Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2013
Comparative StudyRobotic thyroidectomy for benign thyroid diseases: a stepwise strategy to the adoption of robotic thyroidectomy (gasless, transaxillary approach).
Thyroid surgery for benign diseases mainly involves young women, and thus, cosmetic considerations have motivated the development of "no scar to the neck" procedures. Endoscopic techniques are often strenuous, and therefore, discouraging to adopt. However, the recent incorporation of robotic technology proposes a feasible, safe, extracervical approach that alleviates most of the technical difficulties associated with endoscopy. Here, the authors present a series of robotic thyroidectomies performed to treat benign thyroid diseases and detail the key issues of initial patient selection. ⋯ Robotic thyroidectomy, although novel and sophisticated, has already been used to treat over 4000 thyroid cancer patients in Korea. Female patients with a small to average build, with a follicular lesion and concerned about neck scarring, seem to be the best candidates. Patients with small suspicious nodules without severe thyroiditis are also a rational choice. In contrast, patients with Graves disease should be reserved, unless significant experience has been gained.
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Surg Laparosc Endosc Percutan Tech · Jun 2013
Comparative StudyLaparoscopic pancreaticoduodenectomy assisted by mini-laparotomy.
Pancreaticoduodenectomy (PD) is the treatment of choice for periampullary disease. Even with the increasing number of successful reports from around the globe, laparoscopic pancreaticoduodenectomy (LPD) is still not fully accepted. We report the results of our experience of LPD assisted by mini-laparotomy. ⋯ When performed by a surgeon with ample experience in laparoscopic surgery, LPD assisted by mini-laparotomy is a safe, feasible alternative to conventional PD for select cases. The method described in this study can be used to perform pancreaticoenteric anastomosis in the same manner as an open PD, while taking advantage of the merits of minimally invasive surgery.
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Surg Laparosc Endosc Percutan Tech · Jun 2013
Case ReportsIntractable hiccup accompanying pleural effusion: reversible clipping of an intrathoracic phrenic nerve.
Hiccup is usually a self-limiting condition, and can be treated with medications and physical maneuvers. However, hiccup episodes continuing for days or weeks can be incapacitating, and disturb work, sleep, and eating. ⋯ We report on a successful phrenic nerve block for intractable hiccups, which consisted of thoracoscopic nerve clipping under general anesthesia and reversal under local anesthesia. This method has the advantage of assured diaphragmatic functional recovery while controlling intractable hiccups.
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Surg Laparosc Endosc Percutan Tech · Apr 2013
Randomized Controlled TrialDoes intraocular pressure increase during laparoscopic surgeries? It depends on anesthetic drugs and the surgical position.
Pneumoperitoneum in the pelvic laparoscopic surgery induces a rise in the intraocular pressure (IOP). This study investigated whether IOP changes were different depending on the surgical position (Trendelenburg vs. reverse Trendelenburg) and the anesthetic drugs (propofol vs. desflurane). ⋯ : Impact of anesthetics on IOP during laparoscopic surgery may change depending on the surgical position. For the laparoscopic surgery performed in the head-down position, propofol may be more helpful in preventing ocular hypertension.
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Surg Laparosc Endosc Percutan Tech · Apr 2013
Randomized Controlled Trial Comparative StudyAddition of ketamine to propofol-alfentanil anesthesia may reduce postoperative pain in laparoscopic cholecystectomy.
The aim of this study was to assess whether intravenous anesthesia supplemented with ketamine reduces postoperative pain after elective laparoscopic cholecystectomy. ⋯ Our study showed that ketamine supplemented with propofol and alfentanil produced better analgesia intraoperatively and postoperatively and decreased analgesic consumption compared with the propofol group after laparoscopic cholecystectomy.