scholarly journals Laparoscopic Cholecystectomy in a Child Using Slender Forceps

2017 ◽  
Vol 8 (3) ◽  
pp. 18
Author(s):  
Kazuaki Shibuya ◽  
Hideki Kawamura ◽  
Munenori Tahara ◽  
Masahiro Takahashi ◽  
Akinobu Taketomi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Careful Monitoring ◽  
Laparoscopic Procedures ◽  
Needlescopic Surgery ◽  
Working Space

Laparoscopic procedures in children are technically demanding because of reduced working space with careful monitoring of pneumoperitoneum pressure. We report a case of laparoscopic cholecystectomy performed in a 9-year-old boy using slender forceps which addressed all the above mentioned concerns. This shows a possibility of needlescopic surgery in children.

scholarly journals Isolated pneumomediastinum following laparoscopic cholecystectomy: a rare complication

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Minas Kostis ◽  
Vasileios Patriarcheas ◽  
Stamatios Apergis ◽  
Michail Leontis ◽  
George Panayiotakopoulos
Keyword(s):  
Differential Diagnosis ◽  
Laparoscopic Cholecystectomy ◽  
Early Detection ◽  
Rare Complication ◽  
Careful Monitoring ◽  
Laparoscopic Procedures ◽  
Life Threatening

Abstract Development of postoperative pneumomediastinum is one of the most infrequent complications of laparoscopic procedures. We report a case of a 47-year-old woman who developed pneumomediastinum consequently to laparoscopic cholecystectomy. The patient was treated conservatively and was discharged on the fifth postoperative day. Early detection of this condition, differential diagnosis and careful monitoring of the patient are important, as it may lead to severe consequences, including the life-threatening tension pneumomediastinum.

scholarly journals Prediction and management of a low-lying costal arch which restricts the operative working space during laparoscopic cholecystectomy

2010 ◽  
Vol 18 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Yoshitsugu Tajima ◽  
Tamotsu Kuroki ◽  
Amane Kitasato ◽  
Tomohiko Adachi ◽  
Taiichiro Kosaka ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Working Space ◽  
Costal Arch

scholarly journals Intraoperative safety of low pressure pneumoperitoneum cholecystectomy: a comparative study

2017 ◽  
Vol 4 (11) ◽  
pp. 3679 ◽  
Author(s):  
Salil Mahajan ◽  
Manu Shankar ◽  
Vinod K. Garg ◽  
Vijender Gupta ◽  
Jaya Sorout
Keyword(s):  
High Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Low Pressure ◽  
Parietal Peritoneum ◽  
Working Space ◽  
Significant Difference ◽  
Operative Difficulty ◽  
Secondary Port ◽  
Care Surgery ◽  
Bile Spillage

Background: With the establishment of laparoscopic cholecystectomy as gold standard for management of cholelithiasis, the current stress is on increasing patient safety. Hence, this study was undertaken to compare the effect of low pressure pneumoperitoneum (LPP <10mm Hg) versus high pressure pneumoperitoneum (HPP >14mm Hg) in a prospective randomized manner on intraoperative safety, assessing the working space and safety by seeing contact of parietal peritoneum to underlying viscera during secondary port insertion.Methods: 120 patients undergoing laparoscopic cholecystectomy were randomized into the LPP (<10mm Hg) group (n=60) and the HPP (>14mm Hg) group (n=60) prospectively. Available working space assessed directly, safety by contact of parietal peritoneum to underlying viscera during secondary port insertion and operative difficulty assessed by visualization, dissection and grasping, total duration of surgery; intra-operative gas consumption, and bile spillage were assessed.Results: There was no significant difference in terms of available working space, operative duration, consumption of carbon dioxide, surgeon’s operative difficulty and intraoperative bile spillage. Out of 180 secondary ports inserted, there was evident contact of 20 (11.1%) secondary ports in high pressure groups and 14 (7.7%) secondary ports in low pressure group, which is suggestive of adequate exposure and working space available for surgery at both pressures.Conclusions: Low-pressure cholecystectomy did not compromise intraoperative safety and should be the standard of care in day care surgery.

scholarly journals Controlled traction-a key for safe laparoscopic cholecystectomy

2021 ◽  
Vol 8 (2) ◽  
pp. 773
Author(s):  
Mallikarjuna Manangi ◽  
Dharini Dharini ◽  
Tanvi Sunil Kumar ◽  
Ramya M. Vishweshwara
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Laparoscopic Procedures ◽  
Unique Method

Laparoscopic cholecystectomy (LC) is one of the most common laparoscopic procedures performed. The technique of LC has witnessed numerous modifications according to surgeon’s preferences to improve the ergonomics, surgical ease, safety and outcome. Dissection of the gall bladder from the liver bed is one of the troublesome steps. We aim to describe a unique method which is technically easy to perform and provides excellent exposure as well. A total of 206 patients underwent laparoscopic cholecystectomy at our Institute over a year from January 2017 to 2018. The technique of torquing the gallbladder to dissect it off its bed is surgeon friendly with advantages of instrumentation and visualization.

scholarly journals EXPERIENCE OF LAPAROSCOPIC SURGERY IN PREGNANT PATIENTS SAFETY OF LAPAROSCOPIC SURGERY IN PREGNANT PATIENTS

1969 ◽  
Vol 3 (2) ◽  
pp. 335-337
Author(s):  
MUHAMMAD ASLAM RAI
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Acute Cholecystitis ◽  
Maternal Death ◽  
Laparoscopic Appendectomy ◽  
Safety And Efficacy ◽  
Laparoscopic Procedures ◽  
Antibiotic Cover

OBJECTIVES: Laparoscopic surgery is well established in general patients but its safety and efficacy inpregnant patients isstill debated especially in emergency situation.METHODS: This study was conducted at Rai Medical Complex, Sargodha as prospective single centrestudy for all pregnant patients in need of laparoscopic appendectomy and cholecystectomy for acuteappendicitis and acute cholecystitis respectively from April 2009 to December,2011 .After routinepreoperative assessment, all were operated under general anesthesia with antibiotic cover, foure porttechnique for lap. chole. And three port technique for lap. appendectomy were used. Peri-operativemorbidity and mortality for the mother and fetus were evaluated at Rai Medical Complex, Sargodha from2009 to 2011.RESULTS:32 patients underwent laparoscopic procedures. 18 had laparoscopic cholecystectomy and 14laparoscopic appendectomies. No maternal death and no loss of fetus.CONCLUSION: Laparoscopic cholecystectomy and appendectomy appears to be as safe as in opensurgery in pregnant women.

scholarly journals Laparoscopic Surgery in a Developing Country in East Africa: An Audit at the Initial Part of a Surgeons’ Learning Curve

2020 ◽  
pp. 66-73
Author(s):  
Richard Wismayer
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
East Africa ◽  
Developing Country ◽  
Initial Period ◽  
Operating Time ◽  
Early Discharge ◽  
Laparoscopic Appendicectomy ◽  
Laparoscopic Procedures ◽  
Surgical Access

Background: In many surgical conditions, laparoscopic surgery has been used for surgical access. In the West, laparoscopic cholecystectomy is the gold standard treatment for           cholecystitis. On the other hand controversy has been generated with laparoscopic appendicectomy due to the cost, time consuming nature of the procedure, together with many trocar sites which in all approximate to the length of an open appendicectomy incision. The purpose of this study is to audit the initial laparoscopic units experience in a developing country in East Africa. Methods: This was a retrospective study conducted in the Department of Surgery. All patients that consented to laparoscopic cholecystectomy and laparoscopic appendicectomy over the initial period of 13 months were included in this study. Results: A total of thirty (30) patients consented to having laparoscopic surgery; Ten (10) patients consented to laparoscopic cholecystectomies with a male:female ration of 1:2.33 and twenty (20) patients consented to laparoscopic appendicectomies with a male:female ratio of 1:1.2. The mean operating time was 58.5 minutes for laparoscopic cholecystectomy and 40.45 minutes for laparoscopic appendicectomy. The duration of post-operative admission ranged from 3 days to 5 days with a mean duration of 4.2 days for laparoscopic cholecystectomy and from 2 days to 5 days with a mean of 2.65 days for laparoscopic appendicectomy. No complications were reported apart from spinal headache in 2 patients (2.6%) out of the total laparoscopic procedures. There were no readmissions over the one month of follow up. Conclusions: Laparoscopic cholecystectomy and laparoscopic appendicectomy allows for early discharge and is safe. In Uganda, the low incidence of cholecystitis compared to the higher incidence of appendicitis, supports the adoption of laparoscopic appendicectomy compared to cholecystectomy for hand and eye coordination training. The surgeons’ initial cases of laparoscopic procedures have demonstrated an adequate level of safety which supports laparoscopic appendicectomy to acquire the basic laparoscopic surgery skills.

scholarly journals Complications of laparoscopic cholecystectomy performed by junior surgeon in resource-restricted settings

2019 ◽  
Vol 6 (9) ◽  
pp. 3470
Author(s):  
Pon Rachel Vedamanickam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Learning Curve ◽  
Complication Rate ◽  
Comfort Level ◽  
Electronic Records ◽  
Team Members ◽  
Laparoscopic Procedures ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Standard Practices ◽  
Bile Leaks

Background: The aims of this audit were to determine the rate of complications of laparoscopic cholecystectomy performed by a junior surgeon, to identify changes that can be made to reduce the complications, and to re-audit the complication rate after the changes have been made.Methods: Laparoscopic cholecystectomies performed by the surgeon between August and November, 2018 were assessed retrospectively. Data was collected from electronic records and operation notes and entered in the format as enclosed within. A re-audit was conducted between December 15th, 2018 and June 15th, 2019.Results: In the initial audit, the complication rate of laparoscopic cholecystectomy was 40% and the incidence of bile leaks was 6%. The re-audit showed a significant reduction in the overall complication rate to 24% with no incidence of bile leaks.Conclusions: The learning curve of surgeons for laparoscopic procedures is steep and cases should be chosen carefully depending on the current skill set and comfort level of the surgeon. Recommended standard practices should be followed in all situations, and all the team members should be involved in identifying risks during the surgery.

scholarly journals Advanced laparoscopic surgery: our initial experience at Nepal Medical College

2016 ◽  
Vol 18 (3) ◽  
pp. 17
Author(s):  
Dr Nishes ◽  
Dr Subash ◽  
Prof Pranil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Standard Of Care ◽  
Operative Management ◽  
Rapid Expansion ◽  
Resource Poor Setting ◽  
Laparoscopic Technique ◽  
Medical College ◽  
Laparoscopic Procedures ◽  
Laparoscopic Techniques

If we consider the last century of history of surgery, few advances can be compared to the changes engendered by the introduction of minimally invasive surgery, which in the last decade has represented a revolution in surgical practice and patient care. Since 1987, when the first laparoscopic cholecystectomy was performed, laparoscopic procedures have been the standard of care for many routine diagnostic and therapeutic procedures. Laparoscopic techniques have become an integral part of the operative management in virtually every realm of general surgery. The success of the laparoscopic technique has been due mainly to patient demand, which has contributed to a rapid expansion in the number of laparoscopic procedures performedThe benefits conferred to patients by less invasive procedures like decreased pain, and shorter recovery time have to be weighed against overzealous application and the problems created by the lack of familiarity with new techniques and instruments. Basic laparoscopic procedures include laparoscopic cholecystectomy, laparoscopic appendectomy, and diagnostic laparoscopy. All other laparoscopic operations are defined as “advanced”. Learning curve and added expenses have been prohibitative in development of advanced laparoscopic surgery in resource poor setting like ours. However, advance laparoscopic surgery is here to stay. We must therefore have a concentrated effort to move towards offering these facilities to our patients.Despite the initial hiccups, some advanced laparoscopic surgeries are being performed and at Nepal Medical College, moving a step closer towards the gold standards in surgical management. Surgeons from various units and subspecialties work together and help each other and utilize each other’s limited experience. This spirit has been a great help to reach our way to develop ourselves despite our technical limitations. Our experience is limited but the outcomes so far are encouraging and we have tried to highlight the significance of framework. There is a long road ahead but a hood beginning is more than half done.

Red Flags: Barriers to Listening and Spoken Language in Children with Hearing Loss

2014 ◽  
Vol 24 (1) ◽  
pp. 11-18
Author(s):  
Andrea Bell ◽  
K. Todd Houston
Keyword(s):  
Hearing Loss ◽  
Early Diagnosis ◽  
Skill Acquisition ◽  
Dynamic Process ◽  
Spoken Language ◽  
Red Flags ◽  
Careful Monitoring ◽  
Auditory Development ◽  
Children With Hearing Loss ◽  
Family Centered

To ensure optimal auditory development for the acquisition of spoken language, children with hearing loss require early diagnosis, effective ongoing audiological management, well fit and maintained hearing technology, and appropriate family-centered early intervention. When these elements are in place, children with hearing loss can achieve developmental and communicative outcomes that are comparable to their hearing peers. However, for these outcomes to occur, clinicians—early interventionists, speech-language pathologists, and pediatric audiologists—must participate in a dynamic process that requires careful monitoring of countless variables that could impact the child's skill acquisition. This paper addresses some of these variables or “red flags,” which often are indicators of both minor and major issues that clinicians may encounter when delivering services to young children with hearing loss and their families.

Sign in / Sign up

Export Citation Format

Share Document