Simplified Minimally Invasive Surgical Approach for Prophylactic Laparoscopic Gastropexy in 21 Cases

2019 ◽  
Vol 55 (3) ◽  
pp. 152-159 ◽  
Author(s):  
Claire Deroy ◽  
Harriet Hahn ◽  
Camille Bismuth ◽  
Guillaume Ragetly ◽  
Eymeric Gomes ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Abdominal Ultrasound ◽  
Abdominal Discomfort ◽  
Transversus Abdominis ◽  
Barbed Suture ◽  
Wound Complications ◽  
Minimally Invasive Surgical ◽  
Invasive Surgical Approach ◽  
Seromuscular Layer ◽  
Transversus Abdominis Muscle

ABSTRACT The objective of this study was to describe the operative technique and outcome of a simplified laparoscopic gastropexy approach in dogs. Twenty-one dogs undergoing prophylactic laparoscopic gastropexy with a simple continuous barbed suture without incising the seromuscular layer of the stomach and transversus abdominis muscle were reviewed. In 20 cases, additional procedures were performed (18 ovariectomies and 2 prescrotal castrations); 1 dog had two prior episodes of gastric dilation without volvulus and underwent gastropexy with a prophylactic intent. The gastropexy procedure had a median duration of 33 min (range 19–43 min). V-Loc 180 absorbable and the V-Loc PBT nonabsorbable suturing devices were used in 8 and 13 dogs, respectively. Minor intraoperative complications occurred in four cases: broken suture (1), needle dislodgement (2), and folded needle (1). Minor complications included self-limiting wound complications (3), abdominal discomfort (2), vomiting (1), and inappetence (2). Postoperative abdominal ultrasound performed after a median of 8 mo (6–36 mo) confirmed permanent adhesion at the gastropexy site in all dogs. One dog developed a fistula (1 yr postoperatively) and another a granuloma (3 mo postoperatively), both at the gastropexy site. Prophylactic laparoscopic gastropexy may be performed with knotless unidirectional barbed suture without creating an incision on the abdominal wall and stomach.

scholarly journals Spontaneous Abdominal Bleeding from an Infundibulopelvic Ligament Tear in a Patient with Large Ovarian Fibroma

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Justin To ◽  
Cui-lan Li
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Abdominal Discomfort ◽  
Ca 125 ◽  
Surgical Removal ◽  
Ligament Tear ◽  
Ovarian Fibroma ◽  
Abdominal Bleeding ◽  
Minimally Invasive Surgical ◽  
Invasive Surgical Approach

Ovarian fibromas are rare benign solid tumors of the ovary which are often difficult to differentiate from uterine leiomyomas preoperatively. The symptoms usually include abdominal discomfort and may have ascites and/or an elevation in CA-125 levels. There have been no publications of associated abdominal bleeding to date. The treatment is surgical removal via a laparoscopic or laparotomic approach. We present a case of a 19 cm unilateral ovarian fibroma with abdominal bleeding from a spontaneous right infundibulopelvic ligament (IPL) tear who underwent a laparoscopic and mini-laparotomic right salpingo-oophorectomy. Patients with large ovarian fibromas should be cautioned that abdominal bleeding and/or acute abdominal pain can occur and that a minimally invasive surgical approach is feasible.

scholarly journals Initial UK experience with transversus abdominis muscle release for posterior components separation in abdominal wall reconstruction of large or complex ventral hernias: a combined approach by general and plastic surgeons

2017 ◽  
Vol 99 (4) ◽  
pp. 265-270 ◽  
Author(s):  
ND Appleton ◽  
KD Anderson ◽  
K Hancock ◽  
MH Scott ◽  
CJ Walsh
Keyword(s):  
Abdominal Wall ◽  
Ventral Hernia ◽  
Abdominal Wall Reconstruction ◽  
Transversus Abdominis ◽  
Fascial Closure ◽  
Wound Complications ◽  
Components Separation ◽  
Aesthetic Appearance ◽  
Ventral Hernias ◽  
Transversus Abdominis Muscle

Introduction Large, complicated ventral hernias are an increasingly common problem. The transversus abdominis muscle release (TAMR) is a recently described modification of posterior components separation for repair of such hernias. We describe our initial experience with TAMR and sublay mesh to facilitate abdominal wall reconstruction. Methods The study is a retrospective review of patients undergoing TAMR performed synchronously by gastrointestinal and plastic surgeons. Results Twelve consecutive patients had their ventral hernias repaired using the TAMR technique from June 2013 to June 2014. Median body mass index was 30.8kg/m2 (range 19.0–34.4kg/m2). Four had a previous ventral hernia repair. Three had previous laparostomies. Four had previous stomas and three had stomas created at the time of the abdominal wall reconstruction. Average transverse distance between the recti was 13cm (3-20cm). Median operative time was 383 minutes (150–550 minutes) and mesh size was 950cm2 (532–2400cm2). Primary midline fascial closure was possible in all cases, with no bridging. Median length of hospital stay was 7.5 days (4–17 days). Three developed minor abdominal wall wound complications. At median review of 24 months (18–37 months), there have been no significant wound problems, mesh infections or explants, and none has developed recurrence of their midline ventral hernia. Visual analogue scales revealed high patient satisfaction levels overall and with their final aesthetic appearance. Conclusions We believe that TAMR offers significant advantages over other forms of components separation in this patient group. The technique can be adopted successfully in UK practice and combined gastrointestinal and plastic surgeon operating yields good results.

A Prospective Evaluation of a Modified Belt-Loop Gastropexy in 100 Dogs with Gastric Dilatation-Volvulus

2018 ◽  
Vol 54 (5) ◽  
pp. 239-245
Author(s):  
Luca Formaggini ◽  
Matteo Tommasini Degna
Keyword(s):  
Cohort Study ◽  
Surgical Technique ◽  
Clinical Evidence ◽  
Intraoperative Complications ◽  
Transversus Abdominis ◽  
Gastric Dilatation ◽  
Prospective Evaluation ◽  
Transversus Abdominis Muscle

ABSTRACT Gastropexy is a surgical technique performed to prevent and decrease the recurrence rate of gastric dilatation and volvulus (GDV). The objective of this prospective, a descriptive cohort study on 100 client-owned dogs who were presented with GDV, is to describe a modified belt-loop gastropexy and determine its intraoperative complications and long-term efficacy. The transversus abdominis muscle was used to make an oblique belt-loop. A seromuscular antral fold, instead of a seromuscular antral flap, was passed through the belt-loop, and then, the passed portion of the antral fold was sutured to the dissected edge of the abdominal wall. Intraoperative complications related to gastropexy were recorded, and the incidence of GDV recurrence was determined a minimum of 1 yr postoperatively via telephone with the referring veterinarians and the owners. There were no intraoperative complications related to the modified belt-loop gastropexy technique. Based on follow-up conversations, none of the dogs presented signs of GDV recurrence during the follow-up period. Based on the results, there is strong clinical evidence that a modified belt-loop gastropexy prevents recurrence of GDV in dogs surviving an acute episode.

scholarly journals P134 ROBOTICALLY ASSISTED EXTENDED VIEW TOTALLY EXTRAPERITONEAL VENTRAL HERNIA REPAIR (ETEP) - ESTABLISHMENT OF A NEW SURGICAL TECHNIQUE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Björn Mück ◽  
Frank Heinzelmann ◽  
Robert Vogel ◽  
Peter Büchler
Keyword(s):  
Minimally Invasive ◽  
Ventral Hernia ◽  
Intraoperative Complications ◽  
Lateral Approach ◽  
Transversus Abdominis ◽  
Open Approach ◽  
Mesh Placement ◽  
Surgical Method ◽  
Totally Extraperitoneal ◽  
Minimally Invasive Surgical

Abstract Aim Even today, operations which include retromuscular mesh placement are usually performed using an open approach. Thanks to advent of robotics, these technically demanding operations can be carried out using minimally invasive techniques. The objective of this investigation is to establish a novel minimally invasive surgical method as part of a feasibility study in a hospital providing specialised care. Material and Methods We carried out a retrospective analysis, out of all patients who were operated on a ventral hernia, using a robotically assisted totally extraperitoneal technique, during the period between September 2019 and May 2021. For evaluation we used data from our hospitals information system. All patients had given their consent, to participate in the Herniamed quality assurance study. Results From September 2019 to May 2021, 33 patients underwent robotic surgery on a ventral hernia, using a totally extraperitoneal approach. 23 patients had an incisional hernia (69.70%), 10 patients had a primary hernia (30.30%). We did perform a total of 3 unilateral and 2 bilateral Transversus Abdominis Releases (TAR). A lateral approach was chosen in 26 patients and a caudal “bottom-up” approach in 7 patients. There were no intraoperative complications. A conversion was not necessary. Postoperative complications did occur in 3 patients (2 Clavien Dindo 1, 1 Clavien Dindo 3a). Reoperation was not needed. Conclusions The eTEP technique is a promising surgical method, that can also be carried out in a hospital providing specialised care, with an acceptable risk of complications. This technique enables us, to combine the advantages of minimally invasive surgery with those of extraperitoneal mesh placement.

S178 – Utility of CT-Sestamibi Fusion in Parathyroid Exploration

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P135-P136
Author(s):  
Michael J Clark ◽  
Phillip Pellitteri
Keyword(s):  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Image Fusion ◽  
Fusion Imaging ◽  
Parathyroid Glands ◽  
Preoperative Localization ◽  
Minimally Invasive Surgical ◽  
Sestamibi Imaging ◽  
Invasive Surgical Approach ◽  
Operative Findings

Objectives 1) Delineate the role of CT-technetium 99m sestamibi (CT-MIBI) fusion in directed parathyroidectomy. 2) Determine the clinical situations where CT-MIBI fusion would be strongly recommended. Methods Charts from 190 patients with primary hyperparathyroidism who underwent CT-MIBI mage fusion as a part of a scan directed, minimally invasive parathyroid exploration protocol were reviewed. The results of conventional sestamibi imaging and CT-MIBI image fusion were compared with operative findings. Results CT-MIBI image fusion accurately localized solitary hyperfunctional parathyroid glands in 70% of patients imaged; 55% of patients were localized with conventional sestamibi imaging. CT-MIBI fusion imaging was most accurate and predictive when conventional images suggested that the solitary gland was separated from the thyroid or when the adenoma was located in the retro-thyroidal/ retro-esophageal plane or mediastinum. Conclusions CT-MIBI image fusion is not superior to conventional sestamibi imaging when utilized for routine localization of hyperfunctional parathyroid glands. CT-MIBI fusion is of greatest benefit in guiding the directed approach to solitary glands, which are separate from the thyroid or ectopically located, regions where conventional imaging has proven to be less accurate. This imaging technique will augment the minimally invasive surgical approach in selected patients with primary hyperparathyroidism in order to further refine the focused technique. Its utility as the standard preoperative localization modality is not yet established and requires further investigation. Evaluation of differences in facility utilization with CT-MIBI image fusion and conventional sestamibi imaging may be helpful in determining its role in preoperative localization for hyperparathyroidism.

Laparoscopic resections in the treatment of children with liver tumors: the first experience

2021 ◽  
Vol 61 (3) ◽  
pp. 27-30
Author(s):  
A. B. Riabov ◽  
M. S. Kubirov ◽  
A. V. Khizhnikov ◽  
M. Yu. Rykov
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Laparoscopic Resection ◽  
Liver Tumors ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Techniques ◽  
Resection Volume ◽  
Selection Of

Relevance: Surgery is one of the main methods of treating patients with liver neoplasms. At that, minimally invasive surgical techniques facilitate the course of the postoperative period and rehabilitation. The purpose of the study was the selection of optimal surgical treatment for children with liver tumors. Results: In 2014-2020, five patients aged 3-9 years with liver tumors underwent laparoscopic resection at the Morozovskaya Children’s City Clinical Hospital (Moscow, Russia). Out of 3 patients with hepatoblastomas, two patients had stage PRETEXT I, one – stage II. All patients underwent radical surgical treatment (R0); in one child (4%), the resection volume was R1. The duration of operations did not exceed 60 minutes; intraoperative blood loss was within 10 ml/kg; no intraoperative complications were registered. Conclusion: Laparoscopic techniques reduce surgery time and blood loss, prevent intraoperative and postoperative complications, shorten the hospital stay, decrease enteral and drug burden, and the need for chemotherapy. They also facilitate radical surgery and early patient mobilization.

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