Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Jul 2012
Randomized Controlled Trial Comparative StudySpinal versus general anesthesia for day-case laparoscopic cholecystectomy: a prospective randomized study.
The aim of this study was to compare the surgical outcome of day-case laparoscopic cholecystectomy (DCLC) performed with the patient under spinal anesthesia with that performed with the patients under general anesthesia in the management of symptomatic uncomplicated gallstone disease. ⋯ DCLC performed with the patient under spinal anesthesia is feasible and safe and is associated with less postoperative pain and lower incidence of postoperative nausea and vomiting and therefore a lower incidence of overnight stay compared with that performed with the patient under general anesthesia.
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J Laparoendosc Adv Surg Tech A · Jul 2012
Laparoscopic resection of transverse colon cancer: long-term oncologic outcomes in 58 patients.
Although the advantages of laparoscopic colectomy have been demonstrated, there are few data available on laparoscopic resection of transverse colon cancer. The purpose of this study was to assess operative outcomes, long-term survival, and disease recurrence after laparoscopic resection of transverse colon cancer. ⋯ Compared with previously published multicenter studies such as the COST, COLOR, and CLASICC trials, the long-term outcomes of this study demonstrate that transverse colon cancer can safely be resected using the laparoscopic technique in experienced hands.
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J Laparoendosc Adv Surg Tech A · Jun 2012
Review Case ReportsInternal herniation following laparoscopic left hemicolectomy: an underreported event.
Laparoscopic colorectal surgery creates fewer adhesions compared with open colorectal resection. Small bowel obstruction after laparoscopic colorectal resection may be caused by internal herniation of the small bowel through a colomesenteric defect, probably related to a lack of adhesion formation. This is seen especially after left colonic resections. ⋯ Laparoscopic left hemicolectomy carries a significant risk of internal herniation. Performing a laparoscopic subtotal colectomy or fashioning the colocolonic anastomosis through the small bowel mesentery may minimize this risk.
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J Laparoendosc Adv Surg Tech A · May 2012
Randomized Controlled Trial Comparative StudyComparison of the stress response in patients undergoing gynecological laparoscopic surgery using carbon dioxide pneumoperitoneum or abdominal wall-lifting methods.
Conventional laparoscopy is aided by CO(2) insufflation, but this may impair cardiorespiratory function, induce stress responses, and result in life-threatening complications. CO(2) insufflation is usually conducted under general anesthesia, whereas gasless laparoscopy supposedly eliminates most of these disadvantages. In this study, we compared the changes of concentration of serum cortisol, tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-6, IL-10, and heat shock protein 70 (Hsp70) in patients undergoing gynecological laparoscopic surgery in order to explore the severity of the stress response following CO(2) pneumoperitoneum or abdominal wall-lifting methods combined with the different anesthetic techniques performed. ⋯ Gynecological laparoscopic surgery using abdominal wall-lifting methods could avoid the deleterious effects of CO(2) pneumoperitoneum, and reduce the stress response. The lowest stress response was found when abdominal wall-lifting methods were used with the patient under epidural anesthesia.
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J Laparoendosc Adv Surg Tech A · May 2012
Comparative StudyEvaluation of the safety, efficacy, and versatility of a new surgical energy device (THUNDERBEAT) in comparison with Harmonic ACE, LigaSure V, and EnSeal devices in a porcine model.
THUNDERBEAT™ (TB) (Olympus, Japan) simultaneously delivers ultrasonically generated frictional heat energy and electrically generated bipolar energy. The aim of this study was to evaluate the versatility, bursting pressure, thermal spread, and dissection time of the TB compared with commercially available devices: Harmonic(®) ACE (HA) (Ethicon Endo-Surgery, USA), LigaSure™ V (LIG) (Covidien, USA), and EnSeal(®) (Ethicon). ⋯ TB has a higher versatility compared with the other instruments tested with faster dissection speed, similar bursting pressure, and acceptable thermal spread. This new energy device is an appealing, safe alternative for cutting, coagulation, and tissue dissection during surgery and should decrease time and increase versatility during surgical procedures.