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   2010| April-June  | Volume 6 | Issue 2  
    Online since July 6, 2010

 
 
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REVIEW ARTICLE
Ergonomics in laparoscopic surgery
Avinash N Supe, Gaurav V Kulkarni, Pradnya A Supe
April-June 2010, 6(2):31-36
DOI:10.4103/0972-9941.65161  PMID:20814508
Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon.
  16 7,519 542
UNUSUAL CASES
Laparoscopic transperitoneal pyelopyelostomy and ureteroureterostomy of retrocaval ureter: Report of two cases and review of the literature
Onkar Singh, Shilpi Singh Gupta, Ankur Hastir, Nand Kishore Arvind
April-June 2010, 6(2):53-55
DOI:10.4103/0972-9941.65166  PMID:20814513
We report two cases of retrocaval ureter that were successfully treated by a laparoscopic transperitoneal approach. Presentation of both these cases was with flank pain. Ureteroureterostomy using an intracorporeal suture technique was performed for one, and pyelopyelostomy for the other case. Operative time was 120 min and 110 min, respectively. Pyelopyelostomy was technically easier to perform than ureteroureterostomy that required an extra fourth port insertion to facilitate dissection. With increasing experience with the intracorporeal suturing laparoscopic technique of either pyelopyelostomy or ureteroureterostomy should be the first choice for retrocaval ureter.
  9 2,268 134
Urinary ascites secondary to delayed diagnosis of laparoscopic bladder injury
Hazem Al-Mandeel, Abeer Qassem
April-June 2010, 6(2):50-52
DOI:10.4103/0972-9941.65165  PMID:20814512
We present a case of urinary ascites in a young woman secondary to unrecognized bladder injury during gynaecologic laparoscopic surgery. Delayed diagnosis occurred due to the absence of expected changes in serum biochemistry, which made the diagnosis of urinoma less likely. High suspicion of bladder injury following laparoscopic surgery should be present in patients with ill-defined symptoms even if no biochemical changes are seen. The case demonstrates important points in relation to the consequences of delayed diagnosis as well as overview on detection and prevention of such injury.
  4 6,216 162
ORIGINAL ARTICLES
Retrospective evaluation of patients of gastroesophageal reflux disease treated with laparoscopic Nissen's fundoplication
Anish P Nagpal, Harshad Soni, Sanjiv P Haribhakti
April-June 2010, 6(2):42-45
DOI:10.4103/0972-9941.65163  PMID:20814510
Aims: To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD). Materials and Methods: Forty-two patients with typical symptoms of GERD, who were operated for laparoscopic Nissen's fundoplication from March 2001 to August 2008, were studied. The study was limited to patients with positive findings on upper gastrointestinal (GI) endoscopy done by us and "typical" symptoms (heartburn, regurgitation, and dysphagia) of GERD. Laparoscopic Nissen's fundoplication was performed when clinical assessment suggested adequate oesophageal motility and length. Only one patient who had negative endoscopic findings underwent a 24-h pH monitoring before surgery. Outcome measures included assessment of the relief of the primary symptom responsible for surgery in the early postoperative period; the patient's evaluation of outcome, and quality of life after surgery. Results: Relief of the primary symptom responsible for surgery was achieved in 95.24% of patients at a mean follow-up of 28 months. Thirty-five patients were asymptomatic, two had minor gastrointestinal symptoms not requiring medical therapy, three patients had gastrointestinal symptoms requiring medical therapy/Proton Pump Inhibitors (PPI) and in two patients the symptoms worsened after surgery. There were no deaths. Clinically significant complications occurred in six patients. Median hospital stay was 3 days, decreasing from 6 days in the first 10 patients to 3 days in the last 10 patients. Conclusions: Laparoscopic Nissen's fundoplication is the choice of operation for clinically symptomatic GERD patients.
  3 2,251 213
LETTERS TO EDITOR
Concomitant laparoscopic procedures can be done for urological diseases
Viroj Wiwanitkit
April-June 2010, 6(2):56-56
DOI:10.4103/0972-9941.65167  PMID:20814515
  2 1,060 88
ORIGINAL ARTICLES
'Stepped procedure ' in laparoscopic cyst decortication during the learning period of laparoscopic surgery: Detailed evaluation of initial experiences
Huri Emre, Akgul Turgay, Ayyildiz Ali, Bagcioglu Murat, Yucel Ozgur, Germiyanoglu Cankon
April-June 2010, 6(2):37-41
DOI:10.4103/0972-9941.65162  PMID:20814509
Background: We evaluated the importance and efficacy of 'stepped procedure' in laparoscopic cyst decortication as an initial experience in it. Materials and Methods: A 36 renal cyst cases were included. The stepped retroperitonoscopic cyst excision divided into three groups. First step, doing the incisions to place the ports and expanding the retroperitoneal space with balloon distension, second step, placement of trocars and reach to the cyst, third step, aspiration and decortication of the cyst. The difficulty of the sessions was measured with the Visual Analog Scale (VAS) scoring system. Score was determined according to the difficulty of the surgical step ranging from '0' to '10', '0', too easy, '10' too difficult'. The durations were measured. One-way ANOVA test was used for statistical analysis. Results: The mean age was 52.0 (20-75) years. The mean operation time was 52.0 min. The mean duration of the first step was 12.5, second, 26.0 and third, 22.5 min. The mean VAS of first step, 3.2, second, 6.0 and third, 3.6 There were only significant differences in duration time and VAS score for second step among the surgeons (P<0.05). Conclusions: Laparoscopic cyst decortication may provide gaining experience to approach the kidney laparoscopically. The side, size and localization of cysts were not found associated with the difficulty of the method.
  2 7,568 170
LETTERS TO EDITOR
Concomitant laparoscopic urological procedures -Does it contribute to morbidity?
Kamlesh Maurya, SE Sivanandam, Sudhir Sukumar, Sanjay Bhat, Ginil Kumar, Balagopal Nair
April-June 2010, 6(2):56-57
DOI:10.4103/0972-9941.65168  PMID:20814514
  - 1,189 103
UNUSUAL CASES
Laparoscopic Heller's cardiomyotomy in cirrhosis with oesophageal varices
Abhay N Dalvi, Pinky M Thapar, Nitin M Narawane, Rippan N Shukla
April-June 2010, 6(2):46-49
DOI:10.4103/0972-9941.65164  PMID:20814511
Surgical intervention in cirrhosis of liver with portal hypertension is associated with increased morbidity and mortality. This is attributed to liver decompensation, intra-operative bleeding, prolonged operative time, wound related and anaesthesia complications. Laparoscopic surgery in cirrhosis is advantageous but is associated with technical challenges. We report one such case of hepatitis C cirrhosis with oesophageal varices and symptomatic achalasia cardia, who was successfully treated by laparoscopic cardiomyotomy after thorough preoperative workup and planning. In the review of literature on pubmed, no such case is reported.
  - 2,154 123
2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04