Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Nov 2018
Case ReportsHidden in Plain Sight: Transoral and Submental Thyroidectomy as a Compelling Alternative to "Scarless" Thyroidectomy.
Minimally invasive and remote access thyroid surgery has been evolving with the transoral endoscopic thyroidectomy vestibular approach (TOETVA) emerging as a true "scarless" thyroidectomy. In this study, we describe a hybrid transoral and submental thyroidectomy (TOaST) technique for thyroid lobectomy. ⋯ This is the first reported case of a hybrid TOaST technique. It aims to maintain the principles and advantages of TOETVA while addressing its limitations related to large tumor extraction, mental nerve injury, and chin sensory changes. The shorter distance of dissection required may reduce postoperative pain. This approach may expand the indications for transoral thyroidectomy while maintaining excellent cosmetic outcomes.
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J Laparoendosc Adv Surg Tech A · Nov 2018
Meta AnalysisPain and Surgical Outcomes Reporting After Laparoscopic Ventral Hernia Repair in Relation to Mesh Fixation Technique: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
The aim of this meta-analysis was to examine postoperative pain and surgical outcomes (operative time, hospital stay, the incidence of seroma and recurrence) with different mesh fixation methods following laparoscopic ventral hernia repair (LVHR). ⋯ Meta-analysis of RCTs comparing tacks to suture fixation in LVHR showed comparable results with regard to postoperative chronic pain incidence and PI, and hernia recurrence. However, the operative time is shorter with tacks compared to suture fixation technique.
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J Laparoendosc Adv Surg Tech A · Nov 2018
Outcomes Using Cryoablation for Postoperative Pain Control in Children Following Minimally Invasive Pectus Excavatum Repair.
Pain is the main factor that determines the postoperative course for patients undergoing pectus bar placement. Cryoablation of the intercostal nerves has been suggested to mitigate this pain. We instituted a protocol for using intercostal cryoablation and report our early results compared to our immediately previous cohort. ⋯ Cryoablation after pectus bar placement dramatically decreases narcotic usage and postoperative length of stay.
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J Laparoendosc Adv Surg Tech A · Nov 2018
Leakage Rate After Laparoscopic Ileocolic Intracorporeal Anastomosis.
The prevailing technique in laparoscopic resection of the right colon has been laparoscopic-assisted procedure with externalization of the bowel for extracorporeal creation of the ileocolic anastomosis. The total laparoscopic technique performing all steps intracorporeally, however, has gained increasing interest. The purpose of this study was to describe our experience with creation of an ileocolic intracorporeal anastomosis (IIA) and to determine anastomotic leakage (AL) rate and short-term outcome of performing IIA. ⋯ IIA was found to be a feasible and safe technique in laparoscopic resections of the right colon with an AL rate of 4.2%.