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Santarelli, Stefano, Matthias Zeiler, Tania Monteburini, Rosa Maria Agostinelli, Rita Marinelli, Giorgio Degano e Emilio Ceraudo. "Videolaparoscopic Catheter Placement Reduces Contraindications to Peritoneal Dialysis". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 33, n. 4 (luglio 2013): 372–78. http://dx.doi.org/10.3747/pdi.2011.00314.
Testo completoAbstract (sommario):
BackgroundVideolaparoscopy is considered the reference method for peritoneal catheter placement in patients with previous abdominal surgery. The placement procedure is usually performed with at least two access sites: one for the catheter and the second for the laparoscope. Here, we describe a new one-port laparoscopic procedure that uses only one abdominal access site in patients not eligible for laparotomic catheter placement.MethodWe carried out one-port laparoscopic placement in 21 patients presenting contraindications to blind surgical procedures because of prior abdominal surgery. This technique consists in the creation of a single mini-laparotomy access through which laparoscopic procedures and placement are performed. The catheter, rectified by an introducer, is inserted inside the port. Subsequently, the port is removed, leaving the catheter in pelvic position. The port is reintroduced laterally to the catheter, confirming or correcting its position. Laparotomic placement was performed in a contemporary group of 32 patients without contraindications to blind placement. Complications and long-term catheter outcome in the two groups were evaluated.ResultsAdditional interventions during placement were necessary in 12 patients of the laparoscopy group compared with 5 patients of the laparotomy group ( p = 0.002). Laparoscopy documented adhesions in 13 patients, with need for adhesiolysis in 6 patients. Each group had 1 intra-operative complication: leakage in the laparoscopy group, and intestinal perforation in the laparotomy group. During the 2-year follow-up period, laparoscopic revisions had to be performed in 6 patients of the laparoscopy group and in 5 patients of the laparotomy group ( p = 0.26). The 1-year catheter survival was similar in both groups. Laparoscopy increased by 40% the number of patients eligible to receive peritoneal dialysis.ConclusionsVideolaparoscopy placement in patients not eligible for blind surgical procedures seems to be equivalent to laparotomic placement with regard to complications and long-term catheter outcome. The number of patients able to receive peritoneal dialysis is substantially increased.
2
Malik, Ajaz A. "DIAGNOSTIC LAPAROSCOPY: Utility and solving diagnostic dilemmas". JMS SKIMS 21, n. 2 (1 gennaio 2019): 70–71. http://dx.doi.org/10.33883/jms.v21i2.368.
Testo completoAbstract (sommario):
Diagnostic laparoscopy is the basic procedure in laparoscopic surgery that has wide utility in practice, thus avoiding morbidity associated with open surgery. Laparoscopy is a minimally invasive technique wherein a fibre optic instrument is inserted through the abdominal wall to view the organs in abdomen/pelvis and permit the diagnosis and necessary surgical procedure. Nowadays, almost all general surgical procedures can be performed using minimal invasive techniques. Laparoscopy can be performed both for diagnostic as well as for therapeutic purposes. JMS 2018: 21 (2):70-71
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Hossain, Tahmina, e Md Ashraf Ul Huq. "Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital". Journal of Paediatric Surgeons of Bangladesh 4, n. 1 (30 giugno 2015): 11–18. http://dx.doi.org/10.3329/jpsb.v4i1.23929.
Testo completoAbstract (sommario):
Purpose: Laparoscopy is gaining popularity over laparotomy in various surgical conditions. Now a day, an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically. The aim of this study was to assess the safety and feasibility of laparoscopy in children.Materials and Methods: This retrospective study was carried out in the Department of Pediatric Surgery of Dhaka Medical College Hospital over a period of 52 (Fifty two) months from June 2009 to August 2013. A total of 123 patients were operated laparoscopically up to 12 years of age for different surgical conditions. Data was collected from the hospital records and analyzed retrospectively.Results: Out of these 123 laparoscopically performed cases, Appendectomy was performed in 39 cases, closure of internal inguinal ring for Inguinal Hernia was done in 36 patients, 20 patients underwent Cholecystctomy, 16 patients had laparoscopic procedures for impalpable Undescended Testis (UDT), 5 patients were operated for Adnexal Mass of which one case was converted into open procedure due to technical difficulties and 1 for Pancreatic Pseudo cyst. Diagnostic Laparoscopy was performed for 2 patients with Biliary Atresia and 4 patients for Ambiguous Genitalia. Median age of the patients was 6.08 years (ranging from 2 months to 12 years of age). The length of post operative hospital stay was 2-3 days. All the laparoscopic procedures for Inguinal Hernia and impalpable UDT were performed as day care surgery. Operative and post operative complications were minimal. Other advantages of the laparoscopic procedures were smaller incisions, incidental diagnosis of other associated pathology, lesser post operative pain, earlier oral feeding, quicker mobilization and a better cosmetic result.Conclusion: With the recent development of laparoscopic surgical techniques and equipments, laparoscopic surgical procedures are becoming popular day by day and can be performed safely for both diagnostic and therapeutic purposes in pediatric surgical patients.J. Paediatr. Surg. Bangladesh 4(1): 11-18, 2013 (January)
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Trombetta, C., G. Liguori, G. Savoca, S. Siracusano e E. Belgrano. "Urological laparoscopy: Some unusual applications". Urologia Journal 63, n. 1_suppl (gennaio 1996): 124–28. http://dx.doi.org/10.1177/039156039606301s31.
Testo completoAbstract (sommario):
Since its introduction in 1991 laparoscopy has gained a strong foothold in Urology and during the last 5 years laparoscopic technology has been applied to many urological procedures. Today, better skills in laparoscopic techniques and availability of laparoscopic instruments in urological operating theatres, make these procedures suitable for a large number of surgical purposes, some even unusual. Laparoscopy appears to be an increasingly valid alternative to traditional surgery, being minimally invasive, safe and effective. Availability of proper technological devices and experience in laparoscopic techniques allow a considerable reduction in post-operative pain, hospitalization and recovery times.
5
Paw, Patrick, e Jonathan M. Sackier. "Complications of Laparoscopy and Thoracoscopy". Journal of Intensive Care Medicine 9, n. 6 (novembre 1994): 290–304. http://dx.doi.org/10.1177/088506669400900604.
Testo completoAbstract (sommario):
Laparoscopy was first performed at the turn of the century, but it was not until the introduction of laparoscopic cholecystectomy that the procedure became widely adopted by general surgeons. Since then, traditional open procedures, including cholecystectomy, exploratory laparotomy, colectomy, hernia repair, and appendectomy, are being widely performed laparoscopically. The advantages of laparoscopic surgery, including less postoperative pain due to smaller surgical incisions, shorter hospital stay, quicker return to preoperative activity, and superior cosmesis, resulted in widespread popularity with both surgeons and patients. In certain situations, the traditional method may be superior to the laparoscopic approach, as may be the case with laparoscopic hernia repair. It is difficult to justify converting a local, extraperitoneal, 45-minute, outpatient inguinal hernia repair in a virgin groin into a general anesthetic, transperitoneal, 2-hour plus, possibly inpatient laparoscopic procedure with the implantation of mesh. However, data may indicate that this operation does indeed have benefits. We must, therefore, carefully study such new operations. With the advent of a new surgical procedure, both surgeons and anesthesiologists must be familiar with the various complications unique to this technique. If recognized early, potentially life-threatening complications, including gas embolization and tension pneumothorax, can be corrected.
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Burgmeier, Christine, e Felix Schier. "The Role of Laparoscopy in the Acute Neonatal Abdomen". Surgical Innovation 23, n. 6 (9 luglio 2016): 635–39. http://dx.doi.org/10.1177/1553350616646476.
Testo completoAbstract (sommario):
Introduction.The surgical treatment of the acute neonatal abdomen still poses a challenge in pediatric surgery. Various underlying etiologies require different surgical procedures. Until today the role of laparoscopy in the surgical treatment of the acute neonatal abdomen is controversial. The aim of this study was to analyze our experiences with laparoscopy and to perform a review of the literature. Methods. Retrospective, single-institution study including all term and preterm neonates initially undergoing laparoscopy due to an acute abdomen. Results. Altogether, 17 neonates presenting with an acute neonatal abdomen initially underwent laparoscopy. Unnecessary laparotomy could be avoided in 9 of 17 (53%) neonates. After diagnostic laparoscopy, 2 patients did not require any further surgical intervention. Eight neonates presented midgut atresia intraoperatively, 5 of them underwent laparoscopic-assisted correction. Successful laparoscopic derotation of an acute volvulus (n = 1) and laparoscopic appendectomy (n = 1) could be performed. Conversion to open surgery was necessary in 8 neonates (47%) due to creation of a stoma (n = 5), multiple intestinal bands causing poor visualization (n = 2), and bowel necrosis (n = 1). Conclusions. Laparoscopy is a useful diagnostic tool to evaluate the need for further surgical intervention in the acute neonatal abdomen and enables immediate surgical treatment of acute volvulus, appendicitis, or intestinal atresia. In case of conversion to laparotomy, precise localization of the incision is guaranteed. Minimization of the surgical trauma and avoidance of unnecessary laparotomy are the most important benefits of the minimal-invasive approach for the critically ill neonate.
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Bergström, Bo S. "Lift-Assisted Laparoscopy in Hysterectomy: A Retrospective Study of 32 Consecutive Cases". ISRN Minimally Invasive Surgery 2013 (7 ottobre 2013): 1–4. http://dx.doi.org/10.1155/2013/989727.
Testo completoAbstract (sommario):
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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Jernigan, Amelia M., Melinda Auer, Amanda N. Fader e Pedro F. Escobar. "Minimally Invasive Surgery in Gynecologic Oncology: A Review of Modalities and the Literature". Women's Health 8, n. 3 (maggio 2012): 239–50. http://dx.doi.org/10.2217/whe.12.13.
Testo completoAbstract (sommario):
Minimally invasive surgery is one of the newest and most exciting areas of development in procedural medicine. This field shows tremendous potential to increase therapeutic benefit while minimizing some of the painful or dangerous side effects of surgical interventions. Minimally invasive surgery has strong historic ties to the field of gynecology and has come a long way as technology and techniques have improved. This has increasingly allowed the application of laparoscopy to more complex procedures and the treatment of gynecologic malignancies. Three laparoscopic approaches, traditional laparoscopy, robotic assisted laparoscopy and laparoendoscopic single-site surgery are reviewed here. We discuss the basic approaches to these three laparoscopic techniques, and then review their applications in gynecologic oncology. We also touch on the evidence behind outcomes associated with their use.
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Conrad, Lesley B., Pedro T. Ramirez, William Burke, R. Wendel Naumann, Kari L. Ring, Mark F. Munsell e Michael Frumovitz. "Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology". International Journal of Gynecologic Cancer 25, n. 6 (luglio 2015): 1121–27. http://dx.doi.org/10.1097/igc.0000000000000450.
Testo completoAbstract (sommario):
ObjectivesTo evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.MethodsThe Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.ResultsFour hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.ConclusionsSince our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.
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Jahan, Samsad, Tripti Rani Das, Samira Humaira Habib, Akter Jahan, Mahjabin Joarder, Nurun Nahar e Manisha Banarjee. "A Comparative Study Between Laparoscopic Management of Ectopic Pregnancy and Laparotomy: Experience in Tertiary Care Hospital in Bangladesh: A Prospective Trial". Bangladesh Journal of Endosurgery 2, n. 1 (18 luglio 2014): 1–4. http://dx.doi.org/10.3329/bje.v2i1.19570.
Testo completoAbstract (sommario):
Objectives: To compare the efficiency and surgical morbidity associated with laparoscopic management of tubal ectopic pregnancy (EP) compared with that of open laparotomy. Materials and methods: During November 2008 to October 2012, there were 89 with a confirmed ectopic pregnancy These patients were admitted through emergency or outpatient department and managed by laparoscopy (number 70) and by laparotomy (number 19). The diagnosis of ectopic pregnancy was based on history, clinical symptoms, physical examination, a positive serum B-human chorionic gonadotropin (B-HCG), transvaginal ultrasonography. Patients were informed pre-operatively about the surgical procedures. The main outcome measured included operative time, blood loss, and complications.Results: Laparoscopic surgery gives an overall success rate of 98.9%. Linear salpingostomy was the main procedure performed in both groups. Estimated blood loss was significantly lower in the laparoscopy group compared with laparotomy group (p<0.001). Only 3 (3.81%) patients in the laparoscopy group required blood transfusion, whereas 16 (74.94%) in the laparotomy group needed transfusion (P<0.0001). The duration of operation in laparoscopy group was 53.2 ± 16.8 minutes and 84.5 ± 30.3 minutes in the laparotomy group. The duration of hospitalization was significantly shorter in the laparoscopy group 1.12±0.5 days compared to 5.25±0.1days in the laparotomy group (p<0.0001). ). In the laparoscopy group 57(72.4%) patients did not need analgesia after surgery compared with laparotomy group where all the patients needed analgesia.Conclusion: Laparoscopic treatment (Salpingostomy or Salpingectomy) of EPs offers major benefits superior to laparotomy in terms of less blood loss, less need for blood transfusion and postoperative analgesia, a shorter duration of hospital stay. Laparoscopic management of ectopic pregnancy might be the most beneficial procedure with maximal safety and efficacy.
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Aljahdali, Ettedal A. "The Role of Laparoscopy in Management of Congenital Anomalies of the Müllerian System: Literature Review and Case Series". Journal of King Abdulaziz University - Medical Sciences 22, n. 2 (1 aprile 2015): 39–46. http://dx.doi.org/10.4197/med.22-2.6.
Testo completoAbstract (sommario):
Structural defects of the female reproductive tract become apparent at varying chronologic times during intrauterine life. The diagnosis of all female reproductive tract abnormalities has benefited from enhancements in imaging techniques and the surgical treatment thereof has improved due to advances in the techniques and instrumentation of both surgical and non-surgical procedures. In the last decade, laparoscopy has become increasingly popular and has successfully replaced several open surgical procedures. It has been applied to many aspects of gynecological surgery and has become the procedure of choice for gynecological surgery. A review of the recent literature continues to support the utilization of laparoscopy for the management of genital tract malformation. This review aims to appraise the recent literature to determine how laparoscopy may aid in the diagnosis of reproductive tract anomalies and their treatment, its success in replacing the open surgery in some cases, and the presentation of some cases that were successfully diagnosed and treated with laparoscopy.
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Castilho, Lísias Nogueira, Anuar Ibrahim Mitre, Flávio Haruyo Iizuka, Oscar Eduardo Hidetoshi Fugita, José Roberto Colombo Jr. e Sami Arap. "Laparoscopic treatment of retroperitoneal fibrosis: report of two cases and review of the literature". Revista do Hospital das Clínicas 55, n. 2 (aprile 2000): 69–76. http://dx.doi.org/10.1590/s0041-87812000000200007.
Testo completoAbstract (sommario):
OBJECTIVES: We present the results of treatment by laparoscopy of two patients with retroperitoneal fibrosis and review the literature since 1992, when the first case of this disease that was treated using laparoscopy was published. We also discuss the contemporary alternatives of clinical treatment with corticosteroids and tamoxifen. CASE REPORT: Two female patients, one with idiopathic retroperitoneal fibrosis, and other with retroperitoneal fibrosis associated with Riedel's thyroiditis, were treated using laparoscopic surgery. Both cases had bilateral pelvic ureteral obstruction and were treated using the same technique: transperitoneal laparoscopy, medial mobilization of both colons, liberation of both ureters from the fibrosis, and intraperitonealisation of the ureters. Double-J catheters were inserted before the operations and removed 3 weeks after the procedures. The first patient underwent intraperitonealisation of both ureters in a single procedure. The other had 2 different surgical procedures because of technical difficulties during the first operation. Both patients were followed for more than 1 year and recovered completely from the renal insufficiency. One of them still has occasional vague lumbar pain. There were no abnormalities in the intravenous pyelography in either case. CONCLUSIONS: Surgical correction of retroperitoneal fibrosis, when indicated, should be attempted using laparoscopy. If possible, bilateral ureterolysis and intraperitonealisation of both ureters should be performed in the same operation.
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Levakov, S. A., A. G. Kedrova e N. S. Wanke. "MODERN TRENDS TO LAPAROSCOPIC SURGERY IN GYNECOLOGY". Journal of Clinical Practice 1, n. 3 (15 settembre 2010): 98–102. http://dx.doi.org/10.17816/clinpract1398-102.
Testo completoAbstract (sommario):
Gynecologic laparoscopy has evolved from a limited surgical procedure used only for diagnosis and tubal ligations to a major surgical tool used to treat a multitude of gynecologic indications. Today, laparoscopy is one of the most common surgical procedures performed by gynecologists. The review presents the main trends of development of modern surgery in gynecology with the author's personal views on the key contentious issues of endoscopic sinus surgery.
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Melmer, Patrick D., Christen Chaconas, Ryan Taylor, Elizabeth Verrico, April Cockcroft, Aaron Pinnola, Sharon Holmes, Jason D. Sciarretta e John Mirhan Davis. "Impact of Laparoscopy on Training: Are Open Appendectomy and Cholecystectomy on the Brink of Extinction?" American Surgeon 85, n. 7 (luglio 2019): 761–63. http://dx.doi.org/10.1177/000313481908500739.
Testo completoAbstract (sommario):
The operative experience of present-day surgical residency training has evolved as a result of the contributions of laparoscopic surgery. Some traditional open procedures are now more descriptive and less of a familiarity to many general surgery residents (GSRs). The aim of this study was to investigate how open operative experience compares with laparoscopy for GSRs. A retrospective, multicenter, consecutive cohort study of all patients undergoing surgical intervention involving the appendix and gallbladder identified from the ACS-NSQIP database over a 2.5-year period. All GSR postgraduate year-level operative experience was recorded. Of 777 procedures, 13 laparoscopic appendectomy conversions to open (4.3%) by Rocky-Davis (15%) or lower midline (84.6%) incisions were performed versus 285 that remained laparoscopic (95.6%). Fifty (10.4%) open cholecystectomies (38 open + 10 conversions + 2 common bile duct (CBD) exploration), 27 (5.6%) laparoscopic cholecystectomies with cholangiogram, and 402 (83.9%) laparoscopic cholecystectomies were performed. Twenty-nine different GSRs participated in procedures. Eighty-five (10.9%) operations were performed with multi–postgraduate year levels. Surgical residents have an unequal operative experience for case-specific open procedures. A competency-based system to demonstrate a resident's hands-on surgical skills is fundamental to residency training and should be considered for specific types of low-volume open surgical cases.
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Park, J. Y., J. Bae, M. C. Lim, S. Y. Lim, S. S. Seo, S. Kang e S. Y. Park. "Laparoscopic and laparotomic staging in stage I epithelial ovarian cancer: a comparison of feasibility and safety". International Journal of Gynecologic Cancer 18, n. 6 (2008): 1202–9. http://dx.doi.org/10.1111/j.1525-1438.2008.01190.x.
Testo completoAbstract (sommario):
The aim of this study was to compare laparoscopic and laparotomic surgical staging in patients with stage I epithelial ovarian cancer in terms of feasibility and safety. A retrospective chart review was undertaken of all patients with apparent stage I epithelial ovarian cancer who underwent laparoscopic (laparoscopy group) or laparotomic (laparotomy group) surgical staging at the Center for Uterine Cancer, National Cancer Center, Korea, between January 2001 and August 2006. During the study period, 19 patients underwent laparotomic surgical staging and 17 patients underwent laparoscopic surgical staging. No cases were converted from laparoscopy to laparotomy. The two groups were similar in terms of age, body mass index, procedures performed, number of lymph nodes retrieved, and operating time. The laparoscopy group had less estimated blood loss (P= 0.001), faster return of bowel movement (P< 0.001), and a shorter postoperative hospital stay (P= 0.002) compared to the laparotomy group. Transfusions were required only in two laparotomy patients, and postoperative complications occurred only in four laparotomy patients. However, two patients with stage IA grade 1 and 2 disease in laparoscopy group had recurrence with one patient dying of disease. The accuracy and adequacy of laparoscopic surgical staging were comparable to laparotomic approach, and the surgical outcomes were more favorable than laparotomic approach. However, the oncologic safety of laparoscopic staging was not certain. This is the first report on the possible hazards of laparoscopic staging in early-stage ovarian cancer. In the absence of a large prospective trial, this technique should be performed cautiously.
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Preda, Silviu Daniel, Cătălin Ciobîrcă, Gabriel Gruionu, Andreea Șoimu Iacob, Konstantinos Sapalidis, Lucian Gheorghe Gruionu, Ștefan Castravete, Ștefan Pătrașcu e Valeriu Șurlin. "Preoperative Computer-Assisted Laparoscopy Planning for the Minimally Invasive Surgical Repair of Hiatal Hernia". Diagnostics 10, n. 9 (21 agosto 2020): 621. http://dx.doi.org/10.3390/diagnostics10090621.
Testo completoAbstract (sommario):
Minimal invasive surgical procedures such as laparoscopy are preferred over open surgery due to faster postoperative recovery, less trauma and inflammatory response, and less scarring. Laparoscopic repairs of hiatal hernias require pre-procedure planning to ensure appropriate exposure and positioning of the surgical ports for triangulation, ergonomics, instrument length and operational angles to avoid the fulcrum effect of the long and rigid instruments. We developed a novel surgical planning and navigation software, iMTECH to determine the optimal location of the skin incision and surgical instrument placement depth and angles during laparoscopic surgery. We tested the software on five cases of human hiatal hernia to assess the feasibility of the stereotactic reconstruction of anatomy and surgical planning. A whole-body CT investigation was performed for each patient, and abdominal 3D virtual models were reconstructed from the CT scans. The optical trocar access point was placed on the xipho-umbilical line. The distance on the skin between the insertion point of the optical trocar and the xiphoid process was 159.6, 155.7, 143.1, 158.3, and 149.1 mm, respectively, at a 40° elevation angle. Following the pre-procedure planning, all patients underwent successful surgical laparoscopic procedures. The user feedback was that planning software significantly improved the ergonomics, was easy to use, and particularly useful in obese patients with large hiatal defects where the insertion points could not be placed in the traditional positions. Future studies will assess the benefits of the planning system over the conventional, empirical trocar positioning method in more patients with other surgical challenges.
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Sabharwal, M., UR Swain, V. Sabharwal e S. Kalhan. "Relevance of combining multiple surgical procedures in laparoscopy". Journal of the American Association of Gynecologic Laparoscopists 10, n. 3 (agosto 2003): S68—S69. http://dx.doi.org/10.1016/s1074-3804(03)80216-5.
Testo completo
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Penchev, Dimitar K., Plamen G. Ivanov e Ventzislav M. Mutafchiyski. "Laparoscopy-Assisted Transanal Total Mesorectal Excision". Folia Medica 61, n. 2 (1 giugno 2019): 180–87. http://dx.doi.org/10.2478/folmed-2018-0069.
Testo completoAbstract (sommario):
Abstract Background: Rectal cancer located in distal third still remains a technical challenge for surgeons. Transanal total mesorectal excision with laparoscopic assistance is quite new surgical approach for rectal cancer treatment that seems to solve some of the associated technical issues. The aim of the study was to present our experience in laparoscopy-assisted transanal total mesorectal excision. Materials and methods: After obtaining approval from the local Ethics Committee, a single centre prospective double-arm comparative non-randomized trial was initiated. With recruiting still in progress at present, between 27.02.2017 and 01.10.2017 four laparoscopy-assisted transanal total mesorectal excision procedures and two laparoscopic total mesorectal excisions were performed in the department of Endoscopic Endocrine Surgery and Coloproctolgy at the Military Medical Academy in Sofia. Results: There is no conversion in both groups. No postoperative mortality 30 days after surgery. The quality of total mesorectal excision was satisfactory in all patients estimated by the Quirque classification. There was no distal or proximal tumor involvement of surgical margins. In one of the cases, we reported positive circumferential resection margin. We had two cases with postoperative morbidity. Conclusion: Transanal total mesorectal excision with laparoscopic assistance is quite new minimally invasive surgical approach for rectal cancer treatment. Avoiding the procedure-related complications during the learning curve is essential before applying the method to every patient. Multicenter randomized control trial is needed so that we could answer the questions raised in this study.
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Edeiken, Sara M., Robert A. Maxwell, Benjamin W. Dart e Vincente A. Mejia. "Preliminary Experience with Laparoscopic Peritoneal Lavage for Complicated Diverticulitis: A New Algorithm for Treatment?" American Surgeon 79, n. 8 (agosto 2013): 819–25. http://dx.doi.org/10.1177/000313481307900826.
Testo completoAbstract (sommario):
Patients with findings suggestive of a perforated diverticulitis may be subject to colostomy with the attendant morbidity and quality-of-life concerns. Recent literature demonstrates decreased use of laparotomy and colostomy when diagnostic laparoscopy reveals absence of fecal peritonitis. Ten patients presenting with diverticulitis between May 2009 and February 2012 underwent diagnostic laparoscopy. The indication for surgery in nine patients was failure of medical management with or without percutaneous drainage and one had significant pneumoperitoneum at presentation. A comprehensive algorithm was subsequently developed governing medical and surgical management of diverticulitis including the use of diagnostic laparoscopy and laparoscopic peritoneal lavage for patients with Hinchey Stage 3 diverticulitis or abscess formation not amenable to percutaneous drainage. Eight patients underwent diagnostic laparoscopy and laparoscopic peritoneal lavage, whereas two patients underwent diagnostic laparoscopy with conversion to open procedures (low-anterior resection with diverting ileostomy and Hartmann's procedure). Mortality was 0 per cent. Four patients were subsequently readmitted for relapse or recurrence. Two required laparotomy at the time of readmission, ultimately receiving a diagnosis of adenocarcinoma. Two were managed medically and later underwent elective laparoscopic sigmoid colon resection. Diagnostic laparoscopy and laparoscopy peritoneal lavage appear feasible and safe and may be an alternative to more invasive surgery, avoiding laparotomy and colostomy and staging patients for elective laparoscopic resection. Based on our institutional experience, we propose a novel algorithm for the treatment of hospitalized patients with diverticulitis, which incorporates diagnostic laparoscopy and laparoscopic peritoneal lavage while emphasizing patient selection based on clinical examination and imaging.
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Lee, Keunchul, Heung-Kwon Oh, Jung Rae Cho, Minhyun Kim, Duck-Woo Kim, Sung-Bum Kang, Hyung-Jin Kim et al. "Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study". Annals of Coloproctology 36, n. 6 (31 dicembre 2020): 403–8. http://dx.doi.org/10.3393/ac.2020.03.23.
Testo completoAbstract (sommario):
Purpose: This study aimed to evaluate real-world clinical outcomes from surgically treated patients for sigmoid volvulus.Methods: Five tertiary centers participated in this retrospective study with data collected from October 2003 through September 2018, including demographic information, preoperative clinical data, and information on laparoscopic/open and elective/emergency procedures. Outcome measurements included operation time, postoperative hospitalization, and postoperative morbidity.Results: Among 74 patients, sigmoidectomy was the most common procedure (n = 46), followed by Hartmann’s procedure (n = 23), and subtotal colectomy (n = 5). Emergency surgery was performed in 35 cases (47.3%). Of the 35 emergency patients, 34 cases (97.1%) underwent open surgery, and a stoma was established for 26 patients (74.3%). Elective surgery was performed in 39 cases (52.7%), including 21 open procedures (53.8%), and 18 laparoscopic surgeries (46.2%). Median laparoscopic operation time was 180 minutes, while median open surgery time was 130 minutes (P < 0.001). Median postoperative hospitalization was 11 days for laparoscopy and 12 days for open surgery. There were 20 postoperative complications (27.0%), and all were resolved with conservative management. Emergency surgery cases had a higher complication rate than elective surgery cases (40.0% vs. 15.4%, P = 0.034).Conclusion: Relative to elective surgery, emergency surgery had a higher rate of postoperative complications, open surgery, and stoma formation. As such, elective laparoscopic surgery after successful sigmoidoscopic decompression may be the optimal clinical option.
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Lee, Keunchul, Heung-Kwon Oh, Jung Rae Cho, Minhyun Kim, Duck-Woo Kim, Sung-Bum Kang, Hyung-Jin Kim et al. "Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study". Annals of Coloproctology 36, n. 6 (31 dicembre 2020): 403–8. http://dx.doi.org/10.3393/ac.2020.03.23.1.
Testo completoAbstract (sommario):
Purpose: This study aimed to evaluate real-world clinical outcomes from surgically treated patients for sigmoid volvulus.Methods: Five tertiary centers participated in this retrospective study with data collected from October 2003 through September 2018, including demographic information, preoperative clinical data, and information on laparoscopic/open and elective/emergency procedures. Outcome measurements included operation time, postoperative hospitalization, and postoperative morbidity.Results: Among 74 patients, sigmoidectomy was the most common procedure (n = 46), followed by Hartmann’s procedure (n = 23), and subtotal colectomy (n = 5). Emergency surgery was performed in 35 cases (47.3%). Of the 35 emergency patients, 34 cases (97.1%) underwent open surgery, and a stoma was established for 26 patients (74.3%). Elective surgery was performed in 39 cases (52.7%), including 21 open procedures (53.8%), and 18 laparoscopic surgeries (46.2%). Median laparoscopic operation time was 180 minutes, while median open surgery time was 130 minutes (P < 0.001). Median postoperative hospitalization was 11 days for laparoscopy and 12 days for open surgery. There were 20 postoperative complications (27.0%), and all were resolved with conservative management. Emergency surgery cases had a higher complication rate than elective surgery cases (40.0% vs. 15.4%, P = 0.034).Conclusion: Relative to elective surgery, emergency surgery had a higher rate of postoperative complications, open surgery, and stoma formation. As such, elective laparoscopic surgery after successful sigmoidoscopic decompression may be the optimal clinical option.
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Fernández-Bautista, Beatriz, David Peláez Mata, Alberto Parente, Ramón Pérez-Caballero e Juan Carlos De Agustín. "First Experience with Fluorescence in Pediatric Laparoscopy". European Journal of Pediatric Surgery Reports 07, n. 01 (gennaio 2019): e43-e46. http://dx.doi.org/10.1055/s-0039-1692191.
Testo completoAbstract (sommario):
Background The use of intraoperative fluorescence images with indocyanine green (ICG) has recently been described as an aid in decision-making during surgical procedures in adults.We present our first experiences with different laparoscopic procedures performed in children using ICG fluorescence images. Material and Method We have used ICG fluorescence imaging technique in varicocele ligation, two nephrectomies, cholecystectomy, and one case of aortocoronary fistula closure. All procedures were performed through a minimally invasive approach. A high definition camera equipped with a visible infrared light source and gray-scale vision technology was used.After injection of ICG before or during the laparoscopic procedure, precise identification of vascular anatomy and bile duct architecture were easily identified. Fluorescence helped to assess blood flow from the spermatic vessels, define the variability of renal vascularization, and determine the precise location of the aortocoronary fistula. Biliary excretion of the ICG allowed the definition of the biliary tract. Conclusion Fluorescein-assisted images allowed a clear definition of the anatomy and safe surgical maneuvers during surgical procedures. The ICG imaging system seems to be simple and safe. Larger and more specific studies are needed to confirm its applicability, expand its indications, and address its advantages and disadvantages.
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Prado, S., R. Yazigi, J. Garrido, M. Gonzalez, R. Torres e D. Oddo. "Recurrent ovarian dysgerminoma after laparoscopy". International Journal of Gynecologic Cancer 16, Suppl 1 (gennaio 2006): 397–99. http://dx.doi.org/10.1136/ijgc-00009577-200602001-00073.
Testo completoAbstract (sommario):
To our knowledge, recurrent dysgerminoma at the site of tumor removal by laparoscopy in a patient with stage IA disease has not been previously reported. A woman with ovarian dysgerminoma treated by laparoscopy and tumor removed through the cul-de-sac recurred the 17 months later at the site of tumor removal. She was successfully treated with etoposide, bleomycin, and cisplatin chemotherapy with complete response. This case illustrates the potential for surgical site implant of an ovarian dysgerminoma; surgeons should follow strict guidelines when performing laparoscopic procedures for ovarian malignancies in order to prevent this type of incident.
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de Oliveira, Tiago Ribeiro, Ben Van Cleynenbreugel, Sérgio Pereira, Pedro Oliveira, Sandro Gaspar, Nuno Domingues, Tito Leitão, Artur Palmas, Tomé Lopes e Hein Van Poppel. "Laparoscopic Training in Urology Residency Programs: A Systematic Review". Current Urology 12, n. 3 (2018): 121–26. http://dx.doi.org/10.1159/000489437.
Testo completoAbstract (sommario):
Background/Aims: Laparoscopy is a widespread surgical approach for many urological conditions. Achieving prof-ciency in laparoscopic surgery requires considerable effort due to the steep learning curve. Several residency programs include standardized laparoscopic training periods in their curricula. Our aim was to systematically analyze the evidence on the current status of training in laparoscopy in different residency programs in urology. Methods: We performed a systematic review of PubMed/Medline and the Cochrane library, in February 2018, according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses Statement. Identified reports were reviewed according to the previously defined inclusion criteria. Eight publications, comprising a total of 985 urology residents, were selected for inclusion in this analysis. Results: There was a wide variation between training programs in terms of exposure to laparoscopy. Most residents considered that training in lap-aroscopy was inadequate during residency and had a low degree of confidence in independently performing laparo-scopic procedures by the end of the residency. Only North American residents reported high degrees of confidence in the possibility of performing laparoscopic procedures in the uture, whereas the remaining residents, namely from European countries, reported considerably lower degrees of confidence. Conclusion: There were considerable differences between national urology residency programs in terms of exposure to laparoscopy. Most residents would prefer higher exposure to laparoscopy throughout their residencies.
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Fitzgibbons, Robert J., e Varun Puri. "Laparoscopic Inguinal Hernia Repair". American Surgeon 72, n. 3 (marzo 2006): 197–206. http://dx.doi.org/10.1177/000313480607200301.
Testo completoAbstract (sommario):
As a consequence of the development of laparoscopic cholecystectomy in the late 1980s, diagnostic and therapeutic laparoscopy has now become an integral part of the average general surgeon's practice. Many conventional operations have been successfully adapted for the laparoscopic approach. A laparoscopic operation is unquestionably the surgical procedure of choice for gastroesophageal reflux disease and removal of the gallbladder, spleen, or adrenal gland unless specific contraindications are present. However, the value of laparoscopic techniques for other operations remains controversial within the surgical community. Laparoscopic inguinal herniorrhaphy (LIH) is a case in point. Frequent reanalysis of the controversial procedures such as laparoscopic herniorrhaphy is especially important because videoscopic operations remain in their developmental stages and thus continue to evolve. With this in mind, the purpose of this review was to examine the current state of the art of laparoscopic inguinal herniorrhaphy in relationship to its conventional counterparts.
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Trillsch, Fabian, Jan David Ruetzel, Uwe Herwig, Ulrike Doerste, Linn Lena Woelber, Donata Grimm, Matthias Choschzick, Fritz Jaenicke e Sven Mahner. "Surgical management and perioperative morbidity of patients with primary borderline ovarian tumor (BOT)." Journal of Clinical Oncology 31, n. 15_suppl (20 maggio 2013): e16535-e16535. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e16535.
Testo completoAbstract (sommario):
e16535 Background: Surgery is the central aspect of clinical management in patients with borderline ovarian tumors (BOT). As patients have excellent overall prognosis after successful surgery, perioperative morbidity is a critical point for decision regarding the primary surgical approach. Methods: Clinical and surgical parameters of patients undergoing surgery for primary BOT at two gynecologic cancer centers between 1993 and 2008 were analyzed with regard to perioperative morbidity depending on the surgical approach (laparoscopy vs. laparotomy). Results: A total of 105 patients were analyzed (44 with primary laparoscopy [42%], 61 with primary laparotomy [58%]). Primary laparoscopy was often performed with diagnostic intention and resulted in complete surgical staging in only 9.1% with subsequent formal indication for re-staging procedures. In contrast, complete surgical staging was achieved in 47.5% at primary laparotomy (p < 0.001). Tumor rupture was significantly more frequent during laparoscopy compared to laparotomy (29.5% vs. 13.1%, p = 0.038) but no other intraoperative complications were seen in laparoscopic surgery in contrast to 7 of 61 laparotomies (0% vs. 11.5%, p = 0.020). Postoperative complication rates were similar in both groups (19.7% vs. 18.2%, p = 0.848). Conclusions: Irrespective of the surgical approach, surgical management of BOT has acceptable rates of perioperative complications and morbidity. Choice of initial surgical approach can therefore be made independent of complication-concerns. As the recently published large retrospective AGO ROBOT study observed similar oncologic outcome for both approaches, laparoscopy should be considered as the preferred surgical approach for staging of patients with BOT if this appears feasible in preoperative evaluation.
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Zivaljevic, Milica, Ivan Majdevac, Petar Novakovic e Tamara Vujkov. "The role of laparoscopy in gynecologic oncology". Medical review 57, n. 3-4 (2004): 125–31. http://dx.doi.org/10.2298/mpns0404125z.
Testo completoAbstract (sommario):
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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Han, Ernest S., e Mark Wakabayashi. "Indications for Minimally Invasive Surgery for Ovarian Cancer". Journal of the National Comprehensive Cancer Network 9, n. 1 (gennaio 2011): 126–32. http://dx.doi.org/10.6004/jnccn.2011.0011.
Testo completoAbstract (sommario):
Epithelial ovarian cancer is often diagnosed in advanced stages and typically managed with surgical debulking followed by chemotherapy. For patients with presumed early-stage ovarian cancer, comprehensive surgical staging is essential for management, because 31% are upstaged. Over the past 15 years, minimally invasive techniques have improved and are increasingly being used to treat patients with ovarian cancer. Currently, only retrospective data support laparoscopic staging of patients with a suspicious adnexal mass or those surgically diagnosed with presumed early-stage ovarian cancer. Laparoscopy is also used in patients undergoing second-look procedures and to help evaluate whether patients should undergo optimal tumor debulking procedures or be initially managed with neoadjuvant chemotherapy. Randomized clinical studies are needed to further support the role of minimally invasive surgery in the treatment of ovarian cancer.
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Dimbarre, Daniellson, Paula Marcelo de Loureiro, Christiano Claus, Gustavo Carvalho, Pedro Trauczynski e Fabiano Elias. "Minilaparoscopic fundoplication: technical adaptations and initial experience". Arquivos de Gastroenterologia 49, n. 3 (settembre 2012): 223–26. http://dx.doi.org/10.1590/s0004-28032012000300011.
Testo completoAbstract (sommario):
CONTEXT: Gastroesophageal reflux diasease (GERD) is a highly prevalent disease. Treatment is divided into lifestyle modifications, medical and surgical treatment. Surgical laparoscopy is the gold standard treatment. In the last decade, there were an extensive research on procedures, less aggressive than laparoscopy and with better esthetic results. Minilaparoscopy is "reemerging" as a safe, effective and with excellent cosmetic results in selected patients treated for gastroesophageal reflux diasease. We present a serie of 27 patients treated for GERD by minilaparoscopic laparoscopy. MATERIAL: Between October 2009July 2011 a total of 27 patients underwent fundoplication by minilaparoscopy. It is used one 10mm trocar, a telescope of 30 degrees and four 3 mm trocars at regular positions. Regular surgical steps are done with no modifications. Cardiac tape, suture needles, and eventually extracting bag, gauze, are placed and taked out through the umbilical port. With these technical adjustments, we can perform the procedure safely and effectively, similarly to standard laparoscopic technique. RESULTS: Of the 27 patients, 22 were female and 5 male. The average body mass index was 25.5 kg/m². Hiatal hernias were small (<3 cm) in 24 patients. Mean operative time was 60 minutes. In all cases the hiatoplasty was performed with simple or 'x' stiches of 2.0 Ethibond. There was no need for conversion to standard laparoscopy or open surgery. The length of hospital stay was less than or equal to 24 hours in all patients. In this series of patients there were no postoperative complications. We did not observe any complication of the surgical wound. There were no evidence of recurrence of symptoms or endoscopic changes. CONCLUSION: Hiatoplasty associated with fundoplication using minilaparoscopic instruments is safe, feasible and effective. If compared to other "new access", has a spectacular esthetic results. Can be done with only minor technical adjustments, for any experienced laparoscopic surgeon, and is perfectly adaptable to our financial reality.
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Barrett-Lee, J., J. Vatish, M. Vazirian-Zadeh e P. Waterland. "Routine blood group and antibody screening prior to emergency laparoscopy". Annals of The Royal College of Surgeons of England 100, n. 4 (aprile 2018): 322–25. http://dx.doi.org/10.1308/rcsann.2018.0033.
Testo completoAbstract (sommario):
Introduction Studies show that rates of blood transfusion associated with general surgical laparoscopy are low. Currently, there are no national guidelines in the UK regarding blood group and antibody screening (G&S) for patients undergoing emergency laparoscopy. The aim of this study was to assess whether using G&S before emergency laparoscopic general surgery routinely is worthwhile by identifying rates of perioperative transfusion. Methods Data were collected retrospectively on all emergency laparoscopic procedures at a single district general hospital between January 2014 and 31 December 2016. Emergency laparoscopic general surgical cases were included and gynaecological cases excluded. Records were reviewed to ascertain whether G&S was performed, whether antibodies were detected and whether patients were transfused. Results A total of 562 emergency laparoscopic cases were performed. The median age was 28 years (range: 6–95 years). Laparoscopic appendicectomy (n=446), diagnostic laparoscopy (n=47) and laparoscopic cholecystectomy (n=25) were the most common procedures. Of the total patient cohort, 514 (91.5%) and 349 (70.1%) had a first and second G&S respectively while 30 (5.3%) had no G&S. Four patients (0.71%) had antibodies detected. One patient (0.18%) received a transfusion. This patient had undergone laparoscopic repair of a perforated duodenal ulcer and there was no major intraoperative haemorrhage but he was transfused perioperatively for chronic anaemia. Conclusions These results demonstrate a low rate of blood transfusion in emergency laparoscopic general surgery. The majority of these patients had a low risk of major intraoperative haemorrhage and we therefore argue that G&S was not warranted. We propose a more targeted approach to the requirement for preoperative G&S and the use of O negative blood in the event of acute haemorrhage from major vessel injury.
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DE-QUADROS, Luiz Gustavo, Roberto Luiz KAISER-JUNIOR, Josemberg Marins CAMPOS, Valter Nilton FELIX, Mário FLAMINI-JÚNIOR, Maurício VECCHI, André Teixeira, Marcelo Falcão DE-SANTANA e Idiberto José ZOTARELLI-FILHO. "LAPAROENDOSCOPIC TRANSGASTRIC RESECTION OF SUBEPITHELIAL JUXTACARDIAC TUMORS". ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 30, n. 2 (giugno 2017): 143–46. http://dx.doi.org/10.1590/0102-6720201700020014.
Testo completoAbstract (sommario):
ABSTRACT Background: With a prevalence of 0.4-3.5%, subepithelial lesions of the upper digestive tract are discovered during endoscopic procedures. Treatment depends on etiological and pathophysiological information, ability to diagnose and the different technical resources available. Aim: To demonstrate the effectiveness of a surgical technique that combines endoscopy and videolaparoscopy in the transgastric resection of subepithelial juxtacardic lesions. Method: The patients were assisted with a technical combination between endoscopy and laparoscopy. After diagnosis of subepithelial tumor, intraoperative endoscopy was performed after pneumoperitoneum and placement of laparoscopic tweezers. Through endoscopy, the following steps were performed: demarcation of surgical margins, visualization of the intragastric image for the laparoscopic procedure and removal of the surgical specimen. By laparoscopy the following steps were performed: intragastric intra-abdominal access, resection of the part and closure of the gaps. Results: This technique was applied in two cases in order to evaluate its initial results. There were two videolaparoendoscopic resections of juxtacardiac gastric tumors of the posterior wall. Both had their endoscopic diagnosis confirmed. After laparoendoscopic and tomographic and/or ecoendoscopic diagnostic complementation and preoperative performance, the laparoendoscopic procedure was indicated. The patients had a good recovery, with a short hospitalization time and no complications. Conclusion: The combined use of videolaparoscopy and endoscopy is a safe and effective technique for transgastric resection of juxtacardiac subepithelial lesions. It may be important for definitive diagnosis of the tumor.
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Ramesh, Wijaya, Teo Nan Zun e Tan Su-Ming. "Encompassing an Emerging Laparoscopic Surgical Procedure for Hinchey III Diverticulitis Into Acute Surgical Care Practice: Our Experience With a Case Report and Review of Literature". International Surgery 104, n. 7-8 (1 luglio 2019): 352–57. http://dx.doi.org/10.9738/intsurg-d-15-00098.1.
Testo completoAbstract (sommario):
In the past decade, there has been emerging data from the West supporting the use of laparoscopic lavage (LL) as a minimally invasive surgical (MIS) technique to treat Hinchey III perforated diverticulitis, rather than previous standard open surgical resection procedures. However, this can only be used in a select group of patients and also requires adequate knowledge and experience of colorectal and MIS techniques. This approach remains novel and rarely practiced in Asia. In this report, we review the current literature and discuss the considerations, outcomes, and limitations of this technique with an illustration of our case report. We report on a case of Hinchey III diverticulitis in a 51-year-old Asian woman who was successfully treated with LL after initial diagnostic laparoscopy in our institution and was discharged on the fifth postoperative day. LL is a colorectal MIS technique that has been evaluated and appears to be effective and has less morbidity compared with Hartmann procedure or primary resection with anastomosis. This technique should be incorporated into our practice for patients with Hinchey III diverticulitis who are suitable for laparoscopy at presentation. With the management of our case, we hence propose a clinical algorithm for adoption of this MIS technique by advocating routine diagnostic laparoscopy in hemodynamically stable patients presenting with gross peritonitis from perforated diverticulitis. This will promote the adoption of LL as a management option for perforated diverticulitis.
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Jovanovic, D. D., V. A. Milojkovic, Z. M. Stevanovic e M. M. Vukadin. "Transanal one-stage endorectal technique for Hirschprung's disease: A preliminary report of 24 cases from a single institution". Acta chirurgica Iugoslavica 56, n. 1 (2009): 109–13. http://dx.doi.org/10.2298/aci0901109j.
Testo completoAbstract (sommario):
Numerous surgical techniques for Hirschprung's disease have been developed and modified, being associated with extensive surgical procedures involving laparotomy, resection of affected segment of colon and descensus of the functional bowel to the anus. Conventional surgery was followed by complications, although the incidence of early and late postoperative complications has significantly decreased. Transanal mucosectomy was practiced as a part of conventional and laparoscopic assisted pull through procedures. The latest promising achievement is entirely transanal pull-through procedure, described by De la Tore-Mondragon and Ortega-Salgado: entirely transanal endorectal pull-through, thus avoiding both laparotomy and laparoscopy. Due to minimal invasive surgery it offers excellent results. During a five year period (2003-2008), 24 patients were operated with this technique. The recovery was uneventful in all patients. This study adds valuable information of meticulous details of the new, still developing technique with the emphasis on controversies about surgical complications reported in multicentric studies. .
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Lim, Myong Cheol, Dae Chul Jung, Joo-Young Kim e Sang-Yoon Park. "Laparoscopy-Assisted Intracavitary Radiotherapy Tandem Placement for Patients With Cervical Cancer". International Journal of Gynecologic Cancer 19, n. 6 (luglio 2009): 1125–30. http://dx.doi.org/10.1111/igc.0b013e3181ab5965.
Testo completoAbstract (sommario):
Objective:To determine the requirement and benefit of laparoscopy-assisted surgical procedures for optimal placement of intracavitary radiotherapy (ICR) tandem in patients with cervical cancer patients.Methods:We reviewed a database of 231 cervical cancer patients who underwent radiotherapy and computed tomography-based 3-dimensional ICR planning at our institute between July 2003 and December 2007.Results:Misplacement of ICR tandem was identified in 12 patients. Optimal placement of ICR tandem was possible in 6 patients under sonographic guidance at the second attempt. Laparoscopy-assisted placement of an ICR tandem was required in 6 patients (2.6%) because of failures of ICR tandem insertion. As a result of this procedure, tandem insertions were corrected in all patients, with the exception of 1 patient who initially presented with fixed pelvic wall disease with an acute angle between the uterine body and the cervical axis. Laparoscopic procedures were tolerable with a median operative time of 68 minutes and an estimated blood loss of less than 20 mL. There were no complications related to the laparoscopic procedures. All the patients remain free of local disease at the time of this writing. There was 1 patient with grade 4 late radiation toxicity of the bowel who developed a rectovaginal fistula 3 months after completion of ICR.Conclusions:Laparoscopy-assisted placement of an ICR tandem was required in 2.6% of the patients with primary advanced cervical cancer. Laparoscopy-assisted placement of an ICR tandem allows optimal implementation of ICR in difficult cases without causing significant morbidity and without delaying the planned ICR.
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Liyi, Pang, Hiroshi Sasaki, Liu Chang Qing, Minoru Akiyama, Akihiko Watanabe, Shigeki Niimi e Tadao Tanaka. "Management of Ovarian Dermoid Cysts by Laparoscopy Compared With Laparotomy". Diagnostic and Therapeutic Endoscopy 3, n. 1 (1 gennaio 1996): 19–27. http://dx.doi.org/10.1155/dte.3.19.
Testo completoAbstract (sommario):
Thirty patients with ovarian dermoid cysts removed by laparoscopic surgery were compared with 42 patients with ovarian dermoid cysts removed by laparotomy, with respect to the selection criteria, surgical procedures, operating time, intraoperative and postoperative complications, blood loss, and hospital stay. Although the operating time for unilateral cystectomy, unilateral salpingo-oophorectomy, and bilateral cystectomy performed by laparoscopic surgery was longer (120.3 ± 43.7 min, mean ± SD) than those for the same procedures performed by laparotomy (73.9 ± 21.6 min, p < 0.01), we observed a learning curve with a remarkable declining tendency (linear regression model, p < 0.01). At the end of this study, the times taken for laparoscopic procedures were almost the same as those for laparotomy. Less blood loss (18.2 ± 1.7 ml versus 105.9 ± 84.3 ml, p < 0.01) and shorter hospital stay (5.9 ± 1.9 days versus 12.0 ± 2.9 days, p < 0.01) were also found to be advantages of laparoscopic surgery. This article discusses the technical procedures of laparoscopic surgery. The efficiency and safety of operative laparoscopy as an alternative access route for the management of ovarian dermoid cysts were recognized. We stress that strict criteria for selection of patients should always be followed and the necessity of retraining schedules for gynecologists and nursing staff in the speciality of laparoscopic surgery.
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Janic, Nenad, Zoran Golubovic e Branislav Jovanovic. "Laparoscopic operations in pediatric surgery". Srpski arhiv za celokupno lekarstvo 132, suppl. 1 (2004): 14–16. http://dx.doi.org/10.2298/sarh04s1014j.
Testo completoAbstract (sommario):
From January 2003 to January 2004, laparoscopy was performed in 100 cases, aged from 10 months to 19 years. Diagnostic laparoscopy was applied in 39 patients, most often in nonpalpable testes (29), ovarian cysts (4), abdominal trauma (1), abdominal cysts (2) and intersex states (3). Ninety patients underwent operative laparoscopy: appendectomy (44), orchiopexy (2), orchiectomy (1), herniorrhaphy (1), varicocelectomy (8), adnexectomy (2), cholecystectomy (8), Fowler-Stephens procedure (1), abdominal cysts (2), ovarian cystectomy (6), subdiaphragmatic abscess (1), adhesiotomy (11), liver cysts (2) and splenectomy (1). Diagnostic laparoscopy has proved to be more reliable and less invasive method in comparison to previously used methods. Our conclusion is that operative laparoscopy has many advantages compared with some of the classical surgical procedures.
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Hannan, Md Jafrul. "Laparoscopic Appendectomy in Children: Experience in a Single Centre in Chittagong, Bangladesh". Minimally Invasive Surgery 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/125174.
Testo completoAbstract (sommario):
Background. Since the latter half of 1980s laparoscopy has become a well accepted modality in children in many surgical procedures including appendectomy. We present here the experience of laparoscopic appendectomy in children in a tertiary care hospital in Bangladesh. Subjects & Methods. From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Laparoscopy was performed in all the cases using 3 ports. For difficult and adherent cases submucosal appendectomy was performed. Feeding was allowed 6 h after surgery and the majority was discharged on the first postoperative day. The age, sex, operative techniques, operative findings, operative time, hospital stay, outcome, and complications were evaluated in this retrospective study.Results. Mean age was 8.17 ± 3.28 years and 69% were males. Fifteen percent were complicated appendicitis, 8 cases needed conversion, and 27 cases were done by submucosal technique. Mean operating time was 39.8 ± 14.2 minutes and mean postoperative hospital stay was 1.91 days. About 5% cases had postoperative complications including 4 intra-abdominal abscesses.Conclusions. Laparoscopic appendectomy is a safe procedure in children even in complicated cases.
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Khasnis, Ravindra G., e Rajshankar S. "A study of evaluation of chronic pain abdomen in pediatric patients by laparoscopy". International Surgery Journal 6, n. 3 (25 febbraio 2019): 708. http://dx.doi.org/10.18203/2349-2902.isj20190472.
Testo completoAbstract (sommario):
Background: Pain in abdomen of chronic nature is common in children but being so common difficult to determine the exact cause. It has been estimated that around 2-4% of all the pediatric patients attend the outpatient department are due to pain in the abdomen that is of chronic nature in children. It has been seen that routine diagnostic and therapeutic procedures fail to make a justice of the diagnosis and management for the pain in the abdomen of chronic nature. The aim was to study the role of laparoscopy in children with chronic pain abdomen.Methods: Interventional follow up study was carried out among 19 children with pain in the abdomen of chronic nature. Detailed history pertaining to pain in the abdomen, history of surgical explorations was taken. As a part of the work up of a patient the investigations were done routinely. All children were evaluated by laparoscopy.Results: Majority of the children were in the age group of 11-12 years i.e. 42.1%. Male and female children were almost equal in distribution. USG was diagnostic in 9 patients (47.36%). Laparoscopy was diagnostic in all 18 other cases (95% cases). 73.68% had not complication after the procedure. Only four patients had fever after the surgery and only one patient had wound infection. Thus, overall the laparoscopic procedure was very successful. Laparoscopy and USG were equally effective in diagnosing inguinal hernia.Conclusions: Laparoscopy had better diagnostic value compared to ultrasonography. Laparoscopic intervention was successful with minimum complications.
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Kurtz, Bryan R., e James F. Daniell. "The role of lasers in the laparoscopic treatment of infertility and endometriosis". Reproductive Medicine Review 2, n. 2 (luglio 1993): 85–94. http://dx.doi.org/10.1017/s0962279900000636.
Testo completoAbstract (sommario):
Lasers have now been used laparoscopically in infertility surgery for over a decase. Use of the CO2 laser at laparoscopy began independently in France, Israel and North America. Investigators have subsequently reported use of the argon, Nd-YAG, and the KTP lasers for laparoscopic laser surgery. All of these surgical lasers are now widely available and have been used clinically for many laparoscopic procedures. This review will examine the laparoscopic use of both infrared and visible laser light energy in the treatment of infertility and endometriosis.
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Huhta, H., S. Vuolio, I. Typpö, A. Rahko, K. Suokanerva e J. M. Rintala. "Primary Outcome of Laparoscopic Colorectal Resections in a Northern Finnish Hospital: A Single Center Study". Scandinavian Journal of Surgery 108, n. 2 (4 settembre 2018): 137–43. http://dx.doi.org/10.1177/1457496918798196.
Testo completoAbstract (sommario):
Background and Aims: Over the past decades, laparoscopic colorectal surgery has become widely used for various indications. Large multicenter studies have demonstrated that laparoscopy has clear advantages over open surgery. Compared to open procedures, laparoscopy decreases perioperative blood loss, post-operative pain, and hospitalization time, but provides equivalent long-term oncological and surgical results. Most studies have been conducted in high-volume institutions with selected patients, which may have influenced the reported outcome of laparoscopy. Here, we investigated the primary outcome of all laparoscopic colorectal resections performed between 2005 and 2015 in a low-volume center. Materials and Methods: This retrospective study included bowel resections performed between 2005 and 2015 in the Lapland Central Hospital. Data were retrieved from electronic patient registries, and all operations that began as a laparoscopy were included. Patient records were investigated to determine the primary surgical outcome and possible complications within the first 30 days after surgery. Results: During 2005–2015, 385 laparoscopic colorectal resections were performed. Indications included benign (n = 166 patients, 43.1%) and malignant lesions (n = 219 cases, 56.9%). The median patient age was 68 years, and 50.4% were male. The median American Society of Anesthesiologist score was III, and 48.5% of patients had an American Society of Anesthesiologist class of III or IV. The median hospital stay after surgery was 6 days (interquartile range: 3.8). The conversion rate to open surgery rate was 13%. The total surgical complication rate was 24.2%, and re-operation was required in 11.2% of patients. A total of 26 patients had anastomotic leakage, of which 16 required re-operations. The 30-day mortality was 0.8%. Conclusion: Our results showed that laparoscopic colorectal surgery in a peripheral hospital resulted in primary outcome rates within the range of those reported in previous multicenter trials. Therefore, the routine use of laparoscopic colorectal resections with high-quality outcome is feasible in small and peripheral surgical units.
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van Dam, Peter, Jan Hauspy, Luc Verkinderen, Xuan Bich Trinh, Pieter-Jan van Dam, Luc Van Looy e Luc Dirix. "Are Costs of Robot-Assisted Surgery Warranted for Gynecological Procedures?" Obstetrics and Gynecology International 2011 (2011): 1–6. http://dx.doi.org/10.1155/2011/973830.
Testo completoAbstract (sommario):
The exponential use of robotic surgery is not the result of evidence-based benefits but mainly driven by the manufacturers, patients and enthusiastic surgeons. The present review of the literature shows that robot-assisted surgery is consistently more expensive than video-laparoscopy and in many cases open surgery. The average additional variable cost for gynecological procedures was about 1600 USD, rising to more than 3000 USD when the amortized cost of the robot itself was included. Generally most robotic and laparoscopic procedures have less short-term morbidity, blood loss, intensive care unit, and hospital stay than open surgery. Up to now no major consistent differences have been found between robot-assisted and classic video-assisted procedures for these factors. No comparative data are available on long-term morbidity and oncologic outcome after open, robotic, and laparoscopic gynecologic surgery. It seems that currently only for very complex surgical procedures, such as cardiac surgery, the costs of robotics can be competitive to open surgical procedures. In order to stay viable, robotic programs will need to pay for themselves on a per case basis and the costs of robotic surgery will have to be reduced.
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Medina-Donoso, Gabriel, Paúl Espinosa-Calderón, Secundino Gonzalez-Pardo e Widmark Báez-Morales. "Laparoscopic cystogastrostomy as a treatment for pancreatic pseudocyst: a case report". Bionatura 4, n. 4 (15 novembre 2019): 991–93. http://dx.doi.org/10.21931/rb/2019.04.04.9.
Testo completoAbstract (sommario):
The pancreatic pseudocyst is one of the late local complications of acute pancreatitis, for the management of this entity, there are multiple strategies that range from expectant management, minimally invasive therapy and surgical resolution. Since surgery is the definitive treatment, the laparoscopic approach takes force as a strategy in selected patients. A 47-year-old female patient with multiple comorbidities with pancreatitis of bile origin with subsequent development of pancreatic pseudocyst in whom surgical resolution with a laparoscopic approach is decided. Discussion: The laparoscopic approach shows favorable results; with a procedure duration of 170 minutes on average; the open technique shows several complications: pancreatic fistulas in 40%, enteric fistulas of 20%, incisional hernia of 25%, and mortality of 9 to 25%; Laparoscopic gastrocystostomy allows a much wider communication between the cyst and stomach compared to the endoscopic approach, safe hemostasis and better management of complications. Surgery for the treatment of pseudocyst continues to be the cornerstone; The laparoscopic approach shows the advantages of laparoscopy, with lower morbidity rates compared to open procedures.
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Abbasi, Sharmin, Sehereen Farhad Siddiqua, Mohammad Noor A. Alam e Suha Jesmin. "Evaluation of Anti-Mullerian Hormone level as a marker of Ovarian Reserve and correlate it with Laparoscopic Surgery of Pelvic Endometriosis in Subfertile Patients". BIRDEM Medical Journal 8, n. 1 (27 dicembre 2017): 30–34. http://dx.doi.org/10.3329/birdem.v8i1.35036.
Testo completoAbstract (sommario):
Background: Endometriosis refers to the presence of endometrial glands and stroma outside the uterine cavity. About 10% causes of infertility are due to endometriosis. In women Anti-Mullerian hormone (AMH) level represents the ovarian follicular pool and has been suggested as the most reliable and reproducible marker to asses ovarian reserve. The gold standard approach of management of endometriosis with subfertility is laparoscopy. The objectives of this stydy are evaluation of AMH levels as a marker of ovarian reserve in subfertile patients with different stages of pelvic endometriosis, and correlate it with laparoscopic surgery.Methods: This was a cross sectional observational study on 59 subfertile patients from January 2014 to January 2017 in Anwer Khan Modern Medical College Hospital (AKMMCH). Main outcome measured on the basis of measurement of AMH levels in correlation with the age, types of subfertility, stages of endometriosis, unilateral or bilateral ovarian involvement, size of the cyst, number of the cyst and the impact of different procedures during laparoscopy on AMH levels.Results: Basal AMH levels significantly lower (p= 0.011 and p =0.001) before and after laparoscopy in primary subfertile patients than secondary subfertile patients and AMH significantly decreased (P<0.024) after laparoscopy in primary subfertile patients. AMH level significantly decreased (P<.001) after laparoscopic surgery of two ovaries. Mean serum AMH levels were decreased in moderate and severe stages of endometriosis after laparoscopy (3.01±.04 ng/ml and 2.15±.03ng/ml). Different surgical procedures of laparoscopy showed significant impact on serum AMH levels, in thermal cauterization (p=0.023) and excision plus cauterization (p=0.001) showed significant decreased of AMH.Conclusion: Serum AMH level decreased in many patients after laparoscopy to such an extent from where future fertility is possible.Birdem Med J 2018; 8(1): 30-34
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Zouari, Mohamed, Mahdi Ben Dhaou, Saloua Ammar, Mohamed Jallouli e Riadh Mhiri. "Laparoendoscopic Single-Site (LESS) Surgery in Pediatric Urology: A 4-Year Experience". Current Urology 12, n. 3 (2018): 153–57. http://dx.doi.org/10.1159/000489434.
Testo completoAbstract (sommario):
Objective: The aim of the study was to assess the feasibility and outcomes of pediatric urological laparoendoscopic single-site (LESS) surgery. Materials and Methods: We retrospectively collected charts of all patients who underwent LESS procedures in our department from January 2013 to December 2016. Data included demographic characteristics, type of procedures, intraoperative details, hospital stay, and complications. The umbilicus was used as the surgical site in all cases. All procedures were performed with a homemade glove port and standard straight 3- or 5-mm laparoscopic instruments. Results: Seventy-three patients (55 males, 18 females) were identifed. Procedures included 46 orchidop-exies, 21 pyeloplasties, 8 varicocelectomies, 3 nephrecto-mies, 3 nephroureterectomies, 3 orchiectomies, and 1 renal hydatid cyst treatment. Median operative time for the entire cohort was 47 min (range 26-156 min). There was no signifcant intraoperative blood loss. No conversion to conventional laparoscopy or open surgery was needed. All patients required paracetamol postoperatively. The mean follow-up was 18 months. Two patients had testicular atrophy after a Fowler-Stephens procedure and 1 patient had testicular reascension. Cosmetic results were excellent. Forty-five (62.5%) patients were discharged on the day of surgery. Conclusion: Our study demonstrated that LESS surgery using our glove port technique and conventional laparoscopic instruments is a feasible and safe technique for the surgical management of various pediatric urological conditions.
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Shastri, Shraddha S., Anvita A. Singh, Sameer P. Darawade e Saloni D. Manwani. "Complications of gynaecologic laparoscopy: an audit". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n. 12 (26 novembre 2018): 4870. http://dx.doi.org/10.18203/2320-1770.ijrcog20184931.
Testo completoAbstract (sommario):
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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Bogani, Giorgio, Antonella Cromi, Stefano Uccella, Maurizio Serati, Jvan Casarin, Ciro Pinelli e Fabio Ghezzi. "Perioperative and Long-term Outcomes of Laparoscopic, Open Abdominal, and Vaginal Surgery for Endometrial Cancer in Patients Aged 80 Years or Older". International Journal of Gynecologic Cancer 24, n. 5 (giugno 2014): 894–900. http://dx.doi.org/10.1097/igc.0000000000000128.
Testo completoAbstract (sommario):
ObjectiveThis study was undertaken to evaluate the safety, feasibility, and the long-term effectiveness of laparoscopy in endometrial cancer patients aged 80 years or older.MethodsData of consecutive patients aged 80 years and older undergoing laparoscopic, open abdominal, and vaginal approaches were compared. Postoperative complications were graded per the Accordion Severity Classification. Survival outcomes within the first 5 years were analyzed using the Kaplan-Meier method.ResultsAmong 726 patients, 63 (9%) were aged 80 years and older. Laparoscopic, open abdominal, and vaginal surgery were performed in 22 (35%), 25 (40%), and 16 (25%) cases, respectively. All laparoscopic procedures were completed laparoscopically, whereas a conversion from vaginal to open procedure occurred (0% vs 6%; P = 0.42). Patients undergoing laparoscopy experienced similar operative time (P > 0.05), lower blood loss (P < 0.05), and shorter hospital stay (P < 0.05) than patients undergoing open and vaginal surgery. No intraoperative complications were recorded. Laparoscopy is related to a lower rate of postoperative complications (P = 0.09) and Accordion grade greater than or equal to 2 complications (P = 0.05) in comparison to open abdominal and vaginal surgery. The route of surgical approaches did not influence the 5-year disease-free (P = 0.97, log-rank test) and overall (P = 0.94, log-rank test) survivals.ConclusionsLaparoscopy seems to represent a safe and effective treatment of endometrial cancer in women aged 80 years or older. Our data suggest that in elderly women, laparoscopic surgery improves perioperative outcomes compared with open and vaginal approaches without compromising long-term survival.
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Irani, Mohamad, Cheruba Prabakar, Sepide Nematian, Nitasha Julka, Devika Bhatt e Pedram Bral. "Patient Perceptions of Open, Laparoscopic, and Robotic Gynecological Surgeries". BioMed Research International 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/4284093.
Testo completoAbstract (sommario):
Objective. To investigate patient knowledge and attitudes toward surgical approaches in gynecology. Design. An anonymous Institutional Review Board (IRB) approved questionnaire survey. Patients/Setting. A total of 219 women seeking obstetrical and gynecological care in two offices affiliated with an academic medical center. Results. Thirty-four percent of the participants did not understand the difference between open and laparoscopic surgeries. 56% of the participants knew that laparoscopy is a better surgical approach for patients than open abdominal surgeries, while 37% thought that laparoscopy requires the surgeon to have a higher technical skill. 46% of the participants do not understand the difference between laparoscopic and robotic procedures. 67.5% of the participants did not know that the surgeon moves the robot’s arms to perform the surgery. Higher educational level and/or history of previous abdominal surgeries were associated with the highest rates of answering all the questions correctly (p<0.05), after controlling for age and race. Conclusions. A substantial percentage of patients do not understand the difference between various surgical approaches. Health care providers should not assume that their patients have an adequate understanding of their surgical options and accordingly should educate them about those options so they can make truly informed decisions.
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Marinkin, Igor O., Vasily A. Odintsov, Andrei I. Shevela e Vladimir V. Anischenko. "Experience in the implementation of the single subtotal hysterectomy laparoscopic approach". Journal of obstetrics and women's diseases 65, n. 1 (15 marzo 2016): 43–47. http://dx.doi.org/10.17816/jowd65143-47.
Testo completoAbstract (sommario):
A comparison of the results of subtotal hysterectomy performed by various surgical procedures (SILS, laparoscopy). Indications for these types of surgical techniques, identified the advantages and disadvantages of each method of economic feasibility. It is shown that single-port surgery is characterized by the best cosmetic effect and less postoperative pain than with classical laparoscopy. It defines the single-port surgery as a safe method of choice for endoscopic treatment of uterine pathology.
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NÁCUL, Miguel Prestes, Leandro Totti CAVAZZOLA e Marco Cezário de MELO. "Current status of residency training in laparoscopic surgery in Brazil: a critical review". ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 28, n. 1 (2015): 81–85. http://dx.doi.org/10.1590/s0102-67202015000100020.
Testo completoAbstract (sommario):
INTRODUCTION: The surgeon's formation process has changed in recent decades. The increase in medical schools, new specialties and modern technologies induce an overhaul of medical education. Medical residency in surgery has established itself as a key step in the formation of the surgeon, and represents the ideal and natural way for teaching laparoscopy. However, the introduction of laparoscopic surgery in the medical residency programs in surgical specialties is insufficient, creating the need for additional training after its termination. OBJECTIVE: To review the surgical teaching ways used in services that published their results. METHODS: Survey of relevant publications in books, internet and databases in PubMed, Lilacs and Scielo through july 2014 using the headings: laparoscopy; simulation; education, medical; learning; internship and residency. RESULTS: The training method for medical residency in surgery focused on surgical procedures in patients under supervision, has proven successful in the era of open surgery. However, conceptually turns as a process of experimentation in humans. Psychomotor learning must not be developed directly to the patient. Training in laparoscopic surgery requires the acquisition of psychomotor skills through training conducted initially with surgical simulation. Platforms based teaching problem solving as the Fundamentals of Laparoscopic Surgery, developed by the American Society of Gastrointestinal Endoscopic Surgery and the Laparoscopic Surgical Skills proposed by the European Society of Endoscopic Surgery has been widely used both for education and for the accreditation of surgeons worldwide. CONCLUSION: The establishment of a more appropriate pedagogical process for teaching laparoscopic surgery in the medical residency programs is mandatory in order to give a solid surgical education and to determine a structured and safe professional activity.
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Yeola, Meenakshi, Dilip Gode e Akshay Bora. "Evolution of Laparoscopy through the Ages". International Journal of Recent Surgical and Medical Sciences 03, n. 01 (giugno 2017): 040–47. http://dx.doi.org/10.5005/jp-journals-10053-0036.
Testo completoAbstract (sommario):
AbstractThe field of laparoscopic surgery has experienced tremendous growth in the last three decades. The important events among them have been the invention of incandescent bulbs by Thomas Edison, the development of lens scopes (1870–1980s), the invention of rod lens system by Hopkins (1950s), the fiberoptic cold light transmission (1960s), and the computer chip video camera (1980s).Technological advancements have produced progressively smaller laparoscopic instruments and higher quality imaging that allow laparoscopic surgeons to perform precise dissection with minimal bleeding through most dissection planes, and the major limitations of standard laparoscopy procedures are overcome with these advances.The introduction and evolution of minimally invasive surgery has drastically changed the entire scenario of the ways in which surgeons are treating the patients. With the introduction of various innovative technologies like high-definition television, video systems, integrated digital reporting, head-mounted displays, surgical robotics, virtual reality training, and the integration of various modalities, such as ultrasound, computed tomography, and magnetic resonance imaging, the surgeon has better knowledge of the disease, thereby, treating the patient more effectively.In this review article, we explore the evolution of laparoscopy through the ages, thereby, making way for further development in the field of minimal access surgery.