Saudi Journal of Laparoscopy最新文献

{"title":"Laparoscopic management of ectopic pregnancy: An observational study from North Kashmir","authors":"Sieqa Shah, S. Khanday, M. Mushtaque, Ibrahim Guru","doi":"10.4103/SJL.SJL_12_19","DOIUrl":"https://doi.org/10.4103/SJL.SJL_12_19","url":null,"abstract":"Background: With advancements in field of minimally invasive surgery, increasing number of patients with ectopic pregnancy (EP) can be managed laparoscopically. Aims and Objective: To evaluates our experience of laparoscopic management of ectopic pregnancy in terms of its safety and efficacy. This is an observational study conducted over a period of seven years at Guru Multi-specialty Hospital Sopore, Kashmir, India. Materials and Methods: A total of 84 patients with EP were included in the study. The diagnosis was made by detailed history, clinical examination, βHCG assay, abdominal and transvaginal ultrasonography. All patients underwent laparoscopic salpingectomy or salpingostomy depending on the clinical scenario. The outcome was analysed in terms of details of the procedure, mean operative time, post-operative VAS score (0-10), complications, hospital stay and subsequent fertility. Histopathological examination of the resected fallopian tubes was also evaluated. Statistical analysis was done as a prospective sample survey analyzing percentage and mean values. Results: Sixty-one patients had chronic ectopic while 23 presented acutely. Seventy-seven (91.66%) patients were diagnosed by clinical, laboratory and sonographic modalities while 7 (14.17%) required diagnostic laparoscopy for confirmation. Ampulla was the site of EP in 75% of cases. Ruptured fallopian tubes were found in 20 (86.95%) and 9 (14.75%) patients who presented with acute and chronic ectopic respectively. The patients with chronic ectopic were managed with laparoscopic salpingectomy and laparoscopic salpingostomy in 45 (73.77%) and 16 (26.22%) patients respectively. Patients with acute ectopic were underwent laparoscopic salpingectomy in 18 (78.26%) and salpingostomy in another 5 (21.73%) cases. The operative time was longer in patients with chronic ectopic ranging between 55-135 minutes. A total of five (5.95%) patients required blood transfusions. One each case of chronic and acute ectopic required conversion to open surgery. Histopathological examination of salpingectomy specimen revealed chronic salpingitis was seen in 39.68% of the cases. On follow-up, a total of 18 (29.5%) and 9 (39.13%) patients conceived within a year and another 5 (8.19%) and 2 (8.69%) did so between 1-2 years who presented with chronic and acute ectopic respectively. Conclusions: Laparoscopic approach in treatment of EP is safe and feasible irrespective of the type of presentation with all advantages of minimal access surgery and greatly reduced morbidity.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"357 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122997690","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 gastric bypass for morbid obesity in a patient with situs inversus totalis","authors":"Fahad Bamaehriz, Rami Basardah, Adnan Sabbahi, Mohanad Albalawi, Faris Mustafa","doi":"10.4103/SJL.SJL_1_19","DOIUrl":"https://doi.org/10.4103/SJL.SJL_1_19","url":null,"abstract":"Situs inversus totalis (SIT) is a rare congenital disorder that is characterized by a complete reversal of abdominal and thoracic organs. Laparoscopic gastric surgery may pose a challenge in patients with the condition due to mirror-image anatomy. Further studies are required to assess the impact of surgery on those afflicted with this disorder. We report a case of 22-year-old female with SIT who successfully underwent laparoscopic Roux-en-Y gastric bypass. Laparoscopic surgery is feasible in patients with SIT once anatomical considerations are taken into account.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131603810","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 total gastrectomy with D1+ lymph nodes dissection for a patient with early gastric cancer in Saudi Arabia","authors":"S. Aldubaisi, Sarah Alkhardawi, Saeed Alshomimi, Abdulrahman I. Abduljabbar","doi":"10.4103/SJL.SJL_11_18","DOIUrl":"https://doi.org/10.4103/SJL.SJL_11_18","url":null,"abstract":"Gastric cancer is not uncommon in Saudi Arabia and still one of the top causes of cancer-related deaths. Nevertheless, case reports and literature reviews regarding gastric cancer and its treatment options are rarely published in Saudi Arabia. Hence, we review the first case in Saudi Arabia of total laparoscopic gastrectomy accompanied by D1+ lymph node dissection done for a 55-year-old Saudi female with early gastric cancer (EGC). It was performed following the latest Japanese gastric cancer guidelines. The surgery was successful with neither intraoperative nor postoperative complications. In conclusion, laparoscopic treatment for EGC is a safe and feasible option for treatment in addition to faster recovery and less overall surgical complications on the short term compared with open gastric surgeries.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130035657","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":"Large Hamartoma occupying the whole breast: Creates a Diagnostic Challenge","authors":"A. Abdulkareem","doi":"10.4103/SJL.SJL_3_19","DOIUrl":"https://doi.org/10.4103/SJL.SJL_3_19","url":null,"abstract":"Hamartoma is detected in the breast during screening of breast asymmetry or discovered pathologically in combination with other breast pathologies. Hamartoma should be considered one of the differential diagnoses of breast asymmetry, especially for young women, where mammogram is not frequently ordered or if the patient complains of significant breast asymmetry with no clearly evident breast mass by physical examination and normal breast ultrasound. Hamartoma is detected by mammogram as “'breast within a breast.” Ultrasound can diagnose small localized hamartoma and fine-needle aspiration or core needle biopsy of no significant help in diagnosis of isolated hamartoma not assonating with other pathologies. Mammogram and breast magnetic resonance imaging (MRI) are of great help in diagnosing hamartoma especially if it is large occupying the whole breast. Awareness of isolated hamartoma as a cause of breast asymmetry with the help of mammogram or MRI of the breast will lead to early diagnosis and treatment and avoid patient suffering of undiagnosed breast hamartoma.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133621371","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 management of symptomatic gallbladder stump calculi","authors":"A. Ganai, A. Rashid, Sheikh Junaid, M. Mushtaque","doi":"10.4103/SJL.SJL_11_19","DOIUrl":"https://doi.org/10.4103/SJL.SJL_11_19","url":null,"abstract":"Aim: The aim of the present study was to evaluate the safety of laparoscopic completion cholecystectomy in patients with symptomatic gallbladder stump calculi. Materials and Methods: Ours was a prospective study conducted in three peripheral hospitals over a period of 6 years. All the patients undergoing elective laparoscopic cholecystectomy during this period were enrolled in the study. The outcomes of laparoscopic completion cholecystectomy in patients with gallbladder stump calculi were compared to those undergoing primary laparoscopic cholecystectomy with regards to perioperative morbidity and mortality. Results: A total of 3127 laparoscopic cholecystectomies were performed. Out of them, laparoscopic completion cholecystectomy was done in 36 (1.15%) patients. There were 21 males and 15 females in these 36 patients. The operative time and hospital stay were significantly increased in the completion group. None of our patients in the completion group required conversion. Perioperative complications were seen more often in the patients posted for completion cholecystectomy (6 [6.67%] vs. 207 [6.69%]; P = 0.0026). Bleeding was the most frequent intraoperative complication seen in the patients undergoing completion cholecystectomy. Conclusion: Laparoscopic completion cholecystectomy, though technically demanding, can be safely done even in a peripheral health setup with acceptable morbidity rate.","PeriodicalId":388688,"journal":{"name":"Saudi Journal of Laparoscopy","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122389070","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}