JSLS : Journal of the Society of Laparoendoscopic Surgeons最新文献

Hysterectomy for Large Uterus by Minimally Invasive Surgery (MIS). 通过微创手术（MIS）切除大子宫。

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-07-01 DOI: 10.4293/JSLS.2024.00017

Pengfei Wang, Liaisan Uzianbaeva, Noemi Hughes, Alireza Mehdizadeh

{"title":"Hysterectomy for Large Uterus by Minimally Invasive Surgery (MIS).","authors":"Pengfei Wang, Liaisan Uzianbaeva, Noemi Hughes, Alireza Mehdizadeh","doi":"10.4293/JSLS.2024.00017","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00017","url":null,"abstract":"Background and objective: When the uterus is or more than 18 to 20 weeks in size, laparotomy but not minimally invasive surgery (MIS) is commonly performed for hysterectomy. It is, however, acknowledged that MIS carries numerous benefits to patients compared to laparotomy. The uterine size should therefore not be an excluding factor for MIS. This study aims to demonstrate the feasibility and benefits of MIS for hysterectomy for large uterus and explain specific techniques employed.Methods: Data from 73 laparoscopic and robotic hysterectomy cases were collected. Cases were divided in two groups based on uterine weight (≥500 g vs <500 g). Estimated blood loss (EBL), operative time, length of hospital stays, and perioperative complications were compared between the groups.Results: The average specimen weight in two groups was 244 ± 102.75 g vs 903 ± 438.18 g (P < .01). There was no statistically significant difference in length of hospital stay between the two groups. Only 3 patients were hospitalized for more than one day. There were no instances of conversion to laparotomy, intraoperative or postoperative blood transfusion. There was a statistically significant difference in the EBL (78.19 ± 43.8 ml vs 127.88 ± 69.76 ml, P < .01) and operative time (180.68 ± 48.36 vs 228.85 ± 53.04 minutes, P < .01) between the two groups. There were two cases of bladder laceration in the group with uterine weight exceeding 500 g.Conclusion: With advanced surgical skills and the adoption of specific techniques, hysterectomy for large uterus can be performed safely and efficiently by MIS.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgeons' Approach to Intraoperative Complications in Total Extraperitoneal (TEP) Hernia Repair. 外科医生对全腹膜外 (TEP) 疝修补术术中并发症的处理方法。

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-07-01 DOI: 10.4293/JSLS.2024.00020

Mehmet Esref Ulutas, Abdullah Hilmi Yılmaz

{"title":"Surgeons' Approach to Intraoperative Complications in Total Extraperitoneal (TEP) Hernia Repair.","authors":"Mehmet Esref Ulutas, Abdullah Hilmi Yılmaz","doi":"10.4293/JSLS.2024.00020","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00020","url":null,"abstract":"Background and objectives: This study aimed to determine the frequency of laparoscopic inguinal hernia repair (LIHR) and how surgeons managed complications such as intraoperative bleeding, organ damage, and peritoneal injury that may develop during this procedure.Methods: The data for the study were collected through an electronic survey created using Google Forms and sent using WhatsApp in May 2024.Results: The study included 220 of 250 surgeons (88%) working in 25 healthcare centers located in different regions where the survey was distributed. Fourteen respondents with missing data were excluded from the study. The mean age of the remaining 206 participants was 39.6 (27-69) years. The rate of surgeons using laparoscopic techniques in inguinal hernia surgery was 89.3%. The method most preferred by the surgeons performing LIHR was total extraperitoneal (TEP) repair (60.9%), followed by transabdominal preperitoneal (TAPP) repair (39.1%). The surgeons preferred open procedures in patients with a history of lower abdominal surgery, those with scrotal hernia, and elderly patients. Additionally, in cases of intraoperative complications that developed at different stages of TEP, it was observed that participants mostly convert to the TAPP technique (43.5-46%), and in some cases, almost all participants continued the procedure with the same technique, i.e., TEP repair (94.6%).Conclusion: This study revealed that surgeons preferred open procedures in some specific patient groups, but they mostly preferred LIHR in the remaining cases. Young surgeons, in particular, seem more inclined to employ laparoscopic methods. In cases of intraoperative complications, most surgeons chose to continue with laparoscopic techniques.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electrosurgical Devices Used During Laparoscopic Hysterectomy.

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-07-01 Epub Date: 2025-01-02 DOI: 10.4293/JSLS.2024.00022

Toni S Horton, Paulette E Coombs, Yooree Ha, Zhen Wang, Tara J Brigham, Zenobia E Ofori-Dankwa, Olivia O Cardenas-Trowers

{"title":"Electrosurgical Devices Used During Laparoscopic Hysterectomy.","authors":"Toni S Horton, Paulette E Coombs, Yooree Ha, Zhen Wang, Tara J Brigham, Zenobia E Ofori-Dankwa, Olivia O Cardenas-Trowers","doi":"10.4293/JSLS.2024.00022","DOIUrl":"10.4293/JSLS.2024.00022","url":null,"abstract":"Background: Hysterectomy is one of the most common surgical procedures performed in the United States and most are now being performed in a minimally invasive approach. Electrosurgery and vessel sealing devices are needed in order to provide hemostasis and vascular coaptation; however, there is no guiding evidence and limited recommendations for the use of the currently available devices for laparoscopic hysterectomy. The purpose of this study is to provide a systematic review of electrosurgical devices used in benign hysterectomy and perform a meta-analysis to find the overall effect of various outcomes.Database: A systematic review was performed by searching the literature using MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Review, Science Citation Index Expanded, Emerging Sources Citation Index, Scopus, Epistemonikos, and SciELO databases from each database's inception date until May 2023.Conclusion: Advanced bipolar vessel sealing devices demonstrate reduced blood loss and operative times when compared to conventional electrosurgery, however more high-quality evidence and cost analysis is needed to strengthen the clinical significance of these findings.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inferior-Medial Approach to Laparoscopic Splenic Vessel-Preserving Distal Pancreatectomy. 腹腔镜保留脾脏血管的胰腺远端切除术的下内侧入路

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-07-01 DOI: 10.4293/JSLS.2024.00028

Kee Tae Park, Joo Dong Kim

{"title":"Inferior-Medial Approach to Laparoscopic Splenic Vessel-Preserving Distal Pancreatectomy.","authors":"Kee Tae Park, Joo Dong Kim","doi":"10.4293/JSLS.2024.00028","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00028","url":null,"abstract":"Background and objectives: Complete preservation of the splenic vessels is ideal during laparoscopic spleen-preserving distal pancreatectomy (LSPDP). However, this remains challenging and time-consuming because the vessels are often deeply embedded in the pancreatic parenchyma. Herein, we introduce our inferior-medial approach to laparoscopic splenic vessel-preserving distal pancreatectomy (lap-SVPDP) and evaluate its safety and feasibility.Methods: Forty-three patients underwent LSPDP performed by a single surgeon at our institution: 26 (60.5%) lap-SVPDPs with an inferior-medial approach and 17 with the laparoscopic Warshaw technique (lap-WT). We compared the outcomes of the 2 groups. No patient undergoing lap-SVPDP required conversion to laparotomy or lap-WT.Results: Most preoperative characteristics and postoperative outcomes did not differ between the 2 groups; neither the operation time nor the intraoperative blood loss differed despite the greater technical complexity of lap-SVPDP. The mean tumor size was greater in the lap-WT than the lap-SVPDP group (P = .001). The splenic vein patency rate of the lap-SVPDP group was not inferior to that of the open SVPDP group treated by the same surgeon.Conclusion: Inferior-medial approach lap-SVPDP could be a safe and feasible technique for lap-SVPDP; neither blood loss nor operation time is increased.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Racial Disparities in Minimally Invasive Benign Hysterectomy.

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-07-01 Epub Date: 2025-01-02 DOI: 10.4293/JSLS.2024.00018

Kamran Hessami, Marie-Claire Leaf, Jinxiao Liang, Adi Katz, Frank Chervenak, Abdelrahman AlAshqar, Mostafa A Borahay

{"title":"Racial Disparities in Minimally Invasive Benign Hysterectomy.","authors":"Kamran Hessami, Marie-Claire Leaf, Jinxiao Liang, Adi Katz, Frank Chervenak, Abdelrahman AlAshqar, Mostafa A Borahay","doi":"10.4293/JSLS.2024.00018","DOIUrl":"10.4293/JSLS.2024.00018","url":null,"abstract":"Background and objectives: Racial and ethnic disparities in access to minimally invasive surgery (MIS) and the rate of surgical complications in minority groups remain profoundly underinvestigated. This meta-analysis aims to compare the rate of MIS utilization for benign hysterectomy as well as the surgical morbidity among racial and ethnic minority patients in the United States.Methods: Studies comparing utilization rate of MIS for benign hysterectomy among non-Hispanic white, Black, and Hispanic populations were considered eligible. The primary outcome was the rate of MIS according to race. The secondary outcome was surgical morbidity risk (Clavien-Dindo Classification) according to hysterectomy route and race. Random-effect model meta-analysis pooled unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).Results: Thirteen studies were eligible, with a total of 1,123,851 patients undergoing benign hysterectomy, of whom 817,209 were white, 187,488 Black, and 119,154 Hispanic. Black and Hispanic patients were less likely to undergo MIS compared to white patients (Black: OR 0.44 [95% CI 0.39-0.49] and Hispanic: OR 0.65 [95% CI 0.59-0.71]). After pooling adjusted estimates, the rate of MIS use remained significantly lower in nonwhite populations. Nonwhite patients were more likely to develop surgical complications after hysterectomy in either MIS (OR 1.32 [95% CI: 1.15-1.52]) or open hysterectomy (OR 1.56 [95% CI: 1.40-1.73]).Conclusion: Racial and ethnic disparities in MIS utilization for benign hysterectomy are strikingly apparent in the United States, with nonwhite patients often demonstrating lower access to MIS utilization and higher rates of surgical morbidity than white patients.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot Assisted Cholecystectomy Using the BORNS Simphoni System.

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-07-01 Epub Date: 2025-01-02 DOI: 10.4293/JSLS.2024.00016

Vivek Bindal, Shailesh Gupta, Dhananjay Pandey, Shahiq Ahmed

{"title":"Robot Assisted Cholecystectomy Using the BORNS Simphoni System.","authors":"Vivek Bindal, Shailesh Gupta, Dhananjay Pandey, Shahiq Ahmed","doi":"10.4293/JSLS.2024.00016","DOIUrl":"10.4293/JSLS.2024.00016","url":null,"abstract":"Background and objective: Robotic cholecystectomy has technical advantages of 3D visualization, enhanced instrument maneuverability, and increased precision. Less chance of conversion to open and biliary spillage. This study explores the utilization of the BORNS Simphoni Robotic System for robotic cholecystectomy.Methods: The paper discusses the safety and efficacy of the system during a phase 1 clinical trial, focusing on key technical steps, outcomes, and comparisons with conventional laparoscopic cholecystectomy.Results: Results from the trial indicate successful completion of surgeries with no conversions to open procedures, minimal blood loss, and low postoperative pain.Discussion: The BORNS Simphoni system offers advanced features such as an open console design, articulating and nonarticulating instruments, and integrated ultrasonic energy sources. The study suggests the feasibility and effectiveness of robotic cholecystectomy using the BORNS Simphoni system. However, a larger sample size is needed to further evaluate and confirm these findings, as well as to assess the cost-effectiveness of this platform for broader adoption.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Pain Desensitization Algorithm for Phenotyping and Treating Chronic Pelvic Pain. 用于表型和治疗慢性盆腔疼痛的疼痛脱敏算法。

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00009

Liane Silva Rafael Rogério, Maurice K Chung, Charles W Butrick, Stanley J Antolak, Danniel Rocha Bevilaqua, Sunna Kureishy, Mariana Eiras Cardoso Conforto

{"title":"A Pain Desensitization Algorithm for Phenotyping and Treating Chronic Pelvic Pain.","authors":"Liane Silva Rafael Rogério, Maurice K Chung, Charles W Butrick, Stanley J Antolak, Danniel Rocha Bevilaqua, Sunna Kureishy, Mariana Eiras Cardoso Conforto","doi":"10.4293/JSLS.2024.00009","DOIUrl":"10.4293/JSLS.2024.00009","url":null,"abstract":"Background: Chronic pelvic pain remains challenging for physicians to manage due to central and peripheral sensitization and multiple pain generators including the bladder, pelvic floor, and pudendal nerve. Pain management providers have used nerve blocks for years for diagnosis and treatment. We developed a desensitization algorithm that provides a stepwise approach to improve patients pain scores.Methods: This is a prospective observational cohort study of 182 women aged 15-90 years old with chronic pelvic pain using an algorithm from 2016 to 2018. Treatment started with an Anesthetic Challenge Test of the bladder to guide us through a protocol of intravesical therapy and/or pudendal nerve blocks as a second step.Results: ACT POSITIVE patients, who received intravesical therapy: 84% had a Visual Analog Score pain improvement of at least 50%, 64% improved at least 80% (41% pain-free). Those desiring additional relief that received further Pudendal Blocks: 83% had final improvement of at least 50% (67% pain-free). ACT NEGATIVE patients received Pudendal Blocks with 80% of subjects achieving at least 50% relief, 65% improved at least 80% (35% pain-free). All final groups showed a statistically significance of P < .05% when compared to their initial pain scores.Conclusion: Management of women with chronic pelvic pain would ideally start with treating a specific diagnosis which, in most cases, is difficult to establish since the majority have more than one pain generator. Our algorithm simplified the approach and reduced the severity of pain scores prior to any further necessary surgical interventions.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Status and Role of Artificial Intelligence in Anorectal Diseases and Pelvic Floor Disorders. 人工智能在肛门直肠疾病和盆底障碍中的现状和作用。

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00007

Maryam Aleissa, Tijani Osumah, Ernesto Drelichman, Vijay Mittal, Jasneet Bhullar

{"title":"Current Status and Role of Artificial Intelligence in Anorectal Diseases and Pelvic Floor Disorders.","authors":"Maryam Aleissa, Tijani Osumah, Ernesto Drelichman, Vijay Mittal, Jasneet Bhullar","doi":"10.4293/JSLS.2024.00007","DOIUrl":"10.4293/JSLS.2024.00007","url":null,"abstract":"Background: Anorectal diseases and pelvic floor disorders are prevalent among the general population. Patients may present with overlapping symptoms, delaying diagnosis, and lowering quality of life. Treating physicians encounter numerous challenges attributed to the complex nature of pelvic anatomy, limitations of diagnostic techniques, and lack of available resources. This article is an overview of the current state of artificial intelligence (AI) in tackling the difficulties of managing benign anorectal disorders and pelvic floor disorders.Methods: A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed database to identify all potentially relevant studies published from January 2000 to August 2023. Search queries were built using the following terms: AI, machine learning, deep learning, benign anorectal disease, pelvic floor disorder, fecal incontinence, obstructive defecation, anal fistula, rectal prolapse, and anorectal manometry. Malignant anorectal articles and abstracts were excluded. Data from selected articles were analyzed.Results: 139 articles were found, 15 of which met our inclusion and exclusion criteria. The most common AI module was convolutional neural network. researchers were able to develop AI modules to optimize imaging studies for pelvis, fistula, and abscess anatomy, facilitated anorectal manometry interpretation, and improved high-definition anoscope use. None of the modules were validated in an external cohort.Conclusion: There is potential for AI to enhance the management of pelvic floor and benign anorectal diseases. Ongoing research necessitates the use of multidisciplinary approaches and collaboration between physicians and AI programmers to tackle pressing challenges.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Influencing CRP levels in Laparoscopic and Robotic Total Hysterectomy. 影响腹腔镜和机器人全子宫切除术 CRP 水平的因素。

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00005

Shohei Tanabe, Shi Yutoku, Kotaro Ichida

{"title":"Factors Influencing CRP levels in Laparoscopic and Robotic Total Hysterectomy.","authors":"Shohei Tanabe, Shi Yutoku, Kotaro Ichida","doi":"10.4293/JSLS.2024.00005","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00005","url":null,"abstract":"Background and objectives: Patients with high postoperative C-reactive protein levels are known to have a high risk of complications such as intestinal injuries than those with low levels. However, the factors that influence postoperative C-reactive protein levels in patients without complications are unknown. In this study, we aimed to determine the factors affecting postoperative C-reactive protein levels in patients undergoing laparoscopic and robotic total hysterectomy.Methods: We conducted a retrospective cohort study of patients who had undergone laparoscopic or robotic total hysterectomy for uterine fibroids, adenomyosis, or cervical neoplasia.Results: The study was conducted between July 2016 and December 2022 at our hospital. In total, 185 patients underwent laparoscopic or robotic total hysterectomy during the relevant period. Of these, 180 patients were included, excluding 3 who underwent laparotomy, 1 who developed an abscess, and 1 who did not have a postoperative blood draw. The measured outcome was the C-reactive protein level on the first postoperative day. Patient age, body mass index, operative time, blood loss, and uterine weight were deemed the possible influencing factors. Multiple regression analysis was performed to evaluate the influence of these factors on the postoperative C-reactive protein values. Statistical significance was defined as a P value less than .05. The median value was 1.72 (interquartile range, 1.11-2.52). Body mass index and operative time were determined to be the most significant factors.Conclusion: Patients' body mass index and operative time were found to be associated with first postoperative day C-reactive protein levels in uncomplicated cases.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Sling Technique for Laparoscopic Liver Mobilization. 腹腔镜肝脏移动吊带技术。

IF 1.4 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00011

Andrew N de la Torre, Justin Adibi, Zaineb Zubair

{"title":"The Sling Technique for Laparoscopic Liver Mobilization.","authors":"Andrew N de la Torre, Justin Adibi, Zaineb Zubair","doi":"10.4293/JSLS.2024.00011","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00011","url":null,"abstract":"Background: As liver surgery continues to evolve, be it open, laparoscopic or robotic, it remains a procedure that can deteriorate in the blink of an eye. Liver surgery in patients with hepatoma is further complicated, as the vast majority have significant fibrosis, if not cirrhosis. Thus, parenchymal sparing resection is increasingly necessary. Effective and safe intracorporeal mobilization of the liver is essential for minimal access parenchymal-sparing and conventional resection.Methods: This retrospective review of over 150 cases performed provides a hands-on approach to laparoscopic hepatic mobilization with the use of an inexpensive technique using a 1\" packing tape to \"Sling\" the liver in-order to divide the ligaments holding the liver in place and optimally position the liver for parenchymal transection.Results: Use of a 1\" packing tape to \"Sling\" the liver intracorporeally is demonstrated to enable mobilization of the liver for tissue sparing non-anatomic, anatomic and major resections.Conclusion: Use of a 1\" packing tape to \"Sling\" the liver intracorporeally can facilitate mobilization for resection. Surgeons hoping to master minimal access resection should also be well versed in the use of laparoscopic ultrasound and liver transplant \"Piggyback\" technique.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0