scholarly journals Role of ultrasound in reducing complication during primary trocar insertion in laparoscopic surgery: prospective observational study

2018 ◽  
Vol 7 (7) ◽  
pp. 2747
Author(s):  
Vandana Dhama ◽  
Vipin Dhama ◽  
Rachna Chaudhary ◽  
Shakun Singh ◽  
Saba Aafrin
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Abdominal Cavity ◽  
Rectus Sheath ◽  
Previous Abdominal Surgery ◽  
Slide Test ◽  
History Of ◽  
Visceral Slide

Background: Patients presenting to Gynecology OPD at LLRM Medical College, Meerut, UP, India for benign laparoscopic surgery from June 2016 to May 2017 were included in the study. A total of 130 women completed the study of which 30 had history of previous abdominal surgery and 100 had no history of previous abdominal surgery. The ability of the visceral slide test to detect periumbilical adhesions was compared with laparoscopic detection of adhesions.Methods: Patients fulfilling inclusion and exclusion criteria and preanaesthetic clearance were subjected to office based Visceral Slide test using high frequency ultrasound probe (7.5 MHz) in the sagittal plane at the level of umbilicus. Distance between the skin and posterior rectus sheath was measured. Diagnostic accuracy of visceral slide test and mean time taken to perform the test was noted.Results: On laparoscopy 4 women had periumbilical adhesions while 24 women in the total sample had adhesions elsewhere in the abdominal cavity. The visceral slide test had a sensitivity of 75%, specificity of 98%, positive predictive value of 75% and negative predictive value of 99%. The diagnostic accuracy of the test is 97%. The median time to perform the examination was 1.69 minutes.Conclusions: The visceral slide technique was convenient and rapid to perform, and reliably identified adhesions in the periumbilical area.

A Relook into Visceral Slide Test as a Preoperative Screening Modality to Detect Abdominal Wall Adhesions- A Prospective Observational Cohort Study

2021 ◽  
Vol 17 ◽  
Author(s):  
Himanshi Jain ◽  
Roopa Padavagodu Shivananda ◽  
Shubha Rao ◽  
Nivedita Hegde ◽  
Sangamithra Paladugu ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Observational Cohort Study ◽  
Gynecological Surgery ◽  
Prospective Observational Cohort Study ◽  
Abdominal Adhesions ◽  
Slide Test ◽  
History Of ◽  
Observational Cohort ◽  
Visceral Slide

Background: Background: Ultrasound has become an invaluable tool in our daily practice. Its role in screening for adhesions has been tested since the 1990s. Objective: This study aims to determine the role of the visceral slide test as a screening method to predict abdominal wall adhesions in women undergoing gynecological surgery. Methods: We conducted a prospective observational cohort study from August 2017 to July 2019 in women undergoing elective abdominopelvic surgery for a gynecological indication. Preoperatively, a visceral slide test was performed in 5 specified zones on the abdomen and the test results were clinically correlated with the presence, severity, and extent of adhesions intra-operatively. Results: Results were reported as mean, standard deviation, range of values or number and percentage. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy (including 95% confidence interval for all) of visceral slide test were calculated to determine intra-abdominal adhesions . We also found a correlation between the number of negative slide tests and PAI scores using Spearman’s correlation test. Of the 339 women who completed the study, 41.2% had a previous history of abdominopelvic surgery. In this study, the visceral slide test was found to have a sensitivity of 70.87% ( 95%CI 62.15-78.59), specificity of 86.32% (95% CI 80.95-90.64), positive predictive value (PPV) of 75.63% ( 95% CI 68.49-81.59), negative predictive value (NPV) of 83.18%( 95% CI 78.95-86.70) and diagnostic accuracy of 80.53%( 95% CI 75.91-84.61)with p-value less than 0.001. The number of negative slide tests positively correlated with the Peritoneal Adhesion Index score (r = 0.662, p < 0.001) and also with increasing operative time and intraoperative blood loss. Accuracy and positive predictive value of the test were significantly higher in patients with a history of abdominal surgeries, endometriosis and PID. Conclusion: Visceral slide test is an easy, rapid, non-invasive and reliable screening test to predict abdominal adhesions in women undergoing gynecological surgery. The presence of risk factors for adhesions increases the accuracy of the test.

scholarly journals Laparoscopic Redo Ileocolic Resection for Crohn’s Disease in Patients with Previous Multiple Laparotomies

2018 ◽  
Vol 108 (1) ◽  
pp. 42-48 ◽  
Author(s):  
V. Celentano ◽  
F. Sagias ◽  
K. G. Flashman ◽  
J. Conti ◽  
J. Khan
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Conversion Rate ◽  
Operating Time ◽  
Ileocolic Resection ◽  
Short Term ◽  
Previous Abdominal Surgery ◽  
History Of

Purposes: Over 80% of patients with primary ileocolic Crohn’s disease have a surgical resection within 10 years of diagnosis, and 40%–50% of them need further surgery within 15 years. Laparoscopic surgery can be challenging due to a thickened mesentery and the potential for fistulas, abscesses, and phlegmons. Aim of this study is to analyze the short-term outcomes of laparoscopic redo ileocolic resections for Crohn’s disease in patients with previous multiple laparotomies. Methods: All patients undergoing laparoscopic surgery for ileocolic Crohn’s disease from March 2006 to February 2017 were prospectively evaluated. Short term outcomes of laparoscopic ileocolic resection were compared between patients with previous multiple major surgeries and recurrent Crohn’s disease, and patients undergoing surgery for the first presentation of Crohn’s disease and no history of previous surgery. Conversion rate and 30-day morbidity were the primary outcomes. Reoperations, readmissions, operating time and length of stay were the secondary outcomes. Results: 29 patients with recurrent Crohn’s disease and previous multiple laparotomies were included: the number of laparotomies these patients previously underwent was 2 in 19 cases (65.5%), 3 in 9 (31%), and 4 in 1 (3.5%). In total, 90 patients with no history of any previous abdominal surgery, who underwent laparoscopic ileocecal resection for Crohn’s disease, represented the control group. No differences were found in morbidity and conversion rate. Operating time was longer in patients with history of previous abdominal surgery. Conclusion: Laparoscopic redo ileocolic resection for Crohn’s disease is feasible and safe in patients with previous multiple laparotomies at the expense of longer operating time.

scholarly journals Multiple Abdominal Cocoons: An Unusual Presentation of Intestinal Obstruction and a Diagnostic Dilemma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammad Zain Sohail ◽  
Shumaila Hasan ◽  
Benan Dala-Ali ◽  
Shahanoor Ali ◽  
M. A. Hashmi
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Fibrous Membrane ◽  
Unknown Aetiology ◽  
Abdominal Cocoon ◽  
Diagnostic Dilemma ◽  
Previous Abdominal Surgery ◽  
History Of ◽  
Subacute Intestinal Obstruction ◽  
Encapsulating Peritonitis

Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare acquired condition with an unknown aetiology. It is characterized by encapsulation of the small bowel by a fibrous membrane and can lead to intestinal obstruction. We present the case of a 42-year-old gentleman with a history of hepatitis C, tuberculosis, and previous abdominal surgery, who presented with subacute intestinal obstruction. Surgical exploration of the abdomen revealed that the entire contents were enclosed into three distinct sacs by a dense fibrous membrane. Excision of the sacs was performed followed by adhesiolysis. This is believed to be the first reported case of multiple cocoons within the abdominal cavity. The case is discussed with reference to the literature.

Safety of Left Upper Quadrant Entry during Laparoscopic Surgery in Obese Patients with a History of Prior Abdominal Surgery

2014 ◽  
Vol 21 (6) ◽  
pp. S180-S181
Author(s):  
K.M. Wishall ◽  
J.M. Seufert ◽  
R.B. Danis ◽  
N. Pereira ◽  
C.R. Della Badia
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Obese Patients ◽  
History Of

scholarly journals A STUDY OF INTESTINAL OBSTRUCTION CONSERVTIVE VERSUS SURGICAL MANAGEMENT

2020 ◽  
Vol 1 (2) ◽  
pp. 10-16
Author(s):  
MA Oyinlola ◽  
OA Omisakin
Keyword(s):  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Exploratory Laparotomy ◽  
Related Factors ◽  
Previous Abdominal Surgery ◽  
Intestinal Contents ◽  
History Of ◽  
Obstructed Hernia

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.

scholarly journals Laparoscopic adrenalectomy by the lateral transperitoneal approach in patients with a history of previous abdominal surgery

2013 ◽  
Vol 2 ◽  
pp. 146-151 ◽  
Author(s):  
Michał Pędziwiatr ◽  
Maciej Matłok ◽  
Jan Kulawik ◽  
Piotr Major ◽  
Piotr Budzyński ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Laparoscopic Adrenalectomy ◽  
Transperitoneal Approach ◽  
Previous Abdominal Surgery ◽  
History Of

The Effects of Previous Abdominal Operations and Intraperitoneal Adhesions on the Outcome of Peritoneal Dialysis Catheters

2010 ◽  
Vol 30 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Amir Keshvari ◽  
Mohammad Sadegh Fazeli ◽  
Alipasha Meysamie ◽  
Sepideh Seifi ◽  
Mohammad Kazem Nouri Taromloo
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Surgery ◽  
Previous History ◽  
Laparoscopic Approach ◽  
Surgical Revision ◽  
Intraperitoneal Adhesions ◽  
Previous Abdominal Surgery ◽  
Increased Risk ◽  
History Of ◽  
Abdominal Operations

BackgroundPatients with previous history of abdominal operations are sometimes excluded from consideration for peritoneal dialysis because of concerns for increased risk of complications during the implantation procedure and inadequate dialysis due to reduced peritoneal surface area. Employing a laparoscopic approach, we compared the outcome of peritoneal dialysis catheters in 2 groups of patients with and without intra-abdominal adhesions.MethodsAll data in this report were recorded prospectively. Revision-free and overall survival of catheters, the incidence of mechanical and infectious complication, and surgical revision rates were compared between the 2 groups.ResultsIn 217 successful catheter implantations, there was a history of previous abdominal surgery in 42.9% of procedures; only 26.9% of them had intraperitoneal adhesions; 2.8% of patients without history of previous abdominal surgery had intraperitoneal adhesions. There were no significant differences between the 2 groups for 1- and 2-year revision-free and overall catheter survival, mechanical dysfunction, infectious complications, or surgical revision rates.ConclusionHistory of previous abdominal surgery should not be used to judge the eligibility of patients for peritoneal dialysis. Laparoscopic placement is the best way to ensure optimal catheter outcomes equivalent to patients without previous abdominal surgery.

scholarly journals Trans umbilical first trocar access during laparoscopic surgery

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.

Conservative management of the colonic gallstone

2021 ◽  
Vol 14 (11) ◽  
pp. e243040
Author(s):  
Katherine Victoria Hurst ◽  
Georgina Bryony Peiris ◽  
Michael Booth
Keyword(s):  
Type 2 Diabetes ◽  
Gastrointestinal Tract ◽  
Abdominal Surgery ◽  
Ultrasound Scan ◽  
Past Medical History ◽  
Previous Abdominal Surgery ◽  
Bowel Movements ◽  
History Of ◽  
Cholecystocolonic Fistula

A 74-year-old woman presents with a 7-day history of increasing lower abdominal pains and reduced bowel movements; resulting in absolute constipation.Twenty-four hours prior to admission she also had symptoms of nauseous and significant abdominal distention. Her past medical history included; diverticulitis, type 2 diabetes, hypercholesterolemia, an ultrasound scan in 2005 confirming gallstones, but no previous abdominal surgery.She was initially treated for bowel obstruction and a CT arranged. CT showed a 4.5 cm gallstone in mid-sigmoid colon and a cholecystocolonic fistula. She was booked for colonoscopy±laparotomy, but on the morning of her planned procedure she repeatedly opened her bowels. Subsequent colonoscopy was negative and repeat CT confirmed the stone was no longer within the gastrointestinal tract.

scholarly journals Factors determining conversion of laparoscopic to open cholecystectomy

2017 ◽  
Vol 11 (2) ◽  
pp. 32-35
Author(s):  
Tapash Kumar Maitra ◽  
Mahmud Ekramullah ◽  
Faruquzzaman ◽  
Samiran Kumar Mondol
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Abdominal Surgery ◽  
Open Cholecystectomy ◽  
Gallbladder Wall ◽  
Cystic Artery ◽  
Male And Female ◽  
Previous Abdominal Surgery ◽  
History Of ◽  
The Mean

Background and objectives: Laparoscopic cholecystectomy (LC) has virtually replaced conventional open cholecystectomy (OC) as the standard procedure of treatment for cholelithiasis and cholecystitis. However, OC sometimes becomes a necessity considering the feasibility and safety of the surgical procedure. But the factors that demand conversion from LC to OC differ widely. The present study aimed to determine the prevalence of conversion from LC to OC and to assess the causes of conversion and risk factors related to conversion.Methods: The study was conducted in a referral hospital – ‘Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM)’ from September 2014 to September 2016. Cases of cholelithiasis with or without cholecystitis, and other gall bladder pathology were included in the study. A team of experienced surgeon performed LC of all selected cases. The causes of conversion to OC were systematically recorded by the surgical team and the risk factors (age, sex, obesity, history of previous abdominal surgery, gallbladder thickness) related to conversion from LC to OC was investigated.Results: A total of 261 (M / F = 87 /174) patients were considered eligible for the study. The mean age of all patients was 43 (±1.75) years. For the male and female groups the mean ages were 44±1.9 and 42±1.6 years respectively. Of the total 261 cases, 210 (80.5%) patients had cholelithiasis with chronic cholecystitis, 47 (18.0%) had gallbladder stone plus acute cholecystitis and 4 (1.5%) had gallbladder polyp. Open conversion was required in case of 19 patients. Thus, overall conversion rate was 7.3%. The common causes of conversion were a) difficulty in defining Calot’s triangle (42.1%), b) injury to cystic artery (21.1%) and c) injury to bile duct (15.8%). Both male and female had equal risk for conversion. The investigated risk factors like history of previous abdominal surgery, preoperative ERCP, acute cholecystitis, obesity, increased gallbladder-wall thickness and older age showed no significant association with conversion.Conclusion: The study revealed that a very few patents (7.5%) needed conversion from LC to OC. The commonest cause of conversion was difficulty in defining Calot’s triangle, injury to cystic artery and bile duct. The risk factors like previous abdominal surgery, preoperative ERCP, gallbladder wall thickness, obesity and old age were not found associated with conversion to OC.IMC J Med Sci 2017; 11(2): 32-35

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