Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Feb 2002
Early experience with robotically assisted laparoscopic donor nephrectomy.
The da Vinci robotic system became available at our institution in late August 2000. We decided to use this system to perform robotically assisted laparoscopic donor nephrectomies. A prospective study was conducted of 10 consecutive patients who underwent robotically assisted laparoscopic donor nephrectomy between January and May 2001. ⋯ All kidneys were transplanted successfully; no rejections occurred. This early experience suggests that the results of robotically assisted laparoscopic donor nephrectomy are similar to those of laparoscopic donor nephrectomy. We believe that robotic surgery, which enables regaining of the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, allows us to perform the donor nephrectomy with greater precision, confidence, and comfort.
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Surg Laparosc Endosc Percutan Tech · Feb 2002
Historical ArticleSurgical robotics: the early chronicles: a personal historical perspective.
The use of robotics has been emerging for approximately 75 years, but only during the past 5 years has the potential of robotics been recognized by the surgical community as a whole. This personal perspective chronicles the development of robotics for the general surgical community, the role of the military medical research effort, and many of the major programs that contributed to the current success of robotics.
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Surg Laparosc Endosc Percutan Tech · Jun 2001
Cost-effectiveness of ambulatory laparoscopic cholecystectomy.
The merits of laparoscopic cholecystectomy include faster recovery, less postoperative pain, earlier return to work, and decreased cost. However, there are few economic data comparing laparoscopic cholecystectomy in an ambulatory versus overnight stay setting. In a 12-month period, 74 consecutive cholecystectomies were performed laparoscopically by one surgeon. ⋯ No patient in either group was readmitted to the hospital within 30 days of surgery. Laparoscopic cholecystectomy can be performed safely in an outpatient setting. The cost savings of ambulatory care versus observation are clearly shown in this study.
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Surg Laparosc Endosc Percutan Tech · Apr 2001
Hand-assisted laparoscopic distal pancreatectomy with minilaparotomy for distal pancreatic cystadenoma.
Two patients with cystic tumors of the pancreas treated by laparoscopic distal pancreatectomy are presented. The first patient was a 34-year-old woman with a 6-cm cystadenoma of the tail of the pancreas treated with a complete laparoscopic distal pancreatectomy. After mobilization of the distal pancreas and spleen, the pancreas was transected proximally together with the splenic artery and vein using an endoscopic linear stapler. ⋯ Complete laparoscopic and hand-assisted laparoscopic distal pancreatectomy are preferable to conventional open surgery for benign tumors of the pancreas because of their less-invasive nature. Additionally, in tumors of the body of the pancreas, hand-assisted laparoscopic distal pancreatectomy might have the advantages of laparotomy and laparoscopy in terms of handling the splenic artery and vein just below the minilaparotomy site, suggesting an easier and safer procedure than complete laparoscopic distal pancreatectomy. Therefore, hand-assisted laparoscopic distal pancreatectomy can be recommended as a useful alternative to complete laparoscopic distal pancreatectomy for selected patients with benign tumors of the body and tail of the pancreas.
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Surg Laparosc Endosc Percutan Tech · Dec 2000
Randomized Controlled Trial Clinical TrialIntraperitoneal bupivacaine does not effectively reduce pain after laparoscopic cholecystectomy: a randomized, placebo-controlled and double-blind study.
The analgesic effect of intraperitoneal infusion of local anesthesia after laparoscopic cholecystectomy is controversial, and the reported results range from considerable pain reduction to no significant pain reduction. In this randomized, placebo-controlled and double-blind study, we examined the efficacy of intraperitoneal administration of bupivacaine at the end of surgery in 65 patients undergoing elective laparoscopic cholecystectomy. ⋯ The daily analgesic consumption was recorded. The authors only detected an analgesic effect in the heavier (body weight >77 kg) subgroup of patients at 2 hours, but detected no significant improvement of the peak expiratory flow, no decrease in the analgesic medication requirement, and no influence on the duration of hospital stay.