scholarly journals RETROPERITONEAL VS TRANSPERITONEAL LAPAROSCOPIC URETEROLITHOTOMY

2015 ◽  
Vol 22 (2) ◽  
Author(s):  
Rosadi Putra ◽  
Ferry Safriadi ◽  
Sawkar Vijay Pramod
Keyword(s):  
Length Of Stay ◽  
Operative Time ◽  
Pain Scale ◽  
Clinical Variable ◽  
Ureteral Stones ◽  
P Value ◽  
Early Complications ◽  
Time Length ◽  
Prospective Comparison ◽  
Retroperitoneal Laparoscopic Ureterolithotomy

Objective: To compare retroperitoneal versus transperitoneal laparoscopic ureterolithotomy in effectivity, pain scale and early complications. Material & methods: In this prospective comparison study from January 2013 to June 2014, 32 patients with proximal and mid ureteral stones underwent retroperitoneal laparoscopic ureterolithotomy or transperitoneal laparoscopic ureterolithotomy. The randomization occured on consecutive sampling on a 1 : 1 basis. Group 1 and 2 consisted of patients who underwent retroperitoneal laparoscopic ureterolithotomy and transperitoneal laparoscopic ureterolithotomy, respectively. Demographic and clinical variable, operative time, length of stay, ureteral suturing, pain scale according to visual analog scale (VAS) and early complications data were collected and analyzed. Statistical analysis was performed with SPSS® version 17.0 using student T-test and Mann-Whitney U tests with p value < 0.05 considered statistically significant. Results:VAS on day 1 between the 2 groups was statistically significant, and was higher in group 2 (p < 0.05). According to the Clavien-Dindo classification of surgical complication all the patients were in grade 1 classification. The differences in operative time, length of stay, ureteral suturing, visual pain analog score on day 3, and early complications between the 2 groups were not statistically significant.Conclusion: Transperitoneal laparoscopic ureterolithotomy is significantly associated with pain than retroperitoneal laparoscopic ureterolithotomy in first day after surgery. Successful stone removal remains the same in both groups.

The Impact of Obesity on the Perioperative, Clinicopathologic, and Oncologic Outcomes of Robot Assisted Total Mesorectal Excision for Rectal Cancer

2017 ◽  
Vol 89 (4) ◽  
pp. 23-28 ◽  
Author(s):  
Ajit Pai ◽  
Fahad Alsabhan ◽  
John J. Park ◽  
George Melich ◽  
Suela Sulo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Length Of Stay ◽  
Operative Time ◽  
Statistical Significance ◽  
Oncologic Outcomes ◽  
P Value ◽  
Obese Patients ◽  
Lymph Node Yield ◽  
Conversion Rates ◽  
The Impact

Purpose: To analyze the feasibility and outcomes of robotic rectal cancer surgery in obese patients. Methods: From 2005 to 2012, 101 consecutive rectal cancers operated robotically were enrolled in a prospective database. Patients were stratified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups. Operative, perioperative parameters, and pathologic outcomes were compared. Data were analyzed using SPSS 22.0, while statistical significance was defined as a p value ≤ .05. Results: There were 33 obese patients (mean BMI 33.8 kg/m2). Patients were comparable regarding gender, T stage, and type of operation. Operative time and blood loss were higher in the obese group; only operative time was statistically significant. The conversion rate, length of stay, and anastomotic leak rates were similar. Circumferential margin positivity and lymph node yield were comparable. Disease free and overall survivals at 3 years were 75.8% versus 80.9% and 84.8% versus 92.6%, respectively for obese and non-obese subgroups. Conclusions: Robotic surgery for curative treatment of rectal cancer in the obese is safe and feasible. BMI does not influence conversion rates, length of stay, postoperative complications, and quality of the specimen or survival when the robotic platform is used.

Building a Single-Site Robotic Cholecystectomy Program in a Public Teaching Hospital: Is It Safe for Patients and Feasible for Residents to Participate?

2018 ◽  
Vol 84 (2) ◽  
pp. 188-191
Author(s):  
Michael P. O'Leary ◽  
Reed I. Ayabe ◽  
Christine E. Dauphine ◽  
Danielle M. Hari ◽  
Junko J. Ozao-Choy
Keyword(s):  
Length Of Stay ◽  
Teaching Hospital ◽  
Operative Time ◽  
Resident Training ◽  
Single Site ◽  
Safe Procedure ◽  
Resident Participation ◽  
Total Operative Time ◽  
Time Length ◽  
Robotic Cholecystectomy

Single-site robotic cholecystectomy (SSRC) accounts for most of the robotic surgery cases performed by general surgeons at our institution since acquiring the da Vinci Si Surgical SystemTM (Intuitive Surgical, Inc., Sunnyvale, CA) in 2014. We sought to determine whether a SSRC program is safe to start in a public teaching hospital and to determine whether resident participation in this procedure is feasible. Data on age, gender, race, BMI, total operative time, length of stay, comorbidities, and conversion from laparoscopic to open surgery were examined for elective SSRC and laparoscopic cholecystectomies (LCs) performed by two faculty surgeons between February 2015 and August 2015. Thirty-eight patients underwent elective SSRC, whereas 27 patients underwent LC. Residents participated as operating surgeons for some portion of the case in 15 SSRC cases and in all LC cases. There were no significant differences in operative time, length of stay, or 30-day readmission rates, regardless of resident involvement. Patients in the SSRC group had a significantly lower BMI (25.8 vs 33.7, P = 0.008). This study suggests that resident participation does not increase complications or total operative time and that SSRC is a safe procedure to start in a public teaching hospital after proper faculty and resident training.

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