Int Surg
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The purpose of this study was to describe a new simplified technique for facilitating vesicourethral anastomosis in laparoscopic radical prostatectomy. After prostate removal, an approximately 15-cm-long absorbable suture with one three-eighths arc needle is passed from the outside in on the full thickness of the bladder neck at the 9 o'clock position and then from inside out on the full thickness of the urethra at the 9 o'clock position. It is knotted with the suture tail. ⋯ We present a new simplified method for vesicourethral anastomosis. The method takes little operating time and is easy for novice laparoscopists to master. Moreover, this technique has low rates of urinary leakage and bladder neck stricture.
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We describe the case of a patient with a diaphragmatic hernia associated with radiofrequency ablation for hepatocellular carcinoma who was successfully treated by laparoscopic surgery. A 62-year-old man with a long history of hepatitis C-induced liver cirrhosis was admitted to our institution because of recurrent postprandial periumbilical pain. Eight years earlier, he had undergone radiofrequency ablation for hepatocellular carcinoma at hepatic segment VIII. ⋯ Though the patient experienced the recurrence once, relaparoscopic treatment has improved the patient's conditions. Thus, diaphragmatic hernia can develop as a complication of radiofrequency ablation treatment. A laparoscopic approach is safe, feasible, and minimally invasive, even in patients with cirrhosis who develop iatrogenic diaphragmatic hernia as a complication of radiofrequency ablation treatment.
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Randomized Controlled Trial Comparative Study
ULTRAPRO Hernia System versus lichtenstein repair in treatment of primary inguinal hernias: a prospective randomized controlled study.
The Lichtenstein repair has been recommended as the gold standard for inguinal hernia repair. However, postoperative discomfort still constitutes a concern and an area for improvement. New mesh materials have been continuously introduced to achieve this goal. ⋯ Overall, there was a prolonged operation time in the UHS group compared with the L group (UHS: 53.7±5.7 minutes; L: 44.5±5.5 minutes; P<0.001). UHS may provide results similar to those for the Lichtenstein technique in open repair of inguinal hernias regarding perioperative course, complications, recovery, and recurrence rates. However, because of reduced costs and the lack of need for the exploration of the preperitoneal space, we conclude that the Lichtenstein technique should be recommended as the first choice.
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Comparative Study
A comparison of outcomes and complications of totally implantable access port through the internal jugular vein versus the subclavian vein.
Totally implantable access ports (TIAPs) are generally used in oncology. Few studies have addressed complications associated with the insertion site. A total of 233 consecutive oncology patients were enrolled to receive TIAP inserts via internal jugular vein (IJV) or subclavian vein (SV). ⋯ In conclusion, TIAP insertion site showed no impact on the early and late complication rates. Catheter injury appears to occur at the same frequency with both approaches. Therefore, medical doctors may choose their preferred puncture site when performing TIAP insertion.
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The aim of this study was to design a novel, modified, multifunctional, and safe laryngeal mask airway (LMA). We designed an LMA with an internal catheter extending beyond the tip of the cuff. ⋯ We found that this design prevented reflux or aspiration of gastric content into the airway, prevented LMA dislocation, allowed ventilation through both the internal and external catheters, and allowed endoscopic examination and treatment of the gastrointestinal and respiratory tracts through both the internal and external catheters. This design overcomes the drawbacks and extends the functions of previous LMAs, offering a new approach to the development of LMAs.