Surgical endoscopy
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Comparative Study
A prospective comparative study of needlescopic and conventional endoscopic extraperitoneal inguinal hernioplasty.
Needlescopic inguinal hernioplasty has been made feasible with the miniaturization of instruments and recent advances in laparoscopic surgical technique. Postoperative outcome of needlescopic totally extraperitoneal inguinal hernioplasty (TEP) has not been previously compared with that of conventional TEPs. The objective of the current study is to compare the postoperative outcomes of needlescopic and conventional TEPs. ⋯ Needlescopic TEP is a safe technique for the repair of inguinal hernia. Postoperative recovery following needlescopic and conventional TEPs was similar. Needlescopic TEP conferred a significantly lower pain score upon coughing on the first day after operation.
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Laparoscopic bariatric surgery is a challenging procedure with a high risk of technical misadventures that may increase postoperative morbidity. Routine intraoperative endoscopy may reduce postoperative morbidity. This article reviews our 6-year experience. ⋯ Routine intraoperative endoscopy identified 34 correctable technical errors in a series of 825 laparoscopic bariatric procedures. Of these, 33 (97%) were repaired successfully, which reduced postoperative morbidity.
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The surgical management of acute appendicitis presenting with appendicular mass remains controversial. The aim of this study was to evaluate the role of early laparoscopy and laparoscopic appendectomy (LA) in the management of appendicular mass. ⋯ Early LA during the index admission of patients with an appendicular mass is feasible and safe, obviates the need for a second hospital admission, and avoids misdiagnoses.
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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.