Laparoscopy Using Room Air Insufflation in a Rural African Jungle Hospital: The Bongolo Hospital Experience, January 2006 to December 2013

Introduction. Carbon dioxide is the standard insufflation gas for laparoscopy. However, in many areas of the world, bottled carbon dioxide is not available. Laparoscopy offers advantages over open surgery and has been practiced using filtered room air insufflation since 2006 at Bongolo Hospital in Gabon, Africa. Objective. Our primary goal was to evaluate the safety of room air insufflation related to intraoperative and postoperative complications. Our secondary aim was to review the types of cases performed laparoscopically at our institution. Methods. This retrospective review evaluates laparoscopic cases performed at Bongolo Hospital between January 2006 and December 2013. Demographic and perioperative information for patients undergoing laparoscopic procedures was collected. Insufflation was achieved using a standard, oil-free air compressor using filtered air and a standard insufflation regulator. Results. A total of 368 laparoscopic procedures were identified within the time period. The majority of cases were gynecologic (43%). There was a 2% (8/368) complication rate with one perioperative death. The 2 complications related to insufflation were episodes of hypotension responsive to standard corrective measures. No intracorporeal combustion events were observed in any cases in which the use of diathermy and room air insufflation were combined. The other complications and the death were unrelated to the use of insufflation with air. Conclusion. Insufflation complications with room air occurred in our study. However, the complications related to insufflation with room air in our study were no different than those described in the literature using carbon dioxide. As room air is less costly than carbon dioxide and readily available, confirming the safety of room air insufflation in prospective studies is warranted. Room air appears to be safe for establishing and maintaining pneumoperitoneum, making laparoscopic surgery more accessible to patients in low-resource settings.

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Ureteral laparoscopic surgery: 5 years experience

Urologia Journal ◽

10.1177/039156039606300318 ◽

1996 ◽

Vol 63 (3) ◽

pp. 360-367

Author(s):

E. Belgrano ◽

C. Trombetta ◽

C. Lodolo

Keyword(s):

Laparoscopic Surgery ◽

Ureteral Obstruction ◽

Retroperitoneal Fibrosis ◽

Locally Advanced ◽

Laparoscopic Procedures ◽

The World ◽

Vesico Ureteral Reflux

The main problem in surgically treating ureteral pathologies is the choice of approach. In this study we describe our experience in 8 cases of laparoscopic surgery. Two of these cases involved vesico-ureteral reflux, two retroperitoneal fibrosis, two ureterocele in a poorly functioning duplicated kidney and the last two cases dealt with ureteral obstruction from locally advanced pelvic neoplasia. The most widely performed ureteral laparoscopic procedures in the world are also reviewed.

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Adsorption of Avermectin on Porous Hollow Silica Nanoparticles by Supercritical Technology

Journal of Nanoscience and Nanotechnology ◽

10.1166/jnn.2007.148 ◽

2007 ◽

Vol 7 (2) ◽

pp. 535-541 ◽

Cited By ~ 5

Author(s):

Zhu-Zhu Li ◽

Jian-Feng Chen ◽

Ying Li ◽

Li-Xiong Wen

Keyword(s):

Carbon Dioxide ◽

Silica Nanoparticles ◽

The Other ◽

Hollow Silica ◽

Adsorption Time ◽

Time Period ◽

Adsorption Temperature ◽

Optimal Value ◽

Hollow Silica Nanoparticles ◽

Positive Effect

Porous hollow silica nanoparticles with O.D. of ∼100 nm and a wall thickness of ∼10 nm were prepared by using inorganic CaCO3 templates. The produced PHSN were employed as a novel carrier to study the adsorption of avermectin in supercritical carbon dioxide by applying different adsorption pressure, adsorption temperature, adsorption time and volume of cosolvent. The results indicated that while increasing adsorption pressure and time always showed a positive effect on the avermectin adsorption until adsorption saturation is reached, both the adsorption temperature and volume of cosolvent require an optimal value for achieving the maximum adsorption. It was found that the optimal adsorption could be obtained at an adsorption pressure of 15 MPa and an adsorption temperature of 313 K for 90 minutes with 5 ml cosolvent. In addition, the desorption behavior of avermectin from the avermectin-loaded PHSN samples showed a sustained style: ∼60% of avermectin was released in the first 20 minutes, while the other 40% followed a typical sustained desorption pattern and was dissolved out slowly for a time period of 3000 minutes, which is different from the quick and complete desorption from solid SiO2 carriers.

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Fractional Carbon Dioxide Laser in Treatment of Acne Scars

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2016.004 ◽

2015 ◽

Vol 4 (1) ◽

pp. 38-42 ◽

Cited By ~ 3

Author(s):

Andrej Petrov ◽

Vesna Pljakovska

Keyword(s):

Carbon Dioxide ◽

Carbon Dioxide Laser ◽

The Other ◽

Hypertrophic Scars ◽

Skin Damage ◽

Acne Scars ◽

The World ◽

Fractional Carbon Dioxide Laser ◽

Skin Healing ◽

Residual Lesions

BACKGROUND: Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids.AIM: The aim of the study was to determine efficiency and safety of fractional carbon dioxide laser in the treatment of acne scars.MATERIAL AND METHODS: The study was carried out in Acibadem Sistina Clinical Hospital, Skopje at the Department of Dermatovenerology, with a total of 40 patients treated with fractional carbon dioxide laser (Lutronic eCO2). The study included patients with residual acne scars of a different type.RESULTS: Comedogenic and papular acne in our material were proportionately presented in 50% of cases, while the other half were the more severe clinical forms of acne - pustular inflammatory acne and nodulocystic acne that leave residual lesions in the form of second, third and fourth grade of scars.CONCLUSION: The experiences of our work confirm the world experiences that the best result with this method is achieved in dotted ice pick or V-shaped acne scars.

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Risk factors for postoperative complications of a randomized clinical trial: Laparoscopic versus open surgery with D3 lymphadenectomy for stage II/III colon cancer (JCOG0404).

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.717 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 717-717

Author(s):

Yusuke Nishizawa ◽

Masaaki Ito ◽

Norio Saito ◽

Hiroshi Katayama ◽

Junki Mizusawa ◽

...

Keyword(s):

Risk Factors ◽

Clinical Trial ◽

Colon Cancer ◽

Multivariate Analysis ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Open Surgery ◽

Clinical Stage ◽

Stage Ii ◽

Colon Cancers

717 Background: A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery for clinical stage II/III colon cancers in terms of overall survival was conducted. In this ancillary study, we explored the risk factors for postoperative complications of laparoscopic surgery and open surgery. Methods: Eligibility criteria included colon cancer; tumor located in the cecum, ascending, sigmoid, or rectosigmoid colon; T3 or T4 without involvement of other organs; N0-2; and M0. Postoperative complications which were observed from the end of the operation to discharge were graded according to the CTCAE 3.0. Multivariate analysis was performed using logistic regression model. Results: Between October 2004 and March 2009, a total of 1,057 patients from 30 Japanese centers were registered. By per-protocol set, 524 patients underwent open surgery (OPEN) and 533 patients underwent laparoscopic surgery (LAP). Proportion of any grade (G) complication was 18.3% (OPEN 22.3%, LAP 14.3%), G2–G3 was 12.9% (OPEN 13.9%, LAP 11.8%), G3 was 5.3% (OPEN 6.9%, LAP 3.8%) and G4 was none. Postoperative complications (G2-G3) included leakage (OPEN 2.1%, LAP 1.9%), ileus (OPEN:1.5%, LAP:0.9%), and wound complication (OPEN: 0.2%, LAP: none). Multivariate analysis revealed that risk factors for postoperative complications were operation times 240 min or more (p=0.0019, odds ratio [OR] 2.01 [95% CI: 1.30-3.13]) and open surgery (p=0.0001, OR 2.05 [95% CI: 1.41-2.98]). Conclusions: Operation times more than 240 min and open surgery were considered to be the risk factors for postoperative complications for clinical stage II/III colon cancers. Clinical trial information: C000000105.

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Short-term outcome in robotic vs laparoscopic and open rectal tumor surgery within an ERAS protocol: a retrospective cohort study from the Swedish ERAS database

Surgical Endoscopy ◽

10.1007/s00464-021-08486-y ◽

2021 ◽

Author(s):

Daniel Asklid ◽

Olle Ljungqvist ◽

Yin Xu ◽

Ulf O. Gustafsson

Keyword(s):

Cohort Study ◽

Laparoscopic Surgery ◽

Robotic Surgery ◽

Postoperative Complications ◽

Retrospective Cohort ◽

Open Surgery ◽

Rectal Tumor ◽

Tumor Surgery ◽

Short Term ◽

Eras Protocol

Abstract Background Advantages of robotic technique over laparoscopic technique in rectal tumor surgery have yet to be proven. Large multicenter, register-based cohort studies within an optimized perioperative care protocol are lacking. The aim of this retrospective cohort study was to compare short-term outcomes in robotic, laparoscopic and open rectal tumor resections, while also determining compliance to the enhanced recovery after surgery (ERAS)®Society Guidelines. Methods All patients scheduled for rectal tumor resection and consecutively recorded in the Swedish part of the international ERAS® Interactive Audit System between January 1, 2010 to February 27, 2020, were included (N = 3125). Primary outcomes were postoperative complications and length of stay (LOS) and secondary outcomes compliance to the ERAS protocol, conversion to open surgery, symptoms delaying discharge and reoperations. Uni- and multivariate comparisons were used. Results Robotic surgery (N = 827) had a similar rate of postoperative complications (Clavien–Dindo grades 1–5), 35.9% compared to open surgery (N = 1429) 40.9% (OR 1.15, 95% CI (0.93, 1.41)) and laparoscopic surgery (N = 869) 31.2% (OR 0.88, 95% CI (0.71, 1.08)). LOS was longer in the open group, median 9 days (IRR 1.35, 95% CI (1.27, 1.44)) and laparoscopic group, 7 days (IRR 1.14, 95% CI (1.07, 1.21)) compared to the robotic group, 6 days. Pre- and intraoperative compliance to the ERAS protocol were similar between groups. Conclusions In this multicenter cohort study, robotic surgery was associated with shorter LOS compared to both laparoscopic and open surgery and had lower conversion rates vs laparoscopic surgery. The rate of complications was similar between groups.

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Trans umbilical first trocar access during laparoscopic surgery

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193145 ◽

2019 ◽

Vol 7 (8) ◽

pp. 3039

Author(s):

Ritvik Resutra ◽

Neha Mahajan ◽

Rajive Gupta

Keyword(s):

Carbon Dioxide ◽

Laparoscopic Surgery ◽

Peritoneal Cavity ◽

Routine Procedure ◽

Midline Laparotomy ◽

Previous Abdominal Surgery ◽

Closed Technique ◽

Laparoscopic Procedures ◽

Carbon Dioxide Pneumoperitoneum ◽

History Of

Background: In order to perform laparoscopic procedures, it is necessary to first access the peritoneal cavity and establish carbon dioxide pneumoperitoneum. The placement of the first trocar remains a critical step in laparoscopic surgery. In order to minimize complications associated with placement of first trocar, several techniques have been reported. Author describe a surgical technique that provides a quick, safe, and reliable initial access to the peritoneal cavity with its excellent functional and cosmetic results.Methods: Retrospective study of patients who underwent various laparoscopic procedures at Maxx lyfe Hospital, Bathindi, Jammu was carried out by the closed technique for initial access to the peritoneal cavity through the umbilicus from July 2016 to May 2019. In this study, patients who had a prior midline laparotomy with involvement of the umbilicus were excluded.Results: Authors analyzed 456 patients (M = 190; F = 266) in the study period. Average age of the patients was 32 years (range:12-86). A physiologic defect was identified in the umbilical region in all patients who had no history of previous abdominal surgery in that region. The average time to access the peritoneal cavity was 30 seconds (range: 20-50).Conclusions: This technique is quick, safe, reliable, simple, and easy to learn and easy to perform. It is associated with no mortality and minimal morbidity and has excellent cosmetic results. Based on authors experience, authors believe that this method provides surgeons with an effective and safe way to insert the first trocar and recommend it as a routine procedure to access the peritoneal cavity for abdominal laparoscopic surgery.

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Effect of Carbon Nanoparticle Tracer Combined with Laparoscopy in the Treatment of Colon Cancer

Journal of Nanoscience and Nanotechnology ◽

10.1166/jnn.2020.18598 ◽

2020 ◽

Vol 20 (10) ◽

pp. 6007-6012

Author(s):

Liang Wang ◽

Huaping Xu ◽

Xiaofeng Zhang ◽

Yisheng Zhang ◽

Lianghui Shi ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Recovery Time ◽

Open Surgery ◽

Laparoscopic Group ◽

Intraoperative Blood Loss ◽

Node Dissection ◽

Surgery Group

In this study, our aim was to compare the clinical effects of laparoscopic surgery and open surgery for the treatment of colon cancer. From January 2018 to December 2018, a random sample of 398 colon cancer patients was collected. The open abdominal surgery group underwent open surgery, while the laparoscopic surgery group underwent laparoscopic surgery. The success rate of the two groups, total intraoperative blood loss, length of incision, postoperative bedtime, times of lymph node dissection, and incidence of postoperative complications were compared. Both groups were provided carbon nanotracers for staining. The intraoperative blood loss of the laparoscopic group was significantly lower than that of the open abdominal group (this difference was statistically significant, P < 0.01). However, the operation time and lymph node dissection were similar for the laparoscopic group and the open abdominal group (the difference was not statistically significant, P > 0.05). The gastrointestinal function recovery time, hospital stay, and lung infection rate of patients in the laparoscopic group were significantly lower than those of patients in the open abdominal group. Postoperative bleeding, anastomotic leakage, and wound infection were also observed, but differences between the groups were not statistically significant. The incidence of postoperative complications in the laparoscopic surgery group was lower than that in the open surgery group (statistically significantly, P < 0.05). Laparoscopic surgery in patients with colon cancer is effective and offers patients improved health, shortened recovery time, and better quality of life. Carbon nanotracers can be used to stain lymph nodes and to make distinguishing between diseased and normal tissue easier.

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Learning Curve for Laparoscopic Repair of Pediatric Inguinal Hernia Using Percutaneous Internal Ring Suturing

Children ◽

10.3390/children8040294 ◽

2021 ◽

Vol 8 (4) ◽

pp. 294

Author(s):

Zenon Pogorelić ◽

Dario Huskić ◽

Tin Čohadžić ◽

Miro Jukić ◽

Tomislav Šušnjar

Keyword(s):

Inguinal Hernia ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Hernia Repair ◽

Learning Curve ◽

Operative Time ◽

Learning Curves ◽

The Other ◽

Internal Ring ◽

Significant Difference

Background: Percutaneous internal ring suturing (PIRS) is a simple and popular technique for the treatment of inguinal hernia in children. The aim of this study was to analyze the learning curves during implementation of PIRS in our department. Methods: A total of 318 pediatric patients underwent hernia repair using the PIRS technique by three pediatric surgeons with different levels of experience in laparoscopic surgery. These patients were enrolled in a prospective cohort study during the period October 2015–January 2021. Surgical times, intraoperative and postoperative complications, in addition to outcomes of treatment were compared among the pediatric surgeons. Results: Regarding operative time a significant difference among the surgeons was found. Operative time significantly decreased after 25–30 procedures per surgeon. The surgeon with advanced experience in laparoscopic surgery had significantly less operative times for both unilateral (12 (interquartile range, IQR 10.5, 16.5) min vs. 21 (IQR 16.5, 28) min and 25 (IQR 21.5, 30) min; p = 0.002) and bilateral (19 (IQR 14, 21) min vs. 28 (IQR 25, 33) min and 31 (IQR 24, 36) min; p = 0.0001) hernia repair, compared to the other two surgeons. Perioperative complications, conversion, and ipsilateral recurrence rates were higher at the beginning, reaching the benchmarks when each surgeon performed at least 30 PIRS procedures. The most experienced surgeon had the lowest number of complications (1.4%) and needed a fewer number of cases to reach the plateau. The other two surgeons with less experience in laparoscopic surgery had higher rates of complications (4.4% and 5.4%) and needed a higher number of cases to reach the plateau (p = 0.190). Conclusions: A PIRS learning curve for perioperative and postoperative complications, recurrences, and conversion rates reached the plateau after each surgeon had performed at least 30 cases. After that number of cases PIRS is a safe and effective approach for pediatric hernia repair. A surgeon with an advanced level of experience in pediatric laparoscopic surgery adopted the technique more easily and had a significantly faster learning curve.

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Prognosis Comparisons of Laparoscopy versus Open Surgery for Rectal Cancer Patients after Preoperative Chemoradiotherapy: A Meta-Analysis

Oncology Research and Treatment ◽

10.1159/000508431 ◽

2021 ◽

Vol 44 (5) ◽

pp. 261-268

Author(s):

Jin-Wei Niu ◽

Wu Ning ◽

Zhi-Ze Liu ◽

Dong-Po Pei ◽

Fan-Qiang Meng ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Open Surgery ◽

Locally Advanced ◽

Neoadjuvant Chemoradiotherapy ◽

Current Evidence ◽

Open Thoracotomy ◽

Oncological Outcomes ◽

Duration Of Surgery

Aim: We aimed to compare the oncological outcomes of laparoscopy and open resection for patients with rectal cancer following neoadjuvant chemoradiotherapy (NCRT). Methods: We searched the publications that compared the efficacy of laparoscopic surgery and open thoracotomy in treatment outcomes of rectal cancer after NCRT. All trials analyzed the summary hazard ratios of the endpoints of interest, including survival and individual postoperative complications. Results: Totally, 10 trials met our inclusion criteria. The pooled analysis of 3-year disease-free survival (OR 1.39, 95% CI 0.93–2.06; p = 0.11) and 3-year overall survival (OR 1.01, 95% CI 0.70–1.45; p = 0.97) showed that laparoscopic surgery did not achieve beneficial effects compared with open thoracotomy. The pooled result of duration of surgery indicated that laparoscopic surgery was associated with a trend for longer surgery time (SMD 27.53, 95% CI 1.34–53.72; p = 0.04), shorter hospital stay (SMD –1.64, 95% CI –2.70 to –0.58; p = 0.002), more postoperative complications (OR 0.77, 95% CI 0.60–0.99; p = 0.04), and decreased blood loss (SMD –49.87, 95% CI –80.61 to –19.14; p = 0.001). However, the number of removed lymph nodes, positive circumferential resection margin, as well as complications after surgery showed significant differences between the 2 groups. Conclusions: We focused on current evidence and reviewed the studies indicating that similar oncological outcomes were associated with laparoscopic surgery following NCRT for patients with locally advanced lower rectal cancer in comparison with open surgery.

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Η κατάλυση της συμφιλίωσης από τη διαφορά της μετανεωτερικότητας

Conatus ◽

10.12681/conatus.11846 ◽

2017 ◽

Vol 1 (1) ◽

pp. 57

Author(s):

Σπύρος Χαλβαντζής (Spyros Chalvantzis)

Keyword(s):

The Other ◽

Time Period ◽

The World ◽

Ways Of Thinking ◽

The One ◽

The Way

Main goal of this article is to present perceptions of the world of two different and meaningfully promiscuous ways of thinking: from the one hand the perception formed during the contemporary times and from the other the perception formed during ‘’post-histoire’’. What has to be firstly clarified regarding the matter of post-modern is that it does not fight against its modern ancestor. Post in postmodernity does not mean the replacement of modernity. In other words, post is not connected with a time period that has passed and be replaced with something novel. The entirely analysis goes all the way based upon Derrida’s Thought. To be more specific that means that the goal is the signalization of the differences between modernity and postmodernity without a breath of identification, conciliation or concordant connections but through the percept of complementarity. It is also anticipated to be clarified a model of historic perspective, during its progression social configurations are structured after this model has been firstly approached through the prism of Rousseau’s thought.

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