Surgical endoscopy
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Comparative Study
Validation of a novel laparoscopic adjustable gastric band simulator.
Morbid obesity accounts for more than 90,000 deaths per year in the United States. Laparoscopic adjustable gastric banding (LAGB) is the second most common weight loss procedure performed in the US and the most common in Europe and Australia. Simulation in surgical training is a rapidly advancing field that has been adopted by many to prepare surgeons for surgical techniques and procedures. The aim of our study was to determine face, construct, and content validity for a novel virtual reality laparoscopic adjustable gastric band simulator. ⋯ We created a virtual reality laparoscopic adjustable gastric band simulator. Our initial results demonstrate excellent face, construct, and content validity findings. To our knowledge, this is the first virtual reality simulator with haptic feedback for training residents and surgeons in the laparoscopic adjustable gastric banding procedure.
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Comparative Study
Incisional hernia, midline versus low transverse incision: what is the ideal incision for specimen extraction and hand-assisted laparoscopy?
Minimally invasive surgery is associated with smaller surgical incisions than those of traditional midline laparotomy. However, most colorectal resections and all hand-assisted procedures require an incision either for specimen retrieval or insertion of the hand-assist device. The ideal site of this incision has not been evaluated with respect to the incidence of incisional hernia. This study compares the rates of incisional hernia associated with a standard midline laparotomy, a midline incision of reduced length, and a Pfannenstiel incision. ⋯ A Pfannenstiel incision is associated with the lowest rate of incisional hernia and should be the incision of choice for hand assistance and specimen extraction in minimally invasive colorectal resections wherever applicable.
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Comparative Study
A totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG) for improvement of the early surgical outcomes in high BMI patients.
To evaluate the effectiveness of totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG), we compared its early surgical outcomes with those of laparoscopy-assisted distal gastrectomy with gastroduodenostomy (LADG). ⋯ We suggested that TLDG contributes to the improvement of early surgical outcomes. We further suggest that TLDG in obese patients could be the best way to improve early surgical outcomes, including the bowel movement, pain score, overall complication rate, and hospital discharge.
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Comparative Study
Initial experiences using robot-assisted central pancreatectomy with pancreaticogastrostomy: a potential way to advanced laparoscopic pancreatectomy.
Benign and borderline malignant pancreatic tumors are increasing. Function-preserving and minimally invasive pancreatectomy may be an ideal approach for these tumors. ⋯ Central pancreatectomy can be selected carefully as an appropriate surgical option for benign and borderline malignant lesions limited to the pancreatic neck area. The robotic surgical system may allow surgeons to perform complex and difficult laparoscopic procedures more easily, effectively, and precisely.
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Laparoscopic surgery has been shown to offer superior surgical outcomes for most abdominal surgical procedures. However, there is hardly any evidence on surgical outcomes with patient risk stratification. This study aimed to compare outcomes of common laparoscopic and open surgical procedures for varying illness severity. ⋯ This study demonstrated the superiority of laparoscopy over conventional open surgery across all illness severity risk groups for common surgical procedures. The results in general show that laparoscopic surgery is safe, efficacious, and cost-effective compared with open surgery and suggest that laparoscopic surgery should be the procedure of choice for all common surgical procedures, regardless of illness severity.