Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Jul 2014
Early experience of thoracoscopic aortopexy for severe tracheomalacia in infants after esophageal atresia and tracheo-esophageal fistula repair.
Aortopexy is the most effective treatment for severe tracheomalacia associated with esophageal atresia with distal tracheo-esophageal fistula (EA/TOF). In the last few years, the thoracoscopic approach has been proposed, but the number of patients treated is limited. The purpose of this study is to review our initial experience with thoracoscopic aortopexy. ⋯ Thoracoscopic aortopexy is a feasible and successful treatment for severe tracheomalacia in EA/TOF patients. The complication rate may be lower than after the open procedure and is more satisfactory in terms of cosmetic appearance. However, we need a larger and prospective study with a longer follow-up to confirm these preliminary results.
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J Laparoendosc Adv Surg Tech A · Jun 2014
A novel practical trocar placement technique for extraperitoneal laparoscopic and robotic-assisted laparoscopic radical prostatectomy in patients with lower midline abdominal incisions.
To describe a novel practical technique for trocar placement in extraperitoneal laparoscopic radical prostatectomy (eLRP) and robotic-assisted laparoscopic radical prostatectomy (eRALP) in patients who had lower midline abdominal incisions. ⋯ Our technique seems safe and practical for trocar placements for eLRP and eRALP in patients with lower abdominal incision scars.
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J Laparoendosc Adv Surg Tech A · Apr 2014
Clinical TrialLaparoscopic-assisted percutaneous cecostomy for antegrade continence enema.
The antegrade continence enema (ACE) is an option in the management of fecal incontinence and chronic constipation. We report our experience with a simple laparoscopic technique. ⋯ Laparoscopic-assisted percutaneous cecostomy has an excellent safety profile and patient comfort. The procedure is simple, secure, and reversible. Results were excellent in half of the patients. Associated psychiatric or behavioral problems may predict poor response to ACE.
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J Laparoendosc Adv Surg Tech A · Apr 2014
Hemodynamic effects of thoracoscopic surgery in neonates with cardiac anomalies.
Thoracoscopic repair of esophageal atresia (EA) and congenital diaphragmatic hernia (CDH) repair is increasing in popularity. However, minimally invasive surgery is avoided in infants with heart defects. The aim of this study was to clarify whether cardiac anomalies are a reasonable contraindication to thoracoscopic surgery in term and preterm neonates. ⋯ From this experience it appears that thoracoscopic surgery can be performed safely in term and preterm neonates with cardiac anomalies. Even in babies with multiple cardiac anomalies and complex heart defects, thoracoscopic repair of EA or CDH could be performed without hemodynamic instability. Nevertheless, further studies are necessary to gain sufficient information about the effects of thoracoscopy in neonates with heart defects.
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J Laparoendosc Adv Surg Tech A · Feb 2014
Review Case ReportsLaparoscopic cholecystectomy in patients with HeartMate II left ventricular assist devices.
With an expanding population of patients requiring ventricular assist devices, it is inevitable that these patients will require noncardiac surgery. Ventricular assist devices provide mechanical support for a failing heart either as a bridge to transplant or now as a long-term support if transplant is not available, so-called destination therapy. These devices can add significant technical challenges to abdominal surgery, in that the power supply and drivelines crossing the abdomen can potentially be damaged. The use of preoperative or intraoperative imaging may aid in locating these devices and increase patient safety. ⋯ Laparoscopic cholecystectomy can be performed safely on patients with ventricular assist devices. Complications due to damage to the device can be avoided with the assistance of fluoroscopy to identify the implanted abdominal portions of the ventricular assist device. Each laparoscopic procedure performed on these patients presents the surgeon with unique obstacles in which careful operative planning and intraoperative monitoring are essential.