scholarly journals Single-Incision Laparoscopic Splenectomy for a Large Non-Traumatic Pseudocyst of the Spleen: A Case Report

2019 ◽  
Vol 20 (S1) ◽  
Author(s):  
Pan Chao-wen ◽  
Hsiu-Lung Fan ◽  
Chen Ya-Cheng ◽  
Guo-Shiou Liao ◽  
Mong Fan-Yun ◽  
...  

Introduction: The incidence of splenic cysts is low, and most are asymptomatic. Symptomatic splenic cysts have rarely been reported. Due to the unspecific clinical and radiologic features, the nature of a cyst is difficult to define in the absence of a history of trauma. Therefore, splenectomy is usually the treatment of choice for obtaining a specimen. In particular, total splenectomy has been the treatment of choice for removal of splenic cysts. Case Presentation: A 25-year-old male patient visited the outpatient department at Tri-Service General Hospital Penghu Branch, Taiwan, with the chief complaint of abdominal fullness. No obvious history of trauma was reported. A series of examinations were performed, and abdominal computed tomography showed one large splenic cyst within the splenic septum. We performed single-incision laparoscopic splenectomy, and the patient recovered well and returned to daily activities one week later. Conclusions: In this modern era of minimally invasive surgery, laparoscopic surgery has reduced postoperative pain and improved recovery, with no increase in complications. Laparoscopic splenectomy has become the trend for the management of splenic cysts. Although single-incision laparoscopic surgery is a technical challenge, better cosmetic results and decreased postoperative wound pain are considered to be superior outcomes compared with those of conventional multi-port laparoscopic surgery.

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Noboru Hasegawa ◽  
Hiroshi Takeyama ◽  
Yozo Suzuki ◽  
Shingo Noura ◽  
Kazuki Odagiri ◽  
...  

Abstract Background Paraduodenal hernia is a rare internal hernia which accounts for only 1% of all intestinal hernias. There have been limited reported cases of paraduodenal hernia treated by laparoscopic surgery. We report a case of left paraduodenal hernia that was successfully treated by single-incision laparoscopic surgery (SILS). Case presentation A 17-year-old woman presented with left upper abdominal pain. An abdominal enhanced multi-detector computed tomography demonstrated encapsulated cluster of small bowel loops in the left upper quadrant which passed through the dorsal side of the inferior mesenteric vein, and showed that blood flow of the prolapsed small bowel was preserved. We preoperatively diagnosed left paraduodenal hernia without ischemia or necrosis. We performed elective SILS because she was a young actress training school student and cosmetic benefit was thought to be important. We pulled out the protruded small bowel and closed a defect with a running suture by SILS. The patient was discharged 3 days after the surgery with no complications. Conclusions We reported the case of left paraduodenal hernia successfully diagnosed and treated by SILS.


2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Takahiro Watanabe ◽  
Hidetoshi Wada ◽  
Masanori Sato ◽  
Yuichirou Miyaki ◽  
Norihiko Shiiya

Intersigmoid hernia is a rare form of internal hernia. Here, we report a case of intersigmoid hernia and provide a brief review of the 62 cases involving the mesosigmoid reported in Japan from 2000 to 2013. In the current case, a 26-year-old man with no previous history of abdominal surgery presented with abdominal pain and vomiting. Abdominal computed tomography revealed an extensively dilated small bowel and a closed loop of small bowel in the mesosigmoid. The patient was diagnosed with an intestinal obstruction due to an incarcerated internal hernia involving the mesosigmoid. There was no blood flow obstruction at the incarcerated bowel. An elective single-incision laparoscopic surgery was performed after decompression of the bowel using ileus tube. As the ileum herniated into the intersigmoid fossa, the patient was diagnosed with an intersigmoid hernia. The incarcerated small bowel was reduced in order to make it viable, and the hernial defect was closed with interrupted sutures. The patient had an uneventful recovery and was discharged on postoperative day five.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomohiko Fukunaga ◽  
Toshihiko Kasanami

Abstract Background The arcuate line is the inferior margin of the posterior layer of rectus abdominis sheath. An arcuate line hernia is a parietal interstitial hernia consisting of ascending protrusion of intraperitoneal contents above the arcuate line. Arcuate line hernias are rare, and fewer than 20 cases undergoing surgical repair have been reported. Various surgical approaches were used in previous cases, and there is no consensus regarding the ideal repair method. We report the first case of an arcuate line hernia repaired using single-incision laparoscopic surgery. Case presentation The patient was a 78-year-old man who presented with a history of intermittent lower abdominal quadrant pain of more than 2 month’s duration. He had not previously undergone abdominal surgery, but had a history of mycobacterial lung disease and asthma. His vital signs were normal on presentation, and he experienced no vomiting or nausea. On palpation, his abdomen was flat and soft, and no mass was palpable. However, there was slight tenderness in the right lower quadrant. Blood laboratory test results were within normal ranges. Computed tomography revealed small bowel protrusion between the rectus abdominis and the posterior rectus sheath, and an arcuate line hernia was suspected and subsequently confirmed intraoperatively. The patient underwent single-incision laparoscopic repair with the intraperitoneal onlay mesh technique with tacks and with care to avoid the inferior epigastric vessels. The operation time was 30 min, and no intra- or post-operative complications occurred. Surgery relieved his symptoms, with no recurrence within 1 year postoperatively. Conclusions Single-incision laparoscopic surgery was performed easily and successfully in this rare patient with arcuate line hernia. Arcuate line hernia should be considered in patients presenting with abdominal symptoms, and single-incision laparoscopic repair should be considered for repair.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Noriaki Koizumi ◽  
Hiroki Kobayashi ◽  
Tsuyoshi Takagi ◽  
Kanehisa Fukumoto

We herein report a 66-year-old female patient who developed an undiagnosed small bowel obstruction without a history of prior abdominal surgery and was successfully treated by single-incision laparoscopic surgery. A small bowel obstruction with unknown cause typically requires some sort of surgical treatment in parallel with a definitive diagnosis. Although open abdominal surgery has been generally performed for the treatment of small bowel obstructions, laparoscopic surgery for small bowel obstructions has been increasing in popularity due to its less invasiveness, including fewer postoperative complications and a shorter hospital stay. As a much less invasive therapeutic strategy, we have performed single-incision laparoscopic surgery for the treatment of an undiagnosed small bowel obstruction. We were able to make a definitive diagnosis after sufficient intra-abdominal inspection and to perform enterotomy through a small umbilical incision. Single-incision laparoscopic surgery appears to be comparable to conventional laparoscopic surgery and provides improved cosmesis, although it is an optional strategy only applicable to selected patients.


2011 ◽  
Vol 49 (08) ◽  
Author(s):  
EJM Rijcken ◽  
R Mennigen ◽  
I Argyris ◽  
N Senninger ◽  
M Brüwer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshio Shiraishi ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.


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