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Biomedical subjects

D Rosin

Publications and source records attributed to D Rosin.

At least 19 recordsLinked to original sources

[Laparoscopic surgical of the liver and bile ducts].

The liver, gallbladder, bile ducts, and spleen are the least mobile organs in the upper abdomen. Thus, the laparoscopic approach is commonly used to manage a variety of pathologies related to these organs [5, 10, 60, 78]. Compared with conventional "open" surgery, minimally invasive surgery reduces postoperative pain and discomfort, lowers morbidity rates, promotes early mobilization, decreases recovery time and length of stay, and improves cosmetic results. In addition, the surgical results of laparoscopic surgery are as good as or better than those of conventional surgery [5]. This paper reviews the advances in laparoscopic surgery, and describes current patient selection practices and laparoscopic surgical techniques for benign liver cysts and tumors and biliary tract diseases.

Bile Duct Diseases↗

[Laparoscopic splenectomy: new techniques and indications].

Over the recent years laparoscopic splenectomy has become the preferred approach for the treatment of many conditions requiring splenic removal. At first limited to small spleens and to benign hematologic disorders, this procedure is now used for a variety of indications. Enlarged spleens are possible to be removed laparoscopically, although this is still a demanding procedure. Two factors facilitated the technique and contributed to its wide acceptance: 1) Change in the technique originally used, by positioning the patient in right lateral decubitus, and approaching the spleen from a postero-lateral direction. 2) The development of new technologies to dissect and divide tissues and vessels, including the ultrasonic shears and the laparoscopic linear stapler. In this article we review the current indications for laparoscopic splenectomy, as well as the techniques to accomplish this procedure.

Humans↗

Closure of laparoscopic trocar site wounds with cyanoacrylate tissue glue: a simple technical solution.

Cyanoacrylate-based tissue glue has been widely used for many years around the world, and was recently approved for use in the United States, mainly for skin cuts and lacerations. Other applications were described, in different surgical situations. Although ideal for small, clean incisions, its use in laparoscopic surgery is currently limited. Over a year period, 100 patients with more 250 trocar site wounds had their wounds glued using histoacryl. Infection rate was extremely low (one case), and partial dehiscence of the wound happened in two patients, where wound edge approximation was not optimal. Cosmetic results were excellent and patient satisfaction was high, as no sutures had to be removed. Glue application is easy and quick, with no risk of needle sticks, and it is a viable option for laparoscopic wound closure.

Cyanoacrylates↗

[Sclerosing mesenteritis--an unusual cause of abdominal pain].

Sclerosing mesenteritis (SM) is rare and fewer than 300 cases had been reported up to 1997. We describe a 29-year-old woman who had abdominal pain for 1 year and presented with a palpable abdominal mass. The diagnosis of SM was made only after diagnostic laparoscopy and biopsy of the peritoneum.

Abdominal Pain↗

Laparoscopic interval appendectomy for periappendicular abscess.

BACKGROUND: Laparoscopic appendectomy was first described in the early 1980s and is currently widely used for the treatment of acute appendicitis. The application of laparoscopic techniques to interval appendectomy and the value of this procedure as compared to open elective interval appendectomy remains uncertain. Therefore, we set out to assess the usefulness of interval laparoscopic appendectomy following periappendicular abscess. METHODS: This study analyzes the data for 10 patients who underwent interval laparoscopic appendectomy 8-10 weeks following documented periappendicular abscess in the period between January 1996 and June 1998. RESULTS: Laparoscopic appendectomy was completed successfully in all 10 patients. Nine patients were discharged 1 day after the operation; one patient was discharged on the evening of the operative day. There were no complications and no wound infections. CONCLUSION: We conclude that the laparoscopic approach is the preferable treatment for interval appendectomy. It is associated with minimal or no morbidity and a very short hospital stay.

Abdominal Abscess↗

Laparoscopic approach to small-bowel obstruction.

BACKGROUND: Small-bowel obstruction poses both a diagnostic and a therapeutic challenge. The laparoscopic approach may assist in determining the cause of the obstruction and in many cases to treat the obstructing lesion. METHODS: For the last 2 years, we have been approaching patients with small-bowel obstruction laparoscopically. RESULTS: We have found this technique to be successful as the definitive treatment in more than half of the cases. CONCLUSION: The laparoscopic approach should be the modality of choice for most, if not all, cases of small-bowel obstruction in which there is an indication for exploration.

Adult↗

Laparoscopic resection of huge omental cyst.

Mesenteric cysts are uncommon, and their pathological type includes pseudocyst, mesothelial cyst, lymphangioma, and omental cyst. We describe a case of a giant omental cyst treated successfully by a minimally invasive approach.

Adult↗

[Extraperitoneal laparoscopic adrenalectomy].

Laparoscopic adrenalectomy has recently been shown to be safe and effective for a variety of benign adrenal tumors, such as aldosterone adenoma, pheochromocytoma, nonfunctioning adenoma, Cushing's adenoma and Cushing's syndrome. Recently, laparoscopic surgeons adopted an extraperitoneal approach in which a space is created by the introduction of a trocar with an inflatable balloon tip. This technique with a minimal access procedure provides direct access to the adrenal glands without interfering with intraperitoneal organs. Laparoscopic adrenalectomy using the extraperitoneal approach was completed in 18/20 consecutive patients. Mean operative time was 95 min (range 80-120) and median hospital stay 3 days. Blood transfusion was not required, and there were no postoperative complications.

Adenoma↗

[Laparoscopic approach to perforated duodenal ulcer].

As laparoscopy becomes more prevalent, it is being used for a growing variety of abdominal operations, both electively and as emergency treatment. We describe our preliminary experience in laparoscopic repair of perforated duodenal ulcer. 2 women and 2 men, aged 40-78 were operated over a period of 4 months and in all laparoscopic suture and omentopexy were performed with meticulous abdominal lavage. Despite somewhat longer operative time but a similar period of hospitalization, the easier post-operative course and fewer wound complications justify this technique. The effectiveness of medical treatment of peptic disease, and especially the anti-Helicobacter pylori regimen, supports the view that closure of the perforation is usually enough, and vagotomy is not needed.

Adult↗

[Abdominal compartment syndrome].

Abdominal compartment syndrome refers to a complex of negative effects of intra-abdominal hypertension. Its most common cause is complicated abdominal trauma. The syndrome includes mainly hemodynamic and respiratory manifestations but may involve other systems as well. It may present as a life-threatening emergency in the multi-trauma patient. Awareness of the syndrome may enable the surgeon to take preventive measures or to diagnose it earlier and to treat it effectively. We describe a 21-year old man who developed this syndrome after multiple gunshot wounds, with severe liver injury. After 2 operations the typical manifestations of the syndrome were diagnosed. He was re-operated to release intra-abdominal hypertension and then slowly recovered.

Abdominal Injuries↗

Posterolateral approach. An alternative strategy in laparoscopic splenectomy.

Laparoscopic splenectomy (LS) is effective and technically feasible for treating various hematological diseases, especially idiopathic thrombocytopenic purpura (ITP). An anterior approach to the vascular pedicle is usually described. However, in this approach to the splenic hilum, the dissection of the splenic artery is often difficult. A total of 13 patients with ITP underwent elective laparoscopic splenectomy. We utilized a laparoscopic posterolateral approach involving dissection of the suspensory ligaments at the lower pole, then dissection and division of the posterolateral attachments, followed by the dissection and ligation of all splenic branches near the splenic parenchyma. This procedure was completed in 11 of our 13 patients and converted to open surgery in the other two patients. Mean operative time was 3 h; mean postoperative stay was 3 days. No blood transfusion was required, and no complications were noted in the postoperative period. The posterolateral approach provides better visualization and control of branches of the splenic vein and artery in the splenic hilum. It also permits visualization and control of surgical hemorrhage through the operating ports.

Adolescent↗

Extracranial giant cell arteritis.

Although giant cell arteritis (GCA) of the extracranial arteries is said to be relatively frequent, clinical manifestations are rarely recognized. We describe a case presenting with intestinal perforation who subsequently died with active GCA of the coronary, mesenteric and temporal vessels.

Aged↗

[Laparoscopic cholecystectomy during pregnancy].

The decision whether to perform cholecystectomy during pregnancy, and in what manner, is complex. A 26-year-old pregnant woman was admitted because of persistent biliary colic, which did not respond to conservative treatment. Laparoscopic cholecystectomy was done, with a normal course and without negative effects on the pregnancy. Contraindications to laparoscopic cholecystectomy are becoming fewer as technique improves and experience accumulates. This case report is added to the other few reported, which reinforce the view that pregnancy should no longer be considered a contraindication to laparoscopic cholecystectomy.

Adult↗