Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Feb 2005
Randomized Controlled Trial Clinical TrialHeated and humidified insufflation during laparoscopic gastric bypass surgery: effect on temperature, postoperative pain, and recovery outcomes.
Controversy exists regarding the efficacy of heated and humidified intraperitoneal gases in maintaining core body temperature. We performed a sham-controlled study to test the hypothesis that active warming and humidification of the insufflation gas reduces intraoperative heat loss and improves recovery outcomes. ⋯ The Insuflow device modestly reduced shivering and heat loss, as well as the need for opioid analgesics in the early postoperative period. However, it failed to improve laparoscopic visualization due to fogging, and provided improvement in the quality of recovery only on postoperative day 2.
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J Laparoendosc Adv Surg Tech A · Feb 2005
Case ReportsLaparoscopic removal of a swallowed sewing needle that migrated into the greater omentum without clinical evidence.
We report a case of a sewing needle, presumably originating from the transverse colon or the ligament of Treitz, that migrated to the greater omentum. A 24-year-old woman was referred to our clinic with a complaint of abdominal pain which was exacerbated by breathing or any physical activity. Abdominal plain x-ray showed a needle in the left upper abdominal area. ⋯ An accurate and rapid diagnosis of a perforation in the gastrointestinal tract as the result of an ingested foreign body is difficult in the absence of peritonitis or abscess formation. In such cases, the virtual colonoscopy is useful if there is uncertainty whether the foreign body is in the lumen. Perioperative fluoroscopy can be useful to overcome the lack of tactile discrimination in laparoscopy, in patients who have been scheduled for surgery who have no signs of the localization of the foreign body (such as abscess or solid organ migration).