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Автор: Grafiati

Опубліковано: 4 червня 2021

Оновлено: 31 січня 2023

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1

Shastri, Shraddha S., Anvita A. Singh, Sameer P. Darawade, and Saloni D. Manwani. "Complications of gynaecologic laparoscopy: an audit." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 12 (November 26, 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.

2

Zivaljevic, Milica, Ivan Majdevac, Petar Novakovic, and Tamara Vujkov. "The role of laparoscopy in gynecologic oncology." Medical review 57, no. 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.

3

Doddamani, Rajalaxmi, Srikantaiah Chandrasekharaiah Hiremath, Zameer Ahmed, and Lahari Surapaneni. "Complications of laparoscopic surgery in general surgical practice and their management." International Surgery Journal 5, no. 4 (March 23, 2018): 1233. http://dx.doi.org/10.18203/2349-2902.isj20180988.

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Background: Any new technique is associated with the development of new complication. Laparoscopic surgery has gained popularity over last 20 years, owing to many advantages for patients in terms of smaller scar, less post-operative pain and quicker recovery. Despite the relative safety of laparoscopic techniques, inadvertent serious injuries to bowel, bladder and vascular structures do occur. Therefore, the need has arisen to study the various complications and their management inherent in this technique. The objective was to determine percentage of complications in laparoscopic surgeries of abdomen and also to study their management.Methods: Inpatients of Ramaiah hospitals undergoing abdominal laparoscopic surgeries from October 2014 to October 2015 who are above 14 years of age and undergoing elective or emergency surgeries or diagnostic laparoscopy for acute/chronic appendicitis, cholelithiasis and inguinal hernia repair. Demographic information, clinical findings, intra operative and postoperative findings will be noted. Follow up of the patient is done for 4 weeks.Results: Out of the 272, 134(49.3%) were male patients and 138 (50.7%) were female patients, age group ranging between 31-40 years. Four patients (1.4%) showed CBD injury, three patients (1.1%) showed bowel injury, twelve (4.4%) showed bile leak, all these 9 (3.3%) patients were managed by converting the laparoscopic cholecystectomy into open cholecystectomy. Sixteen patients (5.9%) had laparoscopy converted into open procedure due to the intraoperative complications. Statistically significant impact was noted on the outcome of surgery due the complication that patient underwent during the study.Conclusions: Laparoscopy is a safe, effective and well tolerated procedure if conducted in the skilled and experienced hands. The morbidity and mortality are dependent on age, general condition, presence/ absence of comorbidities and hence preoperative thorough work up is imperative. Large proportions of these complications occur during the initial learning curve of the inexperienced laparoscopic surgeon.

4

Cvijanovic, Radovan, and Dejan Ivanov. "Complications in laparoscopic surgery." Srpski arhiv za celokupno lekarstvo 136, Suppl. 2 (2008): 129–34. http://dx.doi.org/10.2298/sarh08s2129c.

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The development of technology and improvement of laparoscopic equipment enhanced expansion laparoscopic surgeries. Various operations performed using classical operative approach are nowadays done laparoscopic technique. The expansion of the repertoire, the performance of most complicated surgical procedures and increase in the number of laparoscopic interventions result in the increased number of intraoperative and postoperative complications. They occur due to the basic disease that is the cause of surgery and surgical procedure, but also due to other factors. We cannot influence the very disease - it is the reason for surgical treatment. However, we can make some changes in approach concerning the laparoscopic technique, which can considerably influence possible development of complications. This involves a different approach to the operative field, but also to very surgery. In laparoscopic surgery such approach causes specific intraoperative and postoperative complications. These complications are mainly caused by technical factors, such as the quality of the equipment, instruments and human factors, such as inexperience, insufficient education and excessive self-assurance. To decrease the frequency of intraoperative and postoperative complications in laparoscopic operations we require perfect equipment and instruments, education in a referent institution, but also everyday training with laparascopic equipment and experimental animals.

5

Majhi, Harekrishna, Tapan Kumar Nayak, Sheik Salman Raghib, and Anand Seba Tirkey. "Assessment of Port Site Complications in Laparoscopic Surgery – A Prospective Descriptive Study from Western Odisha." Journal of Evidence Based Medicine and Healthcare 8, no. 24 (June 14, 2021): 2106–11. http://dx.doi.org/10.18410/jebmh/2021/394.

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BACKGROUND Laparoscopic surgery has brought about a paradigm shift in modern surgical care. It has varied applications in gastrointestinal surgery, urological surgery, gynaecological surgery and oncosurgery. Better cosmesis, less post-operative pain, hence reduced need for post-operative analgesia, shorter recovery period and faster return to daily activities are its advantages. However, certain complications like port site infection, hemorrhage, hernia, TB or metastasis are morbid complications that undermine its benefits. In this study, we wanted to identify the various port site complications in patients undergoing laparoscopic surgery for different diseases in our hospital and assess its incidence. METHODS This is a prospective descriptive study. 125 patients admitted to the Department of General Surgery from November 2018 to October 2020 who fulfilled the inclusion and exclusion criteria underwent elective laparoscopic surgeries. They were observed post-operatively for various port site complications. All the data was entered into the Microsoft Excel 2007 software and further analysis was done using SPSS software version 24.0 (IBM Inc. Chicago). A P - value of less than 0.05 was considered statistically significant. RESULTS Of 125 patients that underwent laparoscopic surgery, 9 patients (7.2 %) developed complications specific to port site upon a follow-up of 3 months. Complications observed were port site infection (n = 4, 3.2 %), port site hemorrhage (n = 2, 1.6 %). Port site hernia, port site tuberculosis (TB), umblical port site hernia and mild subcutaneous emphysema were observed in one patient each (0.8 %). Scar abnormalitites were seen in 3 patients (2.4 %). CONCLUSIONS Laparoscopy is associated with minimal complications. However rare these complications are, they take away from the advantages of the laparoscopic surgery and the reputation of the hospital and surgeon alike. Apt patient selection, meticulous surgical technique, proper sterilization of the laparoscopic instruments and effective antibiotics use can further reduce the incidence of complications. KEYWORDS Laparoscopy, Port Site Complications, Infection, Hernia, Hemorrhage

6

Muzhikov, S. P., M. Iu Eremenko, and A. G. Baryshev. "Laparoscopic Adrenalectomy: Preventive Principles in Intra- and Postoperative Complications." Creative surgery and oncology 11, no. 4 (December 21, 2021): 284–87. http://dx.doi.org/10.24060/2076-3093-2021-11-4-284-287.

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Background. Laparoscopic adrenalectomy is the current surgery of choice in most adrenal tumours, with a nearly 11 % complication rate and below 1 % mortality. Laparoscopy combines the advantages of minimally invasive surgery with well-known long-term prognosis of a traditional open surgery, at the same time requiring the surgeon’s skill of knowing the technique and avoiding complication.Aim. Concept definition of safe laparoscopic adrenalectomy.Materials and methods. A total of 28 patients with adrenal neoplasms were rendered laparoscopic adrenalectomy by same surgical team under benchmark recommendations during 2016–2019.Results. All patients have been discharged in satisfactory condition, with no intra-, postoperative complications or lethal outcomes.Discussion. Th e evidence presented displays feasibility of using the benchmark principles in laparoscopic adrenalectomy surgery. Laparoscopic adrenalectomy is superior in reducing the recovery time, surgical trauma, complication incidence, length of hospital stay, treatment cost, the improvement of overall wellbeing post-surgery and patients’ quality of life. Th ese principles proved effective to avoid intra- and postoperative complications of laparoscopic adrenalectomy and facilitated revamping of the operation technique in left -sided adrenalectomy.Conclusion. Th e benchmark principles of laparoscopic adrenalectomy enable the procedure higher efficacy and safety and require further implementation and long-term assessment of the outcome.

7

Cakmak, Yusuf, Duygu Kavak Comert, Isik Sozen, and Tufan Oge. "Comparison of Laparoscopy and Laparotomy in Early-Stage Endometrial Cancer: Early Experiences from a Developing Country." Journal of Oncology 2020 (April 30, 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.

8

Patil, Milind, Manish Baria, and Ankita Parmar. "A study of the complications among the patients undergoing retroperitoneal and transperitoneal laparoscopic nephrectomy for pyonephrosis." International Journal of Research in Medical Sciences 7, no. 11 (October 24, 2019): 4287. http://dx.doi.org/10.18203/2320-6012.ijrms20195003.

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Background: Nowadays laparoscopy have gained wider acceptance in urology that leads to more reports on the potential complications. This study was conducted to evaluate the complications among the patients undergoing retroperitoneal and transperitoneal laparoscopic nephrectomy.Methods: Analysis was done retrospectively through review of a maintained database of 219 consecutive laparoscopic simple nephrectomies done for pyonephrosis from July 2001 to February 2013 at the department of urology Civil Hospital and B J Medical College Ahmedabad.Results: Total 219 simple nephrectomies performed between July 2001 to February 2013 for pyonephrosis. In 165 (75.3%) of patient’s procedure was through trans peritoneal route while retroperitoneal access was used in 54(24.6%) patients. In our study there were major complications in 12 patients with laparoscopic transperitoneal group and in 4 patients in laparoscopic retro peritoneal group. The minor complication rate in present study was 13.3% (22/165) in laparoscopic transperitoneal group and 11.1% (6/54) in laparoscopic retroperitoneal group.Conclusions: There were major complications in patients with laparoscopic transperitoneal group and in few patients in laparoscopic retro peritoneal group. In most other series it was seen that retroperitoneoscopic surgery may be associated with more complications, the findings are unfounded. Minor complications can be managed easily if there is low threshold for conversion to open surgery.

9

MAGRINA, JAVIER F. "Complications of Laparoscopic Surgery." Clinical Obstetrics and Gynecology 45, no. 2 (June 2002): 469–80. http://dx.doi.org/10.1097/00003081-200206000-00018.

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10

KAVOUSSI, LOUIS R., R. ERNEST SOSA, and CARL CAPELOUTO. "Complications of Laparoscopic Surgery." Journal of Endourology 6, no. 2 (April 1992): 95–98. http://dx.doi.org/10.1089/end.1992.6.95.

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11

Conter, Robert L. "Complications of Laparoscopic Surgery." Journal of Laparoendoscopic Surgery 5, no. 3 (June 1995): 211–12. http://dx.doi.org/10.1089/lps.1995.5.211a.

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12

Nishii, O., H. Ohnuki, and O. Yoshino. "Complications of Laparoscopic Surgery." Journal of Minimally Invasive Gynecology 16, no. 6 (November 2009): S126. http://dx.doi.org/10.1016/j.jmig.2009.08.476.

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13

Ledger, William L. "Complications of laparoscopic surgery." Obstetrics, Gynaecology & Reproductive Medicine 19, no. 7 (July 2009): 193–96. http://dx.doi.org/10.1016/j.ogrm.2009.03.004.

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14

Cuss, Amanda, and Jason Abbott. "Complications of laparoscopic surgery." Obstetrics, Gynaecology & Reproductive Medicine 22, no. 3 (March 2012): 59–62. http://dx.doi.org/10.1016/j.ogrm.2011.12.002.

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15

Plasencia, Gustavo. "Complications of Laparoscopic Surgery." Gastrointestinal Endoscopy 43, no. 2 (February 1996): 181–82. http://dx.doi.org/10.1016/s0016-5107(06)80137-9.

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16

Arnold, Amy, and Jason Abbott. "Complications of laparoscopic surgery." Obstetrics, Gynaecology & Reproductive Medicine 24, no. 8 (August 2014): 250–53. http://dx.doi.org/10.1016/j.ogrm.2014.05.003.

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17

O'Donovan, Oliver P., and Arvind Vashisht. "Complications of laparoscopic surgery." Obstetrics, Gynaecology & Reproductive Medicine 27, no. 7 (July 2017): 213–17. http://dx.doi.org/10.1016/j.ogrm.2017.04.004.

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18

Khan, Zaibun, and Kenneth Ma. "Complications of laparoscopic surgery." Obstetrics, Gynaecology & Reproductive Medicine 30, no. 11 (November 2020): 342–46. http://dx.doi.org/10.1016/j.ogrm.2020.09.003.

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19

Crist, David W., and Thomas R. Gadacz. "Complications of Laparoscopic Surgery." Surgical Clinics of North America 73, no. 2 (April 1993): 265–89. http://dx.doi.org/10.1016/s0039-6109(16)45981-5.

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20

Shettko, Donna L. "Complications in Laparoscopic Surgery." Veterinary Clinics of North America: Equine Practice 16, no. 2 (August 2000): 377–83. http://dx.doi.org/10.1016/s0749-0739(17)30112-8.

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21

Capelouto, Carl C., and Louis R. Kavoussi. "Complications of laparoscopic surgery." Urology 42, no. 1 (July 1993): 2–12. http://dx.doi.org/10.1016/0090-4295(93)90324-4.

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22

Hendrickson, Dean A. "Complications of Laparoscopic Surgery." Veterinary Clinics of North America: Equine Practice 24, no. 3 (December 2008): 557–71. http://dx.doi.org/10.1016/j.cveq.2008.09.003.

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23

Berci, G. "Complications of laparoscopic surgery." Surgical Endoscopy 8, no. 3 (March 1994): 165–66. http://dx.doi.org/10.1007/bf00591823.

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24

Carey, Larry C. "Complications of Laparoscopic Surgery." JAMA: The Journal of the American Medical Association 274, no. 16 (October 25, 1995): 1313. http://dx.doi.org/10.1001/jama.1995.03530160065039.

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25

Johal, KS, P. Tsim, A. Redfern, C. Weeks, HM Park, C. Morris, P. Kang, and C. Maxwell-Armstrong. "Single-Incision Laparoscopic Surgery Versus Conventional Techniques." Bulletin of the Royal College of Surgeons of England 94, no. 10 (November 1, 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.

26

Sun, Jian, Tania Stafinski, Fernanda Inagaki Nagase, and Devidas Menon. "PP164 Identifying Complications Of Partial Nephrectomy Using Physician Claims." International Journal of Technology Assessment in Health Care 34, S1 (2018): 130–31. http://dx.doi.org/10.1017/s026646231800288x.

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Introduction:Many population-based studies identify surgical complications using hospital discharge abstract databases (DAD). With DAD, however, complications occurring after the discharge date cannot be followed up. This study used physician claims data to identify the complications of partial nephrectomy, and to compare the rates of complications of open, laparoscopic, and robot-assisted nephrectomies.Methods:Physician claims, DAD, and ambulatory care data from April 2003 to March 2016 were provided by Alberta Health. DAD and ambulatory care data were used to extract information on patients with kidney cancer who underwent partial nephrectomy. All physician claims within 30 days before and after surgery for the cohort were extracted. The numbers of the same International Classification of Diseases, Ninth Revision (ICD-9), codes before and after surgery were compared. If a number increased after surgery, this diagnosis was initially identified as a complication. All diagnoses with neoplasms were excluded. The incidence rates of complications for the three surgery groups were calculated. Chi-squared tests were conducted for the following nephrectomy comparisons: laparoscopic versus open; robot-assisted versus open; and robot-assisted versus laparoscopic.Results:A total of 1,890 kidney cancer patients had partial nephrectomies. Among them, 1,080, 411, and 399 had open, laparoscopic, and robot-assisted nephrectomies, respectively. One patient who had two different nephrectomies on the same day was excluded from analysis. The robot-assisted group had lower rates of digestive complications (ICD-9: 537–578, 787, 789, 998.6) and infections (ICD-9: 004–041, 998.5) than the open group, and higher rates of genitourinary complications (ICD-9: 584–599, 788, 997.5) than the laparoscopy group. The robot-assisted group had lower rates than the open group for most of the complication categories, but the differences were not statistically significant.Conclusions:Robot-assisted surgery appears to be superior to open surgery, but no better than laparoscopic surgery, in terms of minimizing the risk of complications following partial nephrectomy.

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Kiblawi, Rim, Christoph Zoeller, Andrea Zanini, Joachim F. Kuebler, Carmen Dingemann, Benno Ure, and Nagoud Schukfeh. "Laparoscopic versus Open Pediatric Surgery: Three Decades of Comparative Studies." European Journal of Pediatric Surgery 32, no. 01 (December 21, 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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Rehman Abbasi, Mujeeb, Muhammad Qasim Mallah, Muhammad Rafique Pathan, Sadaf Iqbal, and Ubedullah Shaikh. "Frequency of umbilicus site port hernia after laparoscopic procedure." Professional Medical Journal 26, no. 08 (August 10, 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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Case, J. Brad, Pedro L. Boscan, Eric L. Monnet, Sirirat R. Niyom, Darren J. Imhoff, Mandy L. Wallace, and 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, no. 1 (January 1, 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.

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Gelbard, Rondi, Desmond Khor, Kenji Inaba, Obi Okoye, Crystal Szczepanski, Kazuhide Matsushima, Aaron Strumwasser, Peter Rhee, and Demetrios Demetriades. "Role of Laparoscopic Surgery in the Current Management of Mirizzi Syndrome." American Surgeon 84, no. 5 (May 2018): 667–71. http://dx.doi.org/10.1177/000313481808400517.

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Mirizzi syndrome (MS) is an uncommon complication of cholelithiasis caused by extrinsic biliary compression by stones in the gallbladder infundibulum or cystic duct. The purpose of this study was to evaluate the outcomes associated with a laparoscopic approach to this disease process. This is a 10-year, retrospective study conducted at two academic medical centers with established acute care surgery practices. Patients with a diagnosis of MS confirmed intraoperatively were included. Eighty-eight patients with MS were identified with 55 (62.5%) being type 1. Twenty six (29.5%) patients, all type 1, underwent successful laparoscopic cholecystectomy. Of the 62 patients that underwent open cholecystectomy, 27.3 per cent had a laparoscopy converted to open procedure. There was no significant difference in overall complications (19.2 vs 29%) among those undergoing laparoscopic versus open cholecystectomy. Length of stay was lower in patients that had a laparoscopic approach ( P = 0.001). Laparoscopic cholecystectomy can safely be attempted in type 1 MS and seems to be associated with fewer overall complications and shorter length of stay compared with an open approach.

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Siletz, Anaar, Jonathan Grotts, Catherine Lewis, Areti Tillou, Henry Magill Cryer, and Ali Cheaito. "Comparative Analysis of Laparoscopic and Open Approaches in Emergency Abdominal Surgery." American Surgeon 83, no. 10 (October 2017): 1089–94. http://dx.doi.org/10.1177/000313481708301015.

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The objective of this study was to evaluate usage and outcomes of emergency laparoscopic versus open surgery at a single tertiary academic center. Over a three-year period 165 patients were identified retrospectively using National Surgical Quality Improvement Program results. Appendectomies and cholecystectomies were excluded. Open and laparoscopic approaches were compared regarding preoperative and operative characteristics, the development of postoperative complications, 30-day mortality, and length of hospital stay. Indications for operation were similar between groups. Patients who underwent open surgery had more severe comorbidities and higher ASA class. Laparoscopy was associated with reduced complication rates, operative time, length of stay, and discharges to skilled nursing facilities on univariate analysis. In a multivariate model, surgical approach was not associated with the development of complications. Older age, dependent status, and dyspnea were predictors of conversion from attempted laparoscopic to open approaches.

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Ghimire, Asmita, Padam Raj Pant, Nilam Subedi, and Samriddha Raj Pant. "Trends of laparoscopic gynecologic surgeries in a tertiary care center: A five-year retrospective study." Grande Medical Journal 1, no. 1 (January 3, 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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Ghani, Umar Fayyaz, Faran Khan, Ameer Yasser Zaid, and Khan Dost Afridi. "LAPAROSCOPIC SURGERY;." Professional Medical Journal 21, no. 03 (June 10, 2014): 529–34. http://dx.doi.org/10.29309/tpmj/2014.21.03.2138.

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Objective: To observe the rate of complications during elective laparoscopiccholecystectomies. Design and study duration: It was a prospective study and was carried outfrom July 2011 to June 2012. Setting: The study was conducted at PAF Hospital Islamabad.Patients: 105 patients with gall stone disease who underwent elective laparoscopiccholecystectomy. Material and Methods: 105 patients ranging in age from 23yrs to 81yrs wereoperated. 12 were males and 93 were females. History, clinical examination and ultrasonographywere used to diagnose the presence of gall stones. Patients with acute symptoms were excludedfrom the study. Results: The main complications encountered were iatrogenic perforation of thegall bladder (8), haemorrhage (7), post-operative bile leakage (4), and large gut injury (1).Conversion to open surgery was done in three cases due to difficulty in identifying anatomy and incase of large gut injury. There was one death. Conclusions: Laparoscopic cholecystectomy (LC)has become the preferred method of treatment in surgery for gall stone disease. A soundknowledge of the complications and their management makes this a safe procedure.

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Tay, Eng-Hseon. "Laparoscopic Pelvic Surgery for Endometrial Cancer." Annals of the Academy of Medicine, Singapore 38, no. 2 (February 15, 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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Thompson, M. H., and J. R. Benger. "Cholecystectomy, Conversion and Complications." HPB Surgery 11, no. 6 (January 1, 2000): 373–78. http://dx.doi.org/10.1155/2000/56760.

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Background Faced with a difficult laparoscopic cholecystectomy the surgeon may feel that conversion to open operation would risk greater complications because of the laparotomy. Information on the effect of conversion is lacking. The purpose of this study is to measure the complications of laparoscopic cholecystectomy and observe the effect of the conversion rate.Methods A total of 957 patients were studied. There were three consecutive series of patients; the first undergoing open cholecystectomy (384 patients), the second laparoscopic cholecystectomy with a 5.8% conversion rate (412 patients) and the third laparoscopic cholecystectomy with a 1.3% conversion rate (161 patients). Data was collected prospectively using a continuous audit, and the complication rate compared on an intention to treat basis. In addition a panel of experienced surgeons was asked to score the complications depending on their severity and a composite complication score calculated. Comparison between the 3 groups was then undertaken. Results Open cholecystectomy produced a postoperative complication rate of 6%. Initially this appeared to fall to 3.1% with the introduction of laparoscopic cholecystectomy, but when the complications occurring in the converted patients were included (i.e., on an intention to treat basis) the rate increased to 5.6% in the first group of laparoscopically- treated patients and 3.1% in the second. These differences were not statistically significant. A similar pattern emerged when scoring the severity of the complications as judged by the expert panel. The inclusion of intra-operative complications appears to remove any small advantage for laparoscopic cholecystectomy. The reduction in the conversion rate between the two laparoscopic groups from 5.8% to 1.2% was statistically significant.Conclusion When considered on an intention to treat basis laparoscopic cholecystectomy offers no advantage over open operation in terms of the frequency or severity of complications. Reducing the frequency of conversion from a laparoscopic to an open procedure also has no significant effect on the complications encountered. We conclude, therefore, that the complication rate is independent of the conversion rate and that the surgeon, when faced with difficulty at laparoscopic cholecystectomy, should not be deterred from converting to open operation for fear of the post-operative consequences.

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Gencdal, Servet, and Emre Ekmekci. "Comparison of Mini-Laparoscopic and Conventional Laparoscopic Surgery for Tubal Ligation." Gynecology Obstetrics & Reproductive Medicine 24, no. 3 (December 25, 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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Santarelli, Stefano, Matthias Zeiler, Tania Monteburini, Rosa Maria Agostinelli, Rita Marinelli, Giorgio Degano, and Emilio Ceraudo. "Videolaparoscopic Catheter Placement Reduces Contraindications to Peritoneal Dialysis." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 33, no. 4 (July 2013): 372–78. http://dx.doi.org/10.3747/pdi.2011.00314.

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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.

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Fuentes, Mariña Naveiro, Antonio Rodríguez-Oliver, José Cesáreo Naveiro Rilo, Aida González Paredes, María Teresa Aguilar Romero, and Jorge Fernández Parra. "Complications of Laparoscopic Gynecologic Surgery." JSLS : Journal of the Society of Laparoendoscopic Surgeons 18, no. 3 (2014): e2014.00058. http://dx.doi.org/10.4293/jsls.2014.00058.

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Istanbulluoglu, Mustafa Okan, and Mehmet Kaynar. "Complications in Urologic Laparoscopic Surgery." Türk Üroloji Seminerleri/Turkish Urology Seminars 1, no. 5 (September 1, 2010): 142–46. http://dx.doi.org/10.5152/tus.2010.18.

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Krishnakumar, S., and P. Tambe. "Entry complications in laparoscopic surgery." Journal of Gynecological Endoscopy and Surgery 1, no. 1 (2009): 4. http://dx.doi.org/10.4103/0974-1216.51902.

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Larach, Sergio, Sanjiv Patankar, Santiago Perozo, Andrea Ferrara, and Paul Williamson. "COMPLICATIONS OF LAPAROSCOPIC COLORECTAL SURGERY." Southern Medical Journal 89, Supplement (October 1996): S22. http://dx.doi.org/10.1097/00007611-199610001-00026.

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Querleu, Denis, and Charles Chapron. "Complications of gynecologic laparoscopic surgery." Current Opinion in Obstetrics and Gynecology 7, no. 4 (August 1995): 257???261. http://dx.doi.org/10.1097/00001703-199508000-00005.

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Madeb, Ralph, Leonidas G. Koniaris, Hitendra R. H. Patel, James F. Dana, Ofer Nativ, Boaz Moskovitz, Erdal Erturk, and Jean V. Joseph. "Complications of Laparoscopic Urologic Surgery." Journal of Laparoendoscopic & Advanced Surgical Techniques 14, no. 5 (October 2004): 287–301. http://dx.doi.org/10.1089/lap.2004.14.287.

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Boni, Luigi, Angelo Benevento, Francesca Rovera, Gianlorenzo Dionigi, Matteo Di Giuseppe, Camillo Bertoglio, and Renzo Dionigi. "Infective Complications in Laparoscopic Surgery." Surgical Infections 7, supplement 2 (July 2006): s—109—s—111. http://dx.doi.org/10.1089/sur.2006.7.s2-109.

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Philosophe, Ralph. "Avoiding complications of laparoscopic surgery." Fertility and Sterility 80 (October 2003): 30–39. http://dx.doi.org/10.1016/s0015-0282(03)01189-0.

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Elsamra, Sammy, and Gyan Pareek. "Complications of laparoscopic renal surgery." International Journal of Urology 17, no. 3 (March 2010): 206–14. http://dx.doi.org/10.1111/j.1442-2042.2010.02446.x.

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Vasquez, Jaime M., Annick M. Demarque, and Michael P. Diamond. "Vascular complications of laparoscopic surgery." Journal of the American Association of Gynecologic Laparoscopists 1, no. 2 (February 1994): 163–67. http://dx.doi.org/10.1016/s1074-3804(05)80783-2.

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Hur, M., and BH Kang. "Complications of multipuncture laparoscopic surgery." Journal of the American Association of Gynecologic Laparoscopists 3, no. 4 (August 1996): S18. http://dx.doi.org/10.1016/s1074-3804(96)80192-7.

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PHILOSOPHE, R. "Avoiding complications of laparoscopic surgery." Sexuality, Reproduction and Menopause 1, no. 1 (October 2003): 30–39. http://dx.doi.org/10.1016/j.sram.2004.02.022.

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Callery, Mark P., Steven M. Strasberg, and Nathaniel J. Soper. "Complications of Laparoscopic General Surgery." Gastrointestinal Endoscopy Clinics of North America 6, no. 2 (April 1996): 423–44. http://dx.doi.org/10.1016/s1052-5157(18)30370-2.

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