SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Surgical laparoscopy, endoscopy & percutaneous techniques

27

The emphasis for research in inguinal hernia repair has shifted from hernia recurrence to groin pain, which is considered the most important factor for poor quality of life.

Concepts: Inguinal hernia, Hernia

27

27

The rate of stoma reversal after Hartmann procedure is low, principally because of the technically demanding nature of the reversal procedure and preexisting comorbid disease frequently present in this patient group. Laparoscopic reversal of Hartmann procedure is an attractive alternative that can reduce perioperative morbidity but the feasibility of completing the procedure laparoscopically is often limited by extensive adhesion formation present after the initial open operation. We describe a technique for laparoscopic reversal of Hartmann procedure where the stoma is mobilized externally and a pneumoperitoneum established through this preexisting defect. Results for the first 7 cases show a median operative duration of 132 minutes and length of hospital stay of 6 days with no conversions. Insertion of the operating ports under direct vision and a more limited dissection to facilitate the anastomosis represents an alternative operative strategy that can be performed successfully, even in patients with comorbid disease.

Concepts: Time, Patient, Hospital, Surgery, Laparoscopic surgery, Laparoscopy, Pneumoperitoneum, Hartmann's operation

26

Recruitment maneuvers (RMs), which aim to ventilate the collaborated alveolus by temporarily increasing the transpulmonary pressure, have positive effects in relation to respiration, mainly oxygenation. Although many studies have defined the pressure values used during RM and the application period, our knowledge of the effects of different oxygen concentrations is limited. In this study, we aimed to determine the effects of different oxygen concentrations during RM on the arterial oxygenation and respiration mechanics in laparoscopic cases.

Concepts: Oxygen, Surgery, Anesthesia, General anaesthesia, Laparoscopic surgery, Laparoscopy, Respiration, Maneuver

26

In recent years, laparoscopy-assisted distal gastrectomy has become the recognized procedure for treatment of early gastric cancer because of improved cosmesis and reduced postoperative pain. However, there are a few reports of laparoscopic-assisted total gastrectomy (LATG) performed for gastric cancer in the upper third or middle third stomach due to the difficulties of surgical techniques and the safety of oncologic short-term and long-term outcomes.

Concepts: Metastasis, Stomach, Helicobacter pylori, Term, Abdomen, Stomach cancer, Gastrectomy

26

Laparoscopic gastrectomy (LAG) is increasingly used as a treatment for gastric cancer. However, it is contraindicated in patients with previous abdominal surgery, because of a higher risk of enteric injury, technical difficulties associated with adhesions, and longer operative times. The aim of this study was to assess the feasibility and clinical outcomes of LAG in patients who had previously undergone gastrectomy for gastric cancer.

Concepts: Surgery, Abdominal pain, Stomach, Abdomen, Amputation

25

3

We aimed to review our experience with laparoscopic cholecystectomy in the pediatric population to better understand the associated complications and outcomes.

Concepts: Laparoscopic surgery, Cholecystectomy

2

The last 2 decades have witnessed a revolution in the treatment of patients with paraesophageal hernia (PEH). Nowadays, the laparoscopic repair with fundoplication is considered as the primary treatment modality in most academic centers for symptomatic patients. Three findings have clearly emerged: (1) this procedure is technically demanding; (2) it is associated with relief of symptoms in most patients; and (3) most recurrences are small and asymptomatic. This article describes our approach step-by-step to the repair of a paraesophageal hiatal hernia, focusing on several technical controversies.

Concepts: Surgery, Hernias, Hiatus hernia

2

Repair of the large paraesophageal hernias-types II, III, and IV is a challenging surgical problem. There are many technical modifications to the numerous aspects of surgical repair. The 2 most critical aspects of repair are: (1) aggressive mobilization of the esophagus to restore and ensure length and (2) the underestimated and understudied technique of hiatal closure. We describe the techniques and unique modifications such as a combined Hill and Nissen repair utilized at Swedish Medical Center There remains considerable opportunity through research and surgical innovation to improve on existing techniques in the repair of the paraesophageal hernia.

Concepts: Medicine, Surgery, Creativity techniques, Hernia, Height, Quantification