Journal of laparoendoscopic surgery

Journal of Laparoendoscopic SurgeryVol. 6, No. 5 RETROPERITONEOSCOPYRobert B. NadlerRobert B. NadlerSearch for more papers by this authorPublished Online:14 Apr 2009https://doi.org/10.1089/lps.1996.6.365AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "RETROPERITONEOSCOPY." , 6(5), p. 365FiguresReferencesRelatedDetails Volume 6Issue 5Oct 1996 To cite this article:Robert B. Nadler.RETROPERITONEOSCOPY.Journal of Laparoendoscopic Surgery.Oct 1996.365-365.http://doi.org/10.1089/lps.1996.6.365Published in Volume: 6 Issue 5: April 14, 2009PDF download

Most reports on laparoscopic fundoplication are from large, tertiary referral medical centers. Presented here is an experience by a single surgeon (M.E.F.) in community hospitals with 74 cases. All patients had esophagitis. All but two patients were Visick grade IV off medication. All patients had an incompetent lower esophageal sphicter. Four with abnormally low esophageal contractions underwent a Toupet procedure; the rest had a Nissen fundoplication. The largest estimated blood loss was 300 cc. One case (1.4%) had to be converted intraoperatively to an open procedure because of bleeding from an iatrogenic liver laceration. There were two minor complications (a urinary tract infection and a pneumothorax) and one death (massive liver necrosis with an otherwise unremarkable post mortem, thus it was felt to be due to anesthesia). The mean length of hospital stay was 2.8 +/- 0.21 days. Eighty-nine percent of the operations totally relieved reflux. Nineteen patients (26%) had mild, early postoperative dysphagia, gas bloat, and/or early satiety. Four patients did not get any improvement in their reflux, three still require chronic medication, and one underwent a redo open fundoplication. Three early patients had severe, new-onset postoperative dysphagia secondary to too tight a fundoplication. Attention must be focused on creating a loose wrap, a "floppy" Nissen by routine division of the short gastric vessels and the use of a large dilator in the esophagus when the fundoplication is constructed. Laparoscopic fundoplication is technically feasible, safe, and effective in a community hospital and does not require a large, tertiary referral medical center.

Journal of Laparoendoscopic SurgeryVol. 6, No. 3 LAPAROSCOPIC SURGERYRichard H. TurnageRichard H. TurnageSearch for more papers by this authorPublished Online:10 Apr 2009https://doi.org/10.1089/lps.1996.6.199AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "LAPAROSCOPIC SURGERY." , 6(3), p. 199FiguresReferencesRelatedDetails Volume 6Issue 3Jun 1996 To cite this article:Richard H. Turnage.LAPAROSCOPIC SURGERY.Journal of Laparoendoscopic Surgery.Jun 1996.199-199.http://doi.org/10.1089/lps.1996.6.199Published in Volume: 6 Issue 3: April 10, 2009PDF download

Splenectomy is an effective treatment for immune thrombocytopenic purpura (ITP). The recent advances in laparoscopic technique and technology have made laparoscopic splenectomy a viable option. Over 36 months we performed a total of 17 laparoscopic splenectomies, 15 of them for ITP and 2 for familial spherocytosis. We present our initial experience with laparoscopic splenectomy in 15 patients (age 16-71 years) with ITP. Operations were performed 2-24 months after the establishment of the diagnosis and initiation of appropriate therapy. Technically, the splenic artery was clipped first; the lower pole of the spleen and its posterolateral attachments were dissected using endoclips and electrocautery; the hilum and short gastric vessels were separated using an endostapler; the spleen was placed in a plastic bag, its opening pulled out through the umbilical incision, and the spleen fragmented and aspirated out of the bag. Operations lasted 100-300 min (mean 170 min). No patient required blood transfusion. The postoperative course was uneventful in all patients with minimal requirement of analgesia and early return to normal activity. Platelet counts returned to normal in all patients in a follow-up period of 2-36 months. Laparoscopic splenectomy is safe and effective for patients with ITP because of reduced operative trauma, less postoperative pain, cosmetic advantage, and possibly less postoperative complications.

Journal of Laparoendoscopic SurgeryVol. 6, No. s1 A Word from the Guest EditorThorn E LobeThorn E LobeSearch for more papers by this authorPublished Online:14 Apr 2009https://doi.org/10.1089/lps.1996.6.iiAboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "A Word from the Guest Editor." , 6(s1), p. iiFiguresReferencesRelatedDetails Volume 6Issue s1Mar 1996 To cite this article:Thorn E Lobe.A Word from the Guest Editor.Journal of Laparoendoscopic Surgery.Mar 1996.ii-ii.http://doi.org/10.1089/lps.1996.6.iiPublished in Volume: 6 Issue s1: April 14, 2009PDF download

Extraperitoneal laparoscopic inguinal hernia repair is a technically demanding procedure that nevertheless has significant advantages over the other types of laparoscopic inguinal hernia repairs. One of the difficulties inherent to the procedure is the establishment of an adequate working space between the abdominal wall and the peritoneum. A quick and efficient method is reported here that was used in 15 consecutive patients. The method provides wide exposure without the use of any sophisticated equipment or the need for a significant learning curve. Exposure of the preperitoneal space with the dissection technique described simplifies a difficult first step and makes the extraperitoneal repair an easier undertaking.

Laparoscopic management of bowel obstruction secondary to adhesions presents a difficult challenge for the general surgeon, The surgical management of two such cases is reported here: one patient with recurrent abdominal pain secondary to partial bowel obstruction, the other with acute small bowel obstruction, Surgical decision-making and technical aspects of the procedures are described, With careful patient selection and meticulous technique laparoscopic resolution of bowel obstruction may be feasible and should be attempted.

Saint's triade of hiatus hernia, colonic diverticula, and cholelithiasis presenting with volvulus of the gallbladder is a unique occurrence. Possible etiology of volvulus of the gallbladder involves kyphosis, viceroptosis, cholelithiasis, and in this case adhesive bands. Laparoscopic decompression of the gallbladder, division of the adhesive bands, detorsion of the volvulus, and finally laparoscopic cholecystectomy successfully resolved this uncommon clinical problem. We describe a case and review the literature.

A 2.8-year prospective multicenter trial was conducted to evaluate the ePTFE peritoneal onlay laparoscopic inguinal hernioplasty. A total of 441 inguinal hernias were repaired in 351 patients (326 male; 25 female). Two hundred twenty-six of the hernias were direct, 185 indirect, 4 femoral, 26 pantaloon, 90 bilateral, and 92 recurrent. Standardized data collection forms were used and submitted for centralized data analysis. For the hernioplasty, Cooper's ligament was exposed and an 8 cm x 12 cm x 1 mm GORE-TEX Soft Tissue Patch was stapled circumferentially to Cooper's ligament and the endoabdominal fascia. Patients were followed at 1 week, 6 months, 1 year, and then annually. Three-month intervals were used as needed. There was a mean follow-up of 447 days, with 21% of the total repairs followed for more than 2 years and 56% for more than a year. The overall follow-up rate was 95.5%. The operative and postoperative complication rates were 0.45% and 8%, respectively. There were 17 recurrent hernias (3.8%). The range of experience among the investigators was 13 to 168 hernioplasties. With the completion of 25 cases per investigator, the recurrence rate fell to 0.39%. Postoperative analgesia averaged a 24-hr supply of medication; 12.2% of patients required no analgesia. Convalescence averaged 5.4 days, and return to work averaged 7.7 days. This multicenter trial demonstrates that the ePTFE laparoscopic peritoneal onlay inguinal hernioplasty is a safe and dependable repair, especially after the initial learning curve is surmounted.

Over a 2-year period 157 inguinal hernias in 151 patients were consecutively entered in this descriptive, observational study to determine any difference in outcome between a laparoscopic inguinal hernia repair versus an open inguinal hernia repair in a community hospital setting. The laparoscopic transabdominal preperitoneal technique was utilized in 50 cases. A conventional open repair was used in 107 cases. There were statistically significant differences when the laparoscopic and open groups were compared for the number of days until driving a car (p < 0.01), the number of days until getting in and out of bed comfortably (p = 0.01), the number of days until working on a limited basis (p = 0.01), and the number of days until working on a full-time basis (p < 0.05), although these differences may be due to confounding factors in this nonrandomized study. The average length of operating time was 72.2 min laparoscopic versus 51.6 min open (p < 0.001). We have shown that laparoscopic inguinal hernia repairs may have benefits over conventional hernia repairs. This may make its use more widespread than it has already become.

The purpose of this study was to determine the feasibility of performing laparoscopic radical prostatectomy in a canine model. Laparoscopic radical prostatectomy was performed on six adult male canines. A new endoscopic needle driver was used to construct a secure vesicourethral anastomosis. Average operative time required to complete the procedure was 304 min (range 270-345 min). Dissection of the prostate gland took an average of 67 min (range 35-90 min), and construction of the vesicourethral anastomosis took 154 min (rage 80-240 min). There were no intraoperative complications and only one postoperative complication (anastomotic leak). Five of the six animals recovered uneventfully from the procedure, and their foley catheters were removed 10-14 days postoperatively after a retrograde cystourethrogram demonstrated an intact vesicourethral anastomosis. Four (80%) of the surviving animals were clinically continent within 10 days after catheter removal. Post mortem examination confirmed that the vesicourethral anastomosis was intact with no evidence of urine extravasation. These data demonstrate the feasibility of laparoscopic radical prostatectomy in a canine model, and suggest that additional work with this technique should be continued to develop its potential clinical application.

Journal of Laparoendoscopic SurgeryVol. 6, No. 3 TISSUE APPROXIMATION IN ENDOSCOPIC SURGERYRobert RegeRobert RegeSearch for more papers by this authorPublished Online:10 Apr 2009https://doi.org/10.1089/lps.1996.6.200AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "TISSUE APPROXIMATION IN ENDOSCOPIC SURGERY." , 6(3), p. 200FiguresReferencesRelatedDetails Volume 6Issue 3Jun 1996 To cite this article:Robert Rege.TISSUE APPROXIMATION IN ENDOSCOPIC SURGERY.Journal of Laparoendoscopic Surgery.Jun 1996.200-200.http://doi.org/10.1089/lps.1996.6.200Published in Volume: 6 Issue 3: April 10, 2009PDF download

Journal of Laparoendoscopic SurgeryVol. 6, No. 1 UROLOGIC LAPAROSCOPYKevin T. McVaryKevin T. McVarySearch for more papers by this authorPublished Online:10 Apr 2009https://doi.org/10.1089/lps.1996.6.69AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "UROLOGIC LAPAROSCOPY." , 6(1), p. 69FiguresReferencesRelatedDetailsCited byLAPAROSCOPY IN THE CHILD28 February 2013Anaesthesia and laparoscopic surgery in childrenPediatric Anesthesia, Vol. 11, No. 4Anaesthesia for laparoscopic procedures in infants and children: indications, intra- and post-operative management, prevention and treatment of complicationsCurrent Opinion in Anaesthesiology, Vol. 12, No. 3Pneumoperitoneum in the Pediatric Age Volume 6Issue 1Feb 1996 To cite this article:Kevin T. McVary.UROLOGIC LAPAROSCOPY.Journal of Laparoendoscopic Surgery.Feb 1996.69-69.http://doi.org/10.1089/lps.1996.6.69Published in Volume: 6 Issue 1: April 10, 2009PDF download

Journal of Laparoendoscopic SurgeryVol. 6, No. 2 TEXTBOOK OF LAPAROSCOPYMary OttersonMary OttersonSearch for more papers by this authorPublished Online:10 Apr 2009https://doi.org/10.1089/lps.1996.6.137AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "TEXTBOOK OF LAPAROSCOPY." , 6(2), p. 137FiguresReferencesRelatedDetails Volume 6Issue 2Apr 1996 To cite this article:Mary Otterson.TEXTBOOK OF LAPAROSCOPY.Journal of Laparoendoscopic Surgery.Apr 1996.137-137.http://doi.org/10.1089/lps.1996.6.137Published in Volume: 6 Issue 2: April 10, 2009PDF download

Laparoscopic splenectomy is a new technique that is being utilized in patients with a variety of mostly hematologic disorders. Its application in children has not been extensively documented. Between January 1994 and February 1995, 11 children less than 15 years of age underwent elective laparoscopic splenectomy. Data collected from this treatment group were compared to that from the ten most recent open splenectomy patients with comparable hematologic disorders. All procedures in both groups were successful in relief of symptoms, increase in platelet count, and/or increase in hematocrit. Operative times averaged 147 mm in the laparoscopic group, compared to 112 mm in the open group. Estimated blood loss was 32 ml in the laparoscopic group and 86 ml in the open group. Days to laparoscopic patient discharge were 3.6, compared to 5.3 days in the open group. There were no wound complications or need for perioperative platelet transfusions in the laparoscopic patients. Patient response has been uniformly positive in the laparoscopic group. Reusable access trocars are utilized for two of the four working ports. Stapling devices and special tissue morselizers are not required. There are no additional operating room or surgeons fees incurred in the laparoscopic procedures. This series demonstrates that laparoscopic splenectomy is a safe, cost-efficient alternative to open splenectomy in children with a variety of hematologic disorders.