Surgical laparoscopy, endoscopy & percutaneous techniques
-
Catamenial pneumothorax is a subclass of secondary spontaneous pneumothorax occurring in women in their third or fourth decade of life. We describe a classic and typical case of this disease. Although it is believed to be rare historically, the recent study showed the much higher prevalence. It is essential to consider this disease in recurrent spontaneous pneumothorax of a middle-aged woman.
-
Surg Laparosc Endosc Percutan Tech · Dec 2007
Anatomy of the Sacral Roots and the Pelvic Splanchnic Nerves in Women Using the LANN Technique.
To report on our anatomic and electrophysiologic findings about the sacral nerve roots and the pelvic splanchnic nerves during laparoscopic pelvic surgery. ⋯ Laparoscopy in combination with the LANN technique not only permits an intraoperative functional mapping of the pelvic motoric autonomous nerves but also a differentiation between the vesical and rectal nerves and between the efferent and afferent pelvic nerves.
-
Surg Laparosc Endosc Percutan Tech · Oct 2007
Case ReportsGastro-bronchial fistula after laparoscopic nissen fundoplication.
Gastro-bronchial fistula (GBF) is an unusual complication of Nissen fundoplication, particularly when performed via a transabdominal approach. The mechanism of such fistula is thought to be related to a previously untreated ulcer in the mucosa of the wall of the gastric wrap or to a subclinical injury to the gastric wall during the process of division of the short gastric vessels and gastric mobilization. This process is greatly aided by herniation of the wrap into the chest in the postoperative period, placing the stomach in intimate contact with the bronchial tree. ⋯ The incidence of this complication seems to have markedly decreased after the widespread adoption of the transabdominal approach to the treatment of GERD. We are reporting the second case in the literature of a GBF developing after a laparoscopic Nissen fundoplication in a 28-year-old male patient. This case report should serve to increase awareness of this uncommon complication that should be considered in the differential diagnosis of patients with recurrent pneumonia or refractory hemoptysis after major upper gastrointestinal surgical procedures.
-
Surg Laparosc Endosc Percutan Tech · Jun 2007
Case ReportsLaparoscopic disconnection of a huge paraumbilical vein shunt for portosystemic encephalopathy.
Chronic portosystemic encephalopathy (CPSE) resulting from portosystemic shunts (PSS) is a devastating clinical problem. When CPSE is refractory to medical treatment, occlusion of the PSS should be considered. We report a case of CPSE due to a huge paraumbilical vein shunt that was successfully treated with laparoscopic disconnection. ⋯ Laparoscopic disconnection of the paraumbilical vein shunt was performed. The postoperative course was uncomplicated and there has been no recurrence of hepatic encephalopathy in the 2 years since, nor has there been a need for further medical treatment. We believe this is the first case report of CPSE treated laparoscopically, and it demonstrates that laparoscopic disconnection of PSS, especially paraumbilical vein shunts, can be a safe and effective procedure to treat CPSE.