Surgical endoscopy
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Spinal anesthesia has been successfully used to perform various laparoscopic procedures. However, laparoscopic cholecystectomy under spinal anesthesia has not been reported. Is this feasible? ⋯ Laparoscopic cholecystectomy can be performed successfully under spinal anesthesia and is well tolerated.
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Review Case Reports
Rupture of the lesser gastric curvature after a Heimlich maneuver.
We present a case of lesser gastric curvature injury after a Heimlich maneuver due to obstruction of the breathing tract that was repaired by laparoscopic surgery. ⋯ Laparoscopic surgery can be technically reproduced in the treatment of gastric injury as a result of closed abdominal traumatism.
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Randomized Controlled Trial Comparative Study Clinical Trial
T lymphocyte subsets and Th1/Th2 balance after laparoscopy-assisted distal gastrectomy.
Laparoscopic surgery provides for a less invasive procedure than open surgery in patients with gastric cancer, but the immune responses after laparoscopic surgery for early gastric cancer remain unknown. ⋯ When compared with ODG, LADG contributes to the preservation of postsurgical Th1 cell-mediated immune function.
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Development and clinical application of semi-loop-shaped retractor for gasless laparoscopic surgery.
Gasless laparoscopy has the advantage of avoiding the risk inherent in pneumoperitoneum, but has not gained widespread popularity because of limited exposure of the operative field. Improved retraction devices are therefore needed. ⋯ This new retractor for gasless laparoscopic surgery provides good exposure and has the potential to enhance the performance of advanced laparoscopic surgery.
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Comparative Study
Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries.
Advanced laparoscopic procedures have necessitated the development of new technology for vascular control. Suture ligation can be time-consuming and cumbersome during laparoscopic dissection. Titanium clips have been used for hemostasis, and recently plastic clips and energy sources such as ultrasonic coagulating shears and bipolar thermal energy devices have become popular. The purpose of this study was to compare the bursting pressure of arteries sealed with ultrasonic coagulating shears (UCS), electrothermal bipolar vessel sealer (EBVS), titanium laparoscopic clips (LCs), and plastic laparoscopic clips (PCs). In addition, the spread of thermal injury from the UCS and the EBVS was compared. ⋯ Both the PC and LC secured all vessel sizes to well above physiologic levels. The EBVS can be used confidently in vessels up to 7 mm. There is no difference in the thermal spread of the LigaSure vessel sealer and the UCS.