scholarly journals Laparoscopy assisted minilaparotomy in the present uterine surgery

1998 ◽  
Vol 47 (3-4) ◽  
pp. 22-25
Author(s):  
G. A. Savitskiy ◽  
N. N. Volkov ◽  
R. D. Ivanova ◽  
S. M. Gorbushin

It has been created the new technology of uterine surgery based on laparoscopy assisted suprapubical middle minilaparotomy. This operative method allows to minimize the surgical injure in the cases when laparoscopy itself may be difficult because of some reasons and typical laparotomy is undesirable. The first experience of these operations has shown that using of this technology does allow to decrease intraoperative blood loss considerably, reduce very much postoperative hospital stay of patients in comparison with laparotomy, minimize the necessity of analgetics, optimize the suture of the uterus in myomectomy and diminish the zone of coagulative necrosis of tissues.

2021 ◽  
Author(s):  
Bin Zhang ◽  
Yang He ◽  
Duo Zheng ◽  
Junyao Liu ◽  
Peng Qi ◽  
...  

Abstract Background: To analyze perioperative conditions and long-term efficacy of open modified ureterosigmoidostomy urinary diversion (OMUUD) in patients with bladder cancer who underwent open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC).Methods: In this retrospective study, the clinical data of patients who underwent open and laparoscopic radical cystectomy plus open modified ureterosigmoidostomy urinary diversion in our hospital were collected from January 2011 to December 2019. In addition, perioperative data of 56 patients who underwent ORC and OMUUD were compared with those of 118 patients who underwent laparoscopic radical cystectomy (LRC) plus OMUUD. A long-term follow-up was performed to compare the overall survival (OS) and progression-free survival (PFS) rate between the two groups.Results: Results showed that there was no significant difference between ORC+OMUUD group and LRC+OMUUD group in terms of gender, age, body index, pre-operative ASA grade, history of transurethral resection of bladder tumor (TURBT) before surgery, tumor T stage, lymph node dissection range, pathological grade, and positive postoperative surgical margin. The mean operation time in the open group was shorter than that in the laparoscopic group (P<0.001). Moreover, the estimated intraoperative blood loss(P<0.001)and postoperative hospital stay(P=0.023)were better in the laparoscopic group than in the open group. The incidence of complications between 30 days (P=0.665) and 90 days (P=0.211) time-points after surgery was not significantly different. Similarly, the OS (P=0.237) and PFS (P=0.307) between the two groups were comparable.Conclusion: This study shows that the LRC group has long operation time, but less estimated intraoperative blood loss, short postoperative hospital stay, small trauma, and fast postoperative recovery compared to open surgery. Moreover, the incidence of complications at 30 - and 90-days postoperation, as well as the OS and PFS is not different between laparoscopy and open surgery.


2019 ◽  
Vol 18 (1) ◽  
pp. 58-65
Author(s):  
N. R. Torchua ◽  
A. A. Ponomarenko ◽  
E. G. Rybakov ◽  
S. I. Achkasov

BACKGROUND: nowadays laparoscopic liver resection (LapLR) in contrast to traditional open approach is more preferable because of reduction of intraoperative blood loss and postop morbidity, decrease of postop hospital stay. Unfortunately, the place of LapLR in surgery for colorectal liver metastases is still controversial because of small number of comparative studies. PATIENTS AND METHODS: between November 2017 and December 2018 fifty two patients with resectable colorectal liver metastases were included in our pilot study - 35 in the prospective group for laparoscopic liver resection and 17 patients in retrospective group of open-approach liver resections (selected group of historical control) (OLR). RESULTS: one patient was excluded from LapLR group because of absence of intraoperative evidence for metastatic disease (in spite of preop MRI). Two patients had lap-to-open conversion (in one case because of technical difficulties due to the location of the permanent ileostomy in the right mesogastric region; in the other case due to intraoperative bleeding). These patients were included into open group. Atypical liver resections were the most often procedures in both groups - 79% (23/32) and 76% (13/19), p=0.3 (LapLR and OLR, respectively). Duration of the procedure was shorter in the OLR group: 218+71 min vs. 237+101min in LapLR, p=0.6. The mediana for blood loss in LapLR was 100 ml (quartile 100; 200) vs. 320 ml (quartile 200;600) in OLR, p=0.0001. The rate of R0 resections was comparable in both groups (p=1.0). The patients of OLR group more often had >1 complication (16 vs. 13, p=0.01) and had higher frequency of bile fistulas, abscesses in the liver resection area and clostridial colitis. Postoperative hospital stay was shorter in the LapLR group: 11+3 vs. 14+5 days, p=0.008. CONCLUSION: laparoscopic liver resections for metastases of colorectal cancer were associated with less intraoperative blood loss, morbidity, and shorter postoperative hospital stay, with comparable rate of R0 resections.


2021 ◽  
Author(s):  
Shuzhen Chang ◽  
Wei Zhang ◽  
Linyv Peng ◽  
Haiyan Zhou ◽  
HAN Li-ping

Abstract Objective To investigate the safety and feasibility of laparoendoscopic single-site surgery (LESS) in the treatment of giant ovarian cysts. Methods A total of 76 patients with giant ovarian cyst (diameter ≥ 10 cm) who received surgical treatment in our hospital from January 2018 to May 2021 were divided into experimental cohort (single-port laparoscopic cohort) (n = 30) and control cohort (traditional laparoscopic cohort) (n = 46).The operation time, intraoperative blood loss, intraoperative cyst fluid spillage rate, application of postoperative analgesic drugs, postoperative first anus exhaust time, incidence rate of perioperative complications, length of postoperative hospital stay and other clinical indicators were summarized and analyzed between the two cohorts. Results The LESS cohorts had an earlier onset of age[ (27.6 ± 8.4) ,years of age], shorter of operation time [(82.2 ± 16.0)min], less of intraoperative blood loss [( 17.5 (10-22.5) ml)] as compared with traditional laparoscopic cohort[ (40.9 ± 15.5 )years of age, (102.7 ± 26.2)min, (20 (18.7–35) )m,P ༜ 0.05]. The first postoperative exhaust time,the rate of postoperative analgesic drugs, incidence rate of perioperative complications and postoperative hospital stay in two cohorts were in the similar line. Conclusion After adequate evaluation and screening of patients, the size of ovarian cysts cannot be the reason for refusing LESS surgery. It is safe and feasible for clinical promotion in the management of giant ovarian cysts.


BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fei Liu ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  

Abstract Background To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results All 55 patients (TLH = 30, CLH = 25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57 ± 0.19 d and 4.56 ± 0.27 d, respectively (t = 3.07, P < 0.01), the postoperative hospital stay was 5.50 ± 0.28 d and 7.00 ± 0.74 d (t = 2.03, P < 0.05), and the hospitalization expenses were CNY 40,085 ± 2447 and CNY 26,084 ± 2776 (t = 3.79, P < 0.001). There were no significant differences in intraoperative blood loss (9.57 ± 3.28 ml vs 8.2 ± 1.13 ml, t = 0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5 ± 2.46 min vs 75.00 ± 2.04 min, t = 1.68, P = 0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, χ2 = 0.07, P = 0.79). Conclusions TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.


2021 ◽  

Background: To explore the efficacy and safety of a new type of testicular excision with ultrasonic dissector. Methods: A retrospective analysis was performed on 69 patients with advanced prostate cancer undergoing orchiectomy in our hospital between June 2017 and June 2019. All patients were divided into a traditional surgery group (n = 27) and an ultrasonic scalpel surgery group (n = 42). The operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rates were compared. Results: The ultrasonic scalpel surgery group had significantly shorter operation times and less intraoperative blood loss than the traditional surgery group (each P < 0.01). Moreover, the incidence of postoperative complication differed significantly between the traditional surgery group (18.52%) and the ultrasonic scalpel surgery group (0%) (P < 0.01). However, there was no significant difference in postoperative hospital stay between the two groups (P > 0.05). Conclusions: The surgery time for testicular excision using the ultrasonic knife is short, the operation is simple and the complications are few and thus it may become a form of replacement for traditional testicular excision.


2020 ◽  
Author(s):  
FEI LIU ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  

Abstract Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively (t=3.07, P<0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d (t=2.03, P<0.05), and the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 (t=3.79, P<0.001). There were no significant differences in intraoperative blood loss (9.57±3.28 ml vs 8.2±1.13 ml, t=0.37, P=0.72) or time for jejunum-cojejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t=1.68, P=0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, c²=0.07, P=0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive. Keywords: Total laparoscopic; Choledochal cyst; Children; Congenital


2020 ◽  
Author(s):  
FEI LIU ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  

Abstract Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively ( t =3.07, P <0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d ( t =2.03, P <0.05), and the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 ( t =3.79, P <0.001). There were no significant differences in intraoperative blood loss (9.57±3.28 ml vs 8.2±1.13 ml, t =0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t =1.68, P =0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, c ² =0.07, P =0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.


2020 ◽  
Author(s):  
Fei Liu ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  

Abstract Background: To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs).Methods: Patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-co-jejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, postoperative complications and perioperative laboratory values were compared.Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively (t=3.07, P<0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d (t=2.03, P<0.05), the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 (t=3.79, P<0.001). There were no significant differences in intraoperative blood loss (9.57±3.28ml vs 8.2±1.13 ml, t=0.37, P=0.72) and time for jejunum-co-jejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t=1.68, P=0.10). The median follow-up periods of TLH and CLH group were 17 and 16 months respectively. Overall comlication rates were comparable between two groups (10% vs 8%, c²=0.07, P=0.79).Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and short hospitalization. However, hospitalization is relatively expensive.


2020 ◽  
Author(s):  
FEI LIU ◽  
Xiaogang Xu ◽  
Menglong Lan ◽  
Boyuan Tao ◽  
Le Li ◽  
...  

Abstract Background : To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs). Methods: Patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-co-jejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, postoperative complications were compared. Results: All 55 patients (TLH=30, CLH=25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57±0.19 d and 4.56±0.27 d, respectively ( t =3.07, P <0.01), the postoperative hospital stay was 5.50±0.28 d and 7.00±0.74 d ( t =2.03, P <0.05), the hospitalization expenses were CNY 40085±2447 and CNY 26084±2776 ( t =3.79, P <0.001). There were no significant differences in intraoperative blood loss (9.57±3.28ml vs 8.2±1.13 ml, t =0.37, P = 0.72) and time for jejunum-co-jejunum anastomosis (80.5±2.46 min vs 75.00±2.04 min, t =1.68, P =0.10). The median follow-up periods of TLH and CLH group were 17 and 16 months respectively. Overall comlication rates were comparable between two groups (10% vs 8%, c ² =0.07, P =0.79). Conclusions: TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and short hospitalization. However, hospitalization is relatively expensive.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaohe Wang ◽  
Yang Yue ◽  
Wenjie Zhang ◽  
Qiaoyu Liu ◽  
Beicheng Sun ◽  
...  

Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections.


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