JSLS : Journal of the Society of Laparoendoscopic Surgeons
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Randomized Controlled Trial Comparative Study
Laparoscopic gastric bypass for morbid obesity-a randomized controlled trial comparing two gastrojejunal anastomosis techniques.
We present a randomized controlled trial of laparoscopic gastric bypass comparing 2 techniques of gastrojejunostomy in patients with morbid obesity. ⋯ Gastrojejunal anastomosis does not seem to be a critical factor in excess weight loss for morbidly obese patients who underwent laparoscopic gastric bypass. The 2 techniques used in this experience are safe and effective; however, the 45-mm liner-stapler is preferable because it has a lower stricture rate.
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We report a case of left adrenal schwannoma in a 62-year-old man, incidentally discovered on an abdominal computed tomography. It was successfully treated with laparoscopic adrenalectomy. ⋯ Although an increasing number of adrenal incidentaloma have been identified with the recent advances in imaging techniques, only a few cases of schwannoma of the adrenal gland have been reported. We reviewed the cases reported previously in an attempt to reveal the characteristic features of this rare disease.
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Although many surgeons advocate early laparoscopic cholecystectomy (LC) in acute cholecystitis, debate still exists regarding its optimal timing. This study compares the outcome of LC performed within and after 72 hours of admission in patients with acute cholecystitis. ⋯ Early LC can be performed safely in most patients with acute cholecystitis, but we recommend intervention within 72 hours of admission to minimize the complication rate and shorten the operation time and total hospital stay.
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To develop an evidence-based protocol for the management of perforated sigmoid diverticular disease. ⋯ A 2-stage laparoscopic approach incorporating the principles of damage limitation surgery may be a safe strategy in the management of perforated diverticular disease.
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Laparoscopic abdominal surgery is conventionally done under general anesthesia. Spinal anesthesia is usually preferred in patients where general anesthesia is contraindicated. We present our experience using spinal anesthesia as the first choice for laparoscopic surgery for over 11 years with the contention that it is a good alterative to anesthesia. ⋯ Laparoscopic surgery done with the patient under spinal anesthesia has several advantages over laparoscopic surgery done with the patient under general anesthesia.