Surgical endoscopy
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Randomized Controlled Trial
Prospective, randomized and controlled trial on magnesium sulfate administration during laparoscopic gastrectomy: effects on surgical space conditions and recovery profiles.
The degree of neuromuscular blockade is one of the important factors that determine the condition of surgical space during laparoscopic surgery. Magnesium sulfate potentiates the actions of neuromuscular blocking agent, and we hypothesized that intraoperative magnesium sulfate infusion may improve surgical space condition during laparoscopic surgery. ⋯ Intraoperative administration of magnesium sulfate improved the quality of surgical space conditions and decreased neuromuscular blocking agent requirement and postoperative pain in patients undergoing laparoscopic gastrectomy.
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POEM is a recently developed achalasia treatment method, which combines the efficacy of surgical myotomy with the benefits of endoscopic procedures. Very few studies have focussed on the efficacy and usefulness of POEM in over 100 cases. ⋯ Our results confirm the efficacy of POEM in a large patient series and support POEM as one of the first-line achalasia therapies in the near future.
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Controlled Clinical Trial
Local wound infiltration plus transversus abdominis plane (TAP) block versus local wound infiltration in laparoscopic colorectal surgery and ERAS program.
Few data are available on TAP block in laparoscopic colorectal surgery and ERAS program. The aim of this prospective study was to evaluate local wound infiltration plus TAP block compared to local wound infiltration in the management of postoperative pain, nausea and vomiting, ileus and use of opioids in the context of laparoscopic colorectal surgery and ERAS program. ⋯ TAP block plus local wound infiltration in the setting of laparoscopic colorectal surgery and ERAS program guarantees a reduced use of opioid analgesics and good pain control allowing the improvement of essential items of enhanced recovery pathways.
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Review Meta Analysis Comparative Study
Systematic review with meta-analysis of studies comparing single-incision laparoscopic colectomy and multiport laparoscopic colectomy.
There is currently a paucity of research comparing the clinical outcomes of single-incision laparoscopic colectomy (SILC) with those obtained with multiport laparoscopic colectomy (MLC). This meta-analysis aimed to examine whether SILC shows real benefits over MLC, especially in terms of feasibility, safety, and oncological adequacy. ⋯ SILC could be considered as a safe and feasible alternative to MLC in experienced hands. Further evidence for this surgical procedure should be assessed in the form of high-quality RCTs, with additional focus on its use in low rectal cancer resection.
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The American Board of Surgery will require graduating surgical residents to achieve proficiency in endoscopy. Surgical simulation can help residents to prepare for this proficiency test, accelerate skill acquisition, shorten the learning, and improve patient safety. Currently, endoscopic simulators are extremely cost-prohibitive. We therefore designed an inexpensive physical endoscopic simulator to (1) facilitate Fundamentals of Endoscopic Surgery skills training and (2) teach basic colonoscopy skills, for <$200.00. ⋯ We have designed a low-cost colonoscopy simulator with easily available materials and which requires very little advanced construction expertise and have demonstrated construct, face, and content validity. We believe this will have broad impact for endoscopic simulation, surgical education, and health education cost.