Single access laparoscopic colorectal surgery: Lights and shadows

Introduction: To minimize the complications related to conventional multiport laparoscopic surgery, the single access laparoscopic surgery has been developed. Some results of case series and case-controlled studies are supporting the feasibility and safety of Single Access Laparoscopic Colectomy (SALC). Materials and Methods: Since January 2009 we performed all kind of colorectal procedure by a single access laparoscopic approach. We began with right colectomy that represent the only procedure in which we did not reproduce the same surgical steps of multiport laparoscopic surgery. In contrast, we reproduce the same surgical technique of multiport colorectal resection during a left or rectal single access laparoscopic procedure as well as total colectomy. Conclusion: About the transferability of SALC, programs of training need to focus on safety and techniques. We believe that only high laparoscopic skills surgeon can perform SALC. It?s mandatory to evaluate outcomes and cost-effectiveness of SALC respect to multiport laparoscopic colectomy using randomized trials.

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LATE IMPACT OF THE LAPAROSCOPIC TREATMENT OF DEEP INFILTRATING ENDOMETRIOSIS WITH SEGMENTAL COLORECTAL RESECTION

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1406 ◽

2018 ◽

Vol 31 (4) ◽

Cited By ~ 1

Author(s):

Antonio Matos ROCHA ◽

Maurício Mendes de ALBUQUERQUE ◽

Eduardo Miguel SCHMIDT ◽

Cristiano Denoni FREITAS ◽

João Paulo FARIAS ◽

...

Keyword(s):

Colorectal Resection ◽

Positive Impact ◽

Therapeutic Option ◽

Case Series ◽

Laparoscopic Approach ◽

Deep Infiltrating Endometriosis ◽

Preoperative Period ◽

Laparoscopic Treatment ◽

Bowel Symptoms ◽

Infiltrating Endometriosis

ABSTRACT Background: Deep infiltrating colorectal endometriosis may severely affect the quality of life and fertility of patients. Although segmental resection is a therapeutic option that provides positive outcomes in the management of symptoms, its functional effects are still unproven. Aim: Assess the late impact of the laparoscopic approach in treating deep infiltrating endometriosis with segmental colorectal resection. Methods: Prospective case series of 46 patients submitted to laparoscopic treatment of deep infiltrating endometriosis with segmental colorectal resection between 2013 and 2016. Fertility, gynecological and bowel symptoms were assessed at the preoperative period and at three and 12 months (or more) after the procedure. Results: Preoperative interview assessed the prevalence of infertility (45.6%), gynecological (87%) and intestinal (80.4%) symptoms. At the third month after the procedure a significant reduction in the prevalence of gynecological symptoms (p<0,001), tenesmus (p=0,001) and dysquesia (p=0,002) was observed. After a period of 12 months or more following the procedure a significant reduction in the prevalence persisted for dysmenorrhea (p=0,001), deep dyspareunia (p=0,041), chronic pelvic pain (p=0,011) and dysquesia (p=0,001), as compared to the preoperative period. Total pregnancy rate was 57.1% and spontaneous pregnancy 47.6%. Conclusion: The treatment of deep infiltrating endometriosis using segmental colorectal resection has provided early and late relief of gynecological and bowel symptoms. The outcomes also indicate a positive impact on the fertility of infertile patients.

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Early experience with a new integrated microwave surgical device, Acrosurg Revo®, for laparoscopic surgery: A case series of two patients

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.12.063 ◽

2021 ◽

Vol 78 ◽

pp. 375-377

Author(s):

Yoshitaka Terada ◽

Hiroya Akabori ◽

Hiroyuki Ohta ◽

Yusuke Nishina ◽

Eji Mekata

Keyword(s):

Laparoscopic Surgery ◽

Case Series ◽

Early Experience ◽

Surgical Device

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Long-term outcomes of single-incision versus multiport laparoscopic colectomy for colon cancer: results of a propensity score-based analysis

Surgical Endoscopy ◽

10.1007/s00464-021-08367-4 ◽

2021 ◽

Author(s):

Yozo Suzuki ◽

Mitsuyoshi Tei ◽

Masaki Wakasugi ◽

Yujiro Nakahara ◽

Atsushi Naito ◽

...

Keyword(s):

Colon Cancer ◽

Propensity Score ◽

Laparoscopic Colectomy ◽

Single Incision ◽

Long Term Outcomes ◽

Multiport Laparoscopic Colectomy

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Assessment of laparoscopic skills of Gynecology and Obstetrics residents after a training program

Einstein (São Paulo) ◽

10.1590/s1679-45082016ao3752 ◽

2016 ◽

Vol 14 (4) ◽

pp. 468-472 ◽

Cited By ~ 4

Author(s):

Carla Ferreira Kikuchi Fernandes ◽

◽

José Maria Cordeiro Ruano ◽

Lea Mina Kati ◽

Alberto Sinhiti Noguti ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Training Program ◽

Demographic Data ◽

Medical Residency ◽

Box Trainer ◽

Laparoscopic Skills ◽

Surgical Competence ◽

Gynecology And Obstetrics ◽

Level 1 ◽

And Training

ABSTRACT Objective To evaluate laparoscopic skills of third-year Gynecology and Obstetrics residents after training at a training and surgical experimentation center. Methods Use of a prospective questionnaire analyzing demographic data, medical residency, skills, competences, and training in a box trainer and in pigs. Results After the training, there was significant improvement in laparoscopic skills according to the residents (before 1.3/after 2.7; p=0.000) and preceptors (before 2.1/after 4.8; p=0.000). There was also significant improvement in the feeling of competence in surgeries with level 1 and 2 of difficulty. All residents approved the training. Conclusion The training was distributed into 12 hours in the box trainer and 20 hours in animals, and led to better laparoscopic skills and a feeling of more surgical competence in laparoscopic surgery levels 1 and 2.

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Management of Ovarian Endometrioma by Single Incision Laparoscopic Surgery: Case Series

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2016.08.623 ◽

2016 ◽

Vol 23 (7) ◽

pp. S181-S182

Author(s):

AHF Brandão ◽

MB Noviello ◽

G Peret ◽

B Lima ◽

AS Santos-Filho

Keyword(s):

Laparoscopic Surgery ◽

Single Incision ◽

Case Series ◽

Single Incision Laparoscopic Surgery ◽

Ovarian Endometrioma

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Impact of SupervIsed TraInIng on the AcquIsItIon of SImulated LaparoscopIc SkIlls

Bulletin of The Royal College of Surgeons of England ◽

10.1308/003588413x13643054410340 ◽

2013 ◽

Vol 95 (6) ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

NA Healy ◽

KH Chang ◽

JB Conneely ◽

C Malone ◽

MJ Kerin

Keyword(s):

Minimally Invasive Surgery ◽

Laparoscopic Surgery ◽

Minimally Invasive ◽

Open Surgery ◽

Alternative Methods ◽

Time Constraints ◽

Laparoscopic Skills ◽

Supervised Training ◽

Initial Learning ◽

Safety Considerations

Laparoscopy or minimally invasive surgery requires surgeons to attain proficiency in skills that are fundamentally different to those required for open surgery. As a result, it both challenges junior trainees and surgeons who are experienced in open surgery. Not surprisingly, the initial learning phase of laparoscopy has been associated with an increased incidence of serious complications. Owing to time constraints and the ethical and safety considerations of allowing novices to perform laparoscopic surgery on patients, alternative methods have been sought to train junior surgeons on the basics of laparoscopic surgery.

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Retroperitoneal laparoscopic surgery in managing the urinary anormalies in children at Viet Duc Hospital

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2019.1.2 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Việt Hoa Nguyễn

Keyword(s):

Laparoscopic Surgery ◽

Retrospective Study ◽

Plastic Surgery ◽

Operative Time ◽

Laparoscopic Approach ◽

Multicystic Dysplastic Kidney ◽

Gender Ratio ◽

Laparoscopic Pyeloplasty ◽

Ureteral Duplication ◽

Dysplastic Kidney

Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật nội soi sau phúc mạc điều trị bệnh lý thận, tiết niệu ở trẻ em Phương pháp nghiên cứu: Nghiên cứu hồi cứu người bệnh phẫu thuật nội soi sau phúc mạc điều trị bệnh lý thận, tiết niệu trong thời gian từ 1/1/2014 - 31/12/2017. Kết quả: Phẫu thuật nội soi sau phúc mạc cho 110 người bệnh trong đó hẹp khúc nối bể thận - niệu quản là 49 người bệnh (44,54%), thận niệu quản đôi 23 người bệnh (20,91%), thận đa nang 21 người bệnh (19,1%), thận teo mất chức năng 17 người bệnh (15,43%). Tuổi phẫu thuật trung bình là 4,5 ± 3,72 tuổi (từ 1 tuổi- 15 tuổi), tỉ lệ nam/ nữ = 3,3/1. Phẫu thuật nội soi cắt thận cho 52 người bệnh (47,27%), nội soi tạo hình cho 11 người bệnh (10%), nội soi hỗ trợ tạo hình cho 47 người bệnh (42,73%). Thời gian phẫu thuật trung bình 100 ± 20 phút. Thời gian nằm viện sau mổ trung bình là 3 ± 2,3 ngày. Không có biến chứng nặng. Kết quả theo dõi sau mổ 3- 36 tháng cho kết quả tốt 88%, trung bình 10%, xấu 2% Kết luận: Nội soi sau phúc mạc điều trị các bệnh lý thận, tiết niệu ở trẻ em là một phương pháp phẫu thuật an toàn, không có biến chứng, thẩm mỹ và cho kết quả tốt. Abstract Introduction: To evaluate the retroperitoneal laparoscopic surgery in children having the urinary anomalies Material and Methods: Retrospective study for children suffering from urinary anomalies underwent retroperitoneal laparoscopic surgery. Results: 110 children were operated by retroperitoneal laparoscopic approach included: 49 patients (44.54%) with ureter pelvic junction obstruction, 23 patients (20.91%) with ureteral duplication, 21 patients (19.1%) with multicystic dysplastic kidney, 17 patients (15.45%) with atrophy kidney. Mean age was 4.5± 3.72 years old (from 1 year to 15 years old); Gender ratio: male/female = 3.3/1. Laparoscopic nephrectomy for 52 cases (47.27%), 58 cases including 11 cases (10%) retroperitoneal laparoscopic pyeloplasty and 47 cases (42.27%) with assisted laparoscopic plastic surgery. Mean operative time was 100 ± 20 minutes, mean hospitalization length stay was 3 ± 2.3 days. No major complications occurred. Followed from 3 to 36 month are favorable with good outcome in 88%, average in 10%, poor in 2%. Conclusion: Retroperitoneal laparoscopic surgery is safe and feasible procedure in children with urinary anomalies. Keyword: Laparoscopic surgery; Retroperitoneal laparoscopic surgery; Urinary anomalies in children.

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Laparoscopic Surgical Management of Rectal Cancer at Tertiary Care Hospital

10.53350/pjmhs2115113285 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3285-3287

Author(s):

Zubair Yousfani ◽

Jabeen Atta ◽

Khenpal Das ◽

Madhu Bala ◽

Shagufta Magsi ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Hospital Stay ◽

Tertiary Care ◽

Case Series ◽

Operation Time ◽

Health Sciences ◽

Care Hospital ◽

Average Hospital ◽

Case Series Study

Objective: To evaluate the consequent outcomes in the patients with rectal cancer endured laparoscopic surgical excision at Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro, Hyderabad and to review their curative resection and recurrence rates, postoperative morbidities and complete survival. Methods: This prospective case series study was done at the Department of General Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan. All patients of 30-65 years ages with rectal cancer and underwent diagnostic laparoscopy either of gender were included. After removing the tumor, the specimen pinned out on a flat surface and placed in fixative solution to allow the orientation of the specimen and assessments of the exact margins. As the specimens had acceptable clear margins and limited invasion to the submucosa, no further surgical procedure was proceeded. Data was collected via study proforma. Results: A total of 40 patients were studied. Patients in the laparoscopic operation lost less blood with an amount of only 200mL during 190 minutes average operation time. The bowel functioning returned in 2 days averagely with 8 days average hospital stay. Conclusion: It is concluded that laparoscopic surgery for rectal cancer is an effective, safe and feasible approach in terms of less post-operative complications and recovery time as well as Hospital stay. Key words: Rectal Cancer, laparoscopic surgery

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Assessment of Anastomotic Perfusion in Left-Sided Robotic Assisted Colorectal Resection by Indocyanine Green Fluorescence Angiography

Minimally Invasive Surgery ◽

10.1155/2019/3267217 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Emanuel Shapera ◽

Roger W. Hsiung

Keyword(s):

Indocyanine Green ◽

Colorectal Resection ◽

Case Series ◽

Fluorescence Angiography ◽

Control Group ◽

Invasive Approach ◽

Robotic Assisted ◽

Anastomotic Complications ◽

Intraoperative Management ◽

Resection And Anastomosis

Background. Indocyanine green fluorescent angiography (IcGA) has been used with success in guiding intraoperative management to prevent colorectal anastomotic complications. Prior studies in open and laparoscopic colorectal surgery, such as PILLAR II, have demonstrated a low anastomotic leak rate (1.4%). As the minimally invasive approach progresses from laparoscopic to robotic approach, the effect and safety of IcGA in assessing anastomotic perfusion in the latter deserve further investigation. Methods. The objective of the study was to determine the safety of IcGA in guiding intraoperative management of robotic assisted colorectal resection via perfusion assessment. The design was single-surgeon, retrospective case-control study. 74 patients underwent left-sided robotic assisted colorectal resection and anastomosis with IcGA guidance. 30 historical controls underwent left-sided robotic assisted colorectal resection and anastomosis without IcGA. Clinical, demographic, operative, and outcome variables were tabulated. Results. In the control group, 1 patient suffered a postoperative anastomotic stricture requiring no surgery, and 1 patient suffered an anastomotic dehiscence requiring return to the operating room. There were no anastomotic complications in the IcGA group, including 4 patients who underwent a change in the chosen level of anastomosis based on intraoperative IcGA. Conclusion. IcGA is safe to use as demonstrated by the very low rate of complications in this case series. It is also safe to rely on to guide re-resection and recreation of an anastomosis intraoperatively by demonstration of blood flow. This may help offset the loss of tactile feedback and assessment of tension in the robotic platform.

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