Surgical endoscopy
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial assessing the benefit of humidified insufflation gas during laparoscopic surgery.
We conducted a randomized controlled trial during laparoscopic cholecystectomy to determine the extent of heat preservation and postoperative pain reduction using humidified carbon dioxide (CO2) gas insufflation instead of standard dry insufflation gas. ⋯ The use of humidified insufflation gas reduces postoperative pain following laparoscopic cholecystectomy, but except for these relatively brief procedures, the heat-preserving effect of humidified gas insufflation is not significant.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. A prospective randomized trial.
Conventional colorectal resections are associated with severe postoperative pain and prolonged fatigue. The laparoscopic approach to colorectal tumors may result in less pain as well as less fatigue, and may improve postoperative recovery after colorectal resections. ⋯ This study confirms that analgetic requirements are lower and pain is less intense after laparoscopic than after conventional colorectal resection. Patients also experience less fatigue after minimal invasive surgery. Because of these differences, the duration of recovery is shortened, and the postoperative quality of life is improved after laparoscopic colorectal resections.
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Randomized Controlled Trial Comparative Study Clinical Trial
Port site metastases and recurrence after laparoscopic colectomy. A randomized trial.
This study was performed to prospectively assess the impact of the laparoscopic approach to the patterns of port site metastases (PSM) and recurrence rate (RR) of resected colon carcinomas as compared with conventional colectomies. ⋯ The laparoscopic approach has a recurrence rate similar to that for open procedures for colon cancer. However, additional follow-up of these patients is needed before we can determine whether or not the laparoscopic approach influences overall survival.
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Randomized Controlled Trial Comparative Study Clinical Trial
Laparoscopic cholecystectomy using abdominal wall retraction. Hemodynamics and gas exchange, a comparison with conventional pneumoperitoneum.
Disadvantages related to CO2 pneumoperitoneum have led to development of the abdominal wall retractor (AWR), a device designed to facilitate laparoscopic surgery without conventional pneumoperitoneum (15 mmHg CO2). We investigated the effects of the AWR on hemodynamics and gas exchange in humans. We also investigated whether the use of an AWR imposed extra technical difficulties for the surgeon. A pilot study revealed that cholecystectomy without low-pressure pneumoperitoneum was technically impossible. ⋯ The results indicate that the view was impaired during use of the AWR and therefore its use was difficult and time-consuming. Possible advantages of this devices' effects on hemodynamics and ventilatory parameters could not be confirmed in this study.
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Randomized Controlled Trial Comparative Study Clinical Trial
Port site electrosurgical (diathermy) burns during surgical laparoscopy.
Direct and capacitive coupling of diathermy current have been reported as causes of occult injury during surgical laparoscopy. ⋯ Burns may be the result of direct or capacitive coupling to metal cannulas or capacitive coupling to the skin edge across plastic cannulas. The potential exists for burns to other tissues also in close proximity to a cannula used for electrosurgery.