World Journal of Laparoscopic Surgery

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2016 | May-August | Volume 9 | Issue 2

EDITORIAL

R.K. Mishra

Editorial

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/wjols-9-2-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Reva Sergey, Nosov Alexander, Djalilov Imran, Petrov Sergey

Comparison of Open and Laparoscopic Radical Cystectomy for Bladder Cancer: Safety and Early Oncological Results

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:7] [Pages No:51 - 57]

   DOI: 10.5005/jp-journals-10033-1272  |  Open Access |  How to cite  | 

Abstract

Objectives

To evaluate perioperative and postoperative morbidity and functional results of laparoscopic radical cystectomy (LRC) in a single-site cohort of patients by comparing it with standard open radical cystectomy (ORC).

Materials and methods

A prospective analysis was performed in 42 muscle invasive and locally advanced bladder cancer (BCa) patients who underwent radical cystectomy (RC) between February 2012 and March 2014 in N.N. Petrov Research Institute of Oncology, Saint Petersburg, Russia. The final cohort included 21 ORC and 21 LRC patients. The average patients’ age was 64 (38 to 81) years, which did not differ between the groups. The pathological stage was similar in the LRC and ORC groups. Multivariable logistic and median regression was performed to evaluate the operating time, perioperative, and postoperative complications (30-day and 90-day) according to Clavien classification, readmission rates, and length of stay (LOS) – both totally and in ICU.

Results

The operating time during LRC was longer than that of ORC (398 vs 243 minutes respectively). Despite that, there was no statistically significant influence of the type of surgery on intraoperative complications. 14.3% in the ORC group and 4.7% in the LRC patients. The major complication rates (Clavien grade. ≥3; 23.8 vs 19.4%) were similar between the groups. However, LRC had four times lower rate of minor complications (Clavien grade 1 and 2) compared to ORC (4.7 vs 19.0%). Laparoscopic radical cystectomy had a significantly shorter LOS (27.8 vs 22.6 days in the ORC and LRC groups respectively), but no significant differences in ICU stay existed (5.1 vs 2.1 days). Morbidity was presented by one patient in each group (average rate 5.8%). The common transfusion rate during and after surgical intervention was 19.6% and was higher in the ORC group (33.3 vs 4.7% in LRC); additionally, intraoperative bleeding was lower after laparoscopic cystectomy. the average volume of blood loss was 285 mL in LRC and 577 mL during ORC. Depending on the timing of complications, there were 30-day complications in 19 patients (37.2%) and 90 days in 27 patients (52.9%). The greatest difference was observed between the grades of gastrointestinal complications (foremost, ileus) with significantly better outcomes in the LRC patients. 14.2% compared to 47.6% in ORC.

Conclusion

We have found that LRC is safe and associated with lower blood loss, reduced postoperative ileus, and lower LOS compared with ORC. Using a population-based cohort, we have found that laparoscopic surgery for bladder cancer reduced minor complications (mainly due to lower bleeding and gastrointestinal complication rate) and had no impact on major complications.

How to cite this article

Sergey R, Alexander N, Imran D, Sergey P. Comparison of Open and Laparoscopic Radical Cystectomy for Bladder Cancer: Safety and Early Oncological Results. World J Lap Surg 2016;9(2):51-57.

RESEARCH ARTICLE

Ahmed E Lasheen, AbdelRhman Sarhan, Ayman Salem, Tark Shiref

Percutaneous Transabdominal External Looped Needle for Peritoneal Closure in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:5] [Pages No:58 - 62]

   DOI: 10.5005/jp-journals-10033-1273  |  Open Access |  How to cite  | 

Abstract

Introduction

Transabdominal preperitoneal (TAPP) hernioplasty is a common procedure for groin hernia repair. The peritoneal closure after mesh placement is recommended to avoid mesh exposure to the viscera with the risk of adhesions and bowel incarceration into peritoneal defects. This study offers a novel technique for peritoneal closure by using external looped needle.

Materials and methods

During the period from April 2013 through August 2015, during laparoscopic inguinal hernia repair in 117 patients, the peritoneal closure was achieved by percutaneous transabdominal external looped needle. The needle was passed directly through the abdominal wall to close the peritoneal flaps using Vicryl no. 0. The mean follow-up period was 28 months.

Results

The age of this patients’ group ranged from 20 to 66 years (mean age 47 years). The mean time to put one stitch was 1.8 minutes. No recurrence, pain, intestinal adhesion, obstruction, mesh bulging, or infection was recorded in this patients’ group during the period of follow-up.

Conclusion

Our technique for peritoneal closure during laparoscopic inguinal hernia repair (TAPP) is effective, safe, and easy.

How to cite this article

Lasheen AE, Sarhan AR, Salem A, Shiref T. Percutaneous Transabdominal External Looped Needle for Peritoneal Closure in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair. World J Lap Surg 2016;9(2):58-62.

RESEARCH ARTICLE

Sheriff Z Kotb, Mohamed El-Metwally, Nazem Shams, Ashraf Khater

Laparoscopic-assisted Vaginal Hysterectomy vs Handassisted Laparoscopic Hysterectomy

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:8] [Pages No:63 - 70]

   DOI: 10.5005/jp-journals-10033-1274  |  Open Access |  How to cite  | 

Abstract

Objectives and background

The use of laparoscopic techniques now permits combination of benefits of both abdominal and vaginal hysterectomy. But, laparoscopic hysterectomy has been associated with a higher risk of urinary tract injury compared with abdominal and vaginal procedures, and the risks of these minimally invasive approaches must be balanced with the benefits. Hand-assisted laparoscopic surgery was first described in the early 1990s as a surgical method designed to facilitate the performance of challenging laparoscopic procedures while maintaining the advantages of a minimally invasive approach.

Our present study aims to compare between laparoscopicassisted vaginal hysterectomy (LAVH) and hand-assisted laparoscopic hysterectomy (HALH).

Materials and methods

This study was conducted at the Oncology Center of Mansoura University (OCMU). A total of 41 sequential patients scheduled for hysterectomy were divided randomly (patient by patient) into two groups: group 1 included 21 patients who underwent LAVH and group 2 included 20 patients who underwent HALH from August 2010 to March 2013.

Patients were excluded from this study if they had contraindications to either vaginal hysterectomy, such as several prior abdominal surgeries, vaginal stenosis, or severe endometriosis, or to laparoscopy, including underlying medical conditions that could be worsened by pneumoperitoneum or the Trendelenburg position. Body mass index was not a limiting factor for patient inclusion in the study.

Results

The clinical characteristics of the 41 patients were similar as regards age, parity, and uterine size. The indications for hysterectomy among the study groups were nearly similar. No statistically significant difference was found between the two groups in operative time. Operative blood loss was higher in the LAVH group. Two cases in the LAVH group were converted to laparotomy to control bleeding and to repair a urinary bladder tear.

Conclusion

The HALH group had less analgesic consumption, earlier ambulation, shorter hospital stay, and earlier regain of daily and coital activities. On the contrary, the HALH group had much more direct costs, which requires much effort to be directed toward this fruitful technique and more training programs to surgeons to increase their experience in enriching hand skills in this emerging technique.

How to cite this article

Kotb SZ, El-Metwally M, Shams N, Khater A. Laparoscopic-assisted Vaginal Hysterectomy vs Hand-assisted Laparoscopic Hysterectomy. World J Lap Surg 2016;9(2):63-70.

REVIEW ARTICLE

TR John Suresh Kumar

Modifications of Laparoscopic Cholecystectomy

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:4] [Pages No:71 - 74]

   DOI: 10.5005/jp-journals-10033-1275  |  Open Access |  How to cite  | 

Abstract

Aims

More than 30 different ways of performing laparoscopic cholecystectomy (LC) are described in the literature. These were developed by surgeons with the aim to improve postoperative and esthetic outcome following LC. The modifications included reduction in port size and/or number than what is used in standard LC. The aim of this literature review was to evaluate the technical feasibility of the modifications of LC without compromising safety and the benefits associated with these modifications in terms of safety, postoperative pain, cosmesis, early recovery, and patient satisfaction.

Materials and methods

Literature review was performed on articles describing different techniques of LC, variations in port number and size, and their advantages over one another. The search was made by using search engines like Google, PubMed, Springer link, and HighWire Press.

Observation

Reduction in number of ports and port size especially in epigastric site gave advantages in terms of decreased postoperative pain score and esthesis. There was an increase in the number of transumbilical single-site surgery (TUSS) being performed in recent years with advantages like decreased postoperative pain and increased patient acceptance being documented in various studies. Hybrid technique of using additional ports during single-site laparoscopic surgery (SSLS) may be used as a bridge to single-site surgery while the surgeon is in a learning curve from a multiport surgery to SSLS. Currently NOTES cholecystectomy is under evaluation and not routinely performed. But current literature does not provide enough evidence of any clear benefit of any of these modifications over standard LC.

Conclusion

This literature review showed that even though there are some advantages in postoperative pain score, esthetic outcome, and patient acceptance while doing the different types of LC in selected patients, there is no evidence of any clear benefit over conventional LC. It is not acceptable to compromise the vision and increase the risk of bile duct injury to the patient while doing LC. Hence, modified LC may be performed by surgeons only after gaining enough experience and in selected group of patients without violating the basic principles of laparoscopic surgery.

How to cite this article

Kumar TRJS. Modifications of Laparoscopic Cholecystectomy. World J Lap Surg 2016;9(2):71-74.

REVIEW ARTICLE

BV Sharath

Single-incision Laparoscopic Cholecystectomy vs Conventional Laparoscopic Cholecystectomy

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:3] [Pages No:75 - 77]

   DOI: 10.5005/jp-journals-10033-1276  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Sharath BV. Single-incision Laparoscopic Cholecystectomy vs Conventional Laparoscopic Cholecystectomy. World J Lap Surg 2016;9(2):75-77.

REVIEW ARTICLE

Surakshith L Gowda

Transabdominal Cervical Cerclage: Laparoscopy or Laparotomy

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:4] [Pages No:78 - 81]

   DOI: 10.5005/jp-journals-10033-1277  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Gowda SL. Transabdominal Cervical Cerclage: Laparoscopy or Laparotomy. World J Lap Surg 2016;9(2):78-81.

REVIEW ARTICLE

Rafique B Parkar, Leeya F Pinder, JG Wanyoike, Yamal Patel, David Otieno, Yusuf Palkhi, Richard Baraza, Khama Rogo

Laparoscopic Surgery in Low-income and Limited-resource Settings: Does It safely add Value? A Review of 2,901 Laparoscopic Gynecologic Procedures

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:4] [Pages No:82 - 85]

   DOI: 10.5005/jp-journals-10033-1278  |  Open Access |  How to cite  | 

Abstract

Objectives

Of the 234 million surgeries conducted yearly worldwide, only 3.5% are carried out in low-income countries. Known advantages exist to laparoscopic surgery, and it is widely utilized in high-income countries; however, many barriers exist to uptake in low-income countries. Since 1992, laparoscopic surgery has been successfully undertaken in various rural public hospitals in Kenya. We sought to review outcomes of laparoscopic surgeries performed by our group in these facilities.

Materials and methods

Between 1992 and 2015, 3,119 laparoscopic procedures were performed at 17 rural hospitals in Kenya as a part of the Round Table's “Week of Healing Project.” The medical and operative records of all patients who underwent gynecological laparoscopic surgery were retrospectively reviewed for outcomes.

Results

During the reporting period, 2,901 cases performed were gynecologic procedures; the mean age of patients was 34.2. Forty-one complications were encountered (1.41%), and one death (0.03%) occurred secondary to hemorrhage following conversion to laparotomy for an ovarian tumor. The mean hospitalization was 1.9 days.

Conclusion

Laparoscopic surgery is feasible, safe, and cost-effective, and it has important advantages in low-income countries with limited resources. Laparoscopic surgery does add value in low-resource settings, and our activities demonstrate that it is a safe alternative to traditional open modalities of surgery.

How to cite this article

Parkar RB, Pinder LF, Wanyoike JG, Patel Y, Otieno D, Palkhi Y, Baraza R, Rogo K. Laparoscopic Surgery in Low-income and Limited-resource Settings: Does It safely add Value? A Review of 2,901 Laparoscopic Gynecologic Procedures. World J Lap Surg 2016;9(2):82-85.

CASE REPORT

Hysteroscopy in Uterine Anomalies: An Edge

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:6] [Pages No:86 - 91]

   DOI: 10.5005/jp-journals-10033-1279  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Lekhi A, Manchanda R, Chithra S, Jain N. Hysteroscopy in Uterine Anomalies: An Edge. World J Lap Surg 2016;9(2):86-91.

CASE REPORT

Vivek Aery, Kishore V Alapati, V Pavan Kumar

Laparoscopic Management of Stump Appendicitis

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:2] [Pages No:92 - 93]

   DOI: 10.5005/jp-journals-10033-1280  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Aery V, Alapati KV, Kumar VP. Laparoscopic Management of Stump Appendicitis. World J Lap Surg 2016;9(2):92-93.

CASE REPORT

Deborah Nagle, Thomas Cataldo, John Tillou, Roger Eduardo, Janet Li, Roger Lefevre, Vitaliy Poylin

Early Postoperative Small Bowel Obstruction associated with the use of V-loc™ Sutures during Surgery for Pelvic Organ Prolapse

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:4] [Pages No:94 - 97]

   DOI: 10.5005/jp-journals-10033-1281  |  Open Access |  How to cite  | 

Abstract

Aims

To describe three cases of early postoperative bowel obstruction after use of barbed suture material during surgery for pelvic organ prolapse (POP).

Introduction

The utilization of minimally invasive surgical techniques for the treatment of POP is increasing, with a subsequent increase in the use of barbed, self-anchoring suture material, such as the V-loc™ suture, which facilitates intracorporeal suturing.

Case report

We present three cases of early postoperative small bowel obstruction related to the use of barbed sutures during minimally invasive surgery for POP, as well as a review of the relevant literature.

Conclusion

Surgeons should use barbed suture material judiciously and should have a high index of suspicion for barbedsuture related mechanical obstructions. These obstructions are not likely to resolve with conservative management.

Clinical significance

Barbed suture materials allow for ease of laparoscopic suturing but carry a risk of contributing to early bowel obstruction. Laparoscopic surgeons should be aware of this relatively unknown potential complication.

How to cite this article

Tillou J, Eduardo R, Nagle D, Cataldo T, Li J, Lefevre R, Poylin V. Early Postoperative Small Bowel Obstruction associated with the use of V-loc™ Sutures during Surgery for Pelvic Organ Prolapse. World J Lap Surg 2016;9(2):94-97.

CASE REPORT

SY Lim, Tikfu Gee, Zubaidah Hanifah

Laparoscopic Management of a Volvulus Secondary to Midgut Malrotation in an Adult with an Incidental Meckel's Diverticulum

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:3] [Pages No:98 - 100]

   DOI: 10.5005/jp-journals-10033-1282  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Lim SY, Gee T, Hanifah Z. Laparoscopic Management of a Volvulus Secondary to Midgut Malrotation in an Adult with an Incidental Meckel's Diverticulum. World J Lap Surg 2016;9(2):98-100.

CASE REPORT

Jignesh Gandhi, Saneya Pandrowala, Sadashiv Choudhari, Suryaprakash Bhandari

Laparoscopic Removal of a Giant Gastroduodenal Bezoar

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:3] [Pages No:101 - 103]

   DOI: 10.5005/jp-journals-10033-1283  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Gandhi J, Pandrowala S, Choudhari S, Bhandari S. Laparoscopic Removal of a Giant Gastroduodenal Bezoar. World J Lap Surg 2016;9(2):101-103.

CASE REPORT

Hanan M Alghamdi

Novel Technique in Laparoscopic Staple-line Reinforcement

[Year:2016] [Month:May-August] [Volume:9] [Number:2] [Pages:3] [Pages No:104 - 106]

   DOI: 10.5005/jp-journals-10033-1284  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Alghamdi HM. Novel Technique in Laparoscopic Staple-line Reinforcement. World J Lap Surg 2016;9(2):104-106.

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