World Journal of Laparoscopic Surgery最新文献

{"title":"Local Anesthetic Use for Pain Relief Following Laparoscopic Ventral Hernia Repair: A Systematic Review","authors":"V. Autagavaia, Jamie-Lee Rahiri, M. Lauti, L. Poole, G. Poole, A. Hill","doi":"10.5005/jp-journals-10033-1349","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1349","url":null,"abstract":"A bstrAct Aim: To assess the effectiveness of the addition of local anesthetic (LA) techniques in reducing pain and morphine consumption in the first 24 hours following laparoscopic ventral hernia repair (LVHR) in adults. Background: Ventral hernias (VH) are a common condition; with risk factors (including obesity), the incidence of VH is projected to increase. Surgical VH repair is required for symptom relief and to prevent related complications. LVHR has significant advantages over open repair, with reduced infectious complications, shorter hospital stays, and more favorable outcomes in obese patients. However, in comparisonto open repair LVHR patients often experience severe pain post-LVHR. LA is an important part of multimodal analgesia regimes and their use in the context of post-operative LVHR pain management is growing in importance. Review results: A systematic review was performed according to PRISMA using search terms related to LA, LVHR post-operative pain, and morphine consumption; studies were limited to adults ( > 18 years) and randomized control trials (RCT). Four RCT met the inclusion criteria. All studies compared bupivacaine with normal saline, one also used bupivacaine with epinephrine; varying LA interventions were used. One study showed a statistically significant, but small (0.08 mg) reduction in pain scores at 24 hours, which is likely to be clinically insignificant. Three studies showed an overall reduction in morphine consumption at 24 hours, with only one reaching statistical and clinical significance. Conclusion: Bupivicaine LA interventions post-LVHR did not reduce pain scores at 24 hours, but morphine consumption appeared to have been reduced. Clinical significance: Despite some evidence of reduction in morphine consumption in the first 24 hours post-LVHR, further investigation is required regarding post-operative LVHR pain management using LA, including agent and mode of delivery.","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":"70798840","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 Chronic Abdominal Pain with Uncertain Diagnosis: A 1-year Cross-sectional Study","authors":"A. Bellad, Amar A Murgod","doi":"10.5005/jp-journals-10033-1362","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1362","url":null,"abstract":"Aim: Diagnosis of chronic abdominal pain is a significant clinical challenge. Laparoscopy, a minimally invasive technique, could potentially be diagnostic as well as therapeutic in patients with chronic undiagnosed abdominal pain. This study was aimed to evaluate the role of laparoscopy as an investigative modality in the diagnosis and management of patients with chronic abdominal pain. Materials and methods: Demographics, clinical data, and medical and surgical history of the patients (55 patients) with chronic abdominal pain were noted. Details of pain such as, severity of pain based on visual analog scale (VAS) score, duration of pain, site of pain, and nature of pain were recorded. Routine along with radiological investigations were also performed. After preoperative investigations, the patients were subjected to diagnostic laparoscopy, either by open or closed technique under general anesthesia. Postoperative assessment of pain was done using VAS score. Results: Most of the patients (65.45%) had a duration of pain between 8 weeks and 12 weeks and mean duration of pain was 10.80 ± 2.78 weeks. Fever was present in 41.82% of the patients. A history of lower segment cesarean section was observed in 5.45% patients. The most common surgical procedure performed was adhesiolysis (30.91%) followed by appendectomy (29.09%). Postoperative pain relief was statistically significant ( p < 0.001). Conclusion: Laparoscopy offers an effective diagnostic modality and excellent pain relief in the management of patients with chronic abdominal pain. Furthermore, adhesions and inflamed appendix are important causes of chronic abdominal pain. However, studies with a large sample size are required to validate the findings. Clinical significance: Laparoscopy is an investigative modality in the diagnosis and management of patients with chronic abdominal pain. underwent adhesiolysis. In a study by Husain et al., 6 patients with chronic abdominal pain had 19% and 17.3% cure rate with laparoscopic appendectomy and adhesiolysis, respectively, after a 6-month follow-up period. In a study by El-labban et al., 19 laparoscopic adhesiolysis resulted in a positive outcome in more than 50% patients.","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":"70799310","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":"Nonbiliary Complications of Laparoscopic Cholecystectomy: A Single-center Experience","authors":"Rachhpal Singh","doi":"10.5005/jp-journals-10033-1367","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1367","url":null,"abstract":"Aim: Bile duct injury is an important complication of laparoscopic cholecystectomy. Nonbiliary injuries after laparoscopic cholecystectomy can be fatal and source of considerable morbidity. In this study we intend to highlight the importance of nonbiliary complications sustained during laparoscopic cholecystectomy and their outcome. Materials and methods: The study is analysis of patients managed in our unit with post-laparoscopic cholecystectomy nonbiliary complications from June 2010 to December 2018. Inclusion criteria—nonbiliary complications. Exclusion criteria—cases of bile duct injury, cases of surgical site infection, trocar-site hernia. Results: A total of nine patients with nonbiliary complications were managed. Mean age of the patients was 51.1 years (range 38–65). There were five males and four females. Nonbiliary injuries were categorized into access-related and procedure-related complications. Three cases (two colonics, one inferior vena cava) were access related. Six cases (five duodenal, one ileal) were procedure related. Conclusion: Nonbiliary injuries are of significant severity. Adequate attention in creating pneumoperitoneum and meticulous dissection helps in preventing complication. Timely detection and early therapeutic intervention can help reduce morbidity and mortality. Inclusion criteria— criteria—cases","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":"70799396","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":"Follow-up Study Comparing Open Hysterectomy of Expert Surgeon and Laparoscopic Approach (Learning Curve) of the Same Surgeon","authors":"M. Arab, Jatinder Sigh Chowhan, S. N. Ardebili, B. Ghavami, Nasrin Yousefi","doi":"10.5005/jp-journals-10033-1359","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1359","url":null,"abstract":"","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":"70798904","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 Choledochal Cyst Resection with Simplified Common Bile Duct Reconstruction in an Adult Population: A Case Series","authors":"D. Gomez, Jean A. Pulido, R. Villarreal, Andres Mendoza, D. Moreno, N. Zundel","doi":"10.5005/jp-journals-10033-1366","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1366","url":null,"abstract":"Introduction: Choledochal cysts (CC) are rare congenital pathology in adult population. Since 1995, laparoscopic management has been described for this entity. Nevertheless, its management is considered to be a controversial matter due to the augmented risk of associated cholangiocarcinoma. Materials and methods: A retrospective, observational, and descriptive study was conducted considering patients diagnosed with CC who were operated at a hepatobiliary surgery referral center from January 2013 to June 2018. Patients were taken to simplified laparoscopic hepaticojejunostomy with a Roux-en-Y reconstruction. A retrospective analysis of the data obtained is presented. Results: Ten adult patients with CC underwent surgical biliary reconstruction at a mean age of 34.5 years; 75% had Todani type I CC and 25% Todani type IV-B CC. About 50% of the patients were diagnosed via endoscopic retrograde cholangiopancreatography (ERCP) and 50% of them via magnetic resonance cholangiopancreatography. None required re-intervention, no mortality was reported; and the mean hospital stay was 5 days, no patient had postoperative biliary leakage, none was converted to open surgery, and all patients had adequate oral feeding tolerance 2 days postoperative. Long-term follow-up showed no incidence of cholangiocarcinoma after 2-year follow-up. Conclusion: Choledochal cysts in adults is a rare pathology that has a high probability of developing malignancy when not adequately surgically managed and because of secondary bile reflux. These factors make surgical management a critical decision. The simplified laparoscopic approach presented in this paper seems to be an effective and safe alternative to biliary duct reconstructive surgery.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799339","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":"Review of Outcome of Laparoscopic Cholecystectomy Done by Consultants vs Surgery Residents at Tertiary Care Teaching Hospital","authors":"Jitendra Sankpal, Shubham Gupta, Jasmine Agarwal, Ratnaprabha P Jadhav, Supriya Bhondve, Ruchira Bhattacharya","doi":"10.5005/jp-journals-10033-1363","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1363","url":null,"abstract":"","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":"70799284","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":"Danger of Laparoscopic Umbilical Port in Portal Hypertensive Cirrhotic Patient: A Case Report","authors":"Suppadech Tunruttanakul, Kotchakorn Verasmith","doi":"10.5005/jp-journals-10033-1371","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1371","url":null,"abstract":"Laparoscopic surgery has been proved to be safe and better option for Child-Pugh (CP) score class I and II cirrhotic patients. Various challenging laparoscopic surgeries have been applied to this group of patients. This case report was of an obese man, CP class I alcoholic cirrhotic patient with radiological evidence of portal hypertension, inflicted with cecal adenocarcinoma. Laparoscopic right hemicolectomy was planned. First camera port incision was made on infraumbilical position and injured to large paraumbilical collateral, which drained blood from the main portal vein. The patient was survived but suffered from postoperative ascites and postponing definite surgery. The preoperative computed tomography was reviewed and detailed of these collateral vessels. This report aims to raise awareness of this potential complication and reveal the imaging with discussion of avoiding options.","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":"70799797","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 Roux-en-Y Gastric Bypass and Mini-gastric Bypass in Patients of Developing Countries","authors":"G. Obonna, Martin C Obonna","doi":"10.5005/jp-journals-10033-1360","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1360","url":null,"abstract":"Background: The disease of obesity mostly common in the developed countries is also predominantly seen in the developing countries in recent times. This is therefore a cause to worry. Aim: To review literature comparing Roux-en-Y gastric bypass (RYGB) and mini-gastric bypass (MGB) to ascertain the more effective and safe bariatric and metabolic operation. Materials and methods: Detailed literature review online was perfected via Springer Link, International Bariatric Club, and the World Health Organization. Of immense use was a database of 1,000 bariatric surgeries collated from multiple hospitals in the developing countries. Conclusion: Both bariatric procedures are effective in the treatment of morbid obesity by restriction and malabsorption. They resolve obesity- related metabolic complications and hence increase quality of life for morbidly obese patients. However, in their comparison, MGB take lesser time to perform than RYGB. Also, MGB has shown to be simpler and safer surgery than RYGB. Thus, in the developing country, with its high population and increasing prevalence of morbidly obese individuals, MGB procedure can be used to treat more patients and also reduce the time and energy taken to manage the patient because of its technical ease, efficacy, revisibility, and reversibility. Overall, a zero mortality in MGB makes it the gold standard in bariatric surgery.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70799059","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":"Effect of Metatarsus Reflexology Massage in Laparoscopic Cholecystectomy Nausea: A Randomized Clinical Trial","authors":"Marzieh Badakhsh, Andishe Hamedi, Salimeh Azizi","doi":"10.5005/jp-journals-10033-1381","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1381","url":null,"abstract":"Ab s t r Ac t Background: Nausea after surgery is an important complication. The incidence of this complication is expressed to be 40–75% in laparoscopy. Due to the risks of nausea following surgery, various methods are used to control it. Metatarsus reflexology is a noninvasive, well-tolerated, inexpensive, convenient, and cost-effective method for treating many diseases. The aim of this study is to identify the effect of metatarsus reflexology massage in laparoscopic cholecystectomy nausea. Materials and methods: In this randomized clinical trial, 60 patients who were candidates for laparoscopic cholecystectomy were randomly divided into two groups. The control group received common drug therapy and the intervention group underwent foot reflexology massage for 10 minutes after common therapy. In recovery and at 6 and 12 hours after surgery, the severity of nausea, vomiting was evaluated in the two groups. The results were analyzed using independent t test, Chi-square, and repeated measures analysis of variance is true. Results: There were no significant differences between the two groups before intervention in terms of demographic characteristics including age, sex, duration of anesthesia, and severity of pain in recovery, However, during the study period (in both the intervention and control groups), the severity of nausea was decreased (p value < 0.001; F = 245.24). Conclusion: Foot reflexology has an important role in nausea control along with other common treatments and it can be done by nurses due to low cost.","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":"70799384","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":"Appendicular Stump Closure by Polymer Clip vs Endoloop in Laparoscopic Appendectomy","authors":"Vishal P Bhabhor","doi":"10.5005/jp-journals-10033-1374","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1374","url":null,"abstract":"Introduction: Several techniques are used to close the appendicular stump during laparoscopic appendectomy. This is especially important in developing countries where resources for training with endoloop are insufficient, and the simplicity of application of polymer clips can enable easy acceptance of laparoscopic appendectomy as a method in the treatment of acute appendicitis. Aim: The aim of the study was to compare results of appendicular stump closure by polymer clip and endoloop with reference to • Days of hospitalization, • Infection rate, and • Ease of application Materials and methods: This is a prospective study of 70 cases of laparoscopic appendectomy operated in the Department of General Surgery, SSG Hospital, Vadodara, from October 2016 to October 2017 (35 patients in each group i.e., polymer clip application group and endoloop application group). Operative data were recorded, and the patients were followed up accordingly. Independent assessors were assigned to obtain days of hospitalization, infection rate, ease of application, and other secondary outcomes. Results: It is more feasible for surgeons to use polymer clip than endoloop to close appendicular stump as per the surgeon’s opinion taken after each surgery. However, days of hospitalization and postoperative complication rates were not statistically significant in both groups. Conclusion: Closure of appendix stump with a polymer clip is a simple and safe method in laparoscopic appendectomy and is comparable with other methods of appendicular stump closure.","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":"70799776","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}