World Journal of Laparoscopic Surgery最新文献

{"title":"Minimal Invasive Management of Gallbladder Perforation","authors":"Ajay H. Bhandarwar, J. More, S. Bhagvat, Prachiti S. Gokhe, A. Wagh","doi":"10.5005/jp-journals-10033-1364","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1364","url":null,"abstract":"Ab s t r Ac t Background: Gallbladder perforation (GBP) is a rare clinical entity but life-threatening complication of cholecystitis with or without stones and associated with increased rate of mortality and morbidity due to late diagnosis. Case description: We describe the case of a 51-year-old male patient who presented with abdominal pain and a Niemeier type II GBP. CT scan revealed a GBP with subhepatic collection and surrounding inflammatory changes. It was communicating through a thin hypodense band with the cystic duct, distal to an impacted stone. Through laparoscopy, the collection was confirmed to be a subhepatic secondary to GBP. The cholecystectomy and the abscess cavity treatment were completely handled via laparoscopic approach. Discussion and conclusion: The case report demonstrates that laparoscopic approach can be a safe and feasible method in order to treat both the cause and the complication in this situation. Early diagnosis and appropriate minimally invasive approach are the key to manage this condition.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70798932","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":"Study of Feasibility of Single Incision Laparoscopic Surgery with Conventional Instruments","authors":"Ajay H. Bhandarwar, P. J. Zanwar, Jitendra Sankpal, M. Tayade, Shubham D Gupta, Jasmine Agarwal","doi":"10.5005/jp-journals-10033-1365","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1365","url":null,"abstract":"Aim: To evaluate the feasibility and safety of single incision laparoscopic surgery using conventional laparoscopy instrument set. Materials and methods: Patients admitted in General Surgery Department of Gokuldas Tejpal Hospital, affiliated to Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, during January 2015 to June 2016 for appendicitis and symptomatic gallstone disease were included in study. Forty cases were enrolled in study and prospective observational study was performed. Results: Total 40 cases included, 21 cases of appendicitis and 19 cases of symptomatic cholelithiasis. Mean age of appendectomy group was 28.71 ± 9.69 years and mean age of cholecystectomy group was 36.71 ± 10.48 years. In our study, mean operative time for single-incision laparoscopic (SIL) appendectomy was 42.04 ± 5.74 minutes. Postoperative fever was noted in three cases (14.25%). Mean postoperative pain as per visual analog scale (VAS) score taken after 24 hours on POD 2 was 2.14. Average postoperative stay in hospital was 2.14 days, and port-site infection occurred in one case (4.17%). Patient satisfaction score obtained on the scale of 1–10 on 1-month follow-up was 7.95, while scar cosmesis score was 7.9. In our study, 19 cases underwent SIL cholecystectomy, of which 7 were male (36.8%) and 12 were female (41.2%), and mean age of patients was 36.71 years. Mean operative time in our study was 75.21 min, mean postoperative pain taken on POD 2 as per VAS score was 2.91, mean postoperative hospital stay was 2.1 days, and port-site infections occurred in 2 cases. Postoperative fever was noted in 2 cases, and postoperative patient satisfaction score obtained at 1-month follow-up was 7.73 and scar score of 7.84 on the scale of 0–10. No case required drain placement and conversion. Conclusion: single-incision laparoscopic surgery (SILS) can be performed using conventional laparoscopic instruments, though it has more operative time, comparable postoperative hospital stay, causes less pain, and has significantly more patient satisfaction regarding postoperative scar and cosmesis. Clinical significance: Since SILS has more patient acceptance and satisfaction, it can be offered to all patients undergoing laparoscopic surgery, irrespective of unavailability of special instruments and financial constraints, as it can be performed using conventional laparoscopic instruments.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799009","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":"Comparative Study of Veress Needle and Visiport in Creating Pneumoperitoneum in Laparoscopic Surgery","authors":"Sheela Prince, P. Kannan","doi":"10.5005/jp-journals-10033-1368","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1368","url":null,"abstract":"Introduction: In minimal access surgery, the technique of first entry in the human body with the telescope and instruments is called the access technique. Laparoscopic access is of two types: closed and open access. 1,2 Here we are analyzing the merits and demerits of two entry techniques and the incidence of complications in both techniques. Comparison is between the blind technique by using the Veress needle and the undervision technique by using Visiport. Aim of study: To assess, evaluate, and compare the incidence of complications in blind and clear view access techniques in laparoscopic surgery. Materials and methods: A total of 150 cases of laparoscopic surgeries using the Veress needle and 150 cases of laparoscopic surgeries done by Visiport have been reported. (All laparoscopic surgeries were done in the General Surgery Department in Rashid Hospital from January 1, 2015 to December 12, 2015.) Result: In this study of comparison, both techniques were seen to have been associated with their own complications. But Visiport is a safe and faster method of creating pneumoperitoneum, though there was a statistically insignificant major vascular injury. It happened with an inexperienced surgeon. Conclusion: Visiport is a safe and faster method of creating pneumoperitoneum in laparoscopic surgery.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799489","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":"Frequency, Complications, and Predictive Factors for Performing Subtotal Laparoscopic Cholecystectomy in a Hepatobiliary Unit: A Comparative Cohort Study","authors":"A. Farrugia, N. Ravichandran, Majid Ali, H. Blege, Saboor Khan, F. Lam, J. Ahmad, G. Marangoni","doi":"10.5005/jp-journals-10033-1369","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1369","url":null,"abstract":"A bstrAct Aims: Laparoscopic subtotal cholecystectomies (LSCs) are occasionally performed for difficult gallbladder (GB) surgery. The aim of this study is to determine the rate, complications, and factors predictive of performing LSC in a hepatobiliary (HPB) unit, in comparison to patients who have undergone a conventional operation. Materials and methods: A 5-year retrospective review of laparoscopic cholecystectomies (LCs) was performed by HPB team at a tertiary center. Demographic, operative, and postoperative data were identified. A randomized group (generated using online randomization software Research Randomizer®) of LC patients was identified from the study cohort, who had the same data recorded for comparison. Significance level was set at p < 0.05 when comparing the two groups of LC and LSC. Results: A total of 1,613 patients underwent LC, of which, 102 (6.3%) underwent LSC. The complication rate was 12.7% in the LSC group, mainly consisting of bile leak (3.9%) and collection requiring drainage (0.98%). The LC group had a 4.9% complication rate, of which, one bile leak was reported, i.e., 1 (0.98%). The length of stay was significantly longer in the LSC group (2 days vs 0 days in the LC group), and this group also had a slightly higher readmission rate (8.8% vs 3.92%). Laparoscopic subtotal cholecystectomy was found to be more likely in patients with previous cholecystitis, thickened GB wall on imaging and previous endoscopic retrograde cholangiopancreatography (ERCP). Conclusion: Laparoscopic subtotal cholecystectomy is a safe procedure and the above characteristics may be used to potentially predict who is more likely to undergo LSC. This may aid in the consenting process and also help to create a score that predicts the probability of undergoing LSC. World (2019):","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799577","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":"Pouch of Douglas: A Noble Route for Surgical Specimen Retrieval in Laparoscopic Pelvic Mass Surgery","authors":"Abhipsa Mishra, S. Behera","doi":"10.5005/JP-JOURNALS-10007-1329","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10007-1329","url":null,"abstract":"Aim: To evaluate the feasibility and surgical outcome of surgical specimen retrieval through the pouch of Douglas by an innovative way of puncturing the same with a 10 mm trocar and cannula in 100 consecutive women undergoing laparoscopic gynecological procedures for a pelvic mass. Materials and methods: A prospective study over a period of 2 years from June 2012 to June 2014; 100 cases of pelvic mass (small-to-large) surgeries were done laparoscopically and specimens removed through pouch of Douglas by our own new method of puncturing the same with 10 mm trocar and cannula and putting the mass in endobag and removing with a grasper. Parameters studied were indications, operative time, blood loss, spillage, postoperative pain, long-term complications. Results: In 96% of cases, surgical specimens were retrieved successfully, with minimal spillage without any intraoperative or postoperative complication. Though the rest 4% were retrieved successfully, 2% had laceration but they were managed intraoperatively, 2% had postoperative abscess formation managed conservatively. Only 5% had pain in vagina at 24 hours on 10 cm visual analog scale (VAS); 95% cases had no complaint of dyspareunia on 3rd month follow-up and 5% were lost to follow-up. Conclusion: A pouch of Douglas approach for specimen removal by our new method after laparoscopic resection of pelvic masses offers the advantage of less postoperative pain, with minimal spillage, good cosmetic result, and patient satisfaction without prolonging the operative time. Clinical significance: Tissue retrieved through pouch of Douglas after puncturing with 10 mm trocar with cannula under vision is a safe, feasible, less time-consuming method in laparoscopic pelvic mass surgery. It avoids the enlargement of operative port site.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70748341","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":"Posterior Rectus Sheath: A Prospective Study of Laparoscopic Live Surgical Anatomy during Total Extraperitoneal Preperitoneal Hernioplasty","authors":"M. M. Ansari","doi":"10.5005/JP-JOURNALS-10007-1327","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10007-1327","url":null,"abstract":"Aim: Posterior rectus sheath (PRS) recently assumed great importance during laparoscopic total extraperitoneal preperitoneal (TEPP) hernioplasty. However, literature is scanty and cadaveric. Novel observations on live PRS anatomy are reported here. Materials and methods: Totally, 60 male patients with primary inguinal hernia underwent 68 TEPP hernioplasties. Standard 3-midline-port technique was used with telescopic dissection. Data were analyzed as mean ± standard deviation (SD). Results: All patients were male with mean age and body mass index of 50.1 ± 17.2 years (18–80) and 22.6 ± 2.0 kg/m2 (19.5–31.2) respectively. The classically described PRS (normal-length whole tendinous) was found in only 46% of the cases, while in the remaining 54%, the PRS was found as variant types, which included short whole-tendinous (4.4%), long whole tendinous (LWT) (4.4%), complete-length whole tendinous (8.8%), normal-length partly tendinous (NPT) (11.8%), long partly tendinous (LPT) (10.3%), normal-length thinned-out (NTO) (1.5%), complete-length thinned-out (4.4%), normal-length grossly attenuated (1.5%), complete-length grossly attenuated (4.4%), complete-length partly tendinous (CPT) (1.5%), and complete-length musculo-tendinous (CMT) (1.5%). Additionally, anatomy of the PRS was not a mirror image on the two sides of the body in 75% of patients with bilateral hernias. No hernia recurrence occurred in mean follow-up of 33 months. Conclusion: Posterior rectus sheath varied markedly in its extent and morphology, resulting in its categorization of 12 types. Truly new visions of the structures known for centuries are realized under excellent perspective and magnification of laparoscopy, and, therefore, continued anatomic research is strongly recommended. Clinical significance: Crisp, precise knowledge of preperitoneal anatomy is of paramount importance for timely identification of its variations in order to perform a seamless laparoscopic hernia repair with better outcome.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70748078","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":"Preoperative Infraumbilical Anthropometry: A Selective Guide to Endoscopic Hernia Repairâ€â€A Pilot Study","authors":"Utpal De, Pronoy Kabiraj","doi":"10.5005/jp-journals-10007-1326","DOIUrl":"https://doi.org/10.5005/jp-journals-10007-1326","url":null,"abstract":"Introduction: Specific preoperative indications for endoscopic hernia repair are nonexistent. The study was aimed to examine the feasibility of preoperative infraumbilical anthropometry (PIA) as a guide to define endoscopic repair. Materials and methods: Forty-five patients were recruited for the study based on predefined inclusion and exclusion criteria. Preoperative anthropometric measurements (fixed bony points of pelvis and umbilicus) were done. All patients were subjected to total extraperitoneal repair (TEP). Failure of TEP was converted to transabdominal preperitoneal repair (TAPP) and reasons for conversion were noted and statistically analyzed. Results: A total of 33 patients underwent TEP (73.3%) and 12 (26.7%) patients had to be converted to TAPP. Raised body mass index (BMI) [mean 22.53, standard deviation (SD) 0.35, p < 0.001], increased infraumbilical fat pad thickness (mean 2.77 cm, SD 0.27, p < 0.00), and pelvic anthropometric parameters were found to be significant (p < 0.001). Conclusion: Preoperative pelvic anthropometry could be a selective guide to endoscopic hernia repair.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70748405","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":"Injectable Tramadol vs Diclofenac for Postoperative Pain Management in Laparoscopic Cholecystectomy Surgery: A Comparative Prospective Study","authors":"K. Chowdhary, Muzzafar Zaman, R. Yadav, Ashish Choudhary, P. Grewal, A. Bawa, Aliya Shah","doi":"10.5005/JP-JOURNALS-10007-1325","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10007-1325","url":null,"abstract":"Introduction: Laparoscopic management of gallstones is considered as the gold standard treatment nowadays and is the most common surgery done in the present scenario. Postoperative pain remains one of the most common complaints after laparoscopic cholecystectomy and should be managed with proper analgesia with minimal side effects. Aim: To compare the efficacy of injectable tramadol and diclofenac in the pain management after laparoscopic cholecystectomy surgery. Materials and methods: A randomized prospective study was done at Maharishi Markandeshwar College of Medical Science & Research in the Department of General Surgery on 50 patients undergoing laparoscopic surgery between December 2016 and December 2017. Postoperative analgesic is decided randomly with the help of dice. Pain is measured on visual analog scale (VAS) on 6, 12, 18, and 24 hours. Results: A total of 50 patients, divided in two groups I and II, were taken in this study from December 2016 to December 2017 who underwent laparoscopic cholecystectomy. Group I was given injection diclofenac and group II was given injection tramadol postoperatively for pain management 8 hourly. Both I and II groups were matched in all respect with age, weight, and operative time. Pain relief after diclofenac first dose postoperatively in 8 hours was seen in 7 patients, in 9 to 16 hours in 12 patients, and 17 to 24 hours in 18 patients. Pain relief after tramadol first dose postoperatively in 8 hours was seen in 16 patients, in 9 to 16 hours in 21 patients, and 17 to 24 hours in 25 patients. Postoperatively, patients complained of nausea and vomiting. Group II having tramadol infusion complained of higher incidence of nausea and vomiting as compared with group I having diclofenac for pain management. Conclusion: Pain after laparoscopic cholecystectomy is a common complaint encountered. Good analgesia should be given to patients but should have minimal side effects. It was concluded from our study that tramadol in injectable form is ORIGINAL ARTICLE 1,2Assistant Professor, 3-7Postgraduate Student 1-6Department of General Surgery, Maharishi Markandeshwar Institute of Medical Sciences & Research, Ambala, Haryana India 7Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences & Research, Ambala, Haryana, India Corresponding Author: Muzzafar Zaman, Assistant Professor Department of General Surgery, Maharishi Markandeshwar Institute of Medical Sciences & Research, Ambala, Haryana India, Phone: +918059931554, e-mail: muzzafarzaman@yahoo. com 10.5005/jp-journals-10007-1325 a better option than diclofenac for pain relief and comfortable postoperative period.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70748461","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":"Meandering Pancreatic Duct as a Cause of Idiopathic Recurrent Pancreatitis","authors":"S. Sundar, B. Purushotham, Rajkumar Rathinasamy, P. Kathiresan","doi":"10.5005/JP-JOURNALS-10007-1333","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10007-1333","url":null,"abstract":"Idiopathic pancreatitis contribute to about 20% of acute and recurrent pancreatitis. Here we present a case of loop-type variant of meandering pancreatitis. A patient with a very rare anomaly of the main pancreatic duct presented with recurrent episodes of pancreatitis.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70748623","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":"Laparoscopic Appendectomy for Perforated Appendicitis in Children","authors":"H. Kasem, Wael Alshahat","doi":"10.5005/jp-journals-10007-1324","DOIUrl":"https://doi.org/10.5005/jp-journals-10007-1324","url":null,"abstract":"","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70747578","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}