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Dietmar Stephan, Heike Sälzer, Frank Willeke
Until recently, robotic-assisted surgery has exclusively been connected to the name DaVinci®. In 2016, a second robotic system, the Senhance®, became available. To introduce the new robotic system into clinical routine, detailed team training and an integration program were useful. Within the first 6 months, 116 cases were performed with this system. The integration program intended to start with simple and well-standardized clinical cases. We chose inguinal hernia repair using the TAPP (transabdominal preperitoneal) technique as the starting procedure...
February 2018: Visceral Medicine
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
April 2018: Expert Review of Gastroenterology & Hepatology
Radhika Smith, David J Maron
Laparoscopic surgery has revolutionized the delivery of care to the surgical patient undergoing colorectal resection. Since the first laparoscopic-assisted colectomy in 1991, significant advances have been made in minimally invasive colorectal surgery. For many benign conditions, laparoscopic colectomy has been proven to be safe and effective, and in some instances superior when compared with open surgery. Complex laparoscopic resections such as those for diverticulitis and inflammatory bowel disease have also been shown to have equivalent outcomes when compared with open surgery...
April 2017: Clinics in Colon and Rectal Surgery
Carlos Hoyuela, Montserrat Juvany, Fernando Carvajal
The aim of this meta-analysis was to evaluate if the advantages of single-incision laparoscopic surgery (SILS) to perform a colorectal resection justify a broad application of this approach. A total of 32 studies including 3863 patients, comparing colorectal procedures performed with SILS or multi-port laparoscopy (LCS) were analyzed after a systematic review. Colorectal SILS had comparable outcomes to multi-port LCS in terms of operating time (P = 0.44), conversion rate (2.0% vs 3.0%; P = 0.52), reoperations (1...
July 2017: American Journal of Surgery
Jagdeep Singh Bhangu, Ruth Exner, Thomas Bachleitner-Hofmann
INTRODUCTION: There is an ongoing debate whether prophylactic drainage or incidental appendectomy should be performed in patients undergoing colorectal surgery. On the other hand, it has been shown that the placement of drains through former trocar sites as well as the use of large (≥10mm) trocars, incomplete fascial closure or closed laparoscopy technique all predispose for the occurrence of trocar site hernias. PRESENTATION OF CASE: We report the case of a 59-year-old male patient who underwent laparoscopic sigmoid colectomy with primary anastomosis for recurrent sigmoid diverticulitis...
2017: International Journal of Surgery Case Reports
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
September 2017: Surgical Endoscopy
Pierluigi Angelini, Antonio Sciuto, Diego Cuccurullo, Felice Pirozzi, Stefano Reggio, Francesco Corcione
BACKGROUND: Laparoscopy has increasingly become the standard of care for patients who undergo colorectal surgery for both benign and malignant diseases. This growing experience has also resulted in more reports of postoperative complications from the minimally invasive approach to primary colorectal resection. Small bowel obstruction from internal hernias and pre-sacral adhesions is an uncommon but not negligible complication. However, there is little literature specific to this topic with recommendations for different methods to prevent it...
July 2017: Surgical Endoscopy
Sebastian Smolarek, Mostafa Shalaby, Giulio Paolo Angelucci, Giulia Missori, Ilaria Capuano, Luana Franceschilli, Silvia Quaresima, Nicola Di Lorenzo, Pierpaolo Sileri
BACKGROUND AND OBJECTIVES: Small-bowel obstruction (SBO) is a common surgical emergency that occurs in 9% of patients after abdominal surgery. Up to 73% are caused by peritoneal adhesions. The primary purpose of this study was to compare the rate of SBOs between patients who underwent laparoscopic (LPS) and those who had open (OPS) colorectal surgery. The secondary reasons were to evaluate the rate of adhesive SBO in a cohort of patients who underwent a range of colorectal resections and to assess risk factors for the development of SBO...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Sasan Saeed Far, Sepide Miraj
BACKGROUND: Laparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions elsewhere in the body. OBJECTIVE: This systematic review is aimed to overview single-incision laparoscopy surgery. METHODS: This systematic review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references...
October 2016: Electronic Physician
Rodolfo J Oviedo, Jarrod C Robertson, Sharifah Alrajhi
BACKGROUND AND OBJECTIVES: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. METHODS: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Nicolò Pecorelli, Salvatore Amodeo, Matteo Frasson, Andrea Vignali, Walter Zuliani, Marco Braga
PURPOSE: To evaluate the impact of laparoscopy compared to open surgery on long-term outcomes in a large series of patients who participated in a randomized controlled trial comparing short-term results of laparoscopic (LPS) versus open colorectal resection. METHODS: This is a retrospective review of a prospective database including 662 patients with colorectal disease (526, 79 % cancer patients) who were randomly assigned to LPS or open colorectal resection and followed every 6 months by office visits...
July 2016: International Journal of Colorectal Disease
K H Chang, M G Bourke, D O Kavanagh, P C Neary, J M O'Riordan
The benefits of laparoscopic versus open surgery for patients with both benign and malignant colorectal disease have been well established. Re-laparoscopy in patients who develop complications following laparoscopic colorectal surgery has recently been reported by some groups and the aim of this systematic review was to summarise this literature. A literature search of PubMed, Medline and EMBASE identified a total of 11 studies that reported laparoscopic re-intervention for complications in 187 patients following laparoscopic colorectal surgery...
October 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
H M N Joshi, M P Gosselink, S Adusumilli, R Hompes, C Cunningham, I Lindsey, O M Jones
INTRODUCTION: The advantages of single port surgery remain controversial. This study was designed to evaluate the safety and feasibility of single incision glove port colon resections using a diathermy hook, reusable ports and standard laparoscopic straight instrumentation. METHODS: Between June 2012 and February 2014, 70 consecutive patients (30 women) underwent a colonic resection using a wound retractor and glove port. Forty patients underwent a right hemicolectomy through the umbilicus and thirty underwent attempted single port resection via an incision in the right rectus sheath (14 high anterior resection, 13 low anterior resection, 3 abdominoperineal resection)...
April 2015: Annals of the Royal College of Surgeons of England
Alberto Farinetti, Luca Reggiani Bonetti, Mario Migaldi, Anna Vittoria Mattioli, Sonia Pennella, Simone Muratori, Aldo Rossi
AIM: Aim of the study was to compare two groups of patients affected by colorectal adenocarcinoma that underwent to open colectomy and laparoscopic colectomy respectively, highlighting the advantage and problems. MATERIAL OF STUDY: This is a retrospective analysis. Between January 2003 and December 2006, 54 patients who underwent colectomy were recruited. Of these, 26 patients underwent open colectomy, and 28 laparoscopy. RESULTS: For open colectomy the average duration of surgery was 177...
January 2015: Annali Italiani di Chirurgia
Christopher T Aquina, Aaron S Rickles, Christian P Probst, Kristin N Kelly, Andrew-Paul Deeb, John R T Monson, Fergal J Fleming
BACKGROUND: High BMI is often used as a proxy for obesity and has been considered a risk factor for the development of an incisional hernia after abdominal surgery. However, BMI does not accurately reflect fat distribution. OBJECTIVE: The purpose of this work was to investigate the relationship among different obesity measurements and the risk of incisional hernia. DESIGN: This was a retrospective cohort study. SETTINGS: The study included a single academic institution in New York from 2003 to 2010...
February 2015: Diseases of the Colon and Rectum
Takefumi Yoshida, Tetsushi Kinugasa, Yousuke Oka, Tomoaki Mizobe, Hiroto Ishikawa, Naoki Mori, Taro Isobe, Eri Katayama, Yoshito Akagi
INTRODUCTION: Laparoscopic surgery is a minimally invasive approach with good treatment outcomes and is currently the standard surgery for colorectal cancer in Japan. Mesenteric closure is considered unnecessary in laparoscopic colorectal surgery because it can damage the bowel and blood vessels. However, an internal hernia may develop if the mesentery is not repaired. CASE PRESENTATION: We report a case of internal hernia in a 61-year-old male of Japanese ethnicity...
December 29, 2014: Journal of Medical Case Reports
A V Navaratnam, R Ariyaratnam, N J Smart, M Parker, R W Motson, T H Arulampalam
INTRODUCTION: Incisional hernia is a common complication of laparoscopic colorectal surgery. Extraction site may influence the rate of incisional hernias. Major risk factors for the development of incisional hernias include age, diabetes, obesity and smoking status. In this study, we investigated the effect of specimen extraction site on incisional hernia rate. METHODS: Two cohorts of patients who underwent laparoscopic colorectal resections in a single centre in 2005 (n=85) and 2009 (n=139) were studied retrospectively...
January 2015: Annals of the Royal College of Surgeons of England
Andreas M Kaiser
The advances of laparoscopic surgery since the early 1990s have caused one of the largest technical revolutions in medicine since the detection of antibiotics (1922, Flemming), the discovery of DNA structure (1953, Watson and Crick), and solid organ transplantation (1954, Murray). Perseverance through a rocky start and increased familiarity with the chop-stick surgery in conjunction with technical refinements has resulted in a rapid expansion of the indications for minimally invasive surgery. Procedure-related factors initially contributed to this success and included the improved postoperative recovery and cosmesis, fewer wound complications, lower risk for incisional hernias and for subsequent adhesion-related small bowel obstructions; the major breakthrough however came with favorable long-term outcomes data on oncological parameters...
November 7, 2014: World Journal of Gastroenterology: WJG
Jun-Kang Zhao, Nan-Zheng Chen, Jian-Bao Zheng, Sai He, Xue-Jun Sun
Colorectal cancer is one of the main malignant tumors threatening human health. Surgery plays a pivotal role in treating colorectal cancer. The present study aimed to compare the clinical effect in patients with rectal cancer undergoing laparoscopic versus open surgery by meta-analysis of the randomized controlled trials (RCTs) published in the past 20 years. The data showed that 14 RCTs comparing laparoscopic surgery with conventional open surgery for rectal cancer matched the selection criteria and reported on 2,114 subjects, of whom 1,111 underwent laparoscopic surgery and 1,003 underwent open surgery for rectal cancer...
November 2014: Molecular and Clinical Oncology
Albert M Wolthuis, Anthony de Buck van Overstraeten, André D'Hoore
Over the last 20 years, laparoscopic colorectal surgery has shown equal efficacy for benign and malignant colorectal diseases when compared to open surgery. However, a laparoscopic approach reduces postoperative morbidity and shortens hospital stay. In the quest to optimize outcomes after laparoscopic colorectal surgery, reduction of access trauma could be a way to improve recovery. To date, one method to reduce access trauma is natural orifice specimen extraction (NOSE). NOSE aims to reduce access trauma in laparoscopic colorectal surgery...
September 28, 2014: World Journal of Gastroenterology: WJG
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