World Journal of Laparoscopic Surgery

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2016 | September-December | Volume 9 | Issue 3

EDITORIAL

R.K. Mishra

Editorial

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/wjols-9-3-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Priyadarshi Dikshit, Md Abu M Ansari, Umakant Verma

Laparoscopic Sleeve Gastrectomy—A Novel Surgical Tool for Weight Loss in morbidly Obese Patients: A Prospective Cohort Study

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:7] [Pages No:107 - 113]

   DOI: 10.5005/jp-journals-10033-1285  |  Open Access |  How to cite  | 

Abstract

Introduction

Obesity has reached epidemic proportions worldwide. India ranks 3rd after the United States and China. The health consequences range from increased risk of premature death due to serious chronic illness like hypertension and diabetes mellitus (DM) which reduces the overall quality of life. Laparoscopic sleeve gastrectomy (LSG) produces long-lasting control of obesity as well as associated comorbidities.

Materials and methods

A prospective cohort study was conducted between the period of January 2015 and March 2016. The criteria for selection were Body mass index (BMI). 40 kg/m2 or BMI. ≥35 kg/m2 with comorbidities. All the patients were screened by a multidisciplinary team. All the patients were operated by the same surgeon to avoid any procedural biasness. Follow-up visit as per our study protocol were evaluated.

Results

Out of 60 patients operated for morbid obesity, the weight loss is substantial and statistically significant. Excess weight loss (EWL) (in %) were 4.31, 8.14, 16.28, and 30.61% at subsequent visits at 1st, 2nd, 4th, and 12th week respectively. Except for a few minor complications which were managed conservatively, the procedure was uneventful.

Conclusion

Laparoscopic sleeve gastrectomy is simple, effective, and reproducible surgical method to treat morbid obesity.

How to cite this article

Kumar S, Ansari AM Md, Verma U, Kumar N. Laparoscopic Sleeve Gastrectomy—A Novel Surgical Tool for Weight Loss in morbidly Obese Patients: A Prospective Cohort Study. World J Lap Surg 2016;9(3):107-113.

RESEARCH ARTICLE

RK Mishra, Sam Koruth, Nivedita Reshme

Role of Mishra's Knots in Various Surgeries in Laparoscopy

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:4] [Pages No:114 - 117]

   DOI: 10.5005/jp-journals-10033-1286  |  Open Access |  How to cite  | 

Abstract

Introduction

In the present era of laparoscopy and its everexpanding application to various different types of surgeries, the art of suturing and knotting still plays a pivotal role in determining the success of any surgery as in case of open surgeries. Despite the introduction of various energy sources as an alternative to suturing and knotting, the various complications associated with them and the cost limitations have to be considered.

Extracorporeal and intracorporeal knotting in laparoscopic surgery can be used in various situations and though it can be technically demanding, it can be overcome with repeated practice. Here we describe a new technique of knot which is simple, easy, and a safe extracorporeal knotting technique which can be used for any continuous tubular structure up to a maximum diameter of 22 mm. This technique was introduced by Professor and Doctor Mishra who has himself worked upon it in the last 2 years after trying various other knots and modifying them to achieve better security.

Technique description

Mishra's knot is a modification of the Roeder's knot or the Meltzer's knot. It's a relative simple technique where we use 3 hitches and 3 loops alternating each other. The modification aims to achieve better knot security by application of a lock after every wind.

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, Roeder's knot, Meltzer's knot, Mishra's knot. A total of more than 300 citations were found. Selected papers were screened for further references according to our requirements.

A list of 280 surgeries where Mishra's knot was successfully used was given to us for study purpose by Professor Dr RK Mishra.

Conclusion

“This is a very simple and safe technique and has been successfully followed in more than 300 cases for tying an extracorporeal knot. It's a very safe and reliable knot even for the critical structures like cystic duct, uterine artery, and various arteries and we observed it to be very secure.”

How to cite this article

Mishra RK, Koruth S, Reshme N. Role of Mishra's Knots in Various Surgeries in Laparoscopy. World J Lap Surg 2016;9(3):114-117.

REVIEW ARTICLE

Roshan Zeirideen Zaid

Should Laparoscopy be the Gold Standard for Isthmocele?

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:4] [Pages No:118 - 121]

   DOI: 10.5005/jp-journals-10033-1287  |  Open Access |  How to cite  | 

Abstract

Materials and methods

An electronic search was done and various articles and studies were reviewed to support the hypothesis.

How to cite this article

Zaid RZ. Should Laparoscopy be the Gold Standard for Isthmocele? World J Lap Surg 2016; 9(3):118-121.

REVIEW ARTICLE

Ebrahim Mansoor

Challenges in the Widespread use of Minimal Access Surgery for the Management of Abdominal Trauma: A Primer

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:4] [Pages No:122 - 125]

   DOI: 10.5005/jp-journals-10033-1288  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Mansoor E, Mishra RK. Challenges in the Widespread use of Minimal Access Surgery for the Management of Abdominal Trauma: A Primer. World J Lap Surg 2016;9(3):122-125.

REVIEW ARTICLE

Bhawna Bansal

Minimally Invasive Surgical Techniques vs Open Myomectomy for Treatment of Uterine Fibroids

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:4] [Pages No:126 - 129]

   DOI: 10.5005/jp-journals-10033-1289  |  Open Access |  How to cite  | 

Abstract

Introduction

Myomectomy is the surgical remedy of preference for women with symptomatic fibroids, who prefer or want uterine conservation. Myomectomy can be finished by using conventional laparotomy, by means of minilaparotomy, or by means of minimal access techniques, such as hysteroscopy and laparoscopy. Since the advent of minimal access surgery, there has been interest in the relative advantages and disadvantages of both surgical modalities.

Objectives

To determine the benefits and harms of laparoscopic myomectomy compared with open myomectomy.

Materials and methods

We used various search engines – PubMed, HighWire Press, Google, and Yahoo – to search for all trials and articles comparing myomectomy via laparotomy, minilaparotomy, or laparoscopically assisted minilaparotomy vs laparoscopy. We found several articles of which 10 were used in this review article based on the outcomes studied, date of publication (after 2005), methodology of study, level of evidence, and the journal in which they were published. The results of these trials were then compared.

Conclusion

Laparoscopic myomectomy is a process associated with less subjectively reported postoperative pain, lower postoperative fever, and shorter hospital stay as opposed to all kinds of open myomectomy. No data suggested a difference in recurrence risk between laparoscopic and open myomectomy. Even more studies are needed to determine fertility outcomes, rates of uterine rupture, occurrence of thromboembolism, and need for repeat myomectomy and hysterectomy at a later stage.

How to cite this article

Bansal B. Minimally Invasive Surgical Techniques vs Open Myomectomy for Treatment of Uterine Fibroids. World J Lap Surg 2016;9(3):126-129.

REVIEW ARTICLE

JS Chowhan

Perspective of Electrosurgical Sources in Minimal Access Surgery

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:8] [Pages No:130 - 137]

   DOI: 10.5005/jp-journals-10033-1290  |  Open Access |  How to cite  | 

Abstract

Introduction

There are devices that apply energy to cut, coagulate, and desiccate the tissue with minimal bleeding and by overcoming the hindrance of laparoscopy facilitate minimal access surgery. The inappropriate utilization of electrosurgical devices may expand horrible morbidity and mortality. The present article surveys different electrosurgical sources as far as their basic uses and safe practices.

Objectives

The aim of this review is to discuss about various types of available energy sources, their biophysics, their tissue effects, and complications. It also emphasizes the advantages and disadvantages of these electrosurgical devices and the need for learning required with them.

Materials and methods

With the end goal of this review, a general pursuit was led through NCBI, SpringerLink, and Google. Articles depicting laparoscopic or minimally access surgeries utilizing single or different energy sources were considered, in addition to articles contrasting different marketed energy devices in lab settings. Keywords, such as laparoscopy, vitality, laser, electrosurgery, monopolar, bipolar, harmonic, ultrasonic, and difficulties were utilized as a part of the search.

Results

The authors in this review of the literature likewise accentuate on the unprejudiced learning of all the energy devices before using them. It also shows that the performance of the energy devices depends upon the type of effect needed. There is no accord as to which device is ideal for a given purpose. The specialized expertise level of the specialist and the learning about the device are both critical variables in choosing safe results.

Conclusion

To defeat the deceptions of laparoscopic hemostasis and cutting, electrosurgery has turned out as an imaginative innovation. It has made the life of an expert simple. Be that as it may, everything accompanies its own burdens. Electrosurgery also has its own disadvantages and complexities. The utilization of electrosurgery ought to be constrained just for spots where essential. An expert ought to try to know totally about the device he/she is utilizing and ought not to be driven by marketing companies.

How to cite this article

Lekhi A, Chowhan JS, Mishra RK. Perspective of Electrosurgical Sources in Minimal Access Surgery. World J Lap Surg 2016;9(3):130-137.

REVIEW ARTICLE

MK Medha

Various Port-site Closure Techniques in Laparoscopic Surgeries

[Year:2016] [Month:September-December] [Volume:9] [Number:3] [Pages:4] [Pages No:138 - 141]

   DOI: 10.5005/jp-journals-10033-1291  |  Open Access |  How to cite  | 

Abstract

Introduction

Minimally invasive surgeries are the advantageous and cosmetically better surgical procedures nowadays. But laparoscopic trocars do create wounds. It is necessary to close these wounds with a good technique in order to decrease the complications related to port-site complications, especially hernia.

Aim

This study is to review and list different techniques used for closure of port-site wounds.

Materials and methods

A literature search was performed for the articles related with techniques of closure of trocar sites. For this purpose, the search engines used were Google, HighWire Press, and SpringerLink. Only those techniques that include the usage of suture materials, suture carriers, and various needles were reviewed in this study. Special devices made for port-closure are not reviewed here.

Results

The study describes many techniques, including classical closure using curved needles, such as the Grice needle, Maciol needles, spinal needles, dual hemostat, suture carrier, modified Veress needle with a slit made in retractable brunt tip, dental awl with an eye, prolene 2/0 on straight needle aided by Veress needle, straight needle armed with suture, modified Veress needle bearing a crochet hook at tip; Foley catheter threaded through port-hole for elevation of fascial edge upon traction; fish-hook needle improvised out of a hypodermic needle by bending it to 180°; U-shaped purse-string suture placed in the fascia around port-hole.

Conclusion

There are plenty of techniques for closure of trocar-site wounds, all of them are effective in closing the fascial defect of abdominal wall.

How to cite this article

Medha MK. Various Port-site Closure Techniques in Laparoscopic Surgeries. World J Lap Surg 2016;9(3):138-141.

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