Journal of minimal access surgery
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J Minim Access Surg · Apr 2012
A prospective nonrandomized comparison of laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication in Indian population using detailed objective and subjective criteria.
Laparoscopic Nissen fundoplication (LNF) is a commonly performed procedure for the treatment of gastro esophageal reflux disease (GERD) worldwide. However, unfavourable postoperative sequel, including gas bloat and dysphagia, has encouraged surgeons to perform alternative procedures such as laparoscopic Toupet fundoplication (LTF). This prospective nonrandomized study was designed to compare LNF with LTF in patients with GERD. ⋯ LNF and LTF are highly effective in the management of GERD with significant improvement in symptoms and objective parameters. LNF may be associated with significantly higher incidence of short onset transient dysphagia that improves with time. Patients in both the groups showed excellent symptom and objective control on 24-hour pH metry on short term follow-up.
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Obturator hernias (OH) account for a rare presentation to the surgical unit usually associated with bowel obstruction and strangulation. The treatment of this condition is classical laparotomy with repair of the hernia and bowel resection, if deemed necessary; recently, the laparoscopic approach has been reported in literature. This review examines the existing evidence of the safety and effectiveness of the laparoscopic approach for the management of OH. ⋯ This approach was found to be a safe and effective approach for the repair of OH as compared to the classical open approach; however, its adoption as the gold standard needs further multicenter trials.
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J Minim Access Surg · Oct 2011
Effects of dexmedetomidine on oxygenation during one-lung ventilation for thoracic surgery in adults.
To evaluate the effects of dexmedetomidine on hypoxic pulmonary vasoconstriction (HPV) and oxygenation during one-lung ventilation (OLV) in adults undergoing thoracic surgery. ⋯ Dexmedetomidine does not adversely affect oxygenation during OLV in adults undergoing thoracic surgical procedures. The improvement in oxygenation in the dexmedetomidine patients may be related to a decrease in the requirements for inhalational anaesthetic agents thereby limiting its effects on HPV.
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J Minim Access Surg · Jul 2011
To study the incidence of organ damage and post-operative care in patients of blunt abdominal trauma with haemoperitoneum managed by laparoscopy.
Laparoscopy is safe and effective in the management of blunt trauma abdomen (BTA) with haemoperitoneum, with all benefits of minimal access surgery. ⋯ The liver and spleen are the most common organs involved in patients with blunt abdominal trauma with haemoperitoneum. Laparoscopy is safe and efficient in patients with blunt trauma abdomen with haemoperitoneum, with fast recovery and low hospital stay.
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J Minim Access Surg · Oct 2010
Secrets of safe laparoscopic surgery: Anaesthetic and surgical considerations.
In recent years, laparoscopic surgery has gained popularity in clinical practice. The key element in laparoscopic surgery is creation of pneumoperitoneum and carbon dioxide is commonly used for insufflation. This pneumoperitoneum perils the normal cardiopulmonary system to a considerable extent. ⋯ There is no absolute contraindication of laparoscopic surgery, though we can anticipate some problems in conditions like obesity, pregnancy and previous abdominal surgery. This review discusses some aspects of the pathophysiology of carbon dioxide induced pneumoperitoneum, its consequences as well as strategies to counteract them. Also, we propose certain guidelines for safe laparoscopic surgery.