Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Apr 2011
Comparative StudyTransgastric or trans-sigmoidal? The impact of the choice of access on task performance in target natural orifice translumenal endoscopic surgery procedures.
The effect of the choice of access upon endoscope control during a navigational task is explored within a simulator model. ⋯ The choice of access route impacts directly on the ease with which the endoscopist navigates to the target. Within this study, the trans-sigmoidal appears the most appropriate to access the appendix and the transgastric for the gallbladder.
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Conventional open surgery for infected pancreatic necrosis is associated with significant surgical morbidity, that is, wound complications, facial dehiscence, and intestinal fistulae. In recent years, there has been interest in attempting to reduce this surgical morbidity by adopting a number of minimally invasive approaches. ⋯ Minimally invasive necrosectomy is technically feasible and a body of evidence now suggests that acceptable outcomes can be achieved. There are no comparisons of results available, either with open surgery or among different minimally invasive techniques.
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J Laparoendosc Adv Surg Tech A · Jan 2011
Intracorporeal anastomosis using a Lapra-ty clip in laparoscopic distal gastrectomy: initial clinical experiences.
The aim of this study was to assess the efficacy, reliability, and performance of the Lapra-Ty clip (LTc) during intracorporeal Roux-en-Y gastrojejunostomy in a totally laparoscopic distal gastrectomy (TLDG). ⋯ The usage of LTc is safe and efficient for bowel anastomosis, especially TLDG in humans, and adoption of LTc may help to reduce overall operative times. Perhaps, most importantly, it can cover the disadvantages of TLDG by making TLDG more easily executable in gastric cancer.
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J Laparoendosc Adv Surg Tech A · Dec 2010
Transumbilical laparoscopically assisted appendectomy: an alternative minimally invasive technique in pediatric patients.
Transumbilical laparoscopically assisted appendectomy (TULAA) has been reported in the literature as an alternative to traditional three-port laparoscopic appendectomy (LA). Our study compares outcomes between LA and the one-trocar transumbilical technique in a single institution over a concurrent time frame for all cases of pediatric appendicitis. ⋯ Our study suggests that TULAA is a reasonable alternative to the standard minimally invasive technique for appendicitis in both acute and ruptured situations. All analyzed complications were similar between the groups, suggesting that TULAA is an acceptable surgical method in pediatric patients for all stages of appendicitis.
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J Laparoendosc Adv Surg Tech A · Dec 2010
Laparoscopy-assisted single-port appendectomy in children: is the postoperative infectious complication rate different?
In childhood, laparoscopy-assisted single-port appendectomy (SPA), including the advantages of open and laparoscopic surgery, is not widely used. However, there is debate whether the retrieval of the infected appendix via the umbilicus results in a higher infection rate compared with other laparoscopic or open techniques. The aim of the study was to determine the postoperative infection rate and possible risk factors for infection after SPA in children. ⋯ In our institution, SPA is the method of choice for appendectomy in children with acute appendicitis, in whom preoperative ultrasound does not reveal signs of perforation. The infection rate (2.7%) after SPA is not increased compared with other laparoscopic or open techniques. Overweight (body mass index greater than the 95th percentile) and perforated appendicitis seem to increase the risk of postoperative infectious complications.