Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Aug 2008
Randomized Controlled TrialIs local anesthesia or oral analgesics necessary after mini-laparoscopic functional surgery in children and young adults?: A prospective randomized trial.
This prospective, randomized, single-blind trial was to determine if local anesthesia or oral analgesics reduce postoperative pain after mini-laparoscopic functional surgery. ⋯ Local anesthesia and routine oral analgesic did not significantly reduce postoperative pain after mini-laparoscopic surgeries in children and young adults.
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Surg Laparosc Endosc Percutan Tech · Aug 2008
Comparative StudyTotally laparoscopic radical BII gastrectomy for the treatment of gastric cancer: a comparison with open surgery.
Laparoscopically assisted distal gastrectomy has been used for distal part early gastric cancer resection. However, use of totally laparoscopic gastric cancer resection remains limited because of technical problems, especially when standard D2 nodal dissection was applied. We had reported the first totally laparoscopic Billroth II (BII) subtotal gastrectomy with lymphadenectomy for early gastric cancer in the year 1998. The aim of this study is to determine whether this procedure is superior to conventional open technique. ⋯ Although totally laparoscopic BII gastrectomy using the upper to lower technique required a longer surgical time and was technically more demanding than conventional open surgery, it resulted in shorter recovery time, less analgesic use, and less severe physical discomfort without compromising the operative curability and oncologic outcomes.
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Surg Laparosc Endosc Percutan Tech · Aug 2008
Case ReportsDeath during laparoscopy: can 1 gas push out another? Danger of argon electrocoagulation.
We report the death of a young man during a laparoscopic partial splenectomy performed with an argon plasma coagulator to remove a benign cyst. The report analyzes the very particular mechanism of a gas embolism, which caused death here. This analysis leads us to recommend a close attention on the use of argon coagulators during laparoscopy. The aim of this article is to draw surgeons' attention to the conclusions of a court-ordered expert assessment intended to elucidate the mechanisms responsible for the death of a 20-year-old man during a laparoscopic partial splenectomy performed with an argon plasma coagulator to remove a benign cyst.
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Surg Laparosc Endosc Percutan Tech · Jun 2008
A national survey of current surgical treatment of acute gallstone disease.
Acute cholecystitis (AC) and acute pancreatitis are 2 potentially life-threatening complications of gallstone disease. There are national guidelines for the treatment of gallstone pancreatitis, but none exist for the management of AC. Consequently, the management of AC is subject to great variation. ⋯ Uncomplicated AC and mild gallstone pancreatitis are conditions managed by all subspecialties within general surgery in Scotland. The majority of surgeons (67%) now manage AC by same admission LC, although those not performing regular elective laparoscopy are significantly less likely to do so. Of those who manage conservatively, more than a third report lack of resources as being the reason. For mild gallstone pancreatitis, the majority of surgeons in Scotland (61.5%) perform urgent LC in accordance with current guidelines. A significant proportion of surgeons (17%) carry out endoscopic retrograde cholangiopancreatography as first line in all patients despite this being recommended only for those unfit for surgery.
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Surg Laparosc Endosc Percutan Tech · Jun 2008
Case ReportsUse of temporary esophageal stent in management of perforations after benign esophageal surgery.
Successful conservative management in 3 patients with catastrophic postoperative esophageal leak after nonresection surgery is presented. In each case, the placement of removable stent played a significant role. First patient had persistent leak after primary repair of intrathoracic esophageal perforation. ⋯ Stent placement was successful in all patients allowing immediate resumption of diet. After stent removal, contrast study showed no leak or stricture. Endoscopic stent therapy is an effective option in the management of postoperative esophageal perforation.