Surgical laparoscopy & endoscopy
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Wandering spleen is a rare clinical diagnosis with a high incidence of splenic torsion and infarction. The preferred treatment for this condition currently is splenopexy to reposition and fixate the spleen in the left upper quadrant of the abdomen to preserve splenic function. We recently performed the first splenopexy for a wandering spleen using laparoscopic techniques. ⋯ Total operative time was 175 min, there were no intra- or postoperative complications, and the patient was discharged on the 1st postoperative day. Follow-up at 2 and 7 months indicated that she was asymptomatic with a nonpalpable spleen. The results suggest that a laparoscopic approach to splenopexy should be considered for the treatment of patients with a wandering spleen.
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We report on thoracoscopic plication of the the paralyzed right hemidiaphragm of a 33-year-old woman with a history of reactive airway disease. The paralysis was secondary to transection of the phrenic nerve during right first rib resection for thoracic outlet syndrome 1 year prior to evaluation. ⋯ Postoperative recovery was uneventful, with minimal pain and early discharge. Preoperative symptoms of exertional dyspnea and orthopnea were significantly improved.
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Surg Laparosc Endosc · Apr 1998
Resistance to venous outflow during laparoscopic cholecystectomy and laparoscopic herniorrhaphy.
The effects of pneumoperitoneum on peak venous flow velocity in the common femoral vein and the vena cava have already been studied. The results suggested that venous stasis occurs during surgical pneumoperitoneum. This study determines the effects of pneumoperitoneum on the overall venous outflow resistance of the lower limbs. ⋯ During pneumoperitoneum, no obstruction to total lower limb venous outflow could be demonstrated, indicating that venous stasis in the limbs did not occur, and consequently, flow in the iliac and inferior caval veins was not compromised. Hypothetically, active vasodilatation resulting from mild compression may explain this. In our view, no special measures to prevent deep venous thrombosis have to be taken during laparoscopic procedures.
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Surg Laparosc Endosc · Feb 1998
The use of laparoscopy as a primary diagnostic and therapeutic method in penetrating wounds of lower thoracal region.
Diagnostic laparoscopy (DL) was found to be a sensitive and specific method that reduced the incidence of negative or nontherapeutic laparotomy in patients having penetrating abdominal trauma. Twenty-two patients with penetrating trauma of the lower thoracal region were evaluated by DL at the Emergency Department of the Istanbul Medical Faculty to decide on either laparotomy or conservative treatment. There were 7 (31.8%) female and 15 (68.2%) male patients. ⋯ All patients who underwent only DL was discharged within 24 hours. There were no mortality or morbidity. Mean follow-up period was 13 months, and no associated complication was encountered during this time.
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Surg Laparosc Endosc · Dec 1997
Review Comparative StudyAppendicitis: laparoscopic versus conventional operation: a study and review of the literature.
A retrospective study was performed after introduction of the laparoscopic technique in patients with suspected appendicitis to validate it in comparison with conventional open appendectomy. A series of 103 patients with suspected acute appendicitis were included. In 51 consecutive patients, a diagnostic laparoscopy was performed, and, if needed, an appendectomy was carried out. ⋯ The postoperative need for analgesia was lower (p < 0.01) and the operation time was longer (p < 0.0001) in the laparoscopic group than the group that underwent open surgery. It can be concluded that the greatest benefits of the laparoscopic technique are that it causes less trauma, the diagnostic accuracy is better, and the cosmetic result is superior to that after a conventional operation. This is all at the price of a longer operation time.