scholarly journals Total laparoscopic pancreaticoduodenectomy in 26 patients: single surgeon experience

2021 ◽  
Vol 8 (2) ◽  
pp. 674
Author(s):  
Rajendra Bagree ◽  
Gaurav Jalendra ◽  
Pradeep Panwar ◽  
Veena Shukla ◽  
Hetish M. Reddy
Keyword(s):  
Hospital Stay ◽  
Open Surgery ◽  
Operative Time ◽  
Tumour Size ◽  
Length Of Hospital Stay ◽  
Resected Specimen ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Early Recovery ◽  
Promising Alternative ◽  
Surgeon Experience

Background: Total laparoscopic pancreaticoduodenectomy (TLPD) has become more feasible and preferred surgery for periampullary tumour. With the innovation of latest equipment and continuous learning curve, this has become more sophisticated and rampant, along the advantages of minimal invasive surgery.  Methods: We analysed data of all the 26 patients who underwent TLPD from October 2015 to November 2019. Preoperative haematological, liver function test, tumour marker, MRCP, triphasic CT, scan with pancreatic protocol, endoscopic ultrasound guided fine needle aspiration or brush cytology done for confirmation of diagnosis, nodal status and operability. Meticulously selected patients with periampullary carcinoma of tumour size≤2.5 cm included. Demographic data, operative time, length of hospital stay, post-operative complication and pathological analyses of resected specimen (en bloc) observed. Results: TLPD for periampullary tumours attempted in twenty-six patients among them six converted to open surgery. Patients were of both genders and mean age was 45 (27-60, SD7.4) years. The mean operative time was 353 SD 28.77 (306-420) minutes. Postoperatively, there were few complications and mean length of hospital stay was 11 (9-13 days) days. The histopathology revealed maximum no. of cholangiocarcinoma with negative margins and positive nodes in all the patients.Conclusions: TLPD is feasible, safe and promising alternative to the standard open surgery with expert hands. This has benefits of short hospital stay, less blood loss, cosmetic, early recovery with few complications. Short-term surgical outcomes are superior or comparable to open surgery.  

scholarly journals TRANSITION FROM PRONE TO SUPINE PERCUTANEOUS NEPHROLITOTOMY: EVALUATING THE LEARNING CURVE FROM THE SINGLE SURGEON EXPERIENCE

2021 ◽  
Vol 28 (2) ◽  
pp. 147-152
Author(s):  
Zulfikar Ali ◽  
Andika Afriansyah
Keyword(s):  
Learning Curve ◽  
Hospital Stay ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Major Complication ◽  
Hemoglobin Level ◽  
Stone Free Rate ◽  
Surgeon Experience ◽  
The Mean ◽  
Free Rate

Objective: This study aims to evaluate the learning curve of the urologist to perform supine PCNL and the perioperative outcome of patients based on a single surgeon’s experience. Material & Methods: 60 consecutive patients who underwent modified supine PCNL for renal stone were analyzed. A single experienced urological surgeon performed the supine PCNL. Mean operative time, drop in hemoglobin level, stone-free rate, complications, and length of hospital stay were analyzed to evaluate the learning curve of the surgeon. All parameters were compared among all six groups obtained from the 60 cases in chronological order. Besides, the outcomes of supine PCNL were also compared to prone PCNL. Results: Mean operative time from 60 cases of supine PCNL was 100 ± 27 minutes. The mean operative time was decreased over time, particularly after 20 cases. Significantly different mean operative times (89 ± 14 minutes vs. 126 ± 21 minutes, p < 0.001) in the groups of cases 21-60 compared to the group of 1–20 cases were observed. The total stone-free rate for supine PCNL from all cases was 68%. There was no difference regarding the reduction of hemoglobin level, stone-free rate, hospital stay, and complication rate. No major complication was found among study subjects. Supine PCNL showed similar outcome parameters compared to prone PCNL. Conclusion: The surgeon acquired the surgical competencies to perform supine PCNL after 20 cases. The supine PCNL could remove the kidney stone as effective and safe as prone PCNL.

scholarly journals Analysis of 300 Total Laparoscopic Hysterectomy Cases Performed by The Same Surgeon

2021 ◽  
Vol 3 (2) ◽  
pp. 20-24
Author(s):  
Esra Tamburacı ◽  
Barış Mulayim
Keyword(s):  
Hospital Stay ◽  
Open Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Technical Difficulty ◽  
Demographic Characteristics ◽  
Total Laparoscopic Hysterectomy ◽  
Conversion To Open Surgery ◽  
Operative Complications

Aim: This study aimed to evaluate the results of 300 cases of total laparoscopic hysterectomy (TLH) performed by the same surgeon. Material and methods: During the study period, a total of 300 TLH operations were performed between January 2017 and December 2018. Demographic characteristics, indications of hysterectomy, uterine weights, intra-operative and post-operative complications, duration of the operation, length of hospital stay, blood loss of patients, visual analogue scores and amount of analgesics needed were retrospectively evaluated. Complications were analysed and compared with literature. Results: Parameters analysed for 300 patients included in the study were as follows: mean age 47.82 ± 6.18 years, mean parity 3.4 ± 2.0 (0–11), BMI 27.41 ± 4.36 (kg/m²), mean uterine weight 367.67 ± 266.21 g (50–1600 g), mean operative time 89.07 ± 37.94 min (30–240 min), mean hospital stay 54.37 ± 21.95 h (24–168 h) and total complication rate 28 (9.3%). Conversion to open surgery was required in 29 (9.7%) patients. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of complications and conversions to laparotomy. Conclusion: Total laparoscopic hysterectomy is a well-designed surgical procedure for the management of benign gynaecological conditions, and after adequate training, it seems to be a safe and effective procedure for patients.

scholarly journals Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Benign Disease ◽  
Post Surgery ◽  
A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

Comparison of Retrograde Intrarenal Surgery and Micro-Percutaneous Nephrolithotomy for Kidney Stones: A Meta-Analysis

2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Gu ◽  
Yucheng Yang ◽  
Rui Ding ◽  
Meili Wang ◽  
Jianming Pu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Clinical Results ◽  
Retrograde Intrarenal Surgery ◽  
Alternative Approach ◽  
Significant Difference

<b><i>Background:</i></b> Advances in micro-percutaneous nephrolithotomy (PCNL) for kidney stones have made it an alternative approach to the retrograde intrarenal surgery (RIRS) approach. Nevertheless, the superiority of micro-PCNL over RIRS is still under debate. The results are controversial. <b><i>Objectives:</i></b> The purpose of this study was to systematically evaluate the clinical results in patients presenting with kidney stones treated with micro-PCNL or RIRS. <b><i>Methods:</i></b> A literature search was done for electronic databases to identify researches that compared micro-PCNL and RIRS till December 2019. The clinical outcome included complications, stone-free rates (SFRs), hemoglobin reduction, length of hospital stay, and operative time. <b><i>Results:</i></b> Five articles were included in our study. The pooled results revealed no statistical difference in the rate of complications (OR = 0.99, 95% CI = 0.57–1.74, <i>p</i> = 0.99), length of hospital stay (MD = −0.29, 95% CI = −0.82 to 0.24, <i>p</i> = 0.28), and operative time (MD = −6.63, 95% CI = −27.34 to 14.08, <i>p</i> = 0.53) between the 2 groups. However, significant difference was present in hemoglobin reduction (MD = −0.43, 95% CI = −0.55 to 0.30, <i>p</i> &#x3c; 0.001) and the SFRs (OR = 0.59, 95% CI = 0.36–0.98, <i>p</i> = 0.04) when comparing RIRS with micro-PCNL. <b><i>Conclusions:</i></b> Compared with micro-PCNL to treat kidney stones, RIRS is associated with better stone clearance and bearing higher hemoglobin loss. As the advantages of both technologies have been shown in some fields, the continuation of well-designed clinical trials may be necessary.

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

Mini-invasive Aortic Surgery: Personal Experience

2014 ◽  
Vol 9 (5) ◽  
pp. 354-360 ◽  
Author(s):  
Francesco Spinelli ◽  
Francesco Stilo ◽  
Michele La Spada ◽  
Filippo Benedetto ◽  
Giovanni De Caridi ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Personal Experience ◽  
Operative Time ◽  
Aortic Surgery ◽  
Abdominal Cavity ◽  
Length Of Hospital Stay ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Solid Diet ◽  
Postoperative Morphine

Objective In this study, we retrospectively evaluated our experience in minilaparotomy (MINI) and compared the results with conventional open repair (OPEN). Methods From January 2005 to December 2012, we surgically treated 234 consecutive patients with elective infrarenal abdominal aortic aneurysms, 195 men and 39 women, with a mean age of 74 years. Inclusion criteria for MINI were not ruptured abdominal aortic aneurysm, increased surgical risk, anatomical limits for endovascular repair, no previous surgical invasion of the abdominal cavity, and no requirement for concomitant abdominal surgical invasion. Surgical treatment was OPEN in 113 patients (48.3%) and MINI through an 8- to 14-cm incision in 121 patients (51.7%). Epidural anesthesia has been added in 26.5% and in 19.3% of the MINI and OPEN patients, respectively. Mortality, complications, aortic clamping time, operative time, need for postoperative morphine therapy, time to solid diet, and length of hospital stay were registered. Results The MINI has been performed in all patients selected, with 72 aortoaortic grafts and 49 aortobisiliac grafts. Early mortality was 1.6% versus 3.5% ( P > 0.5); 1-, 3-, and 5-year mortality were 7% versus 9%, 19% versus 22%, and 29% versus 34% ( P > 0.5); complications were 12.2% versus 26.6% ( P > 0.05); mean (SD) clamping time was 48 (12) versus 44 (14) minutes ( P > 0.5); mean (SD) operative time was 218.72 (41.95) versus 191.44 (21.73) minutes ( P > 0.025); mean (SD) estimated intraoperative blood loss was 425.64 (85.95) versus 385.30 (72.41) mL ( P > 0.1); mean (SD) morphine consumption in the group given epidural and the group not given epidural was 0 (2) and 2 (2) mg intravenously (IV) versus 2 (4) ( P < 0.5) and 4 (3) mg IV ( P > 0.1); mean (SD) ambulation was 2.1 (0.6) versus 4.1 (2.7) ( P < 0.5); mean (SD) time to solid diet was 2.1 (0.4) versus 3.5 (1.6) ( P < 0.5); and mean (SD) length of hospital stay was 4.9 (1.64) versus 7.35 (1.95) days ( P > 0.05), in the MINI and OPEN groups, respectively. Postoperative hernia at 3 years was 18% versus 23% in the MINI and OPEN groups ( P < 0.5), respectively. Conclusions The MINI gives the patients a significantly shorter period of recovery with the quality and safety of the OPEN. This experience suggested extending the indication to all surgical candidates without local limitations.

scholarly journals Laparoscopic versus open surgical approach of cholecystectomy in patients with symptomatic cholelithiasis: a systematic review of comparative trials

2021 ◽  
Vol 7 (3) ◽  
pp. 167
Author(s):  
Omer A. Marzoug
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Symptomatic Cholelithiasis ◽  
Pain Duration ◽  
Comparative Trials

<p class="abstract">Symptomatic cholelithiasis (gallstone disease) is the most common biliary pathology that affects women predominantly around the world. Earlier open cholecystectomy was the gold standard of treatment of this disease before introduction of laparoscopic cholecystectomy. The aim of this study is to systematically review the most recent published data that compared laparoscopic with open cholecystectomy in symptomatic cholelithiasis in terms of operative and post-operative morbidity, mortality, operative time, length of hospital stay, and conversion rates. The Medline, Cochrane library, Embase, and PubMed databases were vigorously searched for trials that compared laparoscopic with open cholectstectomy in patients with symptomatic cholelithiasis, a systematic review of these comparative trials was performed. No mortality was detected in both groups; the conversion rate was 6.75%. The laparoscopic approach associated with significantly shorter hospital stay (2.31 versus 4.42 days, p value&gt;0.001), lower post-operative pain duration (30.5 versus 66.9 hours, p value&gt;0.001) and lower rate of post-operative wound infection (2.8% versus 10.5%, p value&gt;0.001). Regarding operative time it was significantly longer in laparoscopic approach (77.3 versus 67.1 min, p value&gt;0.001), there were no significant differences in the rates of bile duct injury (0.84% versus 0.25%, p value=0.08) and intra-operative bleeding (4.2% versus 3.5%, p value=0.81) between the two procedures. Post-operative wound infection and pain duration in addition to length of hospital stay in patients with symptomatic cholelithiasis were reduced with laparoscopic cholecystectomy. However, the laparoscopic approach associated with longer duration of surgery. No significant differences between the two procedures in the rates of bile duct injury and intra-operative bleeding.</p>

scholarly journals Comparative outcomes and predictive assessment of trifecta in open, laparoscopic, and robotic-assisted partial nephrectomy cases with renal cell carcinoma: a 10-year experience at Ramathibodi Hospital

2021 ◽  
Author(s):  
Chaichant Soisrithong ◽  
Wit Viseshsindh ◽  
Wisoot Kongchareonsombat ◽  
Charoen Leenanupunth ◽  
Wachira Kochakarn ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Predictive Factors ◽  
Operative Time ◽  
Univariate Analysis ◽  
Length Of Hospital Stay ◽  
Laparoscopic Partial Nephrectomy ◽  
P Value ◽  
Open Partial Nephrectomy ◽  
Robotic Assisted

Abstract Purpose: To compare perioperative and trifecta outcomes of open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), and robotic assisted laparoscopic partial nephrectomy (RPN) in patients with small renal mass at Ramathibodi Hospital, and to determine predictive factors in connection with trifecta. Methods: We retrospectively reviewed 141 patients who underwent partial nephrectomy by eight experienced surgeons from January 2009 to December 2018. Baseline preoperative characteristics, postoperative and trifecta outcomes of the three treatment modalities were compared and analyzed. Univariate analysis was performed to determine predictive factors for trifecta achievement. Results: A total of 70 patients had complete data available. 18 OPN, 11 LPN and 41 RPN cases were identified and reviewed. All preoperative and perioperative parameters were similar, except for operative time, which was significantly shorter in the OPN group compared with those undergoing LPN and RPN (135 vs 189 and 225 min, respectively; p-value = 0.001). Of these 70 patients, 59 were deemed eligible for and included in trifecta analysis, which revealed similar trifecta outcomes (64.29.%, 45.45%, and 64.71% in the OPN, LPN, and RPN groups, respectively; p-value = 0.388). Univariate analysis showed that length of hospital stay was a negative associated factor for trifecta achievement (p-value = 0.007, 95% CI =0.619 (0.44-0.88)).Conclusion: Although OPN displayed the shortest operative time, the trifecta achievement rate was not significantly different among the three groups. The sole parameter, which was negatively associated with trifecta outcome achievement, was the length of hospital stay.

Sign in / Sign up

Export Citation Format

Share Document