Laparoendoscopic Single Site Cholecystectomy: The First 100 Patients

2009 ◽  
Vol 75 (8) ◽  
pp. 681-686 ◽  
Author(s):  
Jonathan M. Hernandez ◽  
Connor A. Morton ◽  
Sharona Ross ◽  
Michael Albrink ◽  
Alexander S. Rosemurgy
Keyword(s):  
Length Of Stay ◽  
Pain Control ◽  
Operative Time ◽  
Hospital Length ◽  
Single Site ◽  
Hospital Length Of Stay ◽  
Laparoendoscopic Single Site ◽  
Small Series ◽  
Time Period ◽  
Median Operative Time

Laparoendoscopic single site (LESS) surgery promises improved cosmesis and possibly less pain. However, given the small series reported to date, true estimates of the advantages and possible disadvantages of LESS surgery remain unknown. This study was undertaken to evaluate the first 100 patients undergoing LESS cholecystectomy at our institution. Patients referred for cholecystectomy since November 2007 were considered for LESS cholecystectomy. Outcomes, including blood loss, operative time, complications, and length of stay, were recorded. Outcomes are compared with an uncontrolled concurrent group of patients undergoing multi-incision laparoscopic (i.e., conventional) cholecystectomy. One hundred patients with a median age of 44 years underwent LESS cholecystectomy; 30 patients with a median age of 46 years underwent conventional cholecystectomy over the same time period. Median operative time (70 vs 66 minutes, P = 0.67, Mann-Whitney) and hospital length of stay (1 vs 1 day, P = 0.81, Mann-Whitney) were not different for patients undergoing LESS or multi-incision cholecystectomies, respectively. Five patients undergoing LESS cholecystectomy had postoperative complications: cystic duct stump leak (one), pain control issues (three), and urinary retention (one). LESS cholecystectomy is a safe and effective alternative to conventional cholecystectomy. It can be undertaken without added operative time and provides patients with minimal, if any, scarring.

scholarly journals Similar Efficacy of Arthroscopy and Arthrotomy in Infection Eradication in the Treatment of Septic Knee: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 8 ◽  
Author(s):  
Zhimin Liang ◽  
Xiaofan Deng ◽  
Lingli Li ◽  
Jing Wang
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Septic Arthritis ◽  
Operative Time ◽  
Similar Efficacy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Infection Eradication

Aim: To compare the arthroscopy vs. arthrotomy for the treatment of native knee septic arthritis.Methods: Electronic databases of PubMed, Embase and Cochrane Library were searched for eligible studies. Retrospective comparative studies comparing arthroscopy or arthrotomy for patients with septic arthritis of the native knee were eligible for this review. The primary outcome was recurrence of infection after first procedure. The secondary outcomes included hospital length of stay, operative time, range of motion of the involved knee after surgery, overall complications and mortality rate,Results: Thirteen trials were included in this study. There were a total of 2,162 septic arthritis knees treated with arthroscopic debridement and irrigation, and 1,889 septic arthritis knees treated with open debridement and irrigation. Arthroscopy and arthrotomy management of the knee septic arthritis showed comparable rate of reinfection (OR = 0.85; 95% CI, 0.57–1.27; P = 0.44). No significant difference was observed in hospital length of stay, operative time and mortality rate between arthroscopy and arthrotomy management group, while arthroscopy treatment was associated with significantly higher knee range of motion and lower complication rate when compared with arthrotomy treatment.Conclusion: Arthroscopy and arthrotomy showed similar efficacy in infection eradication in the treatment of native septic knee. However, arthroscopy treatment was associated with better postoperative functional recovery and lower complication rate.

Laparoscopic Shunt Revision Avoids Many Complications of Open Shunt Revision and Has Outcomes Similar to First-time Shunt Placement

2015 ◽  
Vol 81 (3) ◽  
pp. 305-308
Author(s):  
Heather Logghe ◽  
John Maa ◽  
Michael McDermott ◽  
Michael Oh ◽  
Jonathan Carter
Keyword(s):  
Length Of Stay ◽  
Retrospective Cohort ◽  
Operative Time ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Shunt Revision ◽  
Visceral Injury ◽  
Shunt Placement ◽  
Increased Risk ◽  
First Time

Open revision of abdominal shunts is associated with increased risk of wound infection, visceral injury, hernia, and shunt complications. We hypothesized that laparoscopic revision mitigates these risks to a level similar to initial (i.e., first-time) shunt placement. This was a single-center, multisurgeon, retrospective cohort study of patients who underwent either laparoscopic initial shunt placement or laparoscopic shunt revision over a 5-year period. Outcomes were operative time, length of stay, and 30-day complication rate. Sixty-nine patients underwent laparoscopic shunt revision and 99 patients underwent laparoscopic initial shunt placement. Operative times were nearly identical (75 vs 73 minutes, P = 0.63). There were no significant differences in blood loss or hospital length of stay. Abdominal complications and total complications did not differ between groups. Laparoscopic shunt revision avoided many of the known complications of open shunt revision and had outcomes similar to initial laparoscopic shunt placement.

scholarly journals Laparo-endoscopic Single Site Surgery in Pediatrics: Feasibility and surgical outcomes from a preliminary prospective Canadian experience.

2015 ◽  
Vol 9 (1-2) ◽  
pp. 48 ◽  
Author(s):  
Aziz M. Khambati ◽  
Elias Wehbi ◽  
Walid A. Farhat
Keyword(s):  
Length Of Stay ◽  
Surgical Outcomes ◽  
Laparoscopic Approach ◽  
Hospital Length ◽  
Single Site ◽  
Hospital Length Of Stay ◽  
Short Term ◽  
Tertiary Center ◽  
Single Site Surgery

Introduction: Laparo-endoscopic single-site surgery (LESS) is becoming an alternative to standard laparoscopic surgery. Proposed advantages include enhanced cosmesis and faster recovery. We assessed the early post-operative surgical outcomes of LESS surgery utilizing different instruments in the pediatric urological population in Canada.Methods: We prospectively captured data on all patients undergoing LESS at our institution between February 2011 and August 2012. This included patient age, operative time, length of stay, complications and short-term surgical outcomes. Different instruments/ devices were used to perform the procedures. Access was achieved through a transumbilical incision.Results: A total of 16 LESS procedures were performed, including seven pyeloplasties, four unilateral and one bilateral varicocelectomies, two simple nephrectomies, one renal cyst decortication and one pyelolithotomy. There was no statistical difference in the operative times, hospital length of stay and cost (pyeloplasty only) in patients undergoing pyeloplasty and varicocelectomy using the LESS technique when compared to an age matched cohort of patients managed with the traditional laparoscopic approach. One pyeloplasty in the LESS group required conversion to open due to a small intra-renal pelvis. There were no immediate or short term post-operative complications; however, one patient experienced a decrease in renal function status post LESS pyeloplasty. Since all procedures were performed by a vastly experienced surgeon at a tertiary center, the generalizability of the results cannot be assessed.Conclusions: There are only a few series that have assessed the role of LESS in pediatric urological surgery. Although our experience is limited by a heterogeneous group of patients with a short follow-up period, the present cohort demonstrates the safety and feasibility of LESS. Further evaluation with randomized studies is required to better assess the role of LESS in pediatric urology.

scholarly journals Perioperative Outcomes Of Laparoscopic Hysterectomy: Comparison With Abdominal, Vaginal, And Robot-Assisted Surgical Approaches

2015 ◽  
Vol 8 (1) ◽  
pp. 52-60
Author(s):  
Slavcho T. Tomov ◽  
Grigor A. Gortchev ◽  
Latchesar S. Tantchev ◽  
Todor I. Dimitrov ◽  
Chavdar A. Tzvetkov ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Perioperative Outcomes ◽  
Surgical Approaches ◽  
Significant Linear Correlation ◽  
The Mean

SummarySelection of an appropriate surgical method for hysterectomy in an individual patient is currently an issue that remains open and debatable. This study aimed to analyze perioperative outcomes in gynecologic patients who underwent laparoscopic hysterectomy at a single institution during a 6-year period and to compare the data for simple hysterectomy patients treated with different surgical approaches. The study included a retrospective analysis of demographics, pre- and post-operative characteristics of 1,023 patients, operated on using four types of simple hysterectomy approaches: 635 laparoscopic hysterectomies (62.1%), 289 total abdominal hysterectomies (28.3%), 45 total vaginal hysterectomies (4.4%) and 54 robotic-assisted hysterectomies (5.3%). For the laparoscopic hysterectomy group, the mean operative time was shorter as compared to the abdominal and vaginal hysterectomy groups (p<0.05), as well as a significantly shorter hospital length-of-stay when compared to the abdominal, robotic or vaginal hysterectomy groups (p<0.05). Regression analysis revealed significant linear correlation between operative time and body-mass index of laparoscopic hysterectomy patients (R2 =0.008; p=0.026). Complications emergence and hemotransfusion often prolonged the mean operative time significantly by 17.8 min (p=0.002) and 15.5 min, respectively (p<0.001). The rate of major complications was significantly higher in the laparoscopic vs. abdominal groups (p<0.05). Clinical outcomes in patients operated on with laparoscopic hysterectomy were better than in those operated with total abdominal and vaginal hysterectomy in terms of operative time and hospital length-of-stay. Prospective randomized multi-center studies would be desirable to further define the place of the modern minimally invasive hysterectomy approaches.

scholarly journals Analysis of risk factors for unplanned reoperation following primary repair of gastrointestinal disorders in neonates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu Cui ◽  
Rong Cao ◽  
Jia Li ◽  
Ling-mei Deng
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Length Of Stay ◽  
Operative Time ◽  
Primary Repair ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Gastrointestinal Disorders ◽  
Factors Associated ◽  
Link Type

Abstract Background The aim of our study was to identify the factors associated with unplanned reoperations among neonates who had undergone primary repair of gastrointestinal disorders. Methods A retrospective chart review was conducted for neonates who underwent primary gastrointestinal surgery between July 2018 and September 2020. The neonates were divided into two cohort, depending on whether they had an unplanned reoperation. The primary outcome was the occurrence of unplanned reoperation. The risk factors that associated the occurrence of unplanned reoperation were examined. Main results Two hundred ninety-six neonates fulfilled the eligibility criteria. The incidence of unplanned reoperation was 9.8%. Analyses of all patients with respect of developing unplanned reoperation showed that the length of operative time was an independent risk factor [Odds Ratio 1.02; 95% confidence interval 1.00, 1.04; p = 0.03]. Patients with unplanned reoperation had a longer postoperative hospital length-of-stay [19.9 ± 14.7 vs. 44.1 ± 32.1 days; p<0.01]. Conclusion The current study is the first analysis of risk factors associated with an unplanned reoperation in neonates undergoing primary repair of gastrointestinal disorders. The length of operative time is the only risk factor for an unplanned reoperation, and the unplanned reoperation can directly prolong the postoperative hospital length-of-stay. Trial registration This study was registered at http://www.chictr.org.cn/index.aspx with No. ChiCTR2000040260.

scholarly journals The effect of operative time on in-hospital length of stay in revision total knee arthroplasty

2019 ◽  
Vol 7 (4) ◽  
pp. 66-66 ◽  
Author(s):  
Luke J. Garbarino ◽  
Peter A. Gold ◽  
Nipun Sodhi ◽  
Hiba K. Anis ◽  
Joseph O. Ehiorobo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Operative Time ◽  
Revision Total Knee Arthroplasty ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Total Knee

Mini-laparotomy with Adjunctive Care versus Laparoscopy for Placement of Gastric Electrical Stimulation

2016 ◽  
Vol 82 (4) ◽  
pp. 337-342
Author(s):  
Alison Smith ◽  
Robert Cacchione ◽  
ED Miller ◽  
Lindsay Mcelmurray ◽  
Robert Allen ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Length Of Stay ◽  
Pain Control ◽  
Operative Time ◽  
Learning Curves ◽  
Control Measures ◽  
Gastric Electrical Stimulation ◽  
Open Approach ◽  
Median Operative Time ◽  
Mini Laparotomy

We compared outcomes for two gastric electrical stimulation placement strategies, mini-laparotomy with adjunctive care (MLAC) versus laparoscopy without adjunctive care (LAPA). For electrode placement, the peritoneal cavity was accessed with either a single 2.5 to 3.0 cm midline incision (MLAC) or three trocar incisions (LAPA). For both groups, generator was placed subcutaneously over the anterior rectus sheath. For MLAC, adjunctive pain control measures were used for placement of both electrode and generator (transversus abdominus plane block). For LAPA, those that could not be completed by laparoscopy were converted to traditional open approach and kept in the analysis. MLAC (n = 128) resulted in shorter operative times than LAPA (n = 37) (median operative time: 87.5 vs 137.0 minutes, P ≤ 0.01). Hospital length of stay was also shorter for MLAC than for LAPA (median: 2.0 vs 3.0 days, P ≤ 0.01) without any increase in readmission rates to the hospital within 30 days of discharge (11.0 vs 16.2%, P = 0.39). After equalizing learning curves, these differences were even greater (median operative time: 84.5 vs 137.0 minutes, P < 0.01; median length of stay: 1.0 vs 3.0 days; P < 0.01) without increasing 30-day read-mission rates (9.1 vs 16.2%, P = 0.25). For implantation of gastric electrical stimulators, mini-laparotomy can result in improved outcomes when coupled with adjunctive pain control measures.

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