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.

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.

Journal of Laparoendoscopic SurgeryVol. 5, No. 6 Laparoscopic AppendectomyCsak George PostaColCsak George PostaColSearch for more papers by this authorPublished Online:10 Apr 2009https://doi.org/10.1089/lps.1995.5.420AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "Laparoscopic Appendectomy." , 5(6), pp. 420–421FiguresReferencesRelatedDetails Volume 5Issue 6Dec 1995 To cite this article:Csak George PostaCol.Laparoscopic Appendectomy.Journal of Laparoendoscopic Surgery.Dec 1995.420-421.http://doi.org/10.1089/lps.1995.5.420Published in Volume: 5 Issue 6: April 10, 2009PDF download

Nineteen laparoscopic appendectomies by the same general surgeon are reported, using three trocar sites and suspending the appendix along the right lower quadrant trocar. This approach provides a fourth access site to the appendix without an additional port. Once the position of the appendix is stabilized, the two available ports are used to dissect around the base of the mesoappendix and place a silk ligature with extracorporeal ligating technique. All 19 procedures were completed by endoscopic means and without the use of endoscopic stapling devices, even when the mesoappendix was markedly swollen and edematous. The technique is presented here as an alterative method when performing laparoscopic appendectomy.

Laparoscopic cholecystectomy (LC) and laparoscopic appendectomy (LA) are well-established surgical procedures. Although pregnancy initially was considered a contraindication to laparoscopic surgical procedures, successful reports of LC and LA during pregnancy have appeared in the surgical literature. Two cases are presented in this report, one LC and one LA, both in second-trimester pregnancies. Both pregnancies contained undisturbed and ended with spontaneous vaginal delivery of healthy infants. Laparoscopic surgery in pregnant patients is feasible and provides a reasonable alternative to the standard surgical approach.

Mirizzi's syndrome is described as an impaction of gallstone(s) in the infundibulum, Hartmann's pouch, or cystic duct in close proximity to the common hepatic duct, causing secondary inflammation, hepatic duct obstruction, and jaundice. This anatomical configuration can unexpectedly present itself during laparoscopic cholecystectomy without the associated clinical syndrome. Identification of the gallbladder-cystic duct junction may become impossible, leading to dangerous exposure of the common duct. The case presented here demonstrates the dangers and difficulties encountered with such anatomy. Increased awareness of this rare and unusual configuration may help in avoiding injuries to the biliary tree during laparoscopic cholecystectomy.