World Journal of Laparoscopic Surgery

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2011 | September-December | Volume 4 | Issue 3

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EDITORIAL

Editorial

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/wjols-4-3-v  |  Open Access |  How to cite  | 

1,182

RESEARCH ARTICLE

Ali Aminian, Rasoul Mirsharifi

Scarless Cholecystectomy with Standard Laparoscopic Instruments in Selected Patients

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:3] [Pages No:129 - 131]

   DOI: 10.5005/jp-journals-10007-1129  |  Open Access |  How to cite  | 

Abstract

Laparoscopic cholecystectomy is a gold standard for treatment of gallstone-related diseases. We have now modified this technique and introduced scarless cholecystectomy with standard laparoscopic instruments. Patients with normal body mass index and with no previous history of acute cholecystitis are suitable candidates for scarless cholecystectomy. Operation is performed through two 10 mm ports placed just above and below the umbilicus. Surgical exposure is created by applying two traction sutures, one placed in fundus and another in infundibulum of gallbladder. The ends of these sutures are pulled out the abdomen by means of percutaneously inserted suture passer. Applying different traction to these stitches, enable appropriate exposure of the Calot's triangle and gallbladder bed for dissection. We have concluded that scarless cholecystectomy is technically feasible and safe. Further validation of this approach, however, awaits randomized clinical trials and accurate comparison with outcomes of more conventional approaches.

4,544

REVIEW ARTICLE

Muhammad Nurhadi Rahman

The Camera-holding Robotic Device in Laparoscopy Surgery

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:4] [Pages No:132 - 135]

   DOI: 10.5005/jp-journals-10007-1130  |  Open Access |  How to cite  | 

Abstract

Background

The inconvenience of laparoscopic operations lies mainly in the difficulties in mutual understanding between the surgeon and the camera assistant who maneuvers the laparoscope according to the surgeon's instructions. Another problem arises when the operation has to be performed for many hours. In this case, the camera image tends to become unsteady due to fatigue of the camera assistant. The self camera-control by the surgeon gives more stability of the laparoscopic image. A robotic camera assistant, directly under surgeon's control, can help the surgeon control the view better. This review is limited only in the robotic camera holder to replace the assistant camera holder in laparoscopy surgery.

Materials and methods

Several types of the camera-holding robotic devices, such as the AESOP, EndoAssist, PMAT and PARAMIS were reviewed respectively.

Discussion

Most of the camera-holding robotic devices have the advantages, such as elimination of the fatigue of the assistant who holds the camera, elimination of fine motor tremor and small inaccurate movements, delivery of a steady and tremor-free image, nondependency on camera operator, reduced cost of surgery and reduced number of highly skilled staff. Some of them have additional advantages and disadvantages depend on their uniqueness.

Conclusion

There is no fundamental difference between the operation performed with and without the devices, but the machines do contribute to certain aspects of the operations and may help to overcome some of the difficulties encountered in these complex laparoscopy procedures. Unavailability and variability in quality of human camera-holders should not be an obstacle to performing satisfactory laparoscopic surgery. Therefore, some form of standardization of assistance is required and laparoscope-holding systems are a first step in this direction.

2,344

REVIEW ARTICLE

Role and Advantages of Laparoscopic Surgery in Liver Cirrhosis

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:4] [Pages No:136 - 139]

   DOI: 10.5005/jp-journals-10007-1131  |  Open Access |  How to cite  | 

Abstract

Liver cirrhosis has always been associated with operative morbidity and mortality because of associated coagulopathies, nutritional disorders and portal hypertension. Laparoscopic surgery has changed the thinking and now liver cirrhosis is not a contraindication for mild to moderate liver cirrhosis patients.1 This article's review studies done by operating laparoscopically on patients with liver cirrhosis and the methods with which the complications are avoided by laparoscopy during various surgeries and also in the diagnosis and management of cirrhosis of liver.

5,412

RESEARCH ARTICLE

Morvendhran Moodley

Current Laparoscopic Management of Symptomatic Meckel's Diverticulum

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:6] [Pages No:140 - 145]

   DOI: 10.5005/jp-journals-10007-1132  |  Open Access |  How to cite  | 

Abstract

Laparoscopic management is currently becoming an acceptable technique in the management of complicated Meckel's diverticulum. The study reviews the current techniques described in numerous series since over the past 10 years. Three laparoscopic techniques are described namely; LAMD (Laparoscopic-assisted Meckel's diverticulectomy—3 port technique with exteriorization of the diverticulum via the umbilical port and extracorporeal diverticulectomy), VATMD (Video-assisted Meckel's diverticulectomy—single umbilical port using operating laparoscope) and LMD(Laparoscopic Meckel's diverticulectomy—3 port technique with intracorporeal diverticulectomy). Small study sizes make in-depth statistical analysis impossible. Patient outcome with each technique however, seems similar, suggesting that the ultimate choice of procedure should be left to surgeon and institutional preference. The high incidence of heterotropic gastric mucosa (HGM) in complicated Meckel's diverticulum is confirmed and calculated to be an average of 78.2%.

2,818

REVIEW ARTICLE

Ahmed Nihad Abtar

Laparoscopic vs Open Pyeloplasty

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:3] [Pages No:146 - 148]

   DOI: 10.5005/jp-journals-10007-1133  |  Open Access |  How to cite  | 

Abstract

Conclusion

Most of the studies agreed on that LP had less morbidity and less hospital stay than OP, but the main disadvantage was the longer operative time.

7,069

REVIEW ARTICLE

Jayasree Santhosh

Advances in Minimal Access Surgery in the Surgical Staging of Carcinoma Endometrium

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:7] [Pages No:149 - 155]

   DOI: 10.5005/jp-journals-10007-1134  |  Open Access |  How to cite  | 

Abstract

The concept of minimal access surgery for gynecologic malignancies has gone from a perceived near impossibility to a fully recognized option for many patients over the past 10 years. This article reviews the different minimal access techniques used for surgical staging of carcinoma endometrium, their outcome, feasibility and safety in comparison to conventional staging laparotomy. After review of literature, it is concluded that laparoscopic and robotic-assisted procedures are acceptable and safer alternatives to traditional laparotomy in the staging of carcinoma endometrium, especially in obese women. Long-term outcome reports for robotic surgery is awaited.

2,720

REVIEW ARTICLE

Sini S Venugopal

Role of Minimal Access Surgery in Gestational Trophoblastic Disease

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:4] [Pages No:156 - 159]

   DOI: 10.5005/jp-journals-10007-1135  |  Open Access |  How to cite  | 

Abstract

Aim of study

The aim of this study is to evaluate the role of minimal access surgical procedures like laparoscopy, hysteroscopy and robotic surgery in the management of gestational trophoblastic tumors.

Methodology

(1) Materials: The study was carried out through a literature search using the information technology installations of the World Laparoscopy Hospital, Gurgaon, NCR, Delhi. (2) Time: The study was carried out during a period of 2 weeks between July 12th, 2011 and July 26th, 2011.

Data collection

All the publications used in the current study was accessed from the electronic (virtual) library using the following search engines: Google, SpringerLink, PubMed, Highwire press, Medline.

Abbreviations

(1) GTD: Gestational trophoblastic disease, (2) GTT: Gestational trophoblastic tumor, (3) GTN: Gestational trophoblastic neoplasia, (4) PSTT: Placental site trophoblastic tumor.

3,008

REVIEW ARTICLE

Kiran Somani, Dnyanesh M Belekar

Role of Minimal Access Surgery in Management of Infective Pancreatic Necrosis

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:6] [Pages No:160 - 165]

   DOI: 10.5005/jp-journals-10007-1136  |  Open Access |  How to cite  | 

Abstract

Aim

To study various minimal access surgical techniques of pancreatic debridement for infected pancreatic necrosis (IPN).

Method

A review of literature is done using various search engines like Google, Yahoo, PubMed, etc. by using keywords: Pancreatic necrosectomy, laparoscopic, endoscopic pancreatic necrosectomy.

This article reviews various methods of minimally access pancreatic necrosectomy (MAN) can be classified by the type of scope used flexible endoscope, laparoscope, nephroscope and the route of access transperitoneal, transgastric, retroperitoneal. Each of the scopes and access routes has its advantages and disadvantages.

Result and conclusion

Only few large series of cases of MAN have been published, rest are limited to case reports. There are no comparisons of results, either with open surgery or among different minimal access surgeries but a body of evidence now suggests that acceptable outcomes can be achieved and minimal access necrosectomy is technically feasible, well tolerated and beneficial for patients when compared with open surgery.

11,608

REVIEW ARTICLE

JA Maseloane

The Role of Mechanical Bowel Preparation in Gynecologic Laparoscopy

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:3] [Pages No:166 - 168]

   DOI: 10.5005/jp-journals-10007-1137  |  Open Access |  How to cite  | 

Abstract

Various combinations of dietary restriction, antibiotic regimens and mechanical preparations have become routine in preoperative surgical planning for elective colon surgery. This practice has also become commonplace in the field of gynecology, either for planned bowel surgery or in complex cases that are believed to be high risk for inadvertent bowel injury. As the trend in gynecologic surgery shifts toward more minimally invasive approaches, the complexity of cases being performed by laparoscopy and robotics continues to increase. In addition, laparoscopic surgical techniques have a different set of inherent risks and challenges as compared with open pelvic operations. This review summarizes the available data surrounding the use of mechanical bowel preparations, specifically with regard to gynecologic laparoscopy.

3,865

REVIEW ARTICLE

Mohamed Abdellateef

Laparoscopic Partial Nephrectomy: Expanding Role in the Treatment of Localized Renal Cell Carcinoma

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:5] [Pages No:169 - 173]

   DOI: 10.5005/jp-journals-10007-1138  |  Open Access |  How to cite  | 

Abstract

Context

The increasing incidence of localized renal cell carcinoma (RCC) over the last three decades have been well evident and have called for different treatment modalities among which laparoscopic partial nephrectomy has evolved.

Objective

To review the development, techniques, outcomes and current status of laparoscopic partial nephrectomy for the treatment of renal tumors.

Materials and methods

A literature search of English-language publications was performed using the Medline database and website PubMed. Many papers were identified of which 64 papers were selected for review based on their contribution and relevance.

Conclusion

Laparoscopic partial nephrectomy provides perioperative results as well as intermediate and long-term oncologic and functional outcomes comparable with the reference standard (open partial nephrectomy) with significantly decreased patient morbidity. Today, the indications for laparoscopic partial nephrectomy have expanded to include larger, more complex and higher-stage tumors.

5,529

REVIEW ARTICLE

William Wachira Kibe

The Role of Laparoscopy in the Management of Mirizzi's Syndrome: A Review of Literature

[Year:2011] [Month:September-December] [Volume:4] [Number:3] [Pages:3] [Pages No:174 - 176]

   DOI: 10.5005/jp-journals-10007-1139  |  Open Access |  How to cite  | 

Abstract

Minimal access surgery is increasingly becoming the preferred approach to general surgical treatment. Operative experience in the last two decades has established its efficacy and indeed safety in many trials at different centers all over the world.

Laparoscopic cholecystectomy (LC) has therefore become the gold standard of care for patients requiring removal of the gallbladder over this period. In 1992, a National Institute of Health (NIH) consensus development conference concluded that ‘laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones, laparoscopic cholecystectomy appears to have become the procedure of choice for many of these patients’.

The objective of this study was to review the literature on the use of laparoscopy in the management of Mirizzi's syndrome so as determine its role if any in current and future practice.

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