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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  LITERATURE REVIEW
Comparison between Robotic Radical Hysterectomy with Laparoscopic and Open Abdominal Radical Hysterectomy in the Treatment of Early Stage Cervical Cancer
Boy Busmar
[Year:2015] [Month:January-April] [Volume:8 ] [Number:1] [Pages:34] [Pages No:26-31] [No of Hits : 1141]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1241 | FREE

ABSTRACT

Robot-assisted procedures are being increasingly incorporated in gynecologic oncology. Several studies have confirmed the feasibility and safety of robotic radical hysterectomy for selected patients with early-stage cervical cancer. It has been demonstrated that robotic radical hysterectomy offers an advantage over laparoscopic and open abdominal radical hysterectomy approaches with regard to operative time, blood loss and hospital stay.
Also, initial evidences concerning oncological outcomes seem to confirm the equivalence to traditional open technique. Despite the fact that costs of robotic system are still high, they could be compensated by several health-related and social benefits: less pain, faster dismissal, and return to full activity than other surgical approaches.

Keywords: abdominal radical hysterectomy, blood loss, conversion rate, early cervical cancer, hospital stay, laparoscopic radical hysterectomy, number of lymph node, operative time, postoperative infection, recurrence, Robot-assisted radical hysterectomy, urinary tract complication.

How to cite this article: Busmar B. Comparison between Robotic Radical Hysterectomy with Laparoscopic and Open Abdominal Radical Hysterectomy in the Treatment of Early Stage Cervical Cancer. World J Lap Surg 2015;8(1):26-31.

Source of support: Nil

Conflict of interest: None

 
2.  ORIGINAL ARTICLE
Role of Diagnostic Laparoscopy in Patients with Acute or Chronic Nonspecific Abdominal Pain
A Rubbia, GA Faryal, I Javeria, M Roohul
[Year:2015] [Month:January-April] [Volume:8 ] [Number:1] [Pages:34] [Pages No:7-12] [No of Hits : 691]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1237 | FREE

ABSTRACT

Aim: The aim of our study was to evaluate and establish the role of diagnostic laparoscopy (DL) in unexplained/nonspecific abdominal pain (NSAP) in this era of therapeutic laparoscopy, and thus to analyze and support the theory of minimal access surgery in diagnosing and treating abdominal conditions.

Materials and methods: In this prospective study included patients with abdominal pain of (i) more than 6 hours and less than 6 days duration (acute) and (ii) more than or equal to 6 months duration (chronic) were included whether presenting as a surgical emergency or coming to surgical outpatient department (OPD) in whom a DL was performed after failure to achieve a diagnosis with conventional methods. The study included a total of 168 consecutive patients who fulfilled our inclusion criteria and underwent DL for NSAP. Their demographic and clinical data, admission dates and dates of surgery were noted. Outcome of surgery was recorded and the data were analyzed to ascertain the role and diagnostic yield of laparoscopy in our department, both in acute and chronic abdominal pain of nonspecific nature. Patients were followed postoperative for 3 months for any recurrence of symptoms.

Results: Laparoscopy yielded diagnoses in 161 of these patients giving a diagnostic yield of 95.8%. Appendicitis (39.2%), gynecological pathology (16%) and abdominal tuberculosis (8.9%) were the major findings. Therapeutic procedures were performed in 112 cases (66.6%) where peroperative pathology was identified. In 38 cases (22.6%) where there was strong clinical suspicion of appendicitis and no pathology could be identified peroperative, an appendectomy was performed. Twenty-eight (73.6%) of these appendix specimens were found inflamed on subsequent histologic examination. There were no complications in this series.

Conclusion: This study establishes the role of early DL as a safe procedure with high efficacy. Hence, it is an effective investigative tool in undiagnosed abdominal pain of both acute and chronic nature.

Keywords: acute appendicitis, Diagnostic laparoscopy, gynecological pathology.

How to cite this article: Rubbia A, Faryal GA, Javeria I, Roohul M. Role of Diagnostic Laparoscopy in Patients with Acute or Chronic Nonspecific Abdominal Pain. World J Lap Surg 2015;8(1):7-12.

Source of support: Nil

Conflict of interest: None

 
3.  RANDOMIZED CONTROL TRIAL
Effect of Warm-up Exercises on Laparoscopic Trainer: Improvement of Operator Smoothness
Nava Navaneethan, Peter Hewett
[Year:2015] [Month:January-April] [Volume:8 ] [Number:1] [Pages:34] [Pages No:21-25] [No of Hits : 521]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1240 | FREE

ABSTRACT

Background: Several recent studies have produced conflicting results of warming up prior to laparoscopic surgery and surgical performance. The purpose of this study was to investigate whether warming up prior to a laparoscopic task improves a subsequent task performed on a laparoscopic trainer.

Materials and methods: A prospective randomized controlled trial was conducted to compare warm-up modalities to no warm-up. The study was conducted at a single site, with 44 participants, including surgeons, medical students and surgical trainees. Randomization done within each group.
Control group was asked to do a designated task without a warm-up. Warm-up groups were asked to perform a warmup exercise prior to the designated task. Performances were recorded and analyzed with a computerized software different performance parameters were compared.

Results: Warm-up was a significant predictor of smoothness of the operator’s hand movement at the 5% significance level (p = 0.0358).
While there were some improvement of performances between control groups was demonstrated, they were not clinically significant.

Conclusion: This study shows that warming up prior to a task has a positive influence in the subsequent performance in smoothness of instrument movement in surgeons group. The major limitation of the study was the number of participants.

Keywords: Exercises, Laparoscopy, Simulation, Training, Warm-up.

How to cite this article: Navaneethan N, Hewett P. Effect of Warm-up Exercises on Laparoscopic Trainer: Improvement of Operator Smoothness. World J Lap Surg 2015;8(1):21-25.

Source of support: Nil

Conflict of interest: None

 
4.  Review Article
Co2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance
Sefik Hasukic
[Year:2014] [Month:January-April] [Volume:7 ] [Number:1] [Pages:47] [Pages No:33-40] [No of Hits : 2567]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1214 | FREE

ABSTRACT

Background: Knowledge of the pathophysiological basis of laparoscopic procedures, in particular the impact of CO2- pneumoperitoneum (PNP) on the body, can prevent onset of complications during laparoscopy.

Design and Methods: Standard intra-abdominal pressure (IAP), which is used during laparoscopic surgery, is 12 to 15 mm Hg. The direct effect of CO2-pneumoperitoneum is a consequence of the mechanical action of the gas, and increased intra-abdominal pressure. The indirect effect of CO2-pneumoperitoneum caused by the absorption of gas from the abdomen. Analysis of articles that evaluated the effects of CO2-pneumoperitoneum on the body and intra-abdominal organs contributes to an even better use of the laparoscopic method.

Results: The results of numerous experimental and clinical studies have confirmed that increased IAP and CO2-pneumoperitoneum intraoperatively causing reduction the portal venous blood flow, increasing venous stasis, reduced glomerular filtration, reduced Tiffeneau-index and pulmonary compliance what it can lead to hemodynamic and cardiac disorders. Consecutive intraoperative acidosis and hipercarbia impact the function of intra-abdominal organs and heart.

Conclusion: To avoid the side effects of CO2-pneumoperitoneum, which is important in patients with ASA II and more often as necessary to be operate with low pressure (IAP: 6-8 mm Hg) or use gasless laparoscopy.

Keywords: Laparoscopic surgery, CO2-pneumoperitoneum, Hepatic, Renal, Pulmonary and cardial changes, Venous stasis.

How to cite this article: Hasukic š. CO2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance. World J Lap Surg 2014;7(1):33-40.

Source of support: Nil

Conflict of interest: None

 
5.  Review Article
Differences between Thunderbeat, Ligasure and Harmonic Scalpel Energy System in Minimally Invasive Surgery
George Chilaka Obonna, RK Mishra
[Year:2014] [Month:January-April] [Volume:7 ] [Number:1] [Pages:47] [Pages No:41-44] [No of Hits : 2384]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1215 | FREE

ABSTRACT

Background: An essential part of surgery is dissection and securing hemostasis. This is easily done by the use of energy. Thunderbeat energy source has superseded the Ligasure and harmonic energy sources in this respect.

Aim: To review literature on the differences between thunderbeat, LigaSure and harmonic energy systems.

Materials and methods: These were drawn from previous research materials online in pubMed, researchgate, Wikipedia and YouTube.

Conclusion: Thunderbeat has a higher versatility than other instruments. This new energy device is an appealing, safe alternative for cutting, coagulation, and tissue dissection during surgery and decreases time and increases versatility during surgical procedures.

Keywords: Thunderbeat, Ligasure, Harmonic, Energy systems, Versatility.

How to cite this article: Obonna GC, Mishra RK. Differences between Thunderbeat, Ligasure and Harmonic Scalpel Energy System in Minimally Invasive Surgery. World J Lap Surg 2014; 7(1):41-44.

Source of support: Nil

Conflict of interest: None

 
6.  Review Article
Polycystic Ovarian Syndrome: Pathophysiology and Infertility
Bassim Alsadi
[Year:2014] [Month:January-April] [Volume:7 ] [Number:1] [Pages:47] [Pages No:23-27] [No of Hits : 2116]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1212 | FREE

ABSTRACT

Polycystic ovarian syndrome (PCOS) is recognized as the commonest endocrinopathy of women in the reproductive age. The definition, heterogeneity of clinical presentation, variability of symptoms in different age groups, overlapping instrumental and laboratory diagnostic criteria with physiological situations and the etiological hypotheses of PCOS are continuously evolving to accommodate expanding knowledge on the syndrome, which is now known to be more complex than purely a reproductive disorder. This article reviews the pathophysiology aspects known to underlie the ovarian and metabolic abnormalities characterizing PCOS. The interdependence between reproductive and metabolic aspects of PCOS and therapeutic implications for the management of PCOS are also discussed.

Materials and methods: extensive review of literature of articles published in English language was conducted using the following engines: Google, Yahoo, Medline, PubMed and Medscape.

Keywords: Polycystic ovary, Polycystic ovarian syndrome, Infertility.

How to cite this article: Alsadi B. Polycystic Ovarian Syndrome: Pathophysiology and Infertility. World J Lap Surg 2014;7(1):23-27.

Source of support: Nil

Conflict of interest: None

 
7.  Original Article
A Comparative Randomized Parallel Group Study between the Classical TAPP Repair and Modified TAPP Surgical Method for Inguinal Hernia Repair
Sumanta Kumar Ghosh
[Year:2014] [Month:January-April] [Volume:7 ] [Number:1] [Pages:47] [Pages No:16-22] [No of Hits : 1816]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1211 | FREE

ABSTRACT

Objective: To compare equality of clinical outcome of simultaneous bilateral transabdominal preperitoneal (TAPP) repair of inguinal hernia by classical TAPP, with meticulous closure of peritoneal flap and modified TAPP, with peritoneal nonclosure and controlled release of pneumoperitoneum. Study to answer the research question-‘is meticulous closure of peritoneal flap, the only way to provide adequate cover for the mesh in TAPP repair?’

Summary and background data: The objective of meticulous closure of peritoneum is to prevent internal herniation while covering the mesh adequately to avoid contact between mesh and abdominal viscera. The study proposes same objective can also be achieved with nonclosure of peritoneum.

Patients and methods: Between August 2011 and July 2012, 130 inguinal hernias of 65 patients who underwent TAPP repair were randomized in two groups. One group (n = 65) of hernias received classical repair with peritoneal closure (control), while the other (n = 65) without closure (study). The primary end points were bowel related complications and recurrence.

Results: The two groups were comparable in age and types of hernia. Transabdominal preperitoneal was successfully done in all cases. No bowel-related complication and recurrence occurred in either group. Mean operating time was significantly less with modified TAPP (65 mins vs 76 mins, p < 0.05). Lower incidence of chronic pain (3 vs 13.84%, p = 0.007) and seroma (7.69 vs 15.38%) was achieved during mean follow-up of 628 days.

Conclusion: The randomized prospective parallel group study demonstrated equality in clinical outcome on both primary end points by providing equivalent peritoneal cover for the mesh as meticulous peritoneal closure does in classical TAPP.

Keywords: Laparoscopic repair, inguinal hernia, Preperitoneal, Transperitoneal, Complication, Intestinal.

How to cite this article: Ghosh SK. A Comparative Randomized Parallel Group Study between the Classical TAPP Repair and Modified TAPP Surgical Method for Inguinal Hernia Repair. World J Lap Surg 2014;7(1):16-22.

Source of support: Nil

Conflict of interest: None

 
8.  Review Article
Comparing Extracorporeal Knots in Laparoscopy using Knot and Loop Securities
Rasaq Akintunde Akindele, Adeniyi Olanipekun Fasanu, Suresh Chandra Mondal, Johnson Olusanmi Komolafe, Rajneesh Kumar Mishra
[Year:2014] [Month:January-April] [Volume:7 ] [Number:1] [Pages:47] [Pages No:28-32] [No of Hits : 1812]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1213 | FREE

ABSTRACT

Background: Laparoscopic knot tying is a basic surgical skill that has been practiced for centuries having their roots in fishing and sailing.1-4 The advent of endoscopic surgery placed more challenges on the surgeons and this ever growing skills need to be acquired. Since endoscopic and arthroscopic knots must be delivered over a distance to a tissue with minimal access maintaining tension is more important than the knot configuration chosen.5,6 The aim of this article review is to determine which hand tied knot configuration and possibly, suture size, and suture type that would be safe in laparoscopic surgery.

Materials and methods: A literature review was performed using Pubmed, Springerlink, Highwire press and search engines, like Google and Yahoo. The following search terms were used: extracorporeal knot, arthroscopic knots, Roeder's knot, Meltzer's knot, Mishra's knot, Duncan knot, Nicky's knot, SMC knot, Weston knot and Tennessee extracorporeal knot. A total of 48,100 citations were found. Selected papers were screened for further references. Publications that featured illustrations of sliding knots with statistical methods of analysis were selected. More than 20 different sliding knots were used for this review.

Result: Eighty-one articles were reviewed. Most studies have evaluated knot security only and few studies have evaluated simultaneous both loop and knot security and also only a few compared knot and loop securities to the type of suture materials and their sizes. The addition of three RHAPs improves knot security of all sliding knots tested and improves the loop security of most of the sliding knots tested.

Conclusion: the safety of extracorporeal knot depends on knot configuration, especially when further RHAPs are included.

Keywords: Extracorporeal knot, Tissue approximation, Laparoscopic suturing.

How to cite this article: Akindele RA, Fasanu AO, Mondal SC, Komolafe JO, Mishra RK. Comparing Extracorporeal Knots in Laparoscopy using Knot and Loop Securities. World J Lap Surg 2014;7(1):28-32.

Source of support: Nil

Conflict of interest: None

 
9.  Original Article
Laparoscopic Vasectomy vs Laparoscopic Sterilization in Dogs: A Comparison of Two Techniques
Anburaja Mahalingam, Naveen Kumar, Swapan Kumar Maiti, Ashok Kumar Sharma, Umesh Dimri, Meena Kataria, Dayamon David Mathew, V Remya, A Mohsina
[Year:2014] [Month:January-April] [Volume:7 ] [Number:1] [Pages:47] [Pages No:7-15] [No of Hits : 1591]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1210 | FREE

ABSTRACT

Twelve clinically healthy, adult male dogs randomly equally divided into two groups (I and II). Animals of both the groups received xylazine-ketamine anesthesia. Laparoscopic bilateral vasectomy was performed in group I, whereas in animals of group II in additition to vasectomy, spermatic artery-vein plexus were clipped with titanium clips at a distance of 1 to 2 cm. Insufflation of abdominal cavity was achieved by CO2 (2 liter/minute) at 10 mm Hg pressure gradient. Clinical observations revealed no significant changes. Differential leukocyte count (DLC) revealed significant neutrophilia and comparative lymphopenia on 3rd postoperative in both groups. Significant increase (p < 0.05) in plasma alkaline and acid phosphatase level was observed on day 3 postoperatively. Indices of oxidative stress viz lipid peroxidation (LPO), catalase (CAT), superoxide dismutase (SOD), reduced glutathione activity and acute phase protein, ceruloplasmin level in plasma did not revealed any major significant changes but indicated that oxidative stress was more in group II animals. Plasma cortisol level increased significantly (p < 0.01) after operation and testosterone level showed gradual decrease (p > 0.05) up to 7th postoperative day in animals of group II. On the basis of the parameters studied, it can be concluded that capnoperitoneum at 10 mm Hg pressure gradient and CO2 at the flow rate of 2 liter/minute provides optimum visualization of intra-abdominal organs and found suitable for laparoscopic sterilization in male dogs. The laparoscopic vasectomy alone in male dogs was found comparatively quick, less time consuming and can be successfully applied for mass sterilization program. Oxidative stress in laparoscopic vasectomy (group I) was less as compared to other group.

Keywords: Male dogs, Laparoscopic vasectomy, Sterilization, Oxidative stress, Lipid peroxidation, Catalase, Superoxide dismu- tase, Reduced glutathione, Acute phase proteins.

How to cite this article: Mahalingam A, Kumar N, Maiti SK, Sharma AK, Dimri U, Kataria M, Mathew DD, Remya V, Mohsina A. Laparoscopic Vasectomy vs Laparoscopic Sterilization in Dogs: A Comparison of Two Techniques. World J Lap Surg 2014;7(1): 7-15.

Source of support: Nil

Conflict of interest: None

 
10.  Original Article
Laparoscopic Cholecystectomy after Endoscopic Retrograde Cholangiopancreatography: The Optimal Timing for Operation
Samir A Ammar, Mohamad Abdel Bar, Mohy El Shafy
[Year:2014] [Month:May-August] [Volume:7 ] [Number:2] [Pages:54] [Pages No:69-73] [No of Hits : 1260]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10033-1220 | FREE

ABSTRACT

Background: In patients with choledochocystolithiasis (CCL), early laparoscopic cholecystectomy (LC), within 72 hours, is recommended after endoscopic stone extraction. The objective of this study is to investigate LC for CCL within 24 hours of endoscopic retrograde cholangiopancreatography (ERCP) to determine its feasibility and safety.

Materials and methods: Group I, those patients who had LC within 24 hours after ERCP was compared with group II, those who had LC after 24 hours, but within 72 hours. Primary outcome was the conversion rate from LC to open cholecystectomy. Secondary outcomes were duration of LC, postoperative morbidity and hospital stay.

Results: Of 60 consecutive patients, 31 were in group I and 29 were in group II. There were no differences in groups I vs II in demographics, laboratory or ultrasonographic findings. The hospital stay in group I was significantly shorter than that of group II (2.5 ± 1.5 vs 4 ± 2 days respectively). There was no statistically significant difference in operative time, conversion to open cholecystectomy or postoperative morbidity between both groups.

Conclusion: LC for CCL within 24 hours after ERCP is feasible and safe with short hospital stay.

Keywords: Laparoscopic cholecystectomy, Gallstones, Common bile duct stones, Timing of operation.

How to cite this article: Ammar SA, Bar MA, El Shafy M. Laparo- scopic Cholecystectomy after Endoscopic Retrograde Cholangiopancreatography: The Optimal Timing for Operation. World J Lap Surg 2014;7(2):69-73.

Source of support: Nil

Conflict of interest: None

 
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