Safety of Left Upper Quadrant Entry during Laparoscopic Surgery in Obese Patients with a History of Prior Abdominal Surgery

2014 ◽  
Vol 21 (6) ◽  
pp. S180-S181
Author(s):  
K.M. Wishall ◽  
J.M. Seufert ◽  
R.B. Danis ◽  
N. Pereira ◽  
C.R. Della Badia
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Obese Patients ◽  
History Of

scholarly journals Role of ultrasound in reducing complication during primary trocar insertion in laparoscopic surgery: prospective observational study

2018 ◽  
Vol 7 (7) ◽  
pp. 2747
Author(s):  
Vandana Dhama ◽  
Vipin Dhama ◽  
Rachna Chaudhary ◽  
Shakun Singh ◽  
Saba Aafrin
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Abdominal Cavity ◽  
Rectus Sheath ◽  
Previous Abdominal Surgery ◽  
Slide Test ◽  
History Of ◽  
Visceral Slide

Background: Patients presenting to Gynecology OPD at LLRM Medical College, Meerut, UP, India for benign laparoscopic surgery from June 2016 to May 2017 were included in the study. A total of 130 women completed the study of which 30 had history of previous abdominal surgery and 100 had no history of previous abdominal surgery. The ability of the visceral slide test to detect periumbilical adhesions was compared with laparoscopic detection of adhesions.Methods: Patients fulfilling inclusion and exclusion criteria and preanaesthetic clearance were subjected to office based Visceral Slide test using high frequency ultrasound probe (7.5 MHz) in the sagittal plane at the level of umbilicus. Distance between the skin and posterior rectus sheath was measured. Diagnostic accuracy of visceral slide test and mean time taken to perform the test was noted.Results: On laparoscopy 4 women had periumbilical adhesions while 24 women in the total sample had adhesions elsewhere in the abdominal cavity. The visceral slide test had a sensitivity of 75%, specificity of 98%, positive predictive value of 75% and negative predictive value of 99%. The diagnostic accuracy of the test is 97%. The median time to perform the examination was 1.69 minutes.Conclusions: The visceral slide technique was convenient and rapid to perform, and reliably identified adhesions in the periumbilical area.

scholarly journals Laparoscopic Redo Ileocolic Resection for Crohn’s Disease in Patients with Previous Multiple Laparotomies

2018 ◽  
Vol 108 (1) ◽  
pp. 42-48 ◽  
Author(s):  
V. Celentano ◽  
F. Sagias ◽  
K. G. Flashman ◽  
J. Conti ◽  
J. Khan
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Conversion Rate ◽  
Operating Time ◽  
Ileocolic Resection ◽  
Short Term ◽  
Previous Abdominal Surgery ◽  
History Of

Purposes: Over 80% of patients with primary ileocolic Crohn’s disease have a surgical resection within 10 years of diagnosis, and 40%–50% of them need further surgery within 15 years. Laparoscopic surgery can be challenging due to a thickened mesentery and the potential for fistulas, abscesses, and phlegmons. Aim of this study is to analyze the short-term outcomes of laparoscopic redo ileocolic resections for Crohn’s disease in patients with previous multiple laparotomies. Methods: All patients undergoing laparoscopic surgery for ileocolic Crohn’s disease from March 2006 to February 2017 were prospectively evaluated. Short term outcomes of laparoscopic ileocolic resection were compared between patients with previous multiple major surgeries and recurrent Crohn’s disease, and patients undergoing surgery for the first presentation of Crohn’s disease and no history of previous surgery. Conversion rate and 30-day morbidity were the primary outcomes. Reoperations, readmissions, operating time and length of stay were the secondary outcomes. Results: 29 patients with recurrent Crohn’s disease and previous multiple laparotomies were included: the number of laparotomies these patients previously underwent was 2 in 19 cases (65.5%), 3 in 9 (31%), and 4 in 1 (3.5%). In total, 90 patients with no history of any previous abdominal surgery, who underwent laparoscopic ileocecal resection for Crohn’s disease, represented the control group. No differences were found in morbidity and conversion rate. Operating time was longer in patients with history of previous abdominal surgery. Conclusion: Laparoscopic redo ileocolic resection for Crohn’s disease is feasible and safe in patients with previous multiple laparotomies at the expense of longer operating time.

scholarly journals A Case of Strangulation Ileus Caused by the Omentum Adhesion without a History of Abdominal Surgery Treated by Laparoscopic Surgery

2018 ◽  
Vol 43 (1) ◽  
pp. 67-71
Author(s):  
Koichiro Niwa ◽  
Kumpei Honjo ◽  
Shinya Munakata ◽  
Rina Takahashi ◽  
Shun Ishiyama ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
History Of ◽  
Strangulation Ileus

scholarly journals Evaluation of Adhesions Underneath Laparoscopic Sterilization Scar in Patients Undergoing Abdominal Surgery

2020 ◽  
pp. 27-32
Author(s):  
Ravi Singh Dogra ◽  
Sanjeev Kumar ◽  
Som Raj Mahajan ◽  
Rajesh Chaudhary ◽  
Poonam Dogra ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Adhesion Formation ◽  
Invasive Approach ◽  
Medical College ◽  
History Of ◽  
Intraoperative Period ◽  
One Year ◽  
Laparoscopic Sterilization ◽  
Umbilical Scar

Introduction: The minimally invasive approach has become the method of choice for treating most benign abdominal diseases that require surgery. However, it is obvious that laparoscopic procedures are not risk free. The aim of this study was to evaluate the prevalence of intra abdominal adhesions underneath umbilical scar following laparoscopic sterilization, in patients who are undergoing abdominal surgeries. Materials and Methods: The present study was a hospital based prospective observational study conducted in the Department of Surgery, Dr Rajendra Prasad Government Medical College (Dr. RPGMC), Kangra at Tanda (HP). The study group consisted of patients admitted to department of surgery during a period of one year and who fulfilled inclusion criteria. During intraoperative period, they were examined for presence or absence of adhesions at the site of previous laparoscopic sterilization scar at Periumblical area. Results: Total of 60 patients were taken in this study. Two out of 60 (3.3%) patients had adhesions underneath previous Laparoscopic Sterilization scar around umbilicus and adhesive structure was omentum in both cases. Conclusion: Adhesion formation is expected in any abdominal surgery whether open or laparoscopic surgery. In our study only 3.3% of patients had adhesions underneath previous laparoscopic sterilization scar in periumblical region. Therefore umbilical port can be considered for re-entry of index port in next laparoscopic surgery, in patients with history of laparoscopic surgery through umbilical region.

scholarly journals Single-Incision Laparoscopic Surgery for Undiagnosed Small Bowel Obstruction in a Patient without a History of Abdominal Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Noriaki Koizumi ◽  
Hiroki Kobayashi ◽  
Tsuyoshi Takagi ◽  
Kanehisa Fukumoto
Keyword(s):  
Laparoscopic Surgery ◽  
Small Bowel ◽  
Abdominal Surgery ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Single Incision ◽  
Definitive Diagnosis ◽  
Single Incision Laparoscopic Surgery ◽  
Umbilical Incision ◽  
History Of

We herein report a 66-year-old female patient who developed an undiagnosed small bowel obstruction without a history of prior abdominal surgery and was successfully treated by single-incision laparoscopic surgery. A small bowel obstruction with unknown cause typically requires some sort of surgical treatment in parallel with a definitive diagnosis. Although open abdominal surgery has been generally performed for the treatment of small bowel obstructions, laparoscopic surgery for small bowel obstructions has been increasing in popularity due to its less invasiveness, including fewer postoperative complications and a shorter hospital stay. As a much less invasive therapeutic strategy, we have performed single-incision laparoscopic surgery for the treatment of an undiagnosed small bowel obstruction. We were able to make a definitive diagnosis after sufficient intra-abdominal inspection and to perform enterotomy through a small umbilical incision. Single-incision laparoscopic surgery appears to be comparable to conventional laparoscopic surgery and provides improved cosmesis, although it is an optional strategy only applicable to selected patients.

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

Gut Microbiota Patterns in Obese and Type 2 Diabetes (T2D) Patients from Romanian Black Sea Coast Region

2018 ◽  
Vol 69 (8) ◽  
pp. 2260-2267 ◽  
Author(s):  
Andra Iulia Suceveanu ◽  
Anca Pantea Stoian ◽  
Irinel Parepa ◽  
Claudia Voinea ◽  
Razvan Hainarosie ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Organic Acid ◽  
Black Sea ◽  
Metabolic Disorders ◽  
Obese Patients ◽  
Bacterial Counts ◽  
Black Sea Coast ◽  
History Of ◽  
Coast Region ◽  
Sea Coast

Gut microbiota plays a major role in the process of food absorption and low grade inflammation, two key steps in obesity and diabetes mellitus occurrence. Gut microbiota metabolites, such as short chain fatty acids (SCFA), have an important impact over the metabolic pathways like insulin signalling, incretin production and inflammation. [1-3] We aimed to study the microbiota patterns in obese and T2D patients from Black Sea Coast region, considering the ethnic mixture, environmental and geographical particularities, involving diet or various habits in this area. 100 patients and 100 controls matched by age, gender and ethnicity were studied regarding feaces predominance of Lactobacillus and Bifidobacterium species. We compared the results of microbiota patterns from patients to those obtained in a similar control group of healthy subjects. The standard pour plate 0.05% L-cystine enriched method was used to obtain the bacterial cultures and anaerobic conditions. Morphological and biochemical tests were used to identify the Lactobacillus and Bifidobacterium spp. Fecal organic acid concentrations were explored in frozen samples. The association between bacterial counts/organic acid concentrations and independent variables, including age, diet, ethnicity and other risk factors were calculated using multivariable linear regression analysis. Pearson�s correlation coefficients were calculated to detect associations between fecal bacteria counts/organic acid concentrations and laboratory variables (serum biomarkers, body mass index, age, and severity of obesity/T2D according to international scales). Junk and sweet diets, lack of physical activity and familial aggregation of hypercholesterolemia and diabetes were significantly more often present in our T2D/obese patients than in controls. The bacterial counts of the L. acidophilus, L plantarum and L. reuteri subgroups of Lactobacillus sp were significantly lower among patients with T2D and obesity than in controls. The counting of Bifidobacterium spp revealed a higher presence of B. bifidum in controls than in obese or T2D patients. Diet type (junk food and sweets), BMI (]25) and personal history of metabolic disorders were associated with decreased counts of L acidophilus and increased counts of L. fermentum and B. adolescentis in T2D patients. Ethnicity, metabolic disorders history and junk and sweet diet were associated with low counts of L. acidophilus and L. reuteri and low counts of B. longum. Junk and sweet diet was associated with low counts of B. bifidum. Romanian ethnicity and metabolic disorders were associated with low counts of B. choerinum at obese patients, independent of age or previous antidiabetic treatments. The concentrations of acetic and butyric acids were significantly lower in all patients groups, while the concentrations of valeric acid were significantly higher in patients with untreated T2D and obese patients compared to the controls. Low counts of L. acidophilus and L. reuteri were positively correlated with the increased levels of HbA1c, LDL cholesterol, TG and inflammatory markers such as CRP, ESR and IL-6, no matter of diet, age, ethnicity or metabolic disorders history. Also, low counts of B. bifidum and B. infantis were positively correlated with high levels of CRP, IL-6 and TG. In obese patients, statistic analysis results showed that low counts of L. acidophilus, L. plantarum, L. johnsonii and L. reuteri were positively associated with increased levels of CPR, IL-6 and TG, while low counts of B. bifidum, B infantis and B. breve were positively correlated with higher counts of CPR, LDL cholesterol and TG. Low counts of B. bifidum and B choerinum were positively correlated with low counts of HDL cholesterol in Romanian ethnicity patients and in those with previous metabolic disorders. Low bacterial counts of some particular strains of Lactobacillus spp and Bifidobacterium spp were positively correlated with diet type, BMI, Romanian ethnicity and personal history of metabolic disorders obese and T2D patients from Romanian Black Sea Coast Region.

scholarly journals Pancreatic enzymatic mediastinitis followed by total gastrectomy with splenectomy: report of two cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoko Zaitsu ◽  
Takashi Nishizaki ◽  
Takuma Izumi ◽  
Daisuke Taniguchi ◽  
Yuichiro Kajiwara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Abdominal Surgery ◽  
Ct Scan ◽  
Pancreatic Fistula ◽  
Medical History ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Upper Body ◽  
History Of ◽  
Acute Mediastinitis

Abstract Background Acute mediastinitis is a rare disease that rapidly progresses with a high mortality rate. Its most common cause is direct injury of the mediastinum, including iatrogenic causes such as cardiac surgery or upper endoscopy. Enzymatic mediastinitis is a rare complication of a pancreatic fistula caused by the inflammatory digestion of the parietal peritoneum spreading to the mediastinum. Here, we present two cases of enzymatic mediastinitis caused by total gastrectomy with splenectomy. One of them was successfully treated and cured after early diagnosis and transabdominal drainage. Case presentation Case 1 was that of a 60-year-old man (body mass index [BMI] 27) with a medical history of diabetes and hypertension who was diagnosed with advanced gastric cancer in the upper body of the stomach. A total gastrectomy with splenectomy was performed. The patient experienced acute respiratory failure 24 h after surgery. Pulmonary embolism was suspected, so a computed tomography (CT) scan was performed; however, no relevant causes were found. Although he was immediately intubated and treated with catecholamine, he died in the intensive care unit (ICU) 40 h after surgery. Post-mortem findings revealed retroperitonitis caused by a pancreatic fistula spreading towards the mediastinum, causing severe mediastinitis; a review of the CT scan revealed pneumomediastinum. We concluded that the cause of death was enzymatic mediastinitis due to post-gastrectomy pancreatic fistula. Case 2 involved a 61-year-old man (BMI 25) with a medical history of appendicitis who was diagnosed with advanced gastric cancer at the gastric angle between the lesser curvature and the pylorus, spreading to the upper body of the stomach. A total gastrectomy with splenectomy was also performed. The patient had a high fever 3 days after the surgery, and a CT scan revealed pneumomediastinum, indicating mediastinitis. As the inflammation was below the bronchial bifurcation, we chose a transabdominal approach for drainage. The patient was successfully treated and discharged. Conclusion Acute mediastinitis caused by gastrectomy is rare. The acknowledgment of abdominal surgery as a cause of mediastinitis is important. In treating mediastinitis caused by abdominal surgery, transabdominal drainage may be a minimally invasive yet effective method if the inflammation is mainly located below the bifurcation of the trachea.

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