scholarly journals 40 cases of Single-incision laparoscopic surgery to totally extraperitoneal herniorrhaphy via umbilical incision under posterior rectus abdominis sheath

2019 ◽  
Author(s):  
Xiaojun Wang ◽  
Yizhong Zhang ◽  
Changlei Qi ◽  
Encheng Zhou ◽  
Haiqiang Zhang ◽  
...  

Abstract Background Since 2008, the first case of Single-incision laparoscopic surgery totally extraperitoneal (SILS-TEP) was reported, there was more than 10 years history on SILS-TEP. Because of difficult to operation, SILS-TEP is popularized slowly. This study investigate the safety and feasibility of SILS-TEP under posterior rectus abdominis sheath. Methods A single 2.5cm long cured incision was made along the lower umbilical border. A 5.0cm size preperitoneal space was created by electrotome or blunt dissection under the posterior sheath and the linea alba. The silica gel sealing sleeve of Iconport single port device was crammthed under the posterior rectus abdominis sheath, then the preperitoneal space was broadened toward lower abdomen in condition of CO2 gas inflation. Conventional laparoscopic instruments were used to complete the operation according to the operation procedure of laparoscopic total extraperitoneal herniorrhaphy. Results SILS-TEP hernia repair was successfully completed in 39 patients. One need an additional ports to complete totally extraperitoneal hernioplasty. Mean operative time was 73.8 minutes (range, 45 to 130 minutes) and 55.2 minutes (range, 34 to 95 minutes) in unilateral indirect hernia and in unilateral direct or femoral hernia, respectively . Mean operative time was 92.3 minutes (range, 65 to 150 minutes) in bilateral hernia. 3 seroma and 5 chronic pain were seen during the 1-6 months follow-up periods, all were treated conservatively. No other major complications. Mean post-operative hospital stay was 2.6 days. Conclusion The operation of SILS-TEP via umbilical incision under posterior rectus abdominis sheath is safe and feasible. The Iconport single-port device has potential advantages in SILS-TEP surgery. Trial registration: The study was registered with the Chinese Clinical Trial Registry (ChiCTR)(www.chictr.org.cn).Registration number:ChiCTR1900023056. Registration date: May 9, 2019.Retrospectively registered.

2017 ◽  
Vol 102 (3-4) ◽  
pp. 115-118
Author(s):  
Yutaka Tokairin ◽  
Yasuaki Nakajima ◽  
Kenro Kawada ◽  
Akihiro Hoshino ◽  
Kagami Nagai ◽  
...  

Collisions between the laparoscope and the forceps remain a specific problem for single-incision laparoscopic surgery (SILS). We considered that the use of a long forceps would resolve this problem and use the long forceps in SILS for totally extraperitoneal repair (TEP). SILS for TEP (S-TEP) was performed to treat 34 inguinal hernias in 27 patients from November 2013 to February 2015. Among them, unilateral inguinal hernia repair was performed in 5 patients (median age: 71 years; range: 40–88 years) using a laparosonic coagulating shears (LCS) device and a straight long (43 cm) forceps. A 1-cm umbilical incision was made, a 5-mm flexible laparoscope was moved into the peritoneal cavity, and the type of inguinal hernia was diagnosed. Next, preperitoneal space was made using a finger or gauze. The single-port device was applied at preperitoneal space and insufflation was initiated with CO2 gas. The preperitoneal space was more easily created using a long straight forceps rather than standard ones. The hernia sac was then freed from the spermatic cord and a mesh was rolled, inserted, and deployed. Absorbable spiral tackers were used for fixation over the Cooper's ligament, lateral to the inferior epigastric vessels. The use of a long forceps was considered to be associated with reduction of the difficulty for dissection in S-TEP. We considered the use of a long forceps to be useful to the S-TEP operation.


2019 ◽  
Author(s):  
Xiaojun Wang ◽  
Haibo Jin ◽  
YongFeng Shuai ◽  
YiZhong Zhang

Abstract Background To discuss the reliability and clinical value of Iconport, a Self-made single port device, which was applied for transumbilical single port laparoscopic appendectomy. Methods The incision was around 2.5 cm long with curved form around umbilicus. And the skin and each layer of the abdominal wall were cut in sequence. Then the silica gel sleeve of the self-made single-incision sealing device was folded, clamped by the forceps, and carefully inserted into the incision for sealing. The operation of laparoscopic appendectomy was accomplished by-use routine linetype laparoscopic instruments via Iconport. The specimen was discharged from peritoneal cavity through the single port device. Two layers of incision, linea alba abdominus and skin, were separately sutured by absorbable thread and each layer was sutured successively. Results Among the 125 patients, 119 were successfully performed single-port laparoscopic appendectomy, with the operation time ranging from 30 to 110 min (69.34±21.4 min on average). In 6 cases, auxiliary operating hole was added or laparotomy was performed. Total hospital stay was 5.0±1.8 (2-14) days. 5 cases of incision infection. All patients were followed up for 1 to 6 months after surgery, with an average of 3 months. There were no complications such as bleeding, intestinal leakage, intestinal obstruction, and residual peritoneal effusion. Conclusion In single-incision laparoscopic surgery, the u-shaped incision around the umbilical margin of 2.5cm for adult can not only meet the requirements of flexibility of instruments in the operation, but also meet the aesthetic requirements because the incision scar is hidden in the umbilical foramen or looks like the umbilical foramen after the operation. Iconport single-hole device, which has potential promotion value, can be used in relatively simple laparoscopic surgery alone or combined with a single puncture device for relatively complex laparoscopic surgery.


2011 ◽  
Vol 1 (1) ◽  
pp. 18
Author(s):  
Simon Blackburn ◽  
Vanessa Chow ◽  
Varadarajan Kalidasan ◽  
Anies Mahomed

We present a 4-year-old girl who underwent a single incision laparoscopic surgery (SILS) heminephrouretectomy. The procedure was completed without intra-operative complications or conversion. The operative time was 162 min. At 3 month follow up there is no evident scar and the patient is asymptomatic. SILS upper moiety heminephrouretectomy for duplex kidney is safe and technically feasible in children.


ASVIDE ◽  
2016 ◽  
Vol 3 ◽  
pp. 352-352
Author(s):  
Benedetta Bedetti ◽  
Pierfiorgio Solli ◽  
David Lawrence ◽  
Nikolaos Panagiotopoulos ◽  
Martin Hayward ◽  
...  

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Héctor Rolando Herrera Cabral

Introduction: The laparoscopic surgery is done by using a single port. You place a device through a single incision between 18mm to 50mm and 3-4 trocars can be used. Our work consists of making 3 little incisions to put the three trocars which measure 5 mm and use conventional instruments that measure 36 cm of length of laparoscopic surgery within the internal limits of the umbilicus. Objective: Describe the surgery technique and evaluate the initial results of a laparoscopic cholecystectomy option through three intraumbilical incisions. Methods: It is a retrospective, descriptive, multicentre and observational study. Since June 2014 to August 2019, 20 patients, 17 females and 3 males, were operated using this method from the age ranges of 16 to 65 years old. The average surgical time was 65 minutes. Results: In all cases the procedures were concluded by the intraumbilical approach. One of the cases had to be re-operated due to intraabdominal bleeding from the posterior branch of the cystic artery. Conclusions: The technique is reproducible; the usual triangulation of the ports is not available. Therefore, fort this technique the surgeon needs to have experience and have had advanced training in laparoscopic surgery. The cases must be selective.


2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.


2020 ◽  
Vol 7 (8) ◽  
pp. 2714
Author(s):  
Srikant Patro ◽  
Ashish K. Sahoo ◽  
Nikhil Muduli ◽  
Ashish K. Mishra ◽  
Tapan Kumar ◽  
...  

Single incision laparoscopic surgery is an emerging branch of minimally assess surgery to reduce scar and post-operative pain. Appendicitis is a common general surgical problem encountered in day to day practice. Different methods of appendectomy have been described by different surgeons from open to laparoscopic and now single incision laparoscopic surgery has been practised. This is a prospective study carried out in our Department of General Surgery SCB Medical College, Cuttack from February 2019 to March 2020; 60 patients had undergone the procedure and the results are published noted under headings of post-operative pain at (6 hours, 12 hours, 24 hours and 48 hours), post-operative requirement of analgesia (diclofenac) at (6 hours, 12 hours, 24 hours and 48 hours), operative time, days to resume bowel activity, days of hospital stay, post-operative complication in accordance to Clavien-Dindo classification.


2015 ◽  
Vol 33 (07) ◽  
pp. 194-201
Author(s):  
B. Vestweber ◽  
E. Straub ◽  
C. Paul ◽  
B. Kaldowski ◽  
A. Rink ◽  
...  

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomohiko Fukunaga ◽  
Toshihiko Kasanami

Abstract Background The arcuate line is the inferior margin of the posterior layer of rectus abdominis sheath. An arcuate line hernia is a parietal interstitial hernia consisting of ascending protrusion of intraperitoneal contents above the arcuate line. Arcuate line hernias are rare, and fewer than 20 cases undergoing surgical repair have been reported. Various surgical approaches were used in previous cases, and there is no consensus regarding the ideal repair method. We report the first case of an arcuate line hernia repaired using single-incision laparoscopic surgery. Case presentation The patient was a 78-year-old man who presented with a history of intermittent lower abdominal quadrant pain of more than 2 month’s duration. He had not previously undergone abdominal surgery, but had a history of mycobacterial lung disease and asthma. His vital signs were normal on presentation, and he experienced no vomiting or nausea. On palpation, his abdomen was flat and soft, and no mass was palpable. However, there was slight tenderness in the right lower quadrant. Blood laboratory test results were within normal ranges. Computed tomography revealed small bowel protrusion between the rectus abdominis and the posterior rectus sheath, and an arcuate line hernia was suspected and subsequently confirmed intraoperatively. The patient underwent single-incision laparoscopic repair with the intraperitoneal onlay mesh technique with tacks and with care to avoid the inferior epigastric vessels. The operation time was 30 min, and no intra- or post-operative complications occurred. Surgery relieved his symptoms, with no recurrence within 1 year postoperatively. Conclusions Single-incision laparoscopic surgery was performed easily and successfully in this rare patient with arcuate line hernia. Arcuate line hernia should be considered in patients presenting with abdominal symptoms, and single-incision laparoscopic repair should be considered for repair.


2021 ◽  
pp. 5-10
Author(s):  
O. V. Galimov ◽  
E. N. Prazdnikov ◽  
V. O. Khanov ◽  
D. O. Galimov

Aim. To identify a perspectives for using a single incision laparoscopic technologies in surgery.Materials and methods: Today we have a several questions relating to a single incision laparoscopic surgery such as the possible spectrum of their application, safety and economic efficiency. The main is: does this technologies have a perspectives in future.In paper was performed a retro and prospective analysis of the data of modern literature and authors own experience in surgical treatment using a single incision laparoscopic technologies.Results: The study included 74 patients who underwent: cholecystectomy – 64 (86,5%), nephrectomy – 4 (5,4%), ovarian cyst removal – 4 (5,4%), kidney resection – 2 (2,7 %), using various kind of ports: “X-Cone Karl Storz” (28), “Covidien” (18), “PPP” (7), and 21 cases of multi-trocar access.Conclusions: Our opinion that the perspectives for the development of single incision laparoscopy, is the further development of endoscopic devices, including robotic ones, and we believe that it will be a real future and endoscopic surgeons should be ready for this.


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