Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Aug 2011
Comparative StudyProspects of robotic thyroidectomy using a gasless, transaxillary approach for the management of thyroid carcinoma.
Robotic surgical systems are among the most innovative surgical developments and have radically promoted the use of minimally invasive techniques. Robotic technologies using different approaches have also been applied to thyroid surgery. Recently, the authors described a novel robotic surgical method for thyroid surgery based on a gasless, transaxillary approach (TAA), and have since serially reported on its technical feasibility and safety. Here, the authors report their experience of a consecutive series of 1000 cases treated using robotic thyroidectomy, and demonstrate its use for the surgical management of thyroid cancer. ⋯ The authors conclude that robotic thyroidectomy using a gasless TAA is a feasible, safe, and promising surgical alternative for selected patients with low-risk thyroid cancer, and recommend that the inclusion criteria of this technique be gradually extended to advanced thyroid cancer given suitable operator experience and future developments in robotic systems and instrumentation.
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Surg Laparosc Endosc Percutan Tech · Aug 2011
Case ReportsLaparoscopic repair of esophageal perforation due to Boerhaave syndrome.
Boerhaave syndrome is the spontaneous transmural rupture of the esophagus due to an increase in intraesophageal pressure when vomiting against a closed glottis. There are various methods of managing it, with the main principles of limiting sepsis, draining the area, and maintaining nutrition. ⋯ There is a paucity of literature regarding this mode of management and we have discussed the various options available in literature. We conclude that this is a safe and viable option in the management of Boerhaave syndrome in a nonseptic patient presenting early.
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Surg Laparosc Endosc Percutan Tech · Aug 2011
Case ReportsFinding a lost needle in laparoscopic surgery.
A lost needle during laparoscopic surgery is an uncommon major surgical problem. Finding and retrieval can be a challenge, whereas failure to do so carry potentially serious clinical and medicolegal implications. This study aims to investigate the application of a new device to retrieve lost needles intraoperatively compared with traditional management. ⋯ Lost needles during laparoscopic surgery can be located and retrieved by various methods. We found the laparoscopic magnet to be the safest and most efficient way of retrieving lost needles intraoperatively.
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Surg Laparosc Endosc Percutan Tech · Jun 2011
Multicenter Study Comparative StudyLaparoscopic appendicectomy for complicated appendicitis: is it safe and justified?: A retrospective analysis.
Although laparoscopic appendectomy has some advantages over open appendectomy, the literature suggests conflicting results regarding postoperative complications for complicated appendicitis. ⋯ The morbidity rates, particularly for intra-abdominal abscesses and wound infection were less for laparoscopic appendectomy in complicated appendicitis than those reported in the literature for open appendectomy, whereas operating times and hospital stays were similar.
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Surg Laparosc Endosc Percutan Tech · Jun 2011
ReviewUse of fibrin-based sealants and gelatin-matrix hemostats in laparoscopic liver surgery.
During surgery, liver tissue is particularly prone to bleeding which can be difficult to control, especially in patients with liver disease-associated coagulopathy. Topical sealants and hemostats can enhance clot formation and wound healing, and can be useful for controlling or preventing troublesome bleeding during surgical interventions where conventional methods of hemostasis are inadequate. ⋯ On the basis of current evidence of using hemostats and sealants in open liver surgery, there is potential of developing these strategies in laparoscopic liver surgery.