scholarly journals Risks of anaesthesia in laparoscopic interventions in the abdominal cavity

2021 ◽  
Vol 17 (2) ◽  
pp. 122-128
Author(s):  
S.M. Nedashkivskyi ◽  
O.A. Halushko ◽  
D.O. Dzuba

Laparoscopic surgical technologies in abdominal surgeries strengthen their position every year, especially du­ring planned surgeries, reduce the patient’s trauma and length of stay in the hospital. However, the technique of laparoscopic interventions involves non-physiological position of the patient on the operating table (especially during long operations), the use of pneumoperitoneum with carbon dioxide. Pneumoperitoneum creates increased pressure on the diaphragm, disrupts venous return and can create other unpleasant situations. There is no absolute contraindication to laparoscopic surgery, although we should anticipate possible problems in conditions such as obesity, pregnancy and previous abdominal surgeries. In order to reduce the trauma of surgery, laparoscopic techniques are used, and incorrect assessment of their capabilities in high-risk patients can lead to serious complications. Anaesthesiologists should carefully consider all the risks associated with laparoscopic technique, interact with surgeons to reduce the risk of complications, constantly monitor the patient’s state and use modern approaches to the choice of anaesthesia. The purpose of this work is to summarize the best available evidence and established practice for perioperative management of patients with laparoscopic interventions in the abdominal cavity.

2014 ◽  
Vol 26 (1) ◽  
pp. 169
Author(s):  
C. E. Pope ◽  
M. C. Gómez ◽  
A. Cole ◽  
B. L. Dresser

Fishing cats (Prionailurus viverrinus) are small (6–15 kg) spotted cats from dispersed areas of Southeast Asia found mostly in wetland habitats. They are classified by the International Union for Conservation of Nature (IUCN) as endangered, with a decreasing population, due to habitat loss and degradation. Few studies have been done on applying assisted breeding techniques to the species, although the birth of a live kitten after IVF/embryo transfer (ET) has been reported (2006 Theriogenology 66, 1518–1524). Here, we describe the birth of a live fishing cat kitten using the technique of laparoscopic intratubal AI. A ten-year-old female who had served previously as an oocyte donor (5×) following gonadotropin treatment was administered a total of 5 IU of porcine FSH (Sioux Biochemical, Sioux City, Iowa) over 4 days (1×/day) followed by 10 IU of porcine LH on the fifth day. At approximately 28 h after LH treatment, the ovaries/oviduct were accessed by a laparoscopic technique comparable to that used for oviducal embryo transfer (ibid.). To deposit semen into the left oviduct, a 16-guage thin-wall trocar/needle was inserted into the abdominal cavity on the right side, approximately 1 cm lateral to the midline and approximately 2 to 3 cm below the umbilicus. A 14-cm open-end tom cat catheter was inserted into the 16-guage cannula (blunt) and the catheter tip was positioned underneath the fimbria overlaying the ovary. Then, a 50-mm length of 30-guage polytetrafluoroethylene (PTFE) thin-wall tubing containing approximately 30 μL of freshly collected semen was threaded through the catheter and the sample was expelled with positive pressure from a threaded-plunger 1-mL syringe. The left ovary contained 7 to 8 preovulatory (3–4 mm) follicles, 4 of which were manually ruptured immediately after deposition of semen with a 22-guage needle inserted through the 16-guage cannula. Then, with the 16-guage trocar/cannula in the same position (on the right side), the tip was redirected towards the right ovary and approximately 30 μL of semen was deposited underneath the fimbria as described above. The right ovary presented with 5 to 6 preovulatory (3–4 mm) follicles, 2 of which were punctured with the 22-guage needle after insemination. No ovulations were present on either ovary. The semen used for insemination was a fresh sample collected by electroejaculation from a 9-year-old male. The raw sperm concentration was 220 million mL–1, with 70% motility. The number of motile sperm deposited per oviduct was estimated to be approximately 4.6 million. The female was anesthetized 51 days later and radiography was done to determine her pregnancy status. A single fetus was present, so she was moved from an outdoor pen into a large indoor holding pen to allow for video-monitoring during the remainder of gestation. On Day 70, early signs of labour were observed and an elective Caesarean section was done approximately 4 h later. A live, healthy male kitten weighing 204 g was delivered. One year later, gonadotropin treatment/AI were repeated on the same pair. At approximately 30 h post-LH treatment, preovulatory follicles were present, but fewer than the previous treatment (5–6 total). Two fresh ovulation sites were seen on the left ovary. Pregnancy was not established. A reason for the failure was not apparent, unless it was age related.


Author(s):  
Sabriye Dayı

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.


2000 ◽  
Vol 17 (4) ◽  
pp. 239-247 ◽  
Author(s):  
D. Michaloudis ◽  
A. Petrou ◽  
P. Bakos ◽  
A. Chatzimichali ◽  
K. Kafkalaki ◽  
...  

Neurosurgery ◽  
1982 ◽  
Vol 10 (4) ◽  
pp. 422-427 ◽  
Author(s):  
Michael B. Pritz ◽  
Glenn W. Kindt

Abstract Among a large group of patients who underwent either carotid endarterectomy or extracranial-intracranial (EC-IC) bypass were 13 patients who had cardiopulmonary monitoring performed by a dye dilution technique either with or without a thermodilution Swan-Ganz catheter. Each patient had at least two significant medical problems that were thought to place him or her at increased risk. The usefulness of this monitoring approach in the perioperative management of these patients is demonstrated by several clinical examples. No patient sustained myocardial infarction, congestive heart failure, or new neurological deficit during the perioperative period. Our experience suggests that high risk patients can safely undergo either carotid endarterectomy or EC-IC bypass provided that careful attention is paid to myocardial function and the state of hydration.


2000 ◽  
Vol 17 (4) ◽  
pp. 239-247 ◽  
Author(s):  
D. Michaloudis ◽  
A. Petrou ◽  
P. Bakos ◽  
A. Chatzimichali ◽  
K. Kafkalaki ◽  
...  

2019 ◽  
Vol 23 (1) ◽  
pp. 159-162
Author(s):  
A. B. Kebkalo ◽  
A. O. Reyti ◽  
V. V. Gryanila ◽  
I. M. Yatsyk

Reducing the complications of the peritoneal dialysis (PD) procedure prolongs its use. The purpose of the work was to justify prolongation of peritoneal dialysis by modifying its setting. The study included 54 patients with chronic renal insufficiency, they carried out laparoscopic setting of PD; 14 patients were with omentopexy and 40 – with a classical statement. The operation was performed under general anesthesia. Surgical tactics were as follows: omentum folds were fixed to the parietal peritoneum; the control catheter was inserted through the window into the mesentery of the colon, and the dialysis portion at the bottom of the pelvis; sutured the window of the mesentery of the colon. Before insertion of the camera port, pneumoperitoneum was induced with a Veress needle, 10 mm below the navel. The pressure of abdominal gas was 12 mm Hg. Art. The point of entry into the abdominal cavity was established by the Hassan method: 5 cm lateral and 7 cm below the navel along the outer edge of the rectus abdominis muscle. A control catheter was inserted into the window under the transverse colon and inflated the balloon, the omentum was fixed to the parietal peritoneum 3 cm above the navel and the window in the colon mesentery was sutured. All early and late postoperative complications of the patients were recorded for 12 months (wound infections, including “tunnel infection”, dialysate leakage past the catheter, obturation of the catheter lumen, loss of tightness of omentoperitoneopexy). The study included 8 men and 6 women, aged from 43 to 76 years, of whom 2 patients had previously been operated on the abdominal organs. The operative intervention time averaged 54,6±15,4 min. No obstruction, catheter migration, or “tunnel infection” was established during the study. We have developed a laparoscopic technique of peritoneopexy of the upper half of the abdominal cavity, which will be used when the resource of the lower half of the abdominal cavity is exhausted and the effectiveness of preventing mechanical complications of the catheter PD has been proven.


2010 ◽  
Vol 57 (4) ◽  
pp. 33-38 ◽  
Author(s):  
Pavle Gregoric ◽  
Djordje Bajec ◽  
Dejan Radenkovic ◽  
Ana Sijacki ◽  
Aleksandar Karamarkovic ◽  
...  

Laparoscopic diagnostics provides fast, reliable, clear, and obvious information on extent and depth of abdominal organs injury with minimizing additional trauma to the patient. It is performed without any specific preparations and, if needed, it may be promptly converted into conventional laparotomy. Through use of optical equipment with various refraction angles and through variable patient positioning, laparoscopic technique enables visualization of whole abdominal cavity. In approximately 20% of cases of unclear findings, and after other performed diagnostic procedures, laparoscopy provides definitive diagnosis. Abdominal surgeons are familiar with this method, making interpretation of the results very fast and reliable and, what is the most important, this method avoids additional trauma caused by conventional laparotomy.


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