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.

Haemostatic devices in parotid surgery: a systematic review

2021 ◽  
pp. 1-7
Author(s):  
L Allen ◽  
C MacKay ◽  
M H Rigby ◽  
J Trites ◽  
S M Taylor
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Facial Nerve ◽  
Hospital Stay ◽  
Outcome Measures ◽  
Meta Analysis ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Operative Blood Loss ◽  
Parotid Surgery

Abstract Objective The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. Method A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. Results A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. Conclusion Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

scholarly journals Mini-open thoracoscopic-assisted spinal thoracotomy for traumatic injuries: A technical note

2020 ◽  
Vol 11 ◽  
pp. 265
Author(s):  
Vikas Tandon ◽  
Abhinandan Reddy Mallepally ◽  
Ashok Reddy Peddaballe ◽  
Nandan Marathe ◽  
Harvinder Singh Chhabra
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Neurological Status ◽  
Technical Note ◽  
Single Level ◽  
Estimated Blood Loss ◽  
Multiple Variables ◽  
Mini Open

Background: Mini-open thoracoscopic-assisted thoracotomy (MOTA) has been introduced to mitigate disadvantages of conventional open anterior or conventional posterior only thoracoscopic procedures. Here, we evaluated the results of utilizing the MOTA technique to perform anterior decompression/fusion for 22 traumatic thoracic fractures. Methods: There were 22 patients with unstable thoracic burst fractures (TBF) who underwent surgery utilizing the MOTA thoracotomy technique. Multiple variables were studied including; the neurological status of the patient preoperatively/postoperatively, the level and type of fracture, associated injuries, operative time, estimated blood loss, chest tube drainage (intercostal drainage), length of hospital stay (LOS), and complication rate. Results: In 22 patients (averaging 35.5 years of age), T9 and T12 vertebral fractures were most frequently encountered. There were 20 patients who had single level and 2 patients who had two-level fractures warranting corpectomies. Average operating time and blood loss for single-level corpectomy were 91.5 ± 14.5 min and 311 ml and 150 ± 18.6 min and 550 ml for two levels, respectively. Mean hospital stay was 5 days. About 95.45% of cases showed fusion at latest follow-up. Average preoperative kyphotic angle corrected from 34.2 ± 3.5° to 20.5 ± 1.0° postoperatively with an average correction of 41.1% and correction loss of 2.4%. Conclusion: We concluded that utilization of the MOTA technique was safe and effective for providing decompression/fusion of traumatic TBF.

scholarly journals Laparoscopic nephrectomy: Moroccan experience of 68 cases

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abdoulazizi Bilgo ◽  
Amine Saouli ◽  
Tarik Karmouni ◽  
Khalid El Khader ◽  
Abdellatif Koutani ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Upper Urinary Tract ◽  
Laparoscopic Nephrectomy ◽  
Reliable Technique ◽  
Average Hospital ◽  
Estimated Blood Loss

Abstract Background The aim of this study was to analyze the feasibility and the safety of laparoscopic nephrectomy in the treatment of pathologies of the upper urinary tract through the experience of the Urology B department. Methods We have retrospectively and monocentrally selected patients who underwent laparoscopic nephrectomy from January 2017 to December 2019. The collection was carried out on archived files, based on demographic, clinical and perioperative data. The primary endpoint was the occurrence of complications and secondarily the length of the operation and the length of hospital stay. The statistical analysis was carried out using the SPSS software. Results A total of 68 patients were included in our series. The average age of our patients was 57.8 years. There was a slight female predominance: 39 female patients (57.4%) for 29 male patients (42.6%). Indications for nephrectomy were dominated by renal tumor (33.82%) followed by lithiasis (16.17%) and non-functioning kidney (16.17%) at the same rank. During the study period, 31 (45.6%) simple nephrectomy, 26 (38.2%) total nephrectomy, 1 (1.5%) partial nephrectomy and 10 (14.7%) nephroureterectomy were performed in our department. In our series, the average operating time was 180 min. Estimated blood loss averaged 321.8 ml with extremes of a few milliliter to 1100 ml. Intraoperative complications were reported in 10 (14.7%) patients; conversion was necessary in 6 cases (8.82%). The postoperative follow-up was straightforward in 53 (77.94%) patients with an average hospital stay of 3.6 days. The rate of postoperative complications according to Clavien–Dindo was 22.1%. Histological examination of the nephrectomies carried out in our department revealed mainly chronic non-specific pyelonephritis in 24 (35.3%) patients, followed by renal cell carcinoma in 23 (33.82%) patients and urothelial carcinoma in 9 (13.2%) patients. Conclusion Laparoscopic nephrectomy appears to be an efficient and reliable technique. This technique has led to a significant improvement in operative morbidity, mainly represented by the length of hospital stay, operating time and blood loss.

scholarly journals LARAPOSCOPIC LIVER RESECTION IN SURGERY FOR COLORECTAL CANCER METASTASES

2019 ◽  
Vol 18 (1) ◽  
pp. 58-65
Author(s):  
N. R. Torchua ◽  
A. A. Ponomarenko ◽  
E. G. Rybakov ◽  
S. I. Achkasov
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Liver Resection ◽  
Colorectal Liver Metastases ◽  
Postoperative Hospital Stay ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Liver Resections

BACKGROUND: nowadays laparoscopic liver resection (LapLR) in contrast to traditional open approach is more preferable because of reduction of intraoperative blood loss and postop morbidity, decrease of postop hospital stay. Unfortunately, the place of LapLR in surgery for colorectal liver metastases is still controversial because of small number of comparative studies. PATIENTS AND METHODS: between November 2017 and December 2018 fifty two patients with resectable colorectal liver metastases were included in our pilot study - 35 in the prospective group for laparoscopic liver resection and 17 patients in retrospective group of open-approach liver resections (selected group of historical control) (OLR). RESULTS: one patient was excluded from LapLR group because of absence of intraoperative evidence for metastatic disease (in spite of preop MRI). Two patients had lap-to-open conversion (in one case because of technical difficulties due to the location of the permanent ileostomy in the right mesogastric region; in the other case due to intraoperative bleeding). These patients were included into open group. Atypical liver resections were the most often procedures in both groups - 79% (23/32) and 76% (13/19), p=0.3 (LapLR and OLR, respectively). Duration of the procedure was shorter in the OLR group: 218+71 min vs. 237+101min in LapLR, p=0.6. The mediana for blood loss in LapLR was 100 ml (quartile 100; 200) vs. 320 ml (quartile 200;600) in OLR, p=0.0001. The rate of R0 resections was comparable in both groups (p=1.0). The patients of OLR group more often had >1 complication (16 vs. 13, p=0.01) and had higher frequency of bile fistulas, abscesses in the liver resection area and clostridial colitis. Postoperative hospital stay was shorter in the LapLR group: 11+3 vs. 14+5 days, p=0.008. CONCLUSION: laparoscopic liver resections for metastases of colorectal cancer were associated with less intraoperative blood loss, morbidity, and shorter postoperative hospital stay, with comparable rate of R0 resections.

scholarly journals Single-port laparoscopic hysterectomy: preliminary results

2015 ◽  
Vol 61 (5) ◽  
pp. 446-451 ◽  
Author(s):  
Renata Assef Tormena ◽  
Sérgio Conti Ribeiro ◽  
Gustavo Arantes Maciel ◽  
Edmund Chada Baracat
Keyword(s):  
Blood Loss ◽  
Single Port ◽  
Medical Center ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Uterine Disease ◽  
Access Methods ◽  
Port Access

Summary Objective: to describe the initial results of a laparoscopic single port access hysterectomy and also to evaluate the feasibility and safety of this access. Methods: a prospective study was performed at a tertiary university medical center (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo) between March 2013 and June 2014. A total of 20 women, referred for hysterectomy due to benign uterine disease, were included in the study after they had signed an informed consent. Outcome measures, including operating time, blood loss, rate of complications, febrile morbidity, visual analogical pain score and length of hospital stay were registered. Results: mean patient age and body mass index (BMI) were 47.8 years and 27.15 kg/m2, respectively. Mean operating time was 165.5 min. Blood loss was minimal, with no blood transfusion. All procedures but one were successfully performed via a single incision and no post-operative complications occurred. We experienced one conversion to multiport laparoscopic hysterectomy due to extensive pelvic adhesions. There was no conversion to “open” total abdominal hysterectomy. None of the patients required narcotics or NSAD post-operatively. Conclusion: single-port hysterectomy is a feasible and safe technique, with no major complications.

scholarly journals Management of Ovarian Dermoid Cysts by Laparoscopy Compared With Laparotomy

1996 ◽  
Vol 3 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Pang Liyi ◽  
Hiroshi Sasaki ◽  
Liu Chang Qing ◽  
Minoru Akiyama ◽  
Akihiko Watanabe ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Selection Criteria ◽  
Operating Time ◽  
Operative Laparoscopy ◽  
The Times ◽  
Selection Of Patients ◽  
Criteria For Selection ◽  
Selection Of

Thirty patients with ovarian dermoid cysts removed by laparoscopic surgery were compared with 42 patients with ovarian dermoid cysts removed by laparotomy, with respect to the selection criteria, surgical procedures, operating time, intraoperative and postoperative complications, blood loss, and hospital stay. Although the operating time for unilateral cystectomy, unilateral salpingo-oophorectomy, and bilateral cystectomy performed by laparoscopic surgery was longer (120.3 ± 43.7 min, mean ± SD) than those for the same procedures performed by laparotomy (73.9 ± 21.6 min, p < 0.01), we observed a learning curve with a remarkable declining tendency (linear regression model, p < 0.01). At the end of this study, the times taken for laparoscopic procedures were almost the same as those for laparotomy. Less blood loss (18.2 ± 1.7 ml versus 105.9 ± 84.3 ml, p < 0.01) and shorter hospital stay (5.9 ± 1.9 days versus 12.0 ± 2.9 days, p < 0.01) were also found to be advantages of laparoscopic surgery. This article discusses the technical procedures of laparoscopic surgery. The efficiency and safety of operative laparoscopy as an alternative access route for the management of ovarian dermoid cysts were recognized. We stress that strict criteria for selection of patients should always be followed and the necessity of retraining schedules for gynecologists and nursing staff in the speciality of laparoscopic surgery.

scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: systematic review and meta-analysis of comparative cohort studies

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zi-Yu Wang ◽  
Qing-Lian Chen ◽  
Ling-Ling Sun ◽  
Shu-Ping He ◽  
Xiao-Fen Luo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Blood Loss ◽  
Hospital Stay ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Operation Time ◽  
Cochrane Library ◽  
Random Effects Models

Abstract Background The application of laparoscopic liver resection (LLR) has expanded rapidly in recent decades. Although multiple authors have reported LLR shows improved safety and efficacy in treating hepatocellular carcinoma (HCC) compared with open liver resection (OLR), laparoscopic (LMLR) and open (OMLR) major liver resections for HCC treatment remain inadequately evaluated. This work aimed to test the hypothesis that LMLR is safer and more effective than OMLR for HCC. Methods Comparative cohort and registry studies on LMLR and OMLR, searched in PubMed, the Science Citation Index, EMBASE, and the Cochrane Library, and published before March 31, 2018, were collected systematically and meta-analyzed. Fixed- and random-effects models were employed for generating pooled estimates. Heterogeneity was assessed by the Q-statistic. Results Nine studies (1173 patients) were included. Although the pooled data showed operation time was markedly increased for LMLR in comparison with OMLR (weighted mean difference [WMD] 74.1, 95% CI 35.1 to 113.1, P = 0.0002), blood loss was reduced (WMD = − 107.4, 95% CI − 179.0 to − 35.7, P = 0.003), postoperative morbidity was lower (odds ratio [OR] 0.47, 95% CI 0.35 to 0.63, P <  0.0001), and hospital stay was shorter (WMD = − 3.27, 95% CI − 4.72 to − 1.81, P <  0.0001) in the LMLR group. Although 1-year disease-free survival (DFS) was increased in patients administered LMLR (OR = 1.55, 95% CI 1.04 to 2.31, P = 0.03), other 1-, 3-, and 5-year survival outcomes (overall survival [OS] and/or DFS) were comparable in both groups. Conclusions Compared with OMLR, LMLR has short-term clinical advantages, including reduced blood loss, lower postsurgical morbidity, and shorter hospital stay in HCC, despite its longer operative time. Long-term oncological outcomes were comparable in both groups.

scholarly journals Laparoscopic Liver Resection Should Be a Standard Procedure for Hepatocellular Carcinoma with Low or Intermediate Difficulty

2021 ◽  
Vol 11 (4) ◽  
pp. 266
Author(s):  
Ruoh-Yun Gau ◽  
Ming-Chin Yu ◽  
Hsin-I Tsai ◽  
Cheng-Han Lee ◽  
Tony Kuo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Hospital Stay ◽  
Laparoscopic Liver Resection ◽  
Standard Procedure ◽  
Disease Free Survival ◽  
Postoperative Recovery ◽  
Oncologic Outcomes ◽  
Chang Gung Memorial Hospital ◽  
Lower Complication

Background: To investigate the feasibility of laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC), we compared the outcome between LLR and conventional open liver resection (OLR) in patient groups with different IWATE criteria difficulty scores (DS). Methods: We retrospectively reviewed 607 primary HCC patients (LLR: 81, OLR: 526) who underwent liver resection in Linkou Chang Gung Memorial hospital from 2012 to 2019. By using 1:1 propensity score-matched (PSM) analysis, their baseline characteristics and the DS stratified by the IWATE criteria were matched between the LLR and OLR. Their perioperative and oncologic outcomes were compared. Results: After 1:1 PSM, 146 patients (73 in LLR, 73 in OLR) were analyzed. Among them, 13, 41, 13 and 6 patients were classified as low, intermediate, advanced and expert DS group, respectively. Compared to OLR, the LLR had shorter hospital stay (9.4 vs. 11.5 days, p = 0.071), less occurrence of surgical complications (16.4% vs. 30.1%, p = 0.049), lower rate of hepatic inflow control (42.5% vs. 65.8%, p = 0.005), and longer time of inflow control (70 vs. 51 min, p = 0.022). The disease-free survival (DFS) and overall survivals were comparable between the two groups. While stratified by the DS groups, the LLR tended to have lower complication rate and shorter hospital stay than OLR. The DFS of LLR in the intermediate DS group was superior to that of the OLR (p = 0.020). In the advanced and expert DS groups, there were no significant differences regarding outcomes between the two groups. Conclusion: We have demonstrated that with sufficient experience and technique, LLR for HCC is feasible and the perioperative outcome is favorable. Based on the current study, we suggest LLR should be a standard procedure for HCC with low or intermediate difficulty. It can provide satisfactory postoperative recovery and comparable oncological outcomes. Further larger scale prospective studies are warranted to validate our findings.

scholarly journals Laparoskopska resekcija jeter zaradi zasevkov raka debelega črevesa in danke – rezultati zdravljenja

2017 ◽  
Vol 86 (3-4) ◽  
Author(s):  
Arpad Ivanecz ◽  
Vid Pivec ◽  
Irena Plahuta ◽  
Bojan Krebs ◽  
Tomaž Jagrič ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Conversion Rate ◽  
Liver Tumors ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
Secondary Outcome ◽  
Estimated Blood Loss ◽  
The Mean

Background: In many referral centers, laparoscopic liver resection (LLR) is a well-established method for the management of colorectal liver metastases (CLM). The aim of this study is to review a single institution experience.Methods: Between April 2008 and September 2016, 58 patients underwent LLR for various benign and malignant liver tumors. The analysis included 12 patients operated on for CLM. The primary outcomes of this prospective non-randomized study included operative procedure and operating time (minutes), estimated blood loss (mL), conversion rate, R0 resections, resection margins (mm), length of hospital stay (days), post-operative morbidity, and mortality. The secondary outcome of the study was survival analysis.Results: Eight patients (67 %) had atypical LLR. The average operating time was 130 minutes (range 60–210 minutes). The mean estimated blood loss was 140 mL (range < 50–600 mL). In one patient LLR was converted to open procedure (conversion rate 8 %). Seven patients (58 %) had one liver metastasis. The mean metastasis size was 3.6 cm (range 1–9 cm). R0 resection was achieved in all cases. The mean resection margin was 6.8 mm (range 2–15 mm). Te mean length of hospital stay was 6 days (range 3–12 days). Morbidity and mortality rates were 0 %. The median follow-up for surviving patients was 13 months. Nine patients are alive with no evidence of disease, two patients are alive with disease and one patient died of disease.Conclusion: LLR is a feasible and safe method for the treatment of CLM and there is no compromise of oncological surgical principles.

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