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Conventional Laparoscopy (conventional + laparoscopy)
Selected AbstractsMajor complications and outcome of diagnostic and operative transvaginal hydrolaparoscopyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2007Hiroaki Shibahara Abstract Aim:, Transvaginal hydrolaparoscopy (THL) has recently been developed as a less invasive alternative to conventional laparoscopy. There are some reports that described the usefulness and prognostic value of diagnostic THL in infertile women. Moreover, operative THL such as ovarian drilling for unovulatory women with polycystic ovarian syndrome (PCOS) to induce ovulation has also been found to be as effective as that by conventional laparoscopy. The risk of bowel injury and sepsis by transvaginal access with culdoscopy was higher than that with laparoscopy in the previous reports. The purpose of the present study was to examine the risk of diagnostic and operative THL according to two case studies with a literature review. Methods:, The authors carried out diagnostic or operative THL in 177 infertile women, aged 22,43 years. Major complications during THL and a review of the literature were analyzed. Results:, Two cases of bowel injury were diagnosed during diagnostic THL. No complication occurred during operative THL. In total, the incidence of bowel injury was 1.1%. The injuries were diagnosed during THL and treated expectantly under strict conditions in both cases. Ten studies in the literature reported a total of 4232 procedures, including 26 bowel injuries (0.61%) and one perforation of a retroflexed uterus (0.02%). Conclusions:, The usefulness of THL for diagnostic and operative purposes is in no doubt. However, informed consent should be obtained and vigilance before and during THL should be maintained, although it can be done on an outpatient clinic basis. [source] Single-port surgery: Current applications and limitationsASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2009GV Rao Abstract Introduction: In an attempt to further enhance the benefits of cosmesis and reduced morbidity of minimally invasive surgery, single-port (incision) laparoscopic surgery (SPS) has emerged as a bridge between conventional laparoscopy and natural orifice transluminal endoscopic surgery. As the expertise and instrumentation required are an extension of standard laparoscopic techniques, SPS has been adapted for a variety of procedures and specialties in a short span of time. Discussion: In this article, we discuss the various SPS techniques, as well as the new devices and instrumentation available for facilitating SPS. We also review current applications reported for SPS in various surgical specialties. We present a comprehensive review of the potential benefits, limitations and risks of these novel techniques. Conclusion: Initial reports have demonstrated the technical feasibility and safety of SPS for a wide range of surgical applications. With specialized instrumentation and refinement of technique, its role will increase in coming years. Future work is necessary to improve existing instrumentation, to increase clinical experience and to assess the benefits of this surgical approach. [source] Single-port laparoscopic surgery, the new evolution of endoscopic surgeryASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2009H. Rivas Abstract Introduction: Laparoscopic surgery through a single port is gaining great interest throughout the world. Our group has pioneered and been a leader on these novel techniques. Here we describe our experience based on a model of single-port laparoscopic cholecystectomy. Materials and Methods: From January 2008 until August 2009, over 200 patients have undergone single-port laparoscopic surgery at our institution. Here, we analyze a cohort of the initial 100 cholecystectomies in order to evaluate a proposed technique, common challenges, the learning curve and potential solutions. Results: Single-port laparoscopic surgery was feasible in all patients from this cohort. Patients were strictly selected. Operating times similar to those of conventional laparoscopy were only achieved after completing 50 cases. Common technical challenges included clashing instruments, deflection of laparoscope due to conflict with light source, and organ retraction. Acceptance by surgeons and lack of patience and time may become significant obstacles that prevent the procedure's widespread adoption. The excellent aesthetic results are superior to laparoscopy. Other benefits of laparoscopy are preserved and may prove to be superior on clinical trials. Discussion: Single-port laparoscopic surgery is becoming popular worldwide. Safe and successful adoption requires learning the basic concepts of this method, identifying challenges, and implementing solutions. Once these essentials are mastered, the learning curve may be shortened, especially for experienced laparoscopic surgeons, and this technique may then be used to replicate many abdominal operations. Transparency with patients and team building are essential requirements for a successful adoption. Clinical trials are ideal before universal adoption. [source] Robot-assisted surgery in gynaecologyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2009Martin K. OEHLER Robotic surgery is the latest development in minimal invasive surgery. It provides superior visualisation and dexterity and therefore allows the surgeon to perform complex tasks that would exceed his/her abilities with conventional laparoscopy and would be associated with an increased morbidity if performed by laparotomy. Current evidence demonstrates the feasibility and safety of this technology in gynaecology. The costs of robotic surgery remain one of the main sources of controversy but are expected to come down with further developments of the technology. If evidence-based long-term outcome evaluations show the superiority of robotic surgery in comparison to conventional laparoscopic and open surgery, this technology will have a major impact on gynaecological surgery. [source] Laparoscopic resection with transcolonic specimen extraction for ileocaecal Crohn's disease,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2010E. J. Eshuis Background: Ileocolic resection for Crohn's disease can be performed entirely laparoscopically. However, an incision is needed for specimen extraction. This prospective observational study assessed the feasibility of endoscopic transcolonic specimen removal. Methods: Endoscopic specimen removal was attempted in a consecutive series of ten patients scheduled for laparoscopic ileocolic resection. Primary outcomes were feasibility, operating time, reoperation rate, pain scores, morphine requirement and hospital stay. To assess applicability, outcomes were compared with previous data from patients who had laparoscopically assisted operations. Results: Transcolonic removal was successful in eight of ten patients; it was considered not feasible in two patients because the inflammatory mass was too large (7,8 cm). Median operating time was 208 min and median postoperative hospital stay was 5 days. After surgery two patients developed an intra-abdominal abscess, drained laparoscopically or percutaneously, and one patient had another site-specific infection. The operation took longer than conventional laparoscopy, with no benefits perceived by patients in terms of cosmesis or body image. Conclusion: Transcolonic removal of the specimen in ileocolic Crohn's disease is feasible in the absence of a large inflammatory mass but infection may be a problem. It is unclear whether the technique offers benefit compared with conventional laparoscopic surgery. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||