JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons最新文献_第2页

Virtual SLS MIS 2021 Conference Abstract Supplement 虚拟SLS MIS 2021会议摘要补编

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00073

Laparoscopic Robotic Surgeons The Society of

引用次数: 0

“Slim-Mesh” Technique for Giant Ventral Hernia “细网”技术治疗巨大腹疝

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00079

Silvio Alen Canton, C. Pasquali

{"title":"“Slim-Mesh” Technique for Giant Ventral Hernia","authors":"Silvio Alen Canton, C. Pasquali","doi":"10.4293/JSLS.2021.00079","DOIUrl":"https://doi.org/10.4293/JSLS.2021.00079","url":null,"abstract":"Background and Objective: We devised a sutureless “Slim-Mesh” technique to treat ventral hernias, including large-giant/massive ones, reduce intra- and postoperative complications, and lower operation time. Methods: Between September 1, 2009 and October 31, 2020, 43 patients with large (10 – 14.9 cm)-giant (15 – 19.9 cm) and massive (≥ 20 cm) ventral hernia were operated at our Department with the above technique. This was a prospective (79%)-retrospective study. Results: This study comprised 22 males and 21 females. Mean age was 63 years. Large-giant and massive hernias were found intraoperatively in 37 and 6 cases respectively. Mean operation time for all hernias was 116 minutes, 104 for large-giant hernias, and 190 for massive. In 53.4% of cases, hernia-neck operative measurement was larger than preoperative size. In 25.5% of cases, laparoscopy found satellite hernias previously undetected by ultrasound- and/or computed tomography scan. A composite mesh and a noncomposite mesh were used in 95% and 5% of cases respectively. For mesh fixation, titanium tacks and absorbable straps were used in 14% and 86% of cases respectively. Mean length of hospital stay was 2.3 days. Mean follow-up time was 3 years and 4 months. In our study, there were 5 early postoperative complications: 3 seromas, 1 trocar-site hernia, and 1 case of cystitis. We found 2 late small symptomless recurrences (4.6%). Conclusion: The sutureless “Slim-Mesh” technique facilitates intra-abdominal introduction, as well as the handling and fixation of giant and monster (36 × 26 cm) meshes. In our experience, “Slim-Mesh” is safe, simple, and fast, and economical even for large-giant/massive ventral hernia repair.","PeriodicalId":114569,"journal":{"name":"JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133491848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center 在代谢和减肥手术认证和质量改进计划认证中心，公共与商业保险患者的再入院率和急诊就诊率

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2022.00009

B. Clapp, Andres Vivar, Christian Castro, Jisoo Kim, Jesus Gamez, C. Dodoo, B. Davis

{"title":"Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center","authors":"B. Clapp, Andres Vivar, Christian Castro, Jisoo Kim, Jesus Gamez, C. Dodoo, B. Davis","doi":"10.4293/JSLS.2022.00009","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00009","url":null,"abstract":"Background: Patients with governmental insurance are known to utilize the emergency department (ER) at a higher rate and have higher readmission rates than other patients. Twenty percent of our patients are publicly insured. Our objective was to determine if there was a higher rate of readmissions and ER visits within 30 days in publicly insured patients. Methods: Data was analyzed from a single center submitted to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Data File from January 1, 2015 to December 31, 2018. We added insurance status and described quantitative variables using mean, and standard deviation (SD). These were reported as regression coefficients (RC) and prevalence ratio (PR), along with their 95% confidence interval (CI). P values of less than 5% were considered statistically significant. Results: The overall rate of ER visits, readmissions, and reoperations were 3.5%, 7.4%, and 2.2% respectively. Medicaid and Medicare patients were found to have longer operative times, 62.7 minutes vs 57.5 minutes (p = 0.35). Patients on public insurance had higher adjusted risk of ER visits (PR 1.43, 95% CI: 0.41–5.3; p = 0.58) and readmissions (PR 1.64, 95% CI: 0.76–3.55; p = 0.21) than patients on commercial/self-pay insurance. Re-operations were lower in the publicly insured group (PR 0.93, 95% CI: 0.2–4.7; p = 0.92) than patients on commercial/self-pay insurance. However, these outcomes were not statistically significant. Conclusions: Publicly insured patients tend to have a higher adjusted risk of ER visits and readmissions but was not statistically significant. The rate of re-operation was slightly lower in publicly insured patients.","PeriodicalId":114569,"journal":{"name":"JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121947043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robotic Adrenalectomy: A 10-Year Clinical Experience at a Tertiary Medical Center 机器人肾上腺切除术:在三级医疗中心的十年临床经验

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00083

A. Francis, L. Mellert, N. Parekh, M. Pozsgay, A. Dan

{"title":"Robotic Adrenalectomy: A 10-Year Clinical Experience at a Tertiary Medical Center","authors":"A. Francis, L. Mellert, N. Parekh, M. Pozsgay, A. Dan","doi":"10.4293/JSLS.2021.00083","DOIUrl":"https://doi.org/10.4293/JSLS.2021.00083","url":null,"abstract":"Background and Objective: Laparoscopic adrenalectomy is now the preferred approach for most adrenal tumors. As minimally invasive surgery departments gain familiarity with the robotic platform, the safety profiles and efficacy of robotic adrenalectomy has been an area of continued discussion. The objective of this study is to outline our experience with transitioning to the robotic platform and determining the effectiveness and safety of transperitoneal robotic adrenalectomy. Methods: We performed a single-center, retrospective review of 37 patients who underwent transperitoneal robotic adrenalectomy between August 1, 2010 and August 31, 2020. Outcomes included patient morbidity, hospital length of stay, operative time, estimated blood loss, gland volume, pathology, and postoperative complications. Results: Sixty-five percent of the total robotic adrenalectomies were of the left adrenal gland. The average operating room time was 213 minutes. The average gland volume was 71 cm3, estimated blood loss was 74 mL and length of stay was 1.4 days. There were no significant differences in outcomes between the right and left total robotic adrenalectomies. Approximately one-third of our cohort had an adrenal cortical adenoma, while only one patient had adrenal cortical carcinoma. Four patients experienced postoperative complications that resulted in unplanned hospital readmissions and there was one mortality. Conclusions: Although the standard of care for most adrenal tumors is laparoscopic resection, our 10-year experience has shown that robotic adrenalectomy is highly effective and can be a valuable tool in the community and academic setting.","PeriodicalId":114569,"journal":{"name":"JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115903811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Cosmetic Outcome of Robotic Surgery Compared to Laparoscopic Surgery for Benign Gynecologic Disease 妇科良性疾病机器人手术与腹腔镜手术的美容效果比较

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00081

Esra Ozbasli, O. Takmaz, N. Albayrak, M. Gungor

{"title":"Cosmetic Outcome of Robotic Surgery Compared to Laparoscopic Surgery for Benign Gynecologic Disease","authors":"Esra Ozbasli, O. Takmaz, N. Albayrak, M. Gungor","doi":"10.4293/JSLS.2021.00081","DOIUrl":"https://doi.org/10.4293/JSLS.2021.00081","url":null,"abstract":"Background and Objectives: This study was designed to compare patients who have undergone conventional laparoscopic surgery with those who undergone multiport robot-assisted laparoscopic surgery for benign gynecological diseases regarding cosmetic results, patient satisfaction, and quality of life. Methods: Sixty-four patients who underwent either robot-assisted or conventional laparoscopic surgery for benign gynecological diseases from July 1, 2019 to March 31, 2020 at Acibadem Mehmet Ali Aydinlar University Hospital were enrolled. Patients were evaluated using the Patient and Observer Scar Assessment Scale, visual analog scale for cosmetic satisfaction, body image questionnaire, and 12-item Short Form Survey six months postoperatively. Results: The median patient assessment scale and observer assessment scale (general) values were significantly higher in the robotic group than in the laparoscopic group. The mean body image questionnaire (cosmetic section) and visual analog scale values were significantly higher in the laparoscopic group than in the robotic group. No significant differences in body image scale, body image questionnaire 9–10, and 12-item Short Form Survey values were observed between the groups. The number of patients with previous surgical history was significantly higher in the laparoscopic group than in the robotic group. Conclusion: Although esthetic concerns are not a priority consideration when deciding an appropriate surgical method, the higher cosmetic satisfaction rate in the laparoscopic group than in the robotic group suggests that cosmetic results should be discussed with patients after evaluating other factors.","PeriodicalId":114569,"journal":{"name":"JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129714252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Indication and Approach are Associated with Transfusion in Hysterectomy for Benign Disease 良性子宫切除术的手术指征和入路与输血相关

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2022.00013

T. Elfazari, A. Nayak, R. Mallick, K. Arendas, A. Choudhry, I. Chen

{"title":"Surgical Indication and Approach are Associated with Transfusion in Hysterectomy for Benign Disease","authors":"T. Elfazari, A. Nayak, R. Mallick, K. Arendas, A. Choudhry, I. Chen","doi":"10.4293/JSLS.2022.00013","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00013","url":null,"abstract":"Objective: To identify pre-operative and intraoperative factors associated with the risk of red blood cell transfusion among women undergoing hysterectomy. Methods: A retrospective cohort study of hysterectomy for benign indications between January 1, 2011 – December 31, 2017. Patients receiving blood transfusion within 30 days of surgery were compared to patients who did not receive any transfusion. Multivariate logistic regression analysis was performed to identify clinical and surgical variables associated with blood transfusion. Results: Among 171,940 women who underwent hysterectomy for benign indication, 4,667 (2.7%) required blood transfusion. The rate of transfusion was highest among patients with uterine fibroids (4.3%) and lowest in patients with genital prolapse (1.1%) (p < 0.05). Odds of blood transfusion were significantly elevated in patients undergoing hysterectomy for uterine fibroids compared to patients with genital prolapse (adjusted odds ratio [aOR] 1.36, 95% confidence interval [CI] 1.15 – 1.61). Other patient characteristics included body mass index, smoking, bleeding disorders, pre-operative sepsis, and American Society of Anesthesiologists score ≥ 2 (p < 0.05). Higher pre-operative hematocrit significantly decreased the risk of blood transfusion (aOR 0.84, 95% CI 0.84 – 0.85 per percent increase in hematocrit). Abdominal and vaginal hysterectomies were associated with greater odds of transfusion compared with laparoscopic approaches (aOR 5.06, 95% CI 4.70 – 5.44; aOR 1.87, 95% CI 1.67 – 2.10, respectively). Conclusion(s): Certain patient comorbidities, surgical indication, and approach to hysterectomy are associated with increased risk of blood transfusion. These results may have implications for pre-operative patient counseling, perioperative care, and health system planning.","PeriodicalId":114569,"journal":{"name":"JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130657874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Three-Port Laparoscopic Spleen-Preserving Distal Pancreatectomy with Splenic Vessel Preservation 三孔腹腔镜保脾远端胰腺切除术伴脾血管保留

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00087

Tamara Floyd, D. Seok, M. Jacobs

引用次数: 0

Incidental Bladder Cancer at the Time of Routine Cystoscopy following Laparoscopic Hysterectomy 腹腔镜子宫切除术后常规膀胱镜检查时的偶发膀胱癌

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00095

Wenjia Zhang, M. Loring

引用次数: 0

Virtual SLS MIS 2020 Conference Abstract Supplement 虚拟SLS MIS 2020会议摘要补编

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2020.00117

引用次数: 0

Stapler Malfunctions in Bariatric Surgery: An Analysis of the MAUDE Database 减肥手术中订书机故障:MAUDE数据库分析

JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons Pub Date : 1900-01-01 DOI: 10.4293/JSLS.2021.00074

B. Clapp, A. Schrodt, Maria Ahmad, Ellen Wicker, Nishtha Sharma, Andres Vivar, B. Davis

{"title":"Stapler Malfunctions in Bariatric Surgery: An Analysis of the MAUDE Database","authors":"B. Clapp, A. Schrodt, Maria Ahmad, Ellen Wicker, Nishtha Sharma, Andres Vivar, B. Davis","doi":"10.4293/JSLS.2021.00074","DOIUrl":"https://doi.org/10.4293/JSLS.2021.00074","url":null,"abstract":"Background: Staple line leaks are a serious problem in bariatric surgery and a major cause of serious morbidity and mortality. Adverse events caused by medical devices are reported to the Food and Drug Administration which maintains the Manufacturer and User Facility Device Experience (MAUDE) database. We examined adverse stapler events reported to the MAUDE database, specifically with regards to bariatric surgery. Methods: The MAUDE database was queried for adverse events caused by staplers between January 1, 2018 – December 31, 2020; events reported by Intuitive, Ethicon, and Medtronic/Covidien; and limited our search to “gastric bypass”, “sleeve gastrectomy”, “stapler malfunction” combined with each company. Results: There were 883 adverse events reported for Medtronic, 353 for Ethicon, and 35 for Intuitive. Approximately 3.5 million staple reloads sold in the study period. The reported misfire rate for Medtronic was 0.04% and for Ethicon was 0.02%. Data for Intuitive was unavailable. The most common reported event for Medtronic was failure to fire (n = 349), followed by misfire (n = 186). For Ethicon, the most common event was failure to fire (n = 146), followed by mechanical problems (n = 27). The most common event with the Intuitive stapler was leak (n = 10) and bleeding from staple line (n = 8). Conclusions: Stapler malfunction is a very rare event in metabolic and bariatric surgery. All of the major stapler producers have transitioned to powered staplers with excellent safety profiles. Open and honest reporting about stapler malfunction is essential to determine the true safety of these ubiquitous devices.","PeriodicalId":114569,"journal":{"name":"JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123136749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4