Surgical laparoscopy & endoscopy
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Surg Laparosc Endosc · Dec 1997
Review Comparative StudyAppendicitis: laparoscopic versus conventional operation: a study and review of the literature.
A retrospective study was performed after introduction of the laparoscopic technique in patients with suspected appendicitis to validate it in comparison with conventional open appendectomy. A series of 103 patients with suspected acute appendicitis were included. In 51 consecutive patients, a diagnostic laparoscopy was performed, and, if needed, an appendectomy was carried out. ⋯ The postoperative need for analgesia was lower (p < 0.01) and the operation time was longer (p < 0.0001) in the laparoscopic group than the group that underwent open surgery. It can be concluded that the greatest benefits of the laparoscopic technique are that it causes less trauma, the diagnostic accuracy is better, and the cosmetic result is superior to that after a conventional operation. This is all at the price of a longer operation time.
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Surg Laparosc Endosc · Oct 1997
Case ReportsTension pneumothorax precluding laparoscopic repair of diaphragmatic hernia.
Pneumothorax can result from laparoscopic procedures in the abdomen. Usually, pneumothoraxes are mild and asymptomatic and do not require conversion to an open procedure. ⋯ In this patient, the tension pneumothorax did not respond to conventional means of therapy and required conversion to a laparotomy. A large diaphragmatic hernia with communication between the peritoneal and pleural cavities may be a contraindication to minimally invasive laparoscopic procedures.
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Surg Laparosc Endosc · Aug 1997
Case ReportsVideo thoracoscopic resection of neurogenic tumor in a superior-posterior mediastinum: three case reports.
Neurogenic tumors of the thorax can originate in any neurogenic structure within the chest. Surgical resection is considered the primary treatment of such tumors and usually is performed through a thoracotomy. Recently, using a new approach, we applied the technique of video thoracoscopic surgery to resection a posterior mediastinal tumor. ⋯ A standard thoracotomy was avoided in all three cases. All patients had uncomplicated postoperative courses. Video thoracoscopic resection of a neurogenic tumor in the superior-posterior mediastinum may be a safe and useful approach with improved cosmetic results.
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Surg Laparosc Endosc · Aug 1997
Case ReportsEndoscopic removal of nasogastric tube sutured unintentionally to gastrojejunostomy.
A nasogastric tube mistakenly sutured to the anastomotic site is a rare surgical error during gastrointestinal operation. When it does happen, proper management will prevent subsequent complications. If resistance is experienced when pulling the nasogastric tube after gastrointestinal surgery, it should never be pulled more forcefully. The endoscope should be introduced to document the etiology and to provide treatment after 2 weeks postoperation based on the wound healing process and strength of suture materials.
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Surg Laparosc Endosc · Jun 1997
Multicenter StudyTrends in resident experience in open and laparoscopic cholecystectomy.
Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy (OC) as the most common operation for gallbladder disease. Our goal was to determine the effect of this phenomenon on resident training in biliary surgery. The numbers of all cholecystectomies (ACs), OCs, LCs, and advanced procedures (common bile duct exploration and choledochoscopy, (CBDE) performed by residents during academic years 1989 to 1994 were examined. ⋯ Experience in CBDE for the residency as a whole and for the cohort was stable. In conclusion, experience in ACs and LCs has increased, and experience in OCs has decreased. Also, experience in biliary surgery has shifted to the senior level.