Journal of laparoendoscopic surgery
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J Laparoendosc Surg · Feb 1996
Case ReportsLaparoscopic drainage of right subphrenic abscess: report of one case.
Laparoscopic surgery has proven to be a very useful technique. Subphrenic abscess, although a rare entity, occurs in the majority of the cases in association with gastroduodenal and biliary disease, appendicitis, or following abdominal surgery. We present the case of a 45-year-old male with a right subphrenic abscess that was successfully treated by laparoscopy. Laparoscopic drainage of subphrenic abscess should be considered as an alternative modern option when dealing with this problem.
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J Laparoendosc Surg · Feb 1996
Case ReportsDiagnostic laparoscopy and laparoscopic transdiaphragmatic pericardial window in a patient with an epigastric stab wound: a case report.
Stab wounds to the abdomen can present a diagnostic dilemma to the trauma surgeon, especially in the thoracoabdominal region. Patients with lower chest and upper abdominal stab wounds are at risk for both intraabdominal and cardiac injury. ⋯ Each has its own inherent advantages and disadvantages, but none of them represents the gold standard. Herein is reported a case of a patient with an epigastric stab wound who underwent diagnostic laparoscopy and laparoscopic transdiaphragmatic pericardial window to rule out both peritoneal penetration and cardiac injury.
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Virchow's triad of venous stasis, vessel wall damage, and hypercoagulability cites three factors that predispose to the formation of venous thrombosis. The pneumoperitoneum created during laparoscopic surgery results in an intraabdominal pressure that exceeds the pressure of venous blood return from the legs. This may alter venous hemodynamics enough to result in venous stasis in the legs, thus increasing the risk of thrombus formation. ⋯ After deflation of the abdomen, there was no significant change in cross-sectional area of the common femoral vein, but there was an increase in venous flow (6.06 to 9.94 cm3/sec; p = 0.0005). Abdominal insufflation during laparoscopic cholecystectomy results in dilation of and decreased flow in the common femoral vein. After deflation of the abdomen, flow in the vein returns to baseline levels.
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J Laparoendosc Surg · Oct 1995
Comparative StudySenior versus proctored young and resident surgeons' experience in laparoscopic cholecystectomy: is there any need of previous exposure to open biliary surgery?
Since its introduction in 1987 laparoscopic cholecystectomy (LC) has gained rapid acceptance as the preferred management of symptomatic cholelithiasis. In our department, during the past 3 years, the number of open cholecystectomies (OCs) has dramatically decreased. The impact of the introduction of LC as a part of the overall surgical procedures performed by residents is analyzed. ⋯ More intraoperative cholangiographies (IOCs) were performed by residents. This was probably due to the anxiety of making a mistake because of their lack of experience. This report suggests that the decrease in the number of OCs is not a drawback and that it is possible to acquire an adequate knowledge of biliary anatomy and surgery from LC training, if strict proctoring criteria are respected.
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J Laparoendosc Surg · Oct 1995
Case ReportsManagement of cecal perforation secondary to Ogilvie's syndrome by laparoscopic tube cecostomy.
Acute pseudoobstruction of the colon (Ogilvie's syndrome) rarely leads to perforation of the colon. A case of such a perforation is described that was successfully managed laparoscopically with tube cecostomy.