Comparison of Single-Port Laparoscopic Totally Extraperitoneal Hernioplasty Versus Conventional Laparoscopic Totally Extraperitoneal Hernioplasty

2020 ◽  
pp. 000313482094999
Author(s):  
Chu-Wen Fang ◽  
Allen W. Chiu ◽  
Steven Kuan-Hua Huang
Keyword(s):  
Blood Loss ◽  
Single Port ◽  
Operation Time ◽  
Hernia Recurrence ◽  
Asa Score ◽  
Conventional Laparoscopic ◽  
Totally Extraperitoneal ◽  
Postoperative Length ◽  
American Society ◽  
Totally Extraperitoneal Hernioplasty

Background To evaluate the safety and outcomes of single-port laparoscopic totally extraperitoneal (SPLTEP) and conventional laparoscopic totally extraperitoneal (CLTEP) hernioplasty. Methods Retrospectively, we collected patients who underwent a laparoscopic totally extraperitoneal approach. The inclusion criteria were as follows: (1) male patients aged >20 years, (2) untreated hernia, and (3) American Society of Anesthesiologists (ASA) score ≤3. The exclusion criteria included: (1) additional procedures received during surgery, (2) inguinoscrotal hernia, (3) ASA score >3, (4) previous lower abdominal surgery, (5) bleeding disorders, and (6) incarcerated, obstructed, strangulated, or recurrent inguinal hernias. Patients were classified into SPLTEP and CLTEP groups. The demographics, body mass index (BMI), ASA score, comorbidities, blood loss, operation time, postoperative length of stay (LOS)/complications, hernia recurrence, visual analog scale (VAS), and postoperative analgesic requirements were collected for analysis. Results A total of 246 patients were enrolled. There were 103 patients in the SPLTEP group and 143 patients in the CLTEP group. The mean age was 56.1 ± 16.2 years versus 57.9 ± 15.1 years. There were no significances in demographics, BMI, ASA score, comorbidities, blood loss, operation time, postoperative LOS/complications, and hernia recurrence. The SPLTEP group had a shorter postoperative LOS, lower VAS at 18 hours postoperation, and a reduced amount of 24-hour postoperative analgesics. Conclusion SPLTEP hernioplasty is as safe as the CLTEP procedure. In addition, the SPLTEP group had a shorter LOS and a lower VAS score and required less postoperative analgesics. Further studies may focus on long-term complications, hernia recurrence, and chronic pain in these 2 groups.

scholarly journals Surgical management of sarcoma in adolescent and young adult patients

2020 ◽  
Author(s):  
Kazuhiko Hashimoto ◽  
Shunji Nishimura ◽  
Naohiro Oka ◽  
Masao Akagi
Keyword(s):  
Survival Rate ◽  
Young Adult ◽  
Blood Loss ◽  
Surgical Margin ◽  
Operation Time ◽  
Adolescent And Young Adult ◽  
Intraoperative Blood Loss ◽  
Physical Status ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract Objective: To examine the clinical features and outcomes of adolescent and young adult sarcoma patients who underwent surgical management and clarify important factors associated with prognosis. We reviewed 18 young adult sarcoma patients sarcoma patients treated surgically in our hospital. The tumor site, histology, grade, stage, and American Society of Anesthesiologists-Physical Status before surgery, operation time, intraoperative blood loss, complications, surgical margin, local recurrence, metastasis, and outcomes were investigated. The 3-year survival rate was also calculated. We compared survival based on age, grade, and surveyed features of poor outcome cases.Results: The 3-year survival rate was 61.3%. There was no significant difference in survival based on age, grade, operation time, or intraoperative blood loss. Three of five patients who died of the disease had stage ≥ IV at diagnosis. All patients with R1 surgical margins developed recurrence and all those with an American Society of Anesthesiologists-Physical Status ≥ 2 died. Patients with late-stage sarcomas, R1 tumor margin, or high American Society of Anesthesiologists-Physical Status score had poor prognoses. To achieve a favorable outcome in adolescent and young adult sarcoma patients, early detection and obtaining R0≥ surgical margin are essential.

scholarly journals Surgical management of sarcoma in adolescent and young adult patients

2020 ◽  
Author(s):  
Kazuhiko Hashimoto ◽  
Shunji Nishimura ◽  
Naohiro Oka ◽  
Masao Akagi
Keyword(s):  
Survival Rate ◽  
Young Adult ◽  
Blood Loss ◽  
Surgical Margin ◽  
Operation Time ◽  
Adolescent And Young Adult ◽  
Intraoperative Blood Loss ◽  
Physical Status ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract Objective To examine the clinical features and outcomes of adolescent and young adult sarcoma patients who underwent surgical management and clarify important factors associated with prognosis. We reviewed 18 young adult sarcoma patients sarcoma patients treated surgically in our hospital. The tumor site, histology, grade, stage, and American Society of Anesthesiologists-Physical Status before surgery, operation time, intraoperative blood loss, surgical margin, local recurrence, metastasis, and final outcome were investigated. The 3-year survival rate was also calculated. We compared survival based on age, grade, operation time, and intraoperative blood loss and surveyed features of cases of poor outcomes.Results The 3-year survival rate was 61.3%. There was no significant difference in survival based on age, grade, operation time, or intraoperative blood loss. Three of five patients who died of the disease had stage ≥ IV at diagnosis. All patients with inadequate surgical margins developed recurrence and all those with an American Society of Anesthesiologists-Physical Status ≥ 2 died. Patients with a late-stage sarcomas, inadequate tumor margin, or high American Society of Anesthesiologists-Physical Status score had poor prognosis. To achieve a favorable outcome in adolescent and young adult sarcoma patients, early detection and obtaining an adequate surgical margin are important.

Surgical Stress Response and Clinical Outcomes of Single Port Laparoscopic Cholecystectomy: Prospective Nonrandomized Study

2012 ◽  
Vol 78 (4) ◽  
pp. 485-491 ◽  
Author(s):  
Hyung Joon Han ◽  
Sae Byeol Choi ◽  
Wan Bae Kim ◽  
Jin-Suk Lee ◽  
Yoon Jung Boo ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Stress Response ◽  
Pain Score ◽  
Clinical Outcomes ◽  
Single Port ◽  
Operation Time ◽  
Conventional Group ◽  
Conventional Laparoscopic ◽  
Laparoscopic Cholecystectomy Group ◽  
The Mean

The levels of interleukin-6 (IL-6) are proportionate to injury; it is the most commonly used quantitative marker in surgical studies. Cytokines and the acute-phase response play an important role in controlling the human immune system. The objective of this study was to compare the systemic acute cytokine response and clinical outcomes of conventional laparoscopic and single port laparoscopic cholecystectomy. We compared patients who underwent single port laparoscopic cholecystectomy (the single port group) with patients who underwent conventional laparoscopic cholecystectomy (the conventional group) according to the clinical variables, IL-6, leukocyte subpopulations, and visual analog scale (VAS) pain score. The mean age in the single port group was significantly younger ( P = 0.010) and the mean operation time in the conventional group was significantly shorter ( P = 0.002). Postoperative 4-hour VAS pain score was slightly worse in the single port laparoscopic cholecystectomy group, but was not significantly different. We found no difference in clinical outcomes, the level of serum IL-6, C-reactive protein, leukocyte subpopulations, and complications between the two groups. Stress response in single port laparoscopic cholecystectomy is equal to conventional surgery. Postoperative 4-hour VAS pain score was slightly worse and the operation time is significantly longer in the single port laparoscopic cholecystectomy group.

scholarly journals Clinical Application and Observation of Single-Port Inflatable Mediastinoscopy Combined With Laparoscopy for Radical Esophagectomy in Esophageal Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Qifan Yin ◽  
Huining Liu ◽  
Yongbin Song ◽  
Shaohui Zhou ◽  
Guang Yang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Blood Loss ◽  
Esophageal Squamous Cell Carcinoma ◽  
Single Port ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Radical Esophagectomy ◽  
Cardiopulmonary Complications ◽  
Postoperative Cardiopulmonary Complications

Abstract Background Transthoracic esophagectomy is a crucial independent risk factor for the incidence of postoperative cardiopulmonary complications in elderly or comorbid patients. To reduce postoperative cardiopulmonary complications and promote postoperative recovery. We made a bold attempt to adopt the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer to observe the clinical application and effect. Method Data of patients with esophageal carcinoma were collected in the Hebei General Hospital from May 2018 to November 2019. The operation time、surgical blood loss、the number of dissected lymph nodes、duration of drainage tube、postoperative complications、the length of postoperative hospital stay were collected to assess the safety and feasibility of the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer. Results A total of 22 patients with esophageal cancer were analyzed in our research. There was no case of switching to thoracotomy、perioperative death or postoperative cardiopulmonary complications. The average operation time、surgical blood loss、amount of dissected lymph nodes、duration of drainage tube、postoperative hospital stay of all enrolled patients was 4.26±0.52 hours、142±36.50 ml、21.6±4.2、5.8±2.5 days、12.6±2.5 days, respectively. Among all the enrolled patients, one patient(4.5%) developed anastomotic fistula on the third day after surgery. 5 patients(22.7%) with anastomotic stricture. Pleural effusion was found in 4 cases (18.2%). Recurrent laryngeal nerve injury caused hoarseness or cough after drinking water in 3 cases (13.6%). one patients(4.5%) was switched from laparoscopy to open surgery as the patient had serious peritoneal adhesion. All of the patients were discharged successfully. Conclusion Our results showed that this surgery of single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal squamous cell carcinoma is safe and feasible. The feasibility and safety could be further and better investigated with a RCT to achieve more conclusive results.

scholarly journals Single-port Laparoscopic Reversal of Hartmann's Procedure: Technique and Results

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Th. Carus ◽  
A. Emmert
Keyword(s):  
Laparoscopic Surgery ◽  
Single Port ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Hartmann’S Procedure ◽  
Laparoscopic Technique ◽  
High Morbidity ◽  
Conventional Laparoscopic ◽  
Hartmann's Procedure ◽  
Port Access

In general, reversal of Hartmann's procedure is associated with a high morbidity and therefore leads to a low rate of intestinal restoration. Reversal of Hartmann's procedure has to be seen as a complex abdominal operation with the same possible complications as in other colorectal resections. By using the laparoscopic technique, operative access trauma by laparotomy can be minimized. After introducing single-port access into laparoscopic surgery beginning with cholecystectomies and sigmoid resections, we started with the first single-port laparoscopic reversal of Hartmann's procedure in January 2010. After excision of the colostoma, mobilization, and reponing into the abdominal cavity, the single-port trocar was placed at the stoma incision without any extra scar. We investigated whether the single-port laparoscopic reversal is as safely feasible as the “conventional” laparoscopic procedure. Till December 2010, single-port reversal operation was performed in 8 patients 2–4 months after Hartmann's procedure because of complicated diverticulitis. No conversion to “conventional” laparoscopic or open procedure was necessary in 1 patient one extra 5 mm trocar was used. The average operation time was 74 min. Except for one wound complication, the postoperative course was uncomplicated. The patients were discharged after 4 to 8 postoperative days. Single-port reversal of Hartmann's procedure has showed as a new method for minimizing the access trauma even further than “conventional” laparoscopic surgery.

scholarly journals Surgical management of sarcoma in adolescent and young adult patients

2020 ◽  
Author(s):  
Kazuhiko Hashimoto ◽  
Shunji Nishimura ◽  
Naohiro Oka ◽  
Masao Akagi
Keyword(s):  
Survival Rate ◽  
Young Adult ◽  
Blood Loss ◽  
Surgical Margin ◽  
Operation Time ◽  
Adolescent And Young Adult ◽  
Intraoperative Blood Loss ◽  
Physical Status ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract Objective: To examine the clinical features and outcomes of adolescent and young adult sarcoma patients who underwent surgical management and clarify important factors associated with prognosis. We reviewed 18 young adult sarcoma patients sarcoma patients treated surgically in our hospital. The tumor site, histology, grade, stage, and American Society of Anesthesiologists-Physical Status before surgery, operation time, intraoperative blood loss, complications, surgical margin, local recurrence, metastasis, and outcomes were investigated. The 3-year survival rate was also calculated. We compared survival based on age, grade, and surveyed features of poor outcome cases.Results: The 3-year survival rate was 61.3%. There was no significant difference in survival based on age, grade, operation time, or intraoperative blood loss. Three of five patients who died of the disease had stage ≥ IV at diagnosis. All patients with R1 surgical margins developed recurrence and all those with an American Society of Anesthesiologists-Physical Status ≥ 2 died. Patients with late-stage sarcomas, R1 tumor margin, or high American Society of Anesthesiologists-Physical Status score had poor prognoses. To achieve a favorable outcome in adolescent and young adult sarcoma patients, early detection and obtaining R0≥ surgical margin are essential.

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

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