JSLS : Journal of the Society of Laparoendoscopic Surgeons
-
Laparoscopic cholecystectomy (LC) is increasingly being used as an appropriate early treatment in patients with cholecystitis. This study evaluated the safety, effectiveness, and complications of LC in all cases of acute cholecystitis. ⋯ LC is a safe, effective procedure for the early management of patients with acute cholecystitis. LC can be safely performed without routine IOC when ERCP is performed preoperatively on the basis of specific indications. Meticulous dissection and good exposure of Calot's triangle may prevent bile duct injuries.
-
The "Chinese Fan Spread" (CFS) distraction technique for laparoscopic reduction of intussusception is herein described and its outcome and benefits are evaluated. ⋯ Laparoscopic reduction of intussusception by the CFS distraction technique is effective and safe. Lead points may be dealt with together either laparoscopically or via a transumbilical incision.
-
Comparative Study
Laparoscopic versus open right hemicolectomy for carcinoma of the colon.
This study aimed to compare the outcomes of laparoscopic resection (LR) with open resection (OR) for right-sided colon cancer. ⋯ Laparoscopic right hemicolectomy is a safe option for cancers of the right colon. It is associated with a shorter hospital stay and earlier resumption of a normal diet. Mortality and morbidity are similar to that with the open approach. There is no compromise in the survival of patients.
-
Congenital absence of the gallbladder is a rare, usually asymptomatic, anatomical variation. Some affected individuals may present with a clinical picture suggestive of gallbladder disease. This presentation, coupled with the inability of standard abdominal ultrasonography to convincingly diagnose agenesis of the gallbladder, can put the surgeon in a diagnostic and intraoperative dilemma. ⋯ Nonvisualization of the gallbladder at laparoscopy, in the absence of any other diagnosed biliary disorder, need not prompt conversion to open exploration of the extrahepatic biliary system. Newer imaging modalities are relatively noninvasive and can provide good delineation of biliary anatomy. This allows wellplanned treatment and at the same time prevents the added morbidity of a diagnostic laparotomy performed solely to confirm the absence of the gallbladder.
-
Randomized Controlled Trial
Infiltration of suture sites with local anesthesia for management of pain following laparoscopic ventral hernia repairs: a prospective randomized trial.
Postoperative pain control after laparoscopic ventral hernia repairs remains a significant clinical problem. We sought to determine the pain-sparing efficacy of local anesthetic infiltrated into the abdominal wall wounds created by the placement of transabdominal sutures used to ensure adequate fixation of the mesh during laparoscopic ventral hernia repair. ⋯ This small, randomized study demonstrates that infiltration of suture fixation sites is effective in reducing early postoperative pain but not analgesic consumption following laparoscopic incisional and ventral hernia repairs. A larger study is required to investigate this strategy on later postoperative pain and hospital stay.