Surgical endoscopy
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There is still some controversy regarding the optimal timing and best method for the removal of common bile duct stones (CBDS). Intraoperative endoscopic retrograde cholangiopancreaticography (IO-ERCP) is an alternative method that should be considered for this procedure. The aim of our study was to investigate the clinical outcome of a single-step procedure (IO-ERCP) to remove CBDS, thereby combining two existing high-volume clinical modalities-i.e., laparoscopic cholecystectomy (LC) and ERCP. ⋯ The study suggests that elective IO-ERCP is a safe and efficient method for removing CBDS that has a low risk of inducing postoperative pancreatitis and does not prolong postoperative hospitalization. This technique enables perioperative extraction of CBDS without open or laparoscopic surgical exploration of the CBD and can be used safely in a routine clinical setting.
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The aim of this study was to assess the feasibility and safety of laparoscopic surgery for colorectal diseases. ⋯ Laparoscopic colorectal surgery performed in experienced centers is safe; the observed morbidity and mortality rates are low and acceptable and compare favorably to those observed after standard open surgery.
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Paralysis of the diaphragm is a severe complication of cardiothoracic surgery carrying significant morbidity and mortality. This study demonstrates a novel minimally invasive technique for treatment of phrenic nerve injuries presenting with symptomatic eventration of the diaphragm. It also presents long-term results of three patients treated with this operation. ⋯ Laparoscopic diaphragmatic plication provides excellent relief of symptoms caused by diaphragmatic paralysis. There is no perioperative morbidity, and hospital stay is short. The laparoscopic approach, therefore, is an attractive surgical alternative for the treatment of phrenic nerve palsy and should be considered in all suitable patients.
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Review Multicenter Study
Laparoscopic repair of large paraesophageal hernia is associated with a low incidence of recurrence and reoperation.
Laparoscopic repair of paraesophageal hernia (LRPEH) is a feasible and effective technique. There have been some recent concerns regarding possible high recurrence rates following laparoscopic repair. ⋯ LPEHR is a safe and effective treatment for PEH. Postoperative radiographic abnormalities, such as a small sliding hernia, are often seen. The clinical importance of these findings is questionable, since only a small percentage of patients require reoperation. True PEH recurrences are uncommon and frequently asymptomatic.
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Over the last 15 years, tissue expansion has been used in the treatment of 324 patients at the A. V. Vishnevsky Institute of Surgery. The principal drawbacks of the traditional technique for tissue expansion are the prolonged time needed to complete the process and a high rate of complications. With the traditional technique, the wound created by the implantation of the expander inhibits the expansion of the tissue until healing takes place, which requires 10-14 days. However, attempts to reduce of the length of the incision have been limited by the necessity to ensure good hemostasis in the expander pocket. We describe our initial experience with the endoscopic insertion of tissue expanders. ⋯ The advantages of the endoscopic implantation of tissue expanders are a reduction in expansion time, a shorter hospital stay, less patient discomfort, and the prevention of complications (hematoma, seroma, infection, wound dehiscence).