Surgical endoscopy
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Case Reports
Laparoscopic resection of perforated Meckel's diverticulum in a patient with clinical symptoms of acute appendicitis.
We report the laparoscopic resection of a perforated Meckel's diverticulum (MD) found in a 14-year-old boy who presented with abdominal pain and nausea. There was rebound tenderness in the right lower quadrant of the abdomen, which appeared suspicious for acute appendicitis. The patient was referred to the operating room, and laparoscopic appendectomy was performed. ⋯ At this writing, he is completely asymptomatic 6 months later. We conclude from our observation that laparoscopic resection of a perforated MD can be performed safely even when localized peritonitis is present. Inspection of the small intestine should be performed to exclude a symptomatic or perforated MD when the appendix does not show any signs of acute appendicitis.
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Open nephropexy for nephroptosis creates significant morbidity. We describe our technique for retroperitoneoscopic nephropexy and evaluate its efficacy. ⋯ This modified technique of retroperitoneoscopic nephropexy is a minimally invasive, feasible, and highly successful option for treating patients with symptomatic nephroptosis.
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Comparative Study
The effect of intraoperative bupivacaine administration on parenteral narcotic use after laparoscopic appendectomy.
Little is known about the effect that prophylactic administration of local anesthesia into surgical incisions has on pain and analgesic use after laparoscopic appendectomy. We examined how preemptive infiltration of a local anesthetic affected the use of parenteral narcotics after laparoscopic appendectomy. ⋯ Intraoperative bupivacaine infiltrated locally into surgical wounds is associated with both a decreased need for postoperative parenteral narcotics and a reduced number of doses in patients who have undergone a laparoscopic appendectomy.