Surgical laparoscopy, endoscopy & percutaneous techniques
-
Surg Laparosc Endosc Percutan Tech · Dec 2013
Comparative StudyLaparoscopy in blunt and penetrating abdominal trauma.
The objective of our study was to assess the abilities and limitations of laparoscopy and evaluate its role in examination and treatment of patients with abdominal trauma. A total of 628 patients with blunt and penetrating abdominal trauma were included in this retrospective 12-year survey (2000 to 2011). All patients in the study underwent either laparotomy (280 patients) or urgent laparoscopy (348 patients). ⋯ Diagnostic laparoscopy without therapeutic manipulations was used in 160 patients (46%) and therapeutic laparoscopy was carried out in 58 patients (16.7%). Quicker recovery time, less pain, shorter hospital stay, and lower complication rate were observed in patients after laparoscopic surgery compared with patients after open surgery. No missed abdominal organs injuries were revealed after laparoscopic examination of abdominal cavity.
-
Surg Laparosc Endosc Percutan Tech · Oct 2013
Laparoscopic paraesophageal hernia repair: critical steps and adjunct techniques to minimize recurrence.
Laparoscopic repair of paraesophageal hernias (PEH) is associated with a high objective hernia recurrence rate. Tension is a key factor in the repair of any hernia, and tension is a cause for hernia recurrence. ⋯ Efforts to reduce the objective recurrence rate after laparoscopic PEH repair should focus on minimizing tension with the use of a Collis gastroplasty and crural relaxing incisions when necessary. Similar to hernias at other sites, the use of mesh likely is another adjunct step that will improve outcomes with PEH repair, but to avoid erosion synthetic mesh should be avoided.
-
Surg Laparosc Endosc Percutan Tech · Aug 2013
Effects of the ischemic preconditioning on anastomotic healing in laparoscopic colon operations.
Previous experimental studies have repeatedly demonstrated the potential protective effect of remote ischemic preconditioning (IPC) on colon anastomosis. The purpose of this experimental study was to investigate the possible positive effects of IPC by interval insufflations in laparoscopic colon operations. ⋯ Use of IPC with colon anastomosis had positive effects on wound healing and may serve as a safe method to reduce the adverse effects of ischemia and wound healing in laparoscopic colon operations.
-
Surg Laparosc Endosc Percutan Tech · Jun 2013
Review Meta AnalysisSingle-access laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials.
Single-incision laparoscopic surgery has been proposed as a minimally invasive technique with the advantages of fewer scars and reduced pain. The aim of this study was to perform a systematic review and meta-analysis of prospective randomized clinical trials of single-access laparoscopic cholecystectomy (SALC) versus classic laparoscopic cholecystectomy (CLC). ⋯ SALC required longer operative times than CLC without significant benefits in patient overall satisfaction, postoperative pain, and hospital stay. Only satisfaction with the cosmetic result showed a significantly higher preference towards SALC.
-
Surg Laparosc Endosc Percutan Tech · Jun 2013
Randomized Controlled Trial Comparative StudyA comparison of nonabsorbable polymeric clips and endoloop ligatures for the closure of the appendicular stump in laparoscopic appendectomy: a prospective, randomized study.
The aim of this prospective randomized trial was to evaluate the clinical outcomes of hem-o-lok ligation system in laparoscopic appendix stump closure by comparing the endoloop ligature. A total of 53 patients were evaluated in this study (n=26 and 27 for hem-o-lok and endoloop groups, respectively). The mean operation time were shorter in hem-o-lok group than endoloop group (64.7 ± 19.2 vs. 75.4 ± 23, respectively); however, the difference was not significant. ⋯ There was no statistically significant difference in overall nonsurgically or surgically related complications. The mean postoperative hospitalization time was also similar in both groups. Although it is not possible to make general conclusions on basis of such a limited study, in our opinion, closure of the appendix stump with polymeric nonabsorbable clips in laparoscopic appendectomy may be a cheaper and simpler alternative to other widely used methods.