Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2011
Comparative StudyTransumbilical single-port laparoscopic transabdominal preperitoneal repair of inguinal hernia: initial experience of single institute.
Conventional laparoscopic repair of inguinal hernias is generally performed by using 3 ports. In this study, the authors report their initial experiences of transumbilical single-port transabdominal preperitoneal (TAPP) repair of inguinal hernia using a unique "single port." ⋯ Transumbilical single-port TAPP repair of an inguinal hernia is technically feasible, provides nearly scarless surgery and can be performed safely and effectively in selected patients with an inguinal hernia.
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Surg Laparosc Endosc Percutan Tech · Apr 2011
Cost and clinical outcomes of laparoscopic ventral hernia repair using intraperitoneal nonheavyweight polypropylene mesh.
There are a variety of different products available for laparoscopic ventral hernia repairs (LVHR), which vary widely in their costs. There are few clinical studies commenting on cost efficacy of LVHR. The objective of this study is to investigate the cost, safety, and efficacy of using intraperitoneal nonheavyweight polypropylene (PP) mesh in LVHR. ⋯ LVHR with intraperitoneal PP results in outcomes comparable with earlier publications on LVHR but at reduced costs. These data suggest that the use of intraperitoneal PP in LVHR is safe and cost effective.
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Surg Laparosc Endosc Percutan Tech · Apr 2011
Randomized Controlled TrialA simple technique of regional anesthesia to reduce opioid requirements postoperatively in laparoscopic incisional hernia repairs.
Laparoscopic incisional hernia repair can be associated with initial postoperative pain requiring opioids in the form of patient controlled analgesia (PCA). Our study demonstrates the use of an innovative form of intra-operative regional anaesthesia in the form of an abdominal extraperitoneal block (AEP) which reduced mean opioid consumption in our patients by 62% without any intra-operative complications.
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Surg Laparosc Endosc Percutan Tech · Apr 2011
Case ReportsRecurrent pneumothorax diagnosed as catamenial after videothoracoscopic examination of the pleural cavity.
We describe a case of catamenial pneumothorax due to a diaphragmatic defect that was confirmed and treated through the thoracoscopic approach. The patient was a 34-year-old woman who had 3 episodes of right chest pain and shortness of breath, each time starting on the day preceding her menstruation. During thoracoscopy, pathologic changes in the central tendon were apparent, as a 2-mm defect in the diaphragm was discovered. ⋯ Apical pleurectomy and chemical pleurodesis were applied. According to the literature, suspicion of catamenial pneumothorax requires detailed examination of the diaphragm. Every effort, such as pleurectomy and pleurodesis, with postoperative hormonal therapy, should be added to treatment, owing to the high probability of recurrence.
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Surg Laparosc Endosc Percutan Tech · Dec 2010
Review Meta AnalysisLaparoscopy or not: a meta-analysis of the surgical effects of laparoscopic versus open appendicectomy.
Both open appendicectomy and laparoscopic appendicectomy have their own advantages and disadvantages. The purpose of our meta-analysis is to compare the surgical effects of laparoscopic versus open appendicectomy. In our study, Medline, Embase, and the Cochrane Library were searched. ⋯ Time of hospital stay (WMD -0.82; 95% CI: -0.93 to -0.70 d), time to return to normal activities (WMD -6.85; 95% CI: -7.62 to -6.09 d), and diet (WMD -0.61; 95% CI: -0.86 to -0.36 d) were significantly decreased in the laparoscopic appendicectomy group (all P<0.00001). There is no convincing difference in complications (odds ratio 0.99; 95% CI: 0.80-1.22; P=0.92) and death rates (odds ratio 0.97; 95% CI: 0.29-3.25; P=0.96). In conclusion, laparoscopic appendicectomy may have advantages over open appendicectomy in hospital stay and postoperative recovery.