Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Dec 2015
Comparative StudyLaparoscopic Surgery for Transverse Colon Cancer: Short- and Long-Term Outcomes in Comparison with Conventional Open Surgery.
Published studies on laparoscopic surgery for transverse colon cancer are scarce. More studies are necessary to evaluate the feasibility, safety, and long-term oncologic outcomes of laparoscopic surgery for transverse colon cancer. ⋯ Laparoscopic surgery for transverse colon cancer has better short-term outcomes compared with open surgery, with acceptable long-term outcomes. As in colorectal cancer of other sites, laparoscopic surgery can be a feasible alternative to conventional surgery for transverse colon cancer.
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J Laparoendosc Adv Surg Tech A · Dec 2015
Clinical TrialProlene Suture Web-Shoelace-Like Pattern: An Alternative to Avoid the Use of Mesh in the Repair of a Large Hiatus Hernia.
The purpose of this report is to describe a tension-free repair we have used successfully in 12 patients with large hiatal defects. It is based on the creation of a web-shoelace pattern of polypropylene (Prolene®; Ethicon, Somerville, NJ) suture of the crura that functions as a barrier, with the advantages of being stronger and more economical than a mesh without the potential complications that may follow mesh repair or suture repair of a large hiatus hernia without mesh. Despite a success rate of 85%-95% reported in large series with a mid- and long-term follow-up evaluation, significant complications have been associated with hiatus hernia repair. Some of these complications include a slipped Nissen repair with intrathoracic wrap migration and hiatal hernia recurrence, resulting from inadequate closure of the crura, fundoplication disruption, or dehiscence of the hiatoplasty. ⋯ It is our belief that when a correct repair of the hiatus is not achieved with three stitches, adding more sutures will not lead to a tension-free repair, and this hiatoplasty will have an increased risk of dehiscence. It is for this reason that we recommend using our technique instead of using simple nonabsorbable sutures or a prosthetic mesh.
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J Laparoendosc Adv Surg Tech A · Dec 2015
Case ReportsSurgical Technique for Laparoscopic Removal of a Magnetic Lower Esophageal Sphincter Augmentation Device.
Nissen fundoplication is the current gold standard for surgical management of gastroesophageal reflux disease; however, a magnetic antireflux device is now an alternative surgical procedure. The early literature shows good reflux control with minimal complications, and therefore placement of these devices is growing in popularity. As more of these devices are placed, there will be cases in which they will need to be removed. A laparoscopic method for removing the device is presented here. ⋯ Laparoscopic removal of magnetic lower esophageal sphincter augmentation devices will sometimes be necessary and may be challenging if the surgeon encounters significant scar tissue around the gastroesophageal junction. Postoperative complications are similar to those encountered with foregut surgeries and include postoperative delayed gastric emptying.
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J Laparoendosc Adv Surg Tech A · Sep 2015
Randomized Controlled TrialEffect of Tracheal Cuff Shape on Intracuff Pressure Change During Robot-Assisted Laparoscopic Surgery: The Tapered-Shaped Cuff Tube Versus the Cylindrical-Shaped Cuff Tube.
Although the cuff of tracheal tubes can reduce airflow leakage and prevent aspiration, excessive intracuff pressure can cause tracheal mucosal injury. Robot-assisted laparoscopic surgery (RALS) can increase intracuff pressure by the Trendelenburg position and pneumoperitoneum. The aim of our current study was to investigate the effect of tracheal cuff shape on the intracuff pressure increase by comparing two different-shaped cuffs during RALS. ⋯ The TSC tube has a tendency to decrease intracuff pressure change compared with the CSC tube during RALS. However, neither of them was beneficial in preventing intraoperative intracuff pressure increase during RALS.
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J Laparoendosc Adv Surg Tech A · Sep 2015
Getting Started with Minimally Invasive Pancreaticoduodenectomy: Is It Worth It?
This study evaluates the safety and cost of introducing minimally invasive pancreaticoduodenectomy (MIPD) to a surgeon's practice. ⋯ MIPD and OPD had similar safety and cost in this introductory series. However, a trend toward a higher rate of re-operation for pancreatic leak suggests the need for caution in introducing this novel technique.