scholarly journals Single-Port Laparoscopic Appendectomy Performing by Emergency Operation: An Intervention Study in Vietnam

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Duc Minh Pham ◽  
Vu Anh Pham ◽  
Mai Tuyet Vi ◽  
Linh Van Pham
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Port ◽  
White Blood Cells ◽  
Emergency Operation ◽  
Clinical History ◽  
Control Group ◽  
Duration Of Symptoms ◽  
The Mean

Background: Appendectomy is one of the most commonly performed surgical procedures of the abdominal area. One of the recent innovations is single-port laparoscopic surgery (SPLS), which can insert multiple ports through a proprietary device with multiple channels. An incision is sited in the umbilicus to result in no visible scar. Objectives: The study aimed to evaluate the results of the treatment of acute appendicitis by applying single-port laparoscopic surgery. Methods: A clinical single-port laparoscopic appendectomy intervention of 122 patients, with the absence of a control group, was carried out by a sole surgeon at the Hue University of Medicine and Pharmacy Hospital, Hue, Vietnam, from August 2013 to December 2017. Research parameters included clinical history, physical examination, laboratory test, ultrasound imaging, intraoperative characteristics, and surgical outcomes. Results: We included 122 patients (64 males and 58 females) who met the inclusion criteria. The mean age was 31.28 ± 13.51 years (range, 16 - 73 years). The average BMI was 20.4 ± 1.39 kg/m2. All patients had abdominal pain, and the average duration of symptoms was 17.39 ± 5.41 hours (range, 6 - 31 hours). Five patients had a history of abdominal surgery. The mean diameter of appendicitis in ultrasound was 8.8 mm (range, 6 - 15 mm). Moreover, 89.3% of patients had an increase in white blood cells. The difficult location of appendicitis was 1.6% under the liver and 20.5% in the retrocecal region. In addition, 18.0% of retroperitoneal appendicitis and 6.6% of appendicitis were under cecalserosa. The mean operative time was 40.19 ± 14.67 mins (range, 23 - 150 min). Two cases (1.6%) required additional trocar insertion. Three cases (2.5%) had wound infection and no other complications. The median hospital stay was 3.64 ± 1.72 days (range, 2 - 13 days). Conclusions: Single port laparoscopic surgery is the safe and effective treatment of acute appendicitis. This technique may be feasible for acute appendicitis with a difficult location.

scholarly journals Post-surgical outcomes of laparoscopic appendectomy observed at BIRDEM hospital

2017 ◽  
Vol 11 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Tapash Kumar Maitra ◽  
Mahmud Ekramullah ◽  
Faruquzzaman ◽  
Samiran Kumar Mondol
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Clinical History ◽  
Laparoscopic Technique ◽  
Operative Outcomes ◽  
The Mean ◽  
Almost All

Background and Objective: Currently, laparoscopic appendectomy (LA) is widely practiced for the management of acute appendicitis (AA). The application of laparoscopic technique for appendectomy is expanding very rapidly and now performed in almost all major cities and tertiary level hospitals. This study addressed to determine the outcomes of laparoscopic appendectomy in our surgical setup at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM).Methodology: All admitted patients at BIRDEM hospital and clinically diagnosed as acute appendicitis considered eligible for the study. Based on clinical history relevant and routine biochemical investigations were done. A board of experienced surgeons selected the eligible cases for LA. The study continued from Sept 2014 to Sept 2016.Result: A total of 47 (M / F = 21 / 26) patients with acute appendicitis were admitted during this period. The mean (SD) age was 21 (±1.4) years in male and 19 (±1.7) years in female. The mean age of the total patients was 20 (±1.6) years. Eighty percent of the patients were of age 30 years or less. Per-operative laparoscopic findings revealed that five cases (10.6%) were misdiagnosed as appendicitis. Two (4.2%) cases were found to have other pathology and necessitated open appendectomy (OA). One was suspected for malignancy and other had appendicitis with adhesion. Overall, four important post-operative outcomes were observed: (a) post-operative pain was found reducing gradually and it fell below pain score 2 or even less after 30 hours; (b) port-site bleeding and infection were observed in 4.3% and 2.1%, respectively; (c) none had visceral bleeding or subcutaneous emphysema and (d) more than 80% were discharged within 72 hours.Conclusion: Most of the patients admitted with acute appendicitis were of younger age (<30 years). Though there was no comparative group undergoing open appendectomy (OA), it was apparent that laparoscopic approach was proved to have reduced pain, less complication and shorter hospital stay thus reducing the treatment cost. Thus, LA was found relatively safe and resilient procedure. An additional benefit of laparoscopy was that it revealed about 10% case were misdiagnosed as having appendicitis. Thus, this approach may be considered as a step forward in the treatment of appendicitis making easier to explore the abdominal cavity while keeping an option to perform an OA.IMC J Med Sci 2017; 11(1): 15-18

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

Immature Platelet Fraction in Patients with Chronic Liver Disease, A Marker for Evaluating Cirrhotic Changes.

2021 ◽  
Vol 17 (2) ◽  
pp. 174-179
Author(s):  
Muhammad Javaid Iqbal ◽  
Muhammad Usman ◽  
Mubarak Ali Anjum ◽  
Yasir Yaqoob ◽  
Ghulam Mujtaba Nasir ◽  
...  
Keyword(s):  
Platelet Count ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
White Blood Cells ◽  
Chronic Liver ◽  
Control Group ◽  
P Value ◽  
Master Program ◽  
Immature Platelet Fraction ◽  
The Mean

Objective: To evaluate the role of Immature platelet fraction in patients with chronic liver disease, a marker for evaluating cirrhotic changes. Methodology: This case control study was conducted at department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of Seven months from June 2020 to January 2021. A total of 126 participants were included in the study consisting of 63 patients with chronic liver disease in group A and 63 participants without any known disease in group B as control. The IPF master program in combination with XE-2100 multiparameter automatic hematology analyzer was used to measure the immature platelet fraction. Ethylene diamine tetraacetic acid was used to collect the blood sample for IPF measurement and was maintained till analysis on room temperature. Ten repeated analyses, immediately and after 24 hours were done for reproducibility of IPF%. Results: The mean age of liver disease patients was 52.35 ± 13.64 years and in control group the mean age was 51.62 ± 11.27 years. There was no significant (p-value > 0.05) difference between both groups based on age and gender. The hemoglobin level and red cell count was found to be significantly (p-value < 0.05) reduced in cases group. While white blood cells count was comparable in both groups. The mean platelet count was significantly (p-value < 0.05) less in cases group (163.5 ± 90.4 vs 233.4 ± 54.5 (x10*3/µl). The mean value of immature platelet fraction (IPF%) was significantly (p-value < 0.05) raised in cases group (5.62 ± 2.92 vs 3.06 ± 1.87). The multivariate discriminant analysis (MDA) score showed a significant (p-value < 0.05) association with chronic hepatis as compared to other liver related diseases. Conclusions: In chronic liver disease patients, there is an inverse relationship between platelet count and IPF% with decreased platelet count and increased IPF%. The proposed MDA function can be used to identify the cirrhotic changes in liver disease patients.

Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: a randomised clinical trial

2020 ◽  
pp. bmjspcare-2020-002618
Author(s):  
Azam Dehghani ◽  
Ali Hajibagheri ◽  
Ismail Azizi-Fini ◽  
Fatemeh Atoof ◽  
Noushin Mousavi
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Surgery ◽  
Pain Intensity ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Early Mobilisation ◽  
Repeated Measures Analysis ◽  
The Mean

BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.

scholarly journals Immunological and hematological changes in patients with hyperthyroidism or hypothyroidism

2010 ◽  
Vol 33 (5) ◽  
pp. 271 ◽  
Author(s):  
Abdollah Jafarzadeh ◽  
Masoud Poorgholami ◽  
Nazanin Izadi ◽  
Maryam Nemati ◽  
Mohammad Rezayati
Keyword(s):  
Eosinophil Count ◽  
Complete Blood Count ◽  
Hematological Parameters ◽  
White Blood Cells ◽  
Serum Levels ◽  
Control Group ◽  
Complement Components ◽  
The Mean ◽  
Hematological Changes ◽  
Hypothyroid Patients

Aims: Thyroid hormones have been shown to influence the immune system and haematopoiesis. The aim of this study was to evaluate some immunological and hematological parameters in peripheral blood of hypo- or hyperthyroid women. Materials and Methods: Blood samples were collected from 50 women with hypothyroid disease, 50 women with hyperthyroid disease and a control group consisting of 50 sex - and age - matched euthyroid subjects. Thyroid function assesed according to measurent of T3, T4 and TSH levels. The complete blood count (CBC), total and differential counts of white blood cells (WBC), serum levels of immunoglobulins (IgG, IgA, IgM and IgE) and C3 and C4 complement components determined in three groups by using standard immunological and hematological methods. Results: In hyperthyroid women the mean serum concentrations of IgG (2312.4±584 mg/dl), IgA (296± 87 mg/dl) and IgE ( 301± 264 IU/ml) were significantly higher than those found in the control group (1539± 974 mg/dl, P < 0.0003; 234± 116 mg/dl, P < 0.01; 109.8±115 IU/ml, P < 0.0001, respectively) and the mean MCV was significantly lower in comparison with the euthyroid group (P < 0.05). Hypothyroid patients had higher serum IgE concentrations in comparison with the euthyroid group (179.8± 218 IU/ml vs. 109.8± 115 IU/ml; P < 0.047). The mean serum C3 concentration in hypothyroid patients was also significantly higher in comparison with the euthyroid group (138.7± 36.6 mg/ml vs. 117.8± 32.1 mg/dl; P < 0.01). In the hypothyroid group the mean eosinophil count was markedly higher in comparison with the hyperthyroid group (P < 0.06) and the mean count of RBC and the levels of some RBC-related indices, such as hematocrit and hemoglobin, were significantly lower in comparison with the euthyroid group (P < 0.05). Conclusion: These results indicate hypergammablobulinemia and lower MVC in hyperythyroid patients, and higher IgE levels, C3 levels and eosinophil count as well as anemia in hypothyroid patients.

scholarly journals Neoadjuvant concurrent chemoradiotherapy followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery for low-lying rectal adenocarcinoma: a single center study

2020 ◽  
Author(s):  
Yen-Jung Lu ◽  
Chien-Hsin Chen ◽  
En-Kwang Lin ◽  
Szu-Yuan Wu
Keyword(s):  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Single Port ◽  
Rectal Adenocarcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Morbidity Rate ◽  
Transanal Total Mesorectal Excision ◽  
Distal Margin ◽  
Mesorectal Excision ◽  
The Mean

Abstract Purpose: To assess the feasibility and short-term outcomes of neoadjuvant chemoradiotherapy (CCRT) followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery (TaTME-SPLS) for low-lying rectal adenocarcinoma.Methods and materials: A total of 23 patients with clinical stage II-III low-lying (from anal verge 0-8 cm) rectal adenocarcinoma who underwent neoadjuvant CCRT followed by TaTME-SPLS consecutively from December 2015 to December 2018, were enrolled into our study. Chi-squared testing and Student’s t testing were used to make parametric comparisons, and Fisher’s exact test or the Mann–Whitney U-test were used to make nonparametric comparisons.Results: Conversion rate in patients who underwent neoadjuvant CCRT followed by TaTME-SPLS was only 4%. The mean operation time was 366 minutes and the inter-sphincter resection (ISR) was done for 14 patients (60%). The mean number of lymph nodes harvested were 15. There was no surgical mortality, but the 30-day morbidity rate was 21% (5 patients were Clavien-Dindo I-II). Pathological complete response was 21.74% with 100% organ preservation and 100% clear distal margin after neoadjuvant CCRT followed by TaTME-SPLS. Conclusion: Neoadjuvant CCRT followed by TaTME-SPLS can be a safe and an effective sphincter-preserving procedure with acceptable morbidity rate for Asian patients with low-lying rectal adenocarcinoma.

scholarly journals Application of Iconport single incision sealing device in laparoscopic surgery.(Experience in 125 cases of appendectomy)

2019 ◽  
Author(s):  
Xiaojun Wang ◽  
Haibo Jin ◽  
YongFeng Shuai ◽  
YiZhong Zhang
Keyword(s):  
Laparoscopic Surgery ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Single Incision Laparoscopic Surgery ◽  
Clinical Value ◽  
Peritoneal Effusion ◽  
Port Device ◽  
Sealing Device

Abstract Background To discuss the reliability and clinical value of Iconport, a Self-made single port device, which was applied for transumbilical single port laparoscopic appendectomy. Methods The incision was around 2.5 cm long with curved form around umbilicus. And the skin and each layer of the abdominal wall were cut in sequence. Then the silica gel sleeve of the self-made single-incision sealing device was folded, clamped by the forceps, and carefully inserted into the incision for sealing. The operation of laparoscopic appendectomy was accomplished by-use routine linetype laparoscopic instruments via Iconport. The specimen was discharged from peritoneal cavity through the single port device. Two layers of incision, linea alba abdominus and skin, were separately sutured by absorbable thread and each layer was sutured successively. Results Among the 125 patients, 119 were successfully performed single-port laparoscopic appendectomy, with the operation time ranging from 30 to 110 min (69.34±21.4 min on average). In 6 cases, auxiliary operating hole was added or laparotomy was performed. Total hospital stay was 5.0±1.8 (2-14) days. 5 cases of incision infection. All patients were followed up for 1 to 6 months after surgery, with an average of 3 months. There were no complications such as bleeding, intestinal leakage, intestinal obstruction, and residual peritoneal effusion. Conclusion In single-incision laparoscopic surgery, the u-shaped incision around the umbilical margin of 2.5cm for adult can not only meet the requirements of flexibility of instruments in the operation, but also meet the aesthetic requirements because the incision scar is hidden in the umbilical foramen or looks like the umbilical foramen after the operation. Iconport single-hole device, which has potential promotion value, can be used in relatively simple laparoscopic surgery alone or combined with a single puncture device for relatively complex laparoscopic surgery.

scholarly journals LAPAROSCOPIC APPENDECTOMY;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Muhammad Umar Younis ◽  
Muhammad Zeeshan Sarwar ◽  
Sanad Saad
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Local Population ◽  
Sampling Technique ◽  
Short Operative Time ◽  
Cross Sectional ◽  
Stump Closure ◽  
Study Results ◽  
The Mean

Introduction: Appendicitis is a condition characterized by inflammation of the appendix and is considered to be the most common emergency encountered in surgical practice. Compared with the open technique for appendectomy, laparoscopic appendectomy has less operative time, hospital stay and rate of complications and has been deemed as a safe and feasible procedure for the treatment of acute appendicitis. The use of endoclips for stump closure has been described to be comparable to other existing techniques with regards to clinical outcomes. However, controversies exist in literature regarding operative time with endoclip application. Objectives: To assess mean operative time for laparoscopic appendectomy using specially designed Double Shanked (DS) endoclips and assessing advantages in the form of better cosmesis, less pain. Study Design: Cross sectional exploratory study using non-probability sampling technique. Setting: West Surgical Ward of Mayo Hospital Lahore. Period: Period of 9 months from April 2014 through to December 2014. Materials and Methods: 120 successive patients fulfilling inclusion criteria were enrolled in the study. Clinical data with respect to their demographic profile (age and sex) were recorded. Laparoscopic Appendectomy was performed or supervised by one consultant. Quantitative variables such as age and operative time was analyzed and mean and standard deviation were calculated. Results: Our study results showed the mean age of the patients to be 25.84±8.09 years. There were 63.3% males whereas 36.7% were females. The mean operative time of the patients was noted to be 0.99±0.39 hours. Conclusions: The study results lend credence to the fact that Laparoscopic Appendectomy with endoclips is a safe, effective technique and has an admissible short operative time which when combined with better cosmesis, lesser pain and faster recovery, give it validity and acceptability. Our results generated for the local population will influence our management strategy for acute appendicitis in our set up.

scholarly journals Single-site laparoscopy in gynecology: preliminary study of a series of 50 cases

2014 ◽  
Vol 60 (6) ◽  
pp. 548-554
Author(s):  
Admário Silva Santos Filho ◽  
Maurício Bechara Noviello ◽  
Rachel Cruz Fraga Damasceno ◽  
Evilane do Carmo Patrício ◽  
Lara Rodrigues Félix ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Single Port ◽  
Perioperative Complications ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Invasive Technique ◽  
Surgical Morbidity ◽  
Single Port Laparoscopy ◽  
The Mean

Objective: to describe the initial experience of a gynecology team, at a tertiary care center, when performing single-port laparoscopic surgery. Methods: this is a retrospective study reviewing the medical records of 50 patients treated at the outpatient gynecology clinic of our institution between June 2012 and July 2013 who underwent single-port laparoscopic surgery. This study was approved by the institution’s Ethics in Research Committee. Results: the mean age of patients is 37.8 years, ranging from 18 to 70 years, and the most frequent surgical indications were adnexal mass (72%) and chronic pelvic pain (24%). The mean operative time was 94.4 minutes with a mean hospital stay of 25.8 hours. There were no perioperative complications. We recorded two conversions to laparotomy due to technical difficulties during the procedure. All cases of conversion had pelvic adhesions. All operative complications were successfully treated and none were considered severe. Conclusion: this is one of the largest case series in the literature regarding surgical treatment by single-port laparoscopy in gynecology and presents evidence on reduction of surgical morbidity and satisfactory cosmetic results. We conclude that single-port laparoscopy is a viable minimally invasive technique, and that it contributes to the construction of a new scenario in modern gynecological surgery.

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