Journal of minimal access surgery
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J Minim Access Surg · Jan 2010
Anastomotic leak rate and outcome for laparoscopic intra-corporeal stapled anastomosis.
A prospective clinical audit of all patients undergoing laparoscopic surgery with the intention of primary colonic left-sided intracorporeal stapled anastomosis to identify the rate of anastomotic leaks on an intention to treat basis with or without defunctioning stoma. ⋯ This clinical audit confirms that the anastomotic leak rate for left-sided colorectal stapled anastomosis is no worse than that for open surgery. Therefore the decision making process for defunctioning stoma should be guided by the same principles as open surgery.
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J Minim Access Surg · Jul 2009
Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma.
The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma. ⋯ VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.
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Changes in oxygenation occur during one-lung ventilation (OLV) due to intrapulmonary shunt. Although arterial oxygenation is generally adequate, there are no studies evaluating the effect of these changes on cerebral oxygenation. ⋯ Significant changes in rSO2 occur during OLV for thoracic surgical procedures. Future studies are needed to determine the impact of such changes on the postoperative course of these patients.
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Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. ⋯ Analgesia management is modelled on that shown effective and therapeutic for thoracotomy. Perioperative management needs to reflect the concern for these complex, and complicating, processes to the morbidity of thoracoscopic surgery.
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J Minim Access Surg · Dec 2006
Teaching impact in pediatric minimal access surgery: Personal perspective from "Fellow".
The global objective of this paper is to review from the "Fellow" perspective, the current status of pediatric minimal access surgery (MAS) in terms of teaching feasibility, safety and impact on standard practice paradigms. In the pediatric general surgery field, surgeons are dealing with a wide range of pathology that includes thoracic, abdominal, urological and gynecological procedures. The learning curve is slow because of a relatively small volume of patients. ⋯ Integration of MAS training into the secondary residency/fellowship curriculum of pediatric surgeons is the inevitable goal. MAS- minded education and research through adequate training will pay dividends and "manufacture" competent, contemporary trainees. National Pediatric Surgery Associations should be responsible for setting criteria that consider the MAS for accreditation with maintaining the international standards of these teaching programs.