Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2016
Transanal Endoscopic Operation for Rectal Tumor: Short-term Outcomes and Learning Curve Analysis.
We aim to report outcomes and learning curve of transanal endoscopic operation (TEO) for rectal tumors, using standard laparoscopic instruments under a magnifying laparoscopic monitor view. ⋯ TEO is a feasible and safe treatment option for local excision of rectal tumors. TEO has the advantage of being a precise surgical procedure with a stable and magnifying endoscopic view. However, TEO requires a learning period and a careful selection of patients through proper indications and preoperative diagnostics.
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Surg Laparosc Endosc Percutan Tech · Jun 2016
Clinical TrialThe Effect of Equal Ratio Ventilation on Oxygenation, Respiratory Mechanics, and Cerebral Perfusion Pressure During Laparoscopy in the Trendelenburg Position.
The aim of this study was to investigate the effects of equal ratio ventilation (ERV) on oxygenation, respiratory mechanics, and the cerebral perfusion pressure during pneumoperitoneum in the Trendelenburg position. Thirty patients undergoing laparoscopic low anterior resection (25 to 65 y) were enrolled. Mechanical ventilator was set to volume-controlled mode at an inspiratory to expiratory (I:E) ratio of 1:2 with a tidal volume of 8 mL/kg of ideal body weight with a 5 cm H2O positive end-expiratory pressure. ⋯ No significant changes in arterial oxygen tension and respiratory compliance after adopting ERV. Mean arterial pressure and cerebral perfusion pressure decreased significantly over time after adopting the Trendelenburg position during pneumoperitoneum (P=0.014 and 0.005, respectively). In conclusion, there was no improvement in oxygenation or respiratory mechanics with ERV.
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Surg Laparosc Endosc Percutan Tech · Apr 2016
Review Meta AnalysisLimited Evidence for Robot-assisted Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
To evaluate available evidence on robot-assisted surgery compared with open and laparoscopic surgery. ⋯ At this point there is not enough evidence to support the significantly higher costs with the implementation of robot-assisted surgery.
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Surg Laparosc Endosc Percutan Tech · Feb 2016
Randomized Controlled TrialPerioperative Continuous Ropivacaine Wound Infusion in Laparoscopic Cholecystectomy: A Randomized Controlled Double-blind Trial.
Wound infusion with local anesthetics has been used for postoperative pain relief with variable results. This randomized, controlled, double-blind clinical trial examines the effect of ropivacaine infusion on pain after laparoscopic cholecystectomy. A total of 110 patients were randomly assigned to 2 groups. ⋯ Analgesic requirements and pain scores were recorded 1 and 3 months after surgery. The ropivacaine group reported less pain during cough (P=0.044) in the postanesthesia care unit (P=0.017) and 4 hours postoperatively (P=0.038). Ropivacaine wound infusion had no effect on late and chronic pain.
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Surg Laparosc Endosc Percutan Tech · Feb 2016
Laparoscopy for Occult Left-sided Diaphragm Injury Following Penetrating Thoracoabdominal Trauma is Both Diagnostic and Therapeutic.
The diagnosis of occult traumatic diaphragm injury (TDI) has posed a dilemma to trauma surgeons. No imaging modality can accurately and conclusively identify small defects in the integrity of the diaphragm following penetrating trauma. Diagnostic laparoscopy (DL) offers a minimally invasive method of evaluating the integrity of the diaphragm. ⋯ TDI presents in a spectrum from the obvious to the occult. Our results validate the utilization of DL as a minimally invasive intervention for both the diagnosis and repair of TDI in selected patients presenting with penetrating left-sided thoracoabdominal trauma.