The Feasibility, Technique, and Medium-Term Follow-Up of Laparoscopic Transvesical Diverticulectomy

2020 ◽  
Vol 104 (11-12) ◽  
pp. 923-927
Author(s):  
Klaus Eredics ◽  
Michael Rauchenwald ◽  
Lukas Lusuardi ◽  
Thomas Kunit ◽  
Hans Christoph Klingler ◽  
...  
Keyword(s):  
Operative Time ◽  
Medium Term ◽  
Ureter Injury ◽  
Day Range ◽  
Valuable Procedure ◽  
Median Diameter ◽  
Transurethral Catheter ◽  
Bladder Diverticula ◽  
Median Operative Time

<b><i>Background:</i></b> To present our experience and results with the transvesical laparoscopic diverticulectomy, developed by Pansadoro et al. [<i>BJU Int</i>. 2009;103(3):412–24], as treatment of symptomatic bladder diverticula, with a medium-term follow-up. <b><i>Methods:</i></b> Between June 2010 and July 2018, we successfully operated 15 patients (13 male/2 female), aged 32–85 years (mean age 61 years) in 2 centers in Austria, using the aforementioned technique. <b><i>Results:</i></b> The median operative time was 297 min (range 83–488 min), and the blood loss was minimal. The median diameter of the diverticula was 94 mm (range 40–110 mm). The transurethral catheter was removed in most patients on day 7 (range 1–26 days), and cystography was performed before catheter removal. Patients were discharged on the ninth postoperative day (range 4–18 days). One case had a Clavien-Dindo grade IIIb complication (ureter injury), and 2 cases had a grade IIIa complication (nephrostomy drainage). After a median follow-up of 19 months, no recurrences were observed. <b><i>Conclusion:</i></b> The laparoscopic, transvesical diverticulectomy is a feasible and valuable procedure with good outcomes. To avoid complications, the ureter needs to be spared meticulously.

scholarly journals Importance of the vessel distribution at splenic hilum for laparoscopic Warshaw procedure

2021 ◽  
Vol 8 (11) ◽  
pp. 3416
Author(s):  
Shinichiro Ono ◽  
Tomohiko Adchi ◽  
Amane Kitasato ◽  
Masaaki Hidaka ◽  
Akihiko Soyama ◽  
...  
Keyword(s):  
High Risk ◽  
Operative Time ◽  
Gastric Varices ◽  
Splenic Infarction ◽  
Safe Procedure ◽  
Splenic Vessel ◽  
Splenic Hilum ◽  
Splenic Vessels ◽  
Median Operative Time

The laparoscopic Warshaw procedure (LWP) is a considered to carry a risk of splenic infarction and perigastric varices formation. We retrospectively analyzed the clinical outcomes and relationship between the distribution of the splenic hilum vessels and splenic infarction in patients who underwent LWP from February 2007 to February 2017.  A total of 19 patients underwent LWP, and the median follow-up duration was 78 months. The median operative time and blood loss were 295 min and 200 gr. Six patients with splenic partial infarction and 3 with gastric varices were detected, but they have not needed any treatments. According to the classification by Michels, the distribution of splenic vessels were divided as distributed type and magistral type at the splenic hilum. In our study, 16 patients were distributed type and 3 were magistral type. Three of the 16 patients developed splenic infarction in distributed type. In contrast, all of magistral patients showed splenic infarction. Although LWP is a safe procedure, there is a high risk of splenic infarction if the splenic vessel distribution is a magistral type. Understanding the type before surgery leads to the identification of an appropriate vascular dissection position and reduces postoperative complications.

scholarly journals The Cervico-Parasternal Thoracotomy (CPT): A New Surgical Approach for the Resection of Cervicothoracic Neuroblastomas

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 229
Author(s):  
Giuseppe Martucciello ◽  
Federica Fati ◽  
Stefano Avanzini ◽  
Filippo Maria Senes ◽  
Irene Paraboschi
Keyword(s):  
Surgical Approach ◽  
Operative Time ◽  
Lateral View ◽  
Thoracic Inlet ◽  
Trap Door ◽  
Postoperative Time ◽  
Neurovascular Structures ◽  
Median Operative Time ◽  
Disease Free

Cervicothoracic neuroblastomas (NBs) pose unique surgical challenges due to the complexity of the neurovascular structures located in the thoracic inlet. To date, two main techniques have been reported to completely remove these tumours in children: the trans-manubrial and the trap-door approaches. Herein, the authors propose a third new surgical approach that allows a complete exposure of the posterior costovertebral space starting from the retro-clavicular space: Cervico-Parasternal Thoracotomy (CPT). The incision is made along the anterior margin of the sternocleidomastoid muscle until its sternal insertion, and then the incision proceeds vertically following the ipsilateral parasternal line. The major pectoralis muscle is detached, and the clavicle and the ribs are disarticulated from their sternal insertions. Following an accurate isolation of the major subclavian blood vessels and the brachial plexus roots, the tumour is then completely exposed and resected by switching from a frontal to a lateral view of the costo-vertebral space. By adopting this technique, five cervicothoracic NBs were completely resected in a median operative time of 370 min (range: 230–480 min). By proceeding in safety with the heart apart, neither vascular injuries nor nerve damages occurred, and all patients were safely discharged in a median postoperative time of 11 days (range: 7–14 days). At the last follow-up visit (median: 16 months, range: 13–21 months), all patients were alive and disease-free.

scholarly journals Evaluation of parallel endplate osteotomy for severe rigid spinal deformities: a retrospective analysis of 36 cases with a minimum 2-year follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hang Liao ◽  
Peng Xie ◽  
Guizhou Zheng ◽  
Houguang Miao ◽  
Ningdao Li ◽  
...  
Keyword(s):  
Operative Time ◽  
Bodily Pain ◽  
Clinical Results ◽  
Spinal Deformities ◽  
Effective Technique ◽  
Estimated Blood Loss ◽  
Sf 36 ◽  
Scoliosis Correction ◽  
Median Operative Time

Abstract Background To report on the technique and results of parallel endplate osteotomy (PEO) for severe rigid spinal deformity. Methods We retrospectively reviewed the clinical data of 36 patients with severe rigid spinal deformities who underwent PEO between July 2016 and December 2018 and who were followed up for at least 24 months. Results Following PEO, the kyphosis and scoliosis correction rates reached 77.4 ± 14.0% and 72.2 ± 18.2%, respectively. The median intraoperative estimated blood loss was 1500 mL and the median operative time was 6.8 h. The SF-36 scores of physical function, role-physical, bodily pain, general health, vitality, social function, role-emotional and mental health changed from 62 ± 28, 51 ± 26, 49 ± 29, 35 ± 30, 53 ± 28, 45 ± 30, 32 ± 34 and 54 ± 18 at baseline to 81 ± 16, 66 ± 41, 72 ± 40, 64 ± 44, 75 ± 25, 71 ± 46, 66 ± 34 and 76 ± 28 at 12 months postoperatively, 82 ± 32, 67 ± 42, 81 ± 30, 71 ± 41, 80 ± 30, 74 ± 36, 68 ± 35 and 85 ± 33 at 18 months postoperatively, and 86 ± 21, 83 ± 33, 88 ± 26, 79 ± 39, 86 ± 36, 86 ± 48, 80 ± 47 and 91 ± 39 at 24 months postoperatively, respectively. Conclusions PEO is an effective technique for successful correction of spinal deformities. At the two-year follow-up visit, all patients achieved better clinical results based on the SF-36 scores.

scholarly journals Ambulatory surgery of umbilical, epigastric and small incisional hernias: open preperitoneal flat mesh technique in local anaesthesia

2006 ◽  
Vol 53 (1) ◽  
pp. 29-34 ◽  
Author(s):  
M. Zuvela ◽  
M. Milicevic ◽  
D. Galun ◽  
N.N. Lekic ◽  
P. Bulajic ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Incisional Hernia ◽  
Local Anaesthesia ◽  
Umbilical Hernia ◽  
Operative Time ◽  
Ambulatory Surgery ◽  
Superficial Infection ◽  
Mesh Technique ◽  
Median Operative Time

Introduction. The dilemma whether to use the mesh or non mesh technique in the management of umbilical, epigastric and small incisional hernia is slowly fading away. The open preperitoneal "flat mesh" technique performed as ambulatory surgery may be one of the solutions. The Aim. The aim of this retrospective study is to present the results of open preperitoneal "flat mesh" technique in the management of umbilical, epigastric and small incisional hernia within Material and methods. This study included 34 patients (11 of them with umbilical, 13 with epigastric and 8 of them with small incisional hernia) operated by one surgeon in the period January 2004 - January 2006. Results. The median operative time was 52 minutes for umbilical hernia?s, 43 minutes for epgastric and 54 minutes for incisional hernia?s. The ambulatory surgery was performed at 91% of patients. The median hospitalization was 4h for patients with umbilical hernia?s, 3,7h for patients with epigastric and, 7,7h for patients with small incisional hernia. The follow up is 10,5 months. Apart of one superficial infection other complications were absent. Conclusion. The open preperitoneal "flat mesh" technique performed in local anesthesia as an ambulatory surgery provides good results in the management of umbilical, epigastric and small incisional hernia.

Effectiveness of Thoracoscopic Truncal Vagotomy in the Treatment of Marginal Ulcers after Laparoscopic Roux-en-Y Gastric Bypass

2012 ◽  
Vol 78 (6) ◽  
pp. 663-668 ◽  
Author(s):  
John Hunter ◽  
Richard D. Stahl ◽  
Manasi Kakade ◽  
Igal Breitman ◽  
Jayleen Grams ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Chart Review ◽  
Operative Time ◽  
Telephone Interview ◽  
Marginal Ulcer ◽  
Symptomatic Improvement ◽  
Truncal Vagotomy ◽  
Peptic Ulcers ◽  
Median Operative Time

Marginal ulcer is a significant complication of laparoscopic Roux-en-Y gastric bypass (LRYGB). Most marginal ulcers resolve with medical management, but nonhealing ulcers may require revision of the gastrojejunostomy, a procedure with significant morbidity and mortality. Traditionally, surgical therapy for refractory peptic ulcers includes a vagotomy. The current study evaluates the effectiveness of thoracoscopic truncal vagotomy (TTV) in the management of refractory marginal ulcers. All patients at two institutions with an intractable marginal ulcer after LRYGB treated with TTV between 2003 and 2010 were reviewed. Data were collected from chart review and telephone interview. Seventeen patients (mean age, 39 ± 13 years; 16 females) were diagnosed with marginal ulceration a median of 18 months after LRYGB and proceeded to TTV at a mean of 39 ± 43 weeks (range, 1 to 114 weeks) after the diagnosis. The median operative time was 89 ± 65 minutes (range, 45 to 318 minutes). Four patients had a complication (sympathetic contralateral pleural effusion, pneumothorax, operative bleeding, and readmission for emesis). Eleven patients had follow-up of 3 months to 6 years (median, 7 months). Nine patients (82%) had symptomatic improvement and/or endoscopic resolution, whereas two (18%) did not. No patient had endoscopic evidence of persistent or recurrent marginal ulcer. TTV achieves symptomatic improvement and/or endoscopic resolution of intractable marginal ulcers in over 80 per cent of patients status post gastric bypass and therefore offers a less morbid alternative to revision of the gastrojejunostomy.

scholarly journals Laparoscopic splenectomy both for primary cytoreductive surgery for advanced ovarian cancer and for secondary surgery for isolated spleen recurrence: feasibility and technique

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Antonio Macciò ◽  
Elisabetta Sanna ◽  
Fabrizio Lavra ◽  
Giacomo Chiappe ◽  
Marco Petrillo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Laparoscopic Splenectomy ◽  
Operative Time ◽  
Advanced Ovarian Cancer ◽  
Open Approach ◽  
Advanced Stage ◽  
Secondary Surgery ◽  
Median Operative Time

Abstract Background This study investigated the feasibility and safety of laparoscopic splenectomy conducted in the contexts of both laparoscopic secondary surgery for isolated recurrence in the spleen and primary laparoscopic cytoreductive surgery for advanced ovarian cancer. Methods We performed a perspective observational study including all consecutive patients with ovarian cancer who underwent laparoscopic splenectomy as part of primary cytoreductive procedures for advanced stage ovarian cancer or secondary surgery for isolated splenic recurrence between January 2016 and May 2020. Results We enrolled 13 consecutive patients, candidate to laparoscopic splenectomy as part of primary cytoreductive procedures for advanced stage ovarian cancer (6 patients) or secondary surgery for isolated splenic recurrence of platinum-sensitive ovarian cancer (7 patients). Median operative time (509 min [range, 200–845]) for primary cytoreductive surgery varied according to surgical complexity depending on the extensiveness of the disease. Median operative time for secondary surgery for isolated splenic metastasis was 253 min (90–380). Only 1 patient with isolated splenic recurrence required conversion to an open approach. No intraoperative complication occurred, and no intraoperative blood transfusions were required. Median hospital stay was 3 days (range, 2–5) for isolated recurrence and 9 days (7–18) for primary cytoreductive surgery. Complete tumor resection was achieved in all patients. Median time from surgery to adjuvant chemotherapy was 16 days (7–24). All six patients who underwent laparoscopic splenectomy during primary cytoreductive surgery remain alive, four of whom exhibit no evidence of disease (median follow-up 25 months [4–36]). Among patients who underwent laparoscopic splenectomy during secondary surgery for isolated splenic relapse, all patients are alive and only one had a central diaphragmatic relapse 2 years after surgery (median follow-up 17 months ([5–48 months]). Conclusions The laparoscopic approach to splenectomy is feasible and safe both in patients undergoing primary cytoreductive surgery for advanced stage disease and those with isolated recurrence of ovarian cancer, without compromising survival and allowing early initiation of postoperative systemic chemotherapy.

Ten-Year Outcome Analysis of Off-Pump Sequential Grafting: Single Surgeon, Single Center Experience

2012 ◽  
Vol 15 (3) ◽  
pp. 136 ◽  
Author(s):  
Shahzad G. Raja ◽  
Kareem Salhiyyah ◽  
Manoraj Navaratnarajah ◽  
Muhammad Umar Rafiq ◽  
Jeremy Felderhof ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Medium Term ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

<p><b>Objectives:</b> Despite increasing recognition that off-pump coronary artery bypass surgery and sequential grafting strategy individually are associated with improved outcomes, concerns persist regarding the safety and efficacy of combining these 2 techniques. We compared in-hospital and midterm outcomes for off-pump multivessel sequential and conventional coronary artery bypass grafting.</p><p><b>Methods:</b> From September 1998 to September 2008, 689 consecutive patients received off-pump multivessel sequential coronary artery bypass grafting performed by a single surgeon. These patients were propensity matched to 689 patients who underwent off-pump coronary artery bypass grafting without sequential anastomoses. A retrospective analysis of prospectively collected perioperative data was performed. In addition, medical notes and charts of all the study patients were reviewed. The mean duration of follow-up was 5.1 � 2.0 years.</p><p><b>Results:</b> The major in-hospital clinical outcomes in the sequential and control groups were found to be similar. After adjusting for clinical covariates, sequential grafting was not an independent predictor of in-hospital adverse events (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.86-1.50; <i>P</i> = .31), medium-term mortality (hazard ratio [HR], 1.26; 95% CI, 1.06-1.32; <i>P</i> = .92), and readmission to hospital (HR, 1.12; 95% CI, 0.96-1.20; <i>P</i> = .80). Sequential grafting was an independent predictor of receiving more than 3 distal anastomoses (OR, 7.46; 95% CI, 4.27-11.45; <i>P</i> < .0001). Risk-adjusted survival was 89% for sequential grafting patients and 88% for conventional grafting patients (<i>P</i> = .96) during the medium-term follow-up.</p><p><b>Conclusion:</b> Our analysis confirms the short- and midterm safety and efficacy of off-pump sequential coronary artery bypass grafting.</p>

Medium-term follow-up of women with menorrhagia treated by rollerball endometrial ablation

2000 ◽  
Vol 79 (10) ◽  
pp. 879-883
Author(s):  
Ghada S. A. El Senoun ◽  
Hatem Mousa ◽  
Tahir Mahmood
Keyword(s):  
Endometrial Ablation ◽  
Medium Term

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

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