Laparoscopy aortic damage

BACKGROUND: The laparoscopic approach for repair of giant and/or recurrent paraesophageal hernias (PEH) is challenging, due to limited access to the dissection of the hernia sac into the proximal mediastinum and esophageal mobilization through the diaphragmatic hiatus. An esophageal lengthening procedure is often necessary, due to the difficulty in obtaining adequate intra-abdominal esophageal length. We, therefore, developed a VATS and laparoscopic technique, which allows for safe and extensive thoracic dissection and intra-abdominal gastric fixation and cruroplasty, yet preserving the benefits of minimally invasive surgery...

BACKGROUND: in patients with early-stage cervical cancer (FIGO IA, IB2 and IIA), the incidence of lymph node metastases is up to 15%; the majority of early cervical cancer patients with pelvic and para-aortic lymphadenectomy does not benefit with the procedure and are at risk of associated morbidity (linfocyst, lymphedema, vascular or nerve damage). OBJECTIVE: To describe the experience and usefulness of lymphatic mapping and sentinel lymph node with total laparoscopic radical hysterectomy in early stage cervical cancer...

OBJECTIVE: To determine the results of laparoscopic lymphadenectomy in gynecologic oncology patients. MATERIAL AND METHOD: Medical records of 31 gynecologic oncology patients who underwent laparoscopic lymphadenectomy between November 1, 2004 and February 28, 2007 were retrospectively reviewed. RESULTS: The median age of the study population was 47 years (range 24-77 years). Sixteen patients (51.6%) had endometrial cancer while 15 (48.4%) had ovarian malignancy, with median numbers of resected pelvic and paraaortic nodes of 12 (range 3-30 nodes) and 1 (range 1-3 nodes)...

OBJECTIVE: This is a phase II study, the aim of which is to determine if a laparoscopic approach can be used in pelvic autonomic nerve-preserving surgery for patients with lower rectal cancer following chemoradiation therapy. METHODS: Patients with T3 lower rectal cancer treated by preoperative chemoradiation were recruited and subjected to laparoscopic pelvic autonomic nerve-preserving surgery with total mesorectal excision and a sphincter-saving procedure. This study was performed with the approval of the ethics committee of National Taiwan University Hospital...

BACKGROUND AND PURPOSE: To study the relations of major blood vessels (aortoiliac bifurcation and iliocaval confluence) and the inferior epigastric arteries to the umbilicus and the anterior superior iliac spine (ASIS) planes and to apply this information to define ideal, anatomically based locations for primary and secondary laparoscopic port insertions to minimize vascular injuries. MATERIALS AND METHODS: Two hundred randomly selected postcontrast CT images of the abdomen and pelvis were assessed by two radiologists...

OBJECTIVE: To evaluate the feasibility, safety and utility of the ultrasonic shears for laparoscopic pelvic and para-aortic lymph node retrieval in the treatment of gynecologic cancers. METHODS: Data on laparoscopic lymphadenectomy performed for gynecologic malignancies using ultrasonic shears over a 5-year period were collected and analyzed prospectively. RESULTS: Laparoscopic lymphadenectomy using ultrasonic shears was performed on 100 patients with a median age of 58 (17-87) years...

Laparoscopic cholecystectomy is considered the gold standard for cholelithiasis. Nevertheless possible complications must not be underestimated. In this department, from 1 July 1991 to 30 November 1995, 1005 patients with cholelithiasis underwent videocholecystectomy. There was no peri-operative mortality. In 36 cases (3.6%) the procedure was changed to laparotomy. In four cases (0.4%) conversion was mandatory due to severe complications: in three patients while introducing a trocar (one aortic lesion, one middle colic vein injury and one visceral perforation) and in one patient due to bleeding in the hepatic hilar region...

The insertion of the inflation needle during laparoscopic procedures carries the risk of severe vascular damage to the aorto-cava bifurcation. Interindividual anatomic variation is great as shown by magnetic resonance imaging, increasing the risk of vascular damage. Four simple technical precautions are recommended to prevent accidents: insertion at the lower umbilical margin, widen distance between the umbilicus and the greater vessels, a 45 degree insertion angle and strictly medial position.