scholarly journals Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Y. El Harrech ◽  
O. Ghoundale ◽  
E. H. Kasmaoui ◽  
D. Touiti
Keyword(s):  
Open Surgery ◽  
Operative Time ◽  
Vena Cava ◽  
Intraoperative Complication ◽  
Conversion To Open Surgery ◽  
Retrocaval Ureter ◽  
The Mean ◽  
Jj Stent ◽  
Urological Diseases ◽  
Tomography Scan

Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU).Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position.Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110–190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4–6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery.Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter.

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

scholarly journals Laparoscopic Urological Surgery: Our Initial Experiences

2020 ◽  
Vol 23 (1) ◽  
pp. 17-23
Author(s):  
Shiba Prasad Nandy ◽  
AKM Akramul Bari ◽  
Anirban Ghose ◽  
Hasmot Ali Mia ◽  
Md Alamgir ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Radical Nephrectomy ◽  
Open Surgery ◽  
Renal Cyst ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Excellent Outcome ◽  
Duration Of Surgery ◽  
The Mean

Introduction and Objective: Laparoscopic surgery is increasingly exercised in urology due to improvements in technical capabilities and experience. It comes with many advantages compared to open surgery such as lesser degree of pain and haemorrhage, shorter hospital stay and better cosmetic results. This study is carried out to evaluate the outcomes and complications of urological laparoscopic surgery cases performed Chittagong Medical College Hospital, Chattogram, Bangladesh. Methods: This was a hospital based prospective observational study of total 29 patients, who received laparoscopic surgery of different kinds between January 2017 and September 2019 for urological causes with a minimum one month follow-up. Included patients were assessed in terms of demographic characteristics, preoperative diagnosis, type of laparoscopic approach, duration of surgery and hospitalization, complications after surgery and need for conversion to open surgery. Results: The mean age was 45.03 years where 12 patients were women and 17 were male. All patients underwent trans-peritoneal procedures where2 patients received renal cyst excision, 4 simple nephrectomy, 5 ureterolithotomy, 9 radical nephrectomy, 1 radical cystectomy, 2 adrenalectomy, 3 pyelolithotomy and 3 pyeloplasty. Three of the 29 patients required conversion to open surgery. Except these patients, no major complication or mortality was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 87.5 (70-105) min, simple nephrectomy 141.25 (120-170) min, ureterolithotomy 120 (100-140) min, radical nephrectomy 215.56 (180-260) min, pyelolithotomy 120 (100-140) min, and pyeloplasty 156.67 (130-190) min. The mean hospital stay was 4.59±1.7 (2-8) days. Conclusions: The success and complications rate of the laparoscopic urological surgeries performed in our hospital were consistent with those reported in the literature. In the light of technological advances and increasing experience, we believe that laparoscopic surgery is an effective technique with excellent outcome along with a safe and feasible alternative to open surgery in the field of urology. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.17-23

Video-Endoscopic Mobilization of the Gracilis Muscle for Rectourinary Fistula Repair

2021 ◽  
pp. 1-5
Author(s):  
Cesar Britto ◽  
Daniel Pfalzgraf ◽  
Ronnie Lima ◽  
Paulo Medeiros ◽  
Rafael Rebouças ◽  
...  
Keyword(s):  
Open Surgery ◽  
Gracilis Muscle ◽  
Rectourethral Fistula ◽  
Reconstructive Procedures ◽  
Conversion To Open Surgery ◽  
Perineal Region ◽  
The Mean ◽  
Minimally Invasive Access ◽  
Rectourinary Fistula ◽  
Mean Time

<b><i>Introduction:</i></b> Transposition of the gracilis has been used in a large number of reconstructive procedures. Its advantage is its proximity to these defects and a good blood supply. Traditionally, the gracilis mobilization is performed by open surgery with one or more incisions. We describe our initial experience with the video-endoscopic mobilization of gracilis. <b><i>Method:</i></b> We described a retrospective review of all patients who underwent gracilis muscle mobilization for treatment of rectourethral fistula, performed by video-endoscopy, between March 2013 and September 2017, for treatment of rectourethral fistula. Also, our surgical technique is described in detail. <b><i>Results:</i></b> Three patients, with a mean age of 66.6 years, underwent the procedures. The mean time for mobilization of the gracilis was 107 min (range 60–145). There was no case of donor area infection, no change in the sensitivity of the medial aspect of the thigh or chronic pain. Conversion to open surgery was not necessary in any case. The hospital discharge occurred in average after 4 days. The bladder catheter was removed after 4 weeks after cystography was performed without evidence of leakage. One patient had a recurrence of the fistula. <b><i>Discussion:</i></b> The gracilis is an excellent choice of tissue to be interposed in reconstructive procedures of the perineal region, especially in the treatment of rectourinary fistulas. However, endoscopic harvest of the gracilis muscle has not yet found its way into everyday practice. The results in the treatment of rectourinary fistulas are excellent, with a success rate of 87.7%. Our rate of 67% is below, probably due to the small number of cases. In open surgery, complications are uncommon; however, approximately half of the patients expressed concern about the painful scar, which can be reduced by minimally invasive access. <b><i>Conclusion:</i></b> Video-endoscopic mobilization of gracilis muscle for the treatment of rectourethral fistula is feasible and safe. Studies comparing this technique with the conventional mobilization are required.

scholarly journals Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics

2021 ◽  
Vol 10 (9) ◽  
pp. 1812
Author(s):  
Iulia Andras ◽  
Angelo Territo ◽  
Teodora Telecan ◽  
Paul Medan ◽  
Ion Perciuleac ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Operative Time ◽  
Vena Cava ◽  
Laparoscopic Approach ◽  
Hepatic Veins ◽  
Combined Approach ◽  
Urological Procedures ◽  
The Mean ◽  
Complications Rate

(1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases.

scholarly journals LAPAROSCOPIC LIVER RESECTION VIA LAPAROSCOPY: EXPERIENCE IN OUR CENTRE

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
P del Val Ruiz ◽  
S Sanz Navarro ◽  
B Carrasco Aguilera ◽  
C García Bernardo ◽  
A Miyar de Leon ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Liver Surgery ◽  
Open Surgery ◽  
Cancer Metastasis ◽  
Initial Experience ◽  
Specific Training ◽  
Laparoscopic Liver Surgery ◽  
Conversion To Open Surgery ◽  
Colon Cancer Metastasis ◽  
The Mean

Abstract INTRODUCTION Laparoscopic liver surgery has undergone a great evolution in recent years, allowing increasingly complex resections without increasing complications and with evident postoperative benefits. Our purpose is to analyze our initial experience in this type of resection. MATERIAL AND METHODS We performed a retrospective observational study analyzing 41 patients who underwent liver resections by laparoscopy in our centre from March 2019 to January 2020. RESULTS The mean age of the patients was 64.5 years (SD 11) with a mean BMI of 27.56 (from 4.59). The most common surgical indication was colon cancer metastasis (41.4%), followed by hepatocarcinoma (36.6%) and usually single lesions (75.6%). The procedure passed without complications except in the case of 5 patients who required conversion to open surgery (12.5%) and 3 patients (7.5%) who required intraoperative transfusion. During the postoperative period 4 patients (9.8%) presented complications and all of them were classified as Clavien-Dindo II. We only reported 1 death (2.4%) in &gt; 90 days, which was not related to the reason for surgery. No reinterventions were necessary during admission and there were no readmissions in the first 30 days after discharge, CONCLUSIONS Laparoscopic liver surgery is technically demanding and requires previous experience in open surgery, as well as specific training, which makes a regulated implementation of the technique necessary.

Pharyngeal pouch: comparison of surgical treatment with botulinum toxin injection to the cricopharyngeus

2019 ◽  
Vol 133 (2) ◽  
pp. 125-128
Author(s):  
K Lau ◽  
M G Watson
Keyword(s):  
Botulinum Toxin ◽  
Open Surgery ◽  
Operative Time ◽  
Botulinum Toxin Injection ◽  
Symptom Control ◽  
Complication Rates ◽  
Open Approach ◽  
Pharyngeal Pouch ◽  
Endoscopic Laser ◽  
The Mean

AbstractBackgroundPharyngeal pouch surgical treatments can be carried out via an endoscopic or open approach. Injection of botulinum toxin into the cricopharyngeus was first described as an alternative treatment to the more invasive surgical procedures performed for cricopharyngeal dysfunction. It has not been previously described as a treatment option for pharyngeal pouch.ObjectivesTo compare operative time, average stay, complication rates and symptom control between endoscopic laser diverticulotomy, botulinum toxin injection and open procedures for pharyngeal pouch patients.MethodsThe medical records for 66 pharyngeal pouch procedures, carried out on 47 patients treated between 2011 and 2017, were identified and reviewed.ResultsThe mean operative time was 21 minutes for botulinum toxin injection, 38 for endoscopic laser diverticulotomy and 104 for open surgery. The mean hospital stay was 0.6 days for botulinum toxin injection, 4.7 for endoscopic laser diverticulotomy and 4 for open surgery. The improvement in Reflux Symptom Index scores was statistically significant for both endoscopic laser diverticulotomy and botulinum toxin injection. Botulinum toxin injection had a 0 per cent complication rate.ConclusionBotulinum toxin injection is a safe and effective treatment for pharyngeal pouch.

EVALUATION OUTCOMES OF THE LAPAROSCOPIC RETROPERITONEAL NEPHRECTOMY FOR BENIGN NONFUNCTIONING KIDNEYS

2017 ◽  
pp. 107-112
Author(s):  
Duc Minh Hoang ◽  
khoa Hung Nguyen ◽  
Vinh Quy Truong ◽  
Van Binh Nguyen ◽  
Hong Duong Nguyen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Open Surgery ◽  
Operating Time ◽  
Indications For Surgery ◽  
Conversion To Open Surgery ◽  
Multicystic Kidney ◽  
Post Operation ◽  
The Mean ◽  
Retroperitoneal Nephrectomy

Purpose: To assess results of retroperitoneoscopy nephrectomy for benign non-function kidneys from June 2013 to June 2017 at Quang Tri General Hospital. Materials and Methods: The study comprised 43 patients who underwent retroperitoneoscopic nephrectomy during a 4 years period beginning from June 2013. Results: Mean age of surgery was 52.6 years (28-72 years). 23 males and 20 females. 25 patients underwent left nephrectomy; 18 underwent right nephrectomy. Retroperitoneoscopic nephrectomy were completed successfully in 38 patients (88.4%). There was 5 patients required conversion to open surgery (11.6%), all cases by poor progression. The mean operating time was 112.7 minutes (range 70 to 210), mean blood loss was 45.7 ml (range 15 to 170 ml), and mean post-operation hospital stay was 4.3 days (range 3 to 9). A total of 21.1% complications (8/38 cases), no severe complications occurred. No re-intervention was needed. No case was mortality. The indications for surgery included hydronephrosis in 19/38 cases (50.0%), atrophic kidney in 13/38 cases (34.2%) and multicystic kidney in 6/38 cases (15.8%). Conclusions: Retroperitoneoscopic nephrectomy can be performed safely and successfully with obvious advantages for benign nonfunctioning kidneys regardless of the etiology or pathogenesis. Key words: nephrectomy, kidney, benign, retroperitoneoscopy

scholarly journals Robot-assisted treatment of epigastric hernias with a suprapubic approach

2020 ◽  
Author(s):  
Ramon Pini ◽  
Matteo Di Giuseppe ◽  
Johannes Maria Alberto Toti ◽  
Francesco Mongelli ◽  
Maria Marcantonio ◽  
...  
Keyword(s):  
Operative Time ◽  
Rectus Sheath ◽  
Length Of Hospital Stay ◽  
Robot Assisted ◽  
Port Placement ◽  
Intraoperative Complication ◽  
Conversion To Open Surgery ◽  
Epigastric Region ◽  
Posterior Rectus Sheath ◽  
Median Operative Time

Abstract BackgroundRobotic ventral hernia repair has shown itself to be feasible and safe in abdominal wall surgery. Presently, the ports are commonly placed laterally to meet the distance from the fascial defect. The aim of our study is to reort our experience of epigastric hernias treatment with the trocars’ insertion in the suprapubic region.MethodsA retrospective search on a prospectively collected dataset was performed to identify patients treated for primary or incisional hernias of the epigastric region with a robotic-assisted approach. In all cases, three 8-mm trocars were inserted in the suprapubic area and the preperitoneal or the posterior rectus sheath spaces dissected to ensure a proper mesh overlap. After hernia reduction, the fascia was closed with a running suture, the mesh placed and the peritoneum sutured.ResultsTwelve patients were selected. Median age was 58.5 years (interquartile range (IQR) 47.8–67.3) and four patients were male (33.3%). All patients were referred to surgery because of pain. The median measure of the hernia defect was 30 mm (IQR 13.75-31), median larger mesh diameter was 13.5 cm (IQR 9.5–15.0) and median operative time was 136.5 minutes (IQR 120-186.5). No intraoperative complication or conversion to open surgery occurred. Postoperatively, two patients presented a seroma and the median length of hospital stay was 2.0 days (IQR 1.75-3).ConclusionsIn the robot-assisted treatment of hernias of the epigastric region, a suprapubic port placement can be considered instead of a lateral one. Further studies are needed to assess the benefits and limitations of such technique.Trial registrationRetrospectively registered (Comitato Etico Cantonale Ticino n. 2019-01132 CE3495)

scholarly journals Initial Experience of Retroperitoneoscopic Surgery in Benign Renal Diseases

2019 ◽  
Vol 17 (01) ◽  
pp. 94-99
Author(s):  
Ashok kumar Kunwar ◽  
Amit Mani Upadhyay ◽  
Sanjesh Bhakta Shrestha ◽  
Udaya Koirala ◽  
Kabir Tiwari ◽  
...  
Keyword(s):  
Open Surgery ◽  
Prospective Observational Study ◽  
Operative Time ◽  
Renal Cyst ◽  
Perioperative Period ◽  
Early Experience ◽  
Renal Diseases ◽  
Post Operative Pain ◽  
The Mean ◽  
Failure To Progress

Background: To review our early experience to determine the feasibility, efficacy and clinical outcomes of retroperitoneoscopic surgery in benign renal diseases.Methods: This is a prospective observational study carried out between December 2014 to March 2018. Among 14 patients enrolled in the study, 9 cases of nonfunctioning kidney underwent retroperitoneoscopic simple nephrectony, 4 cases of benign renal cortical cysts underwent decortication of cysts and one case of pelviureteric junction obstruction underwent Anderson Hynes pyeloplasty. Results: Retroperitoneoscopic nephrectomy, renal cyst decortication and A-H pyeloplasty were performed in 13 patients successfully. The procedure in one patient of RP nephrectomy converted to open surgery due to dense perinephric and hilar adhesions. Which resulted to failure to progress. The mean operative time of RP nephrectomy, decortications and pyeloplasty were 206.4 (150-248), 67.5 (60-80) and 275 minutes, average blood loss was 96.7 (50-120), 27.5 (20-30) and 70 ml, and the mean hospital stay were 3.5 (3-4), 2 (2-2) and 4 days respectively. The perioperative period was uneventful.Conclusions: Retroperitoneoscopic surgery is feasible and safe in benign renal diseases. Because of reduced post operative pain and less chances of bowel injury, retroperitoneoscopic surgery is gaining more popularity.Keywords: Nonfunctioning kidney; pyeloplasty; renal cyst; retroperitoneoscopic surgery.

Evaluating the Learning Curve Associated with Laparoscopic Left Hemicolectomy for Colon Cancer

2013 ◽  
Vol 79 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Masashi Yamamoto ◽  
Junji Okuda ◽  
Keitaro Tanaka ◽  
Keisaku Kondo ◽  
Keiko Asai ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Learning Curve ◽  
Splenic Flexure ◽  
Open Surgery ◽  
Operative Time ◽  
Left Hemicolectomy ◽  
Conversion To Open Surgery ◽  
Descending Colon ◽  
Descending Colon Cancer

The role of laparoscopic surgery for transverse and descending colon cancer remains controversial. The aim of the present study was to characterize the learning curve for laparoscopic left hemicolectomy including the splenic flexure and to identify factors that influence this learning curve. Data from 120 consecutive patients undergoing laparoscopic left hemicolectomy for transverse and descending colon cancer including the splenic flexure between December 1996 and December 2009 were analyzed. Patients undergoing resection combined with cholecystectomy, hepatectomy, hysterectomy, or gastrectomy were excluded. Operative time was analyzed using the moving average method. The operative time, conversion rate, and postoperative complication rate were evaluated among four groups based on the number of cases required for analysis of operative time. In addition, risk factors that influenced conversion to open surgery were analyzed. Operative time for left hemicolectomy decreased with increasing case number with stabilization at 30 cases. There was no significant difference in the conversion rate or postoperative complications over time. Significant factors for conversion to open surgery were T stage (odds ratio [OR], 5.56; 95% confidence interval [CI], 1.5 to 27.4) and previous abdominal surgery (OR, 5.38; 95% CI, 1.6 to 20.2). The learning curve for laparoscopic left hemicolectomy is steep. Thus, surgeons in the early part of this curve should carefully select patients to allow them to build experience in a stepwise manner. Laparoscopic surgery may become the gold standard for management of colon cancer regardless of stage or tumor location.

Sign in / Sign up

Export Citation Format

Share Document