scholarly journals Are there any advantages of 3D laparoscopic technologies in surgery for rectocele and rectal prolapse?

2021 ◽  
Vol 20 (4) ◽  
pp. 56-69
Author(s):  
A. G. Khitaryan ◽  
A. A. Golovina ◽  
S. A. Kovalev ◽  
N. A. Romodan ◽  
A. Z. Alibekov ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rectal Prolapse ◽  
Fluid Collection ◽  
Operation Time ◽  
Main Group ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Laparoscopic Ventral Mesh Rectopexy ◽  
Ventral Mesh Rectopexy ◽  
Mesh Rectopexy

AIM: to assess results of 3D laparoscopic ventral mesh rectopexy versus traditional 2D laparoscopy for rectocele and rectal prolapse.PATIENTS AND METHODS: a prospective randomized study (NCT 04817150) included patients aged 18 to 70 years who underwent laparoscopic ventral mesh rectopexy for rectocele and/or rectal prolapse. The assessment included operation time, intraoperative blood loss, complications rate and their severity by Clavien-Dindo scale, the pain intensity by VAS, the volume of the fluid collection in the implant site 2–3 days and 2–3 weeks after the procedure. The surgeon’s comfort and ergonomics when using 3D systems was evaluated using POMS questionnaire. The late results were assessed by recurrence rate, functional results — by Cleveland Clinic Constipation scale score, Incontinence scale score, P-Qol, and PGII.RESULTS: the study included 29 patients of the main and 32 patients of the control group. The follow-up was 21 ± 20.3 months. One complication developed in the control group (p = 1.0). The operation time in the main group was 74.1 ± 14 minutes (87.1 ± 24.3 minutes in controls, p = 0.01). The intraoperative blood loss was 19.8 ± 9.6 ml in the main group (55 ± 39.2 ml in controls, p = 0.001). The pain intensity was significantly lower in the main group (18.0 vs 22.5 points, p = 0.03). The volume of fluid collection 2–3 after surgery mesh site was 21.2 ± 9.7 cm3 in the main group (30.7 ± 25.6 cm3 in the control group, p = 0.02). The POMS scale assessment for a surgeon in the main group was 56.4 ± 33.5 points (87.3 ± 30.8 points in the control group). A follow-up examination 12 months postop revealed no recurrence in both groups (p = 1.0). The main and the control group showed no significant differences in functional outcomes.CONCLUSIONS: the use of 3D laparoscopic ventral mesh rectopexy for rectocele and rectal prolapse is comparable in late results with traditional laparoscopic procedure. However, it takes less operation time, lower pain intensity, less intraoperative blood loss, smaller fluid collection at mesh site, better comfort and ergonomics for surgeon.

Laparoscopic ventral mesh rectopexy in male patients with internal or external rectal prolapse

2014 ◽  
Vol 16 (12) ◽  
pp. 995-1000 ◽  
Author(s):  
A. E. Owais ◽  
H. Sumrien ◽  
K. Mabey ◽  
K. McCarthy ◽  
G. L. Greenslade ◽  
...  
Keyword(s):  
Rectal Prolapse ◽  
Laparoscopic Ventral Mesh Rectopexy ◽  
Male Patients ◽  
External Rectal Prolapse ◽  
Ventral Mesh Rectopexy ◽  
Mesh Rectopexy

Outcome of laparoscopic ventral mesh rectopexy for external rectal prolapse

2014 ◽  
Vol 16 (11) ◽  
pp. 914-919 ◽  
Author(s):  
J. Randall ◽  
E. Smyth ◽  
K. McCarthy ◽  
A. R. Dixon
Keyword(s):  
Rectal Prolapse ◽  
Laparoscopic Ventral Mesh Rectopexy ◽  
External Rectal Prolapse ◽  
Ventral Mesh Rectopexy ◽  
Mesh Rectopexy

scholarly journals Study on the Effect of Removing the Slide Wire Screw on Locking Plate by Nail Groove Reconstruction Method

2021 ◽  
Author(s):  
Guanglei Zheng ◽  
Yingjie Qi
Keyword(s):  
Blood Loss ◽  
Locking Plate ◽  
Operation Time ◽  
Healing Time ◽  
Control Group ◽  
Reconstruction Method ◽  
Intraoperative Blood Loss ◽  
Limb Function ◽  
Experimental Group ◽  
Tungsten Steel

Abstract Background: This paper is to describe and evaluate the nail groove reconstruction method in removing slide wire screw on locking plate. Then compare the method with tungsten steel drilling nail method, to explore a new method of removing slide wire screw on locking plate.Method: A total of 1254 patients with removal fracture internal fixation devices were collected from the Affiliated Hospital of Hangzhou Normal University from July 2015 to September 2021, of which 62 cases met the inclusion and exclusion criteria. All patients were randomly divided into the experimental group and the control group. 31 people per group. There were 19 males and 12 females in the experimental group, the age of patients was 35.68±11.70years; while 18 males and 13 females in the control group, the age of patients was 36.27±10.37years. Nail groove reconstruction method was used in the experimental group, and the tungsten steel drilling nail method was used in the control group. Collect and count surgical-related indicators, the data of two groups were compared and analyzed from four aspects: intraoperative blood loss, operation time, incision healing time and limb function recovery time.Result: All slide wire screws were removed successfully, and all patients had no serious postoperative complications such as internal fixation retention and neurovascular injury. The experimental group was better than the control group in the following three aspects: the amount of intraoperative blood loss, the operative time, the recovery time of limb function, and the differences were statistically significant(p < 0.05). There was no significant difference in incision healing time between the two groups.Conclusion: The nail groove reconstruction method has less damage to the bone and soft tissue, less intraoperative blood loss, shorter operation time, and faster postoperative recovery of limb function. The nail groove reconstruction method is a simple and effective method, it has obvious advantages compared with the traditional method.

Uterine fibroids, laparoscopic surgery and morcellation: comparative analysis of the results of organ-preserving operations

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 73-77
Author(s):  
Alexander A. Seregin ◽  
Anastasiia B. Nadezhdenskaia ◽  
Anna S. Makarova ◽  
Polina L. Sheshko ◽  
Anna V. Tregubova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Blood Loss ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Operation Time ◽  
Main Group ◽  
Laparoscopic Myomectomy ◽  
Control Group ◽  
Tumor Spread ◽  
Plastic Containers

Aim. To conduct a comparative analysis of the results of organ-preserving laparoscopic operations performed for uterine fibroids with the use of plastic containers for morcellation and without it. Materials and methods. We examined 57 patients with a diagnosis of uterine fibroids who were admitted to the Department of Innovative Oncology and Gynecology of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology for organ-preserving surgical treatment. To achieve the goal of the study, the patients were divided into the following groups: the main group 29 patients who underwent laparoscopic myomectomy and morcellation of removed nodes using plastic containers. The control group consisted of 28 patients who underwent morcellation during laparoscopic myomectomy without the use of plastic containers. Results. The duration of laparoscopic operations performed using plastic containers main group was 85.6925.87 minutes. Laparoscopic conservative myomectomies, performed without the use of limiting systems, took a slightly longer amount of time control group 88.7530.36 minutes. There were no statistically significant differences, but in the second group, more prolonged sanitation of the abdominal cavity and removal of small fragments of myomatous nodes after morcellation outside the sacs were required. Autoinfusion was used in 6 (20.69%) patients in the main group, in 7 (25%) patients in the control group. Blood transfusion was not used in any case. Average blood loss was 120.6967.50 ml in the main group, 125.0099.54 ml in the control. The duration of hospitalization in the main group was 4.661.76 days, in the control group 5.793.62 days. In the main group, histological examination revealed leiomyoma in all cases, leiomyoma was detected in 96.4% (27 patients) of cases in the control group, and leiomyosarcoma in 1 patient (3.6%). Conclusion. In all groups of patients, there was a favorable course of the postoperative period, early activation of patients. In the group of laparoscopic operations, one patient (3.6%) after morcellation of the myomatous node without the use of a plastic container was found to have leiomyosarcoma. The use of plastic containers in our study did not increase the duration of operations and did not affect the volume of blood loss, the frequency of intra- and postoperative complications. In contrast, the operation time was slightly higher among patients who were operated without the use of containers. In all likelihood, this was due to the fact that the morcellation stage itself took longer, since it was required to extract small fragments of myomatous nodes, as well as thorough and prolonged sanitation of the abdominal cavity. It should be noted that the use of plastic containers, of course, requires the development of certain skills from the surgeon, taking less and less time in parallel with the learning curve. Of course, further studies are required to assess the risk of tumor spread in patients undergoing surgery using plastic containers, but preliminary data indicate that ablastic morcellation can and should be used in organ-preserving surgery for uterine myoma.

Sign in / Sign up

Export Citation Format

Share Document