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Laparoscopic management

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https://www.readbyqxmd.com/read/29352753/factors-predicting-length-of-stay-following-bariatric-surgery-retrospective-review-of-a-single-uk-tertiary-centre-experience
#1
Fahad Mahmood, Alistair J Sharples, Adriana Rotundo, Nagammapudur Balaji, Vittal S R Rao
BACKGROUND: Laparoscopic Roux Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly performed bariatric procedures. Improvement in techniques and perioperative management of patients have resulted in shorter hospital stay and reduced overall costs. Many post-operative protocols aspire to post-operative day 1 discharge with studies showing reduction in length of stay without increasing complications. In this study, we investigate the factors predictive of early discharge at our high-volume bariatric centre...
January 19, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29352439/single-incision-laparoscopic-transgastric-underrunning-and-closure-of-cameron-ulcers-in-acute-gastrointestinal-bleeding
#2
Chun Han Nigel Tan, Guowei Kim, Jimmy So, Asim Shabbir
INTRODUCTION: Endoscopic therapy remains the cornerstone of hemostasis for gastrointestinal bleeding. In situations where hemostasis cannot be achieved via endoscopic or radiological methods, surgery is necessary. Traditional open surgery for bleeding gastric ulcers can be very morbid and unsuitable especially in hemodynamically unstable patients in extremis. We describe a minimally invasive, transgastric approach for underrunning and closure of Cameron ulcers. METHODS: Our patient is a 75-year-old Chinese lady, who presented to the emergency department with fresh melena...
January 19, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29351939/retroperitoneal-bile-leak-after-laparoscopic-cholecystectomy
#3
Dee Zhen Lim, Enoch Wong, Sayed Hassen, Yahya Al-Habbal
Bile duct injury (BDI) is a well-recognised complication of laparoscopic cholecystectomy (LC). Following a BDI, bile usually leaks into the peritoneal space and causes biliary peritonitis. This manifests as non-specific abdominal pain and fever occurring several days after the surgery. It can be managed by laparoscopic washout with or without bile duct repair. We present a rare case of retroperitoneal bile leak post-LC. The mechanism of injury here was likely partial avulsion from excessive traction of the cystic duct during intraoperative cholangiogram...
January 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29351705/percutaneous-endoscopic-rendezvous-procedure-for-the-management-of-bile-duct-injuries-after-cholecystectomy-short-and-long-term-outcomes
#4
Anne Marthe Schreuder, Klaske A C Booij, Philip R de Reuver, Otto M van Delden, Krijn P van Lienden, Marc G Besselink, Olivier R Busch, Dirk J Gouma, Erik A J Rauws, Thomas M van Gulik
BACKGROUND:  Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous procedure. METHODS:  All consecutive patients with BDI referred to our tertiary referral center between 1995 and 2016 were analyzed. A rendezvous procedure was performed when endoscopic or radiologic intervention failed, and when deemed feasible by a dedicated multidisciplinary team including hepatopancreaticobiliary surgeons, gastrointestinal endoscopists, and interventional radiologists...
January 19, 2018: Endoscopy
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#5
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29346781/laparoscopic-nephron-sparing-calycectomy-for-treating-fraley-s-syndrome
#6
Francesco Porpiglia, Riccardo Bertolo, Enrico Checcucci, Daniele Amparore, Matteo Manfredi, Cristian Fiori
Background/Aims/Objectives: Various nephron-sparing approaches were described as part of surgical management for Fraley's syndrome, a rare anatomic variant of the renal vascular anatomy that compresses the upper pole infundibulum resulting in an upper calyceal obstruction and dilatation, with symptoms of flank pain and hematuria. To date, descriptions of minimally invasive correction techniques are anecdotal. METHODS: A retroperitoneal pure laparoscopic approach using the nephron-sparing technique was chosen in the presented case...
January 18, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29346011/minimally-invasive-management-of-severe-aortoiliac-occlusive-disease
#7
Luigi Pascarella, Maen Aboul Hosn
BACKGROUND: Peripheral arterial disease (PAD) is a complex and highly prevalent pathology. It has been estimated that ∼8.5 million people in the United States are affected by PAD, of which 12%-20% are older than age 60. The TransAtlantic Inter-Society Consensus (TASC) guidelines classified aortoiliac atherosclerotic disease based on morphology and level of lesions. TASC II guidelines recommend bilateral surgical bypass to the femoral arteries for TASC II C and D lesions. The aortobifemoral bypass (ABF) has been considered the gold standard in the treatment of aortoiliac occlusive disease (AIOD)...
January 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29344632/factors-associated-with-outcomes-and-costs-after-pediatric-laparoscopic-cholecystectomy
#8
Gileh-Gol Akhtar-Danesh, Aristithes G Doumouras, Cecily Bos, Helene Flageole, Dennis Hong
Importance: The prevalence of pediatric cholelithiasis is increasing with the epidemic of childhood obesity. With this rise, the outcomes and costs of pediatric laparoscopic cholecystectomy become an important public health and economic concern. Objective: To assess patient and health system factors associated with the outcomes and costs after laparoscopic cholecystectomy among Canadian children. Design, Setting, and Participants: This was a retrospective, population-based study of children 17 years and younger undergoing laparoscopic cholecystectomy from April 1, 2008, until March 31, 2015...
January 17, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29343662/cost-benefit-performance-simulation-of-robot-assisted-thoracic-surgery-as-required-for-financiall-viability-under-the-2016-revised-reimbursement-paradigm-of-the-japanese-national-health-insurance-system
#9
Naohiro Kajiwara, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda
PURPOSE: To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. METHODS: All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. RESULTS: Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively)...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29340927/achalasia-cardia-in-a-young-infant
#10
V Poornachand, K Kumarasamy, S P Karamath, V Seenivasan, Sumathi Bavanandam, Nirmala Dheivamani
Achalasia cardia is an esophageal motility disorder rarely reported in children and more so in young infants. Common clinical presentations include vomiting, dysphagia, regurgitation, recurrent pulmonary aspiration and failure to thrive. Diagnosis is made by barium swallow study and esophageal manometry, which is the gold standard test. Pharmocological management and endotherapy often fails and results in recurrence of symptoms. Laparoscopic Hellers myotomy, with or without anti-reflux procedure is the standard treatment of choice for children...
January 17, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29340922/prevention-of-internal-hernia-during-robotic-total-gastrectomy-for-gastric-cancer
#11
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
BACKGROUND: Postoperative internal hernia (IH) is a potentially life-threatening acute protrusion of viscus through an iatrogenic mesenteric defect. In our retrospective study of 1943 consecutive gastric cancer (GC) patients who had undergone surgery, the incidence of IH after laparoscopic total gastrectomy (LTG) was 4.9%.1 This high incidence seems to be caused by decreased adhesion formation after LTG. There is no consensus regarding orifice management during robotic total gastrectomy (RTG)...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340920/pure-laparoscopic-transhepatic-enucleation-of-a-mucinous-cystic-neoplasm-abutting-the-major-hepatic-veins-at-the-hepatocaval-confluence-with-video
#12
Ji Hoon Kim
BACKGROUND: A mucinous cystic neoplasm (MCN) of the liver is a rare disease entity, occurring predominantly in the left hemiliver as reported by Simo et al.1 Thomas et al.2 and Vogt et al.3 Surgical resection of tumors at the hepatocaval confluence is a technically demanding procedure. Enucleation procedures have been performed for the management of benign or premalignant lesions such as cystic tumors as previously described by Thomas et al.2 and Vogt et al.3. We present a patient who underwent pure laparoscopic transhepatic enucleation to treat a MCN abutting the major hepatic veins at the hepatocaval confluence...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340829/trends-and-surgical-outcomes-of-laparoscopic-versus-open-pyloromyotomy
#13
William C Kethman, Alex H S Harris, Mary T Hawn, James K Wall
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common pediatric illnesses necessitating surgical intervention. Controversy remains over the optimal surgical approach between laparoscopic pyloromyotomy (LP) and open pyloromyotomy (OP). LP has gained acceptance for management of HPS in an era of expanding minimal access surgical approaches to pediatric conditions. Several studies suggest advantages of LP over OP; however, selection bias and small sample sizes remain a concern...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340826/single-port-laparoscopic-surgery-in-uncomplicated-acute-appendicitis-a-randomized-controlled-trial
#14
Byung Mo Kang, Sung Il Choi, Bum-Soo Kim, Suk-Hwan Lee
BACKGROUND: Single-port laparoscopic surgery (SPLS) is an alternative, minimally invasive surgical approach for managing appendicitis. The aim of this randomized trial was to evaluate the safety and efficacy of SPLS in uncomplicated appendicitis. METHODS: Between December 2009 and November 2010, 194 patients with radiologically diagnosed acute appendicitis were randomly allocated to undergo either SPLS or multiport laparoscopic surgery (MPLS). Patients with intraoperative findings of perforated appendicitis were excluded from the analysis...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340677/association-of-bariatric-surgery-using-laparoscopic-banding-roux-en-y-gastric-bypass-or-laparoscopic-sleeve-gastrectomy-vs-usual-care-obesity-management-with-all-cause-mortality
#15
Orna Reges, Philip Greenland, Dror Dicker, Morton Leibowitz, Moshe Hoshen, Ilan Gofer, Laura J Rasmussen-Torvik, Ran D Balicer
Importance: Bariatric surgery is an effective and safe approach for weight loss and short-term improvement in metabolic disorders such as diabetes. However, studies have been limited in most settings by lack of a nonsurgical group, losses to follow-up, missing data, and small sample sizes in clinical trials and observational studies. Objective: To assess the association of 3 common types of bariatric surgery compared with nonsurgical treatment with mortality and other clinical outcomes among obese patients...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29336748/an-update-on-the-current-management-of-perforated-diverticulitis
#16
Evon Zoog, W Heath Giles, Robert A Maxwell
The management of perforated diverticulitis is a challenging aspect of general surgery. The prevalence of colonic diverticular disease has increased over the last decade and will continue to increase as the baby boomers add to the elderly population. Improvements in diagnostic imaging modalities, efforts to maintain intestinal continuity, and percutaneous drainage procedures now result in several alternatives when selecting a management strategy for complicated presentations. Specifically, laparoscopic lavage and resection with primary anastomosis have emerged as options for treatment of Hinchey III and IV diverticulitis in place of diversion in the appropriately selected patient...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29335897/splenectomy-in-systemic-lupus-erythematosus-and-autoimmune-hematologic-disease-a-comparative-analysis
#17
Nahim Barron, Jesús Arenas-Osuna, Gabriela Medina, María Pilar Cruz-Dominguez, Fernando González-Romero, José Arturo Velásques-García, Ernesto Alonso Ayala-López, Luis J Jara
The objective of the study is to analyze the efficacy and safety of splenectomy in the management of refractory autoimmune thrombocytopenia (AT)/autoimmune hemolytic anemia (AIHA) associated or not with systemic lupus erythematosus. Thirty-four patients after splenectomy due to severe AT and/or AIHA were divided into group 1 (G1) 18 SLE/APS patients: 9 AT/SLE patients, 6 SLE/antiphospholipid syndrome (APS), and 3 primary APS. Group 2 (G2): 16 patients without SLE/APS: 2 Fisher-Evans syndrome and 14 AIHA. Surgery approach when (1) platelets ≤ 50,000/ml despite 2 weeks on medical therapy, (2) medically dependent, and (3) medically intolerant or after two hemolytic crises in AIHA patients...
January 16, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29333207/development-and-feasibility-of-a-robotic-laparoscopic-clipping-tool-for-wound-closure-and-anastomosis
#18
Axel Krieger, Justin Opfermann, Peter C W Kim
This paper reports the design, development, and initial evaluation of a robotic laparoscopic clipping tool for single manipulator wound closure and anastomosis (tubular reconnection). The tool deploys biodegradable clips and clasps with the goal of (i) integrating grasping and suturing into a single device for single hand or manipulator use, (ii) applying the equivalent of interrupted sutures without the need of managing suture thread, and (iii) allowing for full six degrees-of-freedom (DOFs) laparoscopic control when mounted on a robot arm...
March 2018: Journal of Medical Devices
https://www.readbyqxmd.com/read/29333074/laparoendoscopic-rendezvous-may-be-an-effective-alternative-to-a-failed-preoperative-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cholecystocholedocholithiasis
#19
Fotios Tsiopoulos, Andreas Kapsoritakis, Athanassios Psychos, Anastasios Manolakis, Konstantinos Oikonomou, George Tzovaras, Ioannis Baloyiannis, Alexandra Tsikrika, Spyros Potamianos
Background: Endoscopic retrograde cholangiopancreatography (ERCP), followed by laparoscopic cholecystectomy (LC), remains the standard way of management for patients with cholecystocholedocholithiasis. Laparoendoscopic rendezvous (LERV), a combined procedure for removing the gallbladder laparoscopically and clearing the common bile duct (CBD) endoscopically at the same time, could be an attractive alternative. The aim of this study was to compare LERV with classic ERCP in patients with cholecystocholedocholithiasis...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29332100/robot-assisted-radical-prostatectomy-is-more-beneficial-for-prostate-cancer-patients-a-system-review-and-meta-analysis
#20
Yuefeng Du, Qingzhi Long, Bin Guan, Lijun Mu, Juanhua Tian, Yumei Jiang, Xiaojing Bai, Dapeng Wu
BACKGROUND Robot-assisted radical prostatectomy (RARP) is increasingly used worldwide, but comparisons of perioperative, functional, and oncologic outcomes among RARP, laparoscopic radical prostatectomy (LRP), and open radical prostatectomy (ORP) remain inconsistent. MATERIAL AND METHODS Systematic literature searches were conducted using EMBASE, PubMed, the Cochrane Library, CNKI, and Science Direct/Elsevier up to April 2017. A meta-analysis was conducted using Review Manager and Stata software. RESULTS We included 33 studies...
January 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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