Surgical laparoscopy, endoscopy & percutaneous techniques
-
Surg Laparosc Endosc Percutan Tech · Dec 2011
Randomized Controlled TrialUnsupervised virtual reality training may not increase laparoscopic suturing skills.
Numerous studies have been published showing the effect of virtual reality simulator training on laparoscopic skills. Most of these studies have not focused on simulator training in a nonsupervised setting. ⋯ This study indicates that virtual reality simulator training alone may not increase laparoscopic suturing skills.
-
Surg Laparosc Endosc Percutan Tech · Dec 2011
Comparative StudyComparative analysis of station-specific lymph node yield in laparoscopic and open distal gastrectomy for early gastric cancer.
Randomized trials and cohort studies show that laparoscopic distal gastrectomy (LDG) achieves similar oncological results to open distal gastrectomy (ODG). However, studies have consistently demonstrated lower lymph node yield (LNY) for laparoscopic lymphadenectomy. Analysis of station-specific LNY may be useful in evaluating the reasons behind this difference. ⋯ LDG was associated with less extensive lymph node dissection compared with ODG. Station-specific LNY was similar in all nodal stations except for the common hepatic artery nodes. In our experience, laparoscopic sub-D2 lymphadenectomy was adequate in the context of early gastric cancer and represents the future of gastric cancer resection in Japan.
-
Surg Laparosc Endosc Percutan Tech · Dec 2011
Effect of body mass index on short-term outcomes of patients undergoing laparoscopic resection for colorectal cancer: a single institution experience in Japan.
The impact of body mass index (BMI) on laparoscopic surgery for colorectal cancer in Asian countries is unclear, partly because obesity is less common in Asia than in western countries. The purpose of this study was to evaluate the association between BMI and short-term outcomes after laparoscopic resection for colorectal cancer in Japanese patients. ⋯ Laparoscopic surgery for colorectal cancer is technically more demanding in Japanese obese II patients than in nonobese or obese I patients. Special care is required because of the increased risk of developing postoperative complications.
-
Surg Laparosc Endosc Percutan Tech · Dec 2011
Case ReportsLaparoscopic adrenalectomy for a rare 14-cm adrenal schwannoma.
Laparoscopic surgery for adrenal tumors is the gold standard for benign tumors; however, its role for adrenal cancer, metastases, and large suspicious lesions remains controversial. This aspect becomes clinically more important as larger incidentaloma are being detected with increasing frequency. Here, we discuss a rare case of a giant 14-cm adrenal schwannoma, which presented as an incidentaloma and was excised laparoscopically. ⋯ Adrenal schwannoma is an extremely rare entity and can grow considerably in size. So far, this is the largest adrenal schwannoma reported in literature. In agreement with a growing number of publications, laparoscopic adrenalectomy can also be used for potentially malignant tumors larger than 10 cm in diameter provided the tumor does not infiltrate into other organs, conversion to open surgery is carefully considered, and resection occurs within the anatomic planes, thus ensuring the intactness of the tumor capsule.
-
Surg Laparosc Endosc Percutan Tech · Dec 2011
Case ReportsEndoscopic removal of impacted magnetic foreign bodies in the gastroesophageal junction.
Ingestion of foreign bodies is common in gastroenterology practice. Most of them are spontaneously passed through gastrointestinal tract. However, ingestion of multiple magnets can cause serious complications, because magnets attract each other and they hold the gastrointestinal wall. ⋯ In general, impacted magnetic foreign bodies should be removed by surgical intervention because of a high perforation risk. But, in this case, we used an insulated-tip knife for endoscopic submucosal dissection technique to make an incision to expose the impacted magnetic foreign bodies, and removed them successfully without surgery. With this report, we hope to encourage gastroenterologists to consider this new technique as one of procedures for difficult cases, including impacted foreign bodies.