scholarly journals Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Benign Disease ◽  
Post Surgery ◽  
A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

scholarly journals Mini-invasive robotic assisted pyelolithotomy: Comparison between the transperitoneal and retroperitoneal approach

2019 ◽  
Vol 91 (2) ◽  
Author(s):  
Daniele D'Agostino ◽  
Paolo Corsi ◽  
Marco Giampaoli ◽  
Federico Mineo Bianchi ◽  
Daniele Romagnoli ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Retroperitoneal Approach ◽  
Transperitoneal Approach ◽  
Robotic Assisted ◽  
Stone Free Rate ◽  
Free Rate

Objective: To compare the retroperitoneal with the transperitoneal approach in a series of patients underwent to robotic-assisted pyelolithotomy (RP). Materials and methods: From January 2015 to December 2018 we evaluated 20 patients subjected to robotic pyelolithotomy; 11 patients were treated with retroperitoneal approach (RRP) and 9 with transperitoneal approach (TRP). For each patient intra and perioperative data were recorded: operative time (OT), blood loss (BL), length of hospital stay (LOS), stone clearance, post-operative complications and time to remove the drain. The presence of stone fragments < 4 mm was considered as stone free rate. Results: The principal stone burden was greater in the TRP group than in the RRP group (48 ± 10 mm vs 32 ± 14 mm, p = 0.12). Preoperative hydronephrosis was present in 7 (64%) patients in RRP group and a mild hydronephrosis in 3 of TRP group (p = 0.04). The average operative time was higher in the RRP group than in the TRP group (203 ± 45 min vs 137 ± 31 min, p = 0.002). The average blood loss was 305 ± 175 ml in the RRP group versus 94 ± 104 ml in the TRP group (p = 0.005). The stone free rate was similar between the two groups, 36% (4 patients) in the RRP group and 44% (4 patients) in the TRP (p = 0.966). Conclusions: RP appears to be a safe and effective minimally invasive treatment for some patients with renal staghorn calculi or urinary tract malformations. The TRP may give lower operative time and better results in terms of blood loss and length of hospital stay.

scholarly journals African experiences of laparoscopic hysterectomy about a continuous series of 52 cases by the same practitioner: indications, surgical procedures and complications

2018 ◽  
Vol 7 (3) ◽  
pp. 789
Author(s):  
Koffi Abdoul Koffi ◽  
Kacou Edele Aka ◽  
Minata Fomba ◽  
Konan Seni ◽  
Apollinaire Horo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Average Length ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Continuous Series ◽  
Average Size ◽  
A Prospective Study

Background: Laparoscopy is a modern surgical technique that began in 1940 with Raoul Palmer. The present study aimed to analyse the results of a fifty-two-laparoscopic hysterectomy performed.Methods: A prospective study over a period of seven years from 1st January 2010 to 31st December 2015. A total of 52 patients who underwent a laparoscopic hysterectomy were recruited at the teaching hospital of Yopougon-Abidjan.Results: The mean age was 50.2 years (±3.9 years) (36-62 years). The average parity was 3. Few patients had undergone anterior pelvic surgery for either myomectomy or caesarean section. Uterine fibroid was the major surgical indication with a rate of 61.54%. The average size of the uterus was 12 cm (8-18 cm). Total hysterectomies type II and III with or without adnexectomy were essentially performed with rates of 28.85% and 32.69%, respectively. Sometimes it was associated with a lymphadenectomy or a colpo-suspension. The average length of a hysterectomy is 170 minutes (87-385 minutes). Four cases of laparo-conversions have been noted. Blood loss was approximately 95 ml (±12 ml) with a maximum of 300 ml. The complications were mainly two digestive wounds and a bladder fistula. The average length of hospital stay is three days apart from any complication.Conclusions: The laparoscopic approach is less painful, is associated with less blood loss, shorter hospital stay, faster recovery, fewer complications, and better care. A training period of surgeons associated with the equipment of the health structures is necessary to popularize this procedure surgical.

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

scholarly journals Non-descent vaginal hysterectomy surgery associated with less complications and good prognosis

2022 ◽  
Vol 13 (1) ◽  
pp. 123-128
Author(s):  
Pranita Somani ◽  
Priyanka Singh ◽  
Mangala Shinde
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Vaginal Discharge ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Vaginal Route ◽  
Background Removal ◽  
Operative Complications ◽  
Post Operative Complications

Background: Removal of the uterus through vagina when performed in a case without uterine descent or prolapse is known as “non-descent vaginal hysterectomy” or NDVH. Vaginal route is preferred as compared to laparoscopic and abdominal methods. The advantages of vaginal hysterectomy being fewer complications, less post-operative stay, cost effective, and useful in bulky uterus. Aims and Objectives: The aims of the study were as follows: (1) To study the intraoperative and post-operative complications encountered during NDVH and their management. (2) To assess the intraoperative blood loss, the operative time, and post-operative hospital stay. (3) To study and check the feasibility of vaginal route as the primary route for all hysterectomies in the absence of uterine prolapse. Materials and Methods: A total of 50 patients were included in the study. Detailed history was taken including obstetric history and menstrual history and clinical examination was performed. After taking written, informed consent and doing proper pre-operative preparation, the patient was posted for NDVH. Post-operative complications were noted. Patients were asked to come for follow-up after 15 days. Results: In 92% of cases operated, no intraoperative complications were found suggesting low morbidity associated with the procedure. Hemorrhage requiring blood transfusion was found in 4% of cases. Average operative time was 61.2 ± 27.89 min, average blood loss was 170 ± 81.44 ml, and average hospital stay was 5.94 ± 4.95 days. On histopathological examination, 40% were having leiomyoma and dysfunctional uterine bleeding was seen in 22% of cases. Pain was the most common complication seen in 30% of cases while vaginal discharge was seen in just 4% of cases. About 80% of patients were discharged on post-operative day 5. Conclusion: In 92% of NDVH cases, no intraoperative complications were found suggesting low morbidity associated with the procedure. The post-operative hospital stay was restricted to 5 days in 80% of cases which indicates early discharge of the patient. Post-operative complications such as vaginal discharge and fever were seen only in 4% of cases. NDVH should, therefore, be considered as the primary route for all hysterectomies unless contraindicated in the absence of prolapse.

scholarly journals 176 Efficiency of Spinal Anesthesia in Comparison to General Anesthesia in Lumbar Spine Surgery: A Retrospective Analysis of 544 Patients

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-246
Author(s):  
John Thomas Pierce ◽  
Prateek Agarwal ◽  
Paul J Marcotte ◽  
William Charles Welch
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Lumbar Spine Surgery ◽  
Anesthesia Time

Abstract INTRODUCTION Lumbar spine surgery can be successfully performed using various anesthetic techniques. Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia (SA) to general anesthesia (GA) in lumbar surgery. We sought to elucidate the more expedient anesthetic technique. METHODS Following IRB approval, a retrospective review of patients undergoing elective lumbar decompression surgery using GA or SA was performed. Demographic data known to influence perioperative morbidity was collected as well as safety and efficiency parameters. After controlling for patient and procedure characteristics, simple linear and multivariate regression analyses were performed to identify differences in operative blood loss, operative time, time from entering the OR until incision, time from bandage placement to exiting the OR, total anesthesia time, time in the post-anesthesia care unit (PACU), and length of hospital stay. RESULTS >544 consecutive lumbar laminectomy and discectomy surgeries were identified with 183 undergoing GA and 361 undergoing SA. The following times were all shorter for patients receiving SA than GA: operative time (97.4 vs. 151.8 min., P < 0.001), total anesthesia time (145.6 vs. 217.5 min., P < 0.001), time from entering the OR until incision (38.3 vs. 46.8 min., respectively, P < 0.001), time from bandage placement until exiting the OR (10.2 vs. 17.2 min., P < 0.001), and length of hospital stay (1.5 vs. 3.1 days, P < 0.001). The mean PACU length of stay was longer in the SA group than the GA group (178.0 vs. 116.5 min., P < 0.001). Estimated blood loss was less in the SA group than the GA group (62.1 vs. 176.3 mL, P < 0.001). CONCLUSION Spinal anesthesia may be the more expedient method of anesthesia in lumbar spinal surgery for all perioperative time points except for time in the PACU.

scholarly journals A comparative analysis of hysterectomies

Medicina ◽  
2007 ◽  
Vol 43 (2) ◽  
pp. 118 ◽  
Author(s):  
Rosita Aniulienė ◽  
Laima Varžgalienė ◽  
Manvydas Varžgalis
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Significant Difference ◽  
The Mean

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy – less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days – after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). Conclusions. Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications – the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy – the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.

scholarly journals Evaluating the safety of two human experimental intestinal ischemia reperfusion models: A retrospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253506
Author(s):  
Inca H. R. Hundscheid ◽  
Dirk H. S. M. Schellekens ◽  
Joep Grootjans ◽  
Marcel Den Dulk ◽  
Ronald M. Van Dam ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Pancreatic Surgery ◽  
Intestinal Ischemia ◽  
Operative Time ◽  
Ischemia Reperfusion ◽  
Length Of Hospital Stay ◽  
Secondary Outcome ◽  
Complication Rates

Background We developed a jejunal and colonic experimental human ischemia-reperfusion (IR) model to study pathophysiological intestinal IR mechanisms and potential new intestinal ischemia biomarkers. Our objective was to evaluate the safety of these IR models by comparing patients undergoing surgery with and without in vivo intestinal IR. Methods A retrospective study was performed comparing complication rates and severity, based on the Clavien-Dindo classification system, in patients undergoing pancreatoduodenectomy with (n = 10) and without (n = 20 matched controls) jejunal IR or colorectal surgery with (n = 10) and without (n = 20 matched controls) colon IR. Secondary outcome parameters were operative time, blood loss, 90-day mortality and length of hospital stay. Results Following pancreatic surgery, 63% of the patients experienced one or more postoperative complications. There was no significant difference in incidence or severity of complications between patients undergoing pancreatic surgery with (70%) or without (60%, P = 0.7) jejunal IR. Following colorectal surgery, 60% of the patients experienced one or more postoperative complication. Complication rate and severity were similar in patients with (50%) and without (65%, P = 0.46) colonic IR. Operative time, amount of blood loss, postoperative C-reactive protein, length of hospital stay or mortality were equal in both intervention and control groups for jejunal and colon IR. Conclusion This study showed that human experimental intestinal IR models are safe in patients undergoing pancreatic or colorectal surgery.

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