World Journal of Laparoscopic Surgery

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2015 | September-December | Volume 8 | Issue 3

EDITORIAL

Editorial

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/wjols-8-3-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Muzzafar Zaman, Samita Singal, Rikki Singal, Aliya Shah, Karamjot Singh Sandhu, Bir Singh, Aadhar Khera, Sagar Bassi

Comparison of Open and Closed Entry Techniques for Creation of Pneumoperitoneum in Laparoscopic Surgery in Terms of Time Consumption, Entry-related Complications and Failure of Technique

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:3] [Pages No:69 - 71]

   DOI: 10.5005/jp-journals-10033-1250  |  Open Access |  How to cite  | 

Abstract

Aim

To compare the open and closed methods of creating pneumoperitoneum for doing various laparoscopic procedures in terms of their safety, operating time and other parameters.

Settings and design

A prospective randomized double blind study.

Materials and methods

This was a randomized controlled prospective study conducted at Department of General and minimal access surgery, MMIMSR Medical College, Ambala Haryana from August 2013 to December 2015. Pneumoperitoneum was created by closed technique in group A, and by open technique in group B. Time required for successful pneumoperitoneum was calculated in each group. Failure to induce pneumoperitoneum was determined for each technique. Time required to induce pneumoperitoneum, total operating time, air leakage and injuries sustained during induction of pneumoperitoneum were compared in both techniques.

Result

Out of the total 200 patients included in study, 100 were in group A and 100 in group B. Mean time required for successful pneumoperitoneum was 9.17 minutes in group A and 8.11 minutes in group B. Total operating time ranged from 55 minutes to 130 minutes in group A and from 45 to 110 minutes in group B. Mean of total operating time was 78.34 and 67 minutes in groups A and B respectively. Mean time needed to close the wound was 9.88 minutes in group A and 4.97 minutes in group B. Failure of technique was noted in three patients in group A while no failure was experienced in group B. Air leakage was seen in five patients in group B and none in group B. In two cases in group A minor complications during creation of pneumoperitoneum were observed while in group B no complication occurred. Port site infection and port site hernia was seen in group B and none in group A. No patient died in the study. Two patients were having preperitoneal insufflation which was presented as injury due to induction of pneumoperitoneum.

Conclusion

We concluded from this study that open technique of pneumoperitoneum was, less time consuming and safer than the closed technique.

How to cite this article

Zaman M, Singal S, Singal R, Shah A, Sandhu KS, Singh B, Khera A, Bassi S. Comparison of Open and Closed Entry Techniques for Creation of Pneumoperitoneum in Laparoscopic Surgery in Terms of Time Consumption, Entryrelated Complications and Failure of Technique. World J Lap Surg 2015;8(3):69-71.

RESEARCH ARTICLE

Sarbjit Singh, Delie Rhezhii

Laparoscopic Surgery: Results of a Modified Open Technique of Umbilical Port Insertion

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:3] [Pages No:72 - 74]

   DOI: 10.5005/jp-journals-10033-1251  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Singh S, Rhezhii D. Laparoscopic Surgery: Results of a Modified Open Technique of Umbilical Port Insertion. World J Lap Surg 2015;8(3):72-74.

RESEARCH ARTICLE

Ricardo López Osorio, Pablo Hartedt

Sleeve Gastrectomy in Metabolic Syndrome for Nonmorbid Obese Patients: Is this the Future for Diabetes Treatment?

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:6] [Pages No:75 - 80]

   DOI: 10.5005/jp-journals-10033-1252  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Osorio RL, Hartedt P. Sleeve Gastrectomy in Metabolic Syndrome for Nonmorbid Obese Patients: Is this the Future for Diabetes Treatment? World J Lap Surg 2015;8(3):75-80.

REVIEW ARTICLE

Michael Angelo L Suñaz

Efficacy and Safety of Laparoscopic Inguinal Hernia Repair

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:4] [Pages No:81 - 84]

   DOI: 10.5005/jp-journals-10033-1253  |  Open Access |  How to cite  | 

Abstract

Background

Inguinal hernia results from a defect or weakness in the muscles in the inguinal region, through which the peritoneum protrudes, forming the sac. One of the most common operations that general surgeons perform to repair this defect is inguinal herniorrhaphy. Laparoscopic herniorrhaphy started being performed when laparoscopic cholecystectomy has shown definite benefits over the open technique. However, laparoscopic hernia repair is an advanced laparoscopic procedure and has a longer learning curve.4

Objectives

(1) To evaluate the efficacy and safety of three laparoscopic hernia repair techniques: Transabdominal preperitoneal (TAPP), totally extraperitoneal (TEP), and intraperitoneal onlay mesh (IPOM). (2) Specifically, this review aims to: (a) Determine which laparoscopic technique has lowest recurrence rate, (b) determine which laparoscopic technique has the least perioperative complications.

Materials and methods

The database used in this study was PubMed and MeSH. Search terms included: laparoscop*, inguinal, hernia, repair, TAPP, TEP and IPOM. Study designs included in this study were prospective clinical studies, and retrospective clinical studies.

Results

All three laparoscopic techniques had complication rates comparable to those of the open techniques. However, recurrence rates after laparoscopic repair was much lower. IPOM, although technically the easiest procedure to perform among the three laparoscopic techniques, is associated with the highest risk of adhesion formation and the lowest tensile strength. In comparison, the TEP and the TAPP techniques had the advantages of better tissue incorporation and tensile strength.

Conclusion

Laparoscopic inguinal herniorrhaphy is an effective method to correct an inguinal hernia but is not without complications nor risk for recurrences. The TAPP, IPOM, and TEP procedures appear to be equally effective. Training, experience, and proper operative technique will prevent some of these complications.

How to cite this article

Suñaz MAL. Efficacy and Safety of Laparoscopic Inguinal Hernia Repair. World J Lap Surg 2015;8(3):81-84.

REVIEW ARTICLE

Meghana Jetty

Pregnancy Outcomes following Robot-assisted Laparoscopic Myomectomy

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:5] [Pages No:85 - 89]

   DOI: 10.5005/jp-journals-10033-1254  |  Open Access |  How to cite  | 

Abstract

Review study question

What are the characteristics of the pregnancy outcomes in women undergoing robot-assisted laparoscopic myomectomy (RALM) for symptomatic leiomyomata uteri?

Summary answer

Despite a high prevalence of women with advanced maternal age, obesity and multiple pregnancy, the outcomes are comparable with those reported in the literature for laparoscopic myomectomy.

Study design

Review study.

Participants/material, setting, methods

An extensive search for articles related to the topic and review the studies.

Main results

The mean time to conception was 12 to 18 months. Assisted reproduction techniques were employed in 22 to 24% of these women. Spontaneous abortions occurred in 18 to 20%. Preterm delivery prior to 35 weeks of gestational age occurred in 17%. One uterine rupture was documented in all studies together. Pelvic adhesions were discovered in 11 to 16% of patients delivered by cesarean section. Higher preterm delivery rates were significantly associated with a greater number of myomas removed and anterior location of the largest incision. None of the myoma characteristics were related to spontaneous abortion.

How to cite this article

Jetty M. Pregnancy Outcomes following Robot-assisted Laparoscopic Myomectomy. World J Lap Surg 2015;8(3):85-89.

REVIEW ARTICLE

Inamull Hasan SA Shaikh

Surgical Approaches for Rectal Prolapse and their Comparative Study

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:6] [Pages No:90 - 95]

   DOI: 10.5005/jp-journals-10033-1255  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Shaikh IHSA. Surgical Approaches for Rectal Prolapse and their Comparative Study. World J Lap Surg 2015;8(3):90-95.

REVIEW ARTICLE

Rajendra Shitole

Role of Minimally Invasive Surgery in Gynecological Cancers

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:5] [Pages No:96 - 100]

   DOI: 10.5005/jp-journals-10033-1256  |  Open Access |  How to cite  | 

Abstract

Background

Presently due to technological advances, operative laparoscopy now plays a crucial role in the management of pelvic malignancies. With newly developed techniques to complete both pelvic and para-aortic lymph node dissection, the use of the laparoscope has increased in patients with pelvic malignancies. Gynecological oncologists are currently incorporating the techniques of operative laparoscopy in the management of patients with cervical, endometrial, and ovarian cancer.

Aim

To review literature on the role of minimal invasive surgery in various gynecological cancers.

Materials and methods

These were drawn from previous research materials online in PubMed, Cochrane library, Wikipedia.

Conclusion

Minimal invasive surgical approaches to the management of gynecologic malignancies are feasible and provide exciting alternatives. However, the safety and efficacy of these techniques compared to laparotomy in this setting has not been carefully studied. Potential advantages include shorter operative time for some procedures, shorter recovery times, and less adhesion formation. These new surgical techniques need to be evaluated critically and compared to more traditional approaches.

How to cite this article

Shitole R. Role of Minimally Invasive Surgery in Gynecological Cancers. World J Lap Surg 2015;8(3): 96-100.

REVIEW ARTICLE

Mandavi Rai

Comparison between Different Entry Techniques in Performing Pneumoperitoneum in Laparoscopic Gynecological Surgery

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:6] [Pages No:101 - 106]

   DOI: 10.5005/jp-journals-10033-1257  |  Open Access |  How to cite  | 

Abstract

Background

The main challenge facing the laparoscopic surgery is the primary abdominal access, as it is usually a blind procedure associated with vascular and visceral injuries. Laparoscopy is a very common procedure in gynecology. Complications associated with laparoscopy are often related to entry. The life-threatening complications include injury to the bowel, bladder, major abdominal vessels, and anterior abdominalwall vessel. Other less serious complications can also occur, such as postoperative infection, subcutaneous emphysema and extraperitoneal insufflation. There is no clear consensus as to the optimal method of entry into the peritoneal cavity. It has been proved from studies that 50% of laparoscopic major complications occur prior to the commencement of the surgery. The surgeon must have adequate training and experience in laparoscopic surgery before intending to perform any procedure independently. He should be familiar with the equipment, instrument and energy source he intends to use.

Materials and methods

A Literature review was performed using PubMed, MedSpace, Springer Link and search engines like Google and Yahoo. Following search terms were used: trocar, laparoscopy, complications and pneumoperitoneum, entery technique. A total of 10,000 citations were found. Selected papers were screened for further references. Publications that featured illustrations and statistical methods of analysis are selected.

Results

Fifty-one articles were reviewed and the the operations included in our study were diagnostic laparoscopy for infertility and abdominal pathology, ovarian cyst, total laparoscopic hysterectomy, burch operation, myomectomy. The early complications recorded in our study are abdominal wall vascular injuries, visceral injuries, bradycardia, preperitoneal insufflations. The incidence of laparoscopic entry-related injuries in gynecological operations was 6.9%. Overall, there was no evidence of advantage using any single technique in terms of preventing major complications. However, there were two advantages with direct trocar entry when compared with Veress-needle entry, in terms of avoiding extraperitoneal insufflation and failed entry.

Conclusion

On the basis of evidence investigated in this review, there appears to be no evidence of benefit in terms of safety of one technique over another. However, the included studies are small and cannot be used to confirm safety of any particular technique. No single technique or instrument has been proved to eliminate laparoscopic entry-associated injury. Proper evaluation of the patient, supported by good surgical skills and reasonably good knowledge of the technology of the instruments remain to be the cornerstone for safe access and success in minimal access surgery.

How to cite this article

Rai M. Comparison between Different Entry Techniques in Performing Pneumoperitoneum in Laparoscopic Gynecological Surgery. World J Lap Surg 2015;8(3):101-106.

CASE REPORT

Priyakshi Chaudhry, Deepti Shrivastava, SB Bhute, S Jajoo

A Rare Case of Nocturnal Urinary Incontinence and Menouria after Lower Segment Cesarean Section

[Year:2015] [Month:September-December] [Volume:8] [Number:3] [Pages:3] [Pages No:107 - 109]

   DOI: 10.5005/jp-journals-10033-1258  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Shrivastava D, Bhute SB, Jajoo S, Chaudhry P. A Rare Case of Nocturnal Urinary Incontinence and Menouria after Lower Segment Cesarean Section. World J Lap Surg 2015;8(3):107-109.

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