scholarly journals Comparison of the Incidence of Complications among the Different Techniques of Laparoscopic Approach: Experience in a General Surgery Service in a Private Hospital

2018 ◽  
Vol 09 (07) ◽  
pp. 227-232
Author(s):  
Mauricio Valdez-Durón ◽  
Jorge Fernández-Álvarez ◽  
Alberto Manuel González-Chávez ◽  
Francisco Ángel Vega-Romero ◽  
Ketzalcoatl Tecomahua-Román ◽  
...  
Keyword(s):  
General Surgery ◽  
Private Hospital ◽  
Laparoscopic Approach

scholarly journals TP9.2.21Laparoscopy in Emergency General Surgery (The LEGS Study): NELA Database Analysis -Comparison of Outcomes in Laparoscopic versus Open Surgery

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kat Parmar ◽  
Ellena Badrick ◽  
Lee Malcomson ◽  
Andrew Renehan ◽  
Abhi Sharma ◽  
...  
Keyword(s):  
Hospital Admission ◽  
General Surgery ◽  
Open Surgery ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Time Of Day ◽  
Emergency Laparotomy ◽  
Emergency General Surgery ◽  
Icu Stay ◽  
Secondary Outcomes

Abstract Introduction Guidelines suggest the laparoscopic approach may be safe and feasible in emergency general surgery. Despite this, the UK National Emergency Laparotomy Audit (NELA) rate of laparoscopic surgery remains low. Our earlier analysis of the NELA database identified factors associated with use of laparoscopy, then recommended further analysis to compare outcomes between laparoscopic and open surgery. Methods We obtained information from the NELA database (2013 - 2017) and performed logistic regression on all first operations during the hospital admission. Outcomes were compared between open and laparoscopic approach (fully laparoscopic, laparoscopic assisted and laparoscopic converted). The primary outcome was death during hospital admission; secondary outcomes were admission to intensive care unit (ICU), length of ICU stay and return to theatre. Results The cohort comprised 68,928 open (52% men, mean age 65) and 12,144 laparoscopic (51% men, mean age 58). In a model adjusted for all factors influencing primary or secondary outcomes (age, gender, p-possum, weekday versus weekend, operative time of day, malignancy, peritoneal soiling, CEPOD urgency, surgical grade and anaesthetist grade), death rates were significantly lower in the laparoscopic group (OR 0.65, 95% CI 0.59 – 0.71). Post-operative admission to ICU and ICU stay > 3 days were both significantly lower in the laparoscopic group (OR 0.59, 95% CI 0.56 – 0.62; OR 0.82, CI 0.75 – 0.89). There was no difference in return to theatre. Conclusions Outcomes for laparoscopy in emergency general surgery appear superior to open surgery, although there may be residual unmeasured confounding factors. Further analysis will compare outcomes between pathologies.

scholarly journals Analysis of unplanned revisits and readmissions: results of the General Surgery clinic in a private hospital

2022 ◽  
Vol 8 (1) ◽  
pp. 65-73
Author(s):  
Mustafa NARMANLI ◽  
Halil ÖZGÜÇ ◽  
Eralp ÇEVİKKALP ◽  
Nesrin SERBEST
Keyword(s):  
General Surgery ◽  
Private Hospital

scholarly journals Application of robots in general surgery

2021 ◽  
Vol 64 (10) ◽  
pp. 678-687
Author(s):  
Jin Kyong Kim ◽  
Seung Yoon Yang ◽  
Sung Hyun Kim ◽  
Hyoung-Il Kim
Keyword(s):  
Robotic Surgery ◽  
Minimally Invasive ◽  
General Surgery ◽  
New Technologies ◽  
Gastrointestinal Surgery ◽  
Laparoscopic Approach ◽  
Comparative Trial ◽  
Endocrine Surgery ◽  
The Impact ◽  
Upper Gastrointestinal

Background: Application of robotic surgery in the field of general surgery has been increasing. This paper is an overview of the current uses and future perspectives of robotic surgery in four major divisions—endocrine, upper gastrointestinal, hepato-biliary-pancreatic (HBP), and colorectal surgery.Current Concepts: In endocrine surgery, cosmetic advantage is the highest priority when selecting a surgical approach for thyroidectomy. Currently, the transaxillary route is the most common approach. The introduction of the single-port system could maximize the advantages of this technique. In upper gastrointestinal surgery, the use of robots has the advantage of better retrieval of lymph nodes, less bleeding, earlier discharge, and less complications than the laparoscopic approach. However, a more prospective comparative trial is required to confirm those findings. In the HBP field, the indications of robotic surgery have expanded, starting with cholecystectomy to more challenging procedures, such as donor hepatectomy and pancreaticoduodenectomy. Meticulous dissection using robots could provide benefits to patients. In colorectal surgery, robotic surgery is an excellent technical tool for minimally invasive surgeries for rectal cancers, especially in male patients with narrow, deep pelvises. However, further studies are required to confirm the impact of robotic surgery on rectal cancers.Discussion and Conclusion: Robots are used to provide optimal surgical outcomes. Investigating new technologies and innovative surgical procedures is the highly important for a surgeon in the era of minimally invasive surgery.

Does Outcomes Research Impact Quality? Examples from Bariatric Surgery

2006 ◽  
Vol 72 (11) ◽  
pp. 1055-1060 ◽  
Author(s):  
Matthew M. Hutter
Keyword(s):  
Bariatric Surgery ◽  
General Surgery ◽  
Outcomes Research ◽  
Laparoscopic Approach ◽  
Research Impact ◽  
Consensus Conference ◽  
National Institutes Of Health ◽  
Recent Event ◽  
Surgery Outcomes

This manuscript addresses the question “Does outcomes research affect quality?” using examples from the field of bariatric surgery. The roles that outcomes research has played in each of the four major recent events in bariatric surgery are examined. In the first three major events, which include 1) the National Institutes of Health Consensus Conference on Bariatric Surgery in 1991, 2) the dramatic increase in numbers of bariatric operations performed, and 3) the move toward a laparoscopic approach in bariatric surgery, a multitude of outcomes studies seem to be the result, but not the cause, of these changes in the field of bariatric surgery. However, for the most recent event, the 2006 Centers for Medicare and Medicaid Services National Coverage Determination for bariatric surgery and the introduction of accreditation in general surgery, outcomes research has played a significant role in the determination of policy and, ultimately, quality.

The laparoscopy in emergency general surgery (LEGS) study: a questionnaire survey of UK practice

2021 ◽  
Vol 103 (2) ◽  
pp. 120-129
Author(s):  
N Heywood ◽  
KL Parmar ◽  
M Stott ◽  
P Sodde ◽  
DT Doherty ◽  
...  
Keyword(s):  
General Surgery ◽  
Questionnaire Survey ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer ◽  
Emergency Laparotomy ◽  
Emergency General Surgery ◽  
Factors Affecting ◽  
North West ◽  
The North ◽  
General Surgeons

Introduction Recent consensus guidelines suggest that the laparoscopic approach may be a useful, safe and feasible approach in emergency general surgery. Despite this, the UK National Emergency Laparotomy Audit (NELA) suggests the rate of laparoscopy is low (9% fully laparoscopic) and slow to increase over time. A European survey found uptake to be variable. This UK survey was therefore undertaken to establish current UK practice and to determine factors affecting implementation. Materials and methods A questionnaire survey of currently practising UK consultant general surgeons was carried out by the North West Surgical Research Collaborative, using a secure web-based database maintained by the North West Surgical Trials Centre. Results A total of 151 completed questionnaires were returned from 22 UK centres; 18% of respondents were unaware that laparoscopic cases should be reported to NELA. Appendicectomy (97%) and cholecystectomy (87%) were routinely performed laparoscopically. Laparoscopy was infrequently used in perforation, ischaemia or obstructed hernias. There appears to be equipoise regarding laparoscopic compared with open surgery in small-bowel obstruction among all subspecialty emergency general surgeons, in perforated peptic ulcer among upper gastrointestinal surgeons and in Hinchey III diverticulitis among colorectal surgeons. Conclusion Uptake of laparoscopy in UK emergency general surgery is influenced by surgeon preference, subspecialty, patient and operative factors. Further research into outcomes may help to identify areas of greatest potential benefit. The rate of laparoscopy reported by NELA may be an underestimate due to the 18% of surgeons unaware that laparoscopic cases should be reported, which may affect the validity of analyses performed from this dataset.

Identification and classification of flow disruptions in the operating room during two types of general surgery procedures

2010 ◽  
Author(s):  
Sacha N. Duff ◽  
T. Christopher Windham ◽  
Douglas A. Wiegmann ◽  
Jason Kring ◽  
Jennifer D. Schaus ◽  
...  
Keyword(s):  
Operating Room ◽  
General Surgery ◽  
Flow Disruptions

Robots Advance Gyn, General Surgery Techniques

2006 ◽  
Vol 36 (10) ◽  
pp. 63
Author(s):  
BETSY BATES
Keyword(s):  
General Surgery

Isolation of post operative hospital acquired infections in a private hospital of Bangladesh and identification of clonal relatedness of E. coli by using Pulse filed gel electrophoresis

2012 ◽  
Vol 6 (2) ◽  
pp. 7-10
Author(s):  
Mohammad Murshed ◽  
Sabeena Shahnaz ◽  
Md. Abdul Malek
Keyword(s):  
Private Hospital ◽  
Isolation And Identification ◽  
College Hospital ◽  
Hospital Acquired Infection ◽  
E Coli ◽  
Hospital Acquired Infections ◽  
Medical College ◽  
Clonal Relatedness ◽  
Hospital Acquired ◽  
Dressing Materials

Isolation and identification of post operative hospital acquired infection was carried out from July 2008 to December 2008 in Holy Family Red Crescent Medical College Hospital (private hospital). The major pathogen of wound infection was E. coli. A total; of 120 samples were collected from the surrounding environment of post operative room like floor, bed sheets, instruments, dressing materials, catheter, nasogastric and endotracheal tube. E. coli (40%) was the predominant organism followed by S. aureus (24%). DNA fingerprinting analysis using pulsed field gel electreopheresis of XbaI restriction digested genomic DNA showed that clonal relatedness between the two clinical nd environmental isolates were 100%.DOI: http://dx.doi.org/10.3329/bjmm.v6i2.19369 Bangladesh J Med Microbiol 2012; 06(02): 7-10

Congenital Intercostal Hernia: A Rare Entity

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 48
Author(s):  
Syed Muzamil Andrabi ◽  
Mohd Yousuf Dar ◽  
Javid Ahmad Bhat
Keyword(s):  
Male Patient ◽  
General Surgery ◽  
Rare Entity ◽  
Intercostal Hernia ◽  
History Of ◽  
Lateral Chest ◽  
Patient Department

A 35-year-old male patient presented to the General Surgery Out Patient Department with a history of swelling on the left lateral chest since birth. The swelling appeared during inspiration and disappeared during expiration. JMS 2018;21(1):48 

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