scholarly journals Comparison of Laparoscopic versus Open Appendicectomy

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

scholarly journals Robotic adrenalectomy in the pediatric population: initial experience case series from a tertiary center

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anirban P. Mitra ◽  
Evalynn Vasquez ◽  
Paul Kokorowski ◽  
Andy Y. Chang
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Operating Time ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Open Approach ◽  
Invasive Approach ◽  
Patients Âgés ◽  
Tertiary Center

Abstract Background Laparoscopic resection is the most well described minimally-invasive approach for adrenalectomy. While it allows for improved cosmesis, faster recovery and decreased length of hospital stay compared with the open approach, instrument articulation limitations can hamper surgical dexterity in pediatric patients. Use of robotic assistance can greatly enhance operative field visualization and instrument control, and is in the early stages of adoption in academic centers for pediatric populations. Case presentation We present a single-institution series of pediatric adrenalectomy cases. The da Vinci Xi surgical system was used to perform adrenalectomies on three consecutive patients (ages, 2–13 years) at our center. Final pathology revealed ganglioneuroblastoma (n = 2) and pheochromocytoma (n = 1). Median operating time was 244 min (range, 244–265 min); median blood loss was estimated at 100 ml (range, 15–175 ml). Specimens were delivered intact and all margins were negative. Median post-operative hospital stay was 2 days (range, 1–6 days). All patients remain disease-free at median follow-up of 19 months (range, 12–30 months). Conclusion Our experience continues to evolve, and suggests that robotic surgery is safe, feasible and oncologically effective for resection of adrenal masses in well-selected pediatric patients.

scholarly journals Single Port Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Preliminary Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Stephen Kin Yong Chang ◽  
Maria Mayasari ◽  
Iyer Shridhar Ganpathi ◽  
Victor Lee Tswen Wen ◽  
Krishnakumar Madhavan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Laparoscopic Surgery ◽  
Liver Resection ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Liver Resection ◽  
Preliminary Report ◽  
Single Port ◽  
Operating Time ◽  
Length Of Hospital Stay

Single port laparoscopic surgery is an emerging technique, now commonly used in cholecystectomy. The experience of using this technique in liver resection for hepatocellular carcinoma is described in a series of 3 cases with single port laparoscopic liver resection performed during 2010. All patients were male aged 61 to 70 years, with several comorbidities. There were no complications in this early series. The length of hospital stay was 3–5 days. The blood loss was 200–450 mL, with operating time between 142 and 171 minutes. We conclude that this technique is feasible and safe to perform in experienced centers.

International multi-centre study of incidence and risk factors of symptomatic deep venous thrombosis (DVT) and or pulmonary embolism (PE) in prostate cancer patients undergoing laparoscopic radical prostatectomy (LRP)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8555-8555 ◽  
Author(s):  
F. P. Secin ◽  
G. Fournier ◽  
I. S. Gill ◽  
C. C. Abbou ◽  
C. Schulmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Lung Ventilation ◽  
The United States ◽  
P Value ◽  
Tobacco Exposure ◽  
Multi Centre Study ◽  
Exact Test

8555 Background: There is no data regarding the incidence and variables associated with symptomatic DVT and or PE in patients undergoing LRP. Our aim was to evaluate the multi-centric incidence and risk factors for perioperative symptomatic DVT and PE after LRP. Methods: Patients with symptomatic DVT and or PE occurring within 2 months of surgery since start of the respective institutional LRP experience were included. Eight academic centers from both the United States and Europe participated. Diagnoses were made by Doppler ultrasound for DVT; and lung ventilation/perfusion scan and or chest computed tomography for PE. Associations between variables and DVT and/or PE were evaluated using Fisher’s exact test for categorical predictors and logistic regression for continuous predictors. Results: Patient reoperation (p value) (<0.001), tobacco exposure (0.02), prior DVT (0.007), larger prostate size (0.02) and length of hospital stay (0.009) were significantly associated with higher risk of symptomatic DVT/PE. The nonuse of perioperative heparin was not a risk factor (1), as well as neoadjuvant therapy (1), perioperative transfusion (0.1), body mass index (0.9), surgical technique (0.3), operating time (0.2) and pathologic stage (0.5). There were no related deaths. Patients receiving preoperative heparin had significantly higher mean operative blood loss, 480cc vs 332cc (<0.001) However, this did not translate into longer hospital stay (0.07); higher transfusion rates (0.09) or reoperation rates (0.3). The estimated cost of heparin prophylaxis in these patients exceeded $2.5 million. Conclusion: The incidence of symptomatic DVT or PE was similar despite different prophylactic regimens. Our data does not support the administration of prophylactic heparin in LRP to low risk patients (no prior DVT, no tobacco exposure, no prostate enlargement and or no anticipation of prolonged hospital stay). [Table: see text] No significant financial relationships to disclose.

scholarly journals Laparoscopic versus open surgical approach of cholecystectomy in patients with symptomatic cholelithiasis: a systematic review of comparative trials

2021 ◽  
Vol 7 (3) ◽  
pp. 167
Author(s):  
Omer A. Marzoug
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Symptomatic Cholelithiasis ◽  
Pain Duration ◽  
Comparative Trials

<p class="abstract">Symptomatic cholelithiasis (gallstone disease) is the most common biliary pathology that affects women predominantly around the world. Earlier open cholecystectomy was the gold standard of treatment of this disease before introduction of laparoscopic cholecystectomy. The aim of this study is to systematically review the most recent published data that compared laparoscopic with open cholecystectomy in symptomatic cholelithiasis in terms of operative and post-operative morbidity, mortality, operative time, length of hospital stay, and conversion rates. The Medline, Cochrane library, Embase, and PubMed databases were vigorously searched for trials that compared laparoscopic with open cholectstectomy in patients with symptomatic cholelithiasis, a systematic review of these comparative trials was performed. No mortality was detected in both groups; the conversion rate was 6.75%. The laparoscopic approach associated with significantly shorter hospital stay (2.31 versus 4.42 days, p value&gt;0.001), lower post-operative pain duration (30.5 versus 66.9 hours, p value&gt;0.001) and lower rate of post-operative wound infection (2.8% versus 10.5%, p value&gt;0.001). Regarding operative time it was significantly longer in laparoscopic approach (77.3 versus 67.1 min, p value&gt;0.001), there were no significant differences in the rates of bile duct injury (0.84% versus 0.25%, p value=0.08) and intra-operative bleeding (4.2% versus 3.5%, p value=0.81) between the two procedures. Post-operative wound infection and pain duration in addition to length of hospital stay in patients with symptomatic cholelithiasis were reduced with laparoscopic cholecystectomy. However, the laparoscopic approach associated with longer duration of surgery. No significant differences between the two procedures in the rates of bile duct injury and intra-operative bleeding.</p>

Laparoscopic vs open surgery during the COVID-19 pandemic: what are the risks?

2021 ◽  
Author(s):  
C Hadjittofi ◽  
SS Seraj ◽  
A Uddin ◽  
ZJ Ali ◽  
PL Antonas ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Survival Data ◽  
Open Surgery ◽  
Virus Transmission ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Staff Members ◽  
Significant Difference ◽  
The Uk

Introduction The initial intercollegiate surgical guidance from the UK during the COVID-19 pandemic resulted in significant changes to practice. Avoidance of laparoscopy was recommended, to reduce aerosol generation and risk of virus transmission. Evidence on the safety profile of laparoscopy during the pandemic is lacking. This study compares patient outcomes and risk to staff from laparoscopic and open gastrointestinal operations during the COVID-19 pandemic. Methods Single-centre retrospective study of gastrointestinal operations performed during the peak of the COVID-19 pandemic. Demographic, comorbidity, perioperative and survival data were collected from electronic medical records and supplemented with patient symptoms reported at telephone follow up. Outcomes assessed were: patient mortality, illness among staff, patient COVID-19 rates, length of hospital stay and postdischarge symptomatology. Results A total of 73 patients with median age of 56 years were included; 55 (75%) and 18 (25%) underwent laparoscopic and open surgery, respectively. All-cause mortality was 5% (4/73), was related to COVID-19 in all cases, with no mortality after laparoscopic surgery. A total of 14 staff members developed COVID-19 symptoms within 2 weeks, with no significant difference between laparoscopic and open surgery (10 vs 4; p=0.331). Median length of stay was shorter in the laparoscopic versus the open group (4.5 vs 9.9 days; p=0.011), and postdischarge symptomatology across 15 symptoms was similar between groups (p=0.135–0.814). Conclusions With appropriate protective measures, laparoscopic surgery is safe for patients and staff during the COVID-19 pandemic. The laparoscopic approach maintains an advantage of shorter length of hospital stay compared with open surgery.

scholarly journals THE ROLE OF LAPAROSCOPY IN GYNECOLOGIC EMERGENCIES

2020 ◽  
Vol 3 (1) ◽  
pp. 3-7
Author(s):  
I. Slavu ◽  
A. Tulin ◽  
D. N. Păduraru ◽  
B. Socea ◽  
V. Braga ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Abdominal Ultrasound ◽  
Consecutive Series ◽  
Open Approach ◽  
Simultaneous Treatment ◽  
Access Path ◽  
Therapeutic Opportunity

We performed an analytical, cohort, retrospective study, starting from our own experience, to explore the role of laparoscopy in acute gynecological abdominal emergencies. The present work was obtained at the “Prof. Dr. Agrippa Ionescu” Hospital, Bucharest and includes a consecutive series of 37 patients, admitted in emergency settings, during the past 5 years. In order to complete the diagnosis, all of the patients included in the study were investigated using an abdominal ultrasound. The following aspects were investigated: the correlation between the preoperative diagnosis and the lesions identified by laparoscopy, the rate of postoperative complications, reintervention rate, length of hospital stay, conversion rate. Our results show that the laparoscopic approach has a decreased length of hospital stay, and can offer both a diagnosis opportunity and a therapeutic opportunity with results comparable with that of an open approach. Also, laparoscopy allows simultaneous treatment of other abdominal pathologies using the same access path. Our experience shows that the need for a correct and rapid diagnosis when an acute surgical abdomen is suspected is of paramount importance and laparoscopy can offer this opportunity.

Role of Lasix test in retroperitoneal laparoscopic treatment of ureteropelvic junction obstruction at Viet Duc University Hospital – report of 11 cases

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Trường Thành Đỗ ◽  
Keyword(s):  
Laparoscopic Surgery ◽  
Ureteropelvic Junction Obstruction ◽  
Average Length ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Ureteropelvic Junction ◽  
Small Blood Vessel

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi sau phúc mạc (NSSPM) điều trị hẹp khúc nối bể thận - niệu quản (BT-NQ) được áp dụng khá rộng rãi trên thế giới. Tuy nhiên vai trò của Lasix giúp phát hiện chính xác vị trí hẹp, nguyên nhân gây hẹp chưa được các tác giả nhắc tới. Nghiên cứu của chúng tôi nhằm mục tiêu đánh giá vai trò của test Lasix trong khi thực hiện phẫu thuật nội soi SPM điều trị hẹp khúc nối BT-NQ (ureteropelvic junction obstruction - UPJO) tại khoa phẫu thuật Tiết niệu, Bệnh viện Hữu nghị Việt Đức. Phương pháp nghiên cứu: Mô tả tiến cứu trên 11 người bệnh (NB) được mổ NSSPM điều trị hẹp khúc nối BT - NQ từ tháng 1/2016 đến tháng 8/2017 mà có cần thiết phải sử dụng Lasix trong mổ. Kết quả: Nghiên cứu có 7/11 NB nam chiếm tỷ lệ 63,6% và nữ chiếm 36,4%. Độ tuổi trung bình là 32.4 ± 15.7 tuổi (17 - 57 tuổi). Can thiệp bên phải 5 NB và bên trái là 6 NB. Thời gian mổ trung bình: 95.42 ± 21.67 phút (55 - 130). Tiêm tĩnh mạch Lasix 1ống 20mg, thời gian chờ đợi tác dụng của lasix trung bình là 15phút (8 - 30 phút). Lượng máu mất trong mổ trung bình: 33.15 ml (10 - 90). Thời gian nằm viện trung bình: 3.8 ± 1.3 ngày (3 - 6). Có 10 trường hợp phát hiện hẹp khúc nối do nguyên nhân nội tại bên trong tại vị trí nối bể thận niệu quản cần phải cắt nối và tạo hình kèm theo đặt JJ, có 1 trường hợp do mạch máu nhỏ bất thường chèn ép sau khi cắt mạch bất thường không phải cắt nối NQ tạo hình. Giải phẫu bệnh (GPB) đoạn hẹp sau mổ ở 10 người bệnh cắt nối: 100% có viêm xơ hẹp đoạn khúc nối. Kết luận: Test Lasix là cần thiết trong một số trường hợp nhất định, giúp cho phẫu thuật viên đánh giá chính xác vị trí hẹp, xác định nguyên nhân gây hẹp từ đó có thái độ xử trí phù hợp. Abstract Introduction: Retroperitoneal laparoscopic repair of ureteropelvic junction obstruction (UPJO) has been widely applied all over the world. However, role of Lasix test in detecting precisely position and cause of the stenosis not mentioned yet. Objective: Our study aims to assess the role of Lasix test while performing retroperitoneal laparoscopic surgery for UPJO at Urology Surgery Department of Viet Duc University Hospital. Material and Methods: Descriptive study on 11 patients that were operated to repair UPJO by retroperitoneal laparoscopic approach from January 2016 to August 2017, in which Lasix test was required during operation. Results: Our group has 11 patients including 7 men that account for 63,6% and 4 women that account for 36,4%. The average age was 32.4 ± 15.7 years old (17-57). 5 patients had UPJO in the right and 6 patients in the left. Average operating time was 95.42 ± 21.67 minutes (55-130). Injection of 20mg Lasix was done during the operation with the average waiting time of 15 minutes (8-30). Mean blood loss during surgery was 33.15 ml (10-90). Average length of hospital stay was 3.8 ± 1.3 days (3-6). In 10 cases, UPJO were caused by intrinsic factors requiring pyeloplasty with JJ drainage. In 1 case, UPJO was due to an abnormal small blood vessel requiring ablation without pyeloplasty. Postoperative pathology in 10 patients with pyeloplasty showed 100% of fibrotic stenosis. Conclusion: Lasix test is necessary in certain cases, allows surgeon to accurately evaluate position of the stenosis, to identify the cause and thus, to have the appropriate decision of what to do. Keyword: Ureteropelvic Junction Obstruction, Retroperitoneal laparoscopic surgery, Lasix test

Laparoscopic Hysterectomy: Revisited

2014 ◽  
Vol 6 (1) ◽  
pp. 1-4
Author(s):  
Poonam Yadav
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
South Asian ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Adnexal Masses ◽  
Abdominal Route

ABSTRACT Laparoscopic hysterectomy is an alternative to abdominal hysterectomy. Different techniques are described and illustrated. Most laparotomies for hysterectomies can be avoided by using the laparoscopic approach including cases of adhesions, adnexal masses and endometriosis. According to the expertise of the surgeon the time to perform the laparoscopic surgery can be reduced. There are many advantages of laparoscopic hysterectomy for the patient including the length of hospital stay and convalescence. Most hysterectomies currently requiring an abdominal route may be performed with laparoscopic dissection in part followed by removal of uterus vaginally. How to cite this article Garg R, Singh R, Yadav P, Malhotra N. Laparoscopic Hysterectomy: Revisited. J South Asian Feder Obst Gynae 2014;6(1):1-4.

scholarly journals LAPAROSCOPY REPRESENTS THE GOLD STANDARD FOR ACUTE CHOLECYSTITIS EVEN IN ELDERLY PATIENTS

2015 ◽  
Vol 2 (2) ◽  
pp. 59-62
Author(s):  
I. Negoi ◽  
I. Tănase ◽  
B. Stoica ◽  
S. Păun ◽  
S. Hostiuc ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Open Cholecystectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Morbidity Rate ◽  
Open Approach

Nowadays the laparoscopic approach represents the gold standard for acute cholecystitis, but we are facing little evidence regarding the elderly patients. The purpose of this study is to define the benefits in terms of early outcome for laparoscopic cholecystectomy in patients over 70 years old and to compare them with the open cholecystectomy through a retrospective study of patients that underwent a cholecystectomy during 12 months in the Emergency Hospital of Bucharest, Romania. Out of 49 patients, 20 had a laparoscopic cholecystectomy (LC) and 29 an open approach (OC). The mean age was 74,6 ± 4,2 (LC) vs. 77,2 ± 5,4 (OC) (P>0.05). There were 7 (33,3%) (LC) vs. 2 (7,1%) (OC) catarrhal cholecystitis, 13 (62%) (LC) vs. 9 (32,1%) (OC) phlegmonous cholecystitis, and 1 (4,8%) (LC) vs. 17 (60,7%) (OC) gangrenous cholecystitis (P=0.001, Cramer’s V=0,590). The median operative time was 90 (LC) vs. 60 (OC) minutes (P=0.001). There were no differences regarding the ASA risk scale (P=0,253). The median number of days to resume the diet was 3 (LC) vs. 4 (OC) (P=0.009). The median length of hospital stay was 72 hours (LC) vs. 120 hours (OC) (P=0.011). One patient died in the OC group and none in the LC group.To conclude, the laparoscopic approach in acute cholecystitis of elderly patients is safe. It is followed by a lower morbidity rate, a shorter length of hospital stay and by a more rapid return to normal activities.

scholarly journals A Comparative Study on the Bilateral Areolar Endoscopic Approach Versus the Conventional Open Approach for Thyroidectomy

2021 ◽  
Author(s):  
xiao ma ◽  
Qi-Jun Xia ◽  
Yun-Tao Song ◽  
Tian-Xiao Wang
Keyword(s):  
Blood Loss ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Endoscopic Approach ◽  
Open Approach ◽  
Advantages And Disadvantages ◽  
Removal Time ◽  
Conventional Open Approach

Abstract Background: To compare the safety, advantages and disadvantages of thyroidectomy for differentiated thyroid carcinoma (DTC) via the bilateral areolar endoscopic approach (BAA) and the conventional open approach (COA).Methods: Eighty-six female patients who underwent thyroidectomy were enrolled and divided into two groups, 42 in the BAA group and 44 in the COA group, according to aesthetic requirements. The operating time, blood loss during surgery, number of dissected lymph nodes, length of hospital stay, drainage removal time and surgical complications between the two surgical approaches were compared. The pain score and cosmetic results of operative incisions were evaluated with the visual analog scale (VAS).Results: Patients in the BAA group had significantly less intraoperative blood loss and a significantly shorter scar length (P < 0.001) than those in the COA group. However, the operation time of 97.6 minutes in the BAA group was significantly longer than that in the COA group (76.4 minutes; P < 0.001). Comparison of the number of central lymph nodes (CLNs) dissected, drainage removal time and length of hospital stay revealed no significant differences (P>0.05). Patients in the BAA group experienced significantly less pain than those in the COA group (P<0.001). Similarly, patients were significantly more satisfied with the cosmetic outcomes resulting from the BAA than from the COA (P <0.001).Conclusions: These results show that BAA thyroidectomy exhibits superior advantages in clinical outcomes, such as causing less pain and achieving better cosmetic satisfaction, compared with COA thyroidectomy. Therefore, BAA thyroidectomy is a safe and ideal surgical method for DTC.

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