Journal of laparoendoscopic & advanced surgical techniques. Part A
-
J Laparoendosc Adv Surg Tech A · Aug 2015
Comparative StudyLaparoscopic Versus Open Bowel Resection in Emergency Small Bowel Obstruction: Analysis of the National Surgical Quality Improvement Program Database.
Small bowel obstruction (SBO) is commonly encountered by surgeons and has traditionally been handled via an open approach, especially when small bowel resection (SBR) is indicated, although recent series have shown improved outcomes with a laparoscopic approach. In this retrospective study, we sought to evaluate outcomes and identify risk factors for adverse events after emergency SBR for SBO with an emphasis on surgical approach. ⋯ LBR was associated with equivalent operative time, shorter length of stay, less morbidity, and equivalent mortality compared with OBR. Although therapy for SBO secondary to adhesive disease remains controversial, our study shows numerous benefits to the laparoscopic approach to SBOs and thus should be considered a first-line treatment option for the management of this common surgical problem.
-
J Laparoendosc Adv Surg Tech A · Aug 2015
Preventing Distal Catheter Obstruction in Laparoscopic Ventriculoperitoneal Shunt Placement in Adults: The "Falciform Technique".
Distal obstruction of ventriculoperitoneal (VP) shunts is a major problem in the treatment of hydrocephalus. To avoid this complication, we describe a simple method using the falciform ligament to place and hold the distal catheter in the right subdiaphragmatic space, preventing catheter migration and distal obstruction. ⋯ The faparoscopic falciform technique significantly reduces the rate of distal VP shunt obstruction in adults with idiopathic normal-pressure hydrocephalus. Continued follow-up is needed to confirm long-term patency of the catheter.