Saudi Journal of Laparoscopy最新文献

{"title":"Totally extraperitoneal versus transabdominal preperitoneal approach: A comparative study between the two laparoscopic procedures","authors":"M. Aslam, J. Alam, Manisha Singh, Maikal Kujur","doi":"10.4103/sjl.sjl_4_21","DOIUrl":"https://doi.org/10.4103/sjl.sjl_4_21","url":null,"abstract":"Background: Groin hernia surgery is one of the most common procedures performed by surgeons worldwide. With the advent of minimal access surgery, the procedure for repair is now done either by transabdominal preperitoneal approach Transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) approach. The advantage of one procedure over the other is still controversial. Objectives: This prospective study was conducted to find out the intraoperative and postoperative outcomes of TEP and TAPP for inguinal hernia repair in terms of operative time, intraoperative complications, conversion to open, visual analog scale (VAS) score, postoperative complications, length of hospital stay, and recurrence of hernia and chronic pain. Materials and Methods: A total of 88 patients of inguinal hernia enrolled prospectively between November 2017 and November 2019 and patients aged 18 years and above admitted in Jawaharlal Nehru Medical College and Hospital were included in this study. Forty-four patients were included in TEP group, while 44 patients were allocated to TAPP group. Results: The statistical analysis was done using Chi-square test and unpaired t-test, respectively. The mean operative time in TEP was 91.14 ± 11.14 min and in TAPP repair was 103.16 ± 6.79 min, which was found to be significantly significant. The mean pain score on VAS score on postoperative day 1 was 5.70 ± 0.95 in laparoscopic TEP group and 5.86 ± 0.97 in laparoscopic TAPP group. The mean pain score on VAS score on postoperative day 2 was 3 ± 1.27 in laparoscopic TEP group and 2.95 ± 1.29 in laparoscopic TAPP group. Similarly, the mean pain score on VAS scale on postoperative day 7 was 0.863 ± 1.26 in laparoscopic TEP group and 0.659 ± 1.21 in laparoscopic TAPP group. No significant difference was observed in VAS between TEP and TAPP groups during follow-up. Both TEP and TAPP mesh techniques were comparable in terms of the intraoperative complications and postoperative complications (seroma [during hospital stay, after 1 week of discharge, after 1 month of follow-up]; hematoma [during hospital stay, after 1 week of discharge]; wound infection) and in conversion to open and length of hospital stay. The difference in mean cost of surgery was found to be statistically significant. Conclusion: Although the mean operative time and cost of surgery were significantly more in TAPP than in TEP group, no significant difference could be found between the intraoperative and postoperative complication rates, conversion to open, and length of hospital stay. Recurrence was observed in one case of TEP groups during follow-up. Our study supports the view that both laparoscopic TEP and TAPP mesh repairs of inguinal hernia are safe and efficacious.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130364277","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":"Malpractice knowledge, attitudes, and practices among physicians at a University Hospital in Saudi Arabia","authors":"Raneem Alghamdi, Doaa M. Abdelaziz, Elham Alobaid, Ghadah Almazrua","doi":"10.4103/sjl.sjl_6_21","DOIUrl":"https://doi.org/10.4103/sjl.sjl_6_21","url":null,"abstract":"Objectives: To assess knowledge, attitudes, and practices of physicians regarding medical malpractice at King Khalid University Hospital To assess the possible factors that affect malpractice knowledge, attitudes, and practices among physicians. Methods: A cross-sectional questionnaire-based study was conducted in King Khalid University Hospital between November and March 2019. Both medical and surgical physicians were included. A convenience sampling technique was used with a sample size of 336. The questionnaire contains four sections: demographics, knowledge, attitudes, and practices. Results: A total of 293 out of 336 questionnaires were returned giving a response rate of 87.2%. The comparison of the levels of knowledge of the respondents for each form of malpractice showed a statistically significant correlation with gender where female high knowledge score was 73 (62.9%) and male high knowledge score was 50 (35.5%). Another variable that showed statistical significance is specialty where medical specialty doctors scored 81 (54.7%) high knowledge, surgery doctors scored 25 (34.7%) high knowledge, and other specialties scored 17 (45.9%) high knowledge. Other variables showed no statistical significance. About the other two outcome variables, both attitudes and practice showed no statistically significant correlation with all included study variables. Conclusion: The research results show good and bad aspects. The overall knowledge among physicians was good. Moreover, there was no significant difference in knowledge among physicians from different rankings, nor among physicians with different years of experience. Regarding attitude and practice, the results showed no statistical significance. Overall these results can contribute to the quality of healthcare.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132324218","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 safety and efficacy of clipping the staple line in laparoscopic sleeve gastrectomy: A retrospective cohort study","authors":"S. Alshammari, Abdulaziz H. Mulhem, Abdullah Jafar, Hesham Alghofili, Doaa Maher, Elham Alobaid, A. Aldohayan","doi":"10.4103/sjl.sjl_2_22","DOIUrl":"https://doi.org/10.4103/sjl.sjl_2_22","url":null,"abstract":"Background: Obesity is a worldwide health problem and is of particular importance in Saudi Arabia, where there is a high incidence of the disease. There are many surgical procedures for its management, including laparoscopic sleeve gastrectomy (LSG). However, this procedure has postoperative complications such as bleeding and leakage. Patients and Methods: This retrospective cohort study included all patients who underwent LSG at King Khalid University Hospital under one surgeon from July 2015 to May 2018. The 146 patients were divided into a clipping group (n = 72) who underwent LSG with clipping of the staple line, and a nonclipping group (n = 74) who underwent LSG without clipping of the staple line. The incidence of postoperative complications, including bleeding and leak, was compared in the two groups. Results: There was no statistically significant difference between the two groups regarding patient demographic criteria or risk factors for postoperative complications. In addition, there was no statistically significant difference between the two groups in postoperative bleeding (P = 1) or leak (P = 0.324). Conclusion: Clipping the staple line in LSG does not affect the rate of postoperative leaking or bleeding.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127347123","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":"Hepatocellular carcinoma in a healthy liver; Case report and literature review","authors":"Ghaida Almasaad, Mohammed Alkarbi, Weam Hussein, Faisal Al-alem, A. Madkhali, A. Bazuhair, M. Hassanain","doi":"10.4103/sjl.sjl_5_21","DOIUrl":"https://doi.org/10.4103/sjl.sjl_5_21","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide with high mortality rate, and it most commonly develops in the presence of cirrhosis and chronic liver diseases, most commonly in hepatitis. In some cases, however, it may present in noncirrhotic liver or healthy liver without any chronic disease. Our case is a 60-year-old male with primary HCC with no liver disease and negative hepatitis serology. Presented with multiple liver masses in four different segments. Managed with embolization and staged liver resection.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130608643","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-site, multiple port, antireflux laparoscopic fundoplication is a feasible cost-effective technique: The first case report in the United Arab Emirates","authors":"Rajesh Sisodiya, Rajkumar Sankaran, M. Eraki, Jayakrishna A. Reddy, Shreya Rajkumar, Anirudh Rajkumar","doi":"10.4103/sjl.sjl_2_21","DOIUrl":"https://doi.org/10.4103/sjl.sjl_2_21","url":null,"abstract":"Advances in minimal access surgery have led to the emergence of single-incision laparoscopic surgery. Single-incision laparoscopic fundoplication for gastroesophageal reflux disease is safe and feasible in experienced hands. However, the main drawback of this technique is the increased cost factors considering the port devices and specialized instrumentation required. We did single-incision, multiple port laparoscopic Nissen fundoplication with conventional trocars and instruments.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134050129","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":"Port-site hernia leading to bowel obstruction and its logomachy","authors":"Ankit Shukla, V. Verma, Amit Dogra, Roshni Shukla, Ankur Sharma","doi":"10.4103/SJL.SJL_7_20","DOIUrl":"https://doi.org/10.4103/SJL.SJL_7_20","url":null,"abstract":"Since the birth of laparoscopic surgery, the morbidity in context to conventional surgery has hugely reduced; nevertheless, the laparoscopic surgery has its own specific complications, one of them being port-site hernia, which can be devastating. As the minimal access surgery is advancing to the single-port or single-incision laparoscopic surgery and bariatric and robotic surgery, the rise in port site hernia will be noticeable. However, the dilemma still exists regarding the pathogenesis, prophylactic closure of larger port sites, and the optimum technique of management of port-site hernia due to a lack of high level of evidence. Herein, we present a female patient with port-site hernia, leading to small bowel obstruction from one of the working ports.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124576884","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":"Ovarian ectopic pregnancy: A success story","authors":"Beenish Maqsood, Amina Butt, K. Aziz","doi":"10.4103/sjl.sjl_12_20","DOIUrl":"https://doi.org/10.4103/sjl.sjl_12_20","url":null,"abstract":"Ovarian pregnancy is a rare form of ectopic pregnancy. Clinical and imaging diagnosis is challenging and so can be the management, as was in our case, where the pregnancy being located in the ovary was not clear in the beginning. Various case series have concluded that an ovarian pregnancy, in a few cases, can present as an adnexal mass. We present a case of left ovarian pregnancy in a 31-year-old woman. Transvaginal ultrasound showed an empty uterus and a left adnexal mass. A suboptimal rise in beta-human chorionic gonadotropin (β-hCG) levels suggested an ectopic pregnancy. The patient declined a surgical intervention, even after explaining the risks and a likely need of surgery, in view of high β-hCG level. A single dose of methotrexate was given in the presence of hemodynamic stability and absence of pain. Subsequently, a laparoscopy was performed when the patient presented with pain abdomen and a rising β-hCG level, 7 days after methotrexate was administered. Ovarian wedge resection was done. Histopathological assessment confirmed the diagnosis. Increasingly, operative laparoscopy is the method employed for the surgical management of ovarian ectopic pregnancy. In view of concerns about future fertility, the current practice is to resect ovarian pregnancy and preserve healthy ovarian tissue.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127567697","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 active gas suctioning in postoperative pain after laparoscopic cholecystectomy","authors":"S. Pavan Kumar, O. Pathania, Nain Singh, S. Ramesh Kumar","doi":"10.4103/sjl.sjl_1_21","DOIUrl":"https://doi.org/10.4103/sjl.sjl_1_21","url":null,"abstract":"Introduction: Abdominal pain and shoulder pain after laparoscopic cholecystectomy (LC) is most likely a combination of direct stretching of the diaphragm caused by insufflation and the release of hydrogen ions. Reducing postoperative discomfort after LC is an area of active research. Many methods such as low pressure pneumoperitoneum and intraperitoneal instillation of drugs (local anesthetic, saline) to reduce pain have been carried out. Drainage of gas after elective LC reduces early postoperative abdominal pain including shoulder pain. Materials and Methods: Seventy-five adult female patients with symptomatic gall stones were worked up on the outpatient department basis. After detailed history and physical examination, patient underwent elective surgery. After elective laparoscopic cholecystectomy, active suction was performed by inserting the laparoscopic suction irrigation device through a 5-mm trocar. Continuous suction will be applied for 60 s. In all the patients, port sites were closed in the standard manner. Postoperative pain, residual gas volume, and analgesic requirement were assessed and analyzed. Results: The median patient age was 32 years, median duration of surgery being 40 min. Residual gas volume (gas under diaphragm) was present in 22 patients out of 75 patients which accounts for 29.3% of the study population. The median amount of residual gas calculated using the formula was 7.3 ml (4.9–16.10 ml). Out of 75 patients studied, about eight patients developed shoulder pain and the rest of the patients complained of abdominal pain. Out of 75 patients studied, one patient developed gall bladder fossa collection. Conclusion: Active gas suction is a very simple procedure that is safe and feasible. Performing this procedure significantly decreases the residual intraperitoneal gas volume and postoperative pain after laparoscopic surgery and our surgeons should pay more attention in active aspiration of carbon dioxide at the end of laparoscopic operation.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"345 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134266703","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":"Hypomagnesemia following thyroidectomy: Prospective observational - Pilot study","authors":"A. Abdulkareem","doi":"10.4103/sjl.sjl_10_20","DOIUrl":"https://doi.org/10.4103/sjl.sjl_10_20","url":null,"abstract":"Background: Magnesium plays a role in the active transport of calcium (Ca+2) and potassium ions across cell membranes. Most of Mg+2 is intracellular or in the bone <1% is in the blood serum. Post thyroidectomy, hypoparathyroidism leads to acute hypocalcemia that leads to hypomagnesemia. The relation of Ca+2 and magnesium (Mg+2) metabolism is complex and mainly related to the interaction of these cations with parathyroid hormone (PTH) post thyroidectomy. Magnesium is an essential regulator of Ca+2 flux and intracellular action of Ca+2. Hypomagnesemia impairs hypocalcaemia-induced PTH release, which is corrected rapidly after magnesium replacement. Attempting to correct only hypocalcemia may prolong symptoms. It is important to monitor both Ca+2 and Mg+2 levels following thyroidectomy to facilitate prompt resolution of symptoms. The aim: is to highlight the prevalence of hypomagnesemia following thyroidectomy and its association with hypocalcemia which mandate early recognition and treatment to prevent prolongation of hypocalcemia and permanent hypoparathyroidism. Methods: Institutional review board was obtained (E20-4615) and posted in ClinicalTrials.gov NCT04351451. Informed consent taken from all patients. This is a prospective open Label observational pilot study in patients who underwent thyroidectomy. The study period was from January 2019 to January 2020. A total of 74 patients with normal renal function. Serum Ca+2, magnesium, phosphate level, and Vitamin D level are all checked preoperatively and in the first postoperative day. Results: Post thyroidectomy 56.8% of patients had hypomagnesemia. 59.5.1% had hypocalcemia and 41.9% of had combined low level of Ca+2 and Mg+2 (P = 0.004). Conclusions: Causes of hypocalcemia and hypomagnesemia following thyroidectomy is of multi factorial related mainly to Ca+2, Mg+2 interaction in relation to PTH level.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124359646","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":"Factors affecting decisions on choosing bariatric surgeons: A qualitative study","authors":"S. Al Sabah, Eliana Al Haddad","doi":"10.4103/SJL.SJL_8_20","DOIUrl":"https://doi.org/10.4103/SJL.SJL_8_20","url":null,"abstract":"Background: Despite the safety of bariatric surgery (BS), only 0.4% of patients that qualify for it proceed to undergo the procedure. One hypothesized reason is the selectiveness of patients for medical providers. Methods: An online survey was distributed to bariatric surgeons around the world to identify what criteria they observed prospective bariatric patients found most important when selecting a medical provider. Questions were evaluated on a 10-point scale. Results: Our survey was distributed to 76 surgeons practicing in 16 countries. The most influential factors that affect patients' decisions on choosing their bariatric provider were seen to be a recommendation received from others and surgeon reputation. The proximity of the hospital to the patients' home was seen to be of least importance. It was seen that the quality/accreditation of the surgeon was significantly more important in surgeons working in the public setting when the data were analyzed according to the setting of practice. Conclusion: With the emergence of BS, choosing a provider has become of utmost importance. The most influential factors that were seen to affect patient's decisions were recommendations for the surgeons and reputation. This data could lay the groundwork for how medical providers market themselves when working in the BS field.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122919716","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}