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Search Results: 1 - 10 of 11416 matches for " Laparoscopic surgery "
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Laparoscopic colorectal surgery is safe and may be beneficial in patients eighty years of age and over  [PDF]
Mathew A. Kozman, Daniel R. Kozman
Open Journal of Gastroenterology (OJGas) , 2012, DOI: 10.4236/ojgas.2012.22016
Abstract: Objective: To establish that the laparoscopic approach to colorectal resection is safe with regards to post- operative morbidity and mortality in patients eighty years of age and over. Methods: Prospectively collect- ed data for consecutive patients aged eighty years and older who underwent laparoscopic colorectal resec-tion by the same surgeon (Dr Daniel R. Kozman) from 1st January 2009 till 31st March 2011, were retrospectively analysed. Data collected included baseline demographic information, operative indication, American Society of Anaesthesiologists (ASA) grading, procedure type, length of procedure, post-operative course, length of hospital stay, dis-charge destination and complications. Results: Thirty-one patients underwent laparoscopic colectomy during the study period, 28 for adenocarcinoma. The median age was 85.5 (range 80 - 92) years, 15 patients were male and 25 patients were from home. The mean operating time was 118.4 minutes (range 45 - 271). Conversion was required in only 4 of 31 cases (13%). The mortality rate was 10% in total, and 0% in elective cases. Three patients required re-operation, 2 of which initially presented in the emergency setting and were subsequently deceased. For survivors, the length of hospital stay was 8.1 days (range 3 - 30) with 100% returning to original place of residence. Conclusion/ Interpretation: Laparoscopic surgery in patients eighty years and over is safe and may be beneficial in the elective setting. This is evident by low complication rate, fast return to bowel function, short length of hospital stay, and likely return to pre-operative place of residence and low mortality rate in elective patients. Careful consideration should be given to its use in an emergency setting.
Comparison of the Incidence of Complications among the Different Techniques of Laparoscopic Approach: Experience in a General Surgery Service in a Private Hospital  [PDF]
Mauricio Valdez-Durón, Jorge Fernández-álvarez, Alberto Manuel González-Chávez, Francisco ángel Vega-Romero, Ketzalcoatl Tecomahua-Román, Antonio García-Ruiz
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.97027
Abstract: Introduction: At least four techniques or approaches to minimize the risk of injury have been introduced. The correlation between techniques and the complication rate is controversial. The objective of the study is to report the incidence of laparoscopic entry associated injury, in relation to the used technique. Material and Methods: A retrospective study was conducted at the Hospital Espa? ol, in a 12-month period (2013). The medical records of all patients who underwent laparoscopic surgery were reviewed. Demographic and surgical variables were analyzed, comparing the results statistically through an analysis of variance (ANOVA). Results: A total of 792 cases were analyzed. The surgeries performed were: cholecystectomies (42%), appendectomies (26%), diagnostic laparoscopies (20%), ventral or inguinal hernioplasty (9%) and fundoplications (3%). The preferred approach was Hasson’s (79%) and Veres’s needle technique (14%), followed by classic closed (14%) and Palmer technique (2%). We documented six cases of laparoscopic entry associated injury (0.76%), four associated with the Hasson technique, one with Veress’s needle technique and one with direct approach technique were reported. The statistical analysis was performed considering the different techniques and their relation with the injuries. Analysis of variance did not reach statistical significance (p = 0.31). Conclusions: Among our data, the number of laparoscopic entry associated injuries, was less than 1%, and has a similar frequency to the reported literature. We did not find significant differences between the four laparoscopic entry techniques. There remains no clear evidence as to the optimal form of laparoscopic entry in the low-risk patient.
Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center  [PDF]
Takahiro Watanabe, Hidetosi Wada, Masanori Sato, Yuichirou Miyaki, Junpei Tochikubo, Norihiko Shiiya
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.410083
Abstract:

Background and Objectives: Recently, single-incision laparoscopic surgery has been popular for minimally invasive surgery and cosmetic improvement. We studied outcomes of single-incision laparoscopic appendectomy (SILA) in accordance with our strategy for acute appendicitis. Methods: Clinical outcomes were revealed in each of nine emergency SILA (e-SILA) cases and eight interval SILA (i-SILA) cases performed for the treatment of acute appendicitis between September 2010 and August 2012 at our hospital. Results: The male to female ratio was 6:3 for e-SILA and 5:3 for i-SILA cases. Mean ages were 33.1 ± 17.8 years and 41 ± 21.6 years for e-SILA and i-SILA, respectively. The pretreatment white blood cell (WBC) count and C-reactive protein (CRP) levels were 14960 ± 4080/μL and 1.4 ± 2.3 mg/d, respectively, for e-SILA and 12657 ± 4290/μL and 6.7 ± 8.3 mg/d, respectively, for i-SILA. The maximum transverse diameter of appendix was 12.6 ± 3.5 mm for e-SILA and 11.6 ± 3.5 mm for i-SILA. Appendiceal abscesses were encountered in one (11%) e-SILA and three (38%) i-SILA cases. Perforation of the appendix at operation occurred in two (22%) e-SILA cases and no i-SILA cases. Generalized peritonitis occurred in 4 (44%) e-SILA cases but in none of the i-SILA cases. The postoperative hospital stay was 5.3 days for e-SILA, 2.7 days for i-SILA. Conversion to laparotomy was not required in either group. One additional trocar was needed for an e-SILA case, and paralytic ileus occurred as a postoperative complication in one e-SILA case. Conclusion: The outcomes of SILA performed under our strategy w

The surgical management of morbidly obese women with endometrial cancer  [PDF]
Stephanie Kuku, John Dick, Adeola Olaitan
Health (Health) , 2012, DOI: 10.4236/health.2012.412A208
Abstract:

There is an obesity epidemic in the Western World. Currently one in four adults is obese and three in ten children in the UK is overweight or obese [1]. The UK Foresight Study [2] predicts that if nothing is done, this figure will rise to five in ten (50%) in women by 2050. The endocrine changes induced by obesity lead to an increased incidence of endometrial cancer. The majority of women with endometrial cancer present with early disease which means that surgery will form all or part of their treatment. This presents serious challenges as these women often have associated comorbid conditions. In this article we explore the relationship between obesity and endometrial cancer and highlight the surgical challenges.

A Comparison of Pinch Force between Finger and Palm Grasp techniques in Laparoscopic Grasping  [PDF]
Susmitha Wils K, George Mathew, M. Manivannan, Suresh R Devasahayam
Engineering (ENG) , 2012, DOI: 10.4236/eng.2012.410B012
Abstract:

Laparoscopic surgery is a new abdominal surgical procedure which helps the patients in many ways like less hospital stay, faster recovery and reduced pain. The main disadvantage in this surgical procedure is the reduced haptic perception by the surgeons due to the usage of laparoscopic instrument to handle tissues which in turn cause damage of it as compared to an open surgery. The primary aim of this investigation was to compare the pinch force applied during two different methods of laparoscopic grasping: Finger and Palm grasp. A low cost force sensing resistor tailor made for the grasper tip was designed and fabricated for quantifying the grasper tip force in the study. The results indicate more pinch force was applied during palm grasp as compared to finger grasp so as to prevent the slippage of the tissues from the jaws of the laparoscopic graspers.

3-Port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance  [PDF]
Lin Zhang, Guohu Zhang, Peihong Wang, Yonghua Wang, Yaning Song, Hong Zou, Lijun Tang
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.27103
Abstract: Introduction: To present the initial experience of 3-port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance by using a toothed oval clamp. Case Presentation: One patient received 3-port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance by using a toothed oval clamp. Better direct vision and exposure could be acquired for performing laparoscopic surgical procedure, avoiding additional port inserted. Using this procedure, with strictly adhering to the principles of laparoscopic colectomy and oncological procedure, along with the specimen exteriorized via recta, transacted and a stapled anastomosis performed, no incision can be achieved at the end of an operation. The operative time was 180 minutes. The estimated blood loss in the course of an operation was 80 ml. The patient recovered quickly after surgery, with no post-operative pain and no incision. The patient was dischanged home on the 6th postoperative day. Conclusions: With a transrectal assistance by using a toothed oval clamp, 3-port laparoscopic surgery for rectal cancer could be achieved without no incision at the end of the operation, the same as NOTES. It is enormously advantageous to the patient and suitable for application in developing countries, especially in a rural area.

Lost and found  [PDF]
De Lacavalerie Penelope, Iskander Michael, Berney Christophe
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.37A2002
Abstract:

The insertion of intrauterine devices is a common procedure performed all over the world. In some circumstances, however, complications after this procedure can be latent.

Open Distal Gastrectomy versus Laparoscopic Distal Gastrectomy: As Influenced by Facility Background Factors in the Real World  [PDF]
Nozomu Murakami, Shinichi Kadoya, Masanari Shimada, Naoki Endo, Kaname Ishiguro, Koichiro Sawada, Kouichi Tanabe, Hatsuna Yasuda, Noriyuki Inaki, Tetsuji Yamada, Eiji Kanehira, Tatsuhiko Kashii
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.53019
Abstract:

The purpose of our study was to retrospectively evaluate the clinical efficacy and safety of laparoscopy assisted distal gastrectomy (LADG) performed by one operating and advising surgeon in patients with gastric cancer over a period of 10 years. We examined the choice of anastomosis techniques, and compared the duration of surgery, blood loss, number of dissected lymph nodes and intraoperative complications for LADG and open distal gastrectomy (ODG). We studied 254 patients who underwent laparoscopic gastrectomy and 36 patients who underwent ODG. 169 of 254 patients received LADG. Duration of surgery was significantly longer for LADG than that for ODG, blood loss was significantly smaller, and numbers of dissected lymph nodes were similar. With LADG, there was anastomotic leakage in 2 patients and postoperative obstruction in 2 patients. No recurrence of disease and no deaths have been reported to date. Though previous clinical trials have shown that LADG is less invasive, our study of LADG in the real world did not show superiority, but rather equivalence to ODG in terms of other outcomes. This study could be advantageous to evaluate the clinical efficacy and safety of LADG without having to take into account multiple surgeons’ technical levels and the background differences between the facilities.

Effect of cross linked sodium hyaluronate in adhesion reduction within the gynecologic surgical window  [PDF]
Liselotte Mettler
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.43022
Abstract:

Objectives: On an International scale the Surgical and Clinical Adhesion Research studies (SCAR) solidified the huge impact adhesions have on our Health Care System and the daily complications occurring at surgical procedures because of adhesions. Study: Retrospective file and chart review of 462 patients undergoing laparoscopic surgery at the Department of Obstetrics and Gynecology, University Hospitals of Schleswig Holstein, Kiel. Scientific background of HyaCorp endogel for adhesion prevention and reduction. Observational study applying HyaCorp endogel in 125 gynecological laparoscopic surgeries for adhesion reduction: Laparoscopic Total and subtotal hysterectomies(LTH, LSH) myomectomies and endometriosis surgeries. Additionally the application in 30 hysteroscopic surgeries such as polypectomies, intracavitary myomectomies and septum resections are described. Results: 50% of patients (P < 0.005) with chronic pelvic pain had thick fibrous adhesions. HyaCorp endogel perfectly adheres to the tissue surface and the abdominal wall creating an anti adhesion barrier without any side effects. At hysteroscopies the application of 1 - 2 ml into the uterine cavity after intra-cavitary procedures was easily performed through a 2 mm cannula applicator. Postoperatively only in 2 cases patients had a slight pain over the first week, which did not continue. The gel was perfectly tolerated and showed no side effects. Conclusions and Discussion: Fibrous adhesions between pelvic organs and the pelvic side wall during gynecological surgical procedures with laparoscopy cause severe pain and further burden the task of the laparoscopic surgeon. The attempt to reduce these adhesions by applying the site specific, hyaloronic acid based barrier, HyaCorp endogel’ proved to be satisfying and helpful in this purely observational study.

Case Report: A Laparoscopic Treated Case of Deep Infiltrating Endometriosis with Vaginal Invasion Diagnosed by Vaginal Cytology  [PDF]
Kenji Niwa, Ryuichiro Yano, Yui Hatanaka, Sakae Mori, Yoshio Yamaguchi, Minako Mori, Yoko Ueda, Takuji Tanaka
Open Journal of Pathology (OJPathology) , 2015, DOI: 10.4236/ojpathology.2015.53012
Abstract: A recently observed case of deep infiltrating endometriosis with its vaginal invasion diagnosed by vaginal cytology is reported. A 28-year-old Japanese woman complained of a severe dysmenorrhea. Left ovarian endometriotic cyst and deep infiltrating endometriosis were suspected. Two red-spots were also present in the posterior fornix of vagina. Vaginal cytology with?cytokeratin (CK) 7-immunocytochemistry suggested the presence of infiltrating endometriosis. She underwent left ovarian cystectomy and resection of thickened uterosacral ligaments with vaginal endometriotic spots, under a laparoscope, based on the diagnosis of endometriotic cyst. Histopathology revealed DIE with vaginal invasion. Immunostaining for CK7 was positive for endometriotic cyst, while CK20 was negative. The stromal cells in endometriosis were immunohistochemically positive for CD10. The vaginal fornix was well-healed one month later the surgery. Postoperatively, she got pregnant with her natural intercourse and delivered a healthy 2138 g girl at 36 weeks of gestation.
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