scholarly journals Laparoscopic cholecystectomy in a patient with pneumonectomy

2020 ◽  
Vol 8 (4) ◽  
pp. 1582
Author(s):  
Nisha Sharma ◽  
Ankita Chandel ◽  
Manjit Singh Kanwar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Respiratory Mechanics ◽  
Clear Understanding ◽  
Physiological Changes ◽  
Perioperative Outcome ◽  
Lung Functions ◽  
Safe Anaesthesia

Post pneumonectomy patients pose a challenge to the anaesthetist owing to the altered respiratory mechanics and decreased respiratory reserve. Performing laparoscopic surgery in such patients further deteriorates the already compromised lung functions. Authors report a case of laparoscopic cholecystectomy performed in post pneumonectomy patient. A clear understanding of respiratory mechanics and post pneumonectomy physiological changes helped us to administer a safe anaesthesia and safe perioperative outcome.

scholarly journals Effect of pressure-controlled ventilation-volume guaranteed mode combined with individualized positive end-expiratory pressure on respiratory mechanics, oxygenation and lung injury in patients undergoing laparoscopic surgery in Trendelenburg position

2021 ◽  
Author(s):  
Jianli Li ◽  
Saixian Ma ◽  
Xiujie Chang ◽  
Songxu Ju ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Lung Injury ◽  
Respiratory Mechanics ◽  
Lung Mechanics ◽  
Trial Registry ◽  
Positive End Expiratory Pressure ◽  
Clinical Trial Registry ◽  
Trendelenburg Position ◽  
Pressure Controlled Ventilation ◽  
Pressure Controlled

AbstractThe study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH2O PEEP), PF group (PCV-VG plus 5cmH2O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). Pmean, Ppeak, Cdyn, PaO2/FiO2, VD/VT, A-aDO2 and Qs/Qt were recorded at T1 (15 min after the induction of anesthesia), T2 (60 min after pneumoperitoneum), and T3 (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T1 and T3. Our results showed that the Pmean was increased in VI and PI group, and the Ppeak was lower in PI group at T2. At T2 and T3, the Cdyn of PI group was higher than that in other groups, and PaO2/FiO2 was increased in PI group compared with VF and VI group. At T2 and T3, A-aDO2 of PI and PF group was reduced than that in other groups. The Qs/Qt was decreased in PI group compared with VF and VI group at T2 and T3. At T2, VD/VT in PI group was decreased than other groups. At T3, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury.Clinical Trial registry: chictr.org. identifier: ChiCTR-2100044928

scholarly journals Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

2005 ◽  
Vol 33 (3) ◽  
pp. 360-363 ◽  
Author(s):  
A Polychronidis ◽  
AK Tsaroucha ◽  
AJ Karayiannakis ◽  
S Perente ◽  
E Efstathiou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Large Bowel ◽  
Thermal Injury ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Hepatic Flexure ◽  
Temporary Ileostomy ◽  
Delayed Perforation

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.

scholarly journals AUDIT OF EVOLVING ROLES OF LAPAROSCOPY IN THE CURRENT SURGICAL PRACTICE AT CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL: A 5 YEAR REVIEW

2021 ◽  
Vol 8 (5) ◽  
pp. 16-24
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Standard Of Care ◽  
Descriptive Statistics ◽  
Academic Hospital ◽  
Surgical Practice ◽  
The Past ◽  
Wide Range ◽  
Accepted Standard ◽  
The Mean

Background: Laparoscopic surgery (LS) is gaining momentum and has revolutionised the practice of surgery. Over the past thirty years, LS has been used to manage a wide range of surgical pathologies and has become a recognised and generally accepted standard of care. Aim: The aim of this study is to describe the evolution of LS in selected procedures.. Methods: Data were collected from theatre registries. Statistical analysis was performed using the software IMB SPSS. The data were analysed using descriptive statistics of mean and standard deviation for age, and percentage and frequencies for categories of variables . Results: Of the 3745 patients involved in the study, 59.1% were males and 40.9% were females. The mean age of the patients was 35.17±17.30 years. Laparoscopic surgery was represented in 43.2% of the procedures, with laparoscopic appendicectomy (46.73%) and laparoscopic cholecystectomy (32.69%) being the most commonly performed procedures.. Twenty-five adrenalectomies were performed over the study period, and of those 12 (52%) were performed laparoscopically. All the thymectomies (12) were performed thoracoscopically, with one conversion. Conclusion: The findings of this study suggest that there has been an increase in the overall incidence of laparoscopic surgery in selected procedures at CHBAH.

Respiratory Mechanics and Arterial Blood Gases During and After Laparoscopic Cholecystectomy

1997 ◽  
Vol 41 (1) ◽  
pp. 44
Author(s):  
H. IWASAKA ◽  
H. MIYAKAWA ◽  
H. YAMAMOTO ◽  
T. KITANO ◽  
R. TANIGUCHI ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Respiratory Mechanics ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood

General surgery

2018 ◽  
Author(s):  
Matt Rucklidge ◽  
Andrew McLeod ◽  
Tim Wigmore
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
General Surgery ◽  
Breast Surgery ◽  
Fluid Management ◽  
Anaesthetic Management ◽  
Emergency Laparotomy ◽  
Colonic Surgery ◽  
Control Fluid

This chapter discusses the anaesthetic management of general surgery. It begins with a description of management principles for several of the important considerations: analgesia, temperature control, fluid management, and oncological considerations. Surgical procedures covered include colorectal surgery, emergency laparotomy, laparoscopic surgery (including laparoscopic cholecystectomy and laparoscopic colonic surgery), appendicectomy, inguinal hernia repair, haemorrhoidectomy, testicular surgery, and breast surgery.

scholarly journals The Case for Standardisation of the Management of Gallstones Spilled and not Retrieved at Laparoscopic Cholecystectomy

2008 ◽  
Vol 90 (4) ◽  
pp. 310-312 ◽  
Author(s):  
J Mullerat ◽  
K Cooper ◽  
B Box ◽  
B Soin
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Great Britain ◽  
Observational Study ◽  
General Practitioners ◽  
Annual Conference ◽  
Review Of The Literature ◽  
The Uk ◽  
Uncommon Complication

INTRODUCTION This observational study was carried out to establish how surgeons performing laparoscopic cholecystectomy currently deal with the issue of spilled gallstones. MATERIALS AND METHODS A questionnaire was circulated amongst laparoscopic surgeons attending the annual conference of the Association of Laparoscopic Surgery of Great Britain and Ireland in November 2006. RESULTS Eighty-two surgeons completed the questionnaire. Only half of surgeons inform patients when gallstones are spilled. Less than 30% of surgeons inform general practitioners (GPs) of this complication, when it occurs. Less than a quarter of surgeons include this information in the consent literature provided to patients. CONCLUSIONS We recommend that trusts review their policy towards spilled stones either by local audit or adopt the guidance given by the UK Healthcare Commission. While some surgeons feel informing patients and GPs may unnecessarily heighten anxiety from an uncommon complication, our review of the literature suggests this position is not tenable in the current medicolegal climate.

scholarly journals Prospective randomised trial of standard pressure versus low pressure laparoscopic cholecystectomy in a tertiary care hospital from Kolkata: Our experience

2018 ◽  
Vol 9 (4) ◽  
pp. 17-22
Author(s):  
Bikash Chandra Ghosh ◽  
Ambar Gangopadhyay
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Gall Stone ◽  
Low Pressure ◽  
Stone Disease ◽  
Care Hospital ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Standard Pressure ◽  
Symptomatic Gall Stone

Background: Laparoscopic cholecystectomy (LC), the procedure of choice for symptomatic gall stone disease. An emerging trend is to perform Low pressure pnuemoperitonium laparoscopic surgery as it has additive advantages over standard pressure to avoid complications while providing adequate working space.Aims and Objectives: The current study was designed with an aim to compare the advantage of low pressure pneumoperitoneum vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy.Materials and Methods: The study was conducted in the department of General Surgery in R.G.Kar Medical College from January 2014 to June 2015. A total of 52 patients with symptomatic gall stone disease were recruited, 26 patients in each group randomly. Some intraoperative and post-operative parameters were studied.Results: All the intra-operative (IO) cardio-respiratory parameters (Pulse, Mean Arterial Pressure (MAP), End tidal CO2, spO2) were recorded just before incision, 20 minutes intra-operatively and before reversal of general anesthesia (GA). The IO parameters in our study, were found to be significant only at 20 minutes IO and before reversal of GA. The post-operative (PO) parameters (Pulse, MAP, Respiratory rate, spO2) and pain by VAS score at 6 hours, 12 hours and 24 hours post-operatively were studied. In PO period, we observed significant differences at 2 hours post-operatively in all parameters except MAP. There was significant difference in pain at 6, 12 and 24 hours when compared in both groups. The shoulder tip pain (STP) and 2 hours PO nausea and vomiting were found to be significantly higher in Standard pressure Laparoscopic cholecystectomy (SPLC) compared to Low pressure Laparoscopic cholecystectomy (LPLC). The operative time, duration of hospital stay and return to normal life after surgery though had differences but it was statisticallyinsignificant.Conclusion: Low pressure laparoscopic surgery is safe with least post operative complications when performed by experienced surgeons even in patients of ASA III.Asian Journal of Medical Sciences Vol.9(4) 2018 17-22

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