Users Online : 6028
About us
|
Subscribe
|
e-Alerts
|
Feedback
|
Reader Login
|
Current Issue
|
Archives
|
Ahead Of Print
¤
Home
¤
Search
¤
Instructions to authors
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Citation statistics : Table of Contents
2016| April-June | Volume 12 | Issue 2
Online since
March 11, 2016
Archives
Previous Issue
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Cited
Viewed
PDF
ORIGINAL ARTICLES
Randomised controlled trial of n-butyl cyanoacrylate glue fixation versus suture fixation of mesh in laparoscopic totally extraperitoneal hernia repair
Kalpesh Jani
April-June 2016, 12(2):118-123
DOI
:10.4103/0972-9941.169954
PMID
:27073302
Background:
We present a randomised control trial to compare suture fixation of the mesh with non-mechanical fixation using n-butyl cyanoacrylate (NBCA) glue for laparoscopic totally extraperitoneal (TEP) hernioplasty.
Patients and Methods:
After a standard dissection for laparoscopic TEP hernioplasty, the mesh was fixed using sutures or NBCA glue to the Cooper's ligament as per the randomised allocation. The primary endpoints were recurrence at 24 months and chronic groin pain. The secondary endpoints were pain scores, analgesic requirement in the post-operative period and duration of surgery.
Results:
Group A consisting of suture fixation had 127 patients which included a total of 173 hernias while Group B consisting of NBCA had 124 patients including a total of 171 hernias. The patients' age, sex distribution, body mass indices and co-morbidities were comparable in both groups. No patient suffered any major intra-operative or post-operative complication or mortality. There were no conversions to open surgery in either of the groups. The operating time was similar in both the groups though there was a tendency toward a shorter surgery time in Group B. There was lesser consumption of analgesics in the immediate post-operative period in Group B but this did not reach statistical significance. Using visual analogue scale to measure pain, there was no difference in pain at 48 h; however, Group B patients complained of significantly less pain on day 7 as compared to Group A. Almost 98% of Group A patients and 99.2% of Group B patients completed 24 months of follow-up. There were no recurrences in either groups or was there any significant difference in chronic groin pain, in fact, none of the Group B patients complained of chronic groin pain.
Conclusion:
Using NBCA glue to fix the mesh in laparoscopic TEP hernia repair is effective and associated with less pain on day 7 as compared to suture fixation of the mesh.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
8
3,759
196
Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: A prospective randomised study
Mario Schietroma, Beatrice Pessia, Derna Stifini, Laura Lancione, Francesco Carlei, Emanuela Marina Cecilia, Gianfranco Amicucci
April-June 2016, 12(2):109-117
DOI
:10.4103/0972-9941.178513
PMID
:27073301
Background:
The advantages of laparoscopic adrenalectomy (LA) over open adrenalectomy are undeniable. Nevertheless, carbon dioxide (CO
2
) pneumoperitoneum may have an unfavourable effect on the local immune response. The aim of this study was to compare changes in the systemic inflammation and immune response in the early post-operative (p.o.) period after LA performed with standard and low-pressure CO
2
pneumoperitoneum.
Materials and Methods:
We studied, in a prospective randomised study, 51 patients consecutively with documented adrenal lesion who had undergone a LA: 26 using standard-pressure (12-14 mmHg) and 25 using low-pressure (6-8 mmHg) pneumoperitoneum. White blood cells (WBC), peripheral lymphocyte subpopulation, human leucocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin (IL)-6 and IL-1, and C-reactive protein (CRP) were investigated.
Results:
Significantly higher concentrations of neutrophil elastase, IL-6 and IL-1 and CRP were detected p.o. in the standard-pressure group of patients in comparison with the low-pressure group (
P
< 0.05). A statistically significant change in HLA-DR expression was recorded p.o. at 24 h, as a reduction of this antigen expressed on the monocyte surface in patients from the standard group; no changes were noted in low-pressure group patients (
P
< 0.05).
Conclusions:
This study demonstrated that reducing the pressure of the pneumoperitoneum to 6-8 mmHg during LA reduced p.o. inflammatory response and averted p.o. immunosuppression.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
7
4,667
162
HOW I DO IT DIFFERENTLY?
Improving accuracy of intraoperative diagnosis of endometriosis: Role of firefly in minimal access robotic surgery
John R Lue, Adam Pyrzak, Jennifer Allen
April-June 2016, 12(2):186-189
DOI
:10.4103/0972-9941.158969
PMID
:27073317
Endometriosis continues to be a major primary gynecologic etiology of chronic pelvic pain. The symptom profile, which includes cyclic pelvic pain, dysmenorrhea, and dyspareunia or dyschezia, is nonspecific and does not correlate with the extent or severity of disease. Trans-vaginal or trans-rectal ultrasound, as well as magnetic resonance imaging, can help visualize endometriomas and deeply infiltrating endometriosis. Additionally, there have been no serum marker tests available so far. However, even intraoperatively, the diagnosis may be missed, leading to under diagnosis and delayed or noninitiation of treatment. There are thought to be three distinct endometriotic lesions of the pelvis that are seen laparoscopically. The first is that which is visible on the pelvic peritoneal surface or the surface of the ovary, which is commonly termed peritoneal endometriosis. Second, endometriotic lesions that occur within the ovary and form cysts that are often lined with endometrioid mucosa are termed endometriomas. Lastly, rectovaginal endometriomas are endometriotic lesions that contain a mixture of adipose and fibrous tissue located between the rectum and vagina. All of these lesions can be singular or multiple and the pelvis may contain one or all three types of lesions. The shared histologic feature with all three lesions is the presence of endometrial epithelial cells or endometrial stroma. During a diagnostic procedure, the da-Vinci robot and its firefly mode allow for three dimensional visualization and seven degrees of instrument articulation for meticulous dissection of fibrotic areas of peritoneum that may contain deep infiltrating lesions of endometriosis. This case report describes a relatively new and innovative technique for effectively diagnosing and successfully treating endometriosis when other less invasive methods have failed.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
5
4,957
161
ORIGINAL ARTICLES
A prospective randomised controlled trial comparing chronic groin pain and quality of life in lightweight versus heavyweight polypropylene mesh in laparoscopic inguinal hernia repair
Pradeep Prakash, Virinder Kumar Bansal, Mahesh Chandra Misra, Divya Babu, Rajesh Sagar, Asuri Krishna, Subodh Kumar, Vimi Rewari, Rajeshwari Subramaniam
April-June 2016, 12(2):154-161
DOI
:10.4103/0972-9941.170018
PMID
:27073309
Background:
The aim of our study was to compare chronic groin pain and quality of life (QOL) after laparoscopic lightweight (LW) and heavyweight (HW) mesh repair for groin hernia.
Materials and Methods:
One hundred and forty adult patients with uncomplicated inguinal hernia were randomised into HW mesh group or LW mesh group. Return to activity, chronic groin pain and recurrence rates were assessed. Short form-36 v2 health survey was used for QOL analysis.
Results:
One hundred and thirty-one completed follow-up of 3 months, 66 in HW mesh group and 65 in LW mesh group. Early post-operative convalescence was better in LW mesh group in terms of early return to walking (
P
= 0.01) and driving (
P
= 0.05). The incidence of early post-operative pain, chronic groin pain and QOL and recurrences were comparable.
Conclusion:
Outcomes following laparoscopic inguinal hernia repair using HW and LW mesh are comparable in the short-term as well as long-term.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
5
4,232
208
A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children
Zhang Jun, Ge Juntao, Liu Shuli, Long Li
April-June 2016, 12(2):139-142
DOI
:10.4103/0972-9941.169953
PMID
:27073306
Purpose:
The purpose of this study is to determine whether singleport laparoscopic repair (SLR) for incarcerated inguinal hernia in children is superior toconventional repair (CR) approaches.
Method:
Between March 2013 and September 2013, 126 infants and children treatedwere retrospectively reviewed. All the patients were divided into three groups. Group A (48 patients) underwent trans-umbilical SLR, group B (36 patients) was subjected to trans-umbilical conventional two-port laparoscopic repair (TLR) while the conventional open surgery repair (COR) was performed in group C (42 patients). Data regarding the operating time, bleeding volume, post-operative hydrocele formation, testicular atrophy, cosmetic results, recurrence rate, and duration of hospital stay of the patients were collected.
Result:
All the cases were completed successfully without conversion. The mean operative time for group A was 15 ± 3.9 min and 24 ± 7.2 min for unilateral hernia and bilateral hernia respectively, whereas for group B, it was 13 ± 6.7 min and 23 ± 9.2 min. The mean duration of surgery in group C was 35 ± 5.2 min for unilateral hernia. The recurrence rate was 0% in all the three groups. There were statistically significant differences in theoperating time, bleeding volume, post-operative hydrocele formation, cosmetic results and duration hospital stay between the three groups (
P
< 0.001). No statistically significant differences between SLR and TLR were observed except the more cosmetic result in SLR.
Conclusion:
SLR is safe and effective, minimally invasive, and is a new technology worth promoting.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
4
3,540
167
Oxidative stress markers in laparoscopic vs. open appendectomy for acute appendicitis: A double-blind randomized study
Recep Aktimur, Ali Kagan Gokakin, Koksal Deveci, Mustafa Atabey, Omer Topcu
April-June 2016, 12(2):143-147
DOI
:10.4103/0972-9941.156203
PMID
:27073307
Background:
Oxidative stress is a complicated process, which was defined as an increase in prooxidants and decrease in antioxidants caused by various mechanisms, including inflammation and surgical trauma. The association between acute appendicitis and oxidative stress has been showed in previous studies. However, comparison of oxidative stress in laparoscopic or open appendectomy (OA) has not been established.
Patients and Methods:
Patients who were diagnosed as acute appendicitis between October 2012 and January 2013 were randomized to open (OA,
n
= 50) and laparoscopic appendectomy (LA,
n
= 50). Blood samples for oxidative stress markers (total oxidant status [TOS] and total antioxidant status [TAS]), C-reactive protein (CRP) and white blood cells (WBC's) were collected just before the surgery and 24 h after surgery.
Results:
There were no differences in preoperative values of WBC and CRP between LA and OA groups (
P
= 0.523 and 0.424), however, in postoperative 24
th
h, CRP was reduced in LA group (
P
= 0.031). There were no differences in preoperative levels of TOS, TAS, and oxidative stress index (OSI) between LA and OA groups. In the postoperative 24
th
h, TOS and OSI were found to be significantly higher in OA group when compared to LA group (
P
= 0.017 and 0.002) whereas no difference was detected in TAS level in the postoperative 24
th
h (
P
= 0.172).
Conclusions:
This double-blind, randomized clinical trial provides evidence that LA for uncomplicated appendicitis is associated with significantly lower oxidative stress compared with OA. Some of the advantages of LA may be attributed to the significant reduction of oxidative stress in these patients.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
4
4,101
220
Single-incision laparoscopic appendectomy using homemade glove port at low cost
Sang Myoung Lee, Go Sung Hwang, Do Sang Lee
April-June 2016, 12(2):124-128
DOI
:10.4103/0972-9941.169979
PMID
:27073303
Purpose:
The aim of this study was to report homemade glove port technique for single-incision laparoscopic appendectomy (SILA).
Materials and Methods:
Our homemade glove port was composed of a size 6 latex sterile surgical glove, a sterilized plastic bangle, and three pieces of silicon tube (5 cm in length) that were used as the suction tube. Clinical data were retrospectively collected from those patients who underwent SILA at Bucheon St. Mary's Hospital, Bucheon, Gyeonggi-do, South Korea between February 2014 and June 2014, including patient demographics, and operative and postoperative outcomes. To compare the outcomes, a retrospective review was performed for those patients who underwent conventional laparoscopic appendectomy (CLA) between October 2013 and January 2014. Both SILA and CLA were performed by the same surgical team.
Results:
The SILA and CLA groups included 37 and 57 patients, respectively. The mean age, weight, body mass index (BMI), operation time, and pathologic diagnosis of gangrenous appendicitis were not significantly different between the two groups. However, the mean hospital stay in the CLA group was significantly (
P
= 0.018) longer than that in the SILA group (4.2 days vs 3.5 days). There was no conversion to open surgery in both the groups. Of the cases who underwent SILA, 10 (27.0%) needed insertion of additional port and drain. There was one (3.2%) complication of umbilical surgical site infection.
Conclusion:
In this study, SILA, with homemade glove port, was technically feasible and safe at low cost.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
4
3,787
219
UNUSUAL CASES
Advantages of robot-assisted surgery in anorectal malformations: Report of a case
María Rodríguez Ruiz, Nicolas Kalfa, Hossein Allal
April-June 2016, 12(2):176-178
DOI
:10.4103/0972-9941.169988
PMID
:27073314
Laparoscopy has been widely used to repair anorectal malformations (ARMs) by paediatric surgeons in an attempt to be less invasive, offer better cosmetic results, enable a faster return of bowel function, decrease length of hospital stay and pain, and lately to improve functional results. Robotic technology assists the paediatric surgeon by increasing dexterity and precision of movement with a robotic wrist-like mechanism that allows up to 90° of articulation and 7° of freedom. This is important in ARM surgery, where the dissection of the fistula and the pull-through of the rectum into the muscular complex are crucial to achieve continence in future.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
3
2,636
111
ORIGINAL ARTICLES
Early laparoscopic management of appendicular mass in children: Still a taboo, or time for a change in surgical philosophy?
Vikesh Agrawal, Himanshu Acharya, Roshan Chanchlani, Dhananjaya Sharma
April-June 2016, 12(2):98-101
DOI
:10.4103/0972-9941.178518
PMID
:27073299
Introduction:
Early appendicectomy has been found to be a safe and better alternative for management of appendicular mass in various studies in adults, while very few studies report such advantages in the paediatric population. We conducted this study to assess the safety, efficacy and need of early laparoscopic appendicectomy (ELA) in child patients with appendicular mass.
Materials and Methods:
All patients with appendicular mass who underwent ELA at our institute between September 2011 and August 2014 were retrospectively reviewed. Appendicular mass was defined as a right iliac fossa mass in a case of acute appendicitis, diagnosed by clinical, laboratory and radiological evaluation, and palpation under anaesthesia, the patient being subjected to laparoscopic treatment.
Results:
Forty-eight (48) patients were confirmed to have appendicular mass intraoperatively and were included in the analysis. There were 30 males and 18 females, with ages ranging 7-13 years (mean 9 years). In the present study, appendicular complications included appendicular abscess (62.5%), gangrenous appendicitis (25%), sloughed-out appendix (8.33%) and appendicular perforation (4.16%). The average operative time was 72 min (range 45-93 min). One case (1.92%) required conversion to open procedure due to failure of identification of the appendicular base of a sloughed-out appendix. Post-operative complications were found in 4 (7.69%) patients, of whom 3 (5.76%) had minor wound infection at the umbilical port site and 1 (1.92%) had post-operative pelvic abscess, which was managed with percutaneous aspiration.
Discussion:
ELA avoids misdiagnosis, treats complicated appendicitis at its outset, and avoids complications and/or failure of non-operative treatment of a potentially lethal, diseased appendix. This approach is associated with minimal complications in experienced hands and is a safe and feasible option in children with appendicular mass.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
2
4,613
270
UNUSUAL CASES
Giant appendicolith: Rare finding in a common ailment
Sanjeev Singhal, Anu Singhal, Harsh Mahajan, Brahm Prakash, Sunil Kapur, Pankaj K Arora, Bishwanath Tiwari, Punit Sethi
April-June 2016, 12(2):170-172
DOI
:10.4103/0972-9941.178514
PMID
:27073312
Acute appendicitis is one of the commonest surgical emergencies worldwide. There is considerable variation in prevalence of appendicoliths with appendicitis. Most of the patients with appendicoliths are asymptomatic and they are not pathognomic for acute appendicitis. However, appendicoliths show increased association with perforation and abscess formation. Appendicolith are quite common, being present in 3% of general population and in nearly 10% cases of appendicitis. However, giant appendicoliths measuring over 2 centimeters (cms) are extremely rare. Computed Tomography (CT) has increased their pre-operative diagnosis considerably. Use of spectral analysis can give us the details of composition of the stone pre-operatively. We present a young male diagnosed pre-operatively on Non-Contrast Computed Tomography (NCCT) to have a giant calcium struvite appendicolith. On laparoscopy he had a 3 cm stone and an incidental Meckel's diverticulum and underwent appendectomy. The case is presented for the unique size of the appendicolith alongwith review of literature.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
2
4,046
114
INSTRUMENTS AND EQUIPMENTS
Laparoscopic training model using fresh human cadavers without the establishment of penumoperitoneum
Ernesto Sasaki Imakuma, Edson Yassushi Ussami, Alberto Meyer
April-June 2016, 12(2):190-193
DOI
:10.4103/0972-9941.178519
PMID
:27073318
Background:
Laparoscopy is a well-established alternative to open surgery for treating many diseases. Although laparoscopy has many advantages, it is also associated with disadvantages, such as slow learning curves and prolonged operation time. Fresh frozen cadavers may be an interesting resource for laparoscopic training, and many institutions have access to cadavers. One of the main obstacles for the use of cadavers as a training model is the difficulty in introducing a sufficient pneumoperitoneum to distend the abdominal wall and provide a proper working space. The purpose of this study was to describe a fresh human cadaver model for laparoscopic training without requiring a pneumoperitoneum.
Materials and Methods and Results:
A fake abdominal wall device was developed to allow for laparoscopic training without requiring a pneumoperitoneum in cadavers. The device consists of a table-mounted retractor, two rail clamps, two independent frame arms, two adjustable handle and rotating features, and two frames of the abdominal wall. A handycam is fixed over a frame arm, positioned and connected through a USB connection to a television and dissector; scissors and other laparoscopic materials are positioned inside trocars. The laparoscopic procedure is thus simulated.
Conclusion:
Cadavers offer a very promising and useful model for laparoscopic training. We developed a fake abdominal wall device that solves the limitation of space when performing surgery on cadavers and removes the need to acquire more costly laparoscopic equipment. This model is easily accessible at institutions in developing countries, making it one of the most promising tools for teaching laparoscopy.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
1
3,600
125
LETTERS TO EDITOR
Laparoscopic excision of a lipoma of parietal peritoneum
Hrishikesh P Salgaonkar, Ramya Ranjan Behera, Avinash N Katara, Deepraj S Bhandarkar
April-June 2016, 12(2):196-197
DOI
:10.4103/0972-9941.178515
PMID
:27073320
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
1
2,037
91
ORIGINAL ARTICLES
Single-centre experience of retroperitoneoscopic approach in urology with tips to overcome the steep learning curve
Aneesh Srivastava, Sanjoy Kumar Sureka, Saurabh Vashishtha, Shikhar Agarwal, Md Saleh Ansari, Manoj Kumar
April-June 2016, 12(2):102-108
DOI
:10.4103/0972-9941.178517
PMID
:27073300
Context:
The retroperitoneoscopic or retroperitoneal (RP) surgical approach has not become as popular as the transperitoneal (TP) one due to the steeper learning curve.
Aims:
Our single-institution experience focuses on the feasibility, advantages and complications of retroperitoneoscopic surgeries (RS) performed over the past 10 years. Tips and tricks have been discussed to overcome the steep learning curve and these are emphasised.
Settings and Design:
This study made a retrospective analysis of computerised hospital data of patients who underwent RP urological procedures from 2003 to 2013 at a tertiary care centre.
Patients and Methods:
Between 2003 and 2013, 314 cases of RS were performed for various urological procedures. We analysed the operative time, peri-operative complications, time to return of bowel sound, length of hospital stay, and advantages and difficulties involved. Post-operative complications were stratified into five grades using modified Clavien classification (MCC).
Results:
RS were successfully completed in 95.5% of patients, with 4% of the procedures electively performed by the combined approach (both RP and TP); 3.2% required open conversion and 1.3% were converted to the TP approach. The most common cause for conversion was bleeding. Mean hospital stay was 3.2 ± 1.2 days and the mean time for returning of bowel sounds was 16.5 ± 5.4 h. Of the patients, 1.4% required peri-operative blood transfusion. A total of 16 patients (5%) had post-operative complications and the majority were grades I and II as per MCC. The rates of intra-operative and post-operative complications depended on the difficulty of the procedure, but the complications diminished over the years with the increasing experience of surgeons.
Conclusion:
Retroperitoneoscopy has proven an excellent approach, with certain advantages. The tips and tricks that have been provided and emphasised should definitely help to minimise the steep learning curve.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
1
3,179
159
Large gastrointestinal stromal tumours of the stomach: Is laparoscopy reasonable?
Beatrice Ulloa Severino, David Fuks, Panagiotis Lainas, Antoine Blain, Pierre Validire, Jean-Marc Ferraz, Thierry Perniceni, Brice Gayet
April-June 2016, 12(2):148-153
DOI
:10.4103/0972-9941.169955
PMID
:27073308
Background:
Laparoscopic resection (LR) offers significant advantages compared to open resections for gastric gastrointestinal stromal tumours (GISTs). We aimed to evaluate whether LR outcomes jeopardised short and long-term outcomes of patients with large GISTs.
Patients and Methods:
Among 50 patients undergoing surgery for gastric GISTs, 12 underwent LR for large GISTs (>5 cm). Their characteristics, perioperative results and survival were retrospectively compared to those of 22 patients who underwent LR for 'small GIST'.
Results:
The two groups were similar regarding demographics, rate of wedge resection and mean blood loss. No patient required transfusion or conversion. Operative time was significantly increased in the 'large GIST' group (160 min vs 112 min,
P
= 0.001). Mean tumour size was significantly lower in the 'small GIST' group (8.4 cm vs 2.4 cm,
P
= 0.0001). Resection margins were negative. The mortality rate was nil and the overall morbidity rates was similar in both groups. Median length of hospital stay was significantly increased in the 'large GIST' group (7 days vs 5 days,
P
= 0.004). Median follow-up was 47 months and one patient in the 'small GIST' group developed recurrence and died during follow-up 11 years after surgery. No patient died during follow-up.
Conclusions:
LR for large GISTs is safe and technically feasible and does not negatively influence the oncologic course. Prospective randomised trials should be performed before using this approach in routine surgical care.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
1
2,614
108
Transumbilical videolaparoscopic (single site) liver biopsy with laparoscopy equipment
Jorge Ricardo Góis e Cunha, Izabele Rabelo de Oliveira, Milena Passos Lima, Antônio Alves Júnior
April-June 2016, 12(2):135-138
DOI
:10.4103/0972-9941.158953
PMID
:27073305
Introduction:
Liver diseases have a high incidence in the whole world. In order to diagnose, stage and follow these diseases it is often necessary the execution of liver biopsy. There are many possible ways to perform the procedure and the rise of transumbilical endoscopic surgery (TUES) brings to the medical practice an additional good option.
Materials and Methods:
The study is prospective, nonrandomised and cohort type. It involves 42 patients who underwent liver biopsy through TUES using conventional video laparoscopic material.
Results:
Among the patients 18 (42.86%) underwent isolated liver biopsy and 24 (57.14%) to liver biopsy associated with umbilical hernia repair. Within those, 27 (64.28%) were male and 15 (35.71%) female. The average body mass index (BMI) was of 27.26 kg/m
2
, 10 were in the normal BMI range, 24 (57.14%) were in the overweight range, 6 (14.28%) had class I obesity and 2 (4.76%) had class II obesity. In none of the cases the procedure was converted to regular video laparoscopy, all the patients were discharged in the day after the procedure and reported a satisfactory aesthetic result.
Conclusions:
The study shows that liver biopsy using TUES has applicability and good results, including in obese patients that would have a contraindication to other methods.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
[PubMed]
1
1,407
82
LETTERS TO EDITOR
Laparoscopic treatment for an unusual foreign body
Jinbeom Cho, Junhyun Lee
April-June 2016, 12(2):194-195
DOI
:10.4103/0972-9941.178516
PMID
:27073319
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
1,932
116
ORIGINAL ARTICLES
Combination of laparoscopy and endoscopy for fusiform choledochal cysts
Zhang Jun, Liu Shuli, Chen Zhen, Zhang Zhen, Li Long, Cheng Wei
April-June 2016, 12(2):93-97
DOI
:10.4103/0972-9941.169998
PMID
:27073298
Objective:
The purpose of the study was to elucidate the efficacy of laparoscopy and endoscopy in the treatment of fusiform choledochal cysts (CDC).
Materials and Methods:
Between June 2006 and June 2012, 18 patients with fusiform CDC were treated in our hospital. All the 18 patients presented abdominal pain, and 13 presented jaundice. 18 patients presented elevated serum and urinary amylase, when abdominal pain appeared. All the patients underwent laparoscopic and endoscopic surgery successfully. The clinical presentation, radiological features and surgical treatment were analyzed. The postoperative symptoms, laboratory examination and bile duct changes were evaluated during follow-up term.
Results:
Intraoperative cholangiography showed filling defect, dilatation of the common channel and pancreatic ducts visualization in 18 patients, including 9 patients of pancreatic duct dilatation. The protein plugs and/or stones were removed completely under laparoscopy and endoscopy in 18 patients. Patients were followed-up for 3 months to 6 years. The biochemical and ultrasound examination showed no increase in pancreatic amylase and recurrence of the stones in the common channel and pancreatic duct.
Conclusions:
The children with congenital fusiform biliary dilatation presented abdominal pain. Patients presented elevated serum and urinary amylase, when abdominal pain occurred. Filling defect and dilatation of the common channel showed by cholangiography. Laparoscopy and endoscopy clearance of the protein plugs and/or stones in the common channel in congenital fusiform biliary dilatation is effective, and the long-term result is good.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
3,504
178
Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years
Ünal Biçakci, Gürkan Genç, Burak Tander, Mithat Günaydın, Dilek Demirel, Ozan Özkaya, Rıza Rızalar, Ender Arıtürk, Ferit Bernay
April-June 2016, 12(2):162-166
DOI
:10.4103/0972-9941.147364
PMID
:27073310
Introduction:
The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared.
Materials and Methods:
We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014.
Results:
Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (
n
= 4 v s
n
= 25) (
P
<0.01). Patients with peritonitis were younger than those who had no attack of peritonitis (10.95 ± 0.8 years
vs
13.4 ± 0.85 years). According to the development of complications, significant difference has not been found between the open (
n
= 9) and laparoscopic (
n
= 3) approaches except the peritonitis. Catheter survival rate for the first year was 95%, and for five years was 87.5%. There was no difference between open and laparoscopic group according to catheter survival rate. The mean kt/V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V.
Conclusion:
Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
1,583
69
Efficacy and safety of a new single-port model for appendectomy: Experimental study on swine
José Gustavo Olijnyk, Paulo Walter Ferreira, Miguel Prestes Nácul, Leandro Totti Cavazzola
April-June 2016, 12(2):129-134
DOI
:10.4103/0972-9941.158951
PMID
:27073304
Context:
With the cooperation of surgeons and the engineering division of the company Bhio supply
©
(Esteio-RS, Brazil), a permanent single port was developed.
AIMS:
An experimental study assessed the safety and efficacy of the device using a swine laparoscopic appendectomy model (right salpingo-oophorectomy).
Settings and Design:
Experimental randomised study.
Materials and Methods:
A total of 20 pigs were randomised for the conventional laparoscopic (CL) three-trocar technique or the single Centry port (CPort) with two working channels, aided by a transparietal thread. Operative times, surgical complications, CO
2
use, and pneumoperitoneal pressure were checked. Pressure and chromopertubation tests assessed the ligatures.
Statistical Analysis Used:
For quantitative outcomes, the Fisher's exact test analysed the samples to compare the surgeons in each group, the ANOVA test for parametric data (volume and pressure) and the Student's
t
-test for analysis of the fascial incision length. The binaries and isolated occurrence events were described in percentages.
Results:
For all cases, pneumoperitoneum was maintained. The CPort group, however, resulted in higher CO
2
use (26.18 l; standard deviation [SD] ± 11.09) than CL group (5.69 l; SD ± 2.44) (
P
< 0.01). The mean pressure in CPort group (6.604 mmHg, SD ± 1.793) was comparatively lower than in CL group (7.382 mmHg, SD ± 1.833) (
P
= 0.363). There was no statistical difference between operative times, ligature safety or adverse surgical events between the different groups and surgeons.
Conclusion:
The surgical technique used with the single port showed no differences in safety and efficacy. Though it does require more CO
2
use, its working dynamics did not lead to increased operative times. The results were similar between the two surgeons in the study, suggesting that they can be reproduced.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
3,051
140
UNUSUAL CASES
Testicular tumour in non-palpable undescended testis: A rare presentation and laparoscopic management in a 4-year-old
Prakash Agarwal, Raj Kishore Bagdi
April-June 2016, 12(2):167-169
DOI
:10.4103/0972-9941.178520
PMID
:27073311
Testicular tumour in an intra-abdominal undescended testis is a rare finding. We report a case of mature teratoma in an intra-abdominal testis of a 4-year-old boy. He presented with nonpalpable testis on the right side. Abdominal ultrasound was normal. Diagnostic laparoscopy revealed a large tumour arising from an intra-abdominal right testis, and histologic analysis identified a mature teratoma. The tumour was completely removed laparoscopically, and there was no recurrence at follow-up 1 year later.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
2,197
113
Laparoscopic management of hydatid cyst in the lesser sac
Manash Ranjan Sahoo, Saurabh Kumar, Srikanta Panda, P Ahammed Shameel
April-June 2016, 12(2):173-175
DOI
:10.4103/0972-9941.169980
PMID
:27073313
Hydatid cyst is a disease caused by
Echinococcus granulosus
. Various anatomical location of hydatid cyst has been described in literature. Liver is the most common site of hydatid cyst and lungs are the second most common site. Hydatid cyst of lesser sac is a rare entity. Here we present a rare case report of laparoscopic management of hydatid cyst in lesser sac.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
3,073
454
Expect the unexpected: Endometriosis mimicking a rectal carcinoma in a post-menopausal lady
CK Jakhmola, Ameet Kumar, BS Sunita
April-June 2016, 12(2):179-181
DOI
:10.4103/0972-9941.169983
PMID
:27073315
Altered bowels habits along with rectal mass in an elderly would point toward a rectal cancer. We report an unusual case of a post-menopausal lady who presented with these complaints. We had difficulties in establishing a pre-operative diagnosis. With a tentative diagnosis of a rectal cancer/gastrointestinal stromal tumor, she underwent a laparoscopic anterior resection. On histopathology, this turned out to be endometriosis. Bowel endometriosis is an uncommon occurrence. That it occurred in a post-menopausal lady was a very unusual finding. We discuss the case, its management, and the relevant literature.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
2,850
101
Single-incision laparoscopic-assisted ileal resection for adult intussusception
Hong Yu, Shuodong Wu, Renzhong Zhu, Xiaopeng Yu
April-June 2016, 12(2):182-185
DOI
:10.4103/0972-9941.169986
PMID
:27073316
Adult intussuception is rare and laparotomy is required in most of the cases due to the potential pathologic underlying reasons. Although it is technically challenging, single-incision laparoscopic surgery can work as an alternative to laparotomy. Here we report the case of a 45-year-old man with intermittent right lower quadrant abdominal pain for 1 month. Abdominal enhanced computed tomography (CT) scan was performed and ileo-ileal intussusception was found, with lipoma as a likely leading point. Ileal resection was performed using the single-incision laparoscopic-assisted technique. Multiple trocars in the umbilical incision technique and conventional instruments were used. After identification of the ileo-ileal intussusception, the involved small bowel was extracted from the umbilical incision, and resection and anastomosis were performed extracoporeally. The operation time was 65 min and the post-operative hospital stay was 2 days. The patient recovered uneventfully, with better cosmetic results.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
-
2,914
117
Contact us
|
Sitemap
|
Advertise with us
|
What's New
|
Disclaimer
|
Privacy Notice
© 2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer -
Medknow
Online since 15
th
August '04