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Anibal Wood Branco
Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury oc¬curring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who un¬derwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Safinaz Karabayirli, Onder Surgit, Hulya Kasikara, Cemile Koca Bicer, Merve Ergin, Ruveyda Irem Demircioglu, Bunyamin Muslu
BACKGROUND: The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP). MATERIALS AND METHODS: One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N2O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil...
October 24, 2016: Acta Chirurgica Belgica
Maddibande Ramachar Sreevathsa, Khyati Melanta
INTRODUCTION: The most common cause of gas under diaphragm is hollow viscous perforation. In 10% of cases it can be due to rare causes, both abdominal and extra-abdominal, one of them being intra abdominal infection by gas forming organisms. PRESENTATION OF THE CASE: A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas under the right dome of diaphragm and ultrasound abdomen confirmed gross pneumoperitoneum...
October 14, 2016: International Journal of Surgery Case Reports
Nader Shakibazad, Karmella Kamali, Naser Honar, Mohammadreza Bordbar, Erfaneh Mohazabieh
Rigler sign is a double wall sign suggesting pneumoperitoneum and intestinal perforation, and it needs emergency surgical treatment. Early diagnosis of intestinal perforation by clinical symptoms, presence of Rigler sign in abdominal radiography, and then early surgical treatment can reduce mortality. Here, we report a patient with Crigler-Najjar syndrome who underwent liver transplant and then developed posttransplant lymphoproliferative disease and received chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab...
October 20, 2016: Experimental and Clinical Transplantation
Jin Sil Kim, Hyun Jin Kim, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Hyun Kwon Ha
OBJECTIVES: To evaluate the CT features of ruptured GISTs and factors that might be predictive of rupture through comparison with CTs taken prior to rupture and CTs of non-ruptured GIST. METHODS: Forty-nine patients with ruptured GIST and forty-nine patients with non-ruptured GIST matched by age, gender and location were included. Clinical data including pharmacotherapy were reviewed. The imaging features were analyzed. Prior CT obtained before rupture were evaluated...
October 19, 2016: European Radiology
Daniel W Birch, Jerry T Dang, Noah J Switzer, Namdar Manouchehri, Xinzhe Shi, Ghassan Hadi, Shahzeer Karmali
BACKGROUND: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible. Past studies on heated insufflation have shown inconclusive results with regards to maintenance of core temperature and reduction of postoperative pain and recovery times...
October 19, 2016: Cochrane Database of Systematic Reviews
Robson Azevedo Dutra, Adriana Cartafina Perez Boscollo
Background: The anorectal anomalies consist in a complex group of birth defects. Laparoscopic-assisted anorectoplasty improved visualization of the rectal fistula and the ability to place the pull-through segment within the elevator muscle complex with minimal dissection. There is no consensus on how the fistula should be managed. Aim: To evaluate the laparoscopic-assisted anorectoplasty and the treatment of the rectal urinary fistula by a bipolar sealing device...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Dhurjoti Prosad Bhattacharjee, Sauvik Saha, Sanjib Paul, Shibsankar Roychowdhary, Shirsendu Mondal, Suhrita Paul
BACKGROUND: Carbon dioxide pneumoperitoneum for laparoscopic surgery increases arterial pressures, heart rate (HR), and systemic vascular resistance. In this randomized, single-blind, placebo-controlled clinical study, we investigated and compared the efficacy of esmolol and dexmedetomidine to provide perioperative hemodynamic stability in patients undergoing laparoscopic cholecystectomy. METHODS: Sixty patients, of either sex undergoing elective laparoscopic cholecystectomy, were randomly allocated into three groups containing twenty patients each...
September 2016: Anesthesia, Essays and Researches
Amar Parkash Kataria, Joginder Pal Attri, Ramita Kashyap, Leena Mahajan
BACKGROUND: The advent of laparoscopic surgeries has proved to be beneficial for both patient and surgeon although increased morbidity may result from hemodynamic changes associated with laryngoscopy, intubation, and pneumoperitoneum (PNP). AIM: The present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy, intubation, and PNP in laparoscopic cholecystectomy (LC)...
September 2016: Anesthesia, Essays and Researches
Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
October 13, 2016: Gynecologic Oncology
Murlidhar, Rishab Sharma, Sanjiv Maheshwari, Rajesh Jain, Rekha Porwal
Gas under the diaphragm or pneumoperitoneum, is often a sign of grave intra-abdominal pathology. It can be due to either of surgical or non-surgical etiology. Here we present a case of gas under right dome of diaphragm caused by a non-surgical cause i.e. secondary to aspiration of liver abscess.
June 2016: Journal of the Association of Physicians of India
Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim
PURPOSE: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. METHODS: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings...
September 2016: Pediatric Gastroenterology, Hepatology & Nutrition
Xming Yang, Jie Xie, Jun Liu, Tao Wang
This study aims to study the impact of dexmedetomidine on the deformability of erythrocyte in patients with laparoscopic cholecystectomy. 40 patients scheduled for laparoscopic cholecystectomy were randomly divided into 2 groups: Dexmedetomidine group (0.5µg/kg loading within 10 min and 0.5μg•kg-1•h-1maintenance to the end of pneumoperitoneum, n=20, Group A) and control group (normal saline at the identical, n=20, Group B). The induction and maintenance of anesthesia of two groups were identical. Erythrocyte deformability index (EI) and haematocrit (Hct) were assayed before anesthesia and after the operation...
September 2016: Pakistan Journal of Pharmaceutical Sciences
Hong Shi, Su-Yu Chen, Yong-Guang Wang, Sheng-Jun Jiang, He-Li Cai, Kai Lin, Zhao-Fei Xie, Fen-Fang Dong
AIM: To introduce natural orifice transgastric endoscopic surgery (NOTES) tube ileostomy using pelvis-directed submucosal tunneling endoscopic gastrostomy and endoscopic tube ileostomy. METHODS: Six live pigs (three each in the non-survival and survival groups) were used. A double-channeled therapeutic endoscope was introduced perorally into the stomach. A gastrostomy was made using a 2-cm transversal mucosal incision following the creation of a 5-cm longitudinal pelvis-directed submucosal tunnel...
October 7, 2016: World Journal of Gastroenterology: WJG
Bruce Ramshaw, Brandie Forman, Eric Heidel, Jonathan Dean, Andrew Gamenthaler, Michael Fabian
Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months). Initiatives for improved patient outcomes during this period included the administration of a transversus abdominis plane (TAP) block and/or an intra-operative block with long-acting local anesthetic first, and then a low pressure pneumoperitoneum (LPP) system was implemented later in the project...
October 6, 2016: Surgical Technology International
Tetsuya Ishimaru, Masahiko Sugiyama, Mari Arai, Kaori Satoh, Chizue Uotani, Masataka Takahashi, Shohei Takami, Jun Fujishiro, Tadashi Iwanaka
AIM: Scoliosis, which is often associated with neurological impairment in children, sometimes makes it difficult to perform laparoscopic procedures. This study assessed the impact of scoliosis on performing laparoscopic Nissen fundoplication. METHODS: Medical records and radiographic examinations of patients who underwent laparoscopic Nissen fundoplication at a single institution from 2006 to 2015 were reviewed retrospectively. Patients' data on age at surgery, height, weight, duration of pneumoperitoneum, and amount of bleeding were collected...
October 11, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Xixue Zhang, Jionglin Wei, Xiaoxing Song, Yuhao Zhang, Weiqing Qian, Lu Sheng, Zhoujun Shen, Lvjun Yang, Rong Dong, Weidong Gu
BACKGROUND: Robot-assisted laparoscopic radical prostatectomy and robot-assisted radical cystectomy have gradually become the preferred choices for urologists as they allow surgeons to perform complex procedures more precisely and effectively. The pneumoperitoneum, which is normally applied in these surgeries to provide visual clarity and space to perform the procedure, may cause hemodynamic disturbance, potentially myocardial injury. Thus surgeons have recently considered opting for the low-pressure pneumoperitoneum to lower this negative impact...
October 10, 2016: Trials
Roberto Iglesias Lopes, Jessica Ming, Martin A Koyle, Ronald Grant, Adriana Fonseca, Armando J Lorenzo
OBJECTIVE: To describe the experience and technique of zero-ischemia laparoscopic-assisted partial nephrectomy at The Hospital for Sick Children, as an alternative to the traditional open approach for nephron sparing surgery in selected children with Wilms' tumors (WT). MATERIALS AND METHODS: Patients with diagnosis of WT treated with neoadjuvant chemotherapy and who underwent laparoscopic-assisted nephron-sparing surgery at the Hospital for Sick Children from 2012-2016 were identified and charts reviewed retrospectively...
October 6, 2016: Urology
Tassia Soraya Araujo Paixão, Renata Vidal Leão, Natally de Souza Maciel Rocha Horvat, Publio Cesar Cavalcante Viana, Claudia Da Costa Leite, Rodrigo Lautert de Azambuja, Rodrigo Sanford Damasceno, Cinthia Denise Ortega, Marcos Roberto de Menezes, Giovanni Guido Cerri
PURPOSE: The present article provides an overview of the spectrum of abdominal presentations of fishbone (FB) ingestion and its complications. METHODS: In image data from 9 patients, FB perforations were found in different levels of the gastrointestinal tract (GIT), including duodenal, jejunal, and sigmoid perforations; in 4 asymptomatic patients, FBs were observed in the mesentery, falciform ligament, and intestinal bowel. RESULTS: The main imaging features of FB perforation were focal gastric or intestinal wall thickening, fat stranding, bowel obstruction, ascites, localized pneumoperitoneum, intra-abdominal abscess, liver abscess, and a linear hyperdense structure in the abdominal cavity in the GIT or within a parenchymal organ often surrounded by inflammatory changes...
October 8, 2016: Abdominal Radiology
Javier Barrio, Carlos L Errando, Guillermo San Miguel, Boris I Salas, Juan Raga, José L Carrión, Jaime García-Ramón, Juan Gallego
STUDY OBJECTIVE: To evaluate the effect of neuromuscular blockade (NMB) upon the abdominal space during pneumoperitoneum establishment in laparoscopic surgery, comparing moderate NMB and deep NMB. DESIGN: Prospective, randomized, crossover clinical trial. SETTING: Operating room. PATIENTS: Seventy-six American Society of Anesthesiologists 1 to 2 patients scheduled for elective laparoscopic surgery. INTERVENTIONS: Two independent evaluations were performed at the establishment of pneumoperitoneum for a preset intraabdominal pressures (IAPs) of 8 and 12 mm Hg, both during moderate NMB (train-of-four count, 1-3) and deep NMB (posttetanic count, <5)...
November 2016: Journal of Clinical Anesthesia
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