Surgical endoscopy
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Laparoscopic pancreaticoduodenectomy (LPD) is gaining momentum, but there is still uncertainty regarding its safety, reproducibility, and oncologic appropriateness. This review assesses the current status of LPD. ⋯ In selected patients, operated on by expert laparoscopic pancreatic surgeons, LPD is feasible and safe.
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We have evaluated the safety and feasibility of combining median-to-lateral and anterior-to-median (MLAM) approaches to perform laparoscopic complete mesocolic excision (CME) with radical lymph node dissection along the gastrocolic trunk of Henle (GTH) for right hemicolon cancer. ⋯ Laparoscopic CME conducted by fusion fascia exposure with radical lymph node dissection along the GTH via a combination of MLAM approaches is a safe and feasible procedure for right hemicolon cancer.
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Randomized Controlled Trial
A prospective randomized controlled trial assessing the efficacy of omentopexy during laparoscopic sleeve gastrectomy in reducing postoperative gastrointestinal symptoms.
Patients undergoing sleeve gastrectomy experience a significant amount of postoperative gastrointestinal (GI) symptoms. The purpose of our study was to assess the efficacy of omentopexy during laparoscopic sleeve gastrectomy (LSG) in reducing postoperative food intolerance and GI symptoms. ⋯ Omentopexy did not significantly decrease postoperative food intolerance or GI symptoms in morbidly obese patients undergoing LSG. Other methods of mitigating postoperative intolerance to oral intake and GI symptoms should be investigated.
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Randomized Controlled Trial
A prospective, randomized, controlled trial of the postoperative analgesic effects of spraying 0.25 % levobupivacaine after bilateral axillo-breast approach robotic thyroidectomy.
Robotic thyroidectomy (RoT) is frequently performed due to its excellent cosmesis and recovery features. However, postoperative pain in the operating field after RoT remains a concern due to extensive tissue dissection and tension during the operation. The aim of this study was to evaluate the anterior chest pain and the effect of levobupivacaine spraying on postoperative pain control after bilateral axillo-breast approach (BABA) RoT. ⋯ Levobupivacaine spray on the operative field at the end of BABA RoT reduced postoperative pain and PCA consumption without adverse events.
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Observational Study
The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery.
Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. ⋯ Our study documents the unique contribution of different interruptions on surgeons' workload; whereas case-irrelevant communications may be beneficial for mental fatigue and stress in routine cases, procedural interruptions and case-irrelevant communication may contribute to surgeons' mental focus deteriorating. Well-designed OR environments, surgical leadership, and awareness can help to control unnecessary interruptions for effective and safe surgical care.