Surgical endoscopy
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Randomized Controlled Trial Clinical Trial
Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial.
Downsizing the port incisions may reduce pain after laparoscopic cholecystectomy. ⋯ The use of 3.5-mm trocars is feasible in LC, and it both reduces incisional pain and improves the cosmetic result.
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Most ingested foreign bodies pass through the gastrointestinal tract without giving rise to complications. The possibility of penetration of the intestinal tract, by sharp, pointed objects, however, necessitates careful and continued observation. If such objects become lodged in a narrow segment of the gastrointestinal tract, perforation may occur. ⋯ With laparoscopic approach for removal of penetrating intestinal foreign bodies, laparotomy and its attending complications are avoided. This approach is less invasive, has a beneficial impact on postoperative pain, produces a better cosmetic result, and offers a faster return to normal activities. Hospital stay and costs also are reduced.
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Case Reports
Laparoscopic extraction of a swallowed fork in a patient first diagnosed with bulimia nervosa.
Swallowed foreign bodies are relatively common problem. The first reports date back about 3000 years. The first medical report was done by Mestivier in 1759. ⋯ We report an unusual case of an unintentional ingested fork, which required a laparoscopic extraction using three trocars. The 20-year-old female patient was then subsequently diagnosed with bulimia nervosa for the first time during her hospital stay. The patient was discharged home on the fourth postoperative day after an unremarkable course.
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Randomized Controlled Trial Clinical Trial
Ondansetron in the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy: a prospective randomized study.
There is an increased incidence of postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy. The aim of the study was to evaluate the efficacy of intravenous ondansetron, a 5-HT anatagonist, for prevention from PONV after laparoscopic cholecystectomy. ⋯ Routine use of ondansetron does not reduce the incidence of postoperative nausea and vomiting after laparoscopic cholecystectomy.
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The use of laparoscopy in the assessment and treatment of blunt abdominal trauma has been reported for both adults and children. With increasing surgical experience and improvements in equipment, an expanding range of therapeutic interventions is available. The management of a 7-year-old boy who sustained blunt abdominal trauma during a fall from a bicycle is described. ⋯ Computed tomography scanning, ultrasound scanning, and diagnostic peritoneal lavage all have strengths for detecting different injury types, but they also have a low specificity in determining the need for laparotomy. The advantages and limitations of laparoscopy in hemodynamically stable children who have sustained injuries from blunt trauma are discussed. The authors recommend laparoscopy in experienced hands as an additional tool for the optimal management of selected trauma cases.