scholarly journals A Consensus Meeting on Expert Recommendations on Operating Specifications for Laparoscopic Radical Resection of Hilar Cholangiocarcinoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Yongfu Xiong ◽  
Li Jingdong ◽  
Tang Zhaohui ◽  
Joseph Lau
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Approach ◽  
Hilar Cholangiocarcinoma ◽  
Perioperative Management ◽  
Radical Resection ◽  
Consensus Meeting ◽  
Conversion To Open Surgery ◽  
Medical Centers ◽  
Principles Of Treatment ◽  
Laparoscopic Techniques

Background: With advances in techniques and technologies, laparoscopic radical resection of hilar cholangiocarcinoma (HCCA) has gradually been carried out in major medical centers in China. Its feasibility and safety have been accepted by a group of Chinese surgical experts.Methods: To standardize perioperative management of HCCA by using laparoscopic resectional approach, to ensure safety of the patient with standardized management, improve prognosis of the patient, and enable proper application and refinement of this surgical approach, the expert group on specifications for laparoscopic radical resection of HCCA in China organized a consensus meeting.Results: Laparoscopic radical resection of HCCA is difficult and associated with high risks. Appropriate patients should be carefully selected and this surgical approach should be promoted gradually. The experts met and arrived at 16 recommendations on perioperative management of HCCA by using laparoscopic surgery. There were three recommendations on preoperative diagnosis and evaluation; one recommendation on surgical principles of treatment; one recommendation on indications and contraindications; one recommendation on credentialing, staffing, and equipment; nine recommendations on laparoscopic techniques in different stages of operation; and one recommendation on indications for conversion to open surgery.Conclusion: Laparoscopic surgery for HCCA is still in the early phase of development. This consensus provides a clinical reference with the aim to promote and to facilitate its further development.

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

Short- and Long-Term Outcomes of Robotic Surgery for Rectal Neuroendocrine Tumor

2021 ◽  
pp. 155335062110304
Author(s):  
Kentaro Saito ◽  
Yusuke Yamaoka ◽  
Akio Shiomi ◽  
Hiroyasu Kagawa ◽  
Hitoshi Hino ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Neuroendocrine Tumor ◽  
Surgical Approach ◽  
Anal Verge ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Conversion To Open Surgery ◽  
Short And Long Term ◽  
Rectal Neuroendocrine Tumor

Background. The optimal radical surgical approach for rectal neuroendocrine tumor (NET) is unknown. Methods. This study evaluated the short- and long-term outcomes of 27 patients who underwent robotic radical surgery for rectal NET between 2011 and 2019. Results. The median distance from the lower border of the tumor to the anal verge was 5.0 cm. The median tumor size was 9.5 mm. Six patients (22%) had lymph node metastasis. The incidences of postoperative complications of grade II and grade III or more according to the Clavien–Dindo classification were 11% and 0%, respectively. All patients underwent sphincter-preserving surgery, and no patients required conversion to open surgery. The median follow-up time was 48.9 months, and both the 3-year overall survival and relapse-free survival rates were 100%. Conclusions. Short- and long-term outcomes of robotic surgery for rectal NET tumor were favorable. Robotic surgery may be a useful surgical approach for rectal NET.

Feasibility of laparoscopic techniques as the surgical approach of choice for primary colorectal cancer

2008 ◽  
Vol 22 (12) ◽  
pp. 2588-2595 ◽  
Author(s):  
Seok-Byung Lim ◽  
Hyo Seong Choi ◽  
Seung-Yong Jeong ◽  
Jae-Gahb Park
Keyword(s):  
Colorectal Cancer ◽  
Surgical Approach ◽  
Primary Colorectal Cancer ◽  
Laparoscopic Techniques

Urologic laparoscopic surgery: Light and shade

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 80-84
Author(s):  
G. Breda ◽  
P. Silvestre ◽  
L. Gherardi ◽  
A. Giunta ◽  
A. Tamai ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Surgical Approach ◽  
World Wide ◽  
Critical Evaluation ◽  
Minimally Invasive Technique ◽  
Laparoscopic Technique ◽  
Invasive Technique

— Analysing material and world-wide urologic laparoscopie surgery experience, the Authors try to define, also according to their experience, the indications for which the laparoscopic technique is established and well accepted and, on the contrary, those which are still controversial. Critical evaluation about laparoscopic surgery indications are often supported by the costs of the “minimally invasive” technique compared to the traditional surgical approach.

Perioperative management of laparoscopic surgery in a patient with protein S deficiency complications: A case report

2018 ◽  
Vol 12 (3) ◽  
pp. 311-314 ◽  
Author(s):  
Jo Tashiro ◽  
Manato Fujii ◽  
Yasuo Watanabe ◽  
Yuki Ichinose ◽  
Masayoshi Kudo ◽  
...  
Keyword(s):  
Case Report ◽  
Laparoscopic Surgery ◽  
Perioperative Management ◽  
Protein S ◽  
Protein S Deficiency ◽  
S Deficiency

scholarly journals Short- and long-term outcomes after colonic self-expandable metal stent placement for malignant large-bowel obstruction as a bridge to surgery focus on the feasibility of the laparoscopic approach: a retrospective, single center study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jesse Yu Tajima ◽  
Nobuhisa Matsuhashi ◽  
Takao Takahashi ◽  
Chika Mizutani ◽  
Yoshinori Iwata ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Approach ◽  
Stent Placement ◽  
Large Bowel Obstruction ◽  
Long Term Results ◽  
Bridge To Surgery ◽  
Metal Stent ◽  
Sems Placement ◽  
Short And Long Term

Abstract Purpose Malignant large-bowel obstruction (MLBO) is a highly urgent condition in colorectal cancer with high complication rates. Self-expandable metal stent (SEMS) placement in MLBO is a new decompression treatment in Japan. Preoperative stent placement (bridge to surgery: BTS) avoids emergency surgery, but oncological influences of stent placement and post-BTS surgical approach remain unclear. We examined short- and long-term results of surgery for MLBO after SEMS placement in our hospital. Methods We retrospectively reviewed 75 patients with MLBO who underwent resection after SEMS placement at our hospital from June 2013 to December 2018. Postoperative morbidity and mortality were evaluated by comparison with the surgical approach. Results Tumor location was significantly higher in the left-side colon and rectum (n = 59, 78.7%) than right-side colon (n = 16, 21.3%). Technical and clinical success rates for SEMS placement were 97.3% and 96.0%, respectively. Laparoscopic surgery was performed in 54 patients (69.0%), and one-stage anastomosis was performed in 73 (97.3%). Postoperative complications were similar in the open surgery (open) group (n = 5, 23.8%) and laparoscopic surgery (lap) group (n = 7, 13.0%), with no severe complications requiring reoperation. Three-year overall survival (OS) and relapse-free survival (RFS) rates were not significantly different in the lap vs open group (67.5% vs 66.4%; 82.2% vs 62.5%). Conclusion Preoperative stent treatment avoids stoma construction but allows anastomosis. One-time surgery was performed safely contributing to minimally invasive treatment and acceptable short- and long-term results.

Incisional Hernia Risk after Hand-Assisted Laparoscopic Surgery

2012 ◽  
Vol 78 (8) ◽  
pp. 864-869 ◽  
Author(s):  
William S. Cobb ◽  
Alfredo M. Carbonell ◽  
Garrett M. Snipes ◽  
Brianna Knott ◽  
Viet Le ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Incisional Hernia ◽  
Operative Time ◽  
Group Versus ◽  
True Incidence ◽  
Hernia Formation ◽  
The Mean ◽  
Laparoscopic Techniques ◽  
Mean Time

Hand-assisted laparoscopic surgery (HALS) bridges traditional open surgery and pure laparoscopy. The HALS technique provides the necessary site for organ retrieval, reduces operative time, and realizes the postoperative benefits of laparoscopic techniques. Although the reported rates of incisional hernia should be theoretically low, we sought to determine our incidence of hernia after HALS procedures. A retrospective review of all HALS procedures was performed from July 2006 to June 2011. All patients who developed postoperative incisional hernias at the hand port site were confirmed by imaging or examination findings. Patient factors were reviewed to determine any predictors of hernia formation. Over the 5 years, 405 patients undergoing HALS procedures were evaluated: colectomy (264), nephrectomy (107), splenectomy/pancreatectomy (18), and ostomy reversal (10). The overall incidence of incisional hernia was 10.6 per cent. There were three perioperative wound dehiscences. The mean body mass index was significantly higher in the hernia group versus the no hernia cohort (32.1 vs 29.2 kg/m2; P = 0.001). The hernia group also had a higher incidence of renal disease (18.6 vs 7.2%; P = 0.018). Mean time to hernia formation was 11.4 months (range, 1 to 57 months). Follow-up was greater than 12 months in 188 (46%) of patients, in which the rate of incisional hernia was 17 per cent. The rate of incisional hernia formation after hand-assisted laparoscopic procedures is higher than the reported literature. Because the mean time to hernia development is approximately 1 year, it is important to follow these patients to this end point to determine the true incidence of incisional hernia after hand-assisted laparoscopy.

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