World Journal of Laparoscopic Surgery

Register      Login

Table of Content

2014 | January-April | Volume 7 | Issue 1

EDITORIAL

Editorial

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/wjols-7-1-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Parveen Bhatia, Vivek Bindal, RF Ijah, Sudhir Kaltan, Mukund Khetan, Suviraj John, Asfar Ali

Sleeve Gastrectomy for Morbid Obesity: Robotic vs Standard Laparoscopic Sleeve Gastrectomy Methods

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:6] [Pages No:1 - 6]

   DOI: 10.5005/jp-journals-10033-1209  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this study is to compare robotic laparoscopic sleeve gastrectomy with standard laparoscopic sleeve gastrectomy done for morbid obesity with regards to operative time and short-term patient outcome in a developing world.

Background

Excision of the fundus and greater curvature of the stomach in sleeve gastrectomy not only restrict intake but also reduces the level of ghrelin in the circulating blood. Obesity surgery has benefited from the advent of surgical robot with its celebrated advantages (enhanced dexterity, precision and control of endowrist instruments, with 7° of freedom, 90° of articulation, intuitive motion and finger-tip control, motion scaling and tremor reduction). How this new technology under development affect patient outcome has only been reported in a few centers especially in the developed world.

Materials and methods

Data for 21-month retrospective comparative study was collected from the records of 20 adult patients who had robotic sleeve gastrectomy (RSG) and 20 standard laparoscopic sleeve gastrectomy (SLSG) (obtained by randomized sampling of the total number of slsg during the study period).

Results and discussion

Duration of surgery, cost of operation, duration of hospital stay, percentage excess weight loss (%EWL)/BMI, quality of life, comorbidity resolution and complications were the measures of outcome studied in comparing RSG to SLSG. The mean duration of surgery of 143.05 minutes for SLSG and 152.7 minutes RSG (ratio 1:1.07) were in agreement with previous studies in which the duration of RSG was longer than SLSG. The RSG mean docking time of 12.6 minutes in this study obviously contributed to increasing the total operative time.

The cost of surgery was found to be higher RSG 9000 USD compared to 7500 USD for SLSG (ratio1.2:1). This value is relatively higher than that documented in a study in which 400 euros was quoted. Understandably, this varied from center to center. Three patients (15%) were observed to have some signi- ficant complications among the SLSG group as against one patient (5%) in the RSG group.

Conclusion

Sleeve gastrectomy by robotic method in a developing country experience, has comparative advantage over standard laparoscopic methods in reducing complications, though the duration and cost of surgery were higher in the robotic methods. The choice of the method would therefore depend on availability, surgeon's skills, the patient's informed choice and ability to afford.

How to cite this article

Ijah RF, Bhatia P, Kaltan S, Khetan M, John S, Bindal V, Ali A. Sleeve Gastrectomy for Morbid Obesity: Robotic vs Standard Laparoscopic Sleeve Gastrectomy Methods. World J Lap Surg 2014;7(1):1-6.

RESEARCH ARTICLE

Swapan Kumar Maiti, Anburaja Mahalingam, Naveen Kumar, Ashok Kumar Sharma, Umesh Dimri, Meena Kataria, Dayamon David Mathew, V Remya, A Mohsina

Laparoscopic Vasectomy vs Laparoscopic Sterilization in Dogs: A Comparison of Two Techniques

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:9] [Pages No:7 - 15]

   DOI: 10.5005/jp-journals-10033-1210  |  Open Access |  How to cite  | 

Abstract

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.

RESEARCH ARTICLE

Sumanta Kumar Ghosh

A Comparative Randomized Parallel Group Study between the Classical TAPP Repair and Modified TAPP Surgical Method for Inguinal Hernia Repair

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:7] [Pages No:16 - 22]

   DOI: 10.5005/jp-journals-10033-1211  |  Open Access |  How to cite  | 

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.

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.

REVIEW ARTICLE

Bassim Alsadi

Polycystic Ovarian Syndrome: Pathophysiology and Infertility

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:5] [Pages No:23 - 27]

   DOI: 10.5005/jp-journals-10033-1212  |  Open Access |  How to cite  | 

Abstract

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.

How to cite this article

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

REVIEW ARTICLE

Rasaq Akintunde Akindele, Adeniyi Olanipekun Fasanu, Suresh Chandra Mondal, Johnson Olusanmi Komolafe, Rajneesh Kumar Mishra

Comparing Extracorporeal Knots in Laparoscopy using Knot and Loop Securities

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:5] [Pages No:28 - 32]

   DOI: 10.5005/jp-journals-10033-1213  |  Open Access |  How to cite  | 

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.

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.

REVIEW ARTICLE

Šefik Hasukiæ

Co2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:8] [Pages No:33 - 40]

   DOI: 10.5005/jp-journals-10033-1214  |  Open Access |  How to cite  | 

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.

How to cite this article

Hasukiæ Š. CO2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance. World J Lap Surg 2014;7(1):33-40.

REVIEW ARTICLE

George Chilaka Obonna

Differences between Thunderbeat, LigaSure and Harmonic Scalpel Energy System in Minimally Invasive Surgery

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:4] [Pages No:41 - 44]

   DOI: 10.5005/jp-journals-10033-1215  |  Open Access |  How to cite  | 

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.

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.

CASE REPORT

Alireza Farshi, Reza Sari Motlagh, Reza Roshandel

The First Laparoscopic Vesicovaginal Fistula Repair in Iran

[Year:2014] [Month:January-April] [Volume:7] [Number:1] [Pages:3] [Pages No:45 - 47]

   DOI: 10.5005/jp-journals-10033-1216  |  Open Access |  How to cite  | 

Abstract

Background

Vesicovaginal fistula (VVF) is the most common acquired fistula of the urinary system. Different surgical techniques exist, but having several advantages make laparoscopy as a favorable method. According to the recent data, we have performed the first laparoscopic repair of VVF in Iran.

Case report

A 19-year-old (G1P1) woman, referred to our center, complaining from continuous urinary incontinence from 7 months ago. She developed continuous wetting after her first cesarean section, performed 7 months ago. Methylene blue dye test, was positive for VVF and voiding cystourethrogram (VCUG) confirmed the diagnosis. Cystoscopy revealed the exact location of fistula in the bladder wall. Patient underwent laparoscopic VVF repair using transperitoneal transvesical approach in the supine position. Patient did not have any urinary leakage during hospitalization and discharged with urethral indwelling catheter at fourth day after the operation. Voiding cystourethrogram was done after 2 weeks, and it was normal without any extravasations.

Discussion

Dense pelvic adhesions and/or inflammation from prior abdominal surgery can make this approach less desirable in some patients. Furthermore, intracorporeal laparoscopic suturing requirement for VVF repair is an advanced skill many surgeons lack. We used transabdominally transvesical laparoscopic method and, according to the literature review, this is the first case of VVF laparoscopic surgery performed in Iran.

How to cite this article

Farshi A, Motlagh RS, Roshandel R. The First Laparoscopic Vesicovaginal Fistula Repair in Iran. World J Lap Surg 2014;7(1):45-47.

© Jaypee Brothers Medical Publishers (P) LTD.