Single-incision laparoscopic approach for linea alba hernia in children

Abstract Aim Complications of open mesh repair for primary umbilical and midline hernias (PUMH) may lead to significant re-admissions and follow-up costs. Although laparoscopic intraperitoneal onlay mesh repair reduces infection rates, especially in overweight patients, it’s controversial in these hernias, mainly due to potential adhesions’ formation. Laparoscopic transabdominal preperitoneal technique (lap-TAPP) may address these issues, as it combines advantages of both open and laparoscopic approaches. The aim of this study is to present the initial results of lap-TAPP for PUMH in regard to its feasibility and complication rates. Material and Methods We evaluated 25 consecutive cases of lap-TAPP repair for PUMH. Patients’s characteristics, intraoperative findings, and postoperative complications after 30-days follow-up were analyzed. Results 21 male and 4 female patients were included in analysis (mean BMI 29.8 kg/m2). Surgery time was 82 minutes (55-120). We found 20 umbilical and 11 epigastric linea alba hernias. Mesh size was 144cm2 (120-225); mean hernia defect width was 25mm (10-40). In 9 patients (36%) the peritoneal rents were created which were easily closed with sutures. All patients were discharged on 1 POD with no complications. After 30-days we found no recurrences or bulging, no pain complaints. We found one subcutaneous small hematoma with no need for intervention. Conclusions Laparoscopic TAPP for small and medium PUMH is a safe and feasible technique with low complication rate. However, this method is technically demanding and time consuming while performed with laparoscopic approach as it requires precise and subtle plane dissection, and non-ergonomic closure hernia defect.

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Normal laparoscopic anatomy of the caprine pelvic cavity

Veterinary Science Development ◽

10.4081/vsd.2015.6012 ◽

2015 ◽

Vol 5 (1) ◽

Author(s):

Mujeeb Ur Rehman Fazili ◽

Riaz Ahmad Shah ◽

Maajid Hassan Bhat ◽

Firdous Ahmad Khan ◽

Anubhav Khajuria ◽

...

Keyword(s):

Small Ruminants ◽

Laparoscopic Approach ◽

Invasive Procedure ◽

Disease Diagnosis ◽

Pelvic Cavity ◽

Trendelenburg Position ◽

Comprehensive Description ◽

Linea Alba ◽

Secondary Port ◽

Primary Port

Due to the several advantages over conventional procedures, the laparoscopic disease diagnosis and surgery has now started receiving attention in small ruminants. The normal laparoscopic anatomy needs to be described for comparison with the findings in animals with various diseases. The objective of the present study was therefore to describe the laparoscopic anatomy of the caprine pelvic cavity. Adult Bakerwal and Pashmina goats (n=25) of both the sexes were included in this laparoscopy study. All the animals were restrained in dorsal recumbency and Trendelenburg position under lumbosacral epidural anesthesia and sedation. After creating the pneumoperitoneum, the primary port for 5 mm laparoscope was placed at linea alba (3.0 cm cranial to mammary glands in does), and at right paramedian (3.0 cm cranial to the rudimentary teat in the bucks) site. Secondary port was placed under direct laparoscopic observation 5-6 cm away from the primary port in horizontal plane, to allow insertion of the grasping forceps. Scan was performed first at the primary port and subsequently through the secondary port for orientation and exploration of the pelvic cavity. The ventral laparoscopic approach provided satisfactory exposure of the pelvic cavity in goats. Comprehensive description of the pelvic organs could be obtained. However, dorsal aspect of the urinary bladder neck and accessory genital organs of male animals could not be visualized. Major complications were not encountered during or after laparoscopy. Laparoscopy a minimally invasive procedure has several advantages over alternate methods of understanding anatomy, physiology and pathology of most of the intraperitoneal pelvic structures in goats. The technique has high pedagogic value. The procedure is safe in experienced hands.

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Single incision laparoscopic approach for infected necrotizing pancreatitis: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.07.020 ◽

2020 ◽

Vol 73 ◽

pp. 157-160

Author(s):

N. den Dekker ◽

A.A.J. Grüter ◽

S.E. van Oostendorp ◽

B.M. Zonderhuis ◽

J.B. Tuynman

Keyword(s):

Case Report ◽

Single Incision ◽

Necrotizing Pancreatitis ◽

Laparoscopic Approach

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Single-Incision Transumbilical Laparoscopic Splenic Cyst Unroofing: First Reported Case

The American Surgeon ◽

10.1177/000313481007600519 ◽

2010 ◽

Vol 76 (5) ◽

pp. 509-511

Author(s):

Alan A. Saber ◽

Tarek H. El-Ghazaly

Keyword(s):

Laparoscopic Surgery ◽

Minimally Invasive ◽

Single Incision ◽

Single Point ◽

Laparoscopic Approach ◽

Splenic Cyst ◽

Single Incision Laparoscopic Surgery ◽

Invasive Approach ◽

Conventional Laparoscopic Surgery ◽

Point Of Entry

Single-incision laparoscopic surgery is an emerging minimally invasive approach. When using the single-incision laparoscopic surgery approach, the surgeon operates almost exclusively through a single point of entry, usually the patient's umbilicus. This approach is steadily gaining popularity among minimally invasive surgeons, as it combines the cosmetic advantage of Natural Orifice Translumenal Surgery with the technical familiarity of conventional laparoscopic surgery. In this report, we describe our implementation of the single-incision laparoscopic approach to perform an unroofing of a posttraumatic splenic cyst; in this case, the entire procedure is performed through a 2-cm intraumbilical incision.

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Systemic Inflammatory Response After Single-incision Laparoscopic Surgery Versus Standard Laparoscopic Approach

Surgical Laparoscopy Endoscopy & Percutaneous Techniques ◽

10.1097/sle.0b013e318242ea5c ◽

2012 ◽

Vol 22 (1) ◽

pp. 21-24 ◽

Cited By ~ 4

Author(s):

Petros Ypsilantis ◽

Vasilios Didilis ◽

Christina Tsigalou ◽

Michael Pitiakoudis ◽

Anastasios Karakatsanis ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Inflammatory Response ◽

Single Incision ◽

Laparoscopic Approach ◽

Systemic Inflammatory Response ◽

Single Incision Laparoscopic Surgery

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FIRST SINGLE-PORT LAPAROSCOPIC PANCREATECTOMY IN BRAZIL

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032013000400013 ◽

2013 ◽

Vol 50 (4) ◽

pp. 310-312 ◽

Cited By ~ 5

Author(s):

Marcel Autran Cesar MACHADO ◽

Rodrigo Cañada Trofo SURJAN ◽

Fábio Ferrari MAKDISSI

Keyword(s):

Distal Pancreatectomy ◽

Single Incision ◽

Single Port ◽

Laparoscopic Approach ◽

Surgical Trauma ◽

Spleen Preserving ◽

Novel Technique ◽

The Past ◽

Advanced Access ◽

Access Surgery

ContextPancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. In the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. In the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures.ObjectivesWe present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and Latin America.MethodsA 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used.ResultsOperative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4.ConclusionsSingle-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons.

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Single incision laparoscopic adjustable gastric band: technique, feasibility, safety and learning curve

Annals of The Royal College of Surgeons of England ◽

10.1308/003588413x13511609954978 ◽

2013 ◽

Vol 95 (2) ◽

pp. 131-133 ◽

Cited By ~ 4

Author(s):

AJ Osborne ◽

R Clancy ◽

GWB Clark ◽

C Wong

Keyword(s):

Learning Curve ◽

Single Incision ◽

Laparoscopic Approach ◽

Morbidly Obese ◽

Single Incision Laparoscopic Surgery ◽

Obese Patients ◽

Access Port ◽

Conventional Laparoscopic ◽

Laparoscopic Equipment ◽

Wide Range

Introduction Single incision laparoscopic surgery (SILS) is established in many procedures but not in bariatric surgery. One explanation may be that SILS is technically demanding in morbidly obese patients. This report describes our technique and experience with single incision laparoscopic adjustable gastric banding (SILAGB). Methods Prospective data collection was performed on consecutive obese patients who underwent SILAGB between November 2009 and February 2011. A single 3cm transverse incision in the right upper quadrant was used for a Covidien SILS™ multichannel access port. The technique is described with a standard pars flaccida approach and the ‘tips and tricks’ needed for a wide range of candidates using standard laparoscopic equipment. Results A total of 29 patients (27 female) with a median body mass index of 41kg/m 2 (range: 35–52kg/m 2 ) and median age of 44 years (range: 22–57 years) underwent SILAGB. There were no ‘conversions’ to a standard laparoscopic technique. Two cases required the addition of one single 5mm port. The only complications were two postoperative wound infections (one with a port site infection requiring replacement of the port) and one faulty band requiring replacement. There were therefore two returns to theatre and no 30-day deaths. All patients were discharged on the first postoperative day. In this series, operative times reduced significantly to be comparable with the conventional laparoscopic approach. Conclusions SILAGB is safe and feasible in the morbidly obese. Proficiency in this technique using conventional laparoscopic equipment can be achieved with a short learning curve.

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Single-incision versus conventional laparoscopic approach in colorectal cancer surgery

Annals of Oncology ◽

10.1093/annonc/mdx261.343 ◽

2017 ◽

Vol 28 ◽

pp. iii122-iii123

Author(s):

Elizabeth Baker ◽

Deborah Wilson ◽

Talvinder Gill ◽

Dharmendra Garg ◽

David Borowski

Keyword(s):

Colorectal Cancer ◽

Single Incision ◽

Laparoscopic Approach ◽

Cancer Surgery ◽

Colorectal Cancer Surgery ◽

Conventional Laparoscopic

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Single-Incision Laparoscopic Cholecystectomy: Is It a Plausible Alternative to the Traditional Four-Port Laparoscopic Approach?

Minimally Invasive Surgery ◽

10.1155/2012/347607 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Juan Pablo Arroyo ◽

Luis A. Martín-del-Campo ◽

Gonzalo Torres-Villalobos

Keyword(s):

World Wide ◽

Single Incision ◽

Current Knowledge ◽

Laparoscopic Approach ◽

Standard Of Care ◽

Current Standard ◽

New Techniques ◽

Single Incision Laparoscopic Cholecystectomy ◽

Laparoendoscopic Single Site Surgery ◽

Single Site Surgery

The current standard-of-care for treatment of cholecystectomy is the four port laparoscopic approach. The development of single incision/laparoendoscopic single site surgery (SILC/LESS) has now led to the development of new techniques for removal of the gallbladder. The use of SILC/LESS is now currently being evaluated as the next step in treatment of cholecystectomy. This review is an attempt to consolidate the current knowledge and analyze the feasibility of world-wide implementation of SILC/LESS.

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