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Standardization of robot-assisted living donor hysterectomy for uterus transplantation.

OBJECTIVE: To present a standardized surgical technique of robot-assisted living donor hysterectomy for uterus transplantation with preserva … i robotic system. Surgery was performed with the patient in Trendelenburg position (15°), using CO2 pneumoperitoneum (<12 mm Hg), with a four robotic-arm arrangement. Ureteric stents were placed bilaterally, and indocyanine green was injected retrograde to facilitate ureter identification using firefly mode during dissection. Retraction of the uterus was performed …

[A preliminary exploration of reduced port laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF)].

Objective: This study aimed to share preliminary experiences of single-incision plus two ports laparoscopic proximal gastrectomy with right- … e flap was created before returning the remnant stomach to the abdominal cavity and re-establishing pneumoperitoneum. The No.2 clip was used to grasp and elevate the esophageal stump. An incision was made at the right lower edge of the esophageal stump to guarantee that the esophageal lumen was open. The linear stapler was then inserted into the openings of the st …

[Application of KeyPort access to transanal endoscopic mircrosurgery].

Objective: To explore the effectiveness of KeyPort access in transanal endoscopic mircrosurgery (TEM). Methods: A descriptive case series study was performed. Clinicopathological data of 20 patients undergoing KeyPort access TEM in Beijing Chaoyang Hospital of Capital Medical University from December 2016 to April 2018 were collected and analyzed retrospectively. Procedure of KeyPort access TEM: general anesthesia or combined spinal epidural anesthesia (CSEA); lithotomy or prone jack-knife position; anal dilation; placement of the KeyPortaccess; connection of TEM pneumoperitoneum device, light…

Gastrointestinal tract perforation due to blunt abdominal trauma.

A retrospective clinical study was performed to evaluate the etiology, diagnosis, and management of gastrointestinal tract perforation (GITP … not differ significantly. Fifty-four percent (n = 19) of the patients presented with peritonitis; a pneumoperitoneum was detected in 46% (n = 16). Diagnosis was accomplished by plain radiographs, ultrasound, computed tomography, and, most importantly, frequent abdominal examination of the patient. The sites of perforation were the stomach (4), duodenum (2), jejunu …

Unmasking Sapovirus: Chronic Enteritis in an Immunocompromised Adult With Hypogammaglobulinemia.

Sapovirus is a recognized cause of acute viral gastroenteritis, predominantly affecting children and older adults. While typically self-limiting in immunocompetent individuals, sapovirus can result in persistent, severe gastrointestinal illness in immunocompromised patients. Chronic sapovirus enteritis remains underrecognized and lacks standardized treatment guidelines. We report the case of a 69-year-old woman with multiple myeloma and profound hypogammaglobulinemia secondary to chimeric antigen receptor (CAR) T-cell therapy who presented with a 10-month history of chronic watery diarrhea. Im

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… A case report documented the first instance of sapovirus-associated colitis complicated by pneumatosis intestinalis and pneumoperitoneum in a pediatric patient, suggesting that under certain conditions, sapovirus may contribute to more serious intestinal pathology [ 9 ]. … Pneumatosis intestinalis and pneumoperitoneum secondary to Sapovirus colitis. Xu TO, Levin DE. J Pediatr Surg Case Rep. 2019;47:101252. 10. Impact of norovirus/sapovirus-related diarrhea in renal transplant recipients hospitalized for diarrhea. Roos-Weil D, Ambert-Balay K, Lanternier F, et al. …

[Comparative analysis of the prognosis of patients with locally advanced cervical cancer undergoing laparoscopic or abdominal surgery].

Objective: To compare the prognosis of patients with cervical cancer in stage Ⅰb2-Ⅱa2 undergoing laparoscopic radical hysterectomy or abdomi … rrence and death were also analyzed.During laparoscopic surgery, the pressure of the carbon dioxide pneumoperitoneum were controlled, to try avoid the tumor tissue in the vagina from being exposed to the abdominal cavity when taking out the uterine specimen through the vagina, and fully flushed the abdominal cavity with sterile water after the specimen was taken o …

Combined Laparoscopic-Hysteroscopic Isthmoplasty Using the Rendez-vous Technique Guided Step by Step.

OBJECTIVE: To demonstrate the surgical technique of Rendez-vous isthmoplasty for the treatment of symptomatic cesarean scar defect. In this … placed in 0° supine decubitus, with her arms alongside her body. Operative setup included 15 mm Hg pneumoperitoneum, created using the closed Veress technique, and 4 trocars: a 10-mm trocar at the umbilicus for a 0° laparoscope, a 5-mm trocar in the right iliac fossa, a 5-mm trocar in the left iliac fossa, and a 5-mm trocar in the suprapubic area. The procedure b …

Chronic Fistula Post Laparoscopic Nissen Sleeve Gastrectomy: Conversion to Roux-en-Y Gastric Bypass.

BACKGROUND: Sleeve gastrectomy (SG) is the most frequently performed bariatric intervention worldwide, and obese patients have a higher risk … nal pain and fever. A computed tomography (CT) scan was performed showing a massive supra-mesocolic pneumoperitoneum. An explorative laparoscopy was performed with evidence of a generalized peritonitis without identification of the orifice of the leak. Peritoneal lavage of the abdominal cavity was done and the patient was transferred to our institution. An upper g …

Robot-assisted renal transplantation using the retroperitoneal approach (RART) with more than one year follow up: Description of the technique and results.

OBJECTIVES: To describe the technique and report our first experience of robotic-assisted renal transplantation (RART) with more than one ye … ained using an Alexis trocar that permitted the insertion of the kidney with ice without losing the pneumoperitoneum. Ports included a 12-mm camera port (placed under the ombilicus), two 8-mm robotic ports (placed 6cms laterally from the previous port) and a 12-mm assistant port (placed between the upper port and the ombilic). All the pre-, per- and postoperative …

[Laparoscopic cholecystectomy and open cholecystectomy in acute cholecystitis: critical analysis of 520 cases].

INTRODUCTION: Despite the skepticism with which it was initially seen, laparoscopic cholecystectomy is now the technique of choice for acute … the small bowel, perfurations of the gallbladder with spillage of stones); complications during the pneumoperitoneum, unclear anatomy and scoliosis. Postoperative complications in laparoscopic cholecystectomies converted group vs non-converted: surgical 20.4% vs 6.2% (p = 0.0034) and medical 6.8% vs 4.1% (p = 0.4484). DISCUSSION: There are few investigations conc …

[Diagnostic value of hysterosalpingography in examination of Fallopian tubes in infertile women].

UNLABELLED: Hysterosalpingography (HSG) is a radiographic examination of endocervical canals, uterine cavity and Fallopian tube with the use … out in general endotracheal anaesthesia. A Storz laparoscope was used. CO2 was used for artificial pneumoperitoneum and indigolipstick for tube passage. The obtained findings were elaborated statistically. Descriptive and analytic models were used. p < 0.05 and p < 0.01 were considered as a risk factor of statistical significance. RESULTS: An approximate time in …

Missing Jejunal Perforation During Small Bowel Measurement in Patient Operated by Laparoscopic One-Anastomosis Gastric Bypass.

BACKGROUND: Obesity surgery is justified as it produces sustained weight loss, increases life expectancy, and reduces the complications of o … dia (120 bpm) so we decided to order an abdominal CT scan that showed signs of jejunal perforation (pneumoperitoneum, oral contrast extravasation, and small air bubbles next to the jejunum wall). RESULTS: Emergency laparoscopy was done and showed generalized peritonitis caused by a 4-mm perforation in the mesenteric border of the jejunum with everted mucosa that …

COVID-19 and Laparoscopic Surgery: Scoping Review of Current Literature and Local Expertise.

BACKGROUND: The current coronavirus disease (COVID-19) pandemic is holding the world in its grip. Epidemiologists have shown that the mortal … , polio, and rabies. No papers were found discussing tissue extraction or the deflation risk of the pneumoperitoneum after laparoscopic surgery. CONCLUSIONS: There seems to be consensus in the literature that intubation and extubation are high-risk procedures for health care providers and that maximum protective equipment is needed. On the other hand, minimal evi …

Laparoscopic Reverse Technique for Posterior Rectovaginal Deep Endometriosis Nodule Step by Step.

STUDY OBJECTIVE: To demonstrate the application of the so-called reverse technique to approach deep infiltrating endometriosis nodules affec … in the dorsal decubitus position with her arms alongside her body and her lower limbs in abduction. Pneumoperitoneum was achieved using a Veress needle placed at the umbilicus. Four trocars were placed according to the French technique as follows: a 10-mm trocar at the umbilicus for the 0 degree laparoscope; a 5-mm trocar at the right anterosuperior iliac spine; a …

The Effectiveness of Intravenous Dexmedetomidine on Perioperative Hemodynamics, Analgesic Requirement, and Side Effects Profile in Patients Undergoing Laparoscopic Surgery Under General Anesthesia.

BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major a … S: Significant hemodynamic changes are observed in NS group during laryngoscopy, intubation, during pneumoperitoneum formation, and during extubation. Hemodynamic stress response in dexmedetomidine group was significantly attenuated. Analgesic requirement during postoperative 24 h were much less in dexmedetomidine group when compared to NS group. No significant si …

A 62-Year-Old Woman With Diffuse Myalgias, Fatigue, and Shortness of Breath.

A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the ablation, she was found to have some residual thyroid activity, negating the need for therapy. She was lost to follow-up after months of normal thyroid-stimulating hormone values. On this presentation, the patient was noted to be in atrial fibrillation with a rapid ventricular rate, and although she p

Results of laparoscopic cholecystectomy without energized dissection: a prospective study.

INTRODUCTION: Laparoscopic cholecystectomy (LC) a gold standard treatment of symptomatic gall stone disease has yet to become as safe as open cholecystectomy. The concerns of safety for both surgeon as well as patient are present even after the passage of "learning curve" phase. Emphasis on experience and technique have helped but for the morbidity associated with the use of energy sources. The purpose of this study was to evaluate the possibility of avoiding this morbidity by not using energy sources in LC. MATERIAL AND METHOD: Prospective case series, with a minimum follow up of 1 year. Con

Theatrical fire pursuant exploratory laparotomy.

Fire in the operating theater is a rare but potentially fatal complication. We report igniting an intraperitoneal fire while preforming an exploratory laparotomy for perforated viscus. Fortunately, the patient suffered no injuries as a result.

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… An abdominal plain film revealed substantial pneumoperitoneum and general surgery was consulted with concern for perforated viscus. Examination at that time revealed a tympanic, diffusely tender abdomen without overt signs of peritonitis. …

Iatrogenic trauma following percutaneous and minimally invasive surgical interventions.

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery. The application of MIS should follow the good medical practice dictum by Hippocrates i.e. "First do no harm". To remain abreast with new procedures, the medical personnel are required to update and enhance their knowledge and skill. To ensure safety, the innovations are rigorously tested and tried. The learning curve of MIS is shortened by simulator training a