scholarly journals Estimation of the Efficacy of Retroperitoneoscopic Renal Cysts Deroofing

2020 ◽  
Vol 7 (4) ◽  
pp. 5-12
Author(s):  
Sh. T. Mukhtarov ◽  
F. A. Akilov ◽  
D. Kh. Mirkhamidov ◽  
B. A. Ayubov

Introduction. The intensive introduction of modern endovideosurgical techniques creates the prerequisites for the further expansion of minimally invasive surgical interventions. Literature reviews` data on the results of retroperitoneoscopic operations suggest that endovideosurgery in urology has broad prospects for further development.Purpose of the study. To estimate of the efficacy and safety of the retroperitoneoscopic operations for renal cysts.Materials and methods. Retroperitoneoscopic operations (renal cysts deroofing) were performed for 152 symptomatic patients with Bosniak I kidney cysts (from 4.4 х 3.8 cm to 14.5 х 14.0 cm). Proposal of the operations were classified according to the technical difficulty as “Easy” in 147 (96.7%) cases (Е: sum of scores 3-5), in 5 (3.3%) cases – «Slightly difficult» (SD: score 7). Statistical analyses of the results performed by the program Microsoft Office Excel 2007, StatSoft Statistica 8.0 with using the Student-Fisher`s criteria.Results. The mean duration of the operations was 35.7 ± 6.1 min (30-90 min); there were not any intraoperative complications; the mean blood loss was 23.0 ± 4.1 ml (10-100 ml); there was no need for blood transfusion; incidence of postoperative complications were 2.4% - in 4 cases there were manifestation of urinary tract infection during the postoperative period (II category of the complications according to Clavien-Dindo classification); mean hospital stay was 2.2 ± 0.1 day (1-6 days); drainages were removed on second postoperative day; there were not any conversions to open operations and additional procedures in postoperative period.Conclusions. Retroperitoneoscopic renal cysts deroofing is effective and safe procedure for the treatment of simple kidney cysts. This method has the advantages of minimal invasiveness, minimal complications, short in hospital stay and fast recovery of the patients.The study did not have sponsorship. The authors have declared no conflicts of interest.

Author(s):  
Hongyi Liu ◽  
Maolin Xu ◽  
Rong Liu ◽  
Baoqing Jia ◽  
Zhiming Zhao

AbstractSurgery is developing in the direction of minimal invasiveness, and robotic surgery is becoming increasingly adopted in colonic resection procedures. The ergonomic improvements of robot promote surgical performance, reduce workload for surgeons and benefit patients. Compared with laparoscopy-assisted colon surgery, the robotic approach has the advantages of shorter length of hospital stay, lower rate of conversion to open surgery, and lower rate of intraoperative complications for short-term outcomes. Synchronous robotic liver resection with colon cancer is feasible. The introduction of the da Vinci Xi System (Intuitive Surgical, Inc., Sunnyvale, CA, USA) has introduced more flexibility to colonic operations. Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection. Single-port robotic colectomy reduces the number of robotic ports for better looking and faster recovery. Intestinal anastomosis methods using totally robotic surgery result in shorter time to bowel function recovery and tolerance to a solid diet, although the operative time is longer. Indocyanine green is used as a tracer to assess blood supplementation in the anastomosis and marks lymph nodes during operation. The introduction of new surgical robots from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes. The present article reviews recent advances in robotic colonic resection over the past five years.


2001 ◽  
Vol 7 (4-5) ◽  
pp. 838-840
Author(s):  
A. Al Raymoony

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.


2020 ◽  
Vol 21 (2) ◽  
pp. 137-139
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
AKM Shahadat Hossain ◽  
Rifat Zaman ◽  
Prodyut Kumar Saha ◽  
Hafiz Al Asad ◽  
...  

Introduction and objective: Over the last decade laparoscopic surgery has been popularized and developed to such an extent that it can be considered gold standard for many types of procedures in urology. Currently the majority of operations in urologic field can be performed by laparoscopy. This is because it is as effective as open surgery, but associated with less postoperative pain, shorter hospital stay, faster recovery and has better cosmetic result. The aim of the study is to evaluate the results of our experience of treating symptomatic renal cysts by laparoscopy. Materials and methods: This prospective study was conducted from January 2015 to December 2017 in the Department of Urology in a single unit of Dhaka Medical College Hospital. All the patients were admitted through out-patient department. Among them those who fulfilled the criteria were selected for laparoscopic surgery. All patients were diagnosed by ultrasonography and computed tomography to determine the Bosniak classification of the cyst & informed written consent was taken. Total five laparoscopic decortication of renal cysts were performed and the results of our experience were compared with data from published article. Pain and cyst recurrence were assessed during the follow-up. Results: Our study described the results of 05 laparoscopic decortication of renal cysts. All procedures were completed successfully by transperitoneal approach, with no major intraoperative and postoperative complications. There was a placement of drain tube in one patient. The mean (range) operative duration was 68 (40–110) min, affected by the site and number of cysts decorticated. The mean post operative hospital stay was 1.8 (1- 3) days. All patients were symptom-free and no sign of recurrence during the follow-up. Conclusion: Laparoscopic decortication of symptomatic renal cysts should be the standard of care and it is feasible with conventional laparoscopic instruments and gives a better cosmetic outcome. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.137-139


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 120-120
Author(s):  
Chang Hyun Kim ◽  
Jin-Jo Kim

Abstract Background A transhiatal approach in esophageal cancer surgery has limitation for mediastinal lymph node dissection compared with thransthoracic approach for esophageal cancer. Because of insufficient lymph node clearance, single incision mediastinoscopic surgery is an one of the minimally invasive surgical option for esophageal cancer. Herein, we introduce our initial experience with use of the procedure in 3 patients with esophageal cancer Methods We retrospectively collected data from 3 patients who diagnosed with esophageal cancer and who underwent 3 field transmediastinal radical esophagectomy (TMRE) between Jun 2016 and December 2017. TMRE was performed in old age patients (> 75 years) and patients with limited cardiopulmonary reserve in whom thransthoracic approach could not be used. After the left cervical incision and cervical lymphadenectomy, a single port was inserted into the wound. Esophageal mobilization with en bloc lymphadenectomy along the left and right recurrent laryngeal nerve was then performed. Carbon dioxide insufflation expanded the intramediastinal space, and deep mediastinal structures were clearly visualized, allowing lymphadenectomy to be safely and carefully performed along the nerves. Laparoscopic transhiatal esophagectomy was then performed with en bloc lymphadenectomy for lower and/or middle mediastinal nodes. Results The mean age was 75.5 ± 3.5. Among the 3 patients, two patients had severe cardiopulmonary dysfunction. The mean operation time in transmediastinal approach and transhiatal approach were 202.0 ± 18.0 and 350.0 ± 27.8, respectively. The mean retrieval number of mediastinal lymph node was 39.0 ± 5.3. There were no severe postoperative complications and there was no postoperative mortality. Mild pleural effusion was occurred in only one patient. Conclusion TMRE with single incision mediastinoscopic approach was technically feasible and oncologically safe procedure for esophageal cancer, especially in patients with old age or with limited cardiopulmonary reserve. Disclosure All authors have declared no conflicts of interest.


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 123-123
Author(s):  
Atila Eroglu ◽  
Yener Aydin ◽  
Ali Ulas ◽  
Coskun Daharli

Abstract Background Development of hiatal hernia after esophageal resection is a known complication. However, due to the spread of minimally invasive esophagectomy, complications of hiatal hernia seems to increase. This study aimed to present our cases with hiatal hernia after Ivor Lewis minimally invasive esophagectomy. Methods After Ivor Lewis minimally invasive esophagectomy, five cases of hiatal hernia were observed. Patients' age, sex, symptoms, diagnosis, herniated organs, surgical method, morbidity and mortality rates and hospital stay were reviewed. Results Three of the patients were male and two were female. The mean age of the patients was 56.2 years (35–71 years). Hiatal hernia was detected after an average of 1.4 years with minimal invasive esophagectomies (5 months, 1 year, 1 year, 18 months and 3 years respectively). Three of the cases were symptomatic and two cases were asymptomatic. Thorax CT was used in all cases, and two cases were additionally imaged with barium esophagography. Herniated organs were: omentum in 5 cases, transverse colon in 4 cases, small bowel in two cases. All cases were laparoscopically approached. Diaphragmatic defects were repaired using nonabsorbable sutures in all cases. No complication and mortality was observed in patients. The mean length of hospital stay was 4.9 days (range, 3 to 10 days). Conclusion Hiatal hernia is more frequently seen in minimally invasive esophagectomies than open esophagectomies. Patients undergoing minimal esophagectomy should be closely monitored for hiatal hernia postoperatively. These cases can also be treated by minimally invasive laparoscopy. Disclosure All authors have declared no conflicts of interest.


Author(s):  
Radha Vembu ◽  
Sithara Dharmalingam

ABSTRACT Introduction Vaginal route of hysterectomy is a safe procedure with less morbidity and hospital stay. So, there is a need to expand the indication for vaginal hysterectomy beyond uterovaginal prolapse. Aims To determine the feasibility and outcome of nondescent vaginal hysterectomy (NDVH) and to assess the pre- and postoperative complications, duration of surgery, and hospital stay. Materials and methods A prospective observational study was conducted between 2012 and 2014 at a tertiary care center. A total of 256 patients satisfying the selection criteria of hysterectomy for benign gynecological conditions, uterus size <16 weeks, and excluding stage IV endometriosis, genital tract malignancy, and uterine prolapse were included. The NDVH was performed by the standard technique, and the following parameters of age, parity, indication for surgery, duration of surgery, intraoperative and postoperative complications, and hospital stay were recorded. The data were analyzed using Statistical Package for the Social Sciences version 16.0 by frequency and percentage analysis and Chi-square test. Results All 256 patients were analyzed. The mean age was 44.4 ± 6.1 years; fibroid uterus was the commonest indication. About 89.4% had a uterine size ≤12 weeks and 59% had uterine volume <200 cm3. The mean duration of surgery was 83.5 ± 11.0 minutes; salpingo-oophorectomy was performed in 25.8% of the patients. Intraoperatively, 1.2% had bladder injury and 0.4% required conversion to laparotomy for pelvic hematoma. The mean duration of hospital stay was 4.9 ± 2.2 days, and the mean pain score in numerical rating scale pain scale was 3.0 ± 0.3. Intraoperative blood transfusion was required in 1.9% of the patients only. Conclusion The NDVH is a safe and feasible procedure for benign gynecological disorders. Clinical significance The NDVH is a boon in this techno-savvy era by reducing the morbidity and promising early return to work. How to cite this article Vembu R, Dharmalingam S. Hysterectomy by Vaginal Route: Not a Pressure. J South Asian Feder Menopause Soc 2017;5(1):8-10.


2018 ◽  
Vol 28 (Number 1) ◽  
pp. 21-26
Author(s):  
Md. Anisuzzaman ◽  
ASM A Kabir ◽  
Md. A R l Sadiq ◽  
Md. A Matin ◽  
I Ahmed ◽  
...  

Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy and safety of laparoscopic appendectomy in complicated appendicitis in children. This interventional study was carried out during the period from January 2015 to May 2018 in Holy Family Red Crescent Medical College Hospital. The study included 43 patients, age ranges from 3 years to 15 years who underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications such as deur, wound infection and intraabdominal abscess etc. The mean age of studied cases was 7.1 years. In 41 patients (95.3%) the procedure was completed laparoscopically. Two (4.7%) patients required conversion to open appendectomy. The operative time was 83.5+,25.8 minutes. Two patients (4.6%) had post-operative ileus. Four patients (9.7%) developed superficial wound infection. Three patients (7.3%) developed infra-abdominal collections. One (2.4%) patients were readmitted because of recurrent abdominal pain One patients (2.4%) developed postoperative pyrexia due to pneumonitis and Three patients (7.3) developed gastroenteritis. The mean length of hospital stay was 5.8±2.1 days. No mortality was recorded.Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.


2016 ◽  
Vol 175 (5) ◽  
pp. 52-56 ◽  
Author(s):  
Yu. V. Chikinev ◽  
E. A. Drobyazgin

An article presents the results of application of mediatinoscopy in extirpation of the esophagus and cardiac orifice. The comparative assessment was made in group of patients who underwent the standard surgery. An application of mediastinoscopy for excretion and extirpation of the esophagus allowed doctors to cut down the duration of intervention on 40,15%. The volume of intraoperative loss of blood was reduced on 45,52% and the rate of intraoperative complications decreased on more than 45% compared with standard surgery. There was noted the reduction of the rate of postoperative complications more than 30% and the course of postoperative period was smooth. These factors shortened hospital stay and time the patients should be in resuscitation department.


2016 ◽  
Vol 42 (6) ◽  
pp. 444-446 ◽  
Author(s):  
Altair da Silva Costa Jr ◽  
Thiago Bachichi ◽  
Caio Holanda ◽  
Luiz Augusto Lucas Martins De Rizzo

ABSTRACT Objective: To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. Methods: This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks.


2020 ◽  
pp. 112067212096548
Author(s):  
Fernando Quadros Costa ◽  
Ricardo Quadros Costa ◽  
José Bonifácio Barbosa ◽  
José Álvaro Pereira Gomes

Purpose: To report a case series of pterygium surgery with conjunctival autograft fixation using bipolar electrocautery. Design: A noncomparative, retrospective, interventional case series of pterygium surgery with follow-up longer than 12 months to assess recurrence and other complication rates. Participants: Fifty-six eyes of 37 patients were treated between April 2011 and January 2018, either for primary ( n = 53 cases) or recurrent ( n = 3 cases) pterygia. Intervention: After pterygium excision, free conjunctival grafts from the inferior bulbar conjunctiva of the same eye were harvested and fixated with the use of bipolar electrocautery. Main outcome measure: Recurrence of the pterygium and complications. Results: The mean follow-up was 41 months (range 12 to 81 months). There were no intraoperative complications. Recurrence of the lesion was seen in three eyes (5.36%). There were no other postoperative complications such as graft detachment, or formation of dellen or granulomas. Conclusion: Conjunctival autograft fixation using bipolar electrocautery seems to be a fast, costly and safe procedure that can be applied in most cases of pterygium surgery.


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