General surgery

2016 ◽  
Author(s):  
Matt Rucklidge ◽  
Andrew McLeod ◽  
Tim Wigmore
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
General Surgery ◽  
Breast Surgery ◽  
Fluid Management ◽  
Anaesthetic Management ◽  
Emergency Laparotomy ◽  
Colonic Surgery ◽  
Control Fluid

This chapter discusses the anaesthetic management of general surgery. It begins with a description of management principles for several of the important considerations: analgesia, temperature control, fluid management, and oncological considerations. Surgical procedures covered include colorectal surgery, emergency laparotomy, laparoscopic surgery (including laparoscopic cholecystectomy and laparoscopic colonic surgery), appendicectomy, inguinal hernia repair, haemorrhoidectomy, testicular surgery, and breast surgery.

General surgery

2018 ◽  
Author(s):  
Matt Rucklidge ◽  
Andrew McLeod ◽  
Tim Wigmore
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
General Surgery ◽  
Breast Surgery ◽  
Fluid Management ◽  
Anaesthetic Management ◽  
Emergency Laparotomy ◽  
Colonic Surgery ◽  
Control Fluid

This chapter discusses the anaesthetic management of general surgery. It begins with a description of management principles for several of the important considerations: analgesia, temperature control, fluid management, and oncological considerations. Surgical procedures covered include colorectal surgery, emergency laparotomy, laparoscopic surgery (including laparoscopic cholecystectomy and laparoscopic colonic surgery), appendicectomy, inguinal hernia repair, haemorrhoidectomy, testicular surgery, and breast surgery.

Gastrointestinal surgery

2021 ◽  
pp. 669-684
Author(s):  
Matt Rucklidge ◽  
Peter Garnett
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
Gastrointestinal Surgery ◽  
Anaesthetic Management ◽  
Colonic Surgery ◽  
Laparoscopic Surgical Procedures

This chapter discusses the anaesthetic management of gastrointestinal surgery. It begins with a description of management principles for major gastrointestinal (GI) surgery, both open and laparoscopic. Surgical procedures covered include colorectal surgery; laparoscopic surgery (including laparoscopic cholecystectomy and laparoscopic colonic surgery); appendicectomy; inguinal hernia repair, and anal/perianal procedures

scholarly journals Pilvo sienos kartografija ir jos reikšmė laparoskopinėje chirurgijoje

2004 ◽  
Vol 2 (1) ◽  
pp. 0-0
Author(s):  
Algimantas Stašinskas ◽  
Raimundas Lunevičius
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Inguinal Hernia Repair ◽  
Anterior Abdominal Wall ◽  
Central Point ◽  
Rule Following ◽  
Point Mark

Algimantas Stašinskas, Raimundas LunevičiusVilniaus universiteto Bendrosios ir kraujagyslių chirurgijos klinika,Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT–2043 VilniusEl paštas: [email protected], [email protected] Tikslinga priekinės pilvo sienos laukus žymėti pagal vieną sistemą ir ta sistema remtis atliekant laparoskopines operacijas. Centrinis priekinės pilvo sienos atskaitos taškas yra bamba (žymuo "O"). Priekinė pilvo siena skirstoma į keturis tradicinius kvadrantus A, B, C, D, o kiekvienas – į tris sektorius a, b, c ir tris zonas P, M, L. Dalijant į sektorius reikia pasinaudoti laikrodžio rodyklės sukimosi taisykle. Remiantis šia schema sutartiniais ženklais pažymimi 36 priekinės pilvo sienos taškai ir 36 laukai. Pateiktos keturios laparoskopinių operacijų – cholecistektomijos, apendektomijos, kirkšninės hernioplastikos ir duodenorafijos – kartogramos. Prasminiai žodžiai: pilvo sienos kartografija, pilvo sienos schema, laparoskopinė chirurgija Abdominal wall cartography and its significance in laparoscopic surgery Algimantas Stašinskas, Raimundas Lunevičius It is reasonable that the fields of the anterior abdominal wall should be marked according to one system which could be strictly preserved in laparoscopic surgery. A cartographic scheme of the anterior abdominal wall is presented in this paper. The umbilicus is the central point (mark "O"). The anterior abdominal wall was divided into four traditional quadrants, A, B, C, and D. Each of them was subdivided into 3 sectors, a, b, and c, as well as three zones P (proximal), M (middle), and L (lateral). The bourders of the sectors have to be subdivided according to a clockwise rule. Following this scheme, 36 points and 36 fields are marked. There are presented four cartographic maps for laparoscopic cholecystectomy, appendectomy, inguinal hernia repair and duodenorrhaphy. Keywords: abdominal wall cartography, abdominal map, laparoscopic surgery

scholarly journals P-EGS06 Evaluating the impact of COVID-19 on the trend of emergency laparoscopic cholecystectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Simrita Agrawal ◽  
Chaminda Sellahewa
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Royal College ◽  
General Surgery ◽  
Gallstone Disease ◽  
Surgical Care ◽  
Unknown Risk ◽  
The Uk ◽  
Emergency Cholecystectomy ◽  
The Impact

Abstract Background Since the spread of the new SARS-CoV2 coronavirus in March 2020 to the UK, contradictory recommendations on the practice of laparoscopic cholecystectomies fuelled some debates among surgeons. The British Intercollegiate General Surgery Guidance recommended laparoscopic cholecystectomy as the treatment of choice for acute cholecystitis during the COVID-19 pandemic. Contradictorily, the Royal College of Surgeons of England warned about the unknown risk of viral infection and the release of pressurised gas from laparoscopic surgery. The audit aimed to identify the differences in surgical care before and during the pandemic to study their impact on patients. Methods Retrospective patient data was obtained from September 2019 to September 2020 to include data six months before the pandemic and six months during the pandemic. The data obtained had the patient hospital number, fitness for cholecystectomy, decision made regarding surgery, date of admission and date of surgery. Results 178 patients before COVID-19 and 242 patients during COVID-19 were admitted with gallstone disease. Before COVID-19, 60.67% (n = 108) patients were fit and consenting for surgery. Of these patients, 60.19% (n = 65) were discharged for surgery later and 39.81% (n = 43) had inpatient emergency surgery. During COVID-19, 71.49% (n = 173) patients were fit and consenting for surgery. However, 87.86% (n = 152) were discharged for surgery and only 12.14% (n = 21) had inpatient surgery. The average time from admission to surgery increased from 8 days to 51 days during COVID-19. Although majority of inpatient surgeries were performed within eight days, the percentage performed was fewer during COVID-19. Conclusions The COVID-19 pandemic significantly affected emergency laparoscopic cholecystectomies performed in the hospital with a substantial increase in the average time taken from admission to surgery. More emergency laparoscopic cholecystectomies should be included in the weekly elective lists, design for dedicated emergency cholecystectomy lists and increase utilisation of the CEPOD theatres along with staff availability are required to achieve the emergency cholecystectomy service as guided by the Royal Colleges.

Laparoscopic Surgery for Pheochromocytoma and Paraganglioma Removal: A Retrospective Analysis of Anaesthetic Management

2017 ◽  
Vol 12 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Rashmi Ramachandran ◽  
Vimi Rewari ◽  
Ankur Sharma ◽  
Rajeev Kumar ◽  
Anjan Trikha
Keyword(s):  
Laparoscopic Surgery ◽  
Retrospective Analysis ◽  
Anaesthetic Management

Healthcare utilization associated with adherence to antibiotics for abdominal surgeries in Japan: cross-sectional analysis of administrative database

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Shinobu Imai ◽  
Anna Kiyomi ◽  
Munetoshi Sugiura ◽  
Kiyohide Fushimi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Inguinal Hernia ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Healthcare Utilization ◽  
Treatment Duration ◽  
Prophylactic Antibiotic ◽  
Cross Sectional ◽  
Antibiotic Selection ◽  
Therapeutic Guidelines

Abstract Background Since patients receiving surgery may experience surgical site infections, therapeutic guidelines for reducing hospitalization time and cost include appropriate antibiotic use. However, the association between adherence to therapeutic guidelines and healthcare utilization is currently unclear. Objectives This study aimed to confirm the positive association between the adherence to guidelines of antibiotic therapy and a reduction in the length of stay and cost of hospitalization, especially considering the high infection rates in abdominal surgery. Methods This cross-sectional study used administrative data (diagnosis procedure combination data) collected using the case-mix system implemented in acute-care hospitals in Japan. We assessed the length of hospital stay and cost of hospitalization for patients who received prophylactic antibiotic for abdominal surgeries consistent with therapeutic guidelines. The data of patients aged 15 years or older who received appendectomy, laparoscopic cholecystectomy or inguinal hernia repair were extracted. The appropriateness of antibiotic prophylaxis was evaluated in terms of the Japanese guidelines for antibiotic selection and treatment duration. To assess the mean difference in antibiotic costs and length of stay, we performed the propensity score matching by confounding factors. Furthermore, we assessed the progress in healthcare utilization of this therapy over a decade. Results Of the 302 233 patients who received single general surgery from April 2014 to March 2016, 198 885 were eligible for analysis after applying the exclusion criteria (143 975 in the adherence and 54 910 in the non-adherence group). Each group comprised 48 439 patients after propensity score matching. Inappropriate antibiotic selection and duration were observed in 9294 (9.8%) and 687 (0.7%) of inguinal hernia repairs, 6431 (25.3%) and 311 (1.2%) of appendectomies and 38 134 (48.5%) and 391 (0.5%) of laparoscopic cholecystectomy cases, respectively. After propensity score matching by operation type, average hospitalization length (6.5 [SD 3.8] and 7.3 [SD 4.8] days) and costs (536 000 [SD 167 000] JPY and 573 000 [SD 213 000] JPY) differed significantly between adherence and non-adherence groups. Conclusion The results revealed that unnecessary healthcare utilization was associated with failure to adhere to therapeutic guidelines for prophylactic antibiotic therapy in elective general surgeries. We concluded that the progress of reduction in length of hospitalization over the decade was successful. Notably, adherence to treatment duration was better than that was 10 years ago. In this decade, administrators in hospitals have attempted to reduce the duration of hospitalization by developing various clinical pathways for surgical procedures and quality indicators. However, 15 877 patients (8.7%) were prescribed oral antibiotics the day after surgery. These observations should be evaluated further.

scholarly journals Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

2005 ◽  
Vol 33 (3) ◽  
pp. 360-363 ◽  
Author(s):  
A Polychronidis ◽  
AK Tsaroucha ◽  
AJ Karayiannakis ◽  
S Perente ◽  
E Efstathiou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Large Bowel ◽  
Thermal Injury ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Hepatic Flexure ◽  
Temporary Ileostomy ◽  
Delayed Perforation

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.

scholarly journals AUDIT OF EVOLVING ROLES OF LAPAROSCOPY IN THE CURRENT SURGICAL PRACTICE AT CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL: A 5 YEAR REVIEW

2021 ◽  
Vol 8 (5) ◽  
pp. 16-24
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Standard Of Care ◽  
Descriptive Statistics ◽  
Academic Hospital ◽  
Surgical Practice ◽  
The Past ◽  
Wide Range ◽  
Accepted Standard ◽  
The Mean

Background: Laparoscopic surgery (LS) is gaining momentum and has revolutionised the practice of surgery. Over the past thirty years, LS has been used to manage a wide range of surgical pathologies and has become a recognised and generally accepted standard of care. Aim: The aim of this study is to describe the evolution of LS in selected procedures.. Methods: Data were collected from theatre registries. Statistical analysis was performed using the software IMB SPSS. The data were analysed using descriptive statistics of mean and standard deviation for age, and percentage and frequencies for categories of variables . Results: Of the 3745 patients involved in the study, 59.1% were males and 40.9% were females. The mean age of the patients was 35.17±17.30 years. Laparoscopic surgery was represented in 43.2% of the procedures, with laparoscopic appendicectomy (46.73%) and laparoscopic cholecystectomy (32.69%) being the most commonly performed procedures.. Twenty-five adrenalectomies were performed over the study period, and of those 12 (52%) were performed laparoscopically. All the thymectomies (12) were performed thoracoscopically, with one conversion. Conclusion: The findings of this study suggest that there has been an increase in the overall incidence of laparoscopic surgery in selected procedures at CHBAH.

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