SURGICAL COLIC CAUSED BY ADHESIONS IN ABSENCE OF PREVIOUS ABDOMINAL SURGERY: 9 CASES (2012‐2019)

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

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Laparoscopy Is Useful for Successful Distal Ventriculoperitoneal Shunt Placement in Children with Previous Abdominal Surgery

Pediatric Endosurgery & Innovative Techniques ◽

10.1089/109264104773513133 ◽

2004 ◽

Vol 8 (1) ◽

pp. 45-50

Author(s):

Aaron Jensen ◽

Harsh Grewal ◽

Sheryl M. Sahr ◽

Karin S. Bierbrauer

Keyword(s):

Abdominal Surgery ◽

Ventriculoperitoneal Shunt ◽

Shunt Placement ◽

Previous Abdominal Surgery

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The Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Abdominal Surgery

HPB Surgery ◽

10.1155/1998/35456 ◽

1998 ◽

Vol 10 (6) ◽

pp. 353-356 ◽

Cited By ~ 15

Author(s):

J. Diez ◽

R. Delbene ◽

A. Ferreres

Keyword(s):

Laparoscopic Cholecystectomy ◽

Abdominal Surgery ◽

Marlex Mesh ◽

Previous Surgery ◽

Open Laparoscopy ◽

Previous Abdominal Surgery ◽

Abdominal Organs ◽

Abdominal Operations ◽

Elective Laparoscopic Cholecystectomy ◽

Verres Needle

A retrospective study was carried in 1500 patients submitted to elective laparoscopic cholecystectomy to ascertain its feasibility in patients with previous abdominal surgery. In 411 patients (27.4%) previous infraumbilical intraperitoneal surgery had been performed, and 106 of them (7.06%) had 2 or more operations. Twenty five patients (1.66%) had previous supraumbilical intraperitoneal operations (colonic resection, hydatid liver cysts, gastrectomies, etc.) One of them had been operated 3 times. In this group of 25 patients the first trocar and pneumoperitoneum were performed by open laparoscopy. In 2 patients a Marlex mesh was present from previous surgery for supraumbilical hernias. Previous infraumbilical intraperitoneal surgery did not interfere with laparoscopic cholecystectomy, even in patients with several operations. There was no morbidity from Verres needle or trocars. In the 25 patients with supraumbilical intraperitoneal operations, laparoscopic cholecystectomy was completed in 22. In 3, adhesions prevented the visualization of the gallbladder and these patients were converted to an open procedure. In the 2 patients Marlex mesh prevented laparoscopic cholecystectomy because of adhesions to abdominal organs. We conclude that in most instances previous abdominal operations are no contraindication to laparoscopic cholecystectomy.

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Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review

World Journal of Gastrointestinal Surgery ◽

10.4240/wjgs.v8.i7.533 ◽

2016 ◽

Vol 8 (7) ◽

pp. 533 ◽

Cited By ~ 7

Author(s):

Marleny Novaes Figueiredo ◽

Fabio Guilherme Campos ◽

Luiz Augusto D’Albuquerque ◽

Sergio Carlos Nahas ◽

Ivan Cecconello ◽

...

Keyword(s):

Systematic Review ◽

Colorectal Surgery ◽

Abdominal Surgery ◽

Laparoscopic Colorectal Surgery ◽

Short Term ◽

Previous Abdominal Surgery

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Evolution and trends in the adoption of laparoscopic liver resection in Singapore: Analysis of 300 cases

Annals of the Academy of Medicine, Singapore ◽

10.47102/annals-acadmedsg.2021213 ◽

2021 ◽

Vol 50 (10) ◽

pp. 742-750

Author(s):

Brian K Goh ◽

Zhongkai Wang ◽

Ye-Xin Koh ◽

Kai-Inn Lim

Keyword(s):

Liver Resection ◽

Blood Loss ◽

Abdominal Surgery ◽

Laparoscopic Liver Resection ◽

Conversion Rate ◽

Perioperative Outcomes ◽

Transfusion Rate ◽

Open Conversion ◽

Previous Abdominal Surgery ◽

Surgeon Experience

ABSTRACT Introduction: The introduction of laparoscopic surgery has changed abdominal surgery. We evaluated the evolution and changing trends associated with adoption of laparoscopic liver resection (LLR) and the experience of a surgeon without prior LLR experience. Methods: A retrospective review of 310 patients who underwent LLR performed by a single surgeon from 2011 to 2020 was conducted. Exclusion criteria were patients who underwent laparoscopic liver surgeries such as excision biopsy, local ablation, drainage of abscesses and deroofing of liver cysts. There were 300 cases and the cohort was divided into 5 groups of 60 patients. Results: There were 288 patients who underwent a totally minimally invasive approach, including 28 robotic-assisted procedures. Open conversion occurred for 13 (4.3%) patients; the conversion rate decreased significantly from 10% in the initial period to 3.3% subsequently. There were 83 (27.7%) major resections and 131 (43.7%) resections were performed for tumours in the difficult posterosuperior location. There were 152 (50.7%) patients with previous abdominal surgery, including 52 (17.3%) repeat liver resections for recurrent tumours, and 60 patients had other concomitant operations. According to the Iwate criteria, 135 (44.7%) were graded as high/expert difficulty. Major morbidity (>grade 3a) occurred in 12 (4.0%) patients and there was no 30-day mortality. Comparison across the 5 patient groups demonstrated a significant trend towards older patients, higher American Society of Anesthesiologists (ASA) score, increasing frequency of LLR with previous abdominal surgery, increasing frequency of portal hypertension and huge tumours, decreasing blood loss and decreasing transfusion rate across the study period. Surgeon experience (≤60 cases) and Institut Mutualiste Montsouris (IMM) high grade resections were independent predictors of open conversion. Open conversion was associated with worse perioperative outcomes such as increased blood loss, transfusion rate, morbidity and length of stay. Conclusion: LLR can be safely adopted for resections of all difficulty grades, including major resections and for tumours located in the difficult posterosuperior segments, with a low open conversion rate. Keywords: Laparoscopic hepatectomy, laparoscopic liver resection, robotic hepatectomy, robotic liver resection, Singapore

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Impact of previous abdominal surgery on robotic-assisted rectal surgery in patients with locally advanced rectal adenocarcinoma: a propensity score matching study

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02086-1 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Ching-Wen Huang ◽

Wei-Chih Su ◽

Tsung-Kun Chang ◽

Cheng-Jen Ma ◽

Tzu-Chieh Yin ◽

...

Keyword(s):

Propensity Score ◽

Abdominal Surgery ◽

Propensity Score Matching ◽

Locally Advanced ◽

Rectal Adenocarcinoma ◽

Rectal Surgery ◽

Perioperative Outcomes ◽

Group Differences ◽

Robotic Assisted ◽

Previous Abdominal Surgery

Abstract Background The application of minimally invasive surgery in patients with colorectal cancer (CRC) and a history of previous abdominal surgery (PAS) remains controversial. This retrospective study with propensity score matching (PSM) investigated the impact of PAS on robotic-assisted rectal surgery outcomes in patients with locally advanced rectal adenocarcinoma undergoing preoperative concurrent chemoradiotherapy (CCRT). Methods In total, 203 patients with locally advanced rectal adenocarcinoma who underwent preoperative CCRT and robotic-assisted rectal surgery between May 2013 and December 2019 were enrolled. Patients were categorized into PAS and non-PAS groups based on the PAS history. The PSM caliper matching method with 1-to-3 matches was used to match PAS patients with non-PAS. Results Of the 203 enrolled patients, 35 were PAS patients and 168 were non-PAS patients. After PSM, 32 PAS patients and 96 non-PAS patients were included for analysis. No significant between-group differences were noted in the perioperative outcomes, including median console time (165 min (PAS) vs. 175 min (non-PAS), P = 0.4542) and median operation time (275 min (PAS) vs. 290 min (non-PAS), P = 0.5943) after PSM. Postoperative recovery and overall complication rates were also similar (all P > 0.05). Moreover, the between-group differences in pathological or short-term oncological outcomes were also nonsignificant (all P > 0.05). No 30-day postoperative deaths were observed in either group. Conclusion The current results indicate that robotic-assisted surgery is safe and feasible for PAS patients with locally advanced rectal adenocarcinoma undergoing preoperative CCRT. However, future prospective randomized clinical trials are required to verify these findings.

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