South-East European Endo-Surgery Journal最新文献

{"title":"Laparascopic management of non-palpable testis","authors":"Kenan Karavdic","doi":"10.55791/ymxag947","DOIUrl":"https://doi.org/10.55791/ymxag947","url":null,"abstract":"We present a new approach to high intraabdominal testis (IAT) for elongation of the testicular vessels without division. The technique entails fixation of the testis to a point one inch above and medial to the contralateral anterior superior iliac spine for 12 weeks. Subdartos orchiopexy is then done as the second stage. Both stages are laparoscopically assisted. The a new approach to high intraabdominal testis, two-stage laparoscopic traction-orchiopexy, is useful and resulted in significant elongation of the testicular vessels without atrophy. It is a safe and valid alternative to the two-stage laparoscopic Fowler–Stephens technique, which entails division of the main testicular vessels.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"33 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140286007","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":"Surgical Treatment of Crohn’s Disease","authors":"Zlatan Mehmedovic","doi":"10.55791/96v82s36","DOIUrl":"https://doi.org/10.55791/96v82s36","url":null,"abstract":"Crohn’s disease is an idiopathic, incurable, chronic, inflammatory disease of the gastro-intestinal tract, whose incidence is rising around the world for unknown reasons. The characteristic transmural inflammation of Crohn’s disease may occur anywhere along the digestive tract, which results in an inflammatory, fibrostenotic or penetrating phenotype. Although the degree of symptomatology varies, and may increase or disappear during the course of the disease, patients may require chronic immuno-suppressive and surgical treatment, but neither of these can cure the disease. Although the rate of surgical interventions for drug-refractory diseases has decreased over the past six decades, as well as the need for urgent surgical procedures, surgery still has an important place in the treatment of the complications of this serious ailment. After resection, which is not curative, 70 to 90% of patients will suffer endoscopic recurrence within one year, and 35% patients will have repeated intestinal resection within ten years.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"336 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140397807","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":"General Surgeon’s Challenge: Primary Reconstruction of High-Velocity Facial Trauma","authors":"Stanko Baco, Jovica Mišić, Milos Mitric, Zoran Matković","doi":"10.55791/9dbz9r83","DOIUrl":"https://doi.org/10.55791/9dbz9r83","url":null,"abstract":"Background: Facial wounds are often seen in the emergency department. Whether isolated or associated with cranial injuries or poly-trauma, they can have a significant impact on the patient’s facial aesthetics and consequently, their eminent psychological states.Case presentation: A 63-year-old man was referred to our emergency department with an extensive facial injury, which occurred when a grinder disc for working with metal broke, while he was working at home and hit him with high velocity in the face. The patient was hemodynamically stable with a disfiguring, profusely bleeding wound of the maxilla and mandible. One tooth in the lower jaw had been broken and one was missing. The wound was closed with synthetic, resorbable, interrupted sutures in two layers (the inner layer was buccal mucosa, and the other layer was only the skin).Discussion and conclusion: The extent of damage to soft tissue depends on the type and velocity of the object. Proper wound treatment is necessary, including thorough irrigation, removal of foreign bodies, tension-free closure, reconstruction of anatomical landmarks and correct follow-up. Wound healing starts shortly after the initial tissue trauma, and can take up to several months to complete. Disorder in hemostasis and uncontrolled inflammation can lead to an unfavorable outcome. Facial injuries are treated by general surgeons in only 0.5% of cases, with plastic surgeons, oral and maxillofacial surgeons, and otolaryngologists/head and neck surgeons being the most common specialties. Anatomic, diagnostic, and handling considerations should be analyzed to achieve the best results and minimize late post traumatic deformities. Complex facial reconstruction is possible when treated by an experienced general surgeon.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"362 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140397593","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":"Advantages of spinal compared to general anesthesia","authors":"Almir Sakic, Bakir Helic","doi":"10.55791/5n6mvg14","DOIUrl":"https://doi.org/10.55791/5n6mvg14","url":null,"abstract":"Spinal anesthesia is a regional anesthesia technique achieved by a local subarachnoid anesthetic injection. Local anesthetic blocks conduct of pain on the spinal level and provides analgesia of the body below the navel. It can be used in a wide array of procedures, including laparoscopy. Inguinal hernia surgery is performed under general or regional anesthesia, depending on the indications and the individual approach of the anesthetist and surgeon. This article brings review of the literature and our experience in advantages and disadvantages of spinal anesthesia in open inguinal hernia surgery. We find that spinal anesthesia is cost effective and has advantages in inguinal hernia surgery when compared with general anesthesia, in terms of better postoperative pain control, and less nausea and vomiting, with minimal effects on hemodynamic stability.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"335 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140397815","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":"Complete Mesocolic Excision with Central Vascular Ligation during Laparoscopic Right Hemicolectomy: Technical Notes","authors":"M. D. Di Nuzzo, R. Peltrini, Luigi Vanni, M. D’ambra, Umberto Bracale, Francesco Corcione","doi":"10.55791/7khz1t79","DOIUrl":"https://doi.org/10.55791/7khz1t79","url":null,"abstract":"In this article we describe the surgical technique of the Complete Mesocolic Excision (CME) with Central Vascular Ligation (CVL) during laparoscopic right hemicolectomy (LRH) with intracorporeal anastomosis, as performed in our current surgical practice. The preparation of the patient, the operating room, the position of the surgeons, equipment and trocar placement are described in detail. The procedure is divided into well-defined steps, and each one is meticulously described.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"79 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140482106","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":"Robot-assisted colorectal operations compared to the laparoscopic approach","authors":"Igor Černi","doi":"10.55791/tkafg851","DOIUrl":"https://doi.org/10.55791/tkafg851","url":null,"abstract":"Background: The minimally invasive approach has become increasingly interesting in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics used in colorectal cancer in terms of oncologic and clinical outcomes in a small general hospital.Methods: We analyzed and compared two group of patients operated robotically and laparoscopically. 85 patients operated robotically (49% female, 51% male). The average age was 63.5 years, 110 patients operated laparoscopic operations (64% male, 36% female), the average age was 65.5 years.Results: In all patients radical resection was performed. The average number of isolated lymph nodes in the robotic method was 19, while in laparoscopic method there were 155. The hospitalization was shorter in the robotic surgery patients (average 7.3 days), on the other hand the duration of the robotic operations was longer than the laparoscopic operations. Intraoperative blood loss was smaller in the robotic method (50-120 ml) in comparison with laparoscopic method (100-300 ml). Conversion to open surgery was lower when using the robotic method (4,5%) than in laparoscopic method( 7%). Laparoscopic method has more frequent complications 9 (10,3%) while robotic method 4 (9%). In 10 years follow up 9 laparoscopically operated died (10,3%), (5 due to cardiovascular disease, 4 due to progression of disease). In this period, 3 robotically operated patients died (6%), one due to progression of the disease, the others due to cardiovascular disease. The most common operation was right hemicolectomy (46%) by laparoscopic procedure, and using the robotic method it was anterior resection of the rectum (54%).Conclusion: RCS is a promising technique and is a safe and effective alternative to LCS for colorectal surgery. The advantages of RCS include reduced EBLs, lower conversion rates and shorter times to recovery of bowel function. Further studies are required to define the financial effects of RCS and the effects of RCS on long-term oncological outcomes.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"25 5-6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489340","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 appendectomy in obese patients - experience from small, general hospital","authors":"Zoran Matković, Nataša Đekić Matković, Jovica Mišić, Miloš Milićević","doi":"10.55791/drby7529","DOIUrl":"https://doi.org/10.55791/drby7529","url":null,"abstract":"Background: Acute appendicitis (AA) is the most common cause of acute abdominal pain in the general population. In the past 30 years, obesity has become twice as common. Emergency surgery services are more often faced with obese patients with acute abdominal pain whose origin is AA. That is why we wanted to compare our results with data from the literature on laparoscopic surgery of obese patients with AA.Materials and methods: This is a retrospective study, which includes the population of obese patients who underwent surgery at our facility during the period from 1.1.2018. to 31.12.2022. Data were taken from our patients’ electronic records. Patients were included in the study who had body mass index (BMI) 30 and more, without any serious comorbidity. Exclusion criteria were: younger than 20 years, previous laparotomy, periappendicular infiltration, unregulated hypertension and diabetes mellitus, and morbidity obesity (BMI 40 and above). We analyzed demographic data, the length of surgery, PH findings of appendicitis, consumption of analgesics, beginning of peristalsis, length of stay and postoperative complications.Results: In the period in question the laparoscopic approach was used in surgery on 190 patients in the treatment of AA. 20 obese patients (10.52%) were included in our study. There were 11 male and 9 female patients, whose average age was 42 years. The duration of the operation was 55 minutes, the most frequent PH finding was phlegmonous inflammation of the appendix in 12 patients. The appearance of peristalsis was on the first postoperative day, consumption of analgesics was two ampullas of metamizole on the day of the operation. The length of stay was 3 days, and there were two abscesses as postoperative complications.Conclusion: The laparoscopic approach has many advantages that are even greater in the obese population in relation to those of normal weight. The operation takes less time, postoperative pain is reduced, recovery after laparoscopic appendectomy is faster, and there are fewer postoperative complications. This approach should be used more often.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"22 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490198","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":"Acute Care Surgery in the US – A Review and Personal Experience","authors":"Pascal Fuchshuber, Chris Solis","doi":"10.55791/wkg1ed19","DOIUrl":"https://doi.org/10.55791/wkg1ed19","url":null,"abstract":"Acute care surgery is a new specialty created in response to the erosion of traditional general surgery and trauma surgery models. Multiple surgical societies have successfully developed the definition, designation, and training of an Acute Care Surgeon over many years. These are applicable worldwide. In the US, most larger hospital systems have successfully implemented acute care surgery, but rural and economically challenged areas remain underserved. Acute care surgeons in the US are generally employed either by the Hospital or a medical group. The profession provides a perfect work-life balance and, therefore, has become very attractive for the younger generations and surgeons who want to step down from exhausting full-time practices at the end of their careers. In the US, it is an entirely accepted specialty with dedicated and verified fellowship training.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"46 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489181","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 Nassar Scale as an Instrument for Predicting Conversionof Laparoscopic to Open Cholecystectomy","authors":"Edin Hodžić, Sadat Pušina, Adi Mulabdić, Adnan Kulo, Salem Bajramagić, M. Salibašić, Emsad Halilović, Amila Feto, Samir Delibegović","doi":"10.55791/s79fjc03","DOIUrl":"https://doi.org/10.55791/s79fjc03","url":null,"abstract":"Background: Difficult cholecystectomy, often associated with a heightened risk of complications, poses a significant surgical dilemma. Risk factors, such as patient age, increased body weight, the presence of gallstones, acute cholecystitis, and prior abdominal surgeries, can complicate laparoscopic cholecystectomy and necessitate conver- sion to an open procedure for safety. The aim of our study was to assess the applicability of the Nassar scale in predicting the need for conversion from laparoscopic to open cholecystectomy.Material and methods: In our prospective cohort study, we included 85 patients who underwent either emergency or elective laparoscopic cholecystectomy between December 2021 and October 2023. The Nassar scale was used to assess the complexity of laparoscopic cholecystectomy, incorporating parameters such as ‘Gallbladder,’ ‘Cystic pedicle,’and ‘Adhesions’ to determine a final score ranging from 1 to 5. Statistical analysis involved descriptive and analytical methods, with the significance threshold set at p < 0.05.Results: ANOVA analysis revealed a statistically significant difference in the duration of operative procedures with different Nassar grades (p < 0.001). An increase in the Nassar grade by 1 was associated with a statistically significant6.23-fold increase in the odds of conversion to an open procedure (p < 0.001). Receiver Operating Characteristic (ROC) analysis demonstrated a highly significant association (p < 0.001) between the Nassar grade and the conversion event, with an Area Under the Curve (AUC) of 0.881 (95% CI 0.79,0.96). The optimal cutoff value, identified as >2.5, struck a balance between sensitivity (0.86) and 1-specificity (0.23). Conclusion: Our study underscores the utility of the Nassar scale in surgical practice. It provides valuable insights into assessing the severity of operations, facilitating informed decision-making, and optimizing treatment outcomes for patients undergoing laparoscopic cholecystectomy at our institution.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"47 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140487484","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":"TEP, STEP BY STEP","authors":"Samir Delibegović","doi":"10.55791/tkdgy089","DOIUrl":"https://doi.org/10.55791/tkdgy089","url":null,"abstract":"TEP is endoscopic surgery, recommended by many associations as the method of choice in the treatment of primary unilateral inguinal hernias. However, due to the limitations of space, and the complexity of the anatomy of the posterior wall of the inguinal region, it involves a somewhat steeper learning curve. Some steps in the surgical procedure are not simple, therefore we would like to point out and explain the more difficult aspects of dissection during a TEP, and facilitate the acceptance of this excellent technique in the repair of inguinal hernias.","PeriodicalId":517463,"journal":{"name":"South-East European Endo-Surgery Journal","volume":"88 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490307","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}