Surgical laparoscopy, endoscopy & percutaneous techniques
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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.
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Surg Laparosc Endosc Percutan Tech · Dec 2011
Laparoendoscopic single-site cholecystectomy: using a gelport device.
Laparoendoscopic single-site (LESS) surgery has emerged as a viable and widely applicable minimally invasive technique. Presented here are the steps necessary to perform LESS cholecystectomy using a readily available gelport device. ⋯ The gelport may allow for the widespread use of this exciting technology even in nonspecialized centers because of the familiarity of minimally invasive surgeons with this device. The elasticity of this device seems to facilitate the use of 4 trocars, thus, replicating the "critical view" of the structures of the triangle of Calot seen in standard multi-incision laparoscopic cholecystectomy.
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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.
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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.
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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.