Journal of laparoendoscopic surgery
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J Laparoendosc Surg · Oct 1994
Extraperitoneal endoscopic inguinal herniorrhaphy performed without carbon dioxide insufflation.
Laparoscopic extraperitoneal herniorrhaphy is an alternative to the standard open inguinal herniorrhaphy. The procedure is usually done with general or epidural anesthesia and carbon dioxide (CO2) insufflation. ⋯ Eliminating CO2 insufflation from the procedure would obviate this problem. The following is a description of the first 5 reported cases of extraperitoneal endoscopic herniorrhaphy done without the need for CO2 insufflation.
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J Laparoendosc Surg · Apr 1994
Caudal epidural block for analgesia following herniorrhaphy with laparoscopy in children.
This study prospectively evaluated the efficacy of caudal epidural block in providing analgesia following inguinal herniorrhaphy and laparoscopy. Laparoscopy was used only to inspect the contralateral side to determine if a second hernia was present. No surgical manipulation was performed through the telescope. ⋯ Six of 8 patients required a single dose of intravenous fentanyl (0.5 microgram/kg) to maintain scores of 2 or less. No significant complications related to caudal epidural block were noted in any patient. Caudal epidural block provides effective analgesia following inguinal herniorrhaphy and laparoscopy in children.
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A technique for thoracoscopic dissection of the esophagus is described which gives a large and magnified view of the pleural cavity, the mediastinum, and the esophagus. This technique was developed on human cadavers which gives excellent technical resources for learning and practicing endoscopic surgical anatomy of the esophagus. It avoids the need to change the position of the patient to perform a total thoracoabdominal esophagectomy via a triple surgical approach.
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J Laparoendosc Surg · Feb 1993
Subcutaneous wire traction technique without CO2 insufflation for laparoscopic cholecystectomy.
One hundred laparoscopic cholecystectomies were performed since April 1991. Eleven patients were treated with a new technique without CO2 insufflation, using a traction device to elevate the right upper quadrant wall. Two Kirschner wires were introduced subcutaneously to permit the abdominal wall to be lifted for satisfactory laparoscopic view, as the gas insufflation technique yields. ⋯ Three cases were converted to laparotomy because of remarkably distended intestine due to incorrect endotracheal intubations. No complications related to subcutaneous wire traction technique were noted in this series. Subcutaneous wire traction technique provides a simpler, and possibly safer alternative to the gas insufflation technique.
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J Laparoendosc Surg · Dec 1992
Comparative StudyOperative laparoscopy in the management of tubal ectopic pregnancy.
One hundred and seventeen consecutive patients with diagnosis of ectopic pregnancy admitted to Temple University Hospital between October 1989 and March 1992 were divided into two groups. Group 1 consisted of 56 patients with operative laparoscopy and Group 2 consisted of 61 patients treated by laparotomy. The two groups were similar for age, race, parity, gestation, presentation, and location of the ectopic gestations. ⋯ This reflected in a lower cost of hospital stay ($10,105 vs. $13,608). The present data demonstrates that operative laparoscopy is not only safe and effective, but also more economical than open laparotomy in the treatment of ectopic pregnancies. This procedure is expected to replace laparotomy for the treatment of most cases of tubal ectopic pregnancy.