scholarly journals Hysterectomy for Uterine Disease in 2010: From past to Future

2010 ◽  
Vol 4 ◽  
pp. CMRH.S2980
Author(s):  
Liselotte Mettler ◽  
Wael Sammur ◽  
Thoralf Schollmeyer
Keyword(s):  
Laparoscopic Surgery ◽  
Minimal Invasive ◽  
Reproductive Age ◽  
Uterine Disease ◽  
Submucous Myoma ◽  
First Choice ◽  
Uterine Adenomyosis ◽  
Steep Decline ◽  
The 19Th Century ◽  
Treatment Step

Hysterectomies were unknown in the field of obstetrics and gynaecology until the 19th century. In the 20th century they were perhaps too frequently performed whereas the 21st century has witnessed a steep decline in hysterectomy numbers. It is therefore an opportune time to review the indications for hysterectomies, hysterectomy techniques and the present and future status of this surgical procedure. There is a widespread consensus that hysterectomies are primarily to be performed in cancer cases and obstetrical chaos situations even though minimal invasive surgical technologies (MIS) have made the procedure more patient friendly than the classical abdominal opening. Today, minimally invasive hysterectomies are performed as frequently as vaginal hysterectomies and the vaginal approach is the first choice if the correct indications are given. It is no longer necessary to open the abdomen; this procedure has been replaced by laparoscopic surgery. Laparoscopic and robotic-assisted laparoscopic surgery can also be indicated for hysterectomies in selected patients with gynaecological cancers. For women of reproductive age, laparoscopic myomectomies and numerous other uterine- preserving techniques are applied in a first treatment step of meno-metrorrhagia, uterine adenomyosis and submucous myoma. These interventions are only followed by a hysterectomy if the pathology prevails.

scholarly journals Laparoscopic Treatment Experience In Morgagni Hernia Repair In Children

2019 ◽  
Author(s):  
Ali İhsan Anadolulu ◽  
Gonca Gerçel ◽  
Osman Hakan Kocaman
Keyword(s):  
Hernia Repair ◽  
Primary Repair ◽  
Late Complications ◽  
Minimal Invasive ◽  
Laparoscopic Treatment ◽  
Morgagni Hernia ◽  
Hernia Sac ◽  
Treatment Experience ◽  
First Choice

Abstract Background: We aimed to present our laparoscopic treatment experience in Morgagni hernia repair. Methods: The patients who underwent laparoscopic surgery with diagnosis of Morgagni hernia between 2016-2019 were evaluated retrospectively. Results: Their mean age at diagnosis was 4,1±2,6 years (1 year-13 years). All patients were male. The presenting complaints were respiratory tract infection in 3 patients and vomiting in 3. Two patients were diagnosed incidentally. Associated Down’s Syndrome was detected in 3 (38%) cases. The defect was left-sided in 7 (87.5%) patients and bilateral in 1 (12,5%). Omentum was herniated in 2 patients, colon and omentum were in 6 and colon, omentum and stomach were in one. All patients underwent primary repair extracorporeally by removing sutures from single incision, without removal of the hernia sac. There were no complications or recurrence in the mean 19,2±15,8 months (6-42 months) follow-up period Conclusion: Minimal invasive repair of MH is efficient and safe. It should be the first choice because of fast recovery and better cosmetic results. In this series, it was seen that leaving the hernia sac had no effect on early and late complications. Leaving the hernia sac may prevent potential complications due to unnecessary dissection.

scholarly journals Local Resection by Combined Laparoendoscopic Surgery for Duodenal Gastrointestinal Stromal Tumor

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Motohiko Kato ◽  
Kiyokazu Nakajima ◽  
Toshirou Nishida ◽  
Makoto Yamasaki ◽  
Tsutomu Nishida ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Hemorrhage ◽  
Minimal Invasive ◽  
Local Resection ◽  
Gi Tract ◽  
Duodenal Gist ◽  
Attractive Option ◽  
Laparoscopic Assistance ◽  
Duodenal Resection ◽  
Dissection Technique

Combined laparoendoscopic surgery is a novel surgical method which consists of both endoscopic surgery from inside the gastrointestinal tract and laparoscopic surgery from the outside. We report a case of duodenal GIST, in which combined laparoendoscopic local resection was attempted. The lesion was resected endoscopically using endoscopic submucosal dissection technique under laparoscopic assistance. Laparoscope was used for originating the orientation of the tumor, intra-operative EUS, and monitoring serosal injury from the peritoneal cavity. Postoperative hemorrhage occurred; however, precise orientation of the lesion helped us to manage the patient with minimal invasive reoperation. And thus, the bowel integrity was completely preserved, by avoiding segmental duodenal resection and pancreaticoduodenectomy. This novel, less invasive surgical procedure may become an attractive option for the lesions originating in the anatomically challenging portion of the GI tract for endoscopic or laparoscopic surgery alone.

Surgery for pediatric craniopharyngiomas: is less more?

2015 ◽  
Vol 28 (1-2) ◽  
Author(s):  
Jörg Flitsch ◽  
Jens Aberle ◽  
Till Burkhardt
Keyword(s):  
Surgical Complication ◽  
Imaging Techniques ◽  
Third Ventricle ◽  
Minimal Invasive ◽  
Interdisciplinary Treatment ◽  
Childhood And Adolescence ◽  
Complication Rates ◽  
First Choice ◽  
Surgical Methods

AbstractSurgery for craniopharyngiomas, especially in childhood and adolescence, has evolved from an era of aggressive strategies – with the primary goal of gross total removal and accepting an impaired functional outcome – to a more individually tailored therapy that avoids immediate treatment-related and long-term morbidity. Modern imaging techniques and a wider understanding of hypothalamic risk factors have led to surgical strategies adapted to the localization of these inhomogenously grown pathologies. Whereas purely infradiaphragmatic as well as supradiaphragmatic/infrachiasmatic tumors have a favorably surgical outcome with higher gross total resection rates in experienced hands, lesions within the third ventricle extending beyond the mammillary bodies remain a problem. The same is valid for lesions beyond 3 cm in diameter, more or less independent of their localization. Aside from the traditional microscopic approach via the subfrontal or pterional craniotomy, transsphenoidal approaches and other minimal invasive surgical methods, e.g., catheter implantation into cystic formations of the tumor have become popular. Radiotherapy, with its risks and limitations, can effectively be added to avoid recurrences. Nowadays, surgery as part of an interdisciplinary treatment strategy is still the typical first choice. However, taking the patient’s long-term prognosis into considertaion, the surgical complication rates have to be minimized.

scholarly journals A COMPARATIVE STUDY OF HAEMODYNAMIC AND RECOVERY CHARACTERISTICS OF DESFLURANE VERSUS SEVOFLURANE IN PATIENTS UNDER GOING LAPAROSCOPIC SURGERY

2019 ◽  
pp. 1-2
Author(s):  
Ankita Bhensdadia
Keyword(s):  
Laparoscopic Surgery ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Early Mobilization ◽  
Hemodynamic Instability ◽  
Minimal Invasive ◽  
Blood Gas ◽  
Hemodynamic Stability ◽  
Inhaled Anesthetics ◽  
Care Surgery

Laparoscopic surgeries are minimal invasive surgery very popular now a days as a day care surgery as it provide early mobilization, shorter hospital stay. The main drawback is intra-operative hemodynamic instability due to pneumoperitoneum. Therefore, anesthesiologist must choose anesthetic agent which provide hemodynamic stability and rapid recovery. Inhaled anesthetics with low blood: gas partition contributes to faster induction and emergence from anesthesia. Both Desurane and Sevourane have low blood: gas partition coefcient 0.42 and 0.65 respectively .We conducted the study to know which of these two agents contributes to faster recovery and hemodynamics. CONCLUSION- Desurane and Sevourane provide stable intraoperative hemodynamic, however early and intermediate recovery is signicantly faster in Desurane group than Sevourane grou

scholarly journals Hand-assisted laparoscopic surgery for left-sided colon and rectal cancer: 10 Years single centre experience

2016 ◽  
Vol 63 (1) ◽  
pp. 23-28
Author(s):  
Rokas Rackauskas ◽  
Audrius Dulskas ◽  
Vygintas Aliukonis ◽  
Narimantas Samalavicius
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Tertiary Care ◽  
Stage Iv ◽  
Operation Time ◽  
Minimal Invasive ◽  
Invasive Technique ◽  
Colon And Rectal Cancer

Introduction. Hand-assisted laparoscopic surgery (HALS) was introduced into clinical practice in the mid-1990s. Although this technique was established as a bridge to total laparoscopic colorectal surgery there are still those who oppose it. In this study we report our 10 year experience of practicing HALS. Methods. This study is a retrospective analysis of prospectively collected data of 426 patients undergoing hand-assisted laparoscopic colorectal surgery for left-sided colon and rectal cancer in a single tertiary care institution, the National Cancer Institute, from January, 2006, to July, 2016. All consenting patients with left sided colon and rectal cancer were included in the analysis. Results. Patient population showed a similar female and male ratio 212 (49.76%) vs. 214 (50.24%). Average age was 64.13 ? 9.92 years (from 26 to 91). Operation time was 108 minutes ? 44.1 min (30 - 320 min). The mean length of the postoperative hospital stay was 6.88, ranging from 2 to 34 days. The pathohistological examination revealed mean lymph node harvest was 16.4 ? 9.61, ranging from 0 to 54. Stage I and II cancer prevailed in the majority of cases, accounting for 129 (30.28%) for each, stage III - 135 (31.69%), and stage IV - 33 (7.74%). Complication rate was 7.27%. Surgical reintervention was required in 10 cases (2.35%). Mortality rate occurred only in two (0.47%) patients. Conclusion. In conclusion, the HALS technique combines the benefits of a minimal invasive technique for the patient and palpatory benefits for the surgeon, which makes surgery for left-sided colon and rectum cancer faster, and with a similar outcome to laparoscopic colectomy.

scholarly journals A Comparative Study of Low Versus Standard Intraperitoneal Pressures in Gynaecological Laparoscopic Surgery

2021 ◽  
pp. 179-185
Author(s):  
Anup R. Patil ◽  
Deepika Dewani ◽  
Kalyani Mahajan ◽  
Neema Acharya ◽  
Arpita Jaiswal ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Abdominal Cavity ◽  
Laparoscopic Hysterectomy ◽  
Low Pressure ◽  
Minimal Invasive ◽  
Intraabdominal Pressure ◽  
Intraperitoneal Pressure ◽  
Organ Systems ◽  
Patient Will ◽  
Standard Pressure

Background: Minimal access surgery in contrast to open surgery has quicker recovery during the postoperative period as well as reduced scores of pain. As a result of increased pressure in the abdominal cavity, laparoscopic surgery  has many implications over a range of organ systems as well as their functioning. Laparoscopic surgery due to increased intraabdominal pressure also has many implications on various organ systems and their functioning. To overcome the consequences of increased intrabdominal pressure, a number of trials have been formulated to compare low- versus standard-pressure pneumoperitoneum. Aim: The aim of this study was to assess the effectivity of low intraperitoneal pressures v/s  standard intraperitoneal pressure during laparoscopic hysterectomies. Study Design: Experimental study  Materials and Methods: 40 cases with uncomplicated symptomatic benign uterine pathologies who were posted for laparoscopic hysterectomy were selected out of which 20-20 cases were randomized into low and standard pneumoperitoneum groups.  Results: In patients in whom low pressure pneumoperitoneum is employed are better recovered in terms of pain than standard pressure pneumoperitoneum. This means hospital stay can be shortened in low pressure pneumoperitoneum groups which will be more economical and comfortable for patients. Conclusion: Laparoscopic hysterectomy can be done at 10 mmhg with the benefits of : Optimum visualization with low pressure Reduction in post operative pain helping the patient for early ambulation so that patient will get back to routine work and normal life earlier, it is the main purpose of minimal invasive surgery.

scholarly journals Umbilical Nodule with Cyclical Bleeding: A Case Report and Literature Review of Atypical Endometriosis

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Marlene Teixeira Andrade ◽  
Cláudia V. Marques de Freitas ◽  
Sara Filipa Camacho Câmara ◽  
José Joaquim Nunes Vieira
Keyword(s):  
Case Report ◽  
Laparoscopic Surgery ◽  
Literature Review ◽  
Medical History ◽  
Surgical Resection ◽  
Diagnostic Tests ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Atypical Endometriosis ◽  
Umbilical Endometriosis

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. It affects 3 to 10 percent of women of reproductive age. Umbilical endometriosis is rare, with an estimated incidence of 0.5–1.0% among all cases of endometriosis, and is usually secondary to prior laparoscopic surgery involving the umbilicus. In this report, we described a case of umbilical endometriosis treated with surgical resection and highlight the great importance of medical history compared to complementary diagnostic tests that can be sometimes inconclusive.

scholarly journals The development of laparoscopic technology in light of cholecystectomies performed between 1994 and 2007

2009 ◽  
Vol 150 (48) ◽  
pp. 2189-2193
Author(s):  
Péter Lukovich ◽  
Tímea Vanca ◽  
Dániel Gerő ◽  
Péter Kupcsulik
Keyword(s):  
Laparoscopic Surgery ◽  
Gastrointestinal Surgery ◽  
Minimal Invasive ◽  
Chi Square ◽  
Female Ratio ◽  
Surgical Method ◽  
Male Female Ratio ◽  
Significance Levels ◽  
Gallstone Spillage ◽  
Laparoscopic Techniques

The spread of laparoscopy has required surgeons to familiarize with a completely new surgical method and by today this method has clearly become of major importance in gastrointestinal surgery. The evolution of laparoscopic cholecystectomy offers many good lessons to learn for the purposes of advanced laparoscopic surgeries and surgeons may benefit from this experience in any process of introducing new minimal invasive techniques. Methods and Material: We have made a retrospective analysis of the data of the cholecystectomies made in the 1st. Department of Surgery, Semmelweis University, right after laparoscopy had become a widely spread, routine surgical method (1994) as well as 13 years later (2007). The data have been processed using the SPSS 16.0 application package. Significance levels have been established with the chi-square probe. Results: Within the analyzed timeframe we could clearly see a growing use of laparoscopic techniques (52.09% vs. 90.13%) with a growing number of cases (263/304), unchanged average age (~53.5 years) and constant male/female ratio (75/25%). The BMI increased moderately (26.5 vs. 27.6), but the frequency of laparoscopic interventions on extremely obese patients grew (BMI: 25–30 37.93% vs. 44.39%, 30–35 13.79% vs. 20.6% 35–40 6.89% vs. 5.82% and 40 \lt; 0% vs. 1.34%) while the postoperative hospitalization decreased dramatically from 5.9 days to 2.3. In year 1994, patients spent on the average 2.9 days in hospital after a laparoscopic surgery, while in year 2007 nearly 25% of the patients left the hospital 1 day after surgery. The duration of a laparoscopic surgery decreased from 78 minutes to 53, and the occurrence of intraoperative bleeding, gall bladder perforation and gallstone spillage also decreased. The conversion ratio increased from 2.7% to 4.9%. In 3% of the laparoscopic cholecystectomies (10 patients) only 3 ports were used during surgery. Discussion: As surgeons have come to master the new technique, the previous relative and absolute pros and cons have been revised and at present 90% of cholecystectomies are made using laparoscopy. The data collected in the analysis of laparoscopic techniques can be used to research, learn and eventually introduce Natural Orifice Transluminal Endoscopic Surgery.

scholarly journals Comparison of clinical outcomes and postoperative quality of life after surgical treatment of type II submucous myoma via laparoscopy or hysteroscopy

2019 ◽  
Vol 47 (9) ◽  
pp. 4126-4133
Author(s):  
Rui-chun Zhang ◽  
Wei Wu ◽  
Qing Zou ◽  
Hongmei Zhao
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Surgery ◽  
Clinical Outcomes ◽  
Intraoperative Complications ◽  
Type Ii ◽  
Intraoperative Bleeding ◽  
Laparoscopy Group ◽  
Operative Duration ◽  
Submucous Myoma

Objective This study was performed to compare the clinical outcomes, advantages, and disadvantages of laparoscopic myomectomy (LM) and transcervical resection of myoma (TCRM) in the treatment of type II submucous myoma. Methods In total, 136 patients with type II submucous myoma with a tumour diameter of 4 to 5 cm were randomly assigned to the hysteroscopy group or laparoscopy group. Results The operative duration was shorter and the intraoperative bleeding volume was lower in the hysteroscopy than laparoscopy group. The success rate of the single-stage operation was obviously higher in the laparoscopy than hysteroscopy group. The duration of postoperative antibiotic use and the length of hospital stay were shorter in the hysteroscopy than laparoscopy group. The time to complete healing of the muscle layer was shorter in the hysteroscopy than laparoscopy group. The rate of intraoperative complications was lower in the hysteroscopy than laparoscopy group. Conclusion Both hysteroscopic and laparoscopic surgery have beneficial effects in the treatment of type II submucous myoma. Hysteroscopic surgery has the advantages of a short operative duration, low intraoperative bleeding volume, fast postoperative recovery, and high quality of life. Laparoscopic surgery involves many intraoperative complications and slow recovery of ovarian function.

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