Surgical endoscopy
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Laparoscopy is increasingly used for rectal cancer surgery. Laparoscopic surgery is not attempted for some suitable patients because of concerns for conversion or technical difficulty. This study aimed to evaluate oncologic and short-term outcomes for patients undergoing curative resection for rectal cancer via laparoscopic and open approaches. ⋯ Laparoscopic resection for rectal cancer can be attempted for most patients. Conversion to open procedure does not compromise clinical or oncologic outcomes. In practice, combining laparoscopic and open surgery optimizes resource use and results in at least equivalent outcomes.
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Anastomotic leakage is a devastating complication of colorectal surgery. However, there is no technology indicative of in situ perfusion of a laparoscopic colorectal anastomosis. ⋯ Perfusion angiography of colorectal anastomosis at the time of their laparoscopic construction is feasible and readily achievable with minimal added intraoperative time. Further work is required to determine optimum sensitivity and threshold levels for assessment of perfusion sufficiency, in particular with regard to anastomotic viability.
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Randomized Controlled Trial
Electrostatic precipitation is a novel way of maintaining visual field clarity during laparoscopic surgery: a prospective double-blind randomized controlled pilot study.
Ultravision™ is a new device that utilizes electrostatic precipitation to clear surgical smoke. The aim was to evaluate its performance during laparoscopic cholecystectomy. ⋯ Ultravision™ improves visibility during laparoscopic surgery and reduces delays in surgery for smoke clearance and camera cleaning.
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Laparoscopic cholecystectomy (LC) remains one of the most frequently performed surgical procedures. The safety of LC in patients with renal disease is unclear. The postoperative outcomes of elective LC in patients on dialysis were studied and risk factors associated with longer length of stay and mortality were sought. ⋯ Patients on dialysis who undergo LC should be carefully selected due to the significantly higher complication and mortality rate. Several predictors of longer length of stay and mortality were identified that can determine which patients on dialysis are good candidates for LC.
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Laparoscopic colorectal surgery (LCRS) has several advantages over open surgery, but LCRS has been associated with a higher rate of postoperative complications (POCs) among obese patients [body mass index (BMI), ≥30 kg/m(2)]. The prevalence of obesity in Chile is increasing, up to 25.1% in 2010, suggesting that a higher percentage of patients undergoing LCRS will be obese. This study compared POC rates between obese and nonobese patients undergoing LCRS. ⋯ The frequency of POCs after LCRS was no higher among the obese patients than among the nonobese patients.