Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2008
A national survey of current surgical treatment of acute gallstone disease.
Acute cholecystitis (AC) and acute pancreatitis are 2 potentially life-threatening complications of gallstone disease. There are national guidelines for the treatment of gallstone pancreatitis, but none exist for the management of AC. Consequently, the management of AC is subject to great variation. ⋯ Uncomplicated AC and mild gallstone pancreatitis are conditions managed by all subspecialties within general surgery in Scotland. The majority of surgeons (67%) now manage AC by same admission LC, although those not performing regular elective laparoscopy are significantly less likely to do so. Of those who manage conservatively, more than a third report lack of resources as being the reason. For mild gallstone pancreatitis, the majority of surgeons in Scotland (61.5%) perform urgent LC in accordance with current guidelines. A significant proportion of surgeons (17%) carry out endoscopic retrograde cholangiopancreatography as first line in all patients despite this being recommended only for those unfit for surgery.
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Surg Laparosc Endosc Percutan Tech · Jun 2008
Case ReportsUse of temporary esophageal stent in management of perforations after benign esophageal surgery.
Successful conservative management in 3 patients with catastrophic postoperative esophageal leak after nonresection surgery is presented. In each case, the placement of removable stent played a significant role. First patient had persistent leak after primary repair of intrathoracic esophageal perforation. ⋯ Stent placement was successful in all patients allowing immediate resumption of diet. After stent removal, contrast study showed no leak or stricture. Endoscopic stent therapy is an effective option in the management of postoperative esophageal perforation.
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Surg Laparosc Endosc Percutan Tech · Jun 2008
Case ReportsThoracoscopic retrieval of a "smiling" foreign body from the proximal esophagus: an impacted denture.
The esophagus is a common site for foreign bodies (FBs) because of areas of physiologic narrowing. Dentures pose special problems, especially if they are impacted. We present a case of a "smiling" foreign body in the proximal esophagus. ⋯ Minimally invasive techniques have been found to be very useful in the removal of intraluminal FBs, especially when conservative measures fail. Prevention of such incidents should be emphasized.
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Surg Laparosc Endosc Percutan Tech · Jun 2008
Laparoscopic ventral hernia repair: a new method for fixation of the mesh with sutures.
Laparoscopic technique has proven to be a safe and feasible alternative to open mesh repair in the treatment of ventral hernias. It has been seen that the recurrence rate is the same as with open repair but with lesser morbidity. For the repair of ventral hernia with laparoscopy, mesh is placed intraperitoneally. The most common approach for intraperitoneal fixation of the mesh is by using a combination of transfascial sutures and tackers. This paper describes a new technique for intraperitoneal fixation of the mesh using sutures. ⋯ This is a novel technique for fixation of the mesh to the abdominal wall intraperitoneally during laparoscopic repair of ventral hernia. Tackers are not required for the fixation of mesh.
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Surg Laparosc Endosc Percutan Tech · Jun 2008
Infective subcutaneous emphysema after laparoscopic rectopexy: a rare complication.
Subcutaneous emphysema after laparoscopic surgery is not uncommon but infection of the subcutaneous space because of gas forming organisms causing emphysema after a laparoscopic procedure is an extremely rare entity. We report a case of infective subcutaneous emphysema after laparoscopic rectopexy.