Journal articles: 'Laparoscopic surgery (LS)'

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Khan, Zakir Ahmad, Ajmal Khan, Muhammad Bilawal Khan, Kamran Khan, Muhammad Waqas Khan, and Karishma Rehman. "Laparoscopic Vs Open Surgery for Colorectal Cancer: Comparing Short-Term Results." Pakistan Journal of Medical and Health Sciences 16, no. 10 (October 30, 2022): 816–18. http://dx.doi.org/10.53350/pjmhs221610816.

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Background: In developed countries, colorectal cancer continues to rank as the third-most prevalent cancer to be reported and the third-most popular reason for cancer mortality in both genders. Objective: The purpose of the retrospective research was to compare the operational parameters and short-term oncological effects of laparoscopic surgery (LS) with traditional open surgery (OS) in colorectal cancer patients in our hospital. Methods: In this study, 148 patients who underwent CRC surgery between January 2020 and January 2022 at the Medical Teaching Institute (MTI) Peshawar, Pakistan's Khyber Teaching Hospital and Hayatabad Medical Complex Hospital were included. 64 people who had all had LS were included in the study. On the other hand, 84 people who had had OS were randomly selected from groups of people who were of the same gender and age. Result: In the group undergoing OS, the median of dissected lymph nodes was 22.8 (9–35) and 3 (0–14), whereas, in the group undergoing laparoscopy, the median number was 21.56 (8–32) and 6.2 (0–9). For 13 (15.47%) patients undergone through and 9 patients (14.06%) undergone through laparoscopy, blood transfusions were necessary. Although the LS group's procedure took longer than the OS group, their time in the ICU, time to start feeding and duration of stay at the hospital were all shorter. Practical implication Importance Laparoscopic surgery has not been proven to be more effective than open surgery for patients with low rectal cancer. Conclusion: LS provides the benefits of a shorter hospital stay and fewer problems and delivers relatively adequate lymph node dissection. Keywords: laparoscopic surgery, open surgery, colorectal cancer, oncological outcomes, developing countries

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Siniscalchi, Antonio, Giorgio Ercolani, Giulia Tarozzi, Lorenzo Gamberini, Lucia Cipolat, Antonio D. Pinna, and Stefano Faenza. "Laparoscopic versus Open Liver Resection: Differences in Intraoperative and Early Postoperative Outcome among Cirrhotic Patients with Hepatocellular Carcinoma—A Retrospective Observational Study." HPB Surgery 2014 (December 4, 2014): 1–7. http://dx.doi.org/10.1155/2014/871251.

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Introduction. Laparoscopic liver resection is considered risky in cirrhotic patients, even if minor surgical trauma of laparoscopy could be useful to prevent deterioration of a compromised liver function. This study aimed to identify the differences in terms of perioperative complications and early outcome in cirrhotic patients undergoing minor hepatic resection for hepatocellular carcinoma with open or laparoscopic technique. Methods. In this retrospective study, 156 cirrhotic patients undergoing liver resection for hepatocellular carcinoma were divided into two groups according to type of surgical approach: laparoscopy (LS group: 23 patients) or laparotomy (LT group: 133 patients). Perioperative data, mortality, and length of hospital stay were recorded. Results. Groups were matched for type of resection, median number of nodules, and median diameter of largest lesions. Groups were also homogeneous for preoperative liver and renal function tests. Intraoperative haemoglobin decrease and transfusions of red blood cells and fresh frozen plasma were significantly lower in LS group. MELD score lasted stable after laparoscopic resection, while it increased in laparotomic group. Postoperative liver and renal failure and mortality were all lower in LS group. Conclusions. Lower morbidity and mortality, maintenance of liver function, and shorter hospital stay suggest the safety and benefit of laparoscopic approach.

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Levi Sandri, Giovanni Battista. "Welcome to the Laparoscopic Surgery!" Laparoscopic Surgery 1 (2017): 1. http://dx.doi.org/10.21037/ls.2017.09.01.

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Pesi, Benedetta, Francesco Guerra, and Andrea Coratti. "Robotic versus laparoscopic surgery of the liver." Laparoscopic Surgery 1 (2017): 2. http://dx.doi.org/10.21037/ls.2017.12.02.

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An, Sanghyun, and Youngwan Kim. "Laparoscopic surgery for colorectal cancer in emergencies." Laparoscopic Surgery 3 (December 2019): 48. http://dx.doi.org/10.21037/ls.2019.10.01.

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Lasheen, Omar, Mohamed Yehia, Ayman Salah, Sameh Mikhail, and Ahmed Hassan. "Towards cost saving in surgery without compromising safety: stapleless laparoscopic splenectomy in a developing country—a prospective cohort study." BMJ Open Quality 12, no. 1 (January 2023): e002068. http://dx.doi.org/10.1136/bmjoq-2022-002068.

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BackgroundMinimally invasive surgery has been steadily growing in popularity. Control of splenic hilar vessels is the most delicate step during laparoscopic splenectomy (LS). In the earlier eras of LS, hilar vessels were controlled using clips and/or ligation. Laparoscopic staples were later introduced and have arguably led to an increase in popularity of LS. They do not abolish potential complications of splenectomy and theoretically represent an added operative cost.In this study, we aimed to assess the safety and efficacy of stapleless LS (using knots, haemostatic devices and clips) compared with the now more conventional stapled LS.MethodsA pilot randomised prospective study was conducted in a university hospital between September 2018 and April 2020. It included 40 patients randomly assigned to two equal groups: (1) 20 patients: stapleless LS and (2) 20 patients: LS using laparoscopic staples.We compared operative time, intra and postoperative complications and postoperative recovery.ResultsThere was no statistically significant difference between both groups across all comparative outcomes.ConclusionBoth techniques are comparable in terms of safety and operative time. In terms of cost efficiency, we recommend more comprehensive analyses of hospital costs.

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Haloun, Tomáš, Radko Rajmon, Dalibor Řehák, Helena Hartlová, Zuzana Ptáčková, Jaroslav Marek, Petra Folková, Petr Slavík, and Jan Šterc. "Comparison of laparotomic omentopexy vs. laparoscopic abomasopexy treatments of left displaced abomasum in dairy cows under field conditions: biochemical analysis." Acta Veterinaria Brno 89, no. 3 (2020): 209–16. http://dx.doi.org/10.2754/avb202089030209.

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The objective of this retrospective study was to compare the effects of the two methods (laparoscopic or laparotomic) of LDA (left displaced abomasum) correction under field conditions by means of survival rate and biochemical profile evaluation. Holstein cows from one farm with LDA over a 20-month period were included in the study. Cows underwent laparoscopic abomasopexy (Janowitz’s method, LS) or a laparotomic right flank omentopexy (Dirksen’s method, LT). Blood samples for biochemical analysis were taken just prior to surgery (D1) and on days 10 (D10) and 30 (D30) following surgery. Blood profiles of healthy cows identified from the farm’s routine transition cow monitoring program were used as control (C). Aiming to minimize disruptive effects of quite a long period of data collection, the cows’ biochemical profile was evaluated in three orthogonal comparisons: LS cows vs. control group, LT cows vs. control group, and LS cows vs. LT cows. The rate of animal survival was similar for both methods (loss of about 11% until 30 days after treatment). Most of the blood parameters from LS and LT groups were comparable in all three sampling terms indicating continual organism recovery. At D10 the difference of higher cholesterol concentration and lower haptoglobin concentration were favourable for the LS group (P < 0.05). Total protein, calcium, magnesium and albumin showed more positive dynamics in the LS group too. This proves previous laboratory and clinical indices of expediency of LDA laparoscopy treatment under field conditions.

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Fujioka, Shuichi, Kazuhiko Yoshida, Tomoyoshi Okamoto, and Katsuhiko Yanaga. "Stapleless Laparoscopic Splenectomy Using Harmonic Scalpel by 2-Step Sealing." International Surgery 98, no. 4 (October 1, 2013): 385–87. http://dx.doi.org/10.9738/intsurg-d-13-00035.1.

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Abstract Laparoscopic splenectomy (LS) has been accepted as a safe and effective procedure as compared with open splenectomy. Recently, there have been a few reports on the LigaSure vessel sealing system as an alternative hemostasis to clip ligation. Here we report the experience of LS using an alternative energy device, Harmonic Scalpel laparoscopic coagulating shears (LCS). Preliminary experience of LS with LCS for a patient with idiopathic thrombocytopenic purpura (ITP) is reported. Generally, two-step sealing with LCS was used for vessels of the splenic pedicle approximately 5 mm in diameter without using the Endo-GIA stapler. Operative time was 93 minutes, and blood loss was 40 mL. The patient was discharged on the third postoperative day with no intraoperative or postoperative complications. The LS with LCS was performed safely using two-step sealing. Further experience is necessary to verify the safety of this procedure.

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Qu, Yikun, Jian Xu, Chengbin Jiao, Zhuoxin Cheng, and Shiyan Ren. "Long-Term Outcomes of Laparoscopic Splenectomy Versus Open Splenectomy for Idiopathic Thrombocytopenic Purpura." International Surgery 99, no. 3 (May 1, 2014): 286–90. http://dx.doi.org/10.9738/intsurg-d-13-00175.1.

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Abstract The long-term outcomes of laparoscopic splenectomy (LS) versus open splenectomy (OS) in patients with idiopathic thrombocytopenic purpura (ITP) are not known. A retrospective analysis of 73 patients who underwent splenectomy (32 LS and 41 OS) for refractory ITP between April 2003 and June 2012 was conducted. LS was associated with shorter hospital stay (P = 0.01), less blood loss and blood transfusion during surgery, quicker resumption of oral diet (P < 0.0001), and earlier drain removal (P < 0.01). Conversion to OS was required in 4 patients (12.5%). Operation time was significantly longer in LS (P < 0.0001). Deep venous thrombosis (DVT) was observed in 1 patient after LS and in 4 patients after OS (P = 0.52). One patient died from intraperitoneal bleeding after OS, another patient developed pulmonary embolism. Median follow-up of 36 months was performed in LS group (29 of 32, 91%) and of 46 months in OS group (35 of 41, 85%), 25 patients (86%) in LS group and 32 (91%) in OS group reached sustained complete response (P = 0.792). Kaplan-Meier analysis showed that there was no significant difference in the relapse-free survival rate between the groups (P = 0.777). In conclusion, the long-term outcome of laparoscopic splenectomy is not different from that of open splenectomy for patients with ITP.

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Ratti, Francesca, Andrea Casadei Gardini, Federica Cipriani, Guido Fiorentini, Federica Pedica, Valentina Burgio, Stefano Cascinu, and Luca Aldrighetti. "Laparoscopic Surgery for Intrahepatic Cholangiocarcinoma: A Focus on Oncological Outcomes." Journal of Clinical Medicine 10, no. 13 (June 26, 2021): 2828. http://dx.doi.org/10.3390/jcm10132828.

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Background: The aim of the present study was to analyze the long-term outcomes of laparoscopic and open surgery for intrahepatic cholangiocarcinoma (iCCA) in a series, collected in a tertiary referral center with a high annual volume of laparoscopic activity. Methods: Between January 2004 and June 2020, 446 liver resections (LR) were performed for iCCA: of these, 179 were performed by laparoscopic surgery (LS) and 267 with the open approach. The two groups were matched through a 1:1 propensity score using covariates representative of patient and disease characteristics. The study and control groups were compared, with specific attention given to oncological outcomes (rate of R0, depth of resection margins, overall and disease-free survival, rate, and site of recurrence). Results: The number of retrieved nodes, rate, and depth of negative resection margins were comparable between the two groups. The interval time between surgery and subsequent adjuvant treatments was significantly shorter in LS patients. No differences were shown even in the comparison between the LS and the open group in terms of median disease-free and overall survival. Moreover, the disease recurrence rate was comparable between the LS and the open groups (45.2% versus 56.7%), and the recurrence pattern was similar. Conclusions: The minimally invasive approach for iCCA was once again confirmed to be associated with advantages in terms of intraoperative and short-term outcomes, but was also proven to be oncologically non-inferior to the open counterpart. In the present study, overall and disease-free survival were found to be similar between the two approaches.

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Gomaa, Emad, and Magdy Khalil. "Splenectomy for haematological diseases: comparison between laparoscopic and open procedures." International Surgery Journal 4, no. 11 (October 27, 2017): 3599. http://dx.doi.org/10.18203/2349-2902.isj20174637.

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Background: In some hematological diseases, the spleen may become enlarged, inflamed and causes destruction of normal blood elements. Laparoscopic splenectomy (LS) was first prescribed in 1991 by Delaitre et al and since that date, it gained a steadily increasing worldwide agreement as an option for splenectomy in patients with hematological diseases. It was reported that this can be performed safely and effectively, with lower incidence of morbidity and mortality. The objective of the study was to compare laparoscopic with open splenectomy as regard its benefits and hazards in haematological diseases.Methods: This prospective study had been conducted in General Surgery Department, Sohag Faculty of Medicine. The study included patients with haematological diseases indicated for elective splenectomy, during the period from January 2015 to June 2017. Twenty patients were included for open surgery (OS) and 20 cases were included for laparoscopic splenectomy (LS).Results: Surgical time was significantly longer in LS than OS group. There was significant correlation between surgical time and splenic size in both groups. Most of the LS patients had been operated upon using the anterior approach (65%). Hospital stay after operation in the LS group was much less than the OS group. Return of off-bed activities, bowel movements, oral intake and drain removal were longer but not significantly different compared to LS figures.Conclusions: Laparoscopic splenectomy for haematological indications can be done safely for the properly selected patients with less blood loss and hospital stay but it requires more operative time as compared to conventional splenectomy.

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Levic, Katarina, and Orhan Bulut. "Robotic-assisted laparoscopic surgery in treatment of rectal cancer." Laparoscopic Surgery 2 (February 26, 2018): 3. http://dx.doi.org/10.21037/ls.2018.02.03.

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Claudio, Ricci, Alberici Laura, Casadei Riccardo, Minni Francesco, and Nardo Bruno. "Is laparoscopic liver surgery really safe in elderly patients?" Laparoscopic Surgery 2 (September 2018): 43. http://dx.doi.org/10.21037/ls.2018.09.03.

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Farhangmehr, Neda, and Donald Menzies. "Laparoscopic cholecystectomy: from elective to urgent surgery." Laparoscopic Surgery 5 (January 2021): 7. http://dx.doi.org/10.21037/ls-20-46.

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Somasundaram, SK, L. Massey, D. Gooch, J. Reed, and D. Menzies. "Laparoscopic splenectomy is emerging ‘gold standard’ treatment even for massive spleens." Annals of The Royal College of Surgeons of England 97, no. 5 (July 2015): 345–48. http://dx.doi.org/10.1308/003588414x14055925060479.

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Introduction Since its first description by Delaitre and Maignien in 1991, laparoscopic splenectomy (LS) has evolved as treatment of choice for mild-to-moderately-enlarged spleens and for benign haematological disorders. LS is a challenge if massive spleens or malignant conditions necessitate treatment, but we report our method and its feasibility in this study. Methods We undertook a retrospective study of prospectively collected data of all elective splenectomies carried out in our firm of upper gastrointestinal surgeons from June 2003 to June 2012. Only patients opting for elective LS were included in this study. Results From June 2003 to June 2012, elective splenectomy was carried out in 80 patients. Sixty-seven patients underwent LS and 13 underwent open splenectomy (OS). In the LS group, there were 38 males and 29 females. Age ranged from 6 years to 82 years. Spleen size in the LS group ranged from ≤11cm to 27.6cm. Twelve patients had a spleen size of >20cm. Weight ranged from 35g to 2,400g. Eighteen patients had a spleen weight of 600–1,600g and eight had a spleen weight >1,600g. Operating times were available for 56 patients. Mean operating time for massive spleens was 129.73 min. There was no conversion to OS. There were no major complications. Conclusions With improved laparoscopic expertise and advancing technology, LS is safe and feasible even for massive spleens and splenic malignancies. It is the emerging ‘gold standard’ for all elective splenectomies and has very few contraindications.

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Levi Sandri, Giovanni Battista, and Gabriele Spoletini. "The one hundred most-cited articles on laparoscopic liver surgery." Laparoscopic Surgery 1 (2017): 3. http://dx.doi.org/10.21037/ls.2017.12.01.

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Takahara, Takeshi, Go Wakabayashi, Yasushi Hasegawa, Hiroyuki Nitta, Hirokatsu Katagiri, Shouji Kanno, Akira Umemura, and Akira Sasaki. "Preoperative work-up for donor main consideration for laparoscopic surgery." Laparoscopic Surgery 4 (January 2020): 7. http://dx.doi.org/10.21037/ls.2019.12.02.

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Marsman, Hendrik A., and Martin C. Boonstra. "Clinical applications of fluorescence imaging in laparoscopic surgery." Laparoscopic Surgery 5 (July 2021): 27. http://dx.doi.org/10.21037/ls-21-11.

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Brethauer, S. A., S. Chalikonda, A. Dan, V. Nfonsam, C. Goncalves, S. Rosenblatt, A. Lichtin, and R. M. Walsh. "Long-term outcomes after laparoscopic splenectomy for splenomegaly." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 17527. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.17527.

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17527 Background: Numerous studies have demonstrated the feasibility of laparoscopic splenectomy (LS) for splenomegaly. There is little published data on the long-term efficacy of LS. The aim of this study is to determine long-term outcomes following LS for splenomegaly. Methods: Retrospective review of patients undergoing LS between 8/95 and 5/05. Splenomegaly was defined by CT criteria of craniocaudal length > 17 cm. Preoperative diagnoses included lymphoma in 13 patients (20%), leukemia in 15 (23%), autoimmune hemolytic anemia in 3 (5%) and other hematologic disorders in 8 (12%). 26 patients (40%) had no definitive diagnosis prior to splenectomy. Patients with ITP were excluded. Patient demographics, operative indications, operative morbidity and mortality, pathology, pre- and postoperative hematological indices were collected. Follow-up was obtained from patient records and telephone interviews. Results: 311 patients underwent LS during the study period. 65 patients underwent LS for splenomegaly. The mean age was 59 and 62% were male. There were no operative deaths. 7 patients (11%) were converted from LS to open. There were 9 (14%) major complications including 4 re-operations (3 for bleeding), 3 portal vein thromboses, 1 intra-abdominal abscess and 1 postoperative hemorrhage managed non-operatively. Thirty-two patients underwent LS primarily for diagnostic purposes. Nine had an existing hematologic disease and LS was performed to evaluate splenic involvement. LS confirmed a diagnosis in 19 (59%) patients including 11 lymphomas (34%). Thirty-three patients underwent LS primarily for treatment of either symptoms (33%) or cytopenias (66%). LS effectively treated mass symptoms in all patients. Among all patients 33 (51%) had associated cytopenias. At median f/u of 20 months 15 (45%) patients had no recurrence of cytopenias, 15 (45%) patients required further treatment and 3 were lost to follow up. One responder (7%) died of lymphoma 3 months after surgery without recurrence of cytopenia. The 15 non-responders had progression of disease requiring chemotherapy and transfusions and 9 (60%) died a median of 6 months after LS. Conclusions: LS is a valuable diagnostic and therapeutic tool for patients with splenomegaly and provides durable treatment for splenomegaly-associated cytopenias. No significant financial relationships to disclose.

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Zhang, Yang, Ryan W. Walters, and Peter T. Silberstein. "Factors affecting survival in laparoscopic vs. open surgery among stage III colon cancer patients." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e15095-e15095. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e15095.

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e15095 Background: The role of laparoscopic surgery (LS) in the cure of advanced non-metastatic colon cancer is controversial. The study aims to define long-term survival of LS and open surgery (OS) of stage III colon cancer as well as to examine factors that influence the choice in surgical approaches. Methods: We abstracted 22,821 patients from the National Cancer Database who were diagnosed with stage III colon cancer from 2010 to 2012 who had undergone surgery of their primary site by either LS or OS; we only included patients who had also received adjuvant chemotherapy. The probability of undergoing a LS or OS was estimated using multivariable marginal logistic regression model, whereas the between-procedure survival difference was estimated with the Kaplan-Meier method with associated log-rank test and a multivariable marginal Cox regression model. Results: Holding the patient- and facility-level characteristics constant, significantly greater odds of receiving LS was associated with private insurance, patients living in areas with higher socio-economic status, patients receiving care at academic facilities, and patients living in the northeast United States. Kaplan-Meier results indicated that patients undergoing LS had significantly longer survival compared to patients undergoing OS (χ21 = 111.6, p < .001). Table 1 shows three-year survival estimates. After adjusting for the patient- and facility-level covariates, patients who underwent LS had 26.7% lower risk of death compared to those undergoing OS (95% CI: 21.7% to 31.4%, p < .001). In general, lower adjusted risk of death was observed in patients who were younger, female, as well as patients with fewer comorbid conditions and those with private insurance (all p< .05). Conclusions: In this largest, most recent analysis of surgical treatment of stage III colon cancer, our data suggest that long-term survival after LS is superior to conventional OS. Identification of associated demographic factors may prove useful for future allocation of treatment resources. [Table: see text]

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Vennarecci, Giovanni, Nicola Guglielmo, and Giuseppe Maria Ettorre. "Insights in laparoscopic surgery of mucinous cystic neoplasm of the liver." Laparoscopic Surgery 2 (May 2018): 24. http://dx.doi.org/10.21037/ls.2018.04.12.

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Machairas, Nikolaos, and Georgios C. Sotiropoulos. "The impact of obesity on laparoscopic liver surgery: a critical reappraisal." Laparoscopic Surgery 2 (May 2018): 27. http://dx.doi.org/10.21037/ls.2018.05.04.

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Yohanathan, Lavanya, and Sean Cleary. "Assessment of applicability of laparoscopic liver resection after previous abdominal surgery." Laparoscopic Surgery 2 (October 2018): 45. http://dx.doi.org/10.21037/ls.2018.09.04.

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Marino, Marco Vito. "Robotic-assisted versus laparoscopic liver surgery: is it the correct direction?" Laparoscopic Surgery 3 (January 2019): 1. http://dx.doi.org/10.21037/ls.2019.01.01.

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Reddy, V. Seenu, Ho H. Phan, James A. O'Neill, Wallace W. Neblett, John B. Pietsch, Walter M. Morgan, Robert Cywes, and George W. Holcomb. "Laparoscopic versus Open Splenectomy in the Pediatric Population: A Contemporary Single-Center Experience." American Surgeon 67, no. 9 (September 2001): 859–64. http://dx.doi.org/10.1177/000313480106700909.

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The purpose of this study was to compare a recent contemporaneous experience between laparoscopic (LS) and open (OS) splenectomy in children. All splenectomy cases between 1994 and 1999 at our institution were reviewed. The study included open and laparoscopic cases performed according to surgeon preference. Emergency splenectomies for trauma were excluded. The patient record was reviewed for the diagnosis, indications, postoperative length of stay, operative technique, postoperative complications, blood loss/blood transfusion, total amount of parenteral narcotics, and time to resumption of oral intake. Chi-square and t tests were used to compare measured differences for statistical significance. Between May 1994 and December 1999, 52 splenectomies were performed at Vanderbilt Children's Hospital. Of these, 45 were elective operations with 29 open and 16 laparoscopic procedures. During four OS and five LS operations a concomitant cholecystectomy was performed. The median patient age was 9.2 years (range 0.5 to 17.3). There was no statistical difference between the two groups in terms of age, weight, American Society of Anesthesiologists class, or estimated blood loss. There were no immediate postoperative complications in either group. There were no conversions from LS to OS. The mean duration of surgery was 264 minutes (LS) versus 169 minutes (OS) ( P < 0.05). The average time to first oral intake was shorter in patients undergoing LS (1.1 vs 1.6 days, P < 0.05) and the mean postoperative length of stay was also shorter in the LS group (1.3 vs 3.1 days, P < 0.05). The use of postoperative intravenous narcotics (in morphine-equivalent doses) was significantly less in LS patients than in OS patients (7.5 mg or 0.15 mg/kg vs 46.9 mg or 1.5 mg/kg, P < 0.001), as was the need for PCA pump analgesia (90% in the OS group vs 25% in LS group, P < 0.01). Overall the average hospital charge (anesthesia fee, narcotics charge, and hospital room charge) was $5400 (range $4240–6250) in the OS group and $4950 (range $4450–6240) in the LS group ( P < 0.05). Among the nine patients undergoing splenectomy with cholecystectomy, findings between the OS and LS groups were similar except for one late complication consisting of a diaphragmatic hernia in an LS patient. Both LS and OS with or without a concomitant procedure can be accomplished safely in children. LS appears to result in longer operative times but shorter lengths of stay, earlier first oral intake, and significantly fewer requirements for intravenous narcotics; all of these contribute to a reduction in hospital charges compared with the open operation.

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Razumovskiy, A. Yu, Z. B. Mitupov, N. V. Kulikova, N. S. Stepanenko, A. S. Zadvernyuk, E. A. Titova, and N. V. Shubin. "Minilaparotomy in the treatment of choledochal malformations in children." Russian Journal of Pediatric Surgery 25, no. 3 (July 20, 2021): 165–73. http://dx.doi.org/10.18821/1560-9510-2021-25-3-165-173.

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Introduction. The article presents the analysis of surgical treatment of children with choledochal malformations (CM) with mini-laparotomy and laparoscopy techniques.Purpose. The aim of the study is to improve outcomes of surgical treatment of choledochal malformations in children.Material and methods. For the last ten years (January 2010 - May 2020), 84 children with choledochal malformations (CM) (n = 84) were operated on with different surgical techniques in our hospitals. Group 1 - patients who had Roux-en-Y hepaticojejunoanastomosis (RYHJ, n = 68, 81%); Group 2 - patients who had hepaticoduodenoanastomosis (HD, n = 16, 19%). The authors compared outcomes because Roux-en-Y hepaticojejunostomosis and hepaticoduodenanastomosis were formed under mini-laparotomic (ML) and laparoscopic (LS) accesses. Surgical time, short-term and long-term postoperative outcomes were assessed.Results. The groups were comparable in gender, age, clinical manifestations, CM complications before surgery, comorbidities (p > 0.05). A statistically significant (p = 0.0000001, Mann–Whitney U-test) decrease in the surgical time was revealed when using mini-laparotomy access. Independent defecation appeared 3 times faster in the subgroup with mini-laparotomy and Roux-en-Y hepaticojejunostomy (ML RYHJ) than in the subgroup of laparoscopic Roux-en-Y hepaticojejunostomy (LS RYHJ) (p = 0.033, Mann–Whitney U-test), mainly due to early enteral loading in the first subgroup (on 0-1 postoperative day). Long-term postoperative outcomes in laparoscopic subgroups revealed a statistically insignificant (p> 0.05) prevalence of 4 anastomotic stenosis requiring repeated surgical interventions. Good outcomes were seen in 90% of patients after ML RYHJ (p = 0.002, Pearson’s Chi-square with Yates’ correction) versus 52.6% after LS RYHJ.Conclusion. Currently, laparoscopy is not a method of choice in children with CM due to the development of short-term and long-term postoperative complications. Minilaparotomy gives promising results in pediatric CM and can be “a gold standard” in the treatment of children with this pathology.

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Fadipe, Adetokunbo, David Wilkinson, Robert Peters, Catherine Doherty, and Nick Lansdale. "Laparoscopic splenectomy: how minimal can we make it?" Journal of Pediatric Endoscopic Surgery 4, no. 1 (January 13, 2022): 9–12. http://dx.doi.org/10.1007/s42804-021-00125-6.

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Abstract Aims Laparoscopic splenectomy (LS) is routinely performed in children, however, a large spleen in a small child can pose significant operative challenges. We instigated a highly standardised surgical and anaesthetic approach to LS to minimise surgical trauma and enhance recovery. The aim of this study was to assess the outcomes of this programme. Methods Prospective study of all LS’s performed 2018–2021. Surgical approach was via one 10 mm and three 5 mm ports. Early hilar control was accomplished with Hem-o-loks. Splenic retrieval via the 10 mm incision used finger morcellation within an Espiner EcoSac. Anaesthesia utilised a standardised regime of agents and bupivacaine was infiltrated to the splenic bed and wound sites. Post-operative opiates were minimised. Data are presented as median [IQR]. Results Twenty consecutive children were included. Indications for LS were hereditary spherocytosis (n = 12), sickle cell disease (n = 6), beta-thalassaemia (n = 1) and splenic haemangiomatosis (n = 1). Age at surgery was 101 months [75–117] and weight 30 kg [21–37]. Splenic size was 13.4 cm [12–14.4]. Operative time was 178 min [156–185]. There were no open conversions and no significant intra or post-operative bleeding. One patient developed pancreatitis. Median post-operative pain score was 1 [1–3]. Median length of stay was 2 days [2–3]. Conclusion LS is feasible, safe and efficient in smaller children with large spleens. This standardised programme of anaesthesia and surgery based around a core team reliably results in few complications, good analgesia and short length of stay.

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Capozzi, Vito Andrea, and Stefano Cianci. "Laparoscopic surgery for ovarian cancer: limits and potentials." Gynecology and Pelvic Medicine 3 (September 2020): 15. http://dx.doi.org/10.21037/gpm-2020-ls-06.

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Liu, Donald C., Michael O. Meyers, Charles B. Hill, and William A. Loe. "Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans." American Surgeon 66, no. 12 (December 2000): 1168–70. http://dx.doi.org/10.1177/000313480006601216.

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Minimally invasive surgery has recently gained acceptance as the surgical approach of choice for a variety of surgical disorders in children. Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few cases of successful laparoscopic splenectomy (LS) have been reported. We present our initial 11 cases of LS in children assessing surgical outcome. Eleven patients ages 2 through 15 years underwent LS between June of 1996 and July of 1999 at the Children's Hospital of New Orleans. Indications for surgery included idiopathic thrombocytopenic purpura, congenital spherocytosis, and hemolytic anemia. In all patients the diameter of the spleen was less than 15 cm. Surgical outcome was assessed according to the following parameters: operative time, postoperative length of stay, postoperative morbidity, and cosmetic results. Data were accumulated on the basis of retrospective chart review. LS was completed in all 11 patients. Postoperative morbidity was minimal and the median postoperative stay was 2.4 days (range 1–5). Mean operative time was 3 hours and 10 minutes (range 1.5–7 hours) with the last six procedures completed in an average of just over 2 hours. Intravenous analgesia was discontinued in <48 hours in all patients. Cosmetic results were judged excellent in all cases. We conclude that LS was safe in children with certain hematologic disorders. Adequate selection of patients, appropriate preoperative preparation of patients, meticulous surgical technique, and careful postoperative care were key factors in obtaining the same long-term results as with open surgery.

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White, Michael G., and Brian D. Badgwell. "Laparoscopic Heated Intraperitoneal Chemotherapy in the Treatment of Carcinomatosis of Gastric Adenocarcinoma Origin." Journal of Clinical Medicine 10, no. 20 (October 17, 2021): 4757. http://dx.doi.org/10.3390/jcm10204757.

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The use of heated intraperitoneal chemotherapy (HIPEC) in conjunction with cytoreductive surgery has been gaining increasing traction in treating gastric adenocarcinoma with metastasis to the peritoneum in recent years. The addition of laparoscopic HIPEC (LS-HIPEC) to these treatment algorithms has increased the flexibility and adaptability of HIPEC integrating into treatment sequencing, allowing for iterative protocols of LS-HIPEC prior to cytoreduction as neoadjuvant treatment, as well as in the palliation of patients with unresectable disease and uncontrolled ascites. As the use of HIPEC in gastric adenocarcinoma continues to be refined, LS-HIPEC algorithms should continue to be considered and utilized both in curative treatment algorithms as well as in patients in the palliative setting. Given that LS-HIPEC remains a relatively nascent treatment modality, we advocate for its use in the setting of a clinical trial when feasible.

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Lehavi, Amit, Boris Livshits, and Yeshayahu Katz. "Effect of position and pneumoperitoneum on respiratory mechanics and transpulmonary pressure during laparoscopic surgery." Laparoscopic Surgery 2 (November 2018): 60. http://dx.doi.org/10.21037/ls.2018.10.13.

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Velotti, N., M. Manigrasso, K. Di Lauro, A. Vitiello, G. Berardi, D. Manzolillo, P. Anoldo, et al. "Comparison between LigaSure™ and Harmonic® in Laparoscopic Sleeve Gastrectomy: A Single-Center Experience on 422 Patients." Journal of Obesity 2019 (January 3, 2019): 1–5. http://dx.doi.org/10.1155/2019/3402137.

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Background. New laparoscopic devices, such as electrothermal bipolar-activated devices (LigaSure™ (LS)) or ultrasonic systems (Harmonic® scalpel (HS)), have been applied recently to bariatric surgery allowing to reduce blood loss and surgical risks. The aim of this study was to retrospectively compare intraoperative performance of HS and LS, postoperative results, and clinical outcomes in a large cohort of patients undergoing LSG. Methods. Data from 422 morbidly obese patients undergoing LSG in our Bariatric Unit at the Advanced Biomedical Sciences Department of the “Federico II” University of Naples (Italy) between January 2009 and December 2017 were retrospectively analyzed. Subjects were divided into two groups (HS and LS), and operative time, intraoperative complications, and postoperative (within 30 days from surgery) complications were compared. Bleeding from the omentum or from the staple line, use of hemostatic clips, and absorbable hemostat were recorded as intraoperative complications; hemorrhages, abscess formation, gastric leaks, fever, and mortality were considered as postoperative complications. Results. Statistical analysis showed no difference in terms of baseline demographics between the two cohorts. Operative time (48 ± 9 vs 49 ± 6 min, p=0.646) and the rates of intraoperative and postoperative complications did not significantly differ between groups. Conclusion. Harmonic® and LigaSure™ are both useful tools in bariatric surgery, and these two advanced power devices are user-friendly and can facilitate surgeon work; from this point of view, the choice of the energy device should be based on the preference of the surgeon and on the hospital costs policy and availability.

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Guillotreau, J., X. Gamé, M. Mouzin, N. Doumerc, B. Malavaud, and P. Rischmann. "Oncological outcomes of radical cystectomy for bladder cancer: Laparoscopy versus open surgery." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e16059-e16059. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e16059.

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e16059 Background: To compare the oncological outcomes of laparoscopic versus open surgery in radical cystectomy for bladder cancer. Methods: A prospective non-randomized study was conducted between January 2003 and November 2008 in 52 patients, 2 women and 50 men, who underwent radical cystectomy for bladder cancer. Thirty seven cystectomies were carried out by laparoscopic surgery (LS) and 15 by open surgery (OS). Mean patient age was 67.3 ± 9.7 years. The median preoperative ASA score was 2 (1–3) in both groups. Kaplan-Meier curves were constructed to estimate the survival rate for the whole sample. Datas were compared by Log-rank test. Current followup, overall and specific deaths were used as endpoints. The survival time was defined as the time elapsed from the date of radical cystectomy to the endpoint. Results: All tumours were transitional cell carcinoma, high-grade and stage < pT3b pN0. One patient of OS group had a positive surgical margin. Eight patients (15.4%), 7 of LS group and 1 of OS group, completed 5 years of follow-up. At the last follow-up 40 patients (76.9%) were alive with no evidence of disease and 5 (9.6%) died, two patients (3.8%) from metastasis and 3 (5.7%) from different causes. No patient developed port- site metastasis. Overall survival was significantly better in LS group than in the OS group (p=0.039). No statistical difference was noted for Specific survival. Mean patient follow-up was 30.9 ± 20.3 months. Conclusions: The data suggest that LRC provides oncological outcomes comparable to contemporary series of open RC. No significant financial relationships to disclose.

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Doi, Ryuichiro, Eiji Toyoda, Kazuhiko Kitaguchi, Yusuke Abe, and Tetsuro Hirose. "Near-infrared intraoperative imaging of pancreatic neuroendocrine tumors: a new era in laparoscopic pancreatic surgery." Laparoscopic Surgery 2 (May 2018): 29. http://dx.doi.org/10.21037/ls.2018.05.02.

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Sucandy, Iswanto, and Andres Giovannetti. "Advantages of robotic over laparoscopic liver surgery—lesson learned from a high-volume medical center." Laparoscopic Surgery 3 (August 2019): 31. http://dx.doi.org/10.21037/ls.2019.07.10.

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Reddy, Sanjay S., Elin R. Sigurdson, and Jeffrey M. Farma. "Treatment of colorectal cancers with minimally invasive surgical techniques at a dedicated cancer center." Journal of Clinical Oncology 31, no. 4_suppl (February 1, 2013): 549. http://dx.doi.org/10.1200/jco.2013.31.4_suppl.549.

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549 Background: Laparoscopic (LS) and robotic surgery (RS) for colorectal cancer provides a new perspective of the deep pelvis. Our goal was to identify the role of LS and RS for patients with sigmoid and rectal cancer. Methods: We retrospectively analyzed 53 patients treated from 2007-2012. Resection type, previous surgery, neoadjuvant and adjuvant therapy, timing of surgery, lymph nodes (LN) harvested, estimated blood loss (EBL), operative time (OT), complications, and pathology were reviewed. Results: Of 53 patients, 32 underwent LS, and 18 RS. There were 47 patients with adenocarcinoma, 5 with unresectable polyps and 1 with anal melanoma. 62% of patients underwent a recto-sigmoid resection, 23% rectal, and 8% sigmoid. 32% had prior surgery. Neoadjuvant treatment (NAT) was initiated in 31 patients; 3 received chemotherapy without radiation, and 1 short course radiation. An average of 12.8 and 8.4 LN were harvested in the LS and RS groups respectively, with a mean of 9.9 LN after NAT, and 13.9 without. EBL was 155ml (20-650) with LS and 178ml (25-600) with RS. 3 LS cases were converted to an open procedure. Median OT was 270 and 302 minutes for LS and RS groups. Using the Clavien grading system, 12 patients had grade 1-2 complications, 5 grade 3, and 2 grade 4’s within 30 days. Radial margins were positive in 2 patients; one received NAT for a fungating anal adenocarcinoma, and the other had chemotherapy alone. One patient had a positive proximal margin with no prior therapy. Rate of complete pathological response (pCR) was 35%, and 71% were down staged. The mean interval between completion of NAT and resection was 8 weeks (range 4-12), and surgery to adjuvant therapy was 8 weeks (range 4-22). Conclusions: LS and RS surgery for colorectal cancer can be safely performed in conjunction with neoadjuvant and/or adjuvant chemotherapy. NAT should not preclude adoption of these techniques, as we achieved a 35% pCR with minimal operative morbidity allowing patients to proceed to adjuvant chemotherapy in a timely fashion. [Table: see text]

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Kwiatkowska, Radkowiak, Wysocki, Torbicz, Gajewska, Lasek, Kulawik, Budzyński, and Pędziwiatr. "Prognostic Factors for Immune Thrombocytopenic Purpura Remission after Laparoscopic Splenectomy: A Cohort Study." Medicina 55, no. 4 (April 18, 2019): 112. http://dx.doi.org/10.3390/medicina55040112.

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Background and Objectives: Laparoscopic splenectomy (LS) has become the gold standard for patients with immune thrombocytopenic purpura (ITP). The total remission rate after splenectomy is 70%–90%, of which 66% is long-term. Despite this high response rate, some patients do not benefit from surgery. It is therefore important to try to identify risk factors for an unsatisfactory clinical response. The aim of this study was to assess long-term outcomes of LS for ITP and identify factors associated with increased disease remission rates. Materials and Methods: We retrospectively studied consecutive patients with ITP undergoing LS in a tertiary referral surgical center prospectively recorded in a database. Inclusion criteria were: Elective, laparoscopic splenectomy for diagnosed ITP, and complete follow-up. The cohort was divided into two groups—Group 1 (G1) patients with ITP remission after splenectomy and Group 2 (G2) patients without remission. There were 113 G1 patients and 52 G2 patients. Median follow-up was 9.5 (IQR: 5–15) years. Results: In univariate analysis, patient’s age, body mass index (BMI), preoperative platelet count, the need for platelet transfusions, and presence of hemorrhagic diathesis were shown to be statistically significant factors. Next, we built a multivariate logistic regression model using factors significant in univariate analysis. Age <41 years (odds ratio (OR) 4.49; 95% CI: 1.66–12.09), BMI <24.3 kg/m2 (OR: 4.67; 95% CI: 1.44–15.16), and preoperative platelet count ≥97 × 103/mm3 (OR: 3.50; 95% CI: 1.30–9.47) were shown to be independent prognostic factors for ITP remission after LS. Conclusion: The independent prognostic factors for ITP remission after LS revealed in our study are: age <41 years, BMI <24.3 kg/m2, and preoperative platelet count ≥97 × 103/mm3. Duration of the ITP and the time of treatment are not related to remission after LS.

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Tian, Guangjin, Deyu Li, Haibo Yu, Yadong Dong, and Huanzhou Xue. "Splenic Bed Laparoscopic Splenectomy Approach for Massive Splenomegaly Secondary to Portal Hypertension and Liver Cirrhosis." American Surgeon 84, no. 6 (June 2018): 1033–38. http://dx.doi.org/10.1177/000313481808400661.

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This study was performed to evaluate the feasibility of the splenic bed laparoscopic splenectomy approach (SBLS) for massive splenomegaly (≥30 cm) in patients with hypersplenism secondary to portal hypertension and liver cirrhosis. Patients who underwent laparoscopic splenectomy (LS) from January 2012 to December 2016 were retrospectively reviewed. We performed LS in 83 patients with massive splenomegaly (≥30 cm) secondary to portal hypertension and liver cirrhosis. Of these patients, 37 underwent the SBLS and 46 underwent anterior LS (ALS). Five patients in the ALS group and none in the SBLS group underwent conversion to open surgery. The operation time, intraoperative blood loss volume, transfusion volume, frequency of transfusion, hemorrhage of short gastric vessels, conversion rate, postoperative hospital stay, and incidence of pancreatic fistula were all significantly lower in the SBLS than ALS group (all P < 0.05). No death or postoperative bleeding occurred in the two groups, and there were no significant differences in age, gender, spleen size, hemoglobin level, platelet count, prothrombin time, Child-Pugh class, hypoproteinemia, or ascites (all P > 0.05). The SBLS is more feasible and effective than ALS in patients with massive splenomegaly (≥30 cm) secondary to portal hypertension and liver cirrhosis.

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Wysocki, Michał, Dorota Radkowiak, Anna Zychowicz, Mateusz Rubinkiewicz, Jan Kulawik, Piotr Major, Michał Pędziwiatr, and Andrzej Budzyński. "Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases." Journal of Clinical Medicine 7, no. 12 (December 14, 2018): 547. http://dx.doi.org/10.3390/jcm7120547.

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Prediction of intraoperative difficulties may be helpful in planning surgery; however, few studies explored this issue in laparoscopic splenectomy (LS). We performed retrospective analysis of consecutive 468 patients undergoing LS from 1998 to 2017 (295 women; median age 47 years). The patients were divided into difficult LS and control groups. The inclusion criteria for difficult LS were operative time ≥mean + 2SD; intraoperative blood loss ≥500 mL, intraoperative adverse events (IAE), conversion. Primary outcomes were risk factors for difficult splenectomy and secondary outcomes for perioperative morbidity. Fifty-six patients were included in the difficult LS group (12%). Spleens ≥19 cm and higher participation of younger surgeons in consecutive years were predictive for difficult splenectomy. Age ≥53 years and diagnosis other than idiopathic thrombocytopenic purpura (ITP) were independent risk factors of spleen ≥19 cm. The perioperative morbidity was 8.33%; its OR was increased only by blood loss and IAEs. Only blood loss significantly increased serious morbidity. Male sex, spleens ≥19 cm, and IAEs were independent risk factors for intraoperative hemorrhage. Spleen length ≥19 cm was a risk factor for difficult LS and intraoperative hemorrhage. Diagnoses other than ITP in patients aged ≥53 years with ≥19 cm spleens are predictive for intraoperative difficulties and perioperative complications.

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Mori, Toshiyuki, and Yoshihiro Sakamoto. "The role of laparoscopic adhesiolysis in the management of acute small bowel obstruction due to previous surgery." Laparoscopic Surgery 3 (December 2019): 52. http://dx.doi.org/10.21037/ls.2019.11.08.

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Vysotskiy, M. M., I. I. Kuranov, and O. B. Nevzorov. "Indicators of the reproductive function after endoscopic surgical treatment of uterine myomas." Obstetrics, Gynecology and Reproduction 13, no. 4 (January 16, 2020): 297–304. http://dx.doi.org/10.17749/2313-7347.2019.13.4.297-304.

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Aim: to characterize the function of the reproductive system in women after organ-preserving surgery for uterine myoma: hysteroresectoscopic (HRS) myomectomy and laparoscopic (LS) myomectomy.Materials and methods. Forty one patients were examined and divided into 2 groups: Group 1 – 18 patients after HRS myomectomy and Group 2 – 23 patients after LS myomectomy. The control group included 20 healthy women of reproductive age.Results. The HRS operation led to a significant decrease in the production of anti-Mullerian hormone (AMH), estradiol and progesterone, while the levels of luteinizing (LH) and follicle-stimulating (FSH) hormones increased. After myomectomy performed by the laparoscopic access, the levels of estradiol, progesterone, and AMH decreased but the levels of both LH and FSH increased so that the ratio LH/FSH remained unchanged. Almost all indices of gonadotropic and steroid hormone production became normalized over 6 months of the postoperative period.Conclusion. The main factors of unfavorable prognosis in patients with ovarian tecoma are tumor necrosis, degree of malignancy and mitotic activity.

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Braunwarth, Eva M., Alexander Perathoner, Stefan Stättner, and Manuel Maglione. "Laparoscopic liver surgery for colorectal liver metastases—a narrative review of the recent literature." Laparoscopic Surgery 5 (April 2021): 20. http://dx.doi.org/10.21037/ls-20-106.

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Yatabe, Yusuke, Daisuke Uehira, Koji Yonekura, Takahiro Toyofuku, Ayano Murakata, Takayuki Osanai, Hideaki Tanami, Eigo Satoh, and Norihide Sugano. "Laparoscopic appendectomy after kidney transplantation: a case report." Laparoscopic Surgery 6 (April 2022): 20. http://dx.doi.org/10.21037/ls-22-27.

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Bark Awadh Abood, Hashem, Bader Saad S Alshahrani, Amal Yasir Alyousif, Abdulaziz Ibrahim Alkhudairy, Aisha Mubarak B Alghamdi, Sultan Oraiban A. Gohal, Maram Abdualrhman AlMedaires, et al. "Surgical Management of Benign Neoplasms of the Small Intestine." Saudi Medical Horizons Journal 2, no. 3 (November 24, 2022): 113–17. http://dx.doi.org/10.54293/smhj.v2i3.51.

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Small intestinal benign tumours are uncommon clinical conditions that frequently go asymptomatic for the entirety of a patient's life. The small bowel contains only a tiny number of primary neoplasms, while making up most of the surface area and most of the length of the gastrointestinal (GI) tract. There are the following subtypes: Hyperplastic polyps, hamartomas, adenoma, stromal tumours, lipomas, hemangiomas, and patients who have Peutz-Jeghers syndrome. Clinically, speaking, benign small-bowel lesions are distinguished by the absence of distinguishing symptoms. Up to the proximal duodenum lesions can be diagnosed with enteroscopy. Push or double-balloon enteroscopy methods can be used to reach the GI tract beyond the ligament of Treitz. The sole method of treatment for those who have small bowel adenocarcinoma is surgery. The majority of research state that between 40 and 65 percent of patients lend themselves to curative resection. The utilisation of laparoscopic surgery (LS) for small intestine gastrointestinal stromal tumours (GISTs) has expanded with the introduction of LS. There is currently no evidence to suggest a statistically significant difference between LS and open surgery in terms of prognosis. This review aims to summarize evaluation and management of benign neoplasms of the small intestine.

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Colan, Jacinto, Ana Davila, and Yasuhisa Hasegawa. "A Review on Tactile Displays for Conventional Laparoscopic Surgery." Surgeries 3, no. 4 (November 25, 2022): 334–46. http://dx.doi.org/10.3390/surgeries3040036.

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Laparoscopic surgery (LS) is a minimally invasive technique that offers many advantages over traditional open surgery: it reduces trauma, scarring, and shortens recovery time. However, an important limitation is the loss of tactile sensations. Although some progress has been made in robotic-assisted minimally invasive surgery (RMIS) setups, RMIS is still not widely accessible. This review aims to identify which tactile display technologies have been proposed and experimentally validated for the restoration of tactile sensations during conventional laparoscopic surgical tasks. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified relevant articles published over the past 10 years through a search on Web of science, Scopus, IEEE Xplore Digital, and PubMed repositories. A total of 143 articles met the inclusion criteria and 24 were included in the final review. From the reviewed articles, we classified the proposed tactile displays into two categories based on the use of skin contact: (i) skin tactile displays, which include vibrotactile, skin-indentation, and grip-feedback devices, and (ii) non-contact tactile displays based on visualization tools. This survey aims to contribute to further research in the area of tactile displays for laparoscopic surgery by providing a better understanding of the current state of the art and identifying the remaining challenges.

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Şanal Baş, Sema, Gülay Erdoğan Kayhan, Meryem Onay, and Yeliz Kılıç. "Uncuffed Endotracheal Tube Experience in Pediatric Patients with Laparotomy and Laparoscopic Surgeries." BioMed Research International 2020 (May 9, 2020): 1–5. http://dx.doi.org/10.1155/2020/6325293.

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Aim. The aim of this study is to compare endotracheal tube leak, tube selection, mechanical ventilation, and side effects in the use of uncuffed tubes in both laparoscopic and laparotomy surgeries in pediatric patients. Material and Method. Patients who underwent laparotomy (LT group) or laparoscopic (LS group) surgery between 1 and 60 months. In the selection of uncuffed tubes, it was also planned to start endotracheal intubation with the largest uncuffed tube and to start intubation with a small uncuffed tube if the tube encounters resistance and does not pass. Mechanical parameters, endotracheal tube size, tube changes, and side effects are recorded. Results. A total of 102 patients, 38 females and 64 males, with a mean age of 10.9±8.1 months, body weight 7.1±3.7 kg, and height 67±15 cm, were included. 54 patients underwent laparoscopic surgery, and 48 patients underwent laparotomy. Tube exchange was performed in a total of 18 patients. In patients who underwent tube exchange, 11 patients were intubated with a smaller ETT number and others endotracheal intubation; when the MV parameters were TVe<8 ml/kg and ETT leak>20%, a larger uncuffed tube was used due to PIP 30 cmH2O pressure. Patients with aspiration were not found in the LT and LS groups. There was no difference in the intergroup evaluation for postoperative side effects such as cough, laryngospasm, stridor, and aspiration. Conclusion. There was no significant difference between the groups in terms of tube changes and side effects. So that we can start with the largest possible uncuffed tube to decrease ETT leak, both laparotomy and laparoscopic operations in children can be achieved with safe mechanical ventilation and target tidal volume.

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Barabino, Matteo, Gaetano Piccolo, and Enrico Opocher. "Laparoscopic thermal ablation for colorectal liver metastases: technical tips and pitfalls." Laparoscopic Surgery 6 (April 2022): 19. http://dx.doi.org/10.21037/ls-22-12.

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Barabino, Matteo, Gaetano Piccolo, and Enrico Opocher. "Laparoscopic thermal ablation for colorectal liver metastases: technical tips and pitfalls." Laparoscopic Surgery 6 (April 2022): 19. http://dx.doi.org/10.21037/ls-22-12.

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Svensson, Magnus, Mikael Wiren, Eva Kimby, and Hans Hagglund. "Portal Vein Thrombosis a Common Complication Following Splenectomy in Adults Patients with CLL or Myeloproliferative Disease." Blood 104, no. 11 (November 16, 2004): 4041. http://dx.doi.org/10.1182/blood.v104.11.4041.4041.

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Abstract Elective laparoscopic splenectomy (LS) is performed with increasing frequency in relation to open splenectomy (OS). The advantage with LS is reduced morbidity. Moreover, this method is feasible also in patients with splenomegaly, a patient group with more postoperative complications as bleeding, infections and portal vein thrombosis. Portal vein thrombosis (PVT) is a rare but serious complication of splenectomy. We retrospectively reviewed the medical records of 69 consecutive patients splenectomized for haematological diseases during a five-years period (Jan 1999 to Dec 2003) at the Dep. of Surgery Huddinge University Hospital, with the aim of comparing the results and complications after LS and OS, with focus on thromboembolic events. The follow-up for all patients was performed Jan 31. 2004. Thirty-nine patients underwent LS and 30 OS. There were three conversions (7.7%) from laparoscopic to open surgery due to bleeding and splenomegaly. Accessory spleens were found in 16 of 69 (23%) patients, 6 of 39 (15%) in LS and 10 of 30 (33%) in OS. Thromboembolic complications were seen in seven patients; a) deep vein thromboses in the lower leg in two patients with ITP, both with LS and neither had received thromboprophylaxis, b) PVT in five patients, one after LS and four after OS; three with CLL, (two with a concomitant haemolytic anaemia) and two with a myeloproliferative disease. The five patients with PVT had all splenomegaly and had received thromboprophylaxis with low-molecular-weight heparin. PVT was diagnosed from day 6 to day 111 after splenectomy. Three of the five patients had thrombocytosis, 478, 740 and 1459x 10(9) at the time of PVT-diagnosis. In all the splenectomized patients, two patients had overwhelming post splenectomy sepsis (OPSI). One patient with Evans syndrom died of E. coli sepsis four months after splenectomy and one patient with myelofibrosis had severe pneumococksepsis 44 months after splenectomy. Both had recieved preoperative pneumocock vaccination. Further seven patients died during the follow-up period, five due to infections and bleedings, in all related to progressive malignant lymphoma. One patient died of sudden cardiac arrest 15 months postoperative, and one patient performed suicide. Conclusions: Portal vein thrombosis after splenectomy was seen in 13.5 % of patients with haematological malignancies despite thromboprophylaxis. Patients with splenomegaly and myeloproliferative disease or CLL with haemolytic anaemia have high risk of PVT. We recommend careful observation of postoperative thrombocytosis and extended thromboprophylaxis. Ultrasonography or CT should be considered in all patients with abdominal symtoms after splenectomy. Patients should receive pneumocockvaccination and be informed of the lifelong risk of severe infections.

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He, Zhiming, Tao Tian, and Chloe Sto. "Analysis of Postoperative Complications in Patients with Intestinal Obstruction Under Laparoscopic Information Technology." Journal of Medical Imaging and Health Informatics 10, no. 9 (August 1, 2020): 2142–47. http://dx.doi.org/10.1166/jmihi.2020.3157.

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In order to explore the postoperative complications of laparoscopic adhesive release in the treatment of intestinal obstruction, 70 patients with adhesive intestinal obstruction (IO) who visited Banan District People’s Hospital on March 1, 2017 and received surgical treatment on June 30, 2019 were selected as the research objects. The patients were divided into an experimental group (EG) and control group (CG) using random number table, 35 cases in each group. The EG accepted laparoscopic adhesion release, while the CG accepted laparotomy. The time spent during the operation, intraoperative blood loss (IBL), intestinal injury rate and intestinal resection rate, postoperative anal exhaust (PAE) time, hospital stay, feeding time and concurrent symptoms were recorded and compared between the two groups. Multivariate Logistic regression (MLR) model was adopted for the correlation analysis between symptoms after laparoscopic surgery (LS) and basic characteristics of patients and intraoperative information. It was found that the time of LS, IBL, PAE time, hospital stay and feeding time of the EG are greatly lower than that of the CG (P < 0.05). The number of cases of intestinal injury and intestinal resection in the EG was lower than that in the CG. The incidence of intestinal fistula, pulmonary infection, intestinal paralysis, incision infection, renal dysfunction and malnutrition in the EG was also lower than that in the CG. The regression coefficients of concurrent symptoms of LS and operative time and IBL were 0.376 and 0.343, respectively, showing a significant positive correlation (P < 0.05), which indicated that compared with traditional laparotomy, laparoscopic technique can effectively reduce the occurrence of complicated intestinal fistula, pulmonary infection, intestinal paralysis, incision infection, renal dysfunction, malnutrition, and so on. At the same time, ligation and frequent replacement of surgical instruments should be avoided as far as possible during the operation, and the occurrence of concurrent symptoms can be effectively decreased by reducing the operation time, IBL, and postoperative recovery time of patients with IO.

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Journal articles on the topic 'Laparoscopic surgery (LS)'

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