Surgical endoscopy
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Review Multicenter Study Comparative Study
Laparoscopic adrenalectomy for pheochromocytoma. A comparison to aldosteronoma and incidentaloma.
Laparoscopic adrenalectomy is a safe and effective treatment for most surgical diseases of the adrenal gland. However it has been suggested that catecholamine effects associated with pheochromocytoma render the laparoscopic approach a more challenging and a more morbid procedure. The purpose of this study was to compare the operative characteristics and outcomes of laparoscopic adrenalectomy for pheochromocytoma to those of aldosteronoma and incidentaloma. ⋯ Despite concern about increased operative times and morbidity associated with pheochromocytoma, our experience supports that laparoscopic adrenalectomy may be performed as safely as, and achieve outcomes similar to, those for other diseases.
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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).
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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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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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Review Comparative Study
Laparoscopy for appendicitis and cholelithiasis during pregnancy: a new standard of care.
Subsequent to a report from the authors' institution, the laparoscopic management of symptomatic cholelithiasis and appendicitis during pregnancy has become the standard of care at LDS Hospital using institutional guidelines. For comparison with previous outcomes described by the authors, 59 additional laparoscopic cases are reported. ⋯ With the use of the authors' guidelines, laparoscopy has become the standard of care for managing symptomatic cholelithiasis and appendicitis during pregnancy at LDS Hospital without significant increase in morbidity or mortality.