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  Citation statistics : Table of Contents
   2006| October-December  | Volume 2 | Issue 4  
 
 
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UNUSUAL CASE
Laparoscopic management of acute appendicitis in situs inversus
Vishwanath Golash
October-December 2006, 2(4):220-221
PMID:21234150
Situs inversus is often detected incidentally in adults during imaging for a acute surgical emergency. We present a case of acute appendicitis in an adult who was previously unaware about his situs anomaly. A laparoscopic approach is helpful to deal with this condition. A 40 year old man was admitted with history of acute left lower abdominal pain, with uncontrolled diabetic keto-acidosis. Clinically, he was diagnosed as acute diverticulitis with localized peritonitis. Subsequent imaging studies and laparoscopy confirmed the diagnosis of situs inversus and acute left- sided appendicitis. He successfully underwent laparoscopic appendectomy. His postoperative recovery was uneventful. Although technically more challenging because of the reverse laparoscopic view of the anatomy, the laparoscopic diagnosis and management of acute appendicitis is indicated in situs inversus.
  7 5,839 332
EDITORIAL
Laparoscopic approach for Hartmann reversal procedures
H Scheidbach, H Lippert
October-December 2006, 2(4):203-204
PMID:21234146
  6 6,896 258
ORIGINAL ARTICLE
Laparoscopic reversal of Hartmann procedure
Vishwanath Golash
October-December 2006, 2(4):211-215
PMID:21234148
Background: The Hartmann procedure is a standard life-saving operation for acute left colonic complications. It is usually performed as a temporary procedure with the intent to reverse it later on. This reversal is associated with considerable morbidity and mortality by open method. The laparoscopic reestablishment of intestinal continuity after Hartmann procedure has shown better results in terms of decrease in morbidity and mortality. Materials and Methods: The laparoscopic technique was used consecutively in 12 patients for the reversal of Hartmann procedure in the last 3 years. The adhesiolysis and mobilization of the colon was done under laparoscopic guidance. The colostomy was mobilized and returned to abdominal cavity after tying the anvil in the proximal end. An end-to-end intracorporeal anastomosis was performed between the proximal colon and the rectum using the circular stapler. Results: Mean age of the patients was 40 years and the mean time of restoration of intestinal continuity was 130 days. Two patients were converted to open. The mean time of operation was 90 min. There were no postoperative complications and mortality. The mean hospital stay was 5 days. Conclusion: Laparoscopic reversal of Hartmann is technically safe and feasible.
  3 15,977 372
UNUSUAL CASE
Laparoscopic treatment of heterotopic pancreas in the prepyloric region
R Galvez-Valdovinos, A Mendoza-Rodriguez, JH Coronado-Perez, E Marin Santillan, F Funes-Rodriguez
October-December 2006, 2(4):224-226
PMID:21234152
Heterotopic pancreas is a rare condition and its diagnosis is often difficult. Traditionally the condition is treated by open surgery. We report two young women with symptomatic heterotopic pancreas located in the prepyloric region. In the first patient, upper gastrointestinal endoscopy identified a round sessile lesion with a central umbilication of the mucosa without bleeding and in the second endoscopy showed a lesion with intraluminal protrusion. In both cases, a diagnostic laparoscopy identified masses amenable to laparoscopic excision. Intraoperative histology confirmed ectopic pancreatic tissue in both. In the treatment of heterotopic pancreas, laparoscopic excision provides a feasible, safe and effective treatment option.
  3 9,510 228
EDITORIAL
Laparoscopic colostomy takedown offers advantages over traditional surgery
Thomas M Schmelzer, William W Hope, David A Iannitti, Kent W Kercher, B Todd Heniford
October-December 2006, 2(4):201-202
PMID:21234145
  2 24,635 429
REVIEW ARTICLE
Laparoscopic surgery for colorectal cancers: Current status
Parul J Shukla, George Barreto, Piyush Gupta, Shailesh V Shrikhande
October-December 2006, 2(4):205-210
PMID:21234147
Laparoscopy was introduced more than 15 years ago into clinical practice. However, its role in colorectal surgery was not well established for want of better skills and technology. This coupled with high incidences of port site recurrences, prevented laparoscopic surgery from being incorporated into mainstream colorectal cancer surgery. A recent increase in the number of reports, retrospective analyses, randomized trials and multicentric trials has now provided sufficient data to support the role of laparoscopy in colorectal cancer surgery. We, thus, present a review of the published data on the feasibility, safety, short - and long-term outcomes following laparoscopic surgery for colorectal cancers. While the data available strongly favors the use of laparoscopic surgery in colonic cancer, larger well powered studies are required to prove or disprove its role in rectal cancer.
  2 7,711 436
UNUSUAL CASE
Massive intestinal infarction following retroperitoneoscopic right lumbar sympathectomy
Francesco Rulli, Gabriele Galata, Chiara Micossi, Carlo Dell’Isola
October-December 2006, 2(4):222-223
PMID:21234151
The adverse physiological effects of pneumo and retro-peritoneum are relatively well known. However, the clinical implications of compromised mesenteric circulation through several mechanical and physiological mechanisms are not as well recognized. We describe a fatal case of intestinal infarction following an elective retroperitoneoscopic right sympathectomy. The patient was a 88-year-old man who died 30 hours after an uneventful anesthesia and right endoscopic lumbar sympathectomy. An emergency explorative laparotomy revealed a massive intestinal infarction due to thrombosis of the superior mesenteric artery. We reviewed the literature on laparoscopic procedures and mesenteric ischemia. To our knowledge, this is the first reported case of intestinal infarction following retro-pneumoperitoneum. We conclude that the presence of a severe multidistrectual? arteriopathy may represent a major risk factor in retroperitoneoscopic procedures.
  2 4,670 187
PERSONAL VIEWPOINT
Quest for the best procedure in minimal access thoracic surgery: Optimization of what?
Tamas F Molnar
October-December 2006, 2(4):227-230
PMID:21234153
  1 4,029 212
ORIGINAL ARTICLE
Teaching impact in pediatric minimal access surgery: Personal perspective from "Fellow"
Dragan Kravarusic
October-December 2006, 2(4):216-219
PMID:21234149
The global objective of this paper is to review from the "Fellow" perspective, the current status of pediatric minimal access surgery (MAS) in terms of teaching feasibility, safety and impact on standard practice paradigms. In the pediatric general surgery field, surgeons are dealing with a wide range of pathology that includes thoracic, abdominal, urological and gynecological procedures. The learning curve is slow because of a relatively small volume of patients. However, gradually but steadily, a significant proportion of the procedures traditionally performed, with major open exposures at present, are preferentially performed by minimal access. Currently, minimal access surgery training is incorporated into adult general surgery residency/fellowship programs and teaching techniques of pediatric MAS are available only as seldom international workshops. Pediatric surgery fellowship programs with incorporated guidelines for MAS training are just recently feasible in select centers, mostly as "self" established programs. In many other pediatric surgery centers, teaching the "glamour" of MAS is quite dependent on a program director's vision. Integration of MAS training into the secondary residency/fellowship curriculum of pediatric surgeons is the inevitable goal. MAS- minded education and research through adequate training will pay dividends and "manufacture" competent, contemporary trainees. National Pediatric Surgery Associations should be responsible for setting criteria that consider the MAS for accreditation with maintaining the international standards of these teaching programs.
  - 4,665 236
© 2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04