Surgical endoscopy
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Review Comparative Study
Laparoscopic vs open hepatic resection: a comparative study.
Although the feasibility of minor laparoscopic liver resections (LLR) has been demonstrated, data comparing the open vs the laparoscopic approach to liver resection are lacking. ⋯ Minor LLR of the anterior segments has the same rates of mortality and morbidity as OLR. However, the laparoscopic approach reduces blood loss and postoperative hospital stay.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preincisional local infiltration of levobupivacaine vs ropivacaine for pain control after laparoscopic cholecystectomy.
Postoperative pain is less intense after laparoscopic surgery than after open surgery. However, patients may gain additional benefit from a preincisional local infiltration of anesthetic. The aim of this study was to compare the analgesic efficacy of two local anesthetics, ropivacaine and levobupivacaine, for tissue infiltration as a means of improving postoperative pain control after laparoscopic cholecystectomy. ⋯ Local tissue infiltration with levobupivacaine is more effective than ropivacaine in reducing the postoperative pain associated with laparoscopic cholecystectomy.
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Practice Guideline Guideline
Guidelines for institutions granting bariatric privileges utilizing laparoscopic techniques.
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There is no consensus on the best technique for the repair of umbilical hernia in adults. The role of laparoscopic hernioplasty of umbilical hernia remains controversial. This study was undertaken to compare the outcomes of open and laparoscopic onlay patch repair of umbilical hernia in adults. ⋯ Laparoscopic onlay patch hernioplasty is a safe and efficacious technique for the repair of umbilical hernia. Compared to Mayo repair, the laparoscopic approach confers the advantages of reduced postoperative pain, shorter hospital stay, and a diminished morbidity rate.
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Randomized Controlled Trial Clinical Trial
Gastrointestinal transit after laparoscopic versus open colonic resection.
Multimodal rehabilitation with epidural analgesia, early oral nutrition and mobilization, and laxative use has decreased the duration of ileus after colonic surgery to about 2 days, as compared with the usual 3 to 5 days of rehabilitation required after open surgery and the slightly shorter time required with laparoscopic surgery. Gastrointestinal transit after colonic resection with laparoscopy or laparotomy was assessed. ⋯ Postoperative ileus and gastrointestinal transit normalized within 48 h after colonic resection in the patients who received multimodal rehabilitation. No significant difference was observed between the patients who underwent the laparoscopic procedure and those who underwent the open procedure.