World Journal of Laparoscopic Surgery最新文献

{"title":"Comparative Evaluation of Vaginoscopic vs Traditional Hysteroscopy","authors":"N. Gupta, U. Jahan, Anuradha Yadav, R. Kumari","doi":"10.5005/jp-journals-10033-1455","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1455","url":null,"abstract":"A bstrAct Aim: A randomized case–control study was performed to compare the traditional using a speculum vs vaginoscopic hysteroscopy in terms of pain score and procedure time. Materials and methods: A total of 100 patients aged 20 to 60 years old, including nulliparous, multiparous, and postmenopausal, were randomized in two groups: group A undergoing traditional hysteroscopy with speculum and vulselum (50 patients) and group B undergoing “no-touch” vaginoscopic hysteroscopy. Results: Vaginoscopy was significantly more successful than the traditional hysteroscopy. The total pain was calculated for each group, it was significantly lower in the vaginoscopic technique ( p = 0.026). The mean time was 5.71 for traditional hysteroscopy and 4.44 for vaginoscopic hysteroscopy. The time taken to perform hysteroscopy was significantly shorter with vaginoscopic hysteroscopy. There was no difference in failure rates. Conclusion: The vaginoscopic approach is better tolerated, quicker to perform, less painful, and therefore, more successful than the traditional hysteroscopy using the speculum. It should be preferred in an outpatient setting.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44553284","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 Aspects of the Possover LION Procedure: An Emerging Procedure for Recovery of Visceral Functions and Locomotion in Paraplegics","authors":"U. S. Løve, S. B. Elmgreen, A. Forman, I. Arsić, M. Possover, A. Jønsson, H. Kasch","doi":"10.5005/jp-journals-10033-1450","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1450","url":null,"abstract":"Background: Traumatic spinal cord injury (SCI) may be a devastating life event. Motor and sensory recovery after 6 months post-injury is sparse, despite intensive neurorehabilitation. Long-term disabling consequences may further reduce self-supportiveness and the quality of life. A new surgical intervention, the Possover LION procedure (Laparoscopic Implantation of Neuroprosthesis), may improve long-term perspectives providing the patient with an implantable pulse generator (IPG), and leads to pelvic situated nerves (sciatic and femoral nerves) to regain substantial motor and sensory functions in lower extremities. Objective: To report from the surgical point of view, the experience of implementing an IPG system for direct nerve stimulation of pelvic nerves in a series of chronic traumatic SCI patients. Methods: From two substudies, a feasibility study and a controlled clinical study, data from 21 SCI patients with severe paraplegia who had undergone the Possover LION procedure were obtained. The Possover LION procedure was implemented in a surgical department with skilled surgeons in close collaboration with neurological expertise. The developer of the procedure performed the first operations and afterward provided guidance and collaboration. Results: Twenty patients (F = 3, M = 17, age = 36.9 ± 9.0, ISCNSCI AIS A = 19, AIS B = 1) with lesion between Th3 and L1 had IPG and four leads implanted. One patient had a “frozen pelvis” and could not be operated. During operation, severe bleeding was seen in one patient that could be stopped using on-site applied hemostats, with no need of transfusion. One patient had initial normalization of infection parameters postoperatively, but developed Staphylococcus aureus infection near the IPG, removal of IPG and leads was needed. Clinically significant dislocation of leads was seen in two patients and dislocation/tilting of IPG in one patient. Hardware problems with possible lead breakage were observed in one patient. Conclusion: Posttraumatic SCI patients with paraplegia can be elected for the LION procedure by a specialist team of neurorehabilitation experts (neurologists, PTs), and skilled surgeons in the neuro-pelvic area, with Possover LION expertise. Complication rates for the Possover LION procedure are comparable to or better than those seen with spinal cord stimulation, and the procedure is generally safe. We recommend the monitoring of implanted leads and IPG using CT abdomen.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516230","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":"Comparison between Laparoscopic Ultrasound and Intraoperative Cholangiogram in Detection of Common Bile Duct Stones during Laparoscopic Cholecystectomy for Cholelithiasis: A Prospective Study","authors":"Mohamed Elkerkary, G. Ellabban, M. Shams, Mostafa Abdel-Raheem, H. Shaban, A. Hassan","doi":"10.5005/jp-journals-10033-1449","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1449","url":null,"abstract":"Introduction: Intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) is valuable in the detection of biliary abnormalities. In this study, we aimed to investigate the diagnostic accuracy of IOC during LC for the detection of anatomic variations of the biliary system, as well as the visualization ability of IOC on determining the normal anatomy of the biliary tree. Materials and methods: This cross-sectional study was conducted on patients who were presented to the surgery outpatient clinic and were scheduled for elective LC for symptomatic cholelithiasis. Patients underwent intraoperative laparoscopic ultrasound (LUS) before the dissection of Calot’s triangle and IOC video fluoroscopy examination of the extrahepatic biliary tree. Results: Our study enrolled 53 patients. No intraoperative complications occurred in all enrolled patients. LUS was successful in all 53 (100 % ) cases, while IOC was successful in 50 (94.3 % ) cases. IOC had accuracy rate of 100 % (50 patients) in defining biliary ducts at the porta hepatis compared to 84.91 % (45 patients) for LUS with a failure rate of 15.09 % ( p = 0.60). Concerning stones detection, LUS accuracy indexes were as follows: sensitivity = 80 % ; specificity = 95.83 % ; positive predictive value (PPV) = 66.67 % ; negative predictive value (NPV) = 97.87 % 99; and diagnostic odds ratio (DOR) = 92. IOC accuracy indexes were as follows: sensitivity = 80 % ; specificity = 93.33 % ; PPV = 57.14 % ; NPV = 90 % ; and DOR = 56. Conclusion: The results of the current study encourage using IOC as an effective, accurate, feasible, and safe technique to visualize the biliary tree while performing LC.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43435128","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":"Perioperative Antidepressant Use Improves Body Image to a Greater Extent Compared to Those Not Taking Antidepressants in Patients Who Undergo Bariatric Surgery","authors":"John G. Scott, David C. Fipps, S. Holder, Dorothy L. Schmalz","doi":"10.5005/jp-journals-10033-1452","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1452","url":null,"abstract":"Ab s t r Ac t Introduction: Body image often improves after bariatric surgery; however, those who are depressed are more vulnerable to continuing to have body image concerns. Body image dissatisfaction and depression are associated with poorer quality of life, less weight loss after surgery, and poorer overall physical/mental functioning. Our study aims to determine whether antidepressants influence the improvement seen in body image after bariatric surgery. Materials and methods: Body-Esteem Scale for Adolescents and Adults (BESAA), a validated tool for trending body image, was administered preoperatively and at 3, 6, and 12 months postoperative follow-ups. Scores were compared for improvement, and linear regression models were used to determine the influence of medications and demographic factors on score improvement. Results: The study sample was consisted of 47 men and 57 women (22–72 years of age). Preoperative BMI was in the range of 35.87–75.66 (mean: 49.26). Sixty-nine percent (69%) were taking psychiatric medications and 57% of those medications were antidepressants (12 different antidepressants represented). Improvement in BMI was in the range of 1.44–30.77 points (mean: 15.08). The majority (98.07%) showed improved BESAA scores; two factors revealed statistical significance for influence on score magnitude. For every 1 point of BMI improvement, our sample increased BESAA scores by 0.68 points (p = 0.021). Those taking antidepressants scored an average of 8.55 points higher than those not taking antidepressants (p = 0.032). There were no significant differences found for age, gender, race, type of surgery, use of anxiolytics/hypnotics, or stimulants. Conclusion: Perioperative antidepressant usage is associated with a greater improvement in body image after bariatric surgery compared to those who are not taking antidepressants. Given the high comorbidity of depression in bariatric surgery patients, this highlights potential for improved outcomes with treatment of psychiatric comorbidities in this population.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44438089","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 First-stage Approach in a Two-stage Hepatectomy for Bilobar Colorectal Liver Metastases","authors":"Yuki Takahashi, Kuniya Tanaka, T. Wakabayshi, Toshimitsu Shiozawa","doi":"10.5005/jp-journals-10033-1453","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1453","url":null,"abstract":"Ab s t r Ac t Aim: We reviewed a retrospectively collected database of 64 patients undergoing two-stage hepatectomy for colorectal liver metastases with special attention to cases involving a laparoscopic first stage. Materials and methods: Three patients undergoing laparoscopic first-stage hepatectomy were analyzed and compared with 61 other patients who underwent two-stage hepatectomy using open surgery for the first stage. Results: In three patients with a laparoscopic approach, the first-stage operation was a laparoscopic lateral sectionectomy or resection of segment 3, combined with portal vein embolization via the iliac vein directed at the contralateral hemiliver. No postoperative morbidity or mortality resulted. After a mean interval of 37.3 days, second-stage hepatectomy was performed for clearance of tumors in the right hemiliver (two in an open approach and one in a hybrid laparoscopic and open approach), with morbidity in 67% of patients (Clavien–Dindo classes I and IIIb in one patient each) but no mortality. When these three patients were compared with 61 patients treated with an open approach, numbers of metastatic tumors tended to be less in patients with a laparoscopic first stage. Duration of the first-stage hepatectomy (p <0.01) and hospital stay after that hepatectomy were shorter in patients with laparoscopic resection than in patients with open resection (p = 0.03). Conclusion: Our preliminary data support the feasibility and safety of the laparoscopic approach for the first-stage resection during two-stage hepatectomy. Clinical significance: First-stage laparoscopic clearance for patients with relatively small numbers of tumors who are anticipating two-stage hepatectomy for bilobar metastases becomes a standard option.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70800289","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":"Gastric Remnant Perforation after Roux-en-Y Gastric Bypass: A Case Report and Literature Review","authors":"C. Tuero, Gorka Docio, V. Valenti, A. Artajona, S. Montón","doi":"10.5005/jp-journals-10033-1458","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1458","url":null,"abstract":"A bstrAct Aim and objective: The aim and objective of this article was to focus on long-term complications after bariatric surgery, which are usually managed by general surgeons in the emergency department. Background: Roux-en-Y gastric bypass (RYGBP) is one of the most commonly performed bariatric techniques in the world. Gastric remnant complications after this procedure are infrequent and poorly known. Furthermore, the diagnosis of this pathology may be challenging. Case description: We present the case of a 54-year-old woman with intense epigastric pain and history of uncomplicated laparoscopic RYGBP 18 years ago. After clinical, laboratory, and radiological examinations, the patient was diagnosed with a gastric remnant perforation. Laparoscopic surgery was performed, and the perforation was successfully repaired with primary suture and omental patch. Conclusion: Gastric remnant perforation after bariatric surgery is not frequent and usually appears several years after the procedure. This type of pathology is presented without specific clinical manifestations and with few analytical alterations. Complementary radiological studies, such as computed tomography (CT) scan, should be performed. However, pneumoperitoneum and extravasation of oral contrast are usually absent. Depending on the size of the defect, primary suture or gastric remnant resection may be performed. Nevertheless, surgical treatment should not be delayed. Clinical significance: Long-term complications after bariatric surgery are in many circumstances managed by general practitioner surgeons. The low incidence and scarce manifestations make the diagnosis of this pathology challenging. Furthermore, bariatric surgery is progressively increasing its presence all over the world. Complications after this procedure must be known and kept in mind because an early diagnosis is crucial to give a proper treatment and reduce morbidity and mortality.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48673481","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":"A Study on Effects of Leaking Carbon Dioxide Gas on Surgeons during Laparoscopic Surgeries","authors":"Mallikarjuna Manangi, Ranjitha Gangadharaiah, Santhosh S Chikkanayakanahalli, Madhuri Naik, Arun Balagatte Jayappa","doi":"10.5005/jp-journals-10033-1446","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1446","url":null,"abstract":"Background: Laparoscopic surgery is gold standard for treating various abdominal diseases. Carbon dioxide, having high safety profile, is the most commonly used gas for insufflating peritoneal cavity for accurate visualization and operative manipulation. Despite the fact that CO 2 is naturally present in the atmosphere, i.e., 0.035 % (350 ppm), it is one of the most overlooked toxic gases. CO 2 breathing causes numerous cardiorespiratory responses and psychological reactions, such as impaired vision, diminished motor control, slowed responses, disorientation, or reduced attentional capacities that may jeopardize a worker’s health and safety. At high concentrations (8 % ), it has been shown to cause unconsciousness almost instantaneously and respiratory arrest within 1 minute. As laparoscopic surgeons are under constant exposure of leaking CO 2 gas, this study is taken up to evaluate the effects of CO 2 on them by a noninvasive technique that measures end-tidal CO 2 of operating surgeons at the beginning and end of laparoscopic surgeries. Objective: To evaluate the effects of leaking CO 2 gas on surgeons during laparoscopic surgeries. Methods: A Mini-Mental State Exam (MMSE) score and EtCO 2 levels (using a capnometer with 4 L of oxygen/minute) of operating surgeons were obtained before the start of surgery. After surgery, MMSE scores and EtCO 2 levels were again documented, compared, and analyzed using SPSS software. Results: The mean EtCO 2 before surgery was found to be 30.86 with standard deviation of 4.03 and that after surgery was 31.23 with standard deviation of 3.85 with mean duration of surgery being 73 minutes. Correlation of individual EtCO 2 values before and after surgery did not show significant changes ( p value = 0.534). The difference in MMSE scale scores before and after surgery for all participated surgeons was insignificant. Conclusion: In healthy surgeons performing laparoscopic surgeries, there are no effects following exposure to leaking carbon dioxide. Air quality, Laparoscopic surgeries, World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1446","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43273866","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":"Role of Diagnostic Laparoscopy in Nonspecific Chronic Pain Abdomen","authors":"Tanweer Karim, Subhajeet Dey, G. Patel, Atul Jain, N. Mishra, Subhash Lnu","doi":"10.5005/jp-journals-10033-1464","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1464","url":null,"abstract":"Introduction: Laparoscopy has established its role (diagnostic as well as therapeutic role) in patients with nonspecific chronic pain abdomen. In case of diagnostic dilemma and uncertainty, use of laparoscopy can help to avoid unnecessary laparotomy, provides accurate diagnosis, and helps to plan for surgical intervention if required. However, the role of laparoscopy in nonspecific chronic pain abdomen is still debated. Aims and objectives: To assess the accuracy of laparoscopy in the diagnosis of nonspecific chronic pain abdomen and its ability to avoid unnecessary exploratory laparotomy with complications and limitations associated with laparoscopy including failure rate. Materials and methods: This prospective descriptive study was conducted for a period of 1 year in patients with nonspecific chronic pain abdomen for more than 3 months attending the outpatient department or emergency department when clinical features and investigations are not conclusive. Results: Sixty-two patients in age-group from 15 to 60 years were studied. Overall 85.48% of patients had resolution of pain after diagnostic laparoscopy with diagnostic accuracy in our study of 88.7%. Conclusion: Diagnostic laparoscopy should be considered as one of the gold standard tests for diagnosing the nonspecific chronic pain abdomen, when noninvasive diagnostic modality failed in diagnosing cause.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48444645","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":"Role of Laparoscopy in Gastric Trichobezoar: A Case Report and Review of Laparoscopic Techniques in Pediatric and Adolescents","authors":"P. Jain, A. Prasad, Sarika Jain","doi":"10.5005/jp-journals-10033-1438","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1438","url":null,"abstract":"This article presents a case report of the laparoscopic removal of a large gastric trichobezoar in a 13-year-old girl. We reviewed the various laparoscopic techniques and their modifications described in the literature for removal of gastric trichobezoar. Advantages and disadvantages of various techniques were also discussed.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41562220","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":"Efficacy and Safety of Electrothermal Bipolar Vessel Sealer vs ENSEAL in Total Laparoscopic Hysterectomy for Large Uterus: A Comparative Study in Mysuru, South India","authors":"P. Talwar, Swathi Hassan Kumarachar, Lakshmi Velayudam, Tohreen Fathima","doi":"10.5005/JP-JOURNALS-10033-1431","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1431","url":null,"abstract":"Ab s t r Ac t Context: Hysterectomy is the most commonly performed gynecological procedure around the world. Hemostasis is of major concern in an enlarged uterus as chances of hemorrhage are more. New laparoscopic vessel sealing devices have been developed for laparoscopic tissue dissection and vessel sealing. In this study, an ALAN vessel sealer, an indigenous electrothermal bipolar vessel sealing device, is compared with ENSEAL device with respect to safety, efficacy, and perioperative outcomes in laparoscopic hysterectomy for a large uterus. Aims and objectives: This study aimed to determine the efficacy and safety of electrothermal bipolar vessel sealer (ALAN vessel sealer) vs ENSEAL in total laparoscopic hysterectomy (TLH) for a large uterus. Materials and methods: This prospective randomized case–control study included 100 women who underwent TLH for a large fibroid uterus. Of them, 50 women underwent TLH using ALAN vessel sealer, and the remaining 50 using ENSEAL. Efficacy, safety, and perioperative outcomes of both the groups were compared. Statistical analysis: Statistical analysis was done using SPSS version 16.0 software. For evaluating continuous variables and discrete variables, independent T-tests, and Chi-square tests, respectively, were used. Results: Duration of surgery in ALAN vessel sealer group was 56.90 ± 12.45 minutes and in ENSEAL group was 57.25 ± 13.54 minutes (p = 0.9) and mean blood loss in group A and group B was 111.40 ± 22.32 and 107.84 ± 20.33 mL, respectively ( p = 0.4), both of the data were not statistically significant. No significant differences were noticed in the demographic characteristics, intraoperative, and postoperative complications between the two groups. Conclusions: The ALAN vessel sealer is safe and as efficient as ENSEAL in decreasing blood loss and operative time when laparoscopic hysterectomy is performed for an enlarged uterus. It is cost-effective and a promising instrument for TLH in developing countries.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46261870","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}