World Journal of Laparoscopic Surgery最新文献

{"title":"Laparoscopic Management of Hydatid Cyst of Spleen: A Rare Case Report","authors":"N. Ghosh, Ashok Kumar, Nishant K. Malviya","doi":"10.5005/jp-journals-10033-1437","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1437","url":null,"abstract":"Ab s t r Ac t Aim: Aim of reporting this case is to show the feasibility and outcomes of laparoscopic splenectomy in hydatid disease of spleen. Background: Hydatid cyst is a zoonotic disease and it can affect humans. It can involve any organ; liver is the most common organ to involve, and in rare cases spleen could also be involved. Isolated splenic involvement is even rarer. Management is splenectomy. Laparoscopic splenectomy is feasible if uncontrolled spill is avoidable. Here we are presenting a case of laparoscopic splenectomy in an isolated splenic hydatid cyst. Case description: A 41 years old lady presented with left upper abdominal Pain for six months. There was no chest or other abdominal complaints. Examination revealed a palpable spleen. Ultrasonography abdomen, contrast-enhanced computed tomography, and hydatid serology help to diagnose splenic hydatid, cystic echinococcosis type. Vaccination and perioperative albendazole were administered. She underwent laparoscopic splenectomy. Standard steps were followed to prevent spillage. The specimen was delivered through Pfannenstiel incision. Cut-section demonstrated hydatid membranes. Conclusion: Isolated splenic hydatid is rare and rarely managed laparoscopically. It should be practiced when expertise available. Clinical significance: Rare entity of isolated splenic hydatid cyst could be treated by laparoscopic method without causing any perioperative spill or complications and preserve all benefits of laparoscopic surgery in presence of expertise.","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":"43460280","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":"Postoperative Seroma Collection in Operated Case of TAPP Hernioplasty in Unilateral Inguinoscrotal Hernia","authors":"Ronak R Modi, Jatin Modi, Harshil D Modi","doi":"10.5005/jp-journals-10033-1434","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1434","url":null,"abstract":"Introduction: Repair of inguinal hernia is one of the commonest performed surgical procedures worldwide. Usually, a seroma develops in large inguinoscrotal hernias. Generally, a seroma is a cause of significant distress for the patient since it may recur. If the possibility of seroma formation is discussed with the patient before surgery, it may go a long way in alleviating the patient’s distress. Seromas are common after large hernia repair and direct hernia repair. Materials and methods: In this observational study, 50 patients were randomly selected from LG. Hospital (AMC MET Medical College, Ahmedabad, India) who went through TAPP hernioplasty for an inguinoscrotal hernia after a complete explanation of conversion to open as well as post-operative seroma formation. Since all cases were indoor patients, they were initially reviewed on the next day morning after the operation and the next examination time point was seven days later for seroma development. All the patients were followed up at 6 weeks and then every month for 6 months up to 1 year. Results: Out of 50 patients, 44 (88%) patients had an indirect hernia and 6 (12%) patients had a direct hernia. The seroma developed in only three patients (6%) who were managed conservatively with only medicines. Within the follow-up period, no patients had pain, seroma, and recurrence. Conclusion: In some cases of large scrotal hernia, the distal sac was difficult to be inversed or the hernia sac even adhered firmly to the ipsilateral testicle and other structures. In those cases, avoiding inverting the distal sac and leaving the distal sac in place means to avoid dissecting out the distal sac observed lesser occurrence of the seroma. That suggests that the laparoscopic method can help prevent or decrease the chance of the development of seroma in the unilateral inguinoscrotal hernia.","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":"48020675","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":"Congenital Midgut Malrotation Presenting as Acute Duodenal Obstruction in an Adult—Laparoscopic Management","authors":"R. Harvitkar, Abhijit S. Joshi","doi":"10.5005/jp-journals-10033-1439","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1439","url":null,"abstract":"Ab s t r Ac t Background: Intestinal malrotation is a congenital anomaly, wherein the midgut fails to rotate completely or partially during the early embryological developmental phase. The rotation is usually counterclockwise at 270° around the axis of the superior mesenteric artery (SMA). Malrotation is most commonly seen in pediatric population with the majority of patients presenting in their early childhood before the first year of life. Acute duodenal obstruction due to midgut malrotation in an adult is a rare manifestation. Therefore, midgut malrotation should be the differential diagnosis in an adult with bowel obstruction. Case description: We present a case of a 26-year-old male who presented with acute-onset abdominal pain with multiple episodes of bilious vomiting. Contrast-enhanced computed tomography of the abdomen (CECT) revealed intestinal malrotation with all parts of the duodenum (D1–D4) toward the right of the midline. The patient underwent an emergency laparoscopic Ladd’s procedure. Postoperative recovery was uneventful. Conclusion: Adult patients with vague abdominal symptoms should raise a high index of suspicion for malrotation. An early and prompt diagnosis will prevent fatal complications associated with this disease and can be managed laparoscopically by Ladd’s procedure.","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":"49629685","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 Comparative Study of Weight Loss and Reduction in BMI after Gastric Imbrication, Sleeve Gastrectomy, and Roux-en-Y Gastric Bypass","authors":"P. Tejasvi, A. Ghanghoria, Ruchita Banseria","doi":"10.5005/JP-JOURNALS-10033-1443","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1443","url":null,"abstract":"Background: Obesity is a worldwide epidemic and exercise supplemented with pharmacotherapy has poor long-term results; thus, bariatric surgery is the mainstay therapy for morbid obesity. But reduction in weight and BMI after bariatric surgery is not the same and mainly depends on the type of surgery performed. Aim and objective: To study the comparative efficacy among three bariatric surgeries viz. Laparoscopic gastric imbrication (LGI), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) in morbid obese patients in relation to weight loss and reduction in BMI. Study design: Prospective study. Materials and methods: Total of 40 morbid obese patients underwent different types of laparoscopic bariatric surgery and were followed for 1 year. Reduction in weight and BMI after 1 year was correlated with the type of bariatric surgery performed. Statistical analysis: Paired t-test, analysis of variance (ANOVA), Bonferroni. Results: Patients undergone LGI, LSG, and LRYGB had a preoperative mean weight/BMI of 105.33 kg/41.07 kg m −2 , 104.07 kg/42.76 kg m −2 , and 105.8 kg/43.27 kg m −2 , respectively; and postoperative mean weight/BMI after 1 year was 87.4 kg/34.08 kg m −2 , 81.07 kg/33.32 kg m −2 , and 81.2 kg/33.18 kg m −2 , respectively. On applying ANOVA and Bonferroni, LSG and LRYGB group had greater weight loss and reduction in BMI as compared to LGI group. Conclusion: LSG and LRYGB are statistically better in weight and BMI reduction in obese as compared to LGI. Although weight and BMI reduction was more in LRYGB as compared to LSG, it was not statistically significant.","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":"43303153","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":"Simple and Reliable Scoring System to Predict Difficult Laparoscopic Cholecystectomy Preoperatively","authors":"P. Goyal, Shanmugavel Muthuraman, Saurabh Sharma","doi":"10.5005/jp-journals-10033-1444","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1444","url":null,"abstract":"A bstrAct Aim and objective: To validate the efficacy of proposed scoring system compared to the Randhawa scoring system in prediction of difficult laparoscopic cholecystectomy (LC) preoperatively. Materials and methods: A prospective study was conducted including 102 patients who underwent LC for symptomatic cholelithiasis. Preoperatively a score was given to the patient according to both scoring systems. Final outcome was decided on intraoperative findings of operative time, adhesions, and bile spillage. Univariate and multivariate analyses of preoperative factors were done. Receiver operating characteristic (ROC) curves of both the scoring system were compared, and the results were reported as a difference in proportion (95% CI). p value < 0.05 was considered as statistically significant. Results: The specificity and positive predictive value of the modified scoring system were 92 and 95.1% which was higher than Randhawa scoring system, i.e., 76 and 87.5%. Area under ROC curve was also more in modified scoring system. Also, univariate analysis found age > 50 years, history of hospitalization, previous endoscopic retrograde cholangiopancreatography, diabetes mellitus, palpable gallbladder, gallbladder wall thickness, and contracted gallbladder on ultrasound to be statistically significant factors. Conclusion: The proposed modified scoring system significantly increases the specificity and positive predictive value of the Randhawa scoring system. This scoring system is easy to perform, require no additional investigation and can effectively categorize patient where LC will be difficult. Clinical significance: The proposed scoring system can effectively predict difficult preoperatively which would help in better preoperative preparation by the surgical team for a difficult laparoscopic cholecystectomy. Patients can be optimally counseled preoperatively so that they are well prepared for various outcomes of the procedure.","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":"44530332","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 Stapled Gastrojejunostomy in Non-operable Cases of Malignant Gastric Outlet Obstruction (GOO): A Retrospective Study","authors":"Hilal Makhdoomi, T. Rashid, I. Mir, S. Bhat, Asifa Azad","doi":"10.5005/JP-JOURNALS-10033-1427","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1427","url":null,"abstract":"Ab s t r Ac t Background: Inability of gastric contents to go beyond the proximal duodenum is termed as gastric outlet obstruction (GOO). This may be partial or complete. A multitude of causes, benign/malignant, may lead to GOO of gastric and extra gastric origins. Malignant GOO is a common condition among locally advanced gastric cancer patients. One of the relative contraindications for surgery is the presence of advanced malignancy; in these cases, in which life expectancy may be limited to a few months, palliative surgical measures may improve the quality of life. The role of the laparoscopic approach in the treatment of GOO is under investigation and may represent a valid form of therapy with low morbidity. Materials and methods: This was a retrospective study conducted in the Department of General Surgery, Government Medical College, Srinagar, from May 2018 to May 2019. A total of 35 patients who were diagnosed as cases of non-operable malignant GOO were included in the study. All patients underwent laparoscopic stapled gastrojejunostomy after diagnostic laparoscopy. This study was aimed at operative time, time for making anastomosis, hospital stay, return of bowel sounds, and postoperative complications. Results: Mean age of patients in our study was 66.8 years with male predominance. Mean operative time was 94.35 minutes with a mean time of 20.4 minutes for making stapled anastomosis. Mean hospital stay, return of bowel sounds, and resumption of orals were 7.9, 2.28, and 3.85 days, respectively. Bleeding from the anastomotic site was noted in three patients and anastomotic leak was noted in one patient. Conclusion: Laparoscopic stapled gastrojejunostomy is a viable option for palliation in advanced cases of non-operable malignancies leading to GOO. It is associated with less operative times and less immediate postoperative complications. However, further studies are needed before laparoscopic stapled gastrojejunostomy is taken up as a standard for non-operable cases of malignant GOO.","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":"45575362","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":"Intraoperative Cholangiography during Cholecystectomy Using a Biliary-nose Tube: Routinely Used in Patients with Main Bile Duct Stones","authors":"S. Fazzotta, G. Genova, G. Pantuso, S. Buscemi, V. Palumbo, G. Damiano, A. I. Monte, P. Genova","doi":"10.5005/JP-JOURNALS-10033-1425","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1425","url":null,"abstract":"A bstrAct Background: Nowadays, the “gold standard” treatment for gallbladder stones is laparoscopic cholecystectomy but the risk of iatrogenic biliary duct injuries is increased compared to “open” surgery. Intraoperative cholangiography (IOC) can be useful to avoid biliary injuries but it can also be a no-safe procedure in center in which it is not routinely performed. Aim and objective: The aim of our study is to trust the efficacy of IOC in a patient with common bile duct (CBD) and gallbladder stones using a biliary-nose tube. Materials and methods: 135 patients with gallbladder and CBD stones were treated with sequential therapy and randomly divided into two groups. Laparoscopic cholecystectomy was performed within 24/48 h. During endoscopic retrograde cholangiopancreatography, a biliary-nose catheter was left to perform cholangiography during the following surgical procedure. Group A had also a cholangiography at the beginning of the surgical procedure in order to evidence biliary duct structure. Results: Cholangiography avoided a lesion of the biliary ducts in nine patients. Only a patient had a residual stone in the CBD. The dissection at Calot’s triangle was faster in group A patients without differences between the surgeons involved. Conclusion: The biliary-nose tube can be useful in patients with gallbladder and CBD who underwent cholecystectomy for different reasons: it lets the surgeon performing IOC faster and without risk linked to the technique used; it reduces the risk of biliary injuries; and surgeons feel more safe and calm during the surgical procedure.","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":"41668162","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":"Postoperative Acute Pancreatitis in a Patient Who Underwent Laparoscopic Cholecystectomy: A Case Report","authors":"K. T. Challa, P. G. Canchari, M. Gómez, Satheesh B Arja, Mirela Ponduchi","doi":"10.5005/jp-journals-10033-1435","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1435","url":null,"abstract":"Laparoscopic cholecystectomy (LC) is a widely performed procedure worldwide, and it is one of the safest surgical interventions, with few short- and long-term complications. The presentation of post-LC acute pancreatitis (AP) is quite rare and with few reports over time. This case report relates the case of a 34-year-old woman who, 12 days after surgery, presented with AP with no other apparent cause, in addition to which a right renal mass was found incidentally. This case presents us with a rare complication of a fairly safe surgical procedure; however, it should serve to carry out a good follow-up of postoperative patients in the first weeks above all in order to prevent complications.","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":"44219390","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 Novel Technique Using Mesh to Repair a Recurrent Large Indirect Inguinoscrotal Hernia","authors":"H. L. Chong, A. Taib, A. N. Wilson, M. A. Khan, A. Braniste, Ateeq Jamil, A. Warsi","doi":"10.5005/jp-journals-10033-1429","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1429","url":null,"abstract":"Background: The positioning of a slit mesh around cord structures during laparoscopic transabdominal preperitoneal (TAPP) hernia repair rests the mesh better without kinks, thereby minimizing recurrences. However, studies also suggest that insufficient closure of the mesh slit may lead to recurrences. Aim: This report describes a novel technique using AbsorbaTacks (Covidien) to close the mesh slit and refashion an artificial ‘deep ring’ to minimize recurrence. Technique: We report the case of a fit 82-year-old Caucasian male presenting with a recurrent large right indirect inguinoscrotal hernia (8 x 8 × 7 cm with 4 × 4 cm deep inguinal ring). The patient underwent a TAPP repair with a background of unsuccessful open repair by another surgeon previously. Following mesh deployment, the mesh was lifted up by the cord structures, which was under tension due to a large defect. A slit was made in the inferomedial aspect of the mesh. This allowed it to be wrapped around the cord structures. The overlapped trouser flaps were then stapled together encircling the cord, by AbsorbaTacks to create a secure artificial ‘deep ring’. Edges of the mesh were also standardly affixed by AbsorbaTacks to the pectineal ligament and posterior abdominal wall. This creates a secure four-point fixation of the mesh scaffold to prevent ‘windsock’ effect, which happens when the mesh is pushed into the widened deep inguinal ring, leading to early recurrences. The peritoneal incision was also closed with AbsorbaTacks. Conclusion: No complications were registered during the early postoperative period. The patient had an uneventful recovery and was discharged within 20 hours with simple analgesia. No recurrence was reported during the 6 months follow-up period. Clinical significance: The anchoring of a slit mesh with tackers around the cord structures can be used to repair large recurrent inguinal hernias laparoscopically following an open repair. This technique potentially minimizes further recurrences. © Jaypee Brothers Medical Publishers. 2021.","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":"42029798","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":"Technical Report: A Modification in Laparoscopic Cholecystectomy Technique for Left-handed Surgeons","authors":"A. Tavassoli, S. Babaee, Maryam Asgarian Yazdi","doi":"10.5005/jp-journals-10033-1441","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1441","url":null,"abstract":"Introduction: Studies show very few articles addressed left-handed surgeons and their problems. Difficulties occur in using the tools and methods that have been invented by right-handed surgeons. Some previous studies have shown that surgical left-handed residents have much less skilled hands. This study aims to describe some changes that were made that led to 40 safe and comfortable cholecystectomy procedures. Materials and surgical technique: The most important changes compared to the standard method are about trocar placing to improve alignment for a left-handed surgeon. Result: Forty surgeries using the modified methods were done and in comparison to the standard method were much smoother, faster, and with fewer side effects. Discussion: By our modification left-handed surgeons can improve their safety and their comfort during operations and expand their skills in this regard.","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":"42259381","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}