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Rubina Akhtar, Rukhsana Karim und Zoopah Inayat. „Role of laparoscopic surgery in gynecology.“ Professional Medical Journal 30, Nr. 07 (02.07.2023): 912–16. http://dx.doi.org/10.29309/tpmj/2023.30.07.7443.
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Objective: Technological advancements extend the range of indications for gynecological laparoscopy. We are presenting the outcome of our experiences with gynaecological laparoscopies and assessed rate, indications, complications and its benefits in a teaching hospital. Study Design: Retrospective Observational study. Setting: MTI Hayatabad Medical Complex Peshawar. Period: January 2021 to December 2021. Material & Methods: we performed laparoscopic procedure for a total of 222 patients and all were included in the study. Laparoscopic surgeries were performed under general anesthesia. Successful creation of the pneumoperitoneum was done with the help of Veress needle, mostly by closed access technique and occasionally with the open method. Secondary ports were introduced under direct vision. After completing the surgery laparoscope and secondary ports were removed under direct vision to minimize any iatrogenic insult. Results: During the study period, 908 major gynaecological operations including 222 laparoscopies were performed. This gave the rate of 24.45% laparoscopies per 100 operations. Diagnostic laparoscopies were performed in 195 (87.84%) cases and operative were in 27 (12.16%) cases. Complications were only in 5 of the cases, two being of major nature. A ureteric ligation occurred during laparoscopic hysterectomy resulting in conversion of laparoscopic surgeries into open surgery and another was during cystectomy due to excessive bleeding. Conclusion: Laparoscopic surgery propounds unique benefits including definite diagnosis, mobilization and speedy recovery, minimal complications, less cost and shorter hospital stay. In young patients, laparoscopy helps in preserving their fertility with better prognosis in contrast to open surgery.
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Conron, Richard W., Kristin Abbruzzi, Sara Orr Cochrane, Albert J. Sarno und Peter I. Cochrane. „Laparoscopic Procedures in Pregnancy“. American Surgeon 65, Nr. 3 (März 1999): 259–63. http://dx.doi.org/10.1177/000313489906500316.
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As the applications of laparoscopy for general surgical procedures expanded in the 1990s, pregnancy was initially considered a contraindication. Several case reports have suggested the safety of laparoscopy in pregnancy. Previous clinical studies indicate a higher fetal mortality may exist and advised caution. To evaluate the fetal outcome of laparoscopic procedures in pregnant patients at our institution, we retrospectively reviewed the medical records between 1991 and 1997 and identified 21 pregnant patients who underwent either a laparoscopic (n = 12) or open (n = 9) procedure. Appendectomies, cholecystectomies, and diagnostic laparoscopics were performed. Specific variables including age, length of procedure, hospital stay, duration of parenteral analgesic use, gestational age at the time of surgery and delivery, O2 saturation and EtCO2 during surgery, APGAR scores, and birth weights were compared between the two groups. Laparoscopic procedures during pregnancy resulted in shorter hospital stays (34 hours versus 91 hours; P = 0.01), less use of parenteral narcotic analgesics (5 hours versus 29 hours; P = 0.05), and no prolongation of operative times (51 minutes versus 63 minutes; P = 0.20). In addition, laparoscopy was performed at earlier gestational ages (12 weeks versus 29 weeks; P = 0.001). There was one miscarriage 7 days after a laparoscopic cholecystectomy early in the 1st trimester that was not statistically significant. Our experience did not show a higher incidence of fetal loss when comparing laparoscopic to open procedures in pregnant patients.
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McVeigh, J. E., und P. Kononickx. „Laparoscopy and laparoscopic surgery“. Current Obstetrics & Gynaecology 11, Nr. 2 (April 2001): 93–99. http://dx.doi.org/10.1054/cuog.2001.0161.
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Slack, Alexander, und Enda McVeigh. „Laparoscopy and laparoscopic surgery“. Obstetrics, Gynaecology & Reproductive Medicine 17, Nr. 4 (April 2007): 112–18. http://dx.doi.org/10.1016/j.ogrm.2007.02.003.
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Swanton, Alex, Alex Slack und Enda McVeigh. „Laparoscopy and laparoscopic surgery“. Obstetrics, Gynaecology & Reproductive Medicine 20, Nr. 2 (Februar 2010): 33–40. http://dx.doi.org/10.1016/j.ogrm.2009.11.002.
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Swanton, Alex, und Nicolas Vulliemoz. „Laparoscopy and laparoscopic surgery“. Obstetrics, Gynaecology & Reproductive Medicine 22, Nr. 12 (Dezember 2012): 354–61. http://dx.doi.org/10.1016/j.ogrm.2012.10.005.
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Powell, Frances, und Aradhana Khaund. „Laparoscopy and laparoscopic surgery“. Obstetrics, Gynaecology & Reproductive Medicine 26, Nr. 10 (Oktober 2016): 297–303. http://dx.doi.org/10.1016/j.ogrm.2016.07.004.
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Koninckx, John, Philippe Koninckx und Enda McVeigh. „Laparoscopy and laparoscopic surgery“. Current Obstetrics & Gynaecology 14, Nr. 2 (April 2004): 115–22. http://dx.doi.org/10.1016/j.curobgyn.2003.12.011.
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Nicolau, Alexandru Eugen. „The Emergency Hospital Bucharest to the Forefront of the Emergency Laparoscopic Surgery Development“. Jurnalul de Chirurgie 17, Nr. 2 (30.06.2021): 99–106. http://dx.doi.org/10.7438/jsurg.2021.02.03.
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The use of laparoscopy in traumatic and non-traumatic abdominal surgical emergencies is unanimously accepted due to the well-known advantages of minimally invasive surgery. In the period 1961-1966 in the Clinical Emergency Hospital of Bucharest (CEHB) the first diagnostic laparoscopes were performed in the acute surgical abdomen, respectively in the obstructive jaundice by dr. Gh.Popovici, respectively dr.C.Petrescu.In the modern era, the first laparoscopic cholecystectomy was performed in 4 dec. 1993 by A.E.N.In 1994 the first laparoscopic appendectomies, gynecological emergencies, exploration in traumatic abdominal contusion, followed by perforated ulcer (1995), intestinal occlusion (1997), were performed. In the specialized literature, out of the 42 emergency laparoscopy articles published in the journal “Chirurgia” (1994-2019), 16 (38,08%) belonged to the CEHB team, 11 of AEN. In 2004 the original monograph "Laparoscopic Emergency Surgery" appeared. Specialized chapters are added in different volumes of surgical pathology. At the Romanian Assocation of Endoscopic Surgery Congress (RAES) of 2008, the international participation course “Laparoscopy in the acute abdomen” was organized. Since 2013, annual trauma workshops (DSTC ™) and non-traumatic abdominal emergencies have been organized with international participation by CEHB, the surgery clinic, and the UMFCarol Davila Department of Anatomy. CEHB surgeons presented papers at EAES,EATES and ESTES congresses. Of the 1699 laparoscopic operations performed in the clinic in 2018, accounting for 31.27% of the total operations, 493 (29.01%) were in emergency. The SCUB surgeons have had and have a major contribution in preparing the residents, implementing and developing emergency laparoscopy within the miniminvasive therapy, the therapy of the future.
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Bradea, Costel, Eugen Tarcoveanu, Valentina Munteanu, Cristian Dumitru Lupascu, Florina Delia Andriesi-Rusu, Delia Gabriela Ciobanu und Alin Mihai Vasilescu. „Laparoscopic Hartmann Procedure—A Surgery That Still Saves Lives“. Life 13, Nr. 4 (31.03.2023): 914. http://dx.doi.org/10.3390/life13040914.
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Background: A Hartmann operation, which is the intervention by which the lower part of the sigmoid and the upper part of the rectum are resected with the closing of the rectal stump and end colostomy, has as its indications: advanced or complicated rectosigmoid neoplasm, moderate biological condition of the patient, peritoneal sepsis, intestinal occlusion and fragile colonic wall, especially in the context of inflammatory changes. The Hartmann procedure can save lives even at the cost of a stoma reversal failure. Methods: The cases operated with the Hartmann procedure by an open approach or laparoscopic approach in our clinic, between 1 January 2016 and 31 December 2020, were admitted in this study and their medical records were reviewed, also making a comparison between the two types of approach. Univariate statistical comparisons but also a multivariate analysis was performed. Results: We performed 985 operations for intestinal and colonic occlusion (7.15% of the total operations in the clinic), 531 (54%) were non-tumor occlusions and 454 (46%) were occlusive tumors (88 Hartmann operations). Of these, 7.3% were laparoscopically performed (7 laparoscopic Hartmann operations and 23 diagnostic laparoscopies). A total of 11 cases (18%) also had colonic perforation. We compared laparoscopic Hartmann with open Hartmann and observed the benefits of laparoscopy for postoperative morbidity and mortality. The presence of pulmonary and cardiac morbidities is associated with the occurrence of general postoperative morbidities, while peritonitis is statistically significantly associated with the occurrence of local complications that are absent after the laparoscopic approach. Conclusions: The Hartmann procedure is still nowadays an operation widely used in emergency situations. Laparoscopy may become standard for the Hartmann procedure and reversal of the Hartmann procedure, but the percentage of laparoscopy remains low due to advanced or complicated colorectal cancer, poor general condition both at the first and second intervention, and the difficulties of reversal of the Hartmann procedure.
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Tay, Eng-Hseon. „Laparoscopic Pelvic Surgery for Endometrial Cancer“. Annals of the Academy of Medicine, Singapore 38, Nr. 2 (15.02.2009): 130–35. http://dx.doi.org/10.47102/annals-acadmedsg.v38n2p130.
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Introduction: The traditional approach for the treatment of endometrial cancer by laparotomy is increasingly being replaced by laparoscopic surgery. The advantages of laparoscopy have been well-documented. Laparoscopy avoids the morbidity of a laparotomy, overcomes the limitations of vaginal hysterectomy, provides adequate pathological information for an accurate surgical staging and expedites the postoperative recovery of patients. This paper reports the outcome of a series of 50 consecutive cases of laparoscopic hysterectomy and pelvic lymphadenectomy for endometrial cancers that were performed by the author. The objective is to review the perioperative, postoperative experience and survival outcomes of patients with endometrial cancer managed by laparoscopic surgery performed by a single surgeon. Materials and Methods: The records of 50 consecutive patients with endometrial cancers from October 1995 to October 2007 treated by laparoscopic pelvic lymphadenectomy and laparoscopic hysterectomy (total and assisted) were retrospectively reviewed. Data on patients’ attributes, endometrial cancers, surgical procedures, surgical complications and morbidity, perioperative experience, length of hospital stays and clinical outcome were analysed. Results: Laparoscopic surgery was successful in all 50 patients and is clearly an option for the treatment of early endometrial cancer. Conclusion: Careful patient selection and surgical competency are instrumental in ensuring successful treatment. Key words: Endometrial cancer, Hysterectomy, Lymphadenectomy, Laparoscopic surgery, Uterine cancer
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Breda, G., P. Silvestre, L. Gherardi, A. Giunta, A. Tamai und D. Xausa. „Urologic laparoscopic surgery: Light and shade“. Urologia Journal 62, Nr. 1_suppl (Januar 1995): 80–84. http://dx.doi.org/10.1177/039156039506201s21.
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— Analysing material and world-wide urologic laparoscopie surgery experience, the Authors try to define, also according to their experience, the indications for which the laparoscopic technique is established and well accepted and, on the contrary, those which are still controversial. Critical evaluation about laparoscopic surgery indications are often supported by the costs of the “minimally invasive” technique compared to the traditional surgical approach.
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Carmichael, Joseph C., Hossein Masoomi, Steven Mills, Michael J. Stamos und Ninh T. Nguyen. „Utilization of Laparoscopy in Colorectal Surgery for Cancer at Academic Medical Centers: Does Site of Surgery Affect Rate of Laparoscopy?“ American Surgeon 77, Nr. 10 (Oktober 2011): 1300–1304. http://dx.doi.org/10.1177/000313481107701005.
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Use of laparoscopy in colorectal cancer surgery is still limited. The aim of this study was to determine the rate of use of laparoscopic colorectal surgery for cancer at academic medical centers and to evaluate if the site of surgery influences the rate of use. Clinical data of patients who underwent laparoscopic or open colon and rectal resections for cancer from 2007 to 2009 were obtained from the University HealthSystem Consortium database. Data concerning rate of laparoscopy, length of stay, morbidity, and risk-adjusted mortality were obtained. During the 36-month study period, 22,780 operations were performed. The overall rate for use of laparoscopy was 14.8 per cent. Laparoscopy was most often used for total colectomy (22.6%), sigmoid colectomy (17.3%), cecectomy (17.1%), and right hemicolectomy (17.0%). Laparoscopy was most infrequently used for abdominoperineal resection (8.0%), transverse colectomy (10.0%), and left hemicolectomy (13.1%). Length of stay for laparoscopic colon and rectal procedures was 3.2 days shorter than for open surgery. Although the benefits of laparoscopic colorectal surgery for cancer have been demonstrated, the use of laparoscopy for colorectal resection remains under 20 per cent for colon cancer and under 10 per cent for rectal cancer. Further studies are needed to determine the factors limiting the use of laparoscopy in colorectal surgery.
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Ammari Smail. „Emergency laparoscopic surgery in pregnancy“. World Journal of Advanced Research and Reviews 22, Nr. 2 (30.05.2024): 1456–60. http://dx.doi.org/10.30574/wjarr.2024.22.2.1564.
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Introduction: The decision to proceed with surgical intervention is often difficult in pregnant women, particularly in emergency contexts. Opting for laparoscopic surgery in pregnant women is even more challenging. Concerns during laparoscopic procedures include potential fetal injury, reduced uterine blood flow due to pneumoperitoneum, and fetal acidosis. The objective of our study is to evaluate the feasibility and morbidity-mortality of emergency laparoscopy in pregnant women. Materials and Methods: This is a descriptive and prospective study conducted between February 2018 and October 2021, involving 337 patients who underwent laparoscopic surgery for acute non-traumatic abdominal emergencies. Results: Among the 190 female patients operated on, 18 patients (9.47%) were pregnant: 8 (44.5%) had acute appendicitis, 7 (38.9%) had acute lithiasic cholecystitis, 2 (11.2%) had ovarian cyst torsion, and 1 (5.6%) had an appendiceal abscess. This laparoscopic management was performed across different gestational ages. The mean gestational age of our patients was 15 ± 14 weeks of amenorrhea (minimum 7 weeks, maximum 29 weeks). The mean operative time for the surgical interventions in these pregnant women was 61.2 minutes ± 20.16 minutes. No intraoperative complications or incidents, no conversions, and no abortions were recorded. Conclusion: Laparoscopy can be safely used to manage acute non-traumatic abdominal emergencies during pregnancy.
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Kumari, Barkha, Talha Aslam, Malik Muhammad Hamdan Tafheem, Muhammad Nauman Ashraf, Aftab Ahmad Baig und Sardar Muhammad Naseer Uddin. „Outcomes of Open Versus Laparoscopic Surgery for Colorectal Cancer in the Emergency Setting“. Pakistan Journal of Medical and Health Sciences 17, Nr. 1 (31.01.2023): 455–58. http://dx.doi.org/10.53350/pjmhs2023171455.
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Aim: The study aim is to do the comparison of oncological and short-term results of open and laparoscopic surgery for colorectal cancer in emergency setting. Study Design: This retrospective cohort research was held in the Department of Surgery, Civil Hospital, Karachi and Sheikh Zayed Medical College/ Hospital, Rahim Yar Khan for two-years duration from January 2020 to December 2021. Patients and Methods: after approval of this study and an informed consent agreement was signed by each participant. We performed an emergency analysis on 55 consecutive patients who received emergency open (n=40) or laparoscopic (n=15) resection for colorectal cancer. Results: The gender, age, BMI, American Society of Anesthesiologists (ASA) score, tumor location and prior abdominal surgery history were not significantly different between the laparoscopic and open groups. The T4 pathological tumors were more frequent in the open surgery group (50% vs. 13.3%; p=0.031) than in the laparoscopic group. The open surgery group also experienced high proportion of perforation (42.5% vs. 33.3%) and obstruction (47.5% vs. 26.7%) cases. In the laparoscopic group, bleeding or anemia were much common (33.3% vs. 7.5%; p=0.032). The laparoscopic group did not experience any open conversions. The open surgery group had a high pervasiveness of Hartmann's surgery (35%), whereas the laparoscopic group had high pervasiveness of low anterior resection (26.7%; p=0.064). The complication ration at 30-days for laparoscopy (37.5%) and open surgery (33.3%) was comparable (p=0.900). Conclusions: In some individuals with colorectal cancer, emergency laparoscopic surgery has advantages in relation of short-term and oncologic outcomes. As a result, skilled laparoscopic surgeons may actively consider using laparoscopy in life-threatening situations. Keywords: Laparoscopy, colorectal cancer, and emergency.
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Kiblawi, Rim, Christoph Zoeller, Andrea Zanini, Joachim F. Kuebler, Carmen Dingemann, Benno Ure und Nagoud Schukfeh. „Laparoscopic versus Open Pediatric Surgery: Three Decades of Comparative Studies“. European Journal of Pediatric Surgery 32, Nr. 01 (21.12.2021): 009–25. http://dx.doi.org/10.1055/s-0041-1739418.
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Abstract Introduction Despite its wide acceptance, the superiority of laparoscopic versus open pediatric surgery has remained controversial. There is still a call for well-founded evidence. We reviewed the literature on studies published in the last three decades and dealing with advantages and disadvantages of laparoscopy compared to open surgery. Materials and Methods Studies comparing laparoscopic versus open abdominal procedures in children were searched in PubMed/MEDLINE. Reports on upper and lower gastrointestinal as hepatobiliary surgery and on surgery of pancreas and spleen were included. Advantages and disadvantages of laparoscopic surgery were analyzed for different types of procedures. Complications were categorized using the Clavien–Dindo classification. Results A total of 239 studies dealing with 19 types of procedures and outcomes in 929,157 patients were analyzed. We identified 26 randomized controlled trials (10.8%) and 213 comparative studies (89.2%). The most frequently reported advantage of laparoscopy was shorter hospital stay in 60.4% of studies. Longer operative time was the most frequently reported disadvantage of laparoscopy in 52.7% of studies. Clavien–Dindo grade I to III complications (mild–moderate) were less frequently identified in laparoscopic compared to open procedures (80.3% of studies). Grade-IV complications (severe) were less frequently reported after laparoscopic versus open appendectomy for perforated appendicitis and more frequently after laparoscopic Kasai's portoenterostomy. We identified a decreased frequency of reporting on advantages after laparoscopy and increased reporting on disadvantages for all surgery types over the decades. Conclusion Laparoscopic compared with open pediatric surgery seems to be beneficial in most types of procedures. The number of randomized controlled trials (RCTs) remains limited. However, the number of reports on disadvantages increased during the past decades.
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Guven, Cenk, und Dilek Uysal. „Conversion to laparotomy in bening gynecologic laparoscopic surgery; Can surgical experience be protective“. Medicine Science | International Medical Journal 12, Nr. 2 (2023): 368. http://dx.doi.org/10.5455/medscience.2023.01.011.
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Laparoscopy is a surgical technique that is frequently used in the treatment of benign cases, but the conversion to open surgery (CTOS) complication is higher than laparotomy. In some cases, a conversion from laparoscopic surgery to open surgery is necessary to prevent or treat difficulties. In this study, the effect of surgical expertise on CTOS was evaluated on patients who had undergone laparoscopic surgery for benign indications. A total of 305 patients were included during the study period. These patients were divided into two groups: CTOS group (7 patients) and successful laparoscopy group (298 patients). Benign gynecological laparoscopy operation was converted to open surgery in 7 of 305 patients (2.29%) included in this study. Open surgery significantly prolonged hospital stays in patients compared to laparoscopic surgery. While wound infection was observed in 3 patients who underwent open surgery, no infection was observed in laparoscopic surgery group. Obtained results demonstrated that age, body mass index, sufficient surgical expertise, history of previous abdominal surgery and endometriosis, obstetrical status, abdomino-pelvic adhesions, and frozen pelvis did not create risk factor for CTOS in the treatment of benign cases with laparoscopic surgery. It was concluded that the conversion to open surgery is connected with technical problems instead of complication management or surgical complexity.
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Parvaiz, MA, und MA Pervaiz. „Iatrogenic gastric perforation during laparoscopy presenting on anaesthesia monitor“. Annals of The Royal College of Surgeons of England 96, Nr. 5 (Juli 2014): e14-e15. http://dx.doi.org/10.1308/003588414x13946184900129.
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Unfortunately, in the era of minimal access surgery, visceral injuries due to laparoscopic port insertion are common. Most such injuries are diagnosed on direct vision through a laparoscope camera. We report a case of iatrogenic gastric perforation during laparoscopy, presenting in an unusual way in the form of a very high carbon dioxide output on the anaesthesia monitor. This atypical presentation should be borne in mind while performing laparoscopy.
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Zivaljevic, Milica, Ivan Majdevac, Petar Novakovic und Tamara Vujkov. „The role of laparoscopy in gynecologic oncology“. Medical review 57, Nr. 3-4 (2004): 125–31. http://dx.doi.org/10.2298/mpns0404125z.
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In some patients and when performed by a skillful surgeon, gynecologic oncologist familiar with advanced laparoscopic techniques, laparoscopy results with less surgical trauma, reduced blood loss and hospitalization, and faster recovery. The complication rate has been found to increase as the complexity of the operation rises, but it is not higher than in open surgery. Preliminary studies show that recurrence and survival rates are comparable to those reported for patients treated by a standard abdominal approach. Future randomized trials are necessary to deal with long term recurrences and survival data and benefits of laparoscopy in management of gynecologic malignancies. At our institution 97 cancer patients underwent laparoscopic procedures, without complications: explorative and staging laparoscopies with biopsies of ovaries, peritoneal biopsies, retroperitoneal and mesenteric tumors; second look laparoscopy, ovariectomy, laparoscopic assisted vaginal hysterectomy (LAVH). Advanced ovarian cancer was found in 3 patients and laparotomy was performed. No complications were stablished.
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Imaizumi, Junki, Kanako Yoshida, Hiroki Noguchi, Takaaki Maeda, Takeshi Kato und Takeshi Iwasa. „A Safe Laparoscopic Approach for Ovarian Tumors during Pregnancy“. Gynecology and Minimally Invasive Therapy 13, Nr. 1 (2024): 19–24. http://dx.doi.org/10.4103/gmit.gmit_119_22.
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Objectives: Surgery for pregnant women with ovarian tumors poses the risk of uterine irritation. We aimed to demonstrate the superiority of our laparoscopic technique over conventional methods and to compare the outcomes of laparoscopy with those of laparotomy for ovarian tumors during pregnancy. Materials and Methods: This retrospective study included 50 patients undergoing procedures for ovarian tumors during pregnancy at the Tokushima University Hospital between January 2005 and December 2021. We compared surgical outcomes between laparoscopic procedures and laparotomy, along with complications. In addition, we compared the frequency of uterine stimulation with the conventional trocar position to that with the currently used trocar position in laparoscopic surgery. Results: Forty patients in the laparoscopy group and 10 in the laparotomy group underwent procedures. The laparoscopy group had less bleeding (16.4 ± 28.8 vs. 58 ± 72.2 mL, P < 0.05) and shorter hospital stays (7.6 ± 1.7 vs. 12.8 ± 13.1 days, P < 0.05) compared with those of the laparotomy group. The outcomes showed no significant differences between groups. All laparoscopies and laparotomies were successful and without complications. Furthermore, the current trocar position tended to stimulate the uterus less frequently. Conclusion: The results suggested that, compared to laparotomy, laparoscopy for ovarian tumors during pregnancy had better outcomes. The trocar position in our technique allows for easy operation of ovarian tumors without interference by forceps or cameras, resulting in minimal irritation of the uterus. Our original laparoscopic method may be safer with superior outcomes over the conventional method.
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Shastri, Shraddha S., Anvita A. Singh, Sameer P. Darawade und Saloni D. Manwani. „Complications of gynaecologic laparoscopy: an audit“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, Nr. 12 (26.11.2018): 4870. http://dx.doi.org/10.18203/2320-1770.ijrcog20184931.
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Background: Minimal access surgery as a modality of treatment for various gynecologic conditions is rapidly gaining grounds in the recent years1. Approximately 30 years after its introduction; the use of laparoscopy in gynecology has evolved from diagnostic purposes into a more coordinated system for the repair or removal of diseased abdominal and pelvic organs. The rapid increase in the number of procedures being performed, the introduction of new equipment, and variability in the training of surgeons all contribute to the complication rate. The objective is to review complications associated with laparoscopic gynecological surgeries and identify associated risk factors.Methods: Hospital based descriptive observational study performed between January 2013 to December 2017 which included all gynecologic laparoscopies performed in present institute. Variables were recorded for patient characteristics, indication for surgery, length of hospital stay (in days), major and minor complications, conversions to laparotomy and postoperative complications. The laparoscopic procedures were divided into three subgroups: Diagnostic cases, tubal sterilization and Advanced operative laparoscopy.Results: Of all 3724 laparoscopies included, overall frequency of major was 1.96 %, and that of minor complications was 3.51%. Of 3724 laparoscopic procedures, 214 complications occurred (5.8% of all procedures) and one death occurred. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of major complications and conversions to laparotomy.Conclusions: Laparoscopic surgery has many advantages, but it is not without complications. Despite rapidly improving technical equipment’s and surgical skill; complication rates and preventable injuries demonstrate continuous pattern. Delayed recognition and intervention add to morbidity and mortality. Each laparoscopic surgeon should be aware of the potential complications, how they can be prevented and managed efficiently.
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Sundbom, M., und J. Hedberg. „Use of Laparoscopy in Gastrointestinal Surgery in Sweden 1998–2014: A Nationwide Study“. Scandinavian Journal of Surgery 106, Nr. 1 (08.07.2016): 34–39. http://dx.doi.org/10.1177/1457496916630645.
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Background and Aims: One by one, minimally invasive alternatives to established gastrointestinal procedures have become clinical routine. We have studied the use of laparoscopy in four common procedures—cholecystectomy, appendectomy, reflux surgery, and bariatric surgery—as well as in major resectional gastrointestinal surgery in Sweden. Materials and Methods: The National Patient Registry was used to identify all in-hospital procedures performed in patients above the age of 15 during 1998–2014, meeting our inclusion criteria. For each group, the annual number of procedures and proportion of laparoscopic surgery were studied, as well as applicable subgroups. Differences in age, gender, as well as geographical differences were evaluated in the most recent 3-year period (2012–2014). Results: In total, 537,817 procedures were studied, 43% by laparoscopic approach. In 2012–2014, the proportion of laparoscopic surgery ranged from high rates in the four common procedures (cholecystectomy 81%, appendectomy 47%, reflux surgery 72%, and bariatric surgery 97%) to rather low numbers in resectional surgery (4%–10%), however, increasing in the last years. In appendectomy and cholecystectomy, men were less likely to have laparoscopic surgery (42% versus 51% and 74% versus 85%, respectively, p < 0.001). Substantial geographical differences in the use of laparoscopy were also noted, for example, the proportion of laparoscopic appendectomy varied from 11% to 76% among the 21 different Swedish counties. Conclusion: The proportion of laparoscopy was high in the four common procedures and low, but rising, in major resectional surgery. A large variation in the proportion of laparoscopic surgery by age, gender, and place of residence was noted.
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Barleben, Andrew, Dhruvil Gandhi, Xuan-Mai Nguyen, Fred Che, Ninh T. Nguyen, Steven Mills und Michael J. Stamos. „Is Laparoscopic Colon Surgery Appropriate in Patients who Have Had Previous Abdominal Surgery?“ American Surgeon 75, Nr. 10 (Oktober 2009): 1015–19. http://dx.doi.org/10.1177/000313480907501033.
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Laparoscopic techniques in colon surgery reduce postoperative pain, length of hospital stay, and 30-day morbidity when compared with open surgery. The objective of this study was to determine the feasibility of a laparoscopic colectomy in patients who have previously undergone abdominal surgery. We performed a retrospective, single-institution review of laparoscopic colorectal procedures for benign or malignant pathology between October 2002 and September 2008. Our analysis included 55 patients who previously had laparoscopic, open, or a combination of procedures and subsequently underwent laparoscopic colorectal surgery. We observed a 14.5 per cent conversion rate (n = 8). Of the patients who had previous open procedures (n = 48 [87.3%]), the conversion rate was 16.7 per cent. Only one patient (12.5%) who had a history of only laparoscopic surgery required conversion. The highest conversion rate in our study was from patients who underwent a left colectomy (60%, n = 3/5), which was the only statistically significant factor found for conversion. Since the emergence of laparoscopy, use in colon and rectal surgery nationwide has been poor as a result of multiple factors, including a frequent history of abdominal surgery. Our experience shows that laparoscopic colorectal surgery in patients with prior intra-abdominal surgery can be completed with an acceptable conversion rate.
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Gencdal, Servet, und Emre Ekmekci. „Comparison of Mini-Laparoscopic and Conventional Laparoscopic Surgery for Tubal Ligation“. Gynecology Obstetrics & Reproductive Medicine 24, Nr. 3 (25.12.2018): 139. http://dx.doi.org/10.21613/gorm.2018.794.
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<p><strong>Objective:</strong> To compare the intraoperative characteristics and postoperative results of mini laparoscopic and conventional laparoscopic surgeries performed for surgical sterilization.</p><p><strong>Study Design:</strong> This retrospective study was conducted to compare the conventional and mini laparoscopic tubal ligation for surgical tubal sterilization. In total of 39 women, 22 in the conventional laparoscopy and 17 in the mini laparoscopic surgery group participated in the study. The main outcome measures were total operation time, amount of bleeding, intraoperative complications, skin scar formation with patient scale and observer scale and length of hospital stay. </p><p><strong>Results:</strong> Demographical findings did not differ between the two groups. Similarly, rates of intraoperative complications, conversion to laparotomy, length of hospital stay, pre and postoperative hematocrit levels were not significantly different between the groups. Both patient and observer POSAS scores were better in mini laparoscopic surgery group. </p><p><strong>Conclusion:</strong> Mini laparoscopic surgery seems a safe and feasible alternative to conventional laparoscopy for surgical tubal sterilization.</p>
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Karip, Bora, Hasan Altun, Yalın İşcan, Martin Bazan, Kafkas Çelik, Yetkin Özcabı, Birol Ağca und Kemal Memişoğlu. „Difficulties of Bariatric Surgery after Abdominoplasty“. Case Reports in Surgery 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/620175.
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During laparoscopy, the main problems of patients who have undergone previous abdominoplasty are inadequate pneumoperitoneum secondary to fibrosis and reconstructed anatomic landmarks for trocar placement. In this study, we present our laparoscopic bariatric experience in two patients with previous abdominoplasty. The procedures were a laparoscopic sleeve gastrectomy and a robotic Roux-en-Y gastric bypass. Both operations were done successfully by an abdominal wall traction technique, cutting fibrotic tissue and choosing new landmarks. We conclude that after abdominoplasty bariatric surgery can be performed safely either using conventional laparoscopic technique or robotically.
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Rahman, Usman Ali, Muhammad Adil Iftikhar, Khalil Ahmed, Mohammad Zia Ul Miraj, Maliha Javaid Butt und Iftikhar Ahmed. „Does Laparoscopic Lens Contamination Effect Operative Time? A study on the Frequency and Duration of Lens Contamination and Commonly Used Measures to Maintain Clear Vision“. Journal of Islamabad Medical & Dental College 12, Nr. 3 (17.10.2023): 204–7. http://dx.doi.org/10.35787/jimdc.v12i3.1020.
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INTRODUCTION
Laparoscopy surgical procedures are increasing day by day.Laparoscopic lens contamination is most common problem occurring in laparoscopic surgery. This lens fogging results in increase per operative time. Many techniques are available to improve vision during laparoscopy. These include anti fog solutions, touching a visceral organ, use of warm water or scope warmer, sterile cloth can be used which can be dry or wet.
MATERIALS AND METHODS
It was a cross sectional study conducted in general surgery department Gulab Devi Hospital Lahore from January 2022 to July 2022. A total of 70 patient undergoing laparoscopic surgery were recruited in this study. Operative time, duration of time lens remained cleaned or dirty, time wasted during cleaning, methods used for cleaning of lens and there time duration and causes of lens contamination were the variables of this study.
RESULTS
Total operative time in all 70 laparoscopic procedures was found to equate to 53 hours and 13 minutes with a mean of 43.8 ± 8.3 minutes. A total of 288 lens contamination events were observed in all these operations with an average of 4.11 lens contamination events per case. According to study an average, 60.9% of the operational time lens remained clear, 31.2% of the operational time lens remained contaminated and 7.92% of the operative time was spent in cleaning the laparoscope.
CONCLUSION
Our study demonstrates that a significant period of a laparoscopic surgery is performed with foggy display. A lot of time is wasted in lens cleaning which can be saved by reducingcontamination using perfect techniques to clean lens.
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Boudová, Barbora, Adéla Richtárová, Filip Frühauf, Daniela Fischerová und Michal Mára. „The role of power morcellation in minimally invasive gynecologic surgery“. Česká gynekologie 87, Nr. 4 (31.08.2022): 289–94. http://dx.doi.org/10.48095/cccg2022289.
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Objective: To summarize recent data and knowledge of laparoscopic power morcellation. Methods: Review of articles. Results: Laparoscopic morcellation has been introduced to gynecologic surgery in 90’s. In 2014, Food and Drug Administration announced negative statement about the morcellation use due to the risk of potential spreading of malignant tumor cells. This statement reduced utilization of morcellation, especially in the United States. Since that, many health institutions and organizations started new researches focused on the safety of this surgical technique. After a couple of years, the morcellation is considered as a useful tool if certain rules are followed. Conclusion: Morcellation has a place in laparoscopic operative procedures even in 2022, in condition of correct selection of patients and possible utilization of contained in-bag morcellation. Key words: hysterectomy – laparoscopy – morcellation – myomectomy
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Johal, KS, P. Tsim, A. Redfern, C. Weeks, HM Park, C. Morris, P. Kang und C. Maxwell-Armstrong. „Single-Incision Laparoscopic Surgery Versus Conventional Techniques“. Bulletin of the Royal College of Surgeons of England 94, Nr. 10 (01.11.2012): 348–50. http://dx.doi.org/10.1308/147363512x13311314198454.
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Single-Incision laparoscopic surgery (SILS) is a relatively novel technique that employs a single incision to gain access to the peritoneal cavity. Potential advantages over conventional laparoscopy include reduction of port site complications, reduced pain and improved cosmesis. Given that the incidence of surgical site complications in conventional laparoscopic surgery (infection 0.5%, incisional hernia 7.9%, haematoma 6.25%) are all correlated directly with the incisional site, a reduction in the number of incisions has been suggested as a means of improving post-operative morbidity from laparoscopic surgery.
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Cem Esmer, Ahmet, Tahsin Çolak, Akay Edizsoy, Deniz Tazeoğlu und Ahmet Serdar Karaca. „Current status of laparoscopic surgery usage in Türkiye: A middle-income country“. Turkish Journal of Surgery 38, Nr. 4 (01.12.2022): 353–61. http://dx.doi.org/10.47717/turkjsurg.2022.5713.
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Objective: This study aimed to determine the usage status of laparoscopic procedures in general surgical practice in Türkiye, which is a sample of middle-income countries. Material and Methods: The questionnaire was sent to general surgeons, gastrointestinal surgeons, and surgical oncologists who have completed their residency training and are actively working in university, public or private hospitals. Demographic data, laparoscopy training and the period of education, the rate of laparoscopy use, the type and volume of laparoscopic surgical procedures, their views on the advantages and disadvantages of laparoscopic surgery, and the reasons for preferring laparoscopy were determined with a 30-item questionnaire. Results: Two hundred and forty-four questionnaires from 55 different cities of Türkiye were evaluated. The responders were mainly males, younger surgeons (F/M= 11.1/88.9 % and 30-39 y/o), and graduated from the university hospital residence program (56.6%). Laparoscopic training was frequently taken during residency (77.5%) in the younger age group, while the elderly participants mostly received additional training after specialization (91.7%). Laparoscopic surgery was mostly not available in public hospitals for advanced procedures (p< 0.0001) but was available for cholecystectomy and appendectomy operations (p= NS). However, participants working in university hospitals mostly stated that the laparoscopic approach was the first choice for advanced procedures. Conclusion: The results of this study showed that the surgeons working in MICs spent strong effort to use laparoscopy in daily practice, especially in university and high-volume hospitals. However, inappropriate education, cost of laparoscopic equipment, healthcare policies, and some cultural and social barriers might have negatively impacted the widespread use of laparoscopic surgery and its usage in daily practice in MICs such as Türkiye.
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Bergström, Bo S. „Lift-Assisted Laparoscopy in Hysterectomy: A Retrospective Study of 32 Consecutive Cases“. ISRN Minimally Invasive Surgery 2013 (07.10.2013): 1–4. http://dx.doi.org/10.1155/2013/989727.
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A large uterus is the most commonly reported obstacle to laparoscopic hysterectomy. It reduces the intra-abdominal free space, limits visualization and instrumentation, causes technical difficulties, and increases the potential for complications. The logical solution to this dilemma is to address the underlying problem and increase the intra-abdominal free space. This can be done readily by supplementing the conventional pneumoperitoneum by concurrent mechanical lifting of the abdominal wall using the camera trocar as an anchoring device. Such lift-assisted laparoscopy augments the intra-abdominal free space formation, and lifts the laparoscope to a higher position to give a panoramic view, even when the uterus is large. This retrospective study of 32 consecutive cases of laparoscopic hysterectomy indicates that the use of lift-assisted laparoscopy is safe for the patient and that a large uterus is not a contraindication. The operations were long, but complications were few. Lift-assisted laparoscopy is an option to improve patient care by modifying surgical procedures. Operating time, per se, is not a valid measure of quality in laparoscopic hysterectomy. The more traumatic abdominal hysterectomy procedures need not be selected in preference over lengthy minimally invasive techniques. Other techniques, such as solo surgery and in-office surgery, are also discussed.
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Halkias, Constantine, Athanasios Zoikas, Zoe Garoufalia, Michalis K. Konstantinidis, Argyrios Ioannidis und Steven Wexner. „Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review“. Journal of Clinical Medicine 10, Nr. 7 (01.04.2021): 1447. http://dx.doi.org/10.3390/jcm10071447.
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Introduction: Re-operative laparoscopic colorectal surgery is becoming increasingly common. It can be a challenging procedure, but its benefits can outweigh the associated risks. Methods: A systematic review of the literature reporting re-operative laparoscopic surgery was carried out. Retrospective and prospective cohort studies and case series were included, with case reports being excluded. Results: Seventeen articles dated from 2007 to 2020 were included in the systematic review. In total, 1555 patients were identified. Five hundred and seventy-four of them had a laparoscopic procedure and 981 an open re-operation. One hundred and eighty-three women had a laparoscopic operation. The median age ranged from to 44.9 years to 68.7 years. In seven studies, the indication of the index operation was malignancy, one study regarded re-laparoscopy for excision of lateral pelvic lymph nodes, and one study looked at redo surgery of ileal J pouch anal anastomosis. There were 16 mortalities in the laparoscopic arm (2.78%) and 93 (9.4%) in the open surgery arm. One hundred and thirty-seven morbidities were recorded in the open arm and 102 in the laparoscopic arm. Thirty-nine conversions to open occurred. The median length of stay ranged from 5.8 days to 19 days in laparoscopy and 9.7 to 34 days in the open surgery arm. Conclusions: Re-operative laparoscopic colorectal surgery is safe when performed by experienced hands. The management of complications, recurrence of malignancy, and lateral pelvic floor dissection can be safely performed. The complication rate is low, with conversion to open procedures being relatively uncommon.
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Beger, Hans G., und Michael H. Schoenberg. „The Role of Laparoscopy and Ultrasonography in Pancreatic Head Carcinoma“. HPB Surgery 10, Nr. 3 (01.01.1997): 186–88. http://dx.doi.org/10.1155/1997/72893.
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Objective: The authors performed a prospective evaluation of staging laparoscopy with laparoscopic ultrasonography in predicting surgical resectability in patients with carcinomas of the pancreatic head and periampullary region.Summary Background Data: Pancreatic resection with curative intent is possible in a select minority of patients who have carcinomas of the pancreatic head and periampullary region. Patient selection is important to plan appropriate therapy and avoid unnecessary laparotomy in patients with unresectable disease. Laparoscopic ultrasonography is a novel technique that combines the proven benefits of staging laparoscopy with high resolution intraoperative ultrasound of the liver and pancreas, but which has yet to be evaluated critically in the staging of pancreatic malignancy.Methods: A cohort of 40 consecutive patients referred to a tertiary referral center and with a diagnosis of potentially resectable pancreatic or periampullary cancer underwent staging laparoscopy with laparoscopic ultrasonography. The diagnostic accuracy of staging laparoscopy alone and in conjunction with laparoscopic ultrasonography was evaluated in predicting tumor resectability (absence of peritoneal or liver metastases; absence of malignant regional lymphadenopathy; tumor confined to pancreatic head or periampullary region).Results: “Occult” metastatic lesions were demonstrated by staging laparoscopy in 14 patients (35%). Laparoscopic ultrasonography demonstrated factors confirming unresectable tumor in 23 patients (59%), provided staging information in addition to that of laparoscopy alone in 20 patients (53%), and changed the decision regarding tumor resectability in 10 patients (25%). Staging laparoscopy with laparoscopic ultrasonography was more specific and accurate in predicting tumor resectability than laparoscopy alone (88% and 89% versus 50% and 65%, respectively).Conclusions: Staging laparoscopy is indispensable in the detection of “occult” intraabdominal metastases. Laparoscopic ultrasonography improves the accuracy of laparoscopic staging in patients with potentially resectable pancreatic and periampullary carcinomas.
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Yu, Lingtao, Xiaoyan Yu, Xiao Chen und Fengfeng Zhang. „Laparoscope arm automatic positioning for robot-assisted surgery based on reinforcement learning“. Mechanical Sciences 10, Nr. 1 (03.04.2019): 119–31. http://dx.doi.org/10.5194/ms-10-119-2019.
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Abstract. Compared with the traditional laparoscopic surgery, the preoperative planning of robot-assisted laparoscopic surgery is more complex and essential. Through the analysis of the surgical procedures and surgical environment, the laparoscope arm preoperative planning algorithm based on the artificial pneumoperitoneum model, lesion parametrization model is proposed, which ensures that the laparoscope arm satisfies both the distance principle and the direction principle. The algorithm is divided into two parts, including the optimum incision and the optimum angle of laparoscope entry, which makes the laparoscope provide a reasonable initial visual field. A set of parameters based on the actual situation is given to illustrate the algorithm flow in detail. The preoperative planning algorithm offers significant improvements in planning time and quality for robot-assisted laparoscopic surgery. The improved method which combines the preoperative planning algorithm with deep deterministic policy gradient algorithm is applied to laparoscope arm automatic positioning for the robot-assisted laparoscopic surgery. It takes a fixed-point position and lesion parameters as input, and outputs the optimum incision, the optimum angle and motor movements without kinematics. The proposed algorithm is verified through simulations with a virtual environment built by pyglet. The results validate the correctness, feasibility, and robustness of this approach.
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Hull, Tracy L. „Laparoscopic Techniques: What is the Role in Inflammatory Bowel Disease?“ Canadian Journal of Gastroenterology 9, Nr. 1 (1995): 39–41. http://dx.doi.org/10.1155/1995/101760.
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Laparoscopic cholecystectomy has quickly become the preferred technique for removing the gallbladder. Real advantages in the area of laparoscopic gallbladder removal have spurred interest towards other areas of laparoscopic surgery. There has been interest in laparoscopic bowel surgery but this approach has not gained popularity as quickly as gallbladder surgery. Reasons surround the fact that the bowel is a continuous organ (versus an end organ like the gallbladder) laden with bacteria and it has a rich blood supply. These differences make laparoscopic bowel surgery more difficult and challenging. If inflammatory bowel disease (IBD) is considered, the indications to approach surgery laparoscopically fall into two categories: current and future indications. The current indications are diagnostic laparoscopy, fecal diversion, limited bowel resections with extracorporeal anastomosis and stoma closures. Future indications include laparoscopic subtotal colectomy and laparoscopic assisted pelvic pouch procedures. As experience is gained and laparoscopic instruments are modified and refined for bowel surgery, intracorporeal anastomosis and more extensive bowel resections will be feasible. Currently laparoscopic bowel surgery can be done in select circumstances for problems associated with IBD. It has yet to be proven if doing the surgery laparoscopically provides advantages for bowel surgery as has been demonstrated with gallbladder surgery. Prospective studies are underway to answer these questions.
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Cakmak, Yusuf, Duygu Kavak Comert, Isik Sozen und Tufan Oge. „Comparison of Laparoscopy and Laparotomy in Early-Stage Endometrial Cancer: Early Experiences from a Developing Country“. Journal of Oncology 2020 (30.04.2020): 1–5. http://dx.doi.org/10.1155/2020/2157520.
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After minimally invasive surgery gained popularity in gynecology, laparoscopic operations became widespread among oncologic operations. However, more studies evaluating experiences of oncologic surgeons during the learning period of laparoscopy are needed. To compare the surgical outcomes and perioperative complications of laparoscopic surgery and laparotomy in the treatment of early-stage endometrioid endometrial cancer patients, we retrospectively investigated patients who underwent surgery due to endometrial cancer at our institution between 2014 and 2018. Early-stage (stage I) endometrioid endometrial cancer patients were included in the study. Operative times, length of hospital stay, extracted pelvic lymph nodes, perioperative complications, and blood loss were compared. A total of 128 patients were treated for stage I endometrial cancer during the study period. Sixty-two patients (48.4%) underwent laparoscopic surgery, and 66 (51.6%) patients underwent laparotomy. Median operation time and pelvic lymph node count in the laparotomy and laparoscopy groups did not demonstrate statistically significant differences. However, the length of hospital stay, estimated blood loss, and perioperative complication rate were lower in the laparoscopic surgery group. Laparoscopic surgery in early-stage endometrial cancer may be performed with less blood loss, shorter duration of hospital stays, and similar lymph node counts compared to laparotomic surgery.
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Rehman Abbasi, Mujeeb, Muhammad Qasim Mallah, Muhammad Rafique Pathan, Sadaf Iqbal und Ubedullah Shaikh. „Frequency of umbilicus site port hernia after laparoscopic procedure.“ Professional Medical Journal 26, Nr. 08 (10.08.2019): 1238–41. http://dx.doi.org/10.29309/tpmj/2019.26.08.3301.
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The objective of this study is to determine the frequency of umbilicus port site hernia after laparoscopic procedure. Study Design: Prospective study. Setting: Minimal Invasive Surgical Centre and General Surgery Department LUMHS Jamshoro. Period: March 2015 to February 2017. Materials and Methods: During these two years all the patients visiting surgery department for laparoscopic Procedure. All patients regardless of age and both were undergo base line investigation and preoperative anesthetics fitness done were included. We identified 539 cases that matched our inclusion criteria. 10mm trocar was used for umbilical side and closed with J shaped vicryl #1. After surgery, these patients were followed-up for two years and assessed regularly for complications. Results: In our setup, laparoscopic procedures were performed in 539 patients. There were 83.48% (n=450) females and 16.51% (n=89) males who had laparoscopic procedures done. Among these, there were 442 cholecystectomies, 43 appendicectomies and 54 diagnostic laparoscopies. The highest number of patients visiting for laparoscopic cholecystectomies belong to the age range of 31-40 years. In 82% of the cases laparoscopic cholecystectomy was performed while in other cases laparoscopic appendicectomy and diagnostic laparoscopy was performed. After long term follow-up of these patients for a time period of two years, port site hernia was reported in 1.48% (n=8) patients. Conclusion: Port site hernia is a troublesome complication of laparoscopic procedures, although has much lesser rate than conventional procedures. Factors predisposing to development of port site hernia needs to be identified in all patients and steps should be taken to avoid complications. Large size and bladed trocars should not be used, and fascia closure is recommended at umbilical insertion site.
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Ammari, Smail. „Study of Risk Factors for Morbidity in Emergency Abdominal Laparoscopy Surgery“. International Journal of Surgery & Surgical Techniques 8, Nr. 1 (2024): 1–5. http://dx.doi.org/10.23880/ijsst-16000212.
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Introduction: Emergency laparoscopy is regarded as a challenging and high-risk domain due to the requisite expertise in both laparoscopic and emergency surgery. Additionally, the physical fatigue of surgical teams and the urgency context contribute to potential increased morbidity rates in emergency surgery. Furthermore, a primary concern with laparoscopy is the frequency of deep collections. The objective of our study was to evaluate the risk factors for morbi-mortality associated with laparoscopic intervention in non-traumatic acute abdominal emergencies. Materials and Methods: A descriptive, prospective, evaluative study was conducted between February 2018 and October 2021, encompassing 337 patients undergoing laparoscopic surgery for non-traumatic acute abdominal emergencies. Results: Among the 337 operated patients, perioperative morbidity was 0.3%, and postoperative morbidity was 6.2% (21 patients). These postoperative complications were classified as grade I in 85.71% of cases (18 patients). The mean age of the patients was 38 years ± 15 years. Body mass index (BMI) was above 25 in 179 patients (53.11%). The mean operative time across all pathologies was 52.09 minutes ± 24.14 minutes (Range: 14-178 minutes). The average overall hospitalization duration was 1.5 days (Range: 1 to 8.5 days).The only factor correlated with the occurrence of postoperative complications was obesity (p=0.003). Conclusion: Emergency laparoscopy does not exacerbate morbidity and can be safely performed for the management of acute abdominal emergencies.
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Levy, BF, J. De Guara, PD Willson, Y. Soon, A. Kent und TA Rockall. „Bladder injuries in emergency/expedited laparoscopic surgery in the absence of previous surgery: a case series“. Annals of The Royal College of Surgeons of England 94, Nr. 3 (April 2012): e118-e120. http://dx.doi.org/10.1308/003588412x13171221502149.
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INTRODUCTION The use of laparoscopy as a diagnostic and therapeutic tool is being used increasingly in the emergency setting with many of these procedures being performed by trainees. While the incidence of iatrogenic injuries is reported to be low, we present six emergency or expedited cases in which the bladder was perforated by the suprapubic trocar. CASES Three cases were related to the management of appendicitis, two to negative diagnostic laparoscopies for lower abdominal pain and one to an ectopic pregnancy. Management of the bladder injuries varied from a urinary catheter alone to laparotomy with debridement of the abdominal wall due to sepsis and later reconstruction. Four of the six cases were performed by registrars. CONCLUSIONS Although the incidence of bladder injury is low, its importance is highlighted by the large number of laparoscopies being performed. In addition to catheterisation of the patient, care must be taken with the insertion of low suprapubic ports and consideration should be made regarding alternative sites. Adequate laparoscopic supervision and training in port site planning is required for surgical trainees.
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Figurelli, Justine, Lucie Bresson, Fabrice Narducci, Ninad Katdare, Pascale Coulon, Charles Fournier und Eric Leblanc. „Single-Port Access Laparoscopic Surgery in Gynecologic Oncology: Outcomes and Feasibility“. International Journal of Gynecologic Cancer 24, Nr. 6 (Juli 2014): 1126–32. http://dx.doi.org/10.1097/igc.0000000000000150.
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ObjectivesSingle-port access laparoscopic surgery (SPALS) is supposed to simplify and improve the outcomes of current multiport laparoscopic procedures. This retrospective study was performed to assess the actual outcomes of SPALS in 2 simple gynecological oncology procedures, namely, diagnostic laparoscopy and bilateral adnexectomy.MethodsWe conducted a retrospective monocentric study. Case files of only those women who underwent bilateral adnexectomies and diagnostic and/or staging laparoscopy were studied with respect to the operative room time, intraoperative and postoperative complications, postoperative pain, and lengths of hospital stays. The main objective was to assess the feasibility and utility of SPALS surgery in gynecology. The secondary objective was to compare this group with a cohort of patients with multiport conventional laparoscopic surgery (MPCLS) performed during the same period.ResultsFrom December 2009 to March 2013, there were 134 patients who underwent these 2 procedures. Eighty adnexectomies were performed, 41 by SPALS and 39 by MPCLS. Fifty-four diagnostic laparoscopies were performed, with 27 patients in each group. In the group of adnexectomies, operative time was significantly lower in SPALS compared with MPCLS (36 vs 59 minutes, P < 10−4) and also compared with the postoperative stay (1 vs 2.2 nights, P < 10−4). By contrast, no significant difference was observed between the 2 methods of access in all the parameters studied in the group of diagnostic laparoscopies.ConclusionsOur experience demonstrates that SPALS is feasible and safe for simple gynecological procedures. This approach may result in a smooth postoperative course and shorter hospital stay and can thus be promoted to a day care procedure.
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Dawkins, Bryony, Noel Aruparayil, Tim Ensor, Jesudian Gnanaraj, Julia Brown, David Jayne und Bethany Shinkins. „Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India“. PLOS ONE 17, Nr. 8 (03.08.2022): e0271559. http://dx.doi.org/10.1371/journal.pone.0271559.
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Laparoscopic surgery, a minimally invasive technique to treat abdominal conditions, has been shown to produce equivalent safety and efficacy with quicker return to normal function compared to open surgery. As such, it is widely accepted as a cost-effective alternative to open surgery for many abdominal conditions. However, access to laparoscopic surgery in rural North-East India is limited, in part due to limited equipment, unreliable supplies of CO2 gas, lack of surgical expertise and a shortage of anaesthetists. We evaluate the cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery (MIS) for abdominal conditions in rural North-East India. A decision tree model was developed to compare costs, evaluated from a patient perspective, and health outcomes, disability adjusted life years (DALYs), associated with gasless laparoscopy, conventional laparoscopy or open abdominal surgery in rural North-East India. Results indicate that MIS (performed by conventional or gasless laparoscopy) is less costly and produces better outcomes, fewer DALYs, than open surgery. These results were consistent even when gasless laparoscopy was analysed using least favourable data from the literature. Scaling up provision of MIS through increased access to gasless laparoscopy would reduce the cost burden to patients and increase DALYs averted. Based on a sample of 12 facilities in the North-East region, if scale up was achieved so that all essential surgeries amenable to laparoscopic surgery were performed as such (using conventional or gasless laparoscopy), 64% of DALYS related to these surgeries could be averted, equating to an additional 454.8 DALYs averted in these facilities alone. The results indicate that gasless laparoscopy is likely to be a cost-effective alternative to open surgery for abdominal conditions in rural North-East India and provides a possible bridge to the adoption of full laparoscopic services.
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Healy, NA, KH Chang, JB Conneely, C. Malone und MJ Kerin. „Impact of SupervIsed TraInIng on the AcquIsItIon of SImulated LaparoscopIc SkIlls“. Bulletin of the Royal College of Surgeons of England 95, Nr. 6 (01.06.2013): 1–6. http://dx.doi.org/10.1308/003588413x13643054410340.
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Laparoscopy or minimally invasive surgery requires surgeons to attain proficiency in skills that are fundamentally different to those required for open surgery. As a result, it both challenges junior trainees and surgeons who are experienced in open surgery. Not surprisingly, the initial learning phase of laparoscopy has been associated with an increased incidence of serious complications. Owing to time constraints and the ethical and safety considerations of allowing novices to perform laparoscopic surgery on patients, alternative methods have been sought to train junior surgeons on the basics of laparoscopic surgery.
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Chern, Yih-Jong, Jeng-Fu You, Ching-Chung Cheng, Jing-Rong Jhuang, Chien-Yuh Yeh, Pao-Shiu Hsieh, Wen-Sy Tsai, Chun-Kai Liao und Yu-Jen Hsu. „Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study“. Cancers 14, Nr. 1 (28.12.2021): 131. http://dx.doi.org/10.3390/cancers14010131.
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Advanced age is a risk factor for major abdominal surgery due to a decline in physical function and increased comorbidities. Although laparoscopic surgery provides good results in most patients with colorectal cancer (CRC), its effect on elderly patients remains unclear. This study aimed to compare the short- and long-term outcomes between open and laparoscopic surgeries in elderly patients with CRC. Total 1350 patients aged ≥75 years who underwent curative resection for stage I–III primary CRC were enrolled retrospectively and were divided into open surgery (846 patients) and laparoscopy (504 patients) groups. After propensity score weighting to balance an uneven distribution, a competing risk analysis was used to analyze the short-term and long-term outcomes. Postoperative mortality rates were lower in the laparoscopy group, especially due to pulmonary complications. Postoperative hospital stay was significantly shorter in the laparoscopy group than in the open surgery group. Overall survival, disease-free survival, and competing risk analysis showed no significant differences between the two groups. Laparoscopic surgery for elderly patients with CRC significantly decreased pulmonary-related postoperative morbidity and mortality in this large cohort study. Laparoscopic surgery is a favorable method for elderly patients with CRC than open surgery in terms of less hospital stay and similar oncological outcomes.
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Ghimire, Asmita, Padam Raj Pant, Nilam Subedi und Samriddha Raj Pant. „Trends of laparoscopic gynecologic surgeries in a tertiary care center: A five-year retrospective study“. Grande Medical Journal 1, Nr. 1 (03.01.2019): 26–30. http://dx.doi.org/10.3126/gmj.v1i1.22402.
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Background: The use of laparoscopic surgery in modern gynecology has led to faster recovery, lesser hospital stay, and fewer complications. In this study, we aim to analyze the current trends in laparoscopic surgery, its indications, type of procedure and associated complications.
Method: This is a retrospective study done in Grande International Hospital. All patients who underwent laparoscopic surgery over a duration of 5 years from July 2013 to June 2018 were analyzed.
Result: There were a total of 419 laparoscopic surgeries (74 diagnostic, 345 therapeutic) performed. The most common age group of patients for diagnostic laparoscopy was 25-34 years and for therapeutic was 45-54 years. Therapeutic surgery was mostly performed for ovarian cyst (144, 41.74%). There were a total of 152 (44.06%) laparoscopic hysterectomies performed. Complications which occurred during the surgery were insignificant (p<0.01).
Conclusion: Laparoscopic surgery has become the most common procedure for gynecological procedures over the years.
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Savelieva, G. M., S. V. Shtyrov, Y. А. Golova, R. S. Karapetyan und О. Y. Pivovarova. „External endometriosis, effectiveness of laparoscopic surgery“. Journal of obstetrics and women's diseases 51, Nr. 3 (27.12.2021): 32–34. http://dx.doi.org/10.17816/jowd91086.
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In this article, the analysis of laparoscopic curing 64 patients with external endometriosis is presented. For the assessment of internal genitalia state in the late after-operational period in 41 female patients one performed second-look laparoscopy when that disease recidivating has been revealed in 36% observations. It was marked that the anti-recidive therapy in the after-operational period allows decrease the recidivating quantity from 46.8% (intervention only) upto 25% (combined cure).
The authors elaborated and formulated indications for performing second- look laparoscopy in female patients with endometriosis.
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Jamal, Mohammad H., Abdulazeez Karam, Nourah Alsharqawi, Abdulla Buhamra, Ibtesam AlBader, Jasem Al-Abbad, Mohammad Dashti, Yaser B. Abulhasan, Husain Almahmeed und Salman AlSabah. „Laparoscopy in Acute Care Surgery: Repair of Perforated Duodenal Ulcer“. Medical Principles and Practice 28, Nr. 5 (2019): 442–48. http://dx.doi.org/10.1159/000500107.
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Introduction: The use of laparoscopic management as a first choice for the treatment of duodenal perforation is gaining ground but is not routine in many centers. In this report, we aim to report our experience with laparoscopy as the first approach for the repair of duodenal perforation. Materials and Methods: This is a retrospective review of patients during our initial experience with the use of laparoscopy for the treatment of duodenal perforation between 2009 and 2013. Results: A total of 100 patients underwent management of duodenal perforation. Laparoscopy was attempted initially in 76 patients (76%) and completed in 64 patients (64%). The length of hospital stay was shorter in the laparoscopic group (mean 2.6) than in the open group (mean 3.1) (p = 0.008). Complications developed in 14 patients (20%). There was a tendency towards fewer admissions to intensive care, less acute kidney injuries, and less acute respiratory distress syndrome in the laparoscopic group. In patients who underwent laparoscopic surgery, the chances of uneventful recovery were 4.3 times higher than in those patients who underwent open surgery (95% CI 1.3–13.5, p = 0.014). Conclusions: Laparoscopy in the treatment of perforated duodenal ulcer is safe and can be utilized as a routine approach for the treatment of this pathology.
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Milosavljevic, Vladimir, Nikola Grubor, Boris Tadic, Djordje Knezevic, Andja M. Cirkovic, Vesna Milicic, Masa Znidarsic und Slavko Matic. „Laparoscopic Splenectomy in the Treatment of Hematological Diseases of the Spleen“. Serbian Journal of Experimental and Clinical Research 20, Nr. 3 (01.09.2019): 239–44. http://dx.doi.org/10.1515/sjecr-2017-0047.
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Abstract Methods of surgical treatment of hematological diseases of the spleen have changed significantly in the past decade. The introduction of laparoscopic and minimally invasiveprocedures as standard for solving a significant number of conditions in abdominal surgery, has led surgeons toincreasingly use laparoscopic surgery of the spleen. However, some unique anatomical characteristics of the spleen can lead to limitation in the application of laparoscopy. In this study, we investigated the application of laparoscopic splenectomy in the treatment of haematological disorders of the spleen, intraoperative and postoperative characteristics, the presentation ofoperational technique and the evaluation of the success of this procedure. In the treatment of benign hematological diseases, the effectiveness and efficiency of laparoscopy has been proven. The speculation of medical professionals is that laparoscopic splenectomy is an equal, if not the superior way of treating benign hematological diseases of the spleen in relation to the open procedure, and that there is a chance that laparoscopy might completely replace the classical surgery in most of it’s indications.
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Prasad, Bipin Thomas, und Jolly Jacob. „A Systemic Review on Single-Port and Multiport Laparoscopic Hernioplasty“. Global Journal of Health Science 10, Nr. 7 (11.06.2018): 166. http://dx.doi.org/10.5539/gjhs.v10n7p166.
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Herniorrhaphy or Hernioplasty is the surgical treatment for hernia. This surgical procedure is mainly done using local or general anesthesia with laparoscope or conventional incision. Laparoscopic hernioplasty is the best suited laparoscopic technique for almost all the abdominal hernias. This technique has gained its approval in recent treatment and is being widely used. Despite the fact that it is for the most part of safe operation, postoperative complications are found to be less. The recovery time after the surgery is found to be 1 to 2 weeks. Single port laparoscopy is the marginally invasive surgical process where the surgery takes place by a single entry point mainly the umbilicus. This single port technique leaves only a single scar. Multiport laparoscopic technique is the traditional technique where it uses many entry points for operation. Thus the single port laparoscopic technique consists of many advantages like faster recovery time, less blood loss, less post-operative pain etc. This study systematically reviewed the existing literatures for comparing the single site over the multiport hernia repair. The outcomes like hospital stay, operative time, complications and blood loss are reviewed. The remedial advantages in the general management of hernia are reviewed in detail. This review concludes that the single port laparoscopic hernioplasty is the most advantaged technique than the multiport.
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Spinelli, Antonino, Matteo Sacchi, Piero Bazzi, Nicoletta Leone, Silvio Danese und Marco Montorsi. „Laparoscopic Surgery for Recurrent Crohn's Disease“. Gastroenterology Research and Practice 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/381017.
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In spite of the recent improvements in drug therapy, surgery still represents the most frequent treatment for Crohn's disease (CD) complications. Laparoscopy has been widely applied over the last twenty years in colorectal surgery and was associated with lower postoperative pain, shorter hospitalization, faster return to daily activities, and better cosmetic results. Laparoscopy experienced a slower diffusion in inflammatory bowel disease surgery than in oncologic colorectal surgery, but proved to be safe and effective, and is currently considered the gold standard for the treatment of primary uncomplicated ileocolic CD. Indications for laparoscopy in CD have recently been widened to embrace more complicated or recurrent CD. This paper reviews the available data on the subset of recurrent CD patients. The reported results indicate that laparoscopy may be safely applied even in selected recurrent CD cases in hands of IBD surgeons with broad laparoscopic experience.
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Völkel, Vinzenz, Teresa Draeger, Michael Gerken, Monika Klinkhammer-Schalke, Stefan Benz und Alois Fürst. „Laparoscopic surgery for colon cancer“. coloproctology 42, Nr. 5 (10.09.2020): 413–20. http://dx.doi.org/10.1007/s00053-020-00481-6.
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Abstract Background To evaluate a new procedure in daily clinical practice, it might not be sufficient to rely exclusively on the findings of randomized clinical trials (RCTs). This is the first systematic review providing a synthesis of the most important RCTs and relevant retrospective cohort studies on short- and long-term outcomes of laparoscopic surgery in colon cancer patients. Materials and methods In a literature search, more than 1800 relevant publications on the topic were identified. Relevant RCTs and representative high-quality retrospective studies were selected based on the widely accepted Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Finally, 9 RCTs and 14 retrospective cohort studies were included. Results Laparoscopic surgery for colon cancer is associated with a slightly longer duration of surgery, but a variety of studies show an association with a lower rate of postoperative complications and a shorter duration of hospital stay. Particularly in older patients with more frequent comorbidities, laparoscopy seems to contribute to decreasing postoperative mortality. Concerning long-term oncologic outcomes, the laparoscopic and open techniques were shown to be at least equivalent. Conclusion The findings of the existing relevant RCTs on laparoscopic surgery for colon cancer are mostly confirmed by representative retrospective cohort studies based on real-world data; therefore, its further implementation into clinical practice can be recommended.
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Case, J. Brad, Pedro L. Boscan, Eric L. Monnet, Sirirat R. Niyom, Darren J. Imhoff, Mandy L. Wallace und Dan D. Smeak. „Comparison of Surgical Variables and Pain in Cats Undergoing Ovariohysterectomy, Laparoscopic-Assisted Ovariohysterectomy, and Laparoscopic Ovariectomy“. Journal of the American Animal Hospital Association 51, Nr. 1 (01.01.2015): 1–7. http://dx.doi.org/10.5326/jaaha-ms-5886.
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Laparoscopy is an established modality in veterinary medicine. To date, laparoscopy in feline surgery is rarely reported. The objectives of this study were to compare surgical time, complications, and postoperative pain in a group of cats undergoing laparoscopic ovariectomy (LOVE), laparoscopic-assisted ovariohysterectomy (LAOVH), and ovariohysterectomy via celiotomy (COVH). Eighteen healthy cats were randomly assigned to undergo LOVE, LAOVH, or COVH. Severity of pain was monitored 1, 2, 3, and 4 hr after surgery. Surgical time was significantly longer for LAOVH (mean ± standard deviation [SD], 51.6 ± 7.7 min) compared to COVH (mean ± SD, 21.0 ± 7.1 min) and LOVE (mean ± SD, 34.2 ± 11.2 min). There were no major intraoperative complications, although minor complications were more common in both laparoscopic groups. Cats sterilized via laparoscopy (LOVE and LAOVH) were statistically less painful than cats spayed via celiotomy (COVH) 4 hr following surgery. Results suggested that LOVE in cats is safe, can be performed in a comparable amount of time as COVH, and may result in less postoperative discomfort.