford

1994-01-01

282

Laparoscopic Lymphadenectomy for Gynecologic Malignancies  

Microsoft Academic Search

Objective. The purpose of our study was to detail our 5-year experience with laparoscopic lymphadenectomy for gynecologic malignancies.Methods. From 11\\/5\\/92 to 3\\/9\\/98, we performed laparoscopic lymphadenectomies on 94 patients with various gynecologic malignancies. Pelvic, paraaortic, and combinations of both pelvic and paraaortic lymphadenectomies were performed depending on the primary site of disease and indication for lymph node dissection. Data were

Peter R. Dottino; Daniel H. Tobias; AnnMarie Beddoe; Anne L. Golden; Carmel J. Cohen

1999-01-01

283

Mood Symptoms After Natural Menopause and Hysterectomy With and Without Bilateral Oophorectomy Among Women in Midlife  

PubMed Central

Objective To examine whether mood symptoms increased more for women in the years after hysterectomy with or without bilateral oophorectomy relative to natural menopause. Methods Using data from the Study of Women’s Health Across the Nation (n=1,970), depression and anxiety symptoms were assessed annually for up to 10 years with the Center for Epidemiological Studies Depression Index and four anxiety questions, respectively. Piecewise hierarchical growth models were used to relate natural menopause, hysterectomy with ovarian conservation, and hysterectomy with bilateral oophorectomy to trajectories of mood symptoms before and after the final menstrual period or surgery. Covariates included educational attainment, race, menopausal status, age the year prior to final menstrual period or surgery, and time-varying body mass index, self-rated health, hormone therapy, and antidepressant use. Results By the 10th annual visit, 1,793 (90.9%) women reached natural menopause, 76 (3.9%) reported hysterectomy with ovarian conservation, and 101 (5.2%) reported hysterectomy with bilateral oophorectomy. For all women, depressive and anxiety symptoms decreased in the years after final menstrual period or surgery. These trajectories did not significantly differ by hysterectomy or oophorectomy status. The Center for Epidemiological Studies Depression Index means were .72 standard deviations lower, and anxiety symptoms .67 standard deviations lower, five years after final menstrual period or surgery. Conclusion In this study, mood symptoms continued to improve after the final menstrual period or hysterectomy for all women. Women who undergo a hysterectomy with or without bilateral oophorectomy in midlife do not experience more negative mood symptoms in the years after surgery.

Gibson, Carolyn J.; Joffe, Hadine; Bromberger, Joyce T.; Thurston, Rebecca C.; Lewis, Tene T.; Khalil, Naila; Matthews, Karen A.

2012-01-01

284

Outpatient laparoscopic sterilization.  

PubMed

This is a report on a pilot study conducted in Malaysia of outpatient sterilization utilizing laparoscopic technique under local anesthesia and sedation. The preliminary report based on 305 patients is presented with emphasis on the advantages and possible weaknesses of such procedure. Sterilization is performed in the Family Planning Specialist Center, Maternity Hospital. Patients are motivated towards sterilization during the immediate postpartum period in the Maternity Hospital and are counseled regarding the actual procedure. The mean age of the 305 patients was 32.08 years; the mean gravidity was 4.92; and the mean parity was 4.57. The majority of the patients came from the lower social strata with low educational attainment and low income. 253 cases of sterilizations were performed by laparoscopic procedures and 43 cases by minilaparotomy. In 9 cases difficulty was encountered with laparoscopy and subsequently the minilaparotomy was used. The majority of cases seemed to tolerate the sedation and local anesthesia fairly well and without much complaint of pain. Only a very small number of patients complained of pain particularly at the time when the Fallope or Lay rings were applied to the fallopian tubes. The overall complication rate was 14 (4.9%) and of these mild wound sepsis accounted for 6 (1.96%). Most of the wound sepsis was very mild and healed very quickly on daily dressing. No cases of pelvic sepsis were reported. There were 3 cases of uterine perforation by the uterine elevator. There were 2 cases where the fallopian tubes were traumatized and some degree of bleeding occurred. The bleeding was easily controlled by applying another Fallope ring. 2 patients had vomiting during the laparoscopic procedure. There were 7 cases of failed sterilization. 6 of the cases were performed by a trainee registrar in obstetrics and gynecology. The last was performed by a specialist gynecologist. Most of the failures were due to wrong application of rings. The cost per patient was estimated to be around 20 ringgit for a pair of tubal rings, anesthetic agents and suture materials. This preliminary study showed that female sterilization could be done easily as an outpatient procedure. PMID:6459518

Hamid Arshat; Yuliawiratman

1981-03-01

285

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

PubMed Central

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

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

2013-01-01

286

Randomised trial comparing hysterectomy with endometrial ablation for dysfunctional uterine bleeding: psychiatric and psychosocial aspects.  

PubMed Central

OBJECTIVE: To compare in psychiatric and psychosocial terms the outcome of hysterectomy and endometrial ablation for the treatment of dysfunctional uterine bleeding. DESIGN: Prospective randomised controlled trial. SETTING--Obstetrics and gynaecology department of a large teaching hospital. SUBJECTS: 204 women with dysfunctional bleeding for whom hysterectomy would have been the preferred treatment were recruited over 24 months and randomly allocated to hysterectomy (99 women) or to hysteroscopic surgery (transcervical resection (52 women) or laser ablation (53 women). MAIN OUTCOME MEASURES: Mental state, martial relationship, psychosocial and sexual adjustment in assessments conducted before the operation and one month, six months, and 12 months later. RESULTS: Both treatments significantly reduced the anxiety and depression present before the operation, and there were no differences in mental health between the groups at 12 months. Hysterectomy did not lead to postoperative psychiatric illness. Sexual interest after the operation did not vary with treatment. Overall, 46 out of 185 (25%) women reported a loss sexual interest and 50 out of 185 (27%) reported increased sexual interest. Marital relationships were unaffected by surgery. Personality and duration of dysfunctional uterine bleeding played no significant part in determining outcome. CONCLUSIONS: Hysteroscopic surgery and hysterectomy have a similar effect on psychiatric and psychosocial outcomes. There is no evidence that hysterectomy leads to postoperative psychiatric illness.

Alexander, D. A.; Naji, A. A.; Pinion, S. B.; Mollison, J.; Kitchener, H. C.; Parkin, D. E.; Abramovich, D. R.; Russell, I. T.

1996-01-01

287

Lessons Learned from Laparoscopic Gastric Banding.  

PubMed

The author reviews 27 laparoscopic gastric banding operations, of which 19 cases were completed. Of the 27 operations, eight were revisions of earlier laparoscopic banding. The lessons learned from these cases are highlighted. PMID:10757955

Broadbent

1993-11-01

288

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

289

Laparoscopic Anterograde Cholecystectomy in Acute Cholecystitis  

PubMed Central

In the laparoscopic surgery of acute cholecystitis, no identification of anatomic structures in Calot triangle prevents the retrograde disection. Therefore, the anterograde disection of gall bladder, which we often use in open cholecystectomy, was applied as an alternative method in laparoscopic cholecystectomy in our 2 cases. Through this method, the safety of the attempt was increased and the patients were not deprived of the comfort of laparoscopic cholecystectomy. Keywords Laparoscopic anterograde cholecystectomy; Acute cholecystitis; Gall bladder

Engin, Omer; Yildirim, Mehmet; Cengiz, Fevzi; Ilhan, Enver

2009-01-01

290

Optimal teaching environment for laparoscopic ventral herniorrhaphy  

Microsoft Academic Search

.   The introduction of laparoscopic techniques after residency training has created a new paradigm dependent on laparoscopic\\u000a workshops. This study tested the benefit of an animate course and evaluated the role of proctoring in learning to perform\\u000a laparoscopic ventral hernia repair (LVHR). Surgeons who had taken a 1-day LVHR course (n=59) were polled to determine previous experience with laparoscopic procedures

B. T. Heniford; B. D. Matthews; E. Box; C. Backus; K. Kercher; F. Greene; R. Sing

2002-01-01

291

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

Microsoft Academic Search

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

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

2007-01-01

292

Laparoscopic subtotal splenectomy in hereditary spherocytosis  

Microsoft Academic Search

The paper by Sanjeev Dutta et al. [1] about the laparoscopic approach to partial splenectomy in children with hereditary spherocytosis states that they have developed a novel laparoscopic partial splenectomy technique that combines the benefits of partial splenectomy with those of a laparoscopic approach. This technique, however, is not new, as erroneously stated by the authors. The technique was first

C. Vasilescu; O. Stanciulea; C. Arion

2007-01-01

293

Laparoscopic Radical Nephrectomy for Renal Cell Carcinoma  

Microsoft Academic Search

Laparoscopic radical nephrectomy has been developed and applied for patients with renal cell carcinoma since 1992. The number of patients undergoing laparoscopic radical nephrectomy has explosively increased worldwide in the recent years, and laparoscopy is extended to patients with advanced disease. It is very important to clarify the present status of laparoscopic radical nephrectomy among the treatment modalities for patients

Yoshinari Ono; Ryohei Hattori; Momokazu Gotoh; Tsuneo Kinukawa; Shin Yamada; Osamu Kamihira

294

Conventional wait  

SciTech Connect

This article discusses how a set of bilateral U.S.-Soviet accords designed expressly to speed up the conclusion and implementation of the multilateral Chemical Weapons Convention (CWC) now threatens to impede the multilateral CWC. The problem arises with an inability of Russia to fulfill certain aspects of the bilateral accords, which were supposed to demonstrate a significant superpower commitment to chemical disarmament. Russia's problems durings its political and economic transition have threatened the bilateral chemical weapons stockpile reduction and are in turn threatening the multilateral reduction process. It is the opinion of the author that the United States should shoulder the responsibility for keeping the multilateral chemical disarmament process moving forward. Steps toward this goal are outlined in the concluding section of this article. The focus of the article is on the requirements of the bilateral accords and the timetable for meeting these requirements.

Smithson, A.E.

1993-09-01

295

Treatment of dysfunctional uterine bleeding: patient preferences for endometrial ablation, a levonorgestrel-releasing intrauterine device, or hysterectomy  

Microsoft Academic Search

ObjectiveTo investigate patient preferences for endometrial ablation and a levonorgestrel-releasing intrauterine device (IUD) as alternatives to hysterectomy in the treatment of dysfunctional uterine bleeding.

Petra Bourdrez; Marlies Y Bongers; Ben W. J Mol

2004-01-01

296

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.

2011-01-01

297

RACIAL DIFFERENCES IN WOMEN WHO HAVE A HYSTERECTOMY FOR BENIGN CONDITIONS  

PubMed Central

Objective To evaluate if there are racial differences between African-American and Caucasian women who have hysterectomy for benign conditions in terms of (1) presenting symptoms (prolapse, vaginal bleeding, pain, and known history of leiomyomas), (2) serum estradiol and testosterone levels at the visit before hysterectomy, and (3) uterine weight. Methods A multi-ethnic, multisite, community-based longitudinal cohort study of 3,302 women ages 42–52 at enrollment was conducted. During 9 years of follow-up, 203 African-American and Caucasian women reported a hysterectomy, 90 with evidence of uterine leiomyomas. Women were surveyed regarding their overall perceived health before and after hysterectomy, presenting symptoms, and their motivations for surgery. Serum estradiol and testosterone levels were measured. Uterine weight at time of hysterectomy and clinical pathology were determined via medical record abstraction. Results Previously diagnosed leiomyomas were presenting symptoms more frequently in African-American women than Caucasian women (85% vs. 63%; p = .02). African-American women had less prolapse than Caucasian women (0% vs. 10%; p = 0.04). Chronic pain was a more frequent reason for hysterectomy in African-American women than in Caucasian women (49% vs. 29%; p = .05). There were no differences between the groups in levels of estradiol or testosterone. African-American women had almost twice the uterine weight as that of Caucasian women (448 vs. 240 g; p = .0005). Conclusion Racial differences in frequency of hysterectomy for benign conditions are consistent with differences in presenting symptoms, where African-American women seemingly have larger, more symptomatic fibroids.

Weiss, Gerson; Noorhasan, Dorette; Schott, Laura L.; Powell, Lynda; Randolph, John F.; Johnston, Janet M.

2013-01-01

298

Surgery for endometrial cancers with suspected cervical involvement: is radical hysterectomy needed (a GOTIC study)?  

PubMed

Background:Radical hysterectomy is recommended for endometrial adenocarcinoma patients with suspected gross cervical involvement. However, the efficacy of operative procedure has not been confirmed.Methods:The patients with endometrial adenocarcinoma who had suspected gross cervical involvement and underwent hysterectomy between 1995 and 2009 at seven institutions were retrospectively analysed (Gynecologic Oncology Trial and Investigation Consortium of North Kanto: GOTIC-005). Primary endpoint was overall survival, and secondary endpoints were progression-free survival and adverse effects.Results:A total of 300 patients who underwent primary surgery were identified: 74 cases with radical hysterectomy (RH), 112 patients with modified radical hysterectomy (mRH), and 114 cases with simple hysterectomy (SH). Median age was 47 years, and median duration of follow-up was 47 months. There were no significant differences of age, performance status, body mass index, stage distribution, and adjuvant therapy among three groups. Multi-regression analysis revealed that age, grade, peritoneal cytology status, and lymph node involvement were identified as prognostic factors for OS; however, type of hysterectomy was not selected as independent prognostic factor for local recurrence-free survival, PFS, and OS. Additionally, patients treated with RH had longer operative time, higher rates of blood transfusion and severe urinary tract dysfunction.Conclusion:Type of hysterectomy was not identified as a prognostic factor in endometrial cancer patients with suspected gross cervical involvement. Perioperative and late adverse events were more frequent in patients treated with RH. The present study could not find any survival benefit from RH for endometrial cancer patients with suspected gross cervical involvement. Surgical treatment in these patients should be further evaluated in prospective clinical studies. PMID:24002604

Takano, M; Ochi, H; Takei, Y; Miyamoto, M; Hasumi, Y; Kaneta, Y; Nakamura, K; Kurosaki, A; Satoh, T; Fujiwara, H; Nagao, S; Furuya, K; Yokota, H; Ito, K; Minegishi, T; Yoshikawa, H; Fujiwara, K; Suzuki, M

2013-09-03

299

Modified transumbilical laparoscopic cholecystectomy: double-incision, triple-port access.  

PubMed

Transumbilical laparoscopic cholecystectomy has been increasingly performed in recent years, using special access devices and instruments through one incision in the umbilicus. We have modified the technique by using a two-incision triple-port access approach and conventional laparoscopic instruments. A total of 52 patients accepted the modified transumbilical laparoscopic cholecystectomy, and all the procedures were completed successfully. The operative time was 150 minutes for the first case, 100 minutes and 90 minutes for the second and third cases, and an average of 50 ± 14 minutes for the following 49 cases. All patients were discharged on post-operative day 3. No complications were observed during a follow-up of at least three months. The umbilical incisions were nearly invisible, and all patients were satisfied with the abdominal cosmetic results.In conclusion, transumbilical laparoscopic cholecystectomy using a double-incision triple-port access approach and conventional laparoscopic instruments as described in this study is safe and feasible, and it reduces the conflict of instruments without using special devices. PMID:22793779

Zhang, Hai-Feng; Lu, Chun-Lei; Gao, Ying; Chen, Dong-Feng; Wang, Wei-Jia

2012-07-16

300

A prospective, randomized, unicenter study comparing laparoscopic and open treatments of acute appendicitis  

Microsoft Academic Search

Background: Appendectomy in the course of acute appendicitis is one of the most frequently performed surgical procedure in general surgery. The aim of this study was to compare the results of laparoscopic and conventional treatments for acute appendicitis in a prospective, randomized, unicenter study. Methods: The study involved 200 patients treated for acute appendicitis in the Department of General and

M. Milewczyk; M. Michalik; M. Ciesielski

2003-01-01

301

Effects of the Pringle Maneuver on Hemodynamics during Laparoscopic Liver Resection in the Pig  

Microsoft Academic Search

The Pringle maneuver (PM) is recognized in conventional liver surgery as a method of controlling bleeding. To determine the hemodynamic effects of the PM during pneumoperitoneum (PP) for laparoscopic liver resection, we measured hemodynamic and blood gas changes in 7 healthy pigs. All variables were recorded 5 min before and 10 and 30 min after employing PP or PM and

J. Haberstroh; M. Ahrens; T. Munzar; J. Waninger; R. Salm; U. Matern; Eva Pauly; B. U. von Specht

1996-01-01

302

Granulomatous Peritonitis After Laparoscopic Cholecystectomy  

PubMed Central

Background: Granulomatous peritonitis may indicate a number of infectious, malignant, and idiopathic inflammatory conditions. It is a very rare postoperative complication, which is thought to reflect a delayed cell-mediated response to cornstarch from surgical glove powder in susceptible individuals. This mechanism, however, is much more likely to occur with open abdominal surgery when compared with the laparoscopic technique. Methods: We report a case of sterile granulomatous peritonitis in an 80-y-old female after a laparoscopic cholecystectomy. Management was conservative, and no relapse was observed after over 1-y of follow-up. Discussion: We propose that peritoneal exposure to bile acids during the laparoscopic removal of the gallbladder was the trigger of granulomatous peritonitis in this patient. Severe complications, such as peritoneal adhesions, intestinal obstruction, and fistula formation, were observed, but no fatalities were reported. Conclusion: We should be aware of this rare cause of peritonitis in the surgical setting.

Remotti, Daniele; Galluzzo, Michele; Gasbarrone, Laura

2012-01-01

303

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

PubMed

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

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

2009-12-10

304

Pre-menopausal Hysterectomy Is Associated With Increased Brain Ferritin Iron  

PubMed Central

Objective Iron is essential for triggering oligodendrocytes to myelinate, however, in gray matter (GM) iron increases with age and is associated with age-related degenerative brain diseases. Women have lower iron levels than men, both in the periphery and in the brain, particularly in white matter (WM), possibly due to iron loss through menstruation. We tested the hypothesis that hysterectomy could increase WM iron levels. Methods We assessed three WM and five GM regions in 39 post-menopausal women, of whom 15 had premenopausal hysterectomy, utilizing a validated magnetic resonance imaging technique called FDRI that quantifies ferritin iron. A group of 54 matched male subjects was included for comparison. Results Amongst women, hysterectomy was associated with significantly higher frontal lobe WM iron. Men had higher iron levels than women without hysterectomy in three brain regions but did not differ from women with hysterectomy in any region. Conclusions The results suggest that menstruation-associated blood loss is a source of gender differences in brain iron. It is possible that brain iron can be influenced by peripheral iron levels and may thus be a modifiable risk factor for age-related degenerative diseases.

Tishler, Todd A.; Raven, Erika P.; Lu, Po H.; Altshuler, Lori L.; Bartzokis, George

2011-01-01

305

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

306

Hemostasis in laparoscopic renal surgery  

PubMed Central

Hemorrhage is a potential risk at any step of laparoscopic nephrectomies (LNs). The advances in surgical equipment and tissue sealants have increased the safety and efficiency of performing LN and laparoscopic partial nephrectomy (LPN). However, hemostasis remains a major issue and there is still scope for further development to improve haemostatic techniques and devices. In this article a literature review of the current methods and techniques of hemostasis was carried out using the MEDLINE ®/PubMed® resources. The results of the review were categorized according to the three main operative steps: Dissection, control of renal pedicle and excision of the renal lesion.

Hassouna, Hussam A.; Manikandan, Ramaswamy

2012-01-01

307

The impact of intraoperative autologous blood transfusion during type III radical hysterectomy for early-stage cervical cancer  

Microsoft Academic Search

Objective: The aim of this study was to determine the effects on transfusion rates, perioperative complications, and survival of using intraoperative autologous blood transfusions for patients undergoing type III radical hysterectomy and lymphadenectomy. Study Design: A retrospective analysis was conducted on 156 patients treated with type III radical hysterectomy and lymphadenectomy at the University of Miami School of Medicine from

Ramin Mirhashemi; Hervy E. Averette; Krishnaprasad Deepika; Ricardo Estape; Roberto Angioli; Jorge Martin; Michael Rodriguez; Manuel A. Penalver

1999-01-01

308

Tubal ligation, hysterectomy and D&C: evidence from the Melbourne Women's Midlife Health Project.  

PubMed

The question of whether tubal ligation (TL) is associated with increased risk of hysterectomy or dilatation and curettage (D&C) is examined using data from a population-based study. Retrospective information on TL, D&C and hysterectomy was gathered from 1,810 Australian-born women aged 45-55 who were randomly selected from the population of Melbourne, Australia. Odds ratios for the outcomes were adjusted via logistic regression for age, years of education, smoking status, alcohol consumption, history of premenopausal complaints, number of lost pregnancies, and whether women have discussed menstruation or menopause with their doctor. With these variables taken into account, TL does not emerge as a risk factor for hysterectomy. Though there was a significant association between TL and the probability of ever experiencing a D&C, related extraneous variables which appear to link these events are identified. PMID:10965196

Taffe, J; Green, A; Dudley, E; Dennerstein, L

2000-01-01

309

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.

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

2013-01-01

310

Laparoscopic management of superior mesenteric artery syndrome.  

PubMed

Superior mesenteric artery syndrome (SMAS) is a rare clinical condition that should be considered in patients with long-standing abdominal complaints where endoscopic and conventional roentgenographical findings are often negative. It has been claimed that SMAS is caused by intermittent obstruction of the horizontal portion of the duodenum between the superior mesenteric artery and the spine and the aorta. The main target of this presentation is to present our experience in the laparoscopic management of 4 cases of documented SMAS after failure of medical treatment. The laparoscopic severing of the ligament of Treitz is a feasible and safe technique. It could bring about total relief of symptoms in three out of the four patients. The operative time rapidly decreased with the acquaintance of the field. The visualization (exposure) is quite satisfactory. the technique offers added precision and accuracy to the dissection manoeuvres. Recovery was uneventful and rapid with minimal needs for postoperative analgesia. We recommend the use of mini-endoshear (pediatric). Phases of dissection from the mesocolon and retro-pancreatically are presented. We stress the finding of the drainage of the inferior mesenteric vein into the superior mesenteric vein instead of the splenic vein. This could put the inferior mesenteric vein (looking as a fibrous band) in jeopardy. Also it reduces the area of access to the retropancreatic dissection. We raise the possibility of an etiological role of this anatomical variation to the duodenal compression and call upon the study of such a possibility. The importance to attain the proper retropancreatic space has been shown by the possibility of dissecting between the uncinate process and the rest of the pancreas. The psychological impact of a minimal invasive approach together with symptoms relief was quite rewarding. PMID:8740677

Massoud, W Z

311

Single-incision laparoscopic cholecystectomy: a comparison with the gold standard  

Microsoft Academic Search

Background  Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic\\u000a cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective review of patients undergoing SILC over an 8-month period was performed. A cohort of LC patients from the\\u000a same surgeons over the preceding 8 months was used as historic controls. Demographics, comorbidities, diagnosis,

Sigi Joseph; B. Todd Moore; G. Brent Sorensen; John W. Earley; Fengming Tang; Phil Jones; Kimberly M. Brown

312

Internal hernia of the broad ligament: CT diagnosis for laparoscopic management.  

PubMed

One per cent of cases of mechanical occlusion of the small intestine are caused by internal hernias, the rarest type being an internal hernia through the broad ligament of the uterus, and representing approximately 5% of cases. While "conventional" treatment of mechanical occlusions of the small intestine is based on laparotomy, a laparoscopic approach is feasible in nearly half of cases, with an acceptable rate of morbidity. Preoperative diagnosis has for a long time been difficult but the usefulness has recently been emphasized of computed tomography. We report the cases of two patients who presented an internal hernia of the right broad ligament diagnosed with CT who afterwards underwent laparoscopic surgery. PMID:22721604

Marraoui, W; Petitcolin, V; Bros, S; Slim, K; Garcier, J-M; Da Ines, D

2012-06-19

313

Suprapubic approach for laparoscopic appendectomy  

PubMed Central

Objective: To evaluate the results of laparoscopic appendectomy using two suprapubic port incisions placed below the pubic hair line. Design: Prospective hospital based descriptive study. Settings: Department of surgery of a tertiary care teaching hospital located in Rohtas district of Bihar. The study was carried out over a period of 11months during November 2011 to September 2012. Participants: Seventy five patients with a diagnosis of acute appendicitis. Materials and Methods: All patients underwent laparoscopic appendectomy with three ports (one 10-mm umbilical for telescope and two 5 mm suprapubic as working ports) were included. Operative time, conversion, complications, hospital stay and cosmetic results were analyzed. Results: Total number of patients was 75 which included 46 (61.33%) females and 29 (38.67%) males with Mean age (±Standard deviation {SD}) at the time of the diagnosis was 30.32 (±8.86) years. Mean operative time was 27.2 (±5.85) min. One (1.33%) patient required conversion to open appendectomy. No one patient developed wound infection or any other complication. Mean hospital stay was 22.34 (±12.18) h. Almost all patients satisfied with their cosmetic results. Conclusion: A laparoscopic approach using two supra pubic ports yields the better cosmetic results and also improves the surgeons working position during laparoscopic appendectomy. Although, this study had shown better cosmetic result and better working position of the surgeon, however it needs further comparative study and randomized controlled trial to confirm our findings.

Singh, Manish K.; Kumar, Mani K.; Mohan, Lalit

2013-01-01

314

Robot-assisted laparoscopic choledochojejunostomy  

Microsoft Academic Search

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

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

2003-01-01

315

Laparoscopic repair of epiphrenic diverticulum.  

PubMed

Epiphrenic diverticula (ED) are a rare clinical entity characterized by out-pouchings of the esophageal mucosa originating in the distal third of the esophagus, close to the diaphragm. The proportion of diverticula reported symptomatic enough to warrant surgery is extremely variable, ranging from 0% to 40%. The natural history of ED is still almost unknown and the most intriguing question concerns whether or not they all need surgical treatment. From 1993 to 2010 35 patients underwent surgery at our institution. Eleven patients were treated via a thoracotomic approach alone and were excluded from present study. The remaining 24 patients formed our study population. Seventeen patients (48.6%) underwent surgery via a purely laparoscopic approach, and received a diverticulectomy + myotomy + antireflux procedure. Seven patients (23%), with ED positioned well above inferior pulmonary vein, were treated via a combined laparoscopic-thoracotomic approach: they all underwent diverticulectomy + myotomy + an antireflux procedure. Mortality was nil. The overall morbidity rate was 25%. A suture leakage occurred in 4 patients (16.6%) and they were all conservatively treated. Patients' symptom scores decreased from a median of 15 to 0 (P = 0.0005). Laparoscopic surgery for ED is effective, but given the not negligible incidence of complications such suture-line leakage, should be considered only in symptomatic patients or in event of huge diverticula. A tailored combined laparoscopic-thoracotomic approach may be useful in case of ED located high in mediastinum or with large neck. PMID:23200079

Zaninotto, Giovanni; Parise, Paolo; Salvador, Renato; Costantini, Mario; Zanatta, Lisa; Rella, Antonio; Ancona, Ermanno

2012-01-01

316

Laparoscopic-assisted colon resection.  

PubMed

The popularity and success of laparoscopic biliary tract surgery have persuaded surgeons to explore other applications for rigid endoscopic surgery. From July 1990 to February 1993 a total of 65 patients (mean age 57 years; range 41-82) underwent attempted laparoscopic colon resection. Indications for surgical intervention included cancer (39), adenomatous polyps (14), diverticulosis (10), stricture (1), and foreign-body perforation (1). A laparoscopic-assisted technique whereby the specimen was removed and the anastomosis was completed outside of the abdomen was used in all patients. A dilated umbilical opening was used for right-sided lesions and a left-lower-quadrant muscle-splitting incision for descending and sigmoid colon resections. Two patients required conversion to open laparotomy. There were no deaths and only four complications (pneumonia 1, urinary tract infection 1, prolonged ileus 1, and subfascial abscess 1). The mean postoperative stay was 4.4 days (range 3-8 days) and the average interval for return to normal activity was 8 days. Laparoscopic-assisted colon resection appears to be a safe and beneficial option for many patients with pathologic disorders of the large intestine. Future clinical trials are needed to fully determine the appropriateness of this procedure in patients with localized malignancies. PMID:8153858

Zucker, K A; Pitcher, D E; Martin, D T; Ford, R S

1994-01-01

317

[Clinical application of laparoscopic proctocolectomy].  

PubMed

Laparoscopic proctocolectomy is a safe and feasible but complicated procedure, which is widely used clinically. Fully understanding of surgical plane and vascular anatomy is important for operation. The anastomosis methods, the type of ileal reservoir pouch and whether or not performing protective ilostomy should be considered preoperatively. Many details should be paid attention to. PMID:23072018

Tao, Kai-xiong; Shuai, Xiao-ming

2012-08-01

318

The myths of laparoscopic surgery  

Microsoft Academic Search

Laparoscopic surgery has been rapidly accepted without rigorous scientific study. New procedures and technologies have advanced rapidly, and most gynecologists have embraced these techniques. I believe that the new technology has given rise to the following myths: (1) that there are associated cost savings, (2) that new technology is always better than the old, (3) that a steep learning curve

Michael P. Hopkins

2000-01-01

319

Laparoscopic bladder augmentation using stomach  

Microsoft Academic Search

We present a case of bladder augmentation with stomach, via a laparoscopic approach. The patient was a 17-year-old girl with sacral agenesis and a poorly compliant bladder. A wedge of stomach, based on the right gastroepiploic pedicle, was obtained using a stapled technique. The bladder was opened and the gastric segment was sutured in place. A needle suspension was also

Steven G. Docimo; Robert G. Moore; John Adams; Louis R. Kavoussi

1995-01-01

320

Laparoscopic colectomy: A critical appraisal  

Microsoft Academic Search

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

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

1993-01-01

321

Anesthetic implications of laparoscopic surgery.  

PubMed Central

Minimally invasive therapy aims to minimize the trauma of any interventional process but still achieve a satisfactory therapeutic result. The development of "critical pathways," rapid mobilization and early feeding have contributed towards the goal of shorter hospital stay. This concept has been extended to include laparoscopic cholecystectomy and hernia repair. Reports have been published confirming the safety of same day discharge for the majority of patients. However, we would caution against overenthusiastic ambulatory laparoscopic cholecystectomy on the rational but unproven assumption that early discharge will lead to occasional delays in diagnosis and management of postoperative complications. Intraoperative complications of laparoscopic surgery are mostly due to traumatic injuries sustained during blind trocar insertion and physiologic changes associated with patient positioning and pneumoperitoneum creation. General anesthesia and controlled ventilation comprise the accepted anesthetic technique to reduce the increase in PaCO2. Investigators have recently documented the cardiorespiratory compromise associated with upper abdominal laparoscopic surgery, and particular emphasis is placed on careful perioperative monitoring of ASA III-IV patients during insufflation. Setting limits on the inflationary pressure is advised in these patients. Anesthesiologists must maintain a high index of suspicion for complications such as gas embolism, extraperitoneal insufflation and surgical emphysema, pneumothorax and pneumomediastinum. Postoperative nausea and vomiting are among the most common and distressing symptoms after laparoscopic surgery. A highly potent and selective 5-HT3 receptor antagonist, ondansetron, has proven to be an effective oral and IV prophylaxis against postoperative emesis in preliminary studies. Opioids remain an important component of the anesthesia technique, although the introduction of newer potent NSAIDs may diminish their use. A preoperative multimodal analgesic regimen involving skin infiltration with local anesthesia. NSAIDs to attenuate peripheral pain and opioids for central pain may reduce postoperative discomfort and expedite patient recovery/discharge. There is no conclusive evidence to demonstrate clinically significant effects of nitrous oxide on surgical conditions during laparoscopic cholecystectomy or on the incidence of postoperative emesis. Laparoscopic cholecystectomy has proven to be a major advance in the treatment of patients with symptomatic gallbladder disease.

Cunningham, A. J.

1998-01-01

322

Laparoscopic management of bile duct and bowel injury during laparoscopic cholecystectomy  

Microsoft Academic Search

Accidentai injuries to the bile duct and bowel are significant risks of laparoscopic surgery and sometimes require conversion\\u000a to open surgery. Although some of the injuries related to laparoscopic cholecystectomy can be managed by endoscopic techniques,\\u000a laparoscopic surgery is not yet sufficiently perfected. We investigated the efficacy of laparoscopic management combined with\\u000a endoscopic tube or stent insertion in cases of

A.-Hon Kwon; Hiroyuki Inui; Yasuo Kamiyama

2001-01-01

323

[Simulation of laparoscopic surgery--four years' experience at the Department of Surgery of the University Hospital Marburg].  

PubMed

It is well known that learning curves are longer for laparoscopic surgery compared to open surgery. Recently, virtual reality (VR) simulation was developed as alternative to conventional training. Such a new training system makes it possible to offer a wide range of repeatable surgical situations, and thus, enable assessments based on direct observation of performance. During the last four years we did several studies using a VR simulator (LapSim). After a constructive validity study - discrimination between novices and experienced laparoscopic surgeons, we were able to show that advanced residents benefit most from a three-day practical course for laparoscopic surgery, while - in a further investigation - we found contrary to training at the Pelvitrainer that novices in laparoscopic surgery have the most benefit from VR training. Minimally invasive surgery is significantly more sophisticated for the surgeon than open surgery. While Research on laparoscopic surgery has focused primarily on the development and assessment of technical skills, non technical skills such as visual-spatial perception and stress coping has received much less attention. We showed that spatial perception as well as stress coping positively correlates with virtual laparoscopic skills. A high degree of spatial perception led to faster adaption to a non-stereo environment and correlated with high level of laparoscopic skills. Furthermore, Ineffective stress-coping strategies correlate with poor virtual laparoscopic performance. VR simulation seems to be a promising tool to improve laparoscopic skills in a modern apprenticeship model. According to patient safety, the development of this instrument for surgery should be advanced professionally just as a flight simulators in aviation. PMID:18322767

Hassan, Iyad; Osei-Agymang, Thomas; Radu, Daniela; Gerdes, Berthold; Rothmund, Matthias; Fernández, Emilio Domínguez

2008-01-01

324

Laparoscopic partial nephrectomy without ischemia.  

PubMed

The warm ischaemia time appears the most prominent modifiable risk factor for the development of renal impairment following laparoscopic partial nephrectomy. Historically, hilar clamping was the 'gold standard' technique, but now we are pushing our techniques to achieve the ultimate: 'zero ischaemia' approach. Results from 'early unclamping' techniques reinforced the importance of 'every minute counts' (28). Subsequent techniques in non-hilar clamping demonstrated that this approach was indeed feasible, but at the expense of higher bleeding, positive margins, and collecting system breach rates. With the advancement of technology, through the use of robotic assistance, improved haemostatic agents, as well as various imaging modalities (laparoscopic ultrasound, CT angiography), the surgeon can now potentially perform Nephron Sparing Surgery (NSS) in a more precise manner. Specifically, with the use of superselective clamping of the feeding vessel(s) to the tumour, the remaining healthy renal parenchyma should be less compromised, with associated low bleeding rates. NSS in the form of laparoscopic partial nephrectomy is clearly evolving, with increasing demands on the surgeon, requiring more expertise and experience, with the added assistance from other specialties (anaesthetists, radiologists etc). To be able to regularly perform Laparoscopic Partial Nephrectomy (LPN) without ischaemia safely, the laparoscopist must develop his / her experience in a stepwise fashion, perhaps commencing with artery-only clamping, leading on to early declamping, and then 'on demand' clamping. When moving on to LPN without ischaemia, patient selection is paramount. The ideal patient would harbour a single small, polar, exophytic renal mass with a normal functioning contralateral kidney. Although currently the techniques and outcomes laparoscopic partial nephrectomy without ischaemia published are limited to a few authors, with no current long term results to prove its full worth and reproducibility, early results are very encouraging. The pursuit of acquiring 'zero ischaemia' is clearly worthwhile, but needs to be measured against the potential risks of increased morbidity and positive margin rates. PMID:23406810

Hotston, Matthew R; Keeley, Francis X

325

Laparoscopic Repair of a Traumatic Bladder Rupture  

PubMed Central

Laparoscopic repair of the traumatic intraperitoneal bladder rupture is a proven, safe, and effective technique in the appropriate setting. A 23-year-old male with traumatic intraperitoneal bladder rupture proven by cystogram after a motor vehicle collision was successfully repaired via a laparoscopic approach. We describe the technique in detail including 2-layer closure and follow-up care. A review of the literature using PubMed with the key words [laparoscopic repair bladder injury] AND [bladder trauma] was performed. We recommend the consideration of laparoscopic repair of the intraperitoneal bladder rupture in more trauma patients who meet criteria.

Hugo Cuadra, Rene; Ricchiuti, Daniel J.

2012-01-01

326

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

PubMed

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

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

1995-08-01

327

Long-term impact and risk factors for hysterectomy after hysteroscopic surgery for menorrhagia  

Microsoft Academic Search

The objective of this study was to assess the long-term impact of management and establish the incidence of hysterectomy, and to identify factors predictive of failure of the procedure among women who had undergone hysteroscopic endometrial resection with or without myomectomy for menorrhagia. Clinical history and data on additional treatment and follow-up status were obtained by medical record review and

Pentti K. Heinonen; Riikka Helin; Kari Nieminen

2006-01-01

328

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

329

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

330

Comparison of ureteral and cervical descents during vaginal hysterectomy for uterine prolapse  

Microsoft Academic Search

Objective: The study measured ureteral and cervical locations during vaginal hysterectomy for prolapse and the extent of parametrial ligament shortening possible. Study Design: Cervical and ureteral position were measured in 26 women undergoing uterine prolapse correction. Parametrial clamp tip location was also measured. Results: The cervix lay between 0 and –14.5 cm (below) the hymen (mean ± SD –5.35 ±

John O. L. DeLancey; Kris Strohbehn; Michael P. Aronson

1998-01-01

331

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

332

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

Microsoft Academic Search

Purpose. To compare costs and reimbursements for three different treatments for uterine fibroids. Methods. Costs and reimbursements were collected and analyzed from the Thomas Jefferson University Hospital decision support database from 540 women who underwent abdominal hysterectomy (n 299), abdominal myomectomy (n = 105), or uterine fibroid embolization (UFE) (n = 136) for uterine fibroids during 2000-2002. We used the

Jay Goldberg; Anne Bussard; Jean McNeil; James Diamond

2007-01-01

333

'State of the art' of radical hysterectomy; current practice in European oncology centres.  

PubMed

Quality control of medical performance requires adequate 'state-of-the-art' data and this is currently not uniformly defined for radical hysterectomy. We have used data from a randomised multicentre clinical trial examining the clinical significance of surgical drains following radical hysterectomy (European Organisation for Research and Treatment of Cancer (EORTC)-55962). Although the study was not designed to analyse the quality of the surgical procedure per se, surgical data during and after the operation were carefully noted. A total of 234 patients from 12 European institutes were included in the study. We reported on the clinical and surgical characteristics, the radicality of surgery and short- and long-term complications of radical hysterectomy: median duration of surgery: 240 min; median number of nodes removed: 26; lymph node metastases: 22%; post-operative mortality: <1%; urinary tract infection: 42%; deep venous thrombosis: 3%; fistula: 2%. The data from our study provides an honest and realistic picture of the current practice of radical hysterectomy among European oncology centres and may be considered as the 'standard of care' in this part of the world. PMID:14746855

Trimbos, J B; Franchi, M; Zanaboni, F; Velden, J v d; Vergote, I

2004-02-01

334

Laparoscopic Versus Open IleoColonic Resection in Crohn’s Disease: Short and Long-Term Results from a Prospective Longitudinal Study  

Microsoft Academic Search

Possible relations between surgical approaches, frequency, and severity of Crohn’s disease recurrence after ileo-colonic resection\\u000a is unknown. We aimed to assess perioperative outcomes and postsurgical complications of laparoscopic versus standard open\\u000a surgery and to detect differences between the two groups in endoscopical recurrence and patients’ satisfaction. Twenty-eight\\u000a consecutive patients undergoing elective ileo-colonic resection by either laparoscopic approach (n?=?15) or conventional

Giuseppe S. Sica; Edoardo Iaculli; Domenico Benavoli; Livia Biancone; Emma Calabrese; Sara Onali; Achille L Gaspari

2008-01-01

335

Laparoscopic Resection of Large Adrenal Tumors  

PubMed Central

Background: Laparoscopic adrenalectomy has rapidly replaced open adrenalectomy as the procedure of choice for benign adrenal tumors. It still remains to be clarified whether the laparoscopic resection of large (?8cm) or potentially malignant tumors is appropriate or not due to technical difficulties and concern about local recurrence. The aim of this study was to evaluate the short- and long-term outcome of 174 consecutive laparoscopic and open adrenalectomies performed in our surgical unit. Methods: Our data come from a retrospective analysis of 174 consecutive adrenalectomies performed on 166 patients from May 1997 to December 2008. Fifteen patients with tumors ?8cm underwent laparoscopic adrenalectomy. Sixty-five patients were men and 101 were women, aged 16 years to 80 years. Nine patients underwent either synchronous or metachronous bilateral adrenalectomy. Tumor size ranged from 3.2cm to 27cm. The largest laparoscopically excised tumors were a ganglioneuroma with a mean diameter of 13cm and a myelolipoma of 14cm. Results: In 135 patients, a laparoscopic procedure was completed successfully, whereas in 14 patients the laparoscopic procedure was converted to open. Seventeen patients were treated with an open approach from the start. There were no conversions in the group of patients with tumors >8cm. Operative time for laparoscopic adrenalectomies ranged from 65 minutes to 240 minutes. In the large adrenal tumor group, operative time for laparoscopic resection ranged from 150 minutes to 240 minutes. The postoperative hospital stay for laparoscopic adrenalectomy ranged from 1 day to 2 days (mean, 1.5) and from 5 days to 20 days for patients undergoing the open or converted procedure. The mean postoperative stay was 2 days for the group with large tumors resected by laparoscopy. Conclusion: Laparoscopic resection of large (?8cm) adrenal tumors is feasible and safe. Short- and long-term results did not differ in the 2 groups.

Farfaras, Athanasios; Vasiliadis, George; Pappa, Theodora; Aggeli, Chrysanthi; Vasilatou, Evagelina; Kaltsas, Gregory; Piaditis, George

2010-01-01

336

CURRENT TRENDS IN LAPAROSCOPIC CHOLECYSTECTOMY  

PubMed Central

Gallstone disease is still a major health problem worldwide. Open cholecystectomy was the standard treatment for symptomatic gallstones for more than 100 years. The introduction of laparoscopic cholecystectomy in the late 1980s has led to dramatic changes in the management of gallstone disease. The aim of this review is to equip the general practitioner with the answers to questions a patient may ask about the current management of gallstones.

Al-Mulhim, Abdulmohsen A.

1997-01-01

337

Robot-Assisted Laparoscopic Ultrasound  

Microsoft Academic Search

\\u000a Novel tools for existing robotic surgical systems present opportunities for exploring improved techniques in minimally invasive\\u000a surgery. Specifically, intraoperative ultrasonography is a tool that is being used with increased frequency, yet has limitations\\u000a with existing laparoscopic systems. The purpose of this study was to develop and to evaluate a new ultrasound system with\\u000a the da Vinci\\u000a ® Surgical System (Intuitive

Caitlin M. Schneider; Gregory W. Dachs; Christopher J. Hasser; Michael A. Choti; Simon P. DiMaio; Russell H. Taylor

2010-01-01

338

Laparoscopic resection of sigmoid diverticulitis  

Microsoft Academic Search

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

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

1999-01-01

339

Laparoscopic Procedures in Trauma Care  

Microsoft Academic Search

\\u000a The modern concept of diagnostic laparoscopy for trauma patients emerged in the early 1970s. The literature shows that a variety\\u000a of laparoscopic techniques are applicable to patients with abdominal trauma. Treatment of abdominal trauma requires a precise\\u000a diagnosis that is not always possible with imaging techniques. As the danger is particularly great that an injury to the diaphragm\\u000a or intestines

Selman Uranues; Abe Fingerhut; Roberto Bergamaschi

340

Laparoscopic Radical Nephrectomy: Transperitoneal Approach  

Microsoft Academic Search

\\u000a Radical nephrectomy, as described by Robson et al. in 1963, is the traditional gold standard approach to the management of\\u000a renal tumors (1). This procedure has an established success rate but is associated with significant postoperative pain and\\u000a prolonged convalescence, stemming from the flank, subcostal, Chevron or thoraco-abdominal incisions typically used. Laparoscopic\\u000a radical nephrectomy, as introduced by Clayman and associates

Leslie A. Deane; David I. Lee; Jaime Landman; Chandru P. Sundaram; Ralph V. Clayman

341

Severe endometriosis: laparoscopic rectum resection  

Microsoft Academic Search

Aim  Endometriosis is a frequent benign disease of women in reproductive age. An infiltration of the spatium rectovaginal is rare,\\u000a but if it occurs, in up to 73% the rectum is involved. If there is the indication for surgery, a partial resection of the\\u000a rectum might be necessary. This can be performed by a laparoscopic approach. It is the aim of

Ingolf Juhasz-Böss; Claus Lattrich; Alois Fürst; Eduard Malik; Olaf Ortmann

2010-01-01

342

Laparoscopic treatment of pancreatic insulinoma.  

PubMed

Laparoscopy and laparoscopic ultrasonography (LUS) have been proposed for the diagnosis and treatment of pancreatic insulinoma. We present for cases of pancreatic insulinoma approached by laparoscopy guided by LUS. In three cases, insulinomas were in the pancreatic body and in one case in the pancreatic head. All lesions were detected preoperatively by abdominal US and confirmed by computed tomography. Laparoscopy was performed under general anesthesia. LUS was performed using a 10-mm flexible probe. In two cases the adenoma was enucleated using scissors and electrocoagulation, major vessels were controlled using clips, and enucleation was completed using a 30-mm endo-GIA. In one case a laparoscopic distal pancreatectomy with spleen preservation was performed. In one case the adenoma was deep in the pancreatic head; minilaparotomy was performed and the adenoma enucleated. Patients were discharged in good health 5-7 days after surgery. The postoperative course was complicated in one case of enucleation by peripancreatic fluid collection that was treated percutaneously. Our experience confirms that accurate localization followed by excision of tumors via the laparoscopic approach constitute a significant advance in the management of insulinoma. PMID:12802660

Goletti, O; Celona, G; Monzani, F; Caraccio, N; Zocco, G; Lippolis, P V; Battini, A; Seccia, M; Cavina, E

2003-06-17

343

[Laparoscopic management of extrauterine pregnancy].  

PubMed

The radioimmunologic assay of human chorionic gonadotropin and ultrasound have contributed to an earlier diagnosis of ectopic tubal pregnancy. Laparoscopy has modified not only diagnostic, but even therapeutic approach. In fact laparoscopic approach and medical treatment with methotrexate have proved to be safe and effective. Between October 1991 and December 1993 by the Department of Obstetric and Gynecology of the Hospital Felice Villa (Mariano Comense -- CO) all patients (14) with suspected extra-uterine pregnancy were submitted to laparoscopy. Of these 12 were treated by laparoscopic salpingostomy or aspiration. Five cases in which trophoblastic tissue was not present at histologic specimen were submitted to medical treatment with methotrexate. In 2 cases in which the tube was ruptured we performed a salpingectomy after laparotomy. We didn't have any early or late complication. After laparoscopy betahCG levels were monitored every 2 days. We didn't have any case of trophoblastic persistency or any recurrence. Recent studies have demonstrated lower morbidity and higher fertility rate in women treated laparoscopically for GEU. However data from literature show some discrepancy. As a matter of fact it is not so evident that fertility is better preserved by operative laparoscopy than laparotomy. Anyway laparoscopy presents a better outcome for the patient and requires less days of hospitalization. PMID:8820391

Borsellino, G; Danile, G

1995-11-01

344

Laparoscopic nephrectomy for Wilms' tumor.  

PubMed

The role of minimally invasive surgery for the treatment of pediatric urological tumors has been limited to biopsies and resection for small neuroblastomas and benign tumors. The purpose of this study is to present the experience of a Brazilian group pioneering laparoscopic nephrectomy for Wilms' tumor. A total of 15 children with unilateral non-metastatic Wilms' tumor were preoperatively treated with vincristine and actinomycin D, and afterwards were submitted to laparoscopic nephrectomy and lymph node sampling. A Veress needle umbilical punction was performed and a four-trocar transperitoneal approach was used. The tumor was extracted inside a plastic bag and without morcellation through a Pfannenstiel incision. In all 15 patients the tumor was completely removed, as well as lymph node samples and no ruptures occurred. A fibrous capsule involved the tumor, making the dissection easy to perform. Intraoperative bleeding was minimal. The postoperative course was free of complications and all the patients were discharged early. No recurrences or long-term complications have been detected in 7-61 months or more of follow-up. We conclude that laparoscopic nephrectomy for Wilms' tumor is a feasible and safe procedure in a selected group of children after chemotherapy. It reproduces all the steps of the open surgical approach required to treat this tumor, with the advantages of a short hospital stay and cosmetically more acceptable incisions. PMID:19496712

Duarte, Ricardo Jordão; Dénes, Francisco Tibor; Cristofani, Lílian Maria; Srougi, Miguel

2009-06-01

345

Robotic-assisted laparoscopic radical prostatectomy: the Frankfurt technique  

Microsoft Academic Search

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

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

2003-01-01

346

Imaging findings of biliary and nonbiliary complications following laparoscopic surgery  

Microsoft Academic Search

Laparoscopic techniques are evolving for a wide range of surgical procedures although they were initially confined to cholecystectomy and exploratory laparoscopy. Recently, surgical procedures performed with a laparoscope include splenectomy, adrenalectomy, gastrectomy, and myomectomy. In this article, we review the spectrum of complications and illustrate imaging features of biliary and nonbiliary complications after various laparoscopic surgeries. Biliary complications following laparoscopic

Jin-Young Choi; Myeong-Jin Kim; Mi-Suk Park; Joo Hee Kim; Joon Seok Lim; Young Taik Oh; Ki Whang Kim

2006-01-01

347

Imaging of complications of laparoscopic cholecystectomy  

Microsoft Academic Search

Laparoscopic cholecystectomy has gained widespread acceptance for treatment of cholelithiasis. Because radiologists have aprimary role in recognizing and treating complications of this surgical technique, we reviewed the clinical records and imaging studies of 29 patients with complications after laparoscopic cholecystectomy. Complications included bile duct injuries (15 cases), retained common bile duct stones (seven cases), cystic duct stump leak (four cases),

Ellen M. Ward; Andrew J. LeRoy; Claire E. Bender; John H. Donohue; Rollin W. Hughes

1993-01-01

348

Laparoscopic excision of splenic hydatid cyst  

PubMed Central

Hydatid disease of the spleen is a rare condition. The standard treatment is open total or partial splenectomy. Recently hand assisted laparoscopic total splenectomy for splenic hydatid cyst has been reported. A case is described of splenic hydatid cyst in a 45 year old man that was excised laparoscopically; the related literature is reviewed.???Keywords: hydatid disease; spleen; laparoscopy; Jordan

Gharaibeh, K

2001-01-01

349

Diffusion of laparoscopic technologies in Denmark  

Microsoft Academic Search

It has been predicted that minimally invasive therapy will have dramatic consequences for the specialty of general surgery, as demonstrated by the diffusion of laparoscopic cholecystectomy. To investigate the determinants of the diffusion in Denmark of five laparoscopic technologies (cholecystectomy, appendicectomy, surgery for colon cancer, surgery for inguinal hernia and fundoplication), questionnaires on seventeen factors' influence on the adoption (stimulating

Peter Bo Poulsen; Sven Adamsen; Hindrik Vondeling; Torben Jørgensen

1998-01-01

350

Robotic-assisted laparoscopic dismembered pyeloplasty  

Microsoft Academic Search

ObjectivesTo evaluate the feasibility and efficacy of robotic-assisted laparoscopic pyeloplasty. Laparoscopic pyeloplasty has been shown to have a success rate comparable to that of the open surgical approach. However, the steep learning curve has hindered its acceptance into mainstream urologic practice. The introduction of robotic assistance provides advantages that have the potential to facilitate precise dissection and intracorporeal suturing.

Vipul Patel

2005-01-01

351

Laparoscopic-assisted abdominal aortic aneurysm repair  

Microsoft Academic Search

Since the advent of laparoscopy, the sweeping changes seen in general surgery have not been paralleled in vascular surgery. There have been case reports of laparoscopic-assisted aortobifemoral bypass for occlusive disease. Because aneurysmal disease comprises the majority of aortic surgery, we pursued animal and cadaveric feasibility studies for laparoscopic-assisted abdominal aortic aneurysm (AAA) repair. We present a case report of

M. H. M. Chen; E. A. Murphy; V. Halpern; G. R. Faust; J. M. Cosgrove; J. R. Cohen

1995-01-01

352

Laparoscopic ablation of peripelvic renal cysts  

Microsoft Academic Search

Recently, laparoscopic surgery has been reported for symptomatic renal cysts. A 60-year-old female was referred to Toyama Medical and Pharmaceutical University Hospital with a chief complaint of general fatigue and left back pain. CT demonstrated bilateral peripelvic renal cysts, and DIP demonstrated left hydronephrosis and a medial shift of the left renal pelvis. Laparoscopic ablation of bilateral peripelvic renal cysts

Akiou Okumura; Hideki Fuse; Yasuhiro Muraishi; Remon Nishio; Tetsuo Nozaki

2003-01-01

353

Hand-assisted laparoscopic sigmoidectomy for diverticulitis  

Microsoft Academic Search

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

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

1998-01-01

354

Direct inguinal hernias in children: laparoscopic aspects  

Microsoft Academic Search

Among 109 children treated laparoscopically for inguinal hernias, 5 had direct hernias, more than would normally be anticipated.\\u000a Two of the hernias were recurrences of indirect hernias operated upon previously using the open technique. Direct hernias\\u000a are easier to detect with the laparoscopic technique.

F. Schier

2000-01-01

355

Redo laparoscopic repair of benign esophageal disease.  

PubMed

Laparoscopic fundoplication for gastroesophageal reflux disease has been associated with excellent symptom control. Compared with medical treatment, laparoscopic Nissen fundoplication has shown favorable control of typical reflux symptoms. However, in approximately 2% to 17% of patients, surgical treatment fails. The role of reoperative repair for reflux disease and the factors that contribute to it are examined. PMID:22608677

Wee, Jon O

2012-05-17

356

Laparoscopic vs open hemicolectomy for colon cancer  

Microsoft Academic Search

Background: The role of laparoscopic resection in the management of colon cancer is still a subject of debate. In this clinical study, we compared the perioperative results and long-term outcome for two unselected groups of patients undergoing either laparoscopic or open hemicolectomy for colon cancer. Methods: This prospective nonrandomized study was based on a series of 248 consecutive patients operated

E. Lezoche; F. Feliciotti; A. M. Paganini; M. Guerrieri; A. De Sanctis; S. Minervini; R. Campagnacci

2002-01-01

357

Scrub Nurse Robot for Laparoscopic Surgery  

Microsoft Academic Search

During laparoscopic surgeries, changing forceps is a relatively simple procedure that requires a nurse or another surgeon; however, most hospitals lack a scrub nurse in the operating room. Therefore, we have developed an assisting robot for laparoscopic surgery that is able to pass or receive forceps under the voice control of the surgeon. This robot system consists of a magazine

Kazuto Takashima; Hiromichi Nakashima; Toshiharu Mukai; Shuji Hayashi

2008-01-01

358

Laparoscopic Prostatectomy: Where Do We Stand?  

PubMed Central

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

Remzi, Mesut; Djavan, Bob

2002-01-01

359

Robotic and laparoscopic female pelvic floor reconstruction  

Microsoft Academic Search

These disadvantages, in addition to inadequate experience in advanced laparoscopy in residency and fellowship programmes, and the recently introduced minimally invasive transvaginal sling and pelvic floor reconstructive procedures, have thwarted widespread adoption of laparoscopic surgery for urinary incontinence. However, the use of robotic and laparoscopic surgery in the management of female POP appears to be increasing. Many case series have

FIROUZ DANESHGARI; MARIA F. PARAISO; JIHAD KAOUK; FRED E. GOVIER; PAUL M. KOZLOWSKI; KATHLEEN C. KOBASHI

2006-01-01

360

Laparoscopic Surgery for Inflammatory Bowel Disease  

Microsoft Academic Search

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

Sergio Casillas; Conor P. Delaney

2005-01-01

361

Cicatrical Cecal Volvulus Following Laparoscopic Cholecystectomy  

PubMed Central

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

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

2013-01-01

362

Laparoscopic repair of an incarcerated obturator hernia  

Microsoft Academic Search

Obturator hernia is a rare cause of bowel obstruction. Occurring primarily in elderly women, it has a high incidence of incarceration and a high mortality rate. This report describes the successful laparoscopic reduction and repair of an incarcerated obturator hernia. Using open laparoroscopy, an incarcerated obturator hernia was diagnosed intraoperatively. After laparoscopic reduction, a transabdominal preperitoneal repair was completed using

T. L. Bryant; R. K. Umstot

1996-01-01

363

Successful Transfer of Open Surgical Skills to a Laparoscopic Environment Using a Robotic Interface: Initial Experience With Laparoscopic Radical Prostatectomy  

Microsoft Academic Search

PurposeFor a skilled laparoscopic surgeon the learning curve for achieving proficiency with laparoscopic radical prostatectomy (LRP) is estimated at 40 to 60 cases. For the laparoscopically naïve surgeon the curve is estimated at 80 to 100 cases. The development of a robotic interface might significantly shorten the LRP learning curve for an experienced open yet naïve laparoscopic surgeon. To our

THOMAS E. AHLERING; DOUGLAS SKARECKY; DAVID LEE; RALPH V. CLAYMAN

2003-01-01

364

Long-Term Surgical Recurrence, Morbidity, Quality of Life, and Body Image of Laparoscopic-Assisted vs. Open Ileocolic Resection for Crohn's Disease: A Comparative Study  

PubMed Central

Purpose Several studies have compared conventional open ileocolic resection with a laparoscopic-assisted approach. However, long-term outcome after laparoscopic-assisted ileocolic resection remains to be determined. This study was designed to compare long-term results of surgical recurrence, quality of life, body image, and cosmesis in patients who underwent laparoscopic-assisted or open ileocolic resection for Crohn’s disease. Methods Seventy-eight consecutive patients who underwent ileocolic resection during the period 1995 to 1998 were analyzed; 48 underwent a conventional open approach in the Academic Medical Centre (Amsterdam, The Netherlands) and 30 underwent a laparoscopic-assisted approach in the Leiden University Medical Centre (Leiden, The Netherlands). Primary outcome parameters were reoperation and readmission rate. Secondary outcome parameters were quality of life, body image, and cosmesis. Results The two groups were comparable for characteristics of sex, age, and immunosuppressive therapy. Seventy-one patients had a complete follow-up of median 8.5 years. Resection for recurrent Crohn’s disease was performed in 6 of 27 (22 percent) and 10 of 44 (23 percent) patients in the laparoscopic and open groups, respectively. Reoperations for incisional hernia were only performed after conventional open ileocolic resection (3/44?=?6.8 percent). Quality of life and body image were comparable, but cosmesis scores were significantly higher in the laparoscopic group. Conclusions Despite small numbers, we found that surgical recurrence and quality of life after laparoscopic-assisted and open ileocolic resection were comparable. Incisional hernias occurred only after open ileocolic resection, and laparoscopic-assisted ileocolic resection resulted in a significantly better cosmesis.

Eshuis, Emma J.; Polle, Sebastiaan W.; Slors, J. Frederik; Hommes, Daan W.; Sprangers, Mirjam A. G.; Gouma, Dirk J.

2008-01-01

365

Tubal Ligation, Hysterectomy and D&C: Evidence from the Melbourne Women’s Midlife Health Project  

Microsoft Academic Search

The question of whether tubal ligation (TL) is associated with increased risk of hysterectomy or dilatation and curettage (D&C) is examined using data from a population-based study. Retrospective information on TL, D&C and hysterectomy was gathered from 1,810 Australian-born women aged 45–55 who were randomly selected from the population of Melbourne, Australia. Odds ratios for the outcomes were adjusted via

John Taffe; Adèle Green; Emma Dudley; Lorraine Dennerstein

2000-01-01

366

Satisfaction with hysterectomy: Low-income underinsured teaching hospital patients versus insured patients at a private hospital  

Microsoft Academic Search

Objective: The purpose of this study was to measure patient health-related quality of life\\/satisfaction with the results of hysterectomy in 2 distinct groups of women. Study Design: A health-related outcomes questionnaire was completed 3 months after hysterectomy by 50 low-income women who underwent operation at a state-supported teaching hospital and by 50 women who underwent operation at a private hospital.

James B. Unger; Gloria Caldito; Joseph Sams; Jack F. Perrone; Edwin Byrd

2002-01-01

367

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

PubMed Central

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.

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

2007-01-01

368

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

369

Laparoscopic surgery for renal cell carcinoma.  

PubMed

New minimally invasive technologies are currently being applied to the management of renal cell carcinoma in an effort to decrease operative time, pain, morbidity and hospital stay. Foremost among these is the burgeoning role of laparoscopy in tumor destruction and complete in vivo resection. The primary modalities in clinical use today are laparoscopic radical nephrectomy, laparoscopic partial nephrectomy, laparoscopic renal cryoablation and laparoscopic radiofrequency ablation. Most initial reports include only highly selected patients with unifocal, small, exophytic, peripheral lesions away from the collecting system. As experience with these techniques increases, larger and more difficult lesions are being approached laparoscopically, with promising anecdotal results reported. Laparoscopic access to the kidney may be retroperitoneal or transperitoneal. Complete tumor destruction with maximal preservation of unaffected nephrons remains the goal. Herein, an update on laparoscopic surgery for renal cell carcinoma is presented. For each procedure, the current indications and contraindications, perioperative data, complications and oncological outcomes are described. In the future, it appears likely that laparoscopy will play a major role in the established treatment options for renal cell carcinoma, with open surgery being reserved for specific indications. PMID:14686705

Hasan, Waleed A; Abreu, Sidney C; Gill, Inderbir S

2003-12-01

370

Robot-assisted laparoscopic pyeloplasty: outcomes reported by a centre with no previous laparoscopic experience  

Microsoft Academic Search

Laparoscopic pyeloplasty (LP) has proved to be an effective minimally invasive treatment for ureteropelvic junction obstruction\\u000a (UPJO). However, its application is still limited by the challenge of the laparoscopic learning curve, which seems to be overcome\\u000a by the recent introduction of robot assistance. The aim of this manuscript is to show our outcomes after the first robot-assisted\\u000a laparoscopic pyeloplasties (RP)

Claudio Giberti; Fabrizio Gallo; Maurizio Schenone; Pierluigi Cortese

2009-01-01

371

Laparoscopic resection of abdominal paragangliomas.  

PubMed

Paragangliomas are rare catecholamine-secreting tumors arising from chromaffin tissue of the autonomic nervous system. Although they can arise anywhere along the paravertebral axis, the majority is intra-abdominal in location. Frequently, these tumors are closely associated with major vascular structures, necessitating open techniques for resection. As laparoscopic techniques have advanced, minimally invasive approaches to these complex tumors have been attempted. This study presents 3 patients with abdominal paragangliomas, highlighting the use of high-quality preoperative imaging and intraoperative surgeon-performed ultrasound in allowing safe minimally invasive resection of these tumors. PMID:21304376

Mitchell, Jamie; Siperstein, Allan; Milas, Mira; Berber, Eren

2011-02-01

372

Changes in protein C and free protein S during pregnancy and following hysterectomy.  

PubMed Central

Two longitudinal studies were undertaken to measure the naturally occurring coagulation inhibitors, protein C and protein S, in females who were either pregnant or who were undergoing hysterectomy. Functional and immunological protein C and free protein S were assayed. During pregnancy, protein C levels remained unchanged except for a small increase in protein C antigen at 28-32 weeks gestation. The free protein S fell significantly and progressively during pregnancy, although only in about one-third of patients did the level fall below the normal range. In the hysterectomy study, a significant fall in protein C occurred on days one and three after surgery but had returned to normal by the time of discharge (days 7-10). A small rise in free protein S was observed at time of discharge, but this factor was otherwise unchanged. We conclude that the changes observed may contribute to the hypercoagulable state which is associated with pregnancy or major surgery.

Warwick, R; Hutton, R A; Goff, L; Letsky, E; Heard, M

1989-01-01

373

Vaginal evisceration 3 years after abdominal hysterectomy and bilateral salpingo-oophorectomy.  

PubMed

Vaginal evisceration after a pelvic operation is a rare gynecological emergency. When intercourse is the cause, most cases occur within 1 year of surgery. A 53-year-old woman presented to the emergency room for vaginal evisceration half a day after the first postoperative occurrence of intercourse 3 years after an abdominal hysterectomy and bilateral salpingo-oophorectomy. In an emergency laparotomy, the protruding small bowel was replaced within the abdominal cavity. The avulsed vaginal cuff, which measured 6 cm in length and had atrophic but non-necrotic margins, was sutured. Women who go for long periods without intercourse after a hysterectomy, especially post-menopausal women, should be made aware of unrecognized vaginal atrophy that could, in some cases, lead to rupture and evisceration during the next occurrence of intercourse. PMID:22612271

Orito, Seiya; Masuya, Norio; Sakurabashi, Ayako; Minoura, Shigeki

2012-05-21

374

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

375

Surgical techniques: robot-assisted laparoscopic colposacropexy with the da Vinci ® surgical system  

Microsoft Academic Search

Colposacropexy is the gold-standard operation for repair of apical vaginal support defects. While it is feasible to perform\\u000a this operation using conventional laparoscopic techniques, a limited number of surgeons have mastered the advanced minimally\\u000a invasive skills that are required. Introduction of the da Vinci® robotic system with instruments that have improved dexterity and precision and a camera system with three-dimensional imaging

Catherine A. Matthews

2009-01-01

376

Single-Port Laparoscopic Surgery in Children: Concept and Controversies of the New Technique  

PubMed Central

Single-incision laparoscopic surgery (SILS) is emerging as an alternative technique to conventional laparoscopy for the treatment of common surgical diseases. Despite its wide use, the adoption of SILS in children has been slower since the broad application of minimally invasive techniques in children, in general, has historically lagged behind those in adults. This paper reviews the evolution of SILS from its original conception and its application in the field of pediatric surgery.

Blanco, Felix C.; Kane, Timothy D.

2012-01-01

377

Robot-assisted laparoscopic partial adrenalectomy: a case report and review of the literature  

Microsoft Academic Search

Adrenal-sparing surgery has recently been reported in the literature on minimally-invasive surgery. Originally described as\\u000a a conventional laparoscopic procedure, encouraging outcomes in terms of preservation of adrenal function have been reported.\\u000a Since the introduction of robotic surgery, surgeons have utilized robotic assistance for adrenal surgery and have recently\\u000a described adrenal-sparing surgery using this platform. Certain patients that present with adrenal

Jennifer Yates; Jayant Uberoi; Ravi Munver

2010-01-01

378

Laparoscopic Adjustable Gastric Banding in a Morbidly Obese 18-year-old with Hypertrophic Cardiomyopathy  

Microsoft Academic Search

In this case report, we present an 18-year-old morbidly obese male with complicating hypertensive cardiomyopathy who underwent\\u000a laparoscopic adjustable gastric band surgery. The patient had multiple comorbidities associated with his obesity, including\\u000a obstructive sleep apnea, systemic hypertension, asthma, and depression. Given the severity of his underlying cardiac pathology\\u000a and multiple previously unsuccessful attempts at weight loss with conventional medical and

Jasmine Waipa; Sanjeev Dutta; Craig T. Albanese; John M. Morton

2008-01-01

379

Prevention of Post Operative Pain after Abdominal Hysterectomy by Single Dose Etoricoxib  

Microsoft Academic Search

Objective: To test whether a reduction in post operative morphine consumption could be achieved by a single-dose of etoricoxib before induction of anesthesia. Design: Randomized, double-blind, placebo-controlled study. Material and Method: Two hours before surgery, patients undergoing transabdominal hysterectomy (under general anesthesia) were randomized to a single oral dose of: 1) etoricoxib 120 mg (n = 17), 2) etoricoxib 180

Waraporn Chau-in; Somboon Thienthong

2008-01-01

380

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

Microsoft Academic Search

Purpose  To compare costs and reimbursements for three different treatments for uterine fibroids.\\u000a \\u000a \\u000a \\u000a Methods  Costs and reimbursements were collected and analyzed from the Thomas Jefferson University Hospital decision support database\\u000a from 540 women who underwent abdominal hysterectomy (n = 299), abdominal myomectomy (n = 105), or uterine fibroid embolization (UFE) (n = 136) for uterine fibroids during 2000–2002. We used the chi-square

Jay Goldberg; Anne Bussard; Jean McNeil; James Diamond

2007-01-01

381

A comparison of robot-assisted and traditional radical hysterectomy for early-stage cervical cancer  

Microsoft Academic Search

A robotics surgery program was introduced into the division of gynecologic oncology at Northwestern University Feinberg School\\u000a of Medicine in June 2007. A prospective database of all patients undergoing a type III radical hysterectomy for stage IB1\\u000a cervical cancer between July 2007 and June 2008 was collected and analyzed. Demographic data and perioperative outcomes were\\u000a analyzed between a traditional and

M. Patrick Lowe; Anna V. Hoekstra; Arati Jairam-Thodla; Diljeet K. Singh; Barbara M. Buttin; John R. Lurain; Julian C. Schink

2009-01-01

382

Radical hysterectomy versus radiation therapy for stage IB squamous cell cancer of the cervix  

Microsoft Academic Search

Three hundred forty-five patients with Stage IB squamous cell carcinoma of the cervix were treated at the University of Michigan Medical Center from 1970 to 1985. The overall cumulative 5-year survival rate was 89% and the mean age was 44.6 years. In 213 patients undergoing radical hysterectomy the cumulative 5-year survival rate was 92%; 14 patients were explored for radical

Michael P. Hopkins; George W. Morley

1991-01-01

383

Laparoscopic heminephrectomy of a horseshoe kidney.  

PubMed

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; Biyani, Chandra Shekhar; Urol, D

384

Laparoscopic resection of giant mesenteric cyst.  

PubMed

Benign cystic tumors are rare intra-abdominal lesions that may be retroperitoneal, mesenteric, or omental. Most of them cause nonspecific symptoms, but rarely, they cause serious complications such as volvulus, rupture, or bowel obstruction. The diagnosis of these tumors can be made by abdominal ultrasonography or CT. Their only treatment is surgical excision, which can be done by either laparotomy or laparoscopic surgery. In last decade, laparoscopic surgical approaches have replaced open procedures in many surgical abdominal diseases. In this paper, a patient with laparoscopically excised mesenteric cyst is presented along with a literature review. PMID:11132914

Polat, C; Ozaçmak, I D; Yücel, T; Ozmen, V

2000-12-01

385

Fever and Diarrhea after Laparoscopic Bilioenteric Anastomosis  

PubMed Central

Bile duct injuries are well-known complications of laparoscopic and open cholecystectomies. Here, we report anastomosis of the common bile duct to the transverse colon that occurred as a complication of laparoscopic cholecystectomy. To the best of our knowledge, a similar case has not been reported in the literature so far. As in our patient, persistent diarrhea (in addition to fever and icterus) can be a warning sign of complication after these procedures. Surgeons who do advanced laparoscopic techniques must be familiar with this complication.

Fazeli, Mohammad S.; Kazemeini, Alireza; Safari, Saeed; Larti, Farnoosh

2011-01-01

386

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.

Khan, Atif; Myatt, Andrew; Palit, Victor

2011-01-01

387

Intravenous buscopan for analgesia following laparoscopic sterilisation.  

PubMed

Following reports that tubal smooth muscle spasm may contribute to pelvic pain following laparoscopic sterilisation, we studied the effect of buscopan (an anticholinergic agent used to relieve smooth muscle spasm) on 45 patients undergoing general anaesthesia for day-case laparoscopic sterilisation. Patients were randomly allocated to receive either buscopan 20 mg or saline placebo after induction of anaesthesia. There were no significant differences in pain scores or postoperative analgesic requirements between the two groups. We conclude that intravenous buscopan confers no benefit in day-case laparoscopic sterilisation. PMID:10455843

Wilson, C M; Lillywhite, N; Matta, B; Mills, P; Wiltshire, S

1999-04-01

388

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.

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

2011-01-01

389

Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity  

PubMed Central

Background Colorectal cancer is one kind of frequent malignant tumors of the digestive tract which gets high morbidity and mortality allover the world. Despite the promising clinical results recently, less information is available regarding the perioperative immunological effects of laparoscopic surgery when compared with the open surgery. This study aimed to compare the cellular immune responses of patients who underwent laparoscopic(LCR) and open resections(OCR) for colorectal cancer. Methods Between Mar 2009 and Sep 2009, 35 patients with colorectal carcinoma underwent LCR by laparoscopic surgeon. These patients were compared with 33 cases underwent conventional OCR by colorectal surgeon. Clinical data about the patients were collected prospectively. Comparison of the operative details and postoperative outcomes between laparoscopic and open resection was performed. Peripheral venous blood samples from these 68 patients were taken prior to surgery as well as on postoperative days(POD) 1, 4 and 7. Cell counts of total white blood cells, neutrophils, lymphocyte subpopulations, natural killer(NK) cells as well as CRP were determined by blood counting instrument, flow cytometry and hematology analyzer. Results There was no difference in the age, gender and tumor status between the two groups. The operating time was a little longer in the laparoscopic group (P > 0.05), but the blood loss was less (P = 0.039). Patients with laparoscopic resection had earlier return of bowel function and earlier resumption of diet as well as shorter median hospital stay (P < 0.001). Compared with OCR group, cell numbers of total lymphocytes, CD4+T cells and CD8+T cells were significant more in LCR group (P < 0.05) on POD 4, while there was no difference in the CD45RO+T or NK cell numbers between the two groups. Cellular immune responds were similar between the two groups on POD1 and POD7. Conclusions Laparoscopic colorectal resection gets less surgery stress and short-term advantages compared with open resection. Cellular immune respond appears to be less affected by laparoscopic colorectal resection when compared with open resection.

2010-01-01

390

Laparoscopic Management of Gallstone Ileus  

PubMed Central

Gallstone ileus is an uncommon entity that was first described by Bartholin in 1654. Despite advances in peri-operative care, morbidity and mortality remain high in patients with gallstone ileus because: 1) they are geriatric patients; 2) they often have multiple comorbidities; 3) presentation to the hospital is delayed; 4) many are volume depleted with electrolyte abnormalities; and 5) the diagnosis of gallstone ileus is difficult to make. Traditional management has entailed open laparotomy with relief of intestinal obstruction by enterotomy and stone extraction. Cholecystectomy and takedown of the cholecystoenteric fistula can be performed. We propose an alternative method of management in an attempt to limit operative trauma and improve morbidity and mortality. We review the literature and describe two patients with gallstone ileus who were managed laparoscopically. One patient underwent laparoscopic assisted enterolithotomy, and the other patient underwent diagnostic laparoscopy with disimpaction of the gallstone into the large bowel. They were discharged after their ileus had resolved on the fourth and sixth postoperative day, respectively. Laparoscopy is a powerful diagnostic and therapeutic tool that can be effectively used to treat gallstone ileus.

Evan, Stephen J.; Kavic, Michael S.

2001-01-01

391

Technical approaches to single port/incision laparoscopic appendicectomy: a literature review  

PubMed Central

INTRODUCTION Single port/incision laparoscopic surgery (SPILS) is a modern advancement toward stealth surgery. Despite the paucity of high-quality scientific studies assessing its effectiveness, this procedure is being used increasingly. This review aims to describe commonly used techniques for SPILS appendicectomies (SPILA), to summarise complication rates in the literature and to provide discussion on indications and implementation. METHODS All available databases including the Cochrane Central Register of Controlled Trials, MEDLINE® and Embase™ were searched in February 2011 and cross-referenced for available English literature describing SPILA in patients of any age. RESULTS Three broad technical approaches are described: procedures using laparoscopic instruments through a single skin incision in the abdominal wall, regardless of the number of fascial incisions, with or without the additional use of percutaneous sutures or wires to ‘assist’ the operation, and hybrid procedures, in which the appendix is exteriorised using a single incision laparoscopically assisted operation but subsequently divided using a conventional ‘open’ appendicectomy technique. Complication rates seem to be highest in SPILA procedures unassisted by sutures or wires. CONCLUSIONS Future research assessing the efficacy of single incision laparoscopic procedures should consider variation in technique as a possible factor affecting outcome.

Rehman, H; Ahmed, I

2011-01-01

392

Effect of laparoscopic cholecystectomy techniques on postoperative pain: a prospective randomized study  

PubMed Central

Purpose Minimally invasive surgical technics have benefits such as decreased pain, reduced surgical trauma, and increased potential to perform as day case surgery, and cost benefit. The primary aim of this prospective, randomized, controlled study was to compare the effects of single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) procedures regarding postoperative pain. Methods Ninety adult patients undergoing elective laparoscopic cholecystectomy were included in the study. Patients were randomized to either SILC or CLC. Patient characteristics, postoperative abdominal and shoulder pain scores, rescue analgesic use, and intraoperative and early postoperative complications were recorded. Results A total of 83 patients completed the study. Patient characteristics, postoperative abdominal and shoulder pain scores and rescue analgesic requirement were similar between each group except with the lower abdominal pain score in CLC group at 30th minute (P = 0.04). Wound infection was seen in 1 patient in each group. Nausea occurred in 13 of 43 patients (30%) in the SILC group and 8 of 40 patients (20%) in the CLC group (P > 0.05). Despite ondansetron treatment, 6 patients in SILC group and 7 patients in CLC group vomited (P > 0.05). Conclusion In conclusion, in patients undergoing laparoscopic surgery, SILC or CLC techniques does not influence the postoperative pain and analgesic medication requirements. Our results also suggest that all laparoscopy patients suffer moderate and/or severe abdominal pain and nearly half of these patients also suffer from some form of shoulder pain.

Arun, Oguzhan; Apiliogullari, Seza; Acar, Fahrettin; Alptekin, Husnu; Calisir, Ak?n; Sahin, Mustafa

2013-01-01

393

A tactile sensor for laparoscopic cholecystectomy.  

PubMed

During laparoscopic surgery, surgeons observe the three-dimensional abdominal cavity on a two-dimensional TV monitor, which is a limitation. Another limitation is that surgeons are unable to estimate the softness of organs or tissues during laparoscopic surgery as they are only allowed to use instruments which touch objects and direct palpation is not permitted during the procedure. The tactile sensor which we used displays the object softness immediately as a digital score, which can then be superimposed on a TV monitor as a graph. With the tactile sensor, we were able to ascertain the presence of a gallstone in the gallbladder or cholecystic duct during laparoscopic cholecystectomy and also able to discriminate between a stone and an air bubble during intraoperative cholangiography. We were convinced that the tactile sensor would be useful in laparoscopic surgery, which does not permit surgeons to palpate objects with human fingers. PMID:9294278

Matsumoto, S; Ooshima, R; Kobayashi, K; Kawabe, N; Shiraishi, T; Mizuno, Y; Suzuki, H; Umemoto, S

1997-09-01

394

Laparoscopic Marsupialization of Symptomatic Polycystic Kidney Disease  

Microsoft Academic Search

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

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

1996-01-01

395

Should all distal pancreatectomies be performed laparoscopically?  

PubMed

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

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

2009-01-01

396

Laparoscopic mitrofanoff appendicovesicostomy: Our experience in children  

PubMed Central

Introduction: The Mitrofanoff principle was originally described as a method to provide an alternative means to access the bladder. It creates a conduit to the bladder through which patients with a sensitive, absent, or traumatized urethra can perform clean intermittent catheterization (CIC) easily. We report our experience with complete laparoscopic Mitrofanoff appendicovesicostomy to promote a catheterizable abdominal stoma. Materials and Methods: A 4-port transperitoneal approach was used to create a complete laparoscopic Mitrofanoff appendicovesicostomy. Results: Six children with a mean age of 12.8 years (range 9-16 years) underwent laparoscopic Mitrofanoff appendicovesicostomy. Mean operative time was 139.6 min and Mean estimated blood loss was 46 cc. No cases of urinary leaks were noted. There have been no cases of either stomal stenosis or appendicovesical stenosis noted. Conclusions: Pure laparoscopic Mitrofanoff appendicovesicostomy is feasible and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis.

Nerli, Rajendra B.; Reddy, Mallikarjun; Devraju, Shishir; Prabha, Vikram; Hiremath, Murigendra B.; Jali, Sujata

2012-01-01

397

Laparoscopic Treatment of Intrauterine Fallopian Tube Incarceration  

PubMed Central

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

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

2013-01-01

398

Single-incision bilateral laparoscopic oophorectomy  

PubMed Central

Although single-incision laparoscopic surgery made an appearance on the surgical scene only recently, it is being increasingly applied in the treatment of a variety of disorders. We report single-incision bilateral laparoscopic oophorectomy and salpingooophorectomy performed in two patients who had previously undergone breast conservation surgery for early breast cancer. Each procedure was undertaken using two 5-mm and one 3-mm ports inserted through a 2-cm transverse supraumbilical incision and standard laparoscopic instruments. The operative time was 50 and 65 min respectively and the blood loss negligible. The patients were discharged 36 and 24 h after surgery, required minimal postoperative analgesia and remain well at a follow up of 19 and 17 months, respectively. With the benefit of improved cosmesis, the single-incision approach holds the potential to replace the traditional bilateral laparoscopic oophorectomy.

Bhandarkar, Deepraj; Katara, Avinash; Deshmane, Vinay; Mittal, Gaurav; Udwadia, Tehemton E

2011-01-01

399

Teaching Single-Incision Laparoscopic Appendectomy in Pediatric Patients  

PubMed Central

Introduction: Laparoscopic appendectomy is accepted as the gold standard technique for the treatment of acute appendicitis. Recently single-incision laparoscopic surgery (SILS) was tried in the pediatric population and was shown to be both feasible and safe. We describe our early experience in teaching the SILS procedure for appendicitis in a large community hospital center surgical residency program. Methods: SILS appendectomy was performed in 40 consecutive patients with acute appendicitis who were admitted by a single surgeon from May 2011 to August 2011. All patients over the age of 4 y presenting with noncomplicated and complicated appendicitis (perforated) were offered SILS appendectomy. Execution of the technical aspects of 20 SILS operations done by 3 PGY III residents was evaluated. Results: The average age of the patient was 11.1 y (range, 7 to 15). SILS was performed successfully in 19 out of 20 patients. Nineteen patients underwent emergent or urgent appendectomy, while 1 patient underwent an interval procedure. Nine patients were found to have perforated appendicitis, while the other 11 had noncomplicated acute appendicitis. One patient was converted to conventional 3-port laparoscopy due to difficulties during the procedure. The mean operative time was 73 min (range, 47 to 112). A significant learning curve to successfully execute the critical steps of the SILS procedure was noted in all residents evaluated. Conclusion: SILS technology appears promising for the treatment of acute appendicitis. However, its successful incorporation into surgical training programs will depend on the development of innovative simulation strategies.

Nerkar, Hrishikesh

2012-01-01

400

Virtual reality in laparoscopic skills training: is haptic feedback replaceable?  

PubMed

With the emphasis on laparoscopic skills training outside of the operating room (OR), simulators are constantly being developed and improved. Virtual reality (VR) trainers have been looking for solutions to compensate their lack of haptic feedback. A possible solution is the addition of kinematic interaction between laparoscopic instruments and objects. The aim of the study was to determine whether this interaction can replace haptic feedback that is naturally present in box trainers. Novices (n = 50) were randomly assigned to training in a conventional VR setup (VR-I), a VR environment with additional kinematic interaction (VR-II), a box trainer equivalent of these setups (Box-I or Box-II), or to a control group. An identical cylinder task was performed in all four training setups. The effect was established by comparing the performance before and after training during a tissue handling task, using Wilcoxon signed-rank tests. The controls did not improve significantly. The VR-I group improved in time, whereas VR-II and both box trainer groups improved in time, path length and motion in depth. With respect to haptic feedback, box training models are superior to VR systems. However, additional kinematic interaction between instruments and objects can be a promising surrogate for haptic feedback in VR systems. PMID:21438717

Hiemstra, Ellen; Terveer, Elisabeth M; Chmarra, Magdalena K; Dankelman, Jenny; Jansen, Frank Willem

2011-03-27

401

Single-incision laparoscopic herniorrhaphy for inguinal hernia repair.  

PubMed

PURPOSES: Single-incision laparoscopic surgery improves the cosmetic outcome after surgery. We herein report six cases of successful single-incision laparoscopic (SILS) herniorrhaphy. METHODS: Six patients, five with unilateral inguinal hernias and one with bilateral inguinal hernias, underwent SILS herniorrhaphy. A Covidien SILS port was inserted via an umbilical incision, through which three trocars of 5, 5 and 12 mm (or 5 mm) were inserted. The peritoneum was then opened with flexible scissors and electrocoagulation, after which, the preperitoneal space was dissected. A mesh was then fixed, and the peritoneum was finally closed using Covidien SILS Stitch or AbsorbaTack. RESULTS: The mean length of the operation for the unilateral cases was 136 min. The increased time was due to difficulties unrelated to this methodology. However, the length of the operation in the bilateral case was 94 min. All patients were discharged without complications. CONCLUSIONS: SILS herniorrhaphy requires experience and more time than conventional three-port herniorrhaphy. However, if the length of the operation can be shortened, then this novel surgical technique is considered to be feasible and it is expected to improve the cosmetic outcome without any additional risk. PMID:23408084

Takayama, Satoru; Nakai, Nozomu; Sakamoto, Masaki; Takeyama, Hiromitsu

2013-02-14

402

Laparoscopic removal of a bladder urolith in a standing horse.  

PubMed

Case Description-An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week. Clinical Findings-Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis. Treatment and Outcome-A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery. Clinical Relevance-Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder. PMID:24134584

Lund, Caleb M; Ragle, Claude A; Lutter, J Dylan

2013-11-01

403

Laparoscopic Retroperitoneal Lymph Node Dissection: Extraperitoneal Approach  

Microsoft Academic Search

We review our early experience with laparoscopic retroperitoneal lymph node dissection (RPLND) via extraperitoneal approach\\u000a to assess the precise pathological status of retroperitoneal lymph nodes in early-stage testicular cancer. A total of 32 patients\\u000a (23 with stage I, 4 with stage IIa, and 5 with stage IIb) with testicular cancer underwent extraperitoneal laparoscopic RPLND\\u000a in the supine position. After developing

Makoto Satoh; Akihiro Ito; Yoichi Arai

404

The learning curve for laparoscopic cholecystectomy  

Microsoft Academic Search

Background: The use of laparoscopic surgical procedures without previous training has grown rapidly. At the same time, there have been allegations of increased complications among less experienced surgeons.Methods: Using multivariate regression analyses, we evaluated the relationship between bile duct injury rate and experience with laparoscopic cholecystectomy for surgeons in the Southern Surgeons Club.Results: Fifty-five surgeons performed 8,839 procedures. Fifteen bile

Michael J Moore; Charles L Bennett

1995-01-01

405

Complications of laparoscopic pyeloplasty in children  

Microsoft Academic Search

Introduction  Laparoscopic pyeloplasty in children has been proven to be safe and effective, with comparable results to open surgery. Due\\u000a to the extension of laparoscopic indications from ablative to reconstructive procedures requiring endoscopic suturing, most\\u000a centres have plateaued within their learning curve. Based on our own experience with a little more than 100 cases, we focus\\u000a on the complications and the

Rajendra B. Nerli; Mallikarjun Reddy; Vikram Prabha; Ashish Koura; Praveen Patne; M. K. Ganesh

2009-01-01

406

Colonoscopy assisted laparoscopic sigmoidectomy: a case report  

Microsoft Academic Search

INTRODUCTION: We report a case of colonoscopy-assisted laparoscopic sigmoidectomy used for the management of sigmoid volvulus. CASE PRESENTATION: We report a 68-year-old female who underwent colonoscopy assisted laparoscopic sigmoidectomy. In this procedure, an anvil is inserted into the anus with colonoscopic assistance. An anastomosis is established without removing the colon from the abdominal cavity, and the maximum incision size is

Satoru Takayama; Hiromitsu Takeyama

2009-01-01

407

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

408

Laparoscopic Adrenalectomy for Pheochromocytoma in a Child  

PubMed Central

Pheochromocytoma is a catecholamine-secreting tumor of the adrenal medulla. It has wide and subtle range of clinical manifestations including sustained hypertension in about 1% of pediatric patients. Although laparoscopic adrenalectomy is the gold standard treatment method in adult patients, few reports have described this technique in children. We report a child with unilateral pheochromocytoma who presented with poor weight gain, polyuria and polydipsia. Diagnosis was based upon clinical and laboratory evaluation. She was treated successfully by laparoscopic adrenalectomy.

Soheilipour, Fahimeh; Ghorbanpour, Sahar; Tamannaie, Zeinab

2013-01-01

409

Postoperative complications after laparoscopic incisional hernia repair  

Microsoft Academic Search

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

D. Berger; M. Bientzle; A. Müller

2002-01-01

410

Laparoscopic Vertical Banded Gastroplasty: The Milwaukee Experience  

Microsoft Academic Search

Background: laparoscopic techniques are being developed for bariatric surgery. Methods: eleven morbidly obese patients underwent\\u000a laparoscopic vertical banded gastroplasty in 1993-1994. Results: average length of hospital stay was 3.9 days, mean operating\\u000a time was 202 min, and the average hospital charges were $12 800. These numbers were compared to the most recent open gastric\\u000a bypass patients, where average length of

Thomas Y. Chua; Rolando M. Mendiola

1995-01-01

411

Complications of Laparoscopic Radical Nephrectomy and Nephroureterectomy  

Microsoft Academic Search

\\u000a Laparoscopic nephrectomy was first described almost 20 years ago by Clayman et al. [1]. Since then, laparoscopic surgical\\u000a acumen has evolved, and the complexity of operations undertaken has grown in parallel. A body of literature has developed\\u000a which sheds light on both the many advantages and the potential pitfalls of urologic laparoscopy for malignant disease of\\u000a the kidney. It is,

David A. Green; Michael Grasso

412

The adverse hemodynamic effects of laparoscopic cholecystectomy  

Microsoft Academic Search

Recent studies suggest that significant physiologic derangements can occur during laparoscopic surgery. Eighteen patients admitted for laparoscopic cholecystectomy were studied. The mean age was 46.7 (range 19–78). A standard anesthetic technique, reverse Trendelenburg positioning, and an abdominal insufflation pressure of 15 mmHg with CO2 were used with all subjects. Central venous pressure (CVP) and arterial pressures were measured invasively. Stroke

J. G. McLaughlin; D. E. Scheeres; R. J. Dean; B. W. Bonnell

1995-01-01

413

Laparoscopic colectomy in obese and nonobese patients  

Microsoft Academic Search

Obese patients carry a higher risk of wound complications and cardiopulmonary complications along with a higher incidence\\u000a of comorbidity, all of which have the potential to affect outcome after a variety of surgical procedures. The data regarding\\u000a outcomes after laparoscopic colectomy in obese and nonobese patients are limited. The purpose of this report was to compare\\u000a the outcome of laparoscopic

Anthony J. Senagore; Conor P. Delaney; Khaled Madboulay; Karen M. Brady; C. Victor W. Fazio

2003-01-01

414

Laparoscopic Surgery: A Pioneer's Point of View  

Microsoft Academic Search

.   For a surgeon who performed some of the first laparoscopic cholecystectomies, laparoscopic surgery is undoubtedly the main\\u000a revolution in the last decade of this century. It is impossible not to be fascinated by the extraordinary changes introduced\\u000a in our profession in less than 10 years. However, looking back in history, one realizes that laparoscopy is but one of those

Jacques Périssat; Bordeaux F

1999-01-01

415

Robotic-Assisted Laparoscopic Ureteral Reimplantation  

Microsoft Academic Search

\\u000a Laparoscopic antireflux surgery was described initially 10 years ago, but never achieved real popularity, presumably because\\u000a of the difficulty in dissection and suturing. It has been reintroduced slowly in the last 4 years, but is still a technical\\u000a challenge. Robotics facilitates intracorporeal suturing and has recently been deemed safe and feasible. Laparoscopic reimplantation\\u000a with or without robotic-assisted surgical devices is

Pasquale Casale

416

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

417

Laparoscopic Trocar Port Site Endometriosis: A Case Report and Brief Literature Review  

PubMed Central

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.

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

2012-01-01

418

Assessing the impact of a 2-day laparoscopic intestinal workshop  

PubMed Central

Background Surgical educators have responded to the demand for increased skills in minimally invasive surgery by offering short technique-focused workshops at academic centres. The purpose of this study was to determine the impact of a comprehensive laparoscopic intestinal workshop for the adoption of laparoscopic colonic surgery. Methods A 2-day comprehensive laparoscopic intestinal surgery workshop included didactic teaching and supervised hands-on practice of numerous laparoscopic colon resections on a cadaveric model. Participants completed pre-, post- and 6-month postcourse questionnaires. Results The participants (n = 39) had been in practice for a mean of 10 (interquartile range 3–18) years. Fifty-one percent (n = 20) were already performing laparoscopic colectomies as part of their practices prior to the course. Regardless of whether they were performing laparoscopic colectomies prior to the course or not, attending the 2-day workshop improved their self-assessed preparedness to perform laparoscopic colectomies. Six months after the intestinal workshop, 10 of 16 respondents who were not performing laparoscopic colectomies prior to the course had performed at least 1 since the course. Seven of these individuals had a preceptor for their first case. Reasons cited for not performing a laparoscopic colectomy since the workshop included perceived inadequate surgical skill set, a lack of preceptor and the lack of an appropriate patient. Conclusion A comprehensive laparoscopic intestinal workshop contributed to the perceived acquisition of advanced laparoscopic surgical skills. Local laparoscopic preceptorship was an important adjunct to the workshop for the incorporation of laparoscopic colorectal surgery into practice.

Asano, Tracey K.; Soto, Claudia; Poulin, Eric C.; Mamazza, Joseph; Boushey, Robin P.

2011-01-01

419

Laparoscopic Ureteroneocystostomy: Modification of Current Techniques  

PubMed Central

Purpose To review the feasibility of laparoscopic ureteroneocystostomy with extracorporeal eversion of the ureteral end in various distal ureteral lesions. Materials and Methods We conducted a retrospective review of 5 laparoscopic procedures of ureteroneocystostomy with extracorporeal eversion of the ureteral end. Of these, 4 patients (range, 45 to 54 years) had distal ureter stricture or obstruction after gynecological surgeries for endometriosis or a large uterine myoma. One patient (male, 67 years) had low-grade distal ureter cancer. The laparoscopic procedure was combined with cystoscopic insertion of a ureteral stent and extracorporeal eversion of the ureter through the 10-mm port on the affected side. Results The laparoscopic ureteral reimplantations with and without a psoas hitch in patients with distal ureteral lesions was successful in all patients. The mean operation time was 137 minutes (range, 104 to 228 minutes). Two patients underwent additional psoas hitch. In all patients, short-term success was confirmed by voiding cystourethrography and intravenous pyelography conducted 3 months after the operation. The mean follow-up of the entire group was 12 months (range, 3 to 30 months). We noted no major or minor complications over the follow-up period. Conclusions The technique of laparoscopic ureteroneocystostomy for benign or malignant ureteral strictures continues to evolve. Surgeons should be versatile with various options and technical nuances when dealing with these cases. Simple modifications of laparoscopic ureteroneocystostomy with extracorporeal eversion of the ureteral end, nonreflux extravesical anastomosis, and simultaneous cystoscopy will be crucial to the ease of performance and a successful outcome.

Ahn, Jae Hyun; Han, Ji-Yeon; Nam, Jong Kil; Lee, Sang Don; Chung, Moon Kee

2013-01-01

420

A Laparoscopic Simulator Tool for Objective Measurement of Residents' Laparoscopic Ability  

PubMed Central

Objective: We sought to develop an objective measurement of residents' laparoscopic ability by using a laparoscopic simulator assessment tool. Methods: An inexpensive laparoscopic simulator was developed. Three laparoscopic assessment procedures were created: 1) bead/pom-pom drop, 2) checkerboard drill, and 3) bead manipulation. Two minimally invasive surgeons and 8 PGY 3/4 and 15 PGY 1 residents were timed performing the 3 procedures. Ten of the PGY 1 residents were retested at the end of their PGY 1 year. Results: The minimally invasive surgeons completed the laparoscopic drills in approximately half the time of the PGY 3/4 (P=0.02), and PGY 3/4 were 60% faster than PGY 1 (P=0.01). PGY 1 completed the drills in half the time at the end of the PGY 1 year (P=0.005). As an objective measurement of residents' laparoscopic surgery competency, by the completion of the academic year, all PGY 1 residents must be able to complete the drills as fast as or faster than the original PGY 3/4 times. Conclusion: We developed an inexpensive, objective, simple laparoscopic simulator assessment tool for measurement of residents' laparoscopic ability.

Bell, Rebecca; Maseelall, Priya; Fenton, Bradford; Flora, Robert

2007-01-01

421

Grade Seven Consumer Convention.  

ERIC Educational Resources Information Center

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

Berndes, Katherine

1983-01-01

422

Gallstone ileus after laparoscopic cholecystectomy  

PubMed Central

Gallstone ileus represents a rare complication (0,3-0,5%) of a serious, but common disease-gallstones, which affect around 10% of the population in the USA and Western Europe. Associated diseases (usually severe), elderly patients, delayed diagnosis and therapy due to late presentation to the hospital, account for the morbidity and mortality rates described in literature. We present the case of a patient with partial colon obstruction due to a large gallstone that was “lost” during an emergency laparoscopic cholecystectomy. The calculus eroded the intestinal wall, partially occluding the lumen, triggering recurrent Kerwsky-like, subocclusive episodes. The intraperitoneal abscess has spontaneously drained through the subhepatic drain and once the tube has been removed, a persistent intermittent fistula became obvious.

Ivanov, I; Beuran, M; Venter, MD; Iftimie-Nastase, I; Smarandache, R; Popescu, B; Bostina, R

2012-01-01

423

Knowledge, Equilibrium and Convention  

Microsoft Academic Search

There are two general classes of social conventions: conventions of coordination, and conventions of partial conflict. In\\u000a coordination problems, the interests of the agents coincide, while in partial conflict problems, some agents stand to gain\\u000a only if other agents unilaterally make certain sacrifices. Lewis' (1969) pathbreaking analysis of convention in terms of game\\u000a theory focuses on coordination problems, and cannot

P. Vanderschraaf

1998-01-01

424

Laparoscopic duodenoduodenostomy for duodenal atresia.  

PubMed

A 3,220-g newborn baby with trisomy 21 presented with duodenal atresia. No other congenital malformations were diagnosed. Informed consent for a laparoscopic approach was obtained. The child was placed in a supine, head-up position slightly rotated to the left at the end of a shortened operating table. The surgeon stood at the bottom end with the cameraperson to his left and the scrub nurse to his right. The screen was at the right upper end. Open insertion of a cannula for a 5-mm 30 degrees telescope through the inferior umbilical fold was performed. A carbon dioxide (CO2) pneumoperitoneum with a pressure of 8 mmHg and a flow of 2l/min was established. Two 3.3-mm working cannulas were inserted; one in the left hypogastrium and one pararectally on the right at the umbilical level. Two more such cannulas were inserted; one under the xyphoid for a liver elevator and one in the right hypogastrium for a sucker. Mobilization of the dilated upper and collapsed lower duodenum was easy. After transverse enterotomy of the upper duodenum and longitudinal enterotomy of the distal duodenum, a diamond-shaped anastomosis with interrupted 5 zero Vicryl sutures were performed. The absence of air in the bowel beyond the atresia increased the working space and greatly facilitated the procedure. The technique proved to be easy, and the child did very well. Laparoscopic bowel anastomosis in newborn babies had not been described previously. Recently, a diamond-shaped duodenoduodenostomy for duodenal atresia was performed. The technique proved to be simple and is described in detail. The child did very well. PMID:12200660

Bax, N M; Ure, B M; van der Zee, D C; van Tuijl, I

2000-12-21

425

Are There Lewis Conventions?  

Microsoft Academic Search

David Lewis famously proposed to model conventions as solutions to coordination games, where equilibrium selection is driven by precedence, or the history of play. A characteristic feature of Lewis Conventions is that they are intrinsically non- normative. Some philosophers have argued that for this reason they miss a crucial aspect of our folk notion of convention. It is doubtful however

Francesco Guala

426

Postural mechatronic assistant for laparoscopic solo surgery (PMASS)  

Microsoft Academic Search

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

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

2009-01-01

427

Addition of Laparoscopic Uterine Nerve Ablation to Laparoscopic Bipolar Coagulation of Uterine Vessels for Women with Uterine Myomas and Dysmenorrhea  

Microsoft Academic Search

Study ObjectiveTo assess the effectiveness of laparoscopic uterine nerve ablation (LUNA) in women with dysmenorrhea caused by uterine myomas treated by laparoscopic bipolar coagulation of uterine vessels (LBCUV).

Yuan-Kuei Yen; Wei-Min Liu; Chiou-Chung Yuan; Heung Tat Ng

2001-01-01

428

Medico-economic approach to the management of uterine myomas: a 6-month cost-effectiveness study of pelvic embolization versus vaginal hysterectomy  

Microsoft Academic Search

Introduction: Uterine artery embolization is a technique that has been recently proposed for the management of uterine myomas an alternative to vaginal hysterectomy. The results provided by the first published studies demonstrate a significant decrease in symptoms in 70–95% of cases. The aim of our study was to compare the cost-effectiveness ratios for pelvic embolization and vaginal hysterectomy looked at

Xavier J. L. Pourrat; Florence Fourquet; Fabrice Guerif; Nelly Viratelle; Denis Herbreteau; Henry Marret

2003-01-01

429

Laparoscopic Resection of the Left Pancreas: Technique and Indication  

Microsoft Academic Search

Laparoscopic pancreatic resections are rare procedures. A particular position is held by the left resection. In animal trials and 37 operations performed to date, this laparoscopic procedure has been positively assessed. The diseases operated upon were nearly exclusively benign. From November 1998 to July 2001, we performed 5 laparoscopic distal pancreatic resections at our hospital. The indications were: 2 adenocarcinomas;

E. Bärlehner; S. Anders; R. Schwetling

2002-01-01

430

Laparoscopic repair\\/peritoneal toilet of perforated duodenal ulcer  

Microsoft Academic Search

Laparoscopic techniques have been refined to the point where exposure, haemostasis and tissue approximation by suture approach those obtained at open access surgery. We report a patient with acute perforation of an ulcer in the first part of the duodenum who was successfully treated by laparoscopic oversewing and omental patching. The clinical indications for contemplating use of laparoscopic surgery for

Leslie K. Nathanson; David W. Easter; Alfred Cuschieri

1990-01-01

431

Laparoscopic repair of perforated peptic ulcer: a meta-analysis  

Microsoft Academic Search

Background Laparoscopic repair of perforated peptic ulcer has been gaining popularity in recent years, but few data exist to support the superiority of the laparoscopic approach over open repair. The objective of the current study was to compare the safety and efficacy of open and laparoscopic repair of perforated peptic ulcer in an evidence-based approach using meta-analytical techniques. Methods A

H. Lau

2004-01-01

432

Laparoscopic Interventions in the Gut: Yesterday, Today, and Tomorrow  

Microsoft Academic Search

The development of laparoscopic interventional surgery has brought about a revolution in general surgery over the past 5 years. Laparoscopic cholecystectomy has now become the treatment of choice for symptomatic cholelithiasis because of a reduction in access trauma, resulting in less postoperative pain and a faster recovery. Laparoscopic fundoplication for gastroeosophageal reflux also looks to be a promising procedure which

Andrew J. McMahon; Patrick J. O’Dwyer; John N. Baxter

1996-01-01

433

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

434

Laparoscopic repair of perforated peptic ulcer-technical tip.  

PubMed

Increasing number of gastrointestinal emergencies are managed laparoscopically. Laparoscopic repair of a perforated peptic ulcer remains contentious. Fashioning an omental patch is a crucial and an essential part of this repair, whether it is performed open or laparoscopically. This article describes a technique to fashion an adequate omental patch over the perforated peptic ulcer. PMID:23917602

Jayanthi, Naga Venkatesh Gupta

2013-08-01

435

Hand dominance and performance in a laparoscopic skills curriculum  

Microsoft Academic Search

Background: This study evaluated the influence of hand dominance on skill acquisition during a basic laparoscopic skills curriculum. Methods: A total of 27 surgical residents (5 postgraduate year 3 [PGY-3] and 22 PGY-2 residents) participated in a 4-week laparoscopic skills curriculum. The residents were pre- and posttested on six laparoscopic tasks during weeks 1 and 4. During weeks 2 and

T. W. Powers; D. J. Bentrem; A. P. Nagle; M. T. Toyama; S. A. Murphy; K. M. Murayama

2005-01-01

436

Transvaginal laparoscopic nephrectomy: development and feasibility in the porcine model  

Microsoft Academic Search

Objectives. To assess feasibility of laparoscopic nephrectomy completed entirely by way of the vagina in the porcine model.Methods. Six transvaginal laparoscopic nephrectomies were performed in female farm pigs. Two acute and two 1-week survival animals were used for the study. Before killing the survival animals, a second transvaginal laparoscopic nephrectomy was performed on the remaining renal unit. For one renal

Matthew T Gettman; Yair Lotan; Cheryl A Napper; Jeffrey A Cadeddu

2002-01-01

437

LONG-TERM FOLLOWUP AFTER LAPAROSCOPIC RADICAL NEPHRECTOMY  

Microsoft Academic Search

Purpose: Laparoscopic radical nephrectomy has been shown to be less morbid than traditional open radical nephrectomy. The long-term oncological effectiveness of laparoscopic radical ne- phrectomy remains to be established. Materials and Methods: At 3 centers patients undergoing laparoscopic radical nephrectomy before November 1, 1996 with pathologically confirmed renal cell carcinoma were identified. A representative group of patients undergoing open radical

ANDREW J. PORTIS; YAN YAN; JAIME LANDMAN; CATHY CHEN; PETER H. BARRETT; DONALD D. FENTIE; YOSHINARI ONO; ELSPETH M. McDOUGALL; RALPH V. CLAYMAN

2002-01-01

438

Laparoscopic microsurgical tubal anastomosis with and without robotic assistance  

Microsoft Academic Search

BACKGROUND: We previously reported our results with laparoscopic microsurgical tubal anastomosis with robotic assistance. The purpose of this study was to compare the duration of the procedure and hospitalization, blood loss and clinical outcomes for laparoscopic microsurgical tubal anastomosis performed with and without robotic assistance. METHODS: This was a retrospective comparative case study in an academic tertiary referral centre. Laparoscopic

Jeffrey M. Goldberg; Tommaso Falcone

439

Automatic tracking of laparoscopic instruments by color coding  

Microsoft Academic Search

In this paper we describe an autonomous laparoscopic guidance system for laparoscopic surgery. By analyzing the color histogram of typical laparoscopic images, we propose to code the instrument by a color that does not appear. In terms of image processing, we segment the color mark in the visual image and use the location information to control a robot such that

Guo-qing Wei; Klaus Arbter; Gerd Hirzinger

1997-01-01

440

Laparoscopic paravaginal repair plus burch colposuspension: review and descriptive technique  

Microsoft Academic Search

The objective of this article was to review the available literature on laparoscopic Burch urethropexy cure rates and describe the authors’ laparoscopic technique and experience with Burch urethropexy and paravaginal repair. A MEDLINE search (1991 to 1999) was performed for articles describing the laparoscopic Burch urethropexy using suture to elevate and stabilize the paraurethral tissue. Also a retrospective chart review

John R Miklos; Neeraj Kohli

2000-01-01

441

LAPAROSCOPIC PARAVAGINAL REPAIR PLUS BURCH COLPOSUSPENSION: REVIEW AND DESCRIPTIVE TECHNIQUE  

Microsoft Academic Search

The objective of this article was to review the available literature on laparoscopic Burch urethropexy cure rates and describe the authors' laparoscopic technique and experience with Burch urethropexy and para- vaginal repair. A MEDLINE search (1991 to 1999) was performed for articles describing the laparoscopic Burch urethropexy using suture to elevate and stabilize the paraurethral tissue. Also a retrospective chart

JOHN R. MIKLOS

442

Laparoscopic Sigmoidectomy for Diverticulitis: a Prospective Study  

PubMed Central

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

Baca, Ivo; Grzybowski, Leszek; Jaacks, Armin

2010-01-01

443

A fast stereo matching algorithm for 3D reconstruction of internal organs in laparoscopic surgery  

NASA Astrophysics Data System (ADS)

We propose a fast stereo matching algorithm for 3D reconstruction of internal organs using a stereoscopic laparoscope. Stoyanov et al. have proposed a technique for recovering the 3D depth of internal organs from images taken by a stereoscopic laparoscope. In their technique, the dense stereo correspondence is solved by registration of the entire image. However, the computational cost is very high because registration of the entire image requires multidimensional optimization. In this paper, we propose a new algorithm based on a local area registration method that requires only low-dimensional optimization for reduction of computational cost. We evaluated the computational cost of the proposed algorithm using a stereoscopic laparoscope. We also evaluated the accuracy of the proposed algorithm using three types of images of abdominal models taken by a 3D laser scanner. In the matching step, the size of the template used to calculate the correlation coefficient, on which the computational cost is strongly dependent, was reduced by a factor of 16 as compared with the conventional algorithm. On the other hand, the average depth errors were 4.68 mm, 7.18 mm, and 7.44 mm respectively, and accuracy was approximately as same as the conventional algorithm.

Okada, Yoshimichi; Koishi, Takeshi; Ushiki, Suguru; Nakaguchi, Toshiya; Tsumura, Norimichi; Miyake, Yoichi

2008-04-01

444

The Effect of Ultrasound-guided TAPB on Pain Management after Total Abdominal Hysterectomy  

PubMed Central

Background Incisional pain is particularly troublesome after hysterectomy. A method called transversus abdominis plane block (TAPB) has shown promise in managing postoperative pain. In this study, we evaluated the analgesic efficacy of ultrasound-guided TAPB after hysterectomy at different time points and at each time point separately for 48 hours. Methods Forty-two patients (ASA I, II) who were electively chosen to undergo total abdominal hysterectomy were divided into 2 groups, control (group C) and intervention (group I). Twenty-one patients underwent TAPB (group I) and 21 patients received only the standard treatment with a fentanyl pump (group C). Both groups received standard general anesthesia. For patients in group I, following the surgery and bef