Journal of laparoendoscopic surgery最新文献_第9页

Laparoscopic Ladd's procedure and assessment of malrotation. 腹腔镜下Ladd手术及旋转不良的评估。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

J H Waldhausen, R S Sawin

引用次数: 0

Percutaneous access to the uterus for fetal surgery. 经皮进入子宫进行胎儿手术。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

K J VanderWall, M Meuli, Z Szabo, S W Bruch, T Kohl, W Y Hoffman, N S Adzick, M R Harrison

{"title":"Percutaneous access to the uterus for fetal surgery.","authors":"K J VanderWall, M Meuli, Z Szabo, S W Bruch, T Kohl, W Y Hoffman, N S Adzick, M R Harrison","doi":"","DOIUrl":"","url":null,"abstract":"In utero repair of selected life-threatening malformations in the human fetus is now a clinical reality, yet fetal surgery continues to pose significant risks to both the mother and the unborn child. Preterm labor is a major problem directly related to the large uterine incision required for fetal exposure. Using technology developed for laparoscopic surgery, we have devised instruments and techniques to perform fetal endoscopic surgery. We now report a percutaneous technique for direct endoscopic access to the uterus. Minimally invasive fetoscopic surgery may expand the indications for fetal surgery by decreasing fetal risks, facilitating intervention earlier in gestation, and reducing preterm labor. This technique was developed in 4 fetal lambs who underwent endoscopic intervention at 105-110 days gestation (term = 145 days). Under ultrasound guidance, a 20-gauge spinal needle was advanced through the maternal abdomen, uterus, and directly into the amniotic cavity. Warmed saline was infused through the needle to expand the amniotic cavity. Next, a 5-mm balloon-tipped trocar was placed percutaneously with ultrasound guidance into the amniotic cavity. A 5-mm laparoscope was introduced and under endoamniotic vision two more 5-mm trocars were percutaneously placed. In all four sheep a 5-mm trocar was placed percutaneously into the gravid uterus. The most difficult step was puncturing through the amniotic membranes, but the sharp tip of the trocar facilitated getting into the amniotic cavity. Excellent visualization of the fetus was obtained with minimal uterine trauma. We have developed a fetoscopic technique in sheep for percutaneous placement of trocars into the uterus using ultrasound guidance. This approach allowed excellent visualization of the fetus with significantly less uterine trauma than open fetal surgery and is an essential prerequisite for future fetal endoscopic interventions.","PeriodicalId":77211,"journal":{"name":"Journal of laparoendoscopic surgery","volume":"6 Suppl 1 ","pages":"S65-7"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19800747","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}

引用次数: 0

Laparoscopic treatment for varicocele. 精索静脉曲张的腹腔镜治疗。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

M Ugazzi, A Chiriboga, L Proano

引用次数: 0

Laparoscopic fundoplication in children: our first 30 cases. 儿童腹腔镜下手术:前30例。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

B Longis, D Grousseau, J L Alain, G Terrier

{"title":"Laparoscopic fundoplication in children: our first 30 cases.","authors":"B Longis, D Grousseau, J L Alain, G Terrier","doi":"","DOIUrl":"","url":null,"abstract":"We report our experience performing 30 laparoscopic fundoplications in children (24 using the Nissen Rossetti technique and 6 using the Toupet fundoplication). Special instruments adapted to the young children are used: first, a miniature parietal suspender to decrease the intra-abdominal pressure and to provide more space; second, a retractable losenge-shaped liver retractor; and third, a Babcock forceps articulated at 60 degrees. In the Nissen Rossetti procedure, the wrap is fixed to the anterior face of the esophagus, the anterior wall of the fundus, and the upper right crus. In the Toupet procedure, the wrap is a retroesophageal partial fundoplication: the first suture attaches the wrap to the right crus, the second attaches the wrap to the esophagus, and the third recreates the oesogastric angle. We do not use gastrostomy. Patients have no gastric tube after the intervention. Thirty children from 2 to 15 years have undergone laparoscopic fundoplications. One conversion to open procedure was necessary. An average follow-up of 12 months was observed for 18 children with 3 complications: dysphagia for a psychotic girl, intrathoracic valve without any trouble, and recurrent episodes of digestive bleedings during 6 months. Laparoscopic fundoplication is a feasible extension of minimally invasive surgery in the hands of experienced surgeons; however limitations must be recognized to do a safe operation.","PeriodicalId":77211,"journal":{"name":"Journal of laparoendoscopic surgery","volume":"6 Suppl 1 ","pages":"S21-9"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19800850","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}

引用次数: 0

Laparoscopic splenectomy in childhood hematologic disorders. 儿童血液病的腹腔镜脾切除术。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

B A Hicks, W R Thompson, Z R Rogers, P C Guzzetta

{"title":"Laparoscopic splenectomy in childhood hematologic disorders.","authors":"B A Hicks, W R Thompson, Z R Rogers, P C Guzzetta","doi":"","DOIUrl":"","url":null,"abstract":"Laparoscopic splenectomy is a new technique that is being utilized in patients with a variety of mostly hematologic disorders. Its application in children has not been extensively documented. Between January 1994 and February 1995, 11 children less than 15 years of age underwent elective laparoscopic splenectomy. Data collected from this treatment group were compared to that from the ten most recent open splenectomy patients with comparable hematologic disorders. All procedures in both groups were successful in relief of symptoms, increase in platelet count, and/or increase in hematocrit. Operative times averaged 147 mm in the laparoscopic group, compared to 112 mm in the open group. Estimated blood loss was 32 ml in the laparoscopic group and 86 ml in the open group. Days to laparoscopic patient discharge were 3.6, compared to 5.3 days in the open group. There were no wound complications or need for perioperative platelet transfusions in the laparoscopic patients. Patient response has been uniformly positive in the laparoscopic group. Reusable access trocars are utilized for two of the four working ports. Stapling devices and special tissue morselizers are not required. There are no additional operating room or surgeons fees incurred in the laparoscopic procedures. This series demonstrates that laparoscopic splenectomy is a safe, cost-efficient alternative to open splenectomy in children with a variety of hematologic disorders.","PeriodicalId":77211,"journal":{"name":"Journal of laparoendoscopic surgery","volume":"6 Suppl 1 ","pages":"S31-4"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19800851","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}

引用次数: 0

Laparoscopic excision of a cystic lymphangioma. 腹腔镜下囊性淋巴管瘤切除术。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

B Kenney, B Smith, A L Bensoussan

{"title":"Laparoscopic excision of a cystic lymphangioma.","authors":"B Kenney, B Smith, A L Bensoussan","doi":"","DOIUrl":"","url":null,"abstract":"A 16-year-old female was evaluated for recurrent episodes of acute abdominal pain and distension. Initial abdominal radiographs were consistent with recurrent gastric volvulus. Following nasogastric tube decompression, reexamination revealed a mobile abdominal mass in the left upper quadrant. Contrast studies followed by computed tomography demonstrated a cyst measuring 9 X 7 X 6 cm with no obvious relationship to abdominal viscera. Laparoscopy was performed with a 10-mm port at the umbilicus and right upper quadrant,and a 5-mm port in the left lower quadrant. The cyst was excised from the mesentery of the proximal jejunum and placed in a laparoscopic sac. Controlled incision and drainage of the cyst within the sac facilitated its removal from the abdomen with neither enlargement of the trocar site nor intraabdominal spillage. To prevent recurrent gastric volvulus, a gastropexy was performed from the greater and lesser curvatures to the anterior abdominal wall. The histology was typical of a cystic lymphangioma. The patient was discharged on the third postoperative day without complication. Laparoscopic technique allowed the performance of both procedures without large incisions, This is the first reported laparoscopic excision of a cystic lymphangioma.","PeriodicalId":77211,"journal":{"name":"Journal of laparoendoscopic surgery","volume":"6 Suppl 1 ","pages":"S99-101"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19801891","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}

引用次数: 0

Proceedings of the IV International Congress for Endosurgery in Children. Orlando, Florida, May 17-20, 1995. 第四届国际儿童内镜外科会议论文集。1995年5月17日至20日，佛罗里达州奥兰多。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

引用次数: 0

Preanal stapler anastomosis in minimally invasive surgery of Hirschsprung's disease. 吻合器吻合术在巨结肠微创手术中的应用。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

P Rappert, U Losert

{"title":"Preanal stapler anastomosis in minimally invasive surgery of Hirschsprung's disease.","authors":"P Rappert, U Losert","doi":"","DOIUrl":"","url":null,"abstract":"The purpose of this experimental investigation was to optimize the laparoscopic variant of Swenson-Grob's procedure for treatment of Hirschsprung's disease using a circular stapler to perform the preanal anastomosis and to measure its tightness. Several methods of operative treatment of Hirschsprung's disease are described. In our laparoscopic study four methods were evaluated in 10 15-kg piglets. Swenson-Grobs procedure is one of the methods,which can be performed laparoscopically without any laparotomy and was used in this modification on 4 piglets. The laparoscopically mobilized colorectum was pre- anal prolapsed, preanal resected, and anastomosed in a special technique using a circular stapler. The prolapsed anastomosis was replaced into the abdominal cavity and laparoscopically peritonealized. We controlled the anastomosis position by laparotomy, then cut out the anastomosis and controlled its tightness by manometric air insufflation into the orally and aborally tightened bowel below water. In those 4 animals the position was correct and all anastomoses were tight up to a pressure of 40 mm Hg and more. We conclude that preanal stapler anastomosis improves the minimally invasive variant of Swenson-Grob's procedure to treat Hirschsprung's disease, because it minimizes the risk of anastomotic leakage and follows the rules of minimally invasive surgery, because there is no need of laparotomy.","PeriodicalId":77211,"journal":{"name":"Journal of laparoendoscopic surgery","volume":"6 Suppl 1 ","pages":"S75-82"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19800749","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}

引用次数: 0

Incisional hernia in a 5-mm trocar site following pediatric laparoscopy. 小儿腹腔镜术后5毫米套管针部位切口疝。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

J H Waldhaussen

引用次数: 0

Laparoscopic splenectomy using the harmonic scalpel. 腹腔镜下和声刀脾切除术。

Journal of laparoendoscopic surgery Pub Date : 1996-03-01

S S Rothenberg

引用次数: 0