Journal of Minimally Invasive Surgical Sciences最新文献

{"title":"Laparoscopic Tapp Inguinal Hernia Repair: Mesh Fixation With Absorbable Tacks, Initial Experience","authors":"F. Agresta, A. Marzetti, L. A. Verza, D. Prando, A. Azabdaftari, L. Rubinato, U. Vacca, A. Roveran, R. Porfidia, S. Vigna","doi":"10.17795/MINSURGERY-35609","DOIUrl":"https://doi.org/10.17795/MINSURGERY-35609","url":null,"abstract":"Background: Preliminary studies have indicated advantages of mesh fixation using fibrin glue in TAPP compared with tack fixation. Objectives: We report the results of a prospective experience in fixing mesh during TAPP with absorbable tacks. Patients and Methods: 50 consecutive men (who had bilateral inguinal hernia) were enrolled and followed up for at least 1 year. The primary measured outcome was pain experienced in day 1 of post-op. The secondary outcomes measured were postoperative scores of pain at rest, discomfort, and fatigue, foreign-body sensation, and hernia recurrence after 12 months. The outcomes were measured using a visual analogue scale, a verbal rating scale and numerical rating scales. A comparison was done within a historical group with the same demographic and hernia characteristics where the meshes have been fixed with fibrin glue. Results: The group of tacks ‘TAPP’ showed good results concerning the level of pain, fatigue and foreign body sensation comparable with those of the historical group. There were significant differences concerning the length of surgery where absorbable tacks performed better. Regarding cost of surgery, the fibrin glue showed effective results. Conclusions: The use of absorbable tacks during TAPP confers significant benefit regarding the operating time, however it is a disadvantage due to the cost when compared with fibrin glue.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130237644","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}

{"title":"Evolution of Laparoscopic Cholecystectomy: From Multiport to Single Port","authors":"O. Karakuş, Oktay Ulusoy","doi":"10.17795/MINSURGERY-36366","DOIUrl":"https://doi.org/10.17795/MINSURGERY-36366","url":null,"abstract":"Context: Laparoscopic approach with its several techniques has become the standard method for cholecystectomy over the past decades. As technical instruments have improved and varied, the interest in endoscopic surgery has turned towards minimal invasive single site access surgery with fewer instruments, thus resulting in minimal pain, minimal scarring and better cosmesis. Evidence Acquisition: A systematic literature searching of databases MEDLINE, EMBASE, and Google Scholar was done from 1982 and updated in December 2015. Search terms were “cholecystectomy”, “laparoscopic cholecystectomy”, “four port laparoscopic cholecystectomy”, “single-incision laparoscopic surgery”. Results: Four-port laparoscopic cholecystectomy was accepted as the “gold standard” in the treatment of patients with cholelithiasis before millennium. Thereafter, two-port laparoscopic cholecystectomy was reported as a novel, safe and rapid method of gallbladder removal in consecutive reports. Single-site laparoscopic cholecystectomy with non-conventional multi-channel port method was first introduced as an alternative to the standard multi-port laparoscopic cholecystectomy in adult patients in the last decade. Success rates of performing conventional four-port laparoscopic cholecystectomy were ranging from 93% to 100% and single site laparoscopic cholecystectomy was ranging from 84% to 100%. Conclusions: Currently, it has been widely accepted that laparoscopic cholecystectomy is the gold standard for cholecystectomy. Although single site laparoscopic cholecystectomy is becoming more popular with the recent advancements, conventional multiport laparoscopic cholecystectomy is being widely used as the primary treatment modality for the gallbladder removal.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121396614","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}

{"title":"Surgical Wound Infections After Laparoscopic Appendectomy With or Without Using Reusable Retrieval Bag: A Retrospective Study","authors":"Ahmed E. Lasheen, O. A. Elaziz, S. A. Elaal, Mohammed Alkilany, Basem Sieda, tamer A alnaimy","doi":"10.17795/MINSURGERY-36894","DOIUrl":"https://doi.org/10.17795/MINSURGERY-36894","url":null,"abstract":"Background: Despite the reported advantages of laparoscopic appendectomy (LA), an ongoing debate exists about a possible increase in postoperative infectious complication rates. The analyses of risk factors associated with surgical site infections (SSIs) after LA, have been limited. Patients and Methods: One hundred twenty laparoscopic appendectomies performed over one year, were included in this retrospective study. The patients were divided into 2 group; group A was the one in which LA was done with using reusable retrieval bag and group B without using that. Demographic details, operative time, hospital stay and infective postoperative complications were recorded. Results: This patient groups were selected to be similar in both groups A and B in form of appendicitis types. Each group included 27 (45%) acute catarrhal appendicitis, 20 (33.3%) suppurative appendicitis and 13 (21.7%) perforated appendicitis, P = 1.0. The median patients ages were 21 years (range, 16 to 49) in group A and 25 years (range, 18 to 56) in group B, P = 0.053. Group A included 60 patients (35 males and 25 females) and group B 60 patients (32 males and 28 females), P = 0.071. Mean operative time in group A was 55.7 minutes and in group B was 57 minutes, P = 0.0231. Superficial wound infections were recorded in one patient (1.7%) in group A and in 8 patients (13.3%) in group B, P = 0.007. Intra-abdominal abscess formation was a complicated outcome in 2 patients (3.3%) of group B, P = 0.005. Mean hospital stay was 1.6 days in group A and 2.7 days in group B, P = 0.05. Conclusions: Surgical wound infections are less common by using reusable retrieval bag during laparoscopic appendectomy procedure. Also, using reusable retrieval bag has less cost.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134038587","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}

{"title":"Administrative Chief Residents - How Are They Chosen and Does It Matter?","authors":"A. Weiss, Damini Tandon, Katherine C. Lee, Bindupriya Chandrasekaran, N. Lopez, S. Ramamoorthy, V. Malcarne, S. Blair","doi":"10.17795/MINSURGERY-34764","DOIUrl":"https://doi.org/10.17795/MINSURGERY-34764","url":null,"abstract":"Background: There is no literature on the administrative chief resident (ACR) in surgery or disparities of this leadership position. Objectives: The aim of this study is to examine the rates of perceived female and minority leadership at the resident level. Patients and Methods: After institutional review board (IRB) approval, a pilot survey was sent to surgical residents and faculty at a single university surgical program. The survey was revised based on small group feedback and a specialist in study design. It was then sent to all US surgical residents and program directors, and analyzed using Survey Monkey. Results: There was a 10% resident response rate, 22% program director, most from a program with 50% female residents. 71% report no clear ACR policy, 64% believe the position appointed. Half report less than 25% female ACRs, 54% zero minority ACRs. Program directors reported more female ACRs, but similar lack of selection policy. 54% believe ACR receives a stipend. 31% report more than 75% went into academics. Conclusions: Although most surgical programs train 50% female residents, residents perceive that fewer than 25% ACRs are female. ACRs in the United States are often receiving a stipend and going into academic practice. Programs should keep diversity in mind in appointing ACR.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122990239","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}

{"title":"Persistence of Symptoms After Laparoscopic Cholecystectomy","authors":"A. Malik, R. Wani, S. Bari, A. Manhas","doi":"10.17795/MINSURGERY-31791","DOIUrl":"https://doi.org/10.17795/MINSURGERY-31791","url":null,"abstract":"Background: A significant proportion of individuals undergoing cholecystectomy for symptomatic cholelithiasis persist with symptoms even after surgery. Objectives: This study was aimed to test our hypothesis that age of presentation and duration of symptoms are the risk factors that predispose to negative symptomatic outcome after cholecystectomy. PatientsandMethods: 351 patients with diagnosis of symptomatic gallstones admitted to a tertiary care hospital for elective lapro- scopic cholecystectomy over a period of three years from 2009. They were provided a standard symptom questionnaire to evaluate the symptomatic outcome and to compare the quality of life at interval of one, three and six months after the procedure regarding the presenting symptoms at the time of admission. Out of 351 patients, 51 patients refused to continue participation in the study and were excluded from the study group. The remaining 300 patients were followed till six months after procedure. Results: 55.66% of patients were highly satisfied after cholecystectomy with regard to alleviation of preoperative symptoms, while 34.33% of patients were satisfied with the treatment. A minority of 8.6% of patients perceived no change with regard to preoperative symptoms, while 1.3% of them had worsening of symptoms. Conclusions: We conclude that management of gall bladder stone disease should be tailored precisely with respect to the quality of life index, with increased emphasis on early detection and treatment as well as increased emphasis on counseling in an elderly cohort after considering the prognosis after cholecystectomy dierentially .","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129360028","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}

{"title":"Surgical Treatment of Gastro-Esophageal Reflux Disease: A Review of Concepts Misguiding the Indications for Surgery","authors":"P. Armijo, F. Herbella, M. Patti","doi":"10.17795/MINSURGERY-33995","DOIUrl":"https://doi.org/10.17795/MINSURGERY-33995","url":null,"abstract":"Context: Clinical therapies and surgical interventions are the acceptable treatments for gastro-esophageal reflux disease (GERD). Referrals for surgery are yet limited, because of disadvantages associated to surgical treatment, including: (a) high rate of mortality; (b) high risk of side eects, especially dysphagia; (c) need for acid-reducing medications after surgery; (d) need for revision surgery; (e) unclear benefit of surgery on the risk of cancer; and (f) dierences in the outcomes between a community setting and a tertiary care center. In contrast, surgeons report excellent outcomes after anti-reflux operation. Evidence Acquisition: A thorough search in literature was performed with predefined keywords to identify relevant articles pub- lished from 1975 to January 2015, in order to analyze the complications from the aspect of current surgeon's perspective. Results: Our review showed that: (a) the mortality rate of the surgical procedure is negligible and PPI therapy is also accompanied with mortality; (b) there is a 5% chance of severe dysphagia after anti-reflux operation; (c) postsurgical use of PPI is not an indication of surgical failure, but often represents misuse of the medication; (d) there is a 5% chance of re-operation after surgery, often because of severe dysphagia; (e) reduction in the risk of adenocarcinoma is probable but still controversial; and (f) good results can be achieved in a community setting. Conclusions: A significant number of patients would benefit from surgical therapy to treat their GERD symptoms, but some incor- rect beliefs still misguide the indications for the surgical procedure.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132057115","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}

{"title":"Report of the Second International Congress of Bariatric and Metabolic Surgery and the First Obesity Week of Iran","authors":"Gholamreza Mohammadi-Farsani, A. Kabir","doi":"10.17795/MINSURGERY-38222","DOIUrl":"https://doi.org/10.17795/MINSURGERY-38222","url":null,"abstract":"This congress was held for the first time and it was performed simultaneously with the fifth national congress of prevention and treatment of obesity in Iran. It was done as “Iran’s first obesity week” by Iran obesity society and research institute for endocrine sciences in Milad hospital with the aim to increase interdisciplinary cooperation and have a comprehensive approach to obesity treatment and prevention.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124802471","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}

{"title":"The Relation Between Injection Volumes and Efficacy of Epidural Steroid Injections in Treatment of Acute Low Back Pain","authors":"L. Pirbudak, Neslihan Uzture, M. Işık, S. Guner","doi":"10.17795/MINSURGERY-34136","DOIUrl":"https://doi.org/10.17795/MINSURGERY-34136","url":null,"abstract":"Background: Low back pain (LBP) is one of the most common complaints that is reported by all age groups. Objective: This study was aimed to investigate the efficacy of epidural steroid injections (EPSI) related to different volume injections for treatment of acute low back pain with radiculopathy. Patients and Methods: The study is consisted of seventy five patients who had acute discogenic pain. Three groups composed namely Group 1, Group 2 and Group 3. All patients were assigned to one of the groups randomly and recevied combination of triamcinolone (80 mg) and bupivacaine (12.5 mg) as a single epidural dose. Volume of 10 mL, 15 mL, and 20 mL epidural injections were used for Group 1, 2 and 3 respectively. The efficacy of treatment was assessed with visual analog scale; VAS (O = no pain, 10 = unbearable pain) straight leg elevation test; SLET (0° = worst, 85° = best), and oswestry disability index; ODI (0 to 20%: minimal disability, 80 to 100%: bed bound patients) before and 2 weeks after the epidural steroid injections (EPSI). Results: Fifty seven 57 (76%) female and 18 (24%) male were entered to the study. Two weeks after the procedure, significant improvement was observed in each group regarding the results of VAS, SLET and ODI. Temporary radicular pain, not required treatment, was reported for 10 patients; 40% of group II and 18 patients; 72% of group III, but not reported in group I (P < 0.001). Conclusions: Different volumes of EPSI in patients with acute low back pain associated with radiculopathy causes significant pain relief in all groups. There was no superiority between the groups. Temporary radicular pain we encountered can be explained by high volumes.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124623528","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}

{"title":"Petro-Clival Tumours: Role and Indications of Transoral and Transsphenoidal Approaches Followed by Hypofractionated Stereotactic Radiotherapy","authors":"M. Fraioli, G. Giovinazzo, G. Umana, B. Fraioli, P. Lunardi","doi":"10.17795/MINSURGERY-34431","DOIUrl":"https://doi.org/10.17795/MINSURGERY-34431","url":null,"abstract":"Background: Petro-clival,clivalandspheno-petro-clivaltumoursarestillaneurosurgicalchallenge. Usually,theclassicalskullbase transpetrousapproachesareemployed,althoughtheyareburdenedbyanimportantrateof morbidity,andaverylowrateof radical removal is reported. Objectives: We present our indications and results with minimally invasive transnasal and transoral approaches. Patients and Methods: We present 14 patients affected by petro-clival, clival and spheno-petro-clival meningiomas/chordomas with prevalent extension ventrally to the brainstem; cranial nerves V to XII and vertebra-basilar arterial complex resulted posterior and laterally displaced. Preoperative clinical symptoms were represented by aspecific headache in 6 patients, mild and moderate contralateral hemiparesis in 3 and 2 patients respectively, mild and moderate tetraparesis in 2 and 1 patients respectively and cranial nerves deficit in 11 ones. Preoperative planning considered three objectives: to avoid operative and post-operative mor-tality/morbidity, to achieve satisfactory tumour removal and to avoid tumour regrowth. Anterior approach (transoral in 6 and transsphenoidal in 8 other) was selected for these patients according to postero-lateral approaches complexity due to the anterior-medial position of the tumour in respect of cranial nerves and vascular arteries. Results: In no patient radical removal was performed because gross total/subtotal removal had been programmed preoperatively on the basis of tumours extension. Concerning the 4 clival chordomas, gross total in two patients and subtotal removal in the two otheroneswasperformed. Grosstotalremovalwasaccomplishedintheclivalmeningioma,whilesubtotalremovalwasachievedin 5 petro-clival and in 2 spheno-petro-clival meningiomas; partial removal was performed in one spheno-petro-clival and one petro-clivalmeningioma. Nomortalityandnoneurologicdeficitswereregisteredaftersurgery. Preoperativeneurologicdeficitimproved in the majority of patients. Conclusions: Anterior transoral and transsphenoidal approaches are indicated for clival and spheno-petro-clival region tumours located ventrally to the brainstem and medially to acoustic meatus, to perform a prevalently median tumour debulking; these approaches allowed an extremely low rate of new neurological deficit and a rapid resumption of vital activities, obviously in relation with preoperative clinical status in our patients.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129038043","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}

{"title":"Divided Laparoscopic Cholecystectomy for Unusual Gall Stones Complication of Mirizzi's Syndrome","authors":"Ahmed E. Lasheen, Mostafa Baioumy, Mansour M. Morsy, Wael M. Mahmoud, W. Mansy, A. Ismail, Yasser Hussein","doi":"10.17795/MINSURGERY-31574","DOIUrl":"https://doi.org/10.17795/MINSURGERY-31574","url":null,"abstract":"Background: Chronic complications of symptomatic gallstone disease such as Mirizzi’s syndrome are rare. The importance and implications of these conditions are related to their associated surgical complications which are potentially serious such as bile duct injury and to the modern management when encountered during laparoscopic cholecystectomy. Objectives: This research offers a technique to avoid surgical complications in Mirizzi’s syndrome cases during laparoscopic cholecystectomy. Patients and Methods: Between November 2012 and February 2015, 17 patients (12 females and 5 males) with mean age of 51 years (between 29 and 57 years) suffering from Mirizzi’s syndrome underwent the divided cholecystectomy. In this technique the gall bladder was divided into two parts above the gall bladder infundibulum. The distal part was dissected for short distance and used to push liver up. The proximal part of gall bladder was cleared from all its contents and reevaluated from inside. Management was achieved according to the stage of disease. Results: The mean operative time was 70 minutes (between 60 and 90 minutes). No biliary tract obstruction or leakage or stenosis was recorded in this patient group during the period of follow up (18 months). Conclusions: Divided laparoscopic cholecystectomy is a safe and effective technique to face the unusual gallstones complications (Mirizzi’s syndrome).","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129351683","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}