World Journal of Laparoscopic Surgery最新文献

{"title":"Laparoscopic Cholecystectomy: Challenges and Outcomes of the Procedure in Elderly Patients","authors":"Ashwani Kumar, R. Kapoor, Sarbjeet Singh, Amandeep Singh, S. Mahajan","doi":"10.5005/JP-JOURNALS-10033-1383","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1383","url":null,"abstract":"Introduction: Gallstone disease is more prevalent in the elderly population besides having comorbid conditions and poor physiological reserves as compared with their younger counterpart. Laparoscopic procedures have certain inherent technical limitations and unique physiological demands. Hence, the procedures may have higher complications in elderly patients and need evaluation in this age-group of patients. Aim: This study is aimed to evaluate the safety of the procedure of laparoscopic cholecystectomy in elderly patients in terms of preoperative and intraoperative difficulties, postoperative complications, morbidity, and mortality. Materials and methods: The study was conducted retrospectively, collecting data from hospital record of a total of 390 patients (45 elderly patients) operated during a period from 2012 to 2017. Results: The mean age of elderly patients was 66.7 years. All the patients who underwent laparoscopic cholecystectomy had an American Society of Anesthesiologist (ASA) score of I or II. Intraoperative difficulties were encountered in 35.55% patients. Average hospital stay was 2.5 days. One patient had a minor bile leak. No mortality occurred. Conclusion: Procedure of laparoscopic cholecystectomy is safe in elderly patients.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49339038","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":"Portomesenteric Venous Thrombosis with Bowel Ischemia after Laparoscopic Sleeve Gastrectomy","authors":"M. Abdelmohsen, Mubarak Alkandari, Sami Abdulaziz, Mohamed Alsulimy, Nagy Ismaeil","doi":"10.5005/JP-JOURNALS-10033-1385","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10033-1385","url":null,"abstract":"A bstrAct Laparoscopic sleeve gastrectomy has become an increasingly popular surgical option for morbidly obese patients. Portomesenteric venous thrombosis, as a complication of laparoscopic sleeve gastrectomy, has been rarely reported. We report one case of thrombosis of the portal vein and the superior mesenteric vein after sleeve gastrectomy. It is confirmed by CT scan. Thrombosis of the portomesenteric veins after bariatric surgery is a diagnosis that one should know how to raise in front of any postoperative abdominal pain. An obese patient with a history of thrombosis should receive a complete etiology of these thromboses before bariatric surgery. Abnormal blood dirt, an active smoking fat woman having oral contraceptive, or a patient with a history of recurrent venous thrombosis may be a relative contraindication against a complex bariatric surgery with digestive bypass.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42130461","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":"Predictors for Conversion to Open Appendectomy in Patients Undergoing Laparoscopic Appendectomy Based on Clinical Presentations on Ultrasonography Findings and Tzanaki's Scoring","authors":"Vaibhav Srivastav, Nandan Rai, Kajal Mishra","doi":"10.5005/jp-journals-10033-1401","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1401","url":null,"abstract":"Background: Laparoscopic appendectomy (LA) may need to be converted to open appendectomy (OA) if intraoperative complications or severity of the disease hinders with a safe laparoscopic intervention. This may be in the form of abnormal position of appendix, adhesion due to previous inflammations, appendix mass, abscess, perforated appendix and diffuse peritonitis or other pelvic or right iliac fossa pathologies or technical problems, and lack of space for dissection. Even though these pathologies can be dealt with minimal access surgery, conversion to open surgery may become mandatory in a small number of cases. The presence of comorbidities is the independent factor related to conversion during laparoscopic appendicectomy. 1 Materials and methods: The study was carried out in PG Department of Surgery, SRN Hospital associated with MLN Medical College, Prayagraj from September 2018 to September 2019 after approval from the ethical committee and after obtaining written and informed consent either from patient or their legal heir. The study was conducted on the patients admitted in the Department of Surgery, SRN Hospital, MLN. Medical College between September 2018 and September 2019 who underwent conversion appendicectomy. Patients were evaluated and their complete biodata were recorded after taking detailed history. Based on history, clinical examination, laboratory investigations, and ultrasound of abdomen and pelvis, appendicitis diagnosed. The parameters studied include age, sex, previous history of acute appendicitis any lower abdominal surgeries in the past, symptoms, duration of symptoms, sign, white blood cell (WBC) count, ultrasound abdomen and pelvis findings, American Society of Anesthesiologists (ASA) grading, and intraoperative findings including reasons for conversion. Results: Multivariable analysis incorporating these factors available to the surgeon preoperatively identified advanced age, ASA score > 2 points, severity of adhesion in ultrasonography (USG), significantly associated with conversion. These results highlight the complex nature of the decision to convert, in as much as baseline patient characteristics, disease severity, and surgeon factor each independently impact the probability of the successful laparoscopic procedure. Conversion in our study was significantly associated with comorbidities as out of 11 patients with comorbidities [6 hypertension (HTN), 4 diabetes mellitus (DM), 1 asthma], 10 (90.90%) were converted to OA with significant p value ( p = 0.00001). Among nine patients with ASA grade > 2 points, eight were converted to OA. Total leukocyte count was > 12,000 in 25 patients (41.67%) out of which 9 patients (36%) were converted to OA. In this study, 21 patients (35%) had score ≤ 9, while 39 patients (65%) had score ≥ 10. Eleven patients (52.38%) were converted to OA out of 21 having score ≤ 9 in comparison to 1 patient (2.56%) out of 39 patients having score ≥ 10. Conclusion: W e identified preoperatively, pr","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799647","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":"Retroperitoneal Single-port Donor Nephrectomy through Lumbotomy Incision: An Experience of 30 Cases","authors":"Navdeep Singh, D. Kenwar, Sarbpreet Singh, S. Dasgupta, Kunal Kapoor, Ashish Sharma","doi":"10.5005/jp-journals-10033-1399","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1399","url":null,"abstract":"Ab s t r Ac t Introduction: Over the years, laparoscopic donor nephrectomy (LDN) has evolved as a preferred alternative to open-donor nephrectomy (ODN). Laparoscopic donor nephrectomy can be performed either by transperitoneal or retroperitoneal route. Retroperitoneoscopic live donor nephrectomy (RPLDN) results in less analgesic requirement, decreased hospital stay, and better cosmetic acceptance by the donors. Lumbotomy incision has been thought to be an ideal approach without any muscle being cut but is limited by the amount of space in open surgery. Materials and methods: Between November 2014 and September 2016, 350 donor nephrectomies were performed at our department. All the surgeries were performed by a single surgeon. Thirty patients consented for translumbar RPLDN out of the 82 donor nephrectomies assigned to that particular surgeon. Visual analog scale (VAS) was used to evaluate the severity of pain on postoperative day (POD)0 and POD1. Results: Mean age of donors was 44.7 ± 11.4 years, M:F ratio 9:21. Average duration of surgery was 170.33 ± 52 minutes. Four patients (13.3%) had double renal arteries and one patient had double renal vein. In one patient, retrieval was performed by an open approach. No patient had surgical site infection. Most patients (28/30) had a VAS score of <4, and did not require any additional analgesics beyond POD0. Conclusion: Single-site translumbar RPLDN is a feasible alternative approach to the donor surgery.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799453","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 Surgery on Deep Infiltrating Endometriosis Involving the Rectum: A Debate Started 100 Years Ago between Cullen and Sampson","authors":"J. Yovich","doi":"10.5005/jp-journals-10033-1400","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1400","url":null,"abstract":"","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799548","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":"Single-incision Laparoscopy-assisted Appendectomy in the Pediatric Age Group: Our Experience","authors":"H. Shah, Charu Tiwari, Suraj Gandhi, Gursev Sandlas, N. Shenoy","doi":"10.5005/jp-journals-10033-1406","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1406","url":null,"abstract":"Ab s t r Ac t Background: Various methods of laparoscopic appendectomy have been described in children. We present the data of 50 children who underwent interval appendectomy at our institution by transumbilical single-incision laparoscopy-assisted appendectomy (SILAA). Materials and methods: Fifty patients <12 years from June 2011 to June 2017 with inclusion criteria <12 years of age who were admitted with clinical features of acute appendicitis of >24–48 hours’ duration; had abdominal ultrasound (USG) with appendicular diameter of >10 mm and good clinical response to initial management by intravenous antibiotics within 24–48 hours of admission were retrospectively analyzed. They underwent SILAA after 6 weeks. Under general anesthesia, an infraumbilical incision was made and umbilical tube was identified. A 5 mm camera port was inserted by open Hassan’s technique. After visualizing the appendix, another incision was made adjacent to the port site on the left and a 5 mm instrument was introduced through this. The appendix was freed, mobilized, and delivered through the incision. Appendectomy was completed extracorporeally. Results: The average age at presentation was 9.3 years. There were 18 females and 32 males. Two patients required conversion to open procedure in view of extensive adhesions and a short retrocecal appendix which was difficult to mobilize and exteriorize through umbilicus. The mean operating time was 30 minutes. There were no complications. Conclusion: Single-incision laparoscopy-assisted appendectomy combines the advantages of both laparoscopic and open appendectomy and offers reduced operative time and less complications and reduced surgical costs in pediatric age group.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799711","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":"Innovative Technique to Control the COVID-19 Transmission by Laparoscopic Fume: Could It be Possible to Capture the Betal inside the Bottle?","authors":"A. Kumar, N. Ghosh","doi":"10.5005/jp-journals-10033-1421","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1421","url":null,"abstract":"Aim and objective: This article aims to conceptualize the modification in the laparoscopic port to minimize the risk of COVID-19 virus transmission through the aerosol during laparoscopic procedures Background: A recent situation of COVID-19 pandemic has produced so many new unknown challenges for surgeons Surgical fume is a known theoretical biohazard for the operating team There are many suggestions from the international and national surgical societies and already available equipment which could minimize the risk transmission Still, there is no technique available to contain and discharge surgical fume in the proper way Here, we conceptualize a technique to reduce the risk of COVID-19 transmission in the operating team Technique: Here, we have suggested the modification in the laparoscopic port We advise adding an intermediate transparent, pliable, polythene/ silicon bag that could able to contain the leaked surgical fume and safely discharge in an underwater seal bottle, filled with sanitizer liquid Conclusion: The theoretical, potential risk of COVID-19 transmission during laparoscopic surgery has raised many doubts and apprehension of virus transmission through the surgical fume There are many suggestions and available equipment to minimize the spread;however, no definite solution already out surgical fume;here, our suggestion of modification in port could be a permanent solution to the surgical fume problem However, this is an initial concept that has the potential to addition and suggestion to improve the technique Clinical significance: The theoretical risk of surgical fume causing COVID-19 virus transmissions completely changes our surgical practice Here, in this article, we suggested our concept and technique contain and safely discharge of surgical fume during laparoscopic surgery","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70800155","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":"Totally Laparoscopic vs Open Transhiatal Esophagectomy: Our Experience in 93 Patients","authors":"علی جنگجو, سجاد نورشفیعی, احسان علایی, یاسمن ناوری, M. Nooghabi","doi":"10.5005/jp-journals-10033-1370","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1370","url":null,"abstract":"Introduction: The incidence of esophageal cancer has been increasing in the last decade. Different types of treatments are available, including minimally invasive esophagectomy (MIE). The aim of this study was to compare the early outcomes of the open vs totally laparoscopic transhiatal esophagectomy. Materials and methods: This case–control study was conducted between May 2012 and January 2014. Patients with esophageal cancer who presented to Imam Reza Hospital, Mashhad, Iran, were assessed and their eligibility for the surgery type was investigated. Results: Ninety-three esophagectomies performed. The open group comprised 57 patients and the laparoscopic group consisted of 36 patients. Mortality occurred in three patients in the open group and seven patients in the laparoscopic group ( p < 0.05). Chylothorax happened in four patients in the open group and only in one patient in the laparoscopic, which showed no significant difference. The mean operating time was 75 ± 16 minutes in the open group and 125 ± 25 minutes in the laparoscopic group ( p < 0.05). Conclusion: Minimally invasive transhiatal esophagectomy is an available option for treatment of esophageal cancer, but our results should be interpreted with caution due to low sample size and our primary experience in patient selection.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49207762","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 Randomized Clinical Trial of Laser Hemorrhoidoplasty vs Milligan and Morgan Hemorrhoidectomy","authors":"حسین شباهنگ, قدرت اله مداح, احمدعلی مفیدی, M. Nooghabi, سعیده حاجبی خانیکی","doi":"10.5005/jp-journals-10033-1373","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1373","url":null,"abstract":"Introduction: Hemorrhoidectomy is one of the most common surgical procedures, and other treatments such as laser hemorrhoidectomy had been used as an alternative. The aim of this study was to determine the outcome and postoperation complications of treatment by laser compared with open hemorrhoidectomy. Materials and methods: In this randomized clinical trial (RCT), 85 cases with a second or third degree of hemorrhoids were assigned to two groups at random and followed for 6 months. Those patients in the intervention group were treated by laser hemorrhoidoplasty (LHP) and those in the control group underwent Milligan and Morgan hemorrhoidectomy. At the end of follow-up, 80 cases remained in the trial on whom postoperative pain [visual analog scale (VAS)], complications, and quality of life according to the 36-item Short Form Health Survey (SF-36) questionnaire were studied. Data were analyzed using R 3.5.1 software and p value < 0.05 was considered significant. Results: The most common complaints were bleeding (57%) and pain (41%). Postoperative pain immediately and after 6 months was not significantly different between the two groups ( p > 0.05). No complications were seen in any groups in follow-up. All eight scales of SF-36 questionnaire, except general health, were significantly different in the two groups. Physical functioning was lower in patients who underwent LHP, whereas the patients’ quality of life in other scales was better in the laser group. The total score of SF-36 was 66.1 ± 3.6 and 56.0 ± 3.3 in laser and surgery groups, respectively ( p < 0.001). Conclusion: Laser hemorrhoidectomy is a safe procedure, not associated with any excessive postoperative complications. It improves patients’ quality of life and can be a substitution of other surgical methods.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46609323","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 Analysis of Surgical and Pathological Outcomes between Laparoscopic and Open Rectal Cancer Surgeries: Single Institution Experience","authors":"Jagadeesan G. Mani","doi":"10.5005/jp-journals-10033-1361","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1361","url":null,"abstract":"Background: The purpose of our review is to analyze and compare the perioperative and clinicopathologic outcomes of laparoscopic-assisted rectal surgeries (LARS) and open rectal surgeries (ORS) for rectal malignancies. Patients and methods: A retrospective analysis of data available from June 2015 to October 2018 was performed. Patient’s demographic profile, tumor characteristics, perioperative, and short-term clinicopathological outcomes were compiled and contrasted. Statistical tests used were Student’s t test and Fischer’s exact test. Results: During the study period, 34 and 24 patients underwent laparoscopic and open rectal cancer surgeries, respectively. Of 58 patients, there were 30 men (51.7%) and 28 women (48.3%) with average age group of 51.7 years. The median tumor distance was 4 cm and 6 cm from the anal verge in the laparoscopic and open groups, respectively ( p = 0.03). 70.1% of patients underwent preoperative chemoradiation. Conversion rate noted was 14.7%. Operative duration was prolonged for laparoscopic resection (194.7 vs 178.3 minutes, p = 0.168). Blood loss (395.58 vs 506.66 mL), postoperative hospital stay (8.3 vs 11.5 days: mean difference, 3.2 days), 30-day mortality (3% vs 0% p = 0.81), and major complications (11.8% vs 16.7%) failed to differ significantly. Negative circumferential radial margin was noticed in 98.4% of the overall group (94.1% laparoscopic resection and 95.8% open resection; p = 0.93). Conclusion: There were certainly no significant differences between laparoscopic and open surgeries in operative time period, complications, and duration of hospital stay. Hence, laparoscopic surgery is oncologically safe in rectal cancer patients. Clinical significance: Laparoscopic rectal as open with less morbidity, even among patients treated with preoperative chemoradiation.","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":"70799136","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}