Laparoscopic approach for acute right iliac fossa pathology: Our experience

Laparoscopic approach in emergency theatre is an irreplaceable tool to manage patients with acute surgical pathology. We retrospectively reviewed surgical access records from the Emergency Department for acute right iliac fossa pathology. We considered 51 patients (16 male, 35 female, mean age 23.8 years) access for acute right iliac fossa pathology over the last year. 44 patients underwent laparoscopic approach (86%); 8 patients were treated with an open approach. Outcomes evaluation was based on data comparison from open appendicectomy over 4 year time period. Variables considered for data analyses were: role of laparoscopic surgery for gangrenous/perforated appendicitis, Conversion rate, Laparoscopy appendicectomy for elderly patients. Our study demonstrated that a laparoscopic approach at acute right iliac fossa pathology is feasible, safe and can offer a low incidence of infectious complications, less post-operative pain, rapid recovery, and represent a valid diagnostic tool in doubtful cases, at the expense of longer operating time than OA. We suggest that LA should be the initial choice for all patients with acute right iliac fossa pathology.

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Assessment of the Role of Laparoscopic Management in Patients with Complicated Appendicitis

Academia Journal of Surgery ◽

10.47008/ajs/2020.3.2.2 ◽

2020 ◽

Vol 3 (2) ◽

pp. 5-9

Author(s):

Priyank Patel ◽

Jaimini Jaiswal

Keyword(s):

Tertiary Care ◽

Operating Time ◽

Perforated Appendicitis ◽

Complicated Appendicitis ◽

Laparoscopic Management ◽

Post Operative Pain ◽

Mucocele Of The Appendix ◽

Tertiary Care Institution ◽

Wbc Count ◽

The Cost

Background: Present research aimed to evaluate the wellbeing and the effectiveness of laparoscopy for managing complicated appendicitis. Subjects and Methods: Present descriptive research was carry out on 50 patients at tertiary care institution of Gujarat for the period of 1 year. This study is including patients of complicated appendicitis undergoing laparoscopic management. Parameters studied included Age, Gender, WBC count, wound infection and hospital stay. Results: There was increase of total leucocytic count (leukocytosis) in most of the patients; Mean WBCs was 12.71 5.37. 33 patients had pus free IPF collection and perforated appendicitis (PA), 11 patients had turbid free IPF collection with AA (highly inflamed appendix), 2 case was mucocele of the appendix, 2 cases of appendicular abscess (3.3%) and 2 cases of gangrenous appendix. Conclusion: management of complicated appendicitis laparoscopically is practicable, secure and can present a small occurrence of infectious impediments, fewer post-operative pain, fast revival and improved cosmesis on the cost of extended operating time than OA.

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Comparison of Laparoscopic versus Open Appendicectomy

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v10i2.25928 ◽

2015 ◽

Vol 10 (2) ◽

pp. 75-79

Author(s):

SM Shahadat Hossain ◽

Farhana Israt Jahan ◽

Munshi M Mujibur Rahman ◽

Md Abdus Samad Al Azad ◽

Md Shahinur Rahman ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Acute Appendicitis ◽

Hospital Stay ◽

Operating Time ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

Armed Forces ◽

P Value ◽

Surgical Trauma ◽

Open Approach

Introduction: The advent of laparoscopic surgery has dramatically changed the field of surgery. With improvements in the equipment and increasing clinical experience it is now possible to perform almost any kind of procedure under laparoscopic visualization. The idea of minimal surgical trauma, resulting in significantly shorter hospital stay, less postoperative pain, faster return to daily activities, and better cosmetic outcome have made laparoscopic surgery for acute appendicitis very attractive.Objective: The aim of the present study was to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis.Method: This prospective randomized clinical trial was conducted at CMH, Savar Cantonment and Navy Hospital, BNS Patenga, Chittagong. A total of 86 patients who underwent appendicectomy during December 2009 to March 2011 were included in this study. A total of 40 patients had laparoscopic appendicectomy and 46 underwent open procedure. Clinical outcome measures were compared between the two groups with respect to several variables.Results: Among the study population, the operating time was shorter for the OA patients than for the LA patients (LA, 35 min vs. OA, 30 min; p value 0.33), which is not statistically significant. The differences in hospital stay of 4 days for the LA group and 8 days for the OA group and p value 0.01 which is statistically significant. Return to oral diet was same in both groups with no statistical difference LA, 20 h vs. OA, 22 h; return to work LA was 14 days vs. OA 18 days. Although the rate for overall complications was lower in the LA group 5% vs. 18% in OA; p value 0.001 which is statistically significant.Conclusion: The laparoscopic approach to appendicectomy in patients with acute appendicitis does offer a significant advantage over the open approach in terms of length of hospital stay, postoperative complications, or quality of life, which are considered as the major advantages of minimally invasive surgery.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

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Laparoscopic Intervention to Pancreatic Pseudocyst Confers Short-Term Benefits: A Meta-Analysis

Emergency Medicine International ◽

10.1155/2021/7586338 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Yulin Guo ◽

Shun Hu ◽

Shuo Wang ◽

Ang Li ◽

Feng Cao ◽

...

Keyword(s):

Surgical Approach ◽

Pancreatic Pseudocyst ◽

Surgical Intervention ◽

Operating Time ◽

Surgical Techniques ◽

Laparoscopic Approach ◽

Cochrane Library ◽

Open Approach ◽

Qualitative Synthesis ◽

Significant Difference

Background. Surgical interventions for pancreatic pseudocyst (PP) are traditionally managed by an open surgical approach. With the development of minimally invasive surgical techniques, a laparoscopic surgical approach for PPs has been conducted increasingly with comparable outcomes. The present study was conducted to compare the efficacy and safety of surgical intervention for PPs between the laparoscopic approach and the open approach. Methods. Databases including Cochrane Library, PubMed, and EMBASE were searched to identify studies that compared the safety and efficacy of surgical intervention for PPs between the laparoscopic approach and the open approach (until Aug 1st 2020). Results. A total of 6 studies were eligible in qualitative synthesis. The laparoscopic approach was associated with less intraoperative blood loss (MD = −69.97; 95% CI: −95.14 to −44.70, P < 0.00001 ; P = 0.86 for heterogeneity) and shorter operating time (MD = −33.12; 95% CI: −62.24 to −4.00, P = 0.03 ; P < 0.00001 for heterogeneity). There was no significant difference found between the two approaches regarding the success rate and the recurrence rate. The postoperative complications and mortality rates were comparable between the two approaches. Conclusions. The laparoscopic approach for the surgical intervention of PPs is safe and efficacious with shorter-term benefits.

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Laparoscopic approach of excision of anterior abdominal wall actinomycosis

International Surgery Journal ◽

10.18203/2349-2902.isj20210392 ◽

2021 ◽

Vol 8 (2) ◽

pp. 733

Author(s):

Satkunan Mark ◽

Mohd Firdaus ◽

Mohd Muselim ◽

Lewellyn Rajakumar

Keyword(s):

Abdominal Wall ◽

Sigmoid Colon ◽

Anterior Abdominal Wall ◽

Iliac Fossa ◽

Abdominal Mass ◽

Laparoscopic Approach ◽

Open Approach ◽

En Bloc ◽

Left Iliac Fossa ◽

Laparoscopic Excision

Actinomycosis of the abdominal wall is a rare disease. While most of the reported cases are women, we present a 42-year-old male with an abdominal mass for 4 months. Clinical examination of the abdomen revealed a well circumscribed mass in the left iliac fossa. CT abdomen showed an anterior abdominal wall mass with infiltration to the sigmoid colon however colonoscopy ruled out intraluminal origin. In contrast to traditional open approach, a laparoscopic approach was done. The abdominal wall tumour and sigmoid colon was resected en- bloc and continuity restored extra- corporeally through a small incision. Histopathology of the specimen reported an abdominal wall actinomycosis and patient was discharged with antibiotics. Laparoscopic approach was successful as the tumour was small. We therefore conclude that an initial laparoscopic assessment can be advocated and a laparoscopic excision is always possible if the features are favourable.

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Imperforate hymen mimicking acute appendicitis in an adolescent woman: a rare presentation

BMJ Case Reports ◽

10.1136/bcr-2020-238547 ◽

2021 ◽

Vol 14 (3) ◽

pp. e238547

Author(s):

Victoria Rose Russell ◽

Mohamed Ibrahim ◽

Georgina Phillips ◽

Tom Setchell ◽

Sanjay Purkayastha

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Iliac Fossa ◽

Female Genital Tract ◽

Delayed Diagnosis ◽

Rare Presentation ◽

Left Iliac Fossa ◽

Imperforate Hymen ◽

Retrograde Menstruation ◽

Low Incidence

Imperforate hymen is a rare congenital malformation of the female genital tract. The condition poses several diagnostic challenges owing to its low incidence and often atypical presentation. Classical symptoms include amenorrhoea and cyclical abdominal pain. Delayed diagnosis leads to potentially irreversible and lifechanging sequelae including infertility, endometriosis and renal failure. A premenarchal 13-year-old girl with a background of chronic constipation presented with symptoms mimicking acute appendicitis. The underlying cause was imperforate hymen and retrograde menstruation. The diagnosis was made during diagnostic laparoscopy. As with this patient, pre-existing symptoms are often troublesome long before the true diagnosis is made. This case report highlights the importance of recognising imperforate hymen as a potential cause of acute abdominal pain in premenarchal adolescent girls. The clinical picture may present as right or left iliac fossa pain. Early identification reduces the risk of adverse complications and avoids unnecessary and potentially harmful interventions.

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Pure laparoscopic unilateral nephrectomy for a patient with a polycystic horseshoe kidney

Canadian Urological Association Journal ◽

10.5489/cuaj.1919 ◽

2014 ◽

Vol 8 (11-12) ◽

pp. 881 ◽

Cited By ~ 2

Author(s):

Shawn Dason ◽

Christopher B Allard ◽

Bobby Shayegan ◽

Kevin Piercey

Keyword(s):

Renal Transplantation ◽

Autosomal Dominant ◽

Iliac Fossa ◽

Laparoscopic Approach ◽

Horseshoe Kidney ◽

Laparoscopic Nephrectomy ◽

Polycystic Kidney ◽

Large Size ◽

Autosomal Dominant Polycystic Kidney ◽

The Right

A 45-year-old female patient with autosomal dominant polycystic kidney disease (ADPKD) and a horseshoe kidney underwent right laparoscopic nephrectomy. The indication for nephrectomy was to create space within the right iliac fossa for renal transplantation. The operation proceeded as routine for laparoscopic nephrectomy for ADPKD, but was uniquely challenging due to the large size and extensive vasculature of the polycystic horseshoe kidney. In addition to documenting the feasibility of the pure laparoscopic approach for nephrectomy in patients with ADPKD and horseshoe kidney, this case highlights the abnormal location and vasculature encountered when operating on horseshoe kidneys.

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Redo Surgery after Failure of Antireflux Surgery

The American Surgeon ◽

10.1177/000313481808401142 ◽

2018 ◽

Vol 84 (11) ◽

pp. 1819-1824 ◽

Cited By ~ 3

Author(s):

Alberto Vilar ◽

Pablo Priego ◽

Ana Puerta ◽

Marta Cuadrado ◽

Francisco GarcÍA Angarita ◽

...

Keyword(s):

Hiatal Hernia ◽

Laparoscopic Approach ◽

Long Term Results ◽

Complication Rates ◽

Open Approach ◽

Redo Surgery ◽

Primary Surgery ◽

Satisfactory Outcome ◽

Symptomatic Outcome ◽

Recurrent Hiatal Hernia

Surgery for refractory gastroesophageal reflux disease (GERD) has a satisfactory outcome for most patients; however, sometimes redo surgery is required. The Outcome and morbidity of a redo are suggested to be less successful than those of primary surgery. The aim of this study was to describe our experience, long-term results, and complications in redo surgery. From 2000 to 2016, 765 patients were operated on for GERD at our hospital. A retrospective analysis of 56 patients (7.3%) who underwent redo surgery was conducted. Large symptomatic recurrent hiatal hernia (50%) and dysphagia (28.6%) were the most frequent indications for redo. An open approach was chosen in 64.5 per cent of patients. Intraoperative and postoperative complication rates were 18 per cent and 14.3 per cent, respectively. Mortality rate was 1.8 per cent. Symptomatic outcome was successful in 71.3 per cent. Patients reoperated because of dysphagia and large recurrent hiatal hernia had a significantly higher failure rate (32.3% and 31.2%, respectively; P = 0.001). Complication rate was significantly lower in the laparoscopic group (0% vs 22.2%; P = 0.04). There were no statistical differences between expert and nonexpert surgeons. Laparoscopic approach has increased to 83.3 per cent in the last five years. Symptomatic outcome after redo surgery was less satisfactory than that after primary surgery. Complications were lower if a minimally invasive surgical approach was used.

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Liver Surgery for Hepatocellular Carcinoma: Laparoscopic versus Open Approach

International Journal of Hepatology ◽

10.4061/2011/596792 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 34

Author(s):

C. G. Ker ◽

J. S. Chen ◽

K. K. Kuo ◽

S. C. Chuang ◽

S. J. Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Average Length ◽

Survival Rates ◽

Laparoscopic Approach ◽

Operation Time ◽

Open Approach ◽

Full Diet ◽

Or Groups ◽

Significant Difference

In this study, we try to compare the benefit of laparoscopic versus open operative procedures.Patients and Methods. One hundred and sixteen patients underwent laparoscopic liver resection (LR) and another 208 patients went for open liver resection (OR) for hepatocellular carcinoma (HCC). Patients' selection for open or laparoscopic approach was not randomized.Results. The CLIP score for LR and OR was 0.59 ± 0.75 and 0.86 ± 1.04, respectively, (). The operation time was 156.3 ± 308.2 and 190.9 ± 79.2 min for LR and OR groups, respectively. The necessity for blood transfusion was found in 8 patients (6.9%) and 106 patients (50.9%) for LR and OR groups. Patients resumed full diet on the 2nd and 3rd postoperative day, and the average length of hospital stay was 6 days and 12 days for LR and OR groups. The complication rate and mortality rate were 0% and 6.0%, 2.9% and 30.2% for LR and OR groups, respectively. The 1-yr, 3-yr, and 5-yr survival rate was 87.0%, 70.4%, 62.2% and 83.2%, 76.0%, 71.8% for LR and OR group, respectively, of non-significant difference. From these results, HCC patients accepted laparoscopic or open approach were of no significant differences between their survival rates.

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Laparoscopic repair for perforated peptic ulcer: our experience, a comparison with the open approach and a review of the literature.

Journal of Gastric Surgery ◽

10.36159/jgs.v2i2.28 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Samuele Vaccari ◽

Vito D'Andrea ◽

Augusto Lauro ◽

Roberto D'Intino ◽

Eliana Gulotta ◽

...

Keyword(s):

Peptic Ulcer ◽

Laparoscopic Approach ◽

Perforated Peptic Ulcer ◽

Suture Repair ◽

Open Approach ◽

Peptic Ulcers ◽

Severe Condition ◽

Extensive Experience ◽

Optimal Outcomes ◽

Immediate Surgery

Backgrounds: The incidence of perforated peptic ulcers has decreased during the last decades but the optimal treatment for these patients remains controversial. At the same time, a laparoscopic approach to this condition has been adopted by an increased number of surgeons. Therefore, this study wants to evaluate the postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in one Italian center with extensive experience in laparoscopic surgery. Methods: This retrospective study includes 94 patients who were operated for perforated peptic ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for demographics, surgical procedure, complications, and short-term outcomes. Results: The diagnosis was made clinically and confirmed by the presence of gas under diaphragm on abdominal X-ray. All patients underwent primary suture repair with or without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in 28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative complications occurred in 19 (20%) patients and 18 (19%) patients died. Conclusions: Perforated peptic ulcer is a severe condition that requires early hospital admission and immediate surgery. Laparoscopy in experienced centers and for selected patients is safe, associated with optimal outcomes and should be the preferred approach.

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Incidence and management of inguinodynia after inguinal plasty

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204211 ◽

2020 ◽

Vol 8 (10) ◽

pp. 3432

Author(s):

Juan J. Granados-Romero ◽

Jesus C. Ceballos-Villalva ◽

Israel García-Olivo ◽

Cruz Escobar Jonathan E. ◽

María J. Corona-Torres ◽

...

Keyword(s):

Hospital Costs ◽

Laparoscopic Approach ◽

Systematic Investigation ◽

Pain Scale ◽

Diagnostic Methods ◽

Visual Analogue Pain Scale ◽

Open Approach ◽

Cross Sectional ◽

Visual Analogue Pain ◽

Quality Life

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

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