Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · May 2015
Multicenter StudyCurrent Practice and Outcomes of Thoracoscopic Esophageal Atresia and Tracheoesophageal Fistula Repair: A Multi-institutional Analysis in Japan.
In order to better understand the current practice and outcomes of thoracoscopic repair of esophageal atresia (EA)/tracheoesophageal fistula (TEF), a multi-institutional analysis was conducted among seven Japanese institutes. ⋯ The outcome of thoracoscopic repair of EA/TEF was comparable to that of the open procedure. As considerable variability was observed among the seven institutes with respect to the surgical technique and management, standardizing the surgical management may improve the outcome.
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J Laparoendosc Adv Surg Tech A · May 2015
Preliminary evaluation of a novel thoracoscopic infant lobectomy simulator.
Thoracoscopic lobectomy in infants requires advanced minimally invasive skills. Simulation-based education has the potential to improve complex procedural skills without exposing the patient to undue risks. The study purposes were (1) to create a size-appropriate infant lobectomy simulator and (2) to evaluate validity evidence to support or refute its use in surgical education. ⋯ With ratings consistent with high physical attributes and realism, we successfully created an infant lobectomy simulator, and preliminary evidence relevant to test content, response processes, and internal structure was supported. Participants rated the model as realistic, relevant to clinical practice, and valuable as a learning tool. Minor improvements were suggested prior to its full implementation as an educational and testing tool.
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J Laparoendosc Adv Surg Tech A · Apr 2015
Randomized Controlled Trial Comparative StudyComparison of preoperative oral acetazolamide and intraperitoneal normal saline irrigation for reduction of postoperative pain after laparoscopic cholecystectomy.
Visceral and shoulder tip pain following laparoscopic cholecystectomy is mainly due to carbon dioxide (CO2) insufflation. Various methods have been adopted to eliminate residual CO2. We compared the postoperative analgesic efficacy of intraperitoneal normal saline (30 mL/kg) irrigation with preoperative oral acetazolamide administration in patients undergoing laparoscopic cholecystectomy. ⋯ Intraperitoneal normal saline irrigation is more effective than acetazolamide in reducing postoperative visceral pain after laparoscopic cholecystectomy and has significant opioid-sparing effect. However, its effect on shoulder pain is comparable to that of acetazolamide.
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J Laparoendosc Adv Surg Tech A · Apr 2015
Observational StudyBrain oxygenation during laparoscopic correction of hypertrophic pyloric stenosis.
Concern remains about the safety of carbon dioxide (CO2) pneumoperitoneum (PP) in young infants having surgery for pyloric stenosis via laparoscopy. Interests here mainly focus on possible jeopardized organ perfusion and in particular brain oxygenation with possible adverse neurodevelopmental outcomes. The aim of this study was to investigate the intraoperative effects of CO2 gas PP on cerebral oxygenation during laparoscopic surgery for hypertrophic pyloric stenosis in young infants. ⋯ Our results indicate that a laparoscopic procedure with a CO2 PP of 8 mm Hg can be performed under safe anesthetic conditions in the presence of gradually increasing blood pressure and etCO2 without altering regional brain oxygenation levels.
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J Laparoendosc Adv Surg Tech A · Apr 2015
Case ReportsThe first case of robotic pudendal nerve decompression in pudendal nerve entrapment syndrome.
To report the first case of robotic pudendal nerve (PN) decompression for bilateral PN entrapment (PNE). PN decompression is a safe and effective treatment for PNE and can be accomplished laparoscopically with a better exploration of the sacral roots and of the PN. ⋯ We showed the feasibility and effectiveness of robotic PN decompression, with surgical advantages that could potentially extend the indications of robot-assisted surgery.