World Journal of Laparoscopic Surgery最新文献

{"title":"A Comparative Evaluation of Total Laparoscopic Hysterectomy and Laparoscopic Supracervical Hysterectomy for Benign Uterine Diseases","authors":"A. Kriplani, P. Garg, K. Khoiwal","doi":"10.5005/jp-journals-10033-1442","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1442","url":null,"abstract":"Ab s t r Ac t Background: Laparoscopic supracervical hysterectomy (LSH) is a minimally invasive alternative to total laparoscopic hysterectomy (TLH), which is a common procedure in developed countries. The study aimed to evaluate the safety (risks vs benefits) of LSH in the Indian scenario when compared with TLH in terms of intraoperative and postoperative outcome measures. Furthermore, quality of life (bladder, bowel, and sexual functions) was also evaluated. Materials and methods: A prospective randomized study among 30 patients with benign uterine pathology for hysterectomy was included in the study. Patients were divided randomly into LSH (n = 15) and TLH (n = 15) groups. Intraoperative outcome measures, such as operation time, blood loss, and visceral injuries were noted. Postoperative outcome measures included absolute change in hemoglobin (Hb), duration of hospital stay, pain, urinary complaints (retention, dysuria), and bladder, bowel and sexual functions for 6 months. Results: Demographic data were comparable in both groups. The operating time and blood loss were more in LSH than TLH group, (p = 0.29 and 0.37). The absolute change in hemoglobin was more in LSH group than TLH group (p = 0.001). Postoperative pain was indifferent in both the groups on postoperative day 0 and day 7 but it was significantly less in LSH group on day 1 (p = 0.03). Duration of hospital stay was similar in both groups. No patient required readmission. Patients in TLH group took a lesser number of days to return to routine activity compared to LSH group. The postoperative bladder, bowel, and sexual functions were comparable. The incidence of post-LSH vaginal bleeding was 13.3%. No vault prolapse was noted at the end of 6 months follow-up. Conclusion: Laparoscopic supracervical hysterectomy is safe and efficacious as TLH for benign uterine pathologies but has no extra benefits rather is associated with a persistent risk of developing cervical diseases and malignancy.","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":"42497230","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":"Do We Still Encounter Non-appendicitis Pathologies during Laparoscopic Appendectomy?","authors":"Y. Orban, Mohammed Algazar, Ahmed A. Farag, Tamer Elalfy","doi":"10.5005/JP-JOURNALS-10033-1432","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1432","url":null,"abstract":"Aims and objectives: Acute appendicitis is the most common surgical disease with a lifetime risk of 7–8%. Numerous studies have shown many benefits of laparoscopic appendectomy over open appendectomies, such as better visualization and identification of other abdominal pathologies that can mimic acute appendicitis. Herein, we illustrated the current incidence of non-appendicitis pathologies during laparoscopic appendectomies in our hospital. Materials and methods: A retrospective study was carried out involving patients operated for acute appendicitis laparoscopically at the Surgical Emergency Unit, Zagazig University Hospitals, Egypt, during the period from March 2017 to December 2019. The diagnosis of acute appendicitis was based on clinical examination, laboratory findings, and ultrasonography. We drew out the patients’ demographic data, duration of surgery, and surgical procedure reports. Results: One hundred forty-five patients presented clinically, and confirmed by laboratory and ultrasonography with the diagnosis of acute appendicitis. Eighty-nine were males, 56 were females. The median operative time was 56.5 minutes. Eight cases (5.5%) showed a pathology other than acute appendicitis, including gynecological pathologies, Mickel’s diverticulitis, inflamed sigmoid appendices epiploica, low-grade appendiceal mucinous neoplasm, and inflamed cecal diverticulum. Conclusion: Diagnosis of acute appendicitis is challenging up to date. We faced many conditions mimicking acute appendicitis during surgical intervention.","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":"43086376","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 Intraoperative Indocyanine Green Mapping in Laparoscopic Management of Median Arcuate Ligament Syndrome","authors":"Reshma Bhoir, Vishakha Kalikar, R. Patankar","doi":"10.5005/jp-journals-10033-1436","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1436","url":null,"abstract":"Median arcuate ligament syndrome also known as Dunbar syndrome is caused by compression of the celiac axis by the median arcuate ligament. It typically presents with postprandial epigastric pain, weight loss, and vomiting, with the incidence being two cases per lakh in the third to the fifth decade.","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":"47897355","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":"Minimal Access Surgical Experience in Developing Economy: A Young Trainee Stimulant","authors":"P. O. Igwe","doi":"10.5005/JP-JOURNALS-10033-1433","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1433","url":null,"abstract":"Ab s t r Ac t Background: The utilization of minimal access surgery (MAS) is rising in developing countries. Robotic surgery is rarer. The mirage surrounding operating with a telescope is completely changing the dimension of surgery. A young trainee finds it difficult to properly perform this surgery. Aim and objective: This study aimed to elucidate an experience of minimal access surgeons practicing in a developing economy with the hope of stimulating a young trainee surgeon in the same field of study. Materials and methods: This was a review of prospectively collected data of cases performed, stored electronically in an Excel spreadsheet and statistical software, Epi info, from December 2017 to March 2020. This review included laparoscopic procedures, colonoscopies, and esophagogastroduodenoscopies (OGD) performed by the author in a tertiary hospital and two private centers. It excluded all cases assisted by the author. The results were analyzed using statistical software, SPSS version 23. Results: A total of 195 cases were performed. Esophagogastroduodenoscopies consisted of a maximum of 114 cases. This was followed by colonoscopies (52 cases), and laparoscopy (29 cases). The laparoscopic cases consisted of laparoscopic cholecystectomy (6), diagnostic laparoscopy (11), laparoscopic appendectomies (8), laparoscopic fundoplication (1), and foreign body retrieval (1). This study showed a gradual shift from mild to more complex minimal access procedures. Conclusion: Performing minimal access procedures requires extensive training. Findings from this study will guide a young trainee in a developing economy to perform the easily available surgery procedures.","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":"46541208","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 of the Effects of Aprepitant and Ondansetron Individually and Combining on Postoperative Nausea and Vomiting after Laparoscopic Cholecystectomy","authors":"Farhang Safarnejad, K. Nasseri, Reza Karami","doi":"10.5005/JP-JOURNALS-10033-1440","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1440","url":null,"abstract":"Background: Nausea and vomiting are one of the most common postoperative complications that cause unpleasant feelings and delays in the discharge of patients. This study aimed to compare the effect of aprepitant, ondansetron, and their combination on the severity of nausea and vomiting after this procedure for finding a safe and less indisposition regimen. Materials and methods: This study was performed on patients aged 18–50 who had been diagnosed with symptomatic cholelithiasis and who underwent laparoscopic cholecystectomy under general anesthesia. This study was done single-blinded. Patients were categorized into three groups (the recipient of aprepitant, the recipient of ondansetron, and the group receiving ondansetron and aprepitant simultaneously) and the rate of nausea and vomiting was measured at 6 and 24 hours after the operation. Results: The results of one-way analysis of variance analysis and Kruskal–Wallis showed that there was a significant difference between the treatment groups regarding the severity of nausea and vomiting after surgery ( p < 0.001). The severity of nausea and vomiting in the group receiving ondansetron plus aprepitant is less than the other two groups. Conclusion: A combination of ondansetron plus aprepitant can reduce nausea and vomiting after surgery while the effect of aprepitant is much more than ondansetron.","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":"48954098","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 or Open Appendectomy: Which Approach is the Best for Complicated Appendicitis?","authors":"R. F. Jailani, Norjazliney A Jafri, G. Henry, I. Sagap","doi":"10.5005/jp-journals-10033-1430","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1430","url":null,"abstract":"Introduction: Appendicitis is more common in children and young adults. Treatment of appendicitis is either laparoscopic appendicectomy (LA) or open appendicectomy (OA) surgery. Aim and objective: The 30-day postoperative morbidity, surgical site infection, and reoperation rate were compared between open and laparoscopic appendicectomies for complicated appendicitis. Secondary outcome measures were the length of hospital stay, duration of surgery, surgical waiting time, identification of other diseases, and patient satisfaction. Materials and methods: This retrospective study was conducted in two institutions: Hospital Selayang, Selangor, Malaysia, and HUKM, Kuala Lumpur, Malaysia. Data were collected from January 2014 to December 2015 were reviewed. Results: The mean age ( ± SD) for LA and OA were 32 ( ± 15) and 30 ( ± 14) years, respectively. The males showed predominance in LA and OA with 52 and 72%, respectively ( p < 0.001). The majority of LA (73%) and OA (88%) were performed by the trainees ( p < 0.001). There was a significant reduction in postoperative morbidity in LA compared to OA in terms of surgical site infection, LA vs OA [ n = 8 (2.7) vs 26 (6.3), p = 0.029] and duration of surgery [LA vs OA 84 ( ± 39) vs 68 ( ± 6) days ( p < 0.001)]. However, for LA and OA, there were no significant differences in reoperation, 0.7 and 1.0%, respectively ( p = 1.000), and length of stay in LA vs OA 3.55 ( ± 2) vs 3.89 ( ± 3) days, respectively ( p = 0.103). Overall, patient satisfaction scores were not found statistically significant as the response rates were only 32% in LA and 30% in OA. Conclusion: LA significantly reduced surgical site infection and offered an advantage in the detection of other pathologies. Hence, a laparoscopic approach should be offered to patients whose clinical diagnoses are challenging.","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":"42007988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Outcome of Laparoscopic Ovarian Drilling in Patients with Clomiphene-resistant Polycystic Ovarian Syndrome in Ogbmoso, Nigeria: A Prospective Evaluation","authors":"A. Fehintola, O. Awotunde, O. Ogunlaja, S. Akinola, S. Oladeji, O. Aaron, F. Fehintola","doi":"10.5005/JP-JOURNALS-10033-1418","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1418","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is commonly encountered in women with anovulatory infertility. The surgical ovarian drilling procedure aims to restore spontaneous ovulatory cycles. This function is similar to the goal of clomiphene citrate and/or metformin. Objective: We conducted this study to determine the outcome of laparoscopic ovarian drilling (LOD) among patients who presented with clomiphene-resistant PCOS. Materials and methods: The study was prospective in design. We studied 43 patients with clomiphene-resistant PCOS who had laparoscopic ovarian drilling (LOD) using monopolar diathermy at the Bowen University Teaching Hospital, Ogbomoso. The study took place between January 2014 and June 2016. Clinical data recorded at different intervals of follow-up included the menstrual pattern and reproductive history. Results: We successfully performed laparoscopic ovarian drilling without any complication. Four (9.3%) of the patients were lost to follow-up. Thirty (76.9%) of the remaining 39 patients resumed regular menstrual cycles with spontaneous ovulation, while 23 (59.1%) patients achieved spontaneous pregnancy within 6 and 18 months following LOD. No record of multiple pregnancies. Factors associated with failed LOD treatment included obesity and a long duration of infertility. Conclusion: LOD is a feasible and effective first-line treatment option in patients with clomiphene-resistant PCOS in sub-Saharan Africa. Emphasis should be on weight reduction with early application of LOD to treat patients with clomiphene-resistant PCOS. This will reduce the time to achieve pregnancy and the need for gonadotropins to induce ovulation.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43102552","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":"Antenatally Diagnosed Ovarian Cysts with Torsion Managed Laparoscopically","authors":"R. Mishra, S. Sivarajan, J. S. Chowhan","doi":"10.5005/jp-journals-10033-1417","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1417","url":null,"abstract":"Aim and objective: To study the various types of laparoscopic management of antenatal ovarian torsion, their advantages, disadvantages, and its outcome in pregnancy. Background: Ovarian torsion in pregnancy occurs at a rate of about 1 in 5,000 cases. It is a life-threatening condition if not attended to and intervened promptly. Recent years have seen the advent of laparoscopy as a preferred means of management for ovarian torsion in pregnancy. This review article analyzes a series of articles over a span of 5 years from 2014 to 2018 on laparoscopic management of ovarian torsion in pregnancy and its outcome. Results: Various procedures like ovarian detorsion, cystectomy, ovarian cyst puncture, ovariopexy, shortening of the utero-ovarian ligament, and oophorectomy are performed by expert hands. While advantages include quick recovery and early discharge from hospital, disadvantages are a long learning curve and increased need for training. This has led to many uneventful pregnancies with term live births. Conclusion: Each type of laparoscopic management for antenatal ovarian torsion has its pros and cons. Nevertheless, the outcome of the pregnancy has been excellent in the majority of the laparoscopically managed cases. Clinical significance: Laparoscopic management of antenatal ovarian torsion has reduced intraoperative blood loss, improved postoperative pain, and led to a quick recovery, early discharge from hospital, and return to daily activities. Clinicians need to be adequately trained to be competent in performing various laparoscopic surgeries.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44162678","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":"Safety and Feasibility of Laparoscopic Sleeve Gastrectomy with Loop Duodenal Switch Surgery for Obesity in Indian Patients","authors":"A. Vennapusa, R. Panchangam, Charita Kesara, Tejaswi Chivukula","doi":"10.5005/JP-JOURNALS-10033-1423","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1423","url":null,"abstract":"Ab s t r Ac t Aim: Laparoscopic sleeve gastrectomy with loop duodenal switch (SLDS) surgery is a loop modification of biliopancreatic diversion with duodenal switch (BPD-DS) aimed at reducing malabsorption without compromising on the efficacy. This study aimed to analyze the safety and feasibility of SLDS surgery in Indians suffering from obesity. Materials and methods: This was a retrospective study analyzing 169 patients who underwent SLDS surgery between November 2013 and June 2020. The cohort was divided into two subgroups based on the common channel length—2.5 and ≥3 m. Weight-loss parameters, diabetes remission, and investigations at 6 months and 1 year follow-up were analyzed in the total cohort and common channel subgroups. The percentage of total weight loss (%TWL) ≥25% was considered as a successful weight-loss outcome. HbA1C <6% without the need for antidiabetic medications was considered as complete diabetes remission. Safety was analyzed in terms of intraoperative and postoperative complications. Results: Mean preoperative body mass index was 45.39 ± 7.6 kg/m2. 48.52% of the patients were suffering from type II diabetes. Mean %TWL was 30.91 ± 4.98 and 41.86 ± 7.63% and complete diabetes remission was 81.82 and 89.06% at 6 months and 1 year follow-up, respectively. The percentage of total weight loss was inversely proportional to the common channel length. Complete diabetes remission was not significantly affected by the common channel length. Serum albumin <3 gm/dL was significantly high in patients with a common channel length of 2.5 vs ≥3 m—25 vs 4.65% at 6 months and 40 vs 7.14% at 1 year follow-up, respectively. Thirty-day mortality was zero. Conclusion: Sleeve gastrectomy with loop duodenal switch surgery appears to be effective and safe in Indian patients. Malabsorption risk is greatly reduced when the common channel length is ≥3 m. Clinical significance: Sleeve gastrectomy with loop duodenal switch surgery with the common channel length ≥3 m simplifies BPD-DS, gives excellent weight loss and diabetes remission with minimal malabsorption. Restricting the biliopancreatic limb to ≤55% prevents adverse malabsorptive consequences.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45058435","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":"Endoscopic Ectopic Thyroidectomy","authors":"R. Padmakumar, Aravind Balakrishnan, M. Pai, Kevin J Chiramel, Farish Shams, Premna Subin","doi":"10.5005/JP-JOURNALS-10033-1419","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1419","url":null,"abstract":"Ab s t r Ac t Aim and objective: To show the advantage of endoscopic approach for lateral ectopic thyroid removal. Background: Ectopic thyroid tissue lateral to midline is very rare. Because of its unusual location, lateral ectopic thyroid gland can cause diagnostic difficulties when diseased. Case description: Here we are presenting a case of a male patient with submandibular ectopic thyroid tissue with multinodular goiter and absent thyroid tissue in normal anatomic site. He underwent endoscopic-assisted total thyroidectomy. This technique for ectopic thyroid removal has not been reported in the literature so far. Conclusion: Endoscopic approach for removal of the diseased gland will allow for a magnified view of the adjoining structures and better cosmesis for the patient. Clinical significance: Lateral ectopic thyroid should be in differential diagnosis of lateral neck swelling.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49641912","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}