scholarly journals Laparoscopy - Assisted pancreatoduodenectomy in the treatment of Peri - Ampullary tumors

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Hiếu Học Trần ◽  
Keyword(s):  
Operating Time ◽  
Pancreatic Head ◽  
Laparoscopic Approach ◽  
Bile Leakage ◽  
Ampullary Carcinoma ◽  
University Hospital ◽  
Periampullary Tumors ◽  
Estimated Blood Loss ◽  
Laparoscopic Pancreatoduodenectomy ◽  
Laparoscopic Assisted

Tóm tắt Đặt vấn đề: Đánh giá kết quả bước đầu, chỉ định và biến chứng trong phẫu thuật nội soi hỗ trợ cắt khối tá tràng đầu tụy. Phương pháp nghiên cứu: Mô tả tiến cứu 15 trường hợp được phẫu thuật tại Bệnh viện Bạch Mai từ 9/2016 – 9/2017. Kết quả: Chỉ định mổ bao gồm: u bóng Vater (12 người bệnh), u đầu tụy (2 người bệnh), u nang đầu tụy (1 người bệnh). Tuổi trung bình: 53,6 + 11,8 (dao động 37 – 72 tuổi), thời gian mổ trung bình 265,3 + 55 phút trong đó thời gian mổ nội soi 139,5 + 44,3 phút với đường mổ mở dài 8,6 + 3,4 cm, tổng số hạch nạo vét trung bình 9+ 2,6 hạch. Ba người bệnh chuyển mổ mở (20%) với lượng máu mất trong mổ trung bình 438 + 305 ml, thời gian nằm viện 18,3 ngày. Tai biến và biến chứng gặp: 1 người bệnh cắt phải động mạch mạc treo tràng trên (6,7%), 6 người bệnh rò tụy (40%) chủ yếu mức độ A (26,6%), 4 người bệnh rò mật (26,7%), 3 người bệnh chậm lưu thông dạ dày (20%), 1 người bệnh tử vong (6,7%). Kết luận: Phẫu thuật nội soi hỗ trợ có thể áp dụng điều trị các khối u vùng bóng Vater trên những người bệnh được lựa chọn. Hiệu quả và mức độ an toàn của phẫu thuật cần theo dõi thêm với số lượng lớn hơn. Abstract Introduction: We report the clinical short-term outcomes of laparoscopic-assisted pancreatoduodenectomy (LAPD) for periampullary tumors. Material and Methods: A retrospective review of patients who underwent LAPD from 9/2016 to 9/2017 at Bach Mai University Hospital. Results: Fifteen patients were included in this study. The preoperative diagnoses were ampullary carcinoma (n = 12), pancreatic head tumors (n = 2) and intraductal papillary mucinous neoplasm (n = 1). The median age was 53.6 years (range 37 – 72 years). The median operating time was 265.3 minutes (range 180 – 360 minutes) with the median time of laparoscopic approach was 139.5 mins and the median estimated blood loss was 438 ml (range 150 - 1241 ml). The median incision length for laparotomy was 8.6 cm (range 5 – 15 cm). The averaged lymph node collection was 9 + 2.6 nodes. The median hospital stay was 18.3 days with three patients that underwent conventional open surgery. One patient with injury superior mesenteric artery (SMA) during laparoscopic approach that needed be to repaired. Postoperative complications were pancreatic fistula (40%), bile leakage (26.7%), delayed empty gastric (20%) and mortality (6.7%). Conclusion: LAPD is a technically safe and feasible alternative treatment for selected patients with periampullary tumors. The long-term outcomes and potential benefits of this technique need to be obsevered in a larger patient population. Keyword: Pancreatoduodenectomy, Laparoscopic-assisted pancreatoduodenectomy, Laparoscopic pancreatoduodenectomy assisted by mini laparotomy.

scholarly journals ABDOMINAL PREGNANCY -- A RARE AND CHALLENGING DIAGNOSIS

2021 ◽  
Author(s):  
Pawel Sadlecki ◽  
Marek Grabiec ◽  
Malgorzata Walentowicz-Sadlecka
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Ectopic Pregnancy ◽  
Peritoneal Cavity ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Abdominal Pregnancy ◽  
Estimated Blood Loss ◽  
Life Threatening

Abdominal pregnancy is a very rare, life-threatening form of ectopic pregnancy, in which implantation occurs within the peritoneal cavity. The advantages of a laparoscopic approach over a laparotomy in this setting include a reduced estimated blood loss, a shorter operating time, reduced analgesic requirements, shorter hospital stay and convalescence.

scholarly journals Sequential Approach for a Critical-View COlectomy (SACCO): A Laparoscopic Technique to Reduce Operative Time and Complications in IBD Acute Severe Colitis

2020 ◽  
Vol 9 (10) ◽  
pp. 3382
Author(s):  
Gianluca Matteo Sampietro ◽  
Francesco Colombo ◽  
Fabio Corsi
Keyword(s):  
Operating Time ◽  
Laparoscopic Approach ◽  
Perioperative Outcomes ◽  
Laparoscopic Technique ◽  
Sequential Approach ◽  
Critical View ◽  
Critical View Of Safety ◽  
Estimated Blood Loss ◽  
Acute Severe Colitis ◽  
Severe Colitis

Acute severe colitis is the major indication for surgery in inflammatory bowel diseases (IBD), and in particular, in ulcerative colitis (UC). A laparoscopic approach for abdominal colectomy is recommended, due to better perioperative and long-term outcomes. However, costs, time-spending, and outcomes are still a topic of improvement. We designed a standardized 10-steps, sequential approach to laparoscopic colectomy, based on the philosophy of the “critical view of safety”, with the aim to improve perioperative outcomes (operative duration, estimated blood loss, complications, readmissions, reoperations, and length of postoperative stay). We performed a retrospective cohort study using data from a prospectively maintained clinical database. We included all the consecutive, unselected patients undergoing laparoscopic subtotal colectomy (SCo) for IBD between 2008 and 2019 in a tertiary IBD Italian Centre. Starting from 2015, we regularly adopted the novel Sequential Approach for a Critical-View Colectomy (SACCo) technique. We included 59 (40.6%) patients treated with different laparoscopic approaches, and 86 patients (59.4%) operated on by the SACCo procedure. The mean operating time was significantly shorter for the SACCo group (144 vs. 224 min; p < 0.0001). The SACCo technique presented a trend to fewer major complications (6.8% vs. 8.3%), less readmissions (2.3% vs. 13.5%; p = 0.01), and shorter postoperative hospital stay (7.2 vs. 8.8 days; p = 0.003). Laparoscopic SACCo-technique is a safe and reproducible surgical approach for acute severe colitis and may improve the outcomes of this demanding procedure.

scholarly journals A Comparative Study Of Surgical Outcome In Different Approaches For Hysterectomy

2019 ◽  
Vol 17 (1) ◽  
pp. 28-33
Author(s):  
Suman Raj Tamrakar
Keyword(s):  
Operating Time ◽  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
University Hospital ◽  
Gynecologic Surgery ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Significant Difference ◽  
Long Time ◽  
Laparoscopic Assisted ◽  
Selection Of

Introduction: Globally, hysterectomy has been the commonest gynecologic surgery since a long time. One of the most remarkable innovations in surgery has been the changeover from laparotomy to laparoscopy. The first reported laparoscopic hysterectomy was in 1989 by Harry Reich, for endometriosis. As laparoscopic procedure has various important advantages over laparotomy, it has become a preferred surgical method. But open hysterectomy or laparoscopic hysterectomy has been chosen based on various factors and the surgeon's experience and skill. Earlier hysterectomies were done in conventional way at Kathmandu University Hospital. But Laparoscopic assisted vaginal hysterectomy and total laparoscopic hysterectomy were started from 2011 and 2015 respectively. Method: This retrospective study was undertaken to compare the demographic parameters, operative particulars, postoperative outcomes including complications of different hysterectomy approaches done from 2011 to 2018 at Kathmandu University Hospital. Result: A total of 756 hysterectomy cases with 461 of open hysterectomy and 295 of laparoscopic hysterectomy were done in over 8 years. There was no significant difference in mean age of patients who underwent different types of hysterectomies (46.29±6.50 and 45.52±8.15 years, p=0.6829). There was significant increase in Brahmin/Chhetri caste seeking laparoscopic hysterectomy (p=0.0001) and significant decrease in other janajati caste undergoing laparoscopic hysterectomy (p=0.0004). The indications of different type of hysterectomy were almost comparable; with fibroids/adenomyosis (49.7%) followed by abnormal uterine bleeding (19.7%) were common indications. Laparoscopic hysterectomies have significantly increased since 2016. There were significant differences in operating time, blood loss and hospital stay between open and laparoscopic hysterectomy cases with 143.63±43.25 vs 67.56±25.75 minutes, 294.78±51.37 vs 470.24±102.99 ml and 2.61±0.66 vs 5.64±0.69 days respectively (all p<0.0001). There were 30 major complications in open and 10 in laparoscopic hysterectomy respectively with 9 minor complications in both. Eleven laparoscopy cases (3.7%) had to be converted to laparotomy. Conclusions: Laparoscopic hysterectomies are possible with equivalent advantages. A good laparoscopic experiences for surgeons and a careful selection of the cases are the obligatory prerequisites.

scholarly journals Laparoscopic Management of Diverticular Colovesical Fistula: Experience in 15 Cases and Review of the Literature

2013 ◽  
Vol 98 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Lucy A. Marney ◽  
Yik-Hong Ho
Keyword(s):  
Operating Time ◽  
Laparoscopic Approach ◽  
Bowel Function ◽  
Colovesical Fistula ◽  
Median Length ◽  
Laparoscopic Management ◽  
Surgical Expertise ◽  
Laparoscopic Assisted ◽  
Median Blood Loss

Abstract Colovesical fistulas secondary to diverticular disease may be considered a contraindication to the laparoscopic approach. The feasibility of laparoscopic management of complicated diverticulitis and mixed diverticular fistulas has been demonstrated. However, few studies on the laparoscopic management of diverticular colovesical fistulas exist. A retrospective analysis was performed of 15 patients with diverticular colovesical fistula, who underwent laparoscopic-assisted anterior resection and bladder repair. Median operating time was 135 minutes and median blood loss, 75 mL. Five patients were converted to an open procedure (33.3%) with an associated increase in hospital stay (P = 0.035). Median time to return of bowel function was 2 days and median length of stay, 6 days. Overall morbidity was 20% with no major complications. There was no mortality. There was no recurrence during median follow-up of 12.4 months. These results suggest that laparoscopic management of diverticular colovesical fistulas is both feasible and safe in the setting of appropriate surgical expertise.

Role of Lasix test in retroperitoneal laparoscopic treatment of ureteropelvic junction obstruction at Viet Duc University Hospital – report of 11 cases

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Trường Thành Đỗ ◽  
Keyword(s):  
Laparoscopic Surgery ◽  
Ureteropelvic Junction Obstruction ◽  
Average Length ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Ureteropelvic Junction ◽  
Small Blood Vessel

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi sau phúc mạc (NSSPM) điều trị hẹp khúc nối bể thận - niệu quản (BT-NQ) được áp dụng khá rộng rãi trên thế giới. Tuy nhiên vai trò của Lasix giúp phát hiện chính xác vị trí hẹp, nguyên nhân gây hẹp chưa được các tác giả nhắc tới. Nghiên cứu của chúng tôi nhằm mục tiêu đánh giá vai trò của test Lasix trong khi thực hiện phẫu thuật nội soi SPM điều trị hẹp khúc nối BT-NQ (ureteropelvic junction obstruction - UPJO) tại khoa phẫu thuật Tiết niệu, Bệnh viện Hữu nghị Việt Đức. Phương pháp nghiên cứu: Mô tả tiến cứu trên 11 người bệnh (NB) được mổ NSSPM điều trị hẹp khúc nối BT - NQ từ tháng 1/2016 đến tháng 8/2017 mà có cần thiết phải sử dụng Lasix trong mổ. Kết quả: Nghiên cứu có 7/11 NB nam chiếm tỷ lệ 63,6% và nữ chiếm 36,4%. Độ tuổi trung bình là 32.4 ± 15.7 tuổi (17 - 57 tuổi). Can thiệp bên phải 5 NB và bên trái là 6 NB. Thời gian mổ trung bình: 95.42 ± 21.67 phút (55 - 130). Tiêm tĩnh mạch Lasix 1ống 20mg, thời gian chờ đợi tác dụng của lasix trung bình là 15phút (8 - 30 phút). Lượng máu mất trong mổ trung bình: 33.15 ml (10 - 90). Thời gian nằm viện trung bình: 3.8 ± 1.3 ngày (3 - 6). Có 10 trường hợp phát hiện hẹp khúc nối do nguyên nhân nội tại bên trong tại vị trí nối bể thận niệu quản cần phải cắt nối và tạo hình kèm theo đặt JJ, có 1 trường hợp do mạch máu nhỏ bất thường chèn ép sau khi cắt mạch bất thường không phải cắt nối NQ tạo hình. Giải phẫu bệnh (GPB) đoạn hẹp sau mổ ở 10 người bệnh cắt nối: 100% có viêm xơ hẹp đoạn khúc nối. Kết luận: Test Lasix là cần thiết trong một số trường hợp nhất định, giúp cho phẫu thuật viên đánh giá chính xác vị trí hẹp, xác định nguyên nhân gây hẹp từ đó có thái độ xử trí phù hợp. Abstract Introduction: Retroperitoneal laparoscopic repair of ureteropelvic junction obstruction (UPJO) has been widely applied all over the world. However, role of Lasix test in detecting precisely position and cause of the stenosis not mentioned yet. Objective: Our study aims to assess the role of Lasix test while performing retroperitoneal laparoscopic surgery for UPJO at Urology Surgery Department of Viet Duc University Hospital. Material and Methods: Descriptive study on 11 patients that were operated to repair UPJO by retroperitoneal laparoscopic approach from January 2016 to August 2017, in which Lasix test was required during operation. Results: Our group has 11 patients including 7 men that account for 63,6% and 4 women that account for 36,4%. The average age was 32.4 ± 15.7 years old (17-57). 5 patients had UPJO in the right and 6 patients in the left. Average operating time was 95.42 ± 21.67 minutes (55-130). Injection of 20mg Lasix was done during the operation with the average waiting time of 15 minutes (8-30). Mean blood loss during surgery was 33.15 ml (10-90). Average length of hospital stay was 3.8 ± 1.3 days (3-6). In 10 cases, UPJO were caused by intrinsic factors requiring pyeloplasty with JJ drainage. In 1 case, UPJO was due to an abnormal small blood vessel requiring ablation without pyeloplasty. Postoperative pathology in 10 patients with pyeloplasty showed 100% of fibrotic stenosis. Conclusion: Lasix test is necessary in certain cases, allows surgeon to accurately evaluate position of the stenosis, to identify the cause and thus, to have the appropriate decision of what to do. Keyword: Ureteropelvic Junction Obstruction, Retroperitoneal laparoscopic surgery, Lasix test

scholarly journals Early experience of laparoscopic assisted right hemicolectomy: a single-center analysis

2018 ◽  
Vol 5 (3) ◽  
pp. 784
Author(s):  
Asem F. Mohammed ◽  
Mohammed Hamed ◽  
Mahmoud Shaheen
Keyword(s):  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Colon Surgery ◽  
Right Hemicolectomy ◽  
Hepatic Flexure ◽  
University Hospital ◽  
Soft Diet ◽  
Advanced Tumor ◽  
Good Learning ◽  
Laparoscopic Assisted

Background: Laparoscopic colon surgery has been currently accepted as an alternative to open surgery for colon cancer. the laparoscopic approach, also, has been shown to offer clear evidence of benefit when compared to open surgery.Methods: From July 2013 to July 2016, patients admitted via the outpatient clinics of Menofia University Hospital for elective right hemicolectomy of proved malignancy of the cecum, ascending colon, and hepatic flexure of colon were evaluated for eligibility in this study.Results: The study consisted of 22 patients; of them 13 were males (59.1%) and 9 were females (40.9%) patients, with a mean age of 43±9 years (range 25-70 years). mean operative time was 125±14 minutes (range 100-145 minutes). only four (4) intramuscular opioid injections were given as post-operative analgesia. clear fluids were started 48 hours after surgery and soft diet allowed after 72 hours. the mean length of hospital stay was 5.7 days. Only one male patient was converted to conventional surgery due to advanced tumor. two patients developed surgical site infection in the post-operative period that was mild and managed conservatively. there were no cases with intestinal leakage and mortality rate in 30 days postoperative follow up was zero.Conclusions: Laparoscopic assisted right hemicolectomy is safe and feasible technique with a good learning curve

scholarly journals Pancreas-Preserving Total Duodenectomy: A Systematic Review

2021 ◽  
pp. 1-12
Author(s):  
Miguel Cantalejo-Díaz ◽  
José Manuel Ramia-Ángel ◽  
Ana Palomares-Cano ◽  
Mario Serradilla-Martín
Keyword(s):  
Systematic Review ◽  
Postoperative Morbidity ◽  
Operating Time ◽  
Pancreatic Head ◽  
Cochrane Library ◽  
Morbidity Rate ◽  
Intraoperative Bleeding ◽  
Risks And Benefits ◽  
Duodenal Lesions ◽  
The Mean

<b><i>Background:</i></b> The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. <b><i>Summary:</i></b> A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo &#x3c;IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was &#x3e;97.8%. <b><i>Key Messages:</i></b> PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.

scholarly journals Pelviscopic Compared to Laparotomic and Vaginal Intrafascial Hysterectomy

1997 ◽  
Vol 3 (4) ◽  
pp. 231-239
Author(s):  
L. Mettler ◽  
N. Lutzewitsch
Keyword(s):  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Surgical Techniques ◽  
Abdominal Hysterectomy ◽  
Supracervical Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Indications For Operation ◽  
Laparoscopic Assisted ◽  
Benign Disorders ◽  
The University

Between 1993 and 1994, 368 women underwent hysterectomies for benign disorders at the University of Kiel. Of these, 58.7% were performed either by pelviscopic or by laparotomy Classic Intrafascial Supracervical Hysterectomy (CISH). Of the remaining, 14.8% were performed by abdominal hysterectomy, 13.6% by Intrafascial Vaginal Hysterectomy (IVH), 12.2% by Vaginal Hysterectomy (VH), and only 0.05% by Laparoscopic Assisted Vaginal Hysterectomy (LAVH). Comparative data of these six surgical techniques concerning patients characteristics, indications for operation, histological features, blood loss, operating time, hospital stay, uterine weights and postoperatively used analgesics are described.

scholarly journals Defining The Learning Curve of Single-Port Inflatable Mediastinoscopy With Simultaneous Laparoscopic-Assisted Surgery For Radical Esophagectomy

2021 ◽  
Author(s):  
Jinpeng Shi ◽  
Xiaojian Li ◽  
Tianchi Wu ◽  
Xiangwen Wu ◽  
Xiaojin Wang ◽  
...  
Keyword(s):  
Learning Curve ◽  
Single Port ◽  
Thoracoscopic Surgery ◽  
Surgical Team ◽  
Radical Esophagectomy ◽  
Extensive Experience ◽  
Estimated Blood Loss ◽  
Group 2 ◽  
Laparoscopic Assisted ◽  
Group 1

Abstract Background Single-port inflatable mediastinoscopy with simultaneous laparoscopic-assisted surgery for radical esophagectomy is a promising surgical method with high technical requirements and needs team cooperation. Therefore, it is necessary to define a learning curve to guide personnel training and improve the safety of these surgical techniques.Method This study prospectively analyzed the data of 79 consecutive patients, who underwent the surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from October 2016 to May 2018. All of these patients were treated by the same surgical team with extensive experience in thoracotomy, laparotomy, thoracoscopic surgery and laparoscopic surgery. The learning curve was analyzed by cumulative summation (CUSUM) analysis, with the assessment of operative time, estimated blood loss, and postoperative complications.Result By analyzing these data, The scatter diagram of every measure showing a declining situation. The learning curve decreased beginning at 25th operation. All patients were chronologically divided into two groups, the group 1(the first 25 patients) and the group 2 (the last 54 patients). The median estimated blood loss of group 2 was lower than group 1(200 vs 100ml, p<0.05). No other clinic or pathologic characteristics were observed as significantly different.Conclusion For a surgical team with extensive experience in thoracotomy, laparotomy, thoracoscopic surgery and laparoscopic surgery, 25 cases are needed before becoming proficient in this surgery.

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.

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