Surgical laparoscopy & endoscopy最新文献

{"title":"Rectal prolapse.","authors":"L. G. Henry, R. P. Cattey","doi":"10.32388/40wjlj","DOIUrl":"https://doi.org/10.32388/40wjlj","url":null,"abstract":"Marlex rectopexy is a popular and effective procedure for the repair of rectal prolapse. Heretofore, this operation has required a generous laparotomy. As videolaparoscopy provides superior pelvic exposure, performing a modified Ripstein procedure was a logical progression of minimally invasive surgery. Experience with the first sutured Marlex rectopexy suggested the need for a simple fixation device to secure the mesh to the sacrum. A commercially available orthopedic staple allows quick and secure fixation. Five cases of laparoscopic Marlex rectopexy provide our initial clinical experience. The LCR staple has reduced operating times by up to 1 h. Results in these cases show virtual complete repair of the prolapse, minimal postoperative analgesic requirements, and no postoperative incontinence. There was one postoperative complication requiring reoperation. There were no deaths. Laparoscopic stapled Marlex rectopexy is a promising modality for the treatment of procidentia.","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"6 1","pages":"357-60"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87517184","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":"Intraoperative endoscopy during colorectal surgery.","authors":"S. A. Martínez, M. Hellinger, M. Martini, R. Hartmann","doi":"10.1097/00129689-199904000-00019","DOIUrl":"https://doi.org/10.1097/00129689-199904000-00019","url":null,"abstract":"In cases where preoperative studies may have been inadequate or could not be performed, intraoperative endoscopy (IOE) becomes an essential investigative tool for identification of synchronous lesions, of nonpalpable lesions, of sources of bleeding, and localization of lesions during laparoscopic colonic surgery. We report our experience with IOE, and describe our techniques of transabdominal colonoscopy. A review of the IOE performed in hospitals affiliated with the University of Miami was done. Fifty-eight patients received IOE from July 1994 to August 1996. There were 47 colonoscopies (38 transanal and 9 transabdominal), and 11 flexible sigmoidoscopies. Colorectal cancer, diverticulitis, inflammatory bowel disease, and lower gastrointestinal bleeding represented 83% of cases. In 10% of cases IOE changed the extent of the surgical procedure. There were no complications related to IOE. We conclude that in selected patients undergoing colorectal procedures, IOE is an essential tool. It can be performed safely, effectively, and rapidly.","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"20 1","pages":"123-6"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78544969","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":"VATS-stepwise resection of a giant bulla in an oxygen-dependent patient.","authors":"M Shinonaga,&nbsp;A Yamaguchi,&nbsp;K Yoshiya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case of a giant bulla in a 16-year-old boy who was oxygen and wheelchair dependent. He had been diagnosed with Marfan's syndrome and had severe kyphoscoliosis. The giant bulla occupying his entire left thoracic cavity compressed the contralateral lung. Until referral to our hospital, a bullectomy had been deferred during the preceding 5 years because of his poor pulmonary function and severe chest wall deformity. The patient was considered a candidate for thoracoscopic bullectomy. A stepwise resection technique was used. First, the bulla should be emptied by aspiration or wall perforation. Second, the redundant wall of the bulla should be resected by a looped ligation without opening the cavity. Third, a stapled resection of the downsized bulla should be performed. After a successful bullectomy, his subjective symptoms and pulmonary function improved. The reduction of the bulla makes bullectomy easily and decreases the number of staplers, and reduces operating time compared with opening the bulla and suturing it. Therefore, when treating a giant bulla, we recommend a stepwise resection technique.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"70-3"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855522","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 adrenalectomy for primary aldosteronism: clinical experience in 12 patients.","authors":"J Sirén,&nbsp;C Haglund,&nbsp;K Huikuri,&nbsp;A Sivula,&nbsp;R Haapiainen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laparoscopic adrenalectomy has become a viable option for removal of small adrenal neoplasms. We present our initial experience of this operation for primary aldosteronism. In this prospective study, 12 consecutive patients with primary aldosteronism were operated on laparoscopically by one surgeon. Operative time, blood loss, postoperative pain, complications, hospital stay, convalescence time, and outcome were analyzed. Five right-sided and seven left-sided adrenalectomies were performed in six female and six male patients with a mean age of 51 years. The mean operative time was 126 minutes. All procedures were successfully carried out laparoscopically. No major complications occurred. All patients turned normokalemic and the medication for hypertension could be stopped or diminished in all cases. The mean hospital stay was 3.4 days, and the mean sick leave was 13 days. Laparoscopic adrenalectomy seems to be a safe and effective treatment for primary aldosteronism and should be considered the operation of choice.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855676","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":"Experimental laparoscopic aortobifemoral bypass with end-to-side aortic anastomosis.","authors":"Y M Dion,&nbsp;O Hartung,&nbsp;C Gracia,&nbsp;C Doillon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The goal of this animal experiment was to demonstrate the feasibility of laparoscopic end-to-side aortic anastomosis, which is mandatory in certain cases presenting with aortoiliac occlusive disease. Six piglets were submitted to laparoscopic approach of the aortoiliac vessels using the \"apron\" technique. After clamping the infrarenal aorta with a laparoscopic Satinsky clamp, a 3-cm end-to-side laparoscopic aortic anastomosis was constructed. Mean operative and dissection times were 198 (170-240) and 92 (75-105) min, respectively, with a mean blood loss of 86 (50-120) mL. Mean preoperative and postoperative hematocrits were 38 (3448) and 38 (34-46). Aortic cross-clamp and anastomotic times were 51 (40-65) and 44 (35-60) min, respectively. No extra sutures were needed to secure the anastomoses. At autopsy, all the anastomoses were patent without stenoses. Results indicate the feasibility of laparoscopic aortobifemoral bypass with an end-to-side aortic anastomosis.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"35-8"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20854471","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":"Does laparoscopy reduce the incidence of unnecessary appendicectomies?","authors":"C Barrat,&nbsp;J M Catheline,&nbsp;N Rizk,&nbsp;G G Champault","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was to evaluate the impact of laparoscopic appendicectomy on the incidence of histologically normal appendices. Between 1987 and 1997, 1,220 patients (average age 23.5 years [17-73]; 841 women [69%]) had appendicectomy due to the presence of at least one of the following three criteria: right iliac fossa guarding, fever >38 degrees C, and leukocytosis >10,000. Patients were divided into two groups: one group of 930 patients were operated on using the classic Mac Burney approach and the other group of 355 patients underwent laparoscopic exploration, with an appendicectomy performed if macroscopic abnormalities were observed (290 cases). In all cases, the appendices were examined blind and classified as normal or pathologic, with the latter divided with respect to the nature and severity of the lesions. In the Mac Burney group, the incidence of histologically normal appendices was 25.1%. In the laparoscopic group, the incidence was only 8.2% (p=0.015). The types of pathologic appendices were identical between the two groups. In 65 cases (18.3%), a macroscopically normal appendix was left in place. In 56 cases the symptoms were due to another identified cause, however, in 10 cases no cause was found. All patients were followed-up for an average of 3 years. One patient (1.8%) had a second operation (an appendicectomy), which revealed minor histologic lesions. The problem is the inability of the operator to differentiate between a healthy and a pathologic appendix on laparoscopy. The risk of false-positives and false-negatives is approximately 10%. Diagnostic difficulties usually occur in the initial phase of the disease with acute mucosal involvement in a morphologically normal appendix. At this stage the outcome cannot be predicted, although appropriate antibiotic treatment can be effective. This study shows that laparoscopy significantly reduces the number of histologically normal appendices as compared to a conventional Mac Burney operation. This can only be achieved by not removing macroscopically normal appendices, a small proportion of which (5-10%) could be cases of early appendicitis with only mucosal involvement. In the absence of other causes of the symptoms, a 3-day course of antibiotics can be tried to treat possible mucosal lesions. This approach reduces costs without having adverse consequences on the outcome.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855683","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 splenectomy: evolution and current status.","authors":"P J Klingler,&nbsp;G G Tsiotos,&nbsp;K S Glaser,&nbsp;R A Hinder","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this review is to assess the indications for, and surgical approach to, laparoscopic splenectomy (LS) and to propose a recommendation for the surgical approach to LS. The reports of LS were reviewed with a detailed analysis of indications, surgical technique, and clinical outcome. Thirty-two articles including a total of 643 patients (549 adults and 94 children) were published between August 1994 and May 1997, with a mean of 20 cases per report. LS is recommended if the spleen has a maximum diameter of 20 cm. Compared to the open procedure, there are fewer perioperative complications, less morbidity, and a shorter hospital stay. The disadvantages of LS are longer operation times and less sensitivity in identifying accessory spleens. LS is not the operation of choice for hypersplenism and traumatic splenic injury.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855674","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":"A disposable sealing device (Dispo-sand) for conversion between pneumoperitoneum and minilaparotomy.","authors":"S Kitano,&nbsp;T Bandoh,&nbsp;T Yoshida,&nbsp;N Shiraishi,&nbsp;Y Adachi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During laparoscopic procedures, minilaparotomy is a safe technique for removal of large specimens and for the performance of complicated procedures. However, it is time consuming and troublesome to close the minilaparotomy to recreate the pneumoperitoneum. We describe a new device (Dispo-sand) that enables instant conversion between pneumoperitoneum and minilaparotomy.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"32-4"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855684","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":"Argon beam coagulation in the treatment of spontaneous pneumothorax.","authors":"W T Ng","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855525","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 port site metastasis of an undetected primary tumor.","authors":"Y Mintz,&nbsp;C Lotan,&nbsp;D Goitein,&nbsp;M Muggia-Sullam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 50-year-old woman presented with an adenocarcinoma at a port site of a previous laparoscopic cholecystectomy. A thorough investigation and exploratory laparotomy with excision of the tumor failed to detect its origin.</p>","PeriodicalId":77402,"journal":{"name":"Surgical laparoscopy & endoscopy","volume":"9 1","pages":"68-9"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20855521","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}