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Biomedical subjects

N Katkhouda

Publications and source records attributed to N Katkhouda.

52 records · Page 3Linked to original sources
PubMed1994

Laparoscopic surgery: surgical education in the People's Republic of China.

In 1991, because of the international emphasis on laparoscopic surgery, a large contingency of surgeons took on the task of introducing laparoscopy to the People's Republic of China. This trip was a technological feat, since all of the equipment and instrumentation had to be carried into the country. This necessitated a major coordinated effort among professional teaching staff and industry representatives with their transported equipment. This unique educational opportunity is detailed in this article, which highlights, in particular, the contrast between the new "high-tech" surgery and the reality of a developing country.

China↗
PubMed1994

Peptic ulcer surgery in 1994.

Despite successful medical treatment of peptic ulcer disease regarding both acid reduction and eradication of Helicobacter pylori, there is still an increasing number of emergency operations for complications and no decrease of mortality. Elective surgery after complete physiologic work-up can improve the results for a certain group of patients. In cases requiring acid reduction only, laparoscopic procedures such as posterior truncal vagotomy and anterior seromyotomy can be offered. The minimal invasive approach--as we have experienced in other procedures-increases patient acceptance of surgical treatment.

Humans↗
PubMed1994

Laparoscopic posterior vagotomy and anterior seromyotomy.

Laparoscopic truncal vagotomy with anterior seromyotomy, as described by Taylor, is our operation of choice in open surgery for elective treatment of chronic duodenal ulcer because it is a rapid, reliable and efficacious procedure. This procedure also does not have the variability of highly selective vagotomy in relation to the surgeon who is performing the operation. The technique is standardised and the results on 90 patients showed minimal morbidity and no mortality with a recurrence rate of 4.2% after a follow-up of 2-41 months. These results are very similar to those obtained in open surgery and compare favorably with the recurrence results after medical treatment. The procedure is therefore effective and safe and should be included in the armamentarium of treatment of chronic duodenal ulcer resistant to a thorough medical treatment.

Adult↗
PubMed1993

[Dissection of the Calot's triangle by the celioscopic approach].

Laparoscopy seems to increase the frequency of post-cholecystectomy biliary complications. Irrespective of the instruments and techniques utilized, dissection of Calot's triangle must be performed in compliance with the classical rules of bile duct surgery. These rules are: always keep in contact with the gallbladder; completely dissect the Calot's triangle area which must not contain more than one biliary tract element; never dissect the cystic duct beyond the right border of the hepatic choledochus; never section an element that is not identified with certainty; systematically perform a peroperative transcystic cholangiography, in particular to detect the anatomical variants of the extra-hepatic biliary ducts.

Cholecystectomy, Laparoscopic↗
PubMed1993

Laparoscopic treatment of inguinal hernias. A personal approach.

Laparoscopic hernia repair has suffered from a lack of careful anatomical appreciation and the application of sound surgical principles. Key anatomical landmarks which must be clearly identified in every hernia repair are Cooper's ligament, the umbilical artery and the epigastric vessels. The preperitoneal transabdominal mesh repair is the technique advocated by the authors. Between January 1991 and February 1993, 180 hernias were repaired. One hernia has recurred. Morbidity was minimal, with no major complication. The hospital stay was 1.3 days and the majority of patients returned rapidly to full activity. The best indications for laparoscopic hernia repair are recurrent hernias, a large hernia in patients with a weak muscular abdominal wall and bilateral hernias, for which the technique is considered ideal.

Follow-Up Studies↗
PubMed1993

Laparoscopy-assisted aortobifemoral bypass.

Therapeutic laparoscopy has substantially simplified the postoperative course of patients suffering from hepatobiliary, gastric, or colonic disease. One important advantage of this modality is the decrease in postoperative pain, which diminishes the potential for cardiopulmonary problems. Patients with aortoiliac atherosclerotic disease are at high risk for postoperative complications, and a minimally invasive procedure may favorably affect their postoperative recovery. We describe here the first patient on whom we performed a laparoscopy-assisted aortobifemoral bypass. Under the pneumoperitoneum, seven 10-mm trocars were inserted to permit aortic dissection and creation of retroperitoneal tunnels to the femoral regions. After evacuation of the pneumoperitoneum, an 8-cm midline incision was made to allow a side-to-end aortic anastomosis. The patient's postoperative period was uncomplicated by any cardiopulmonary problems despite his history of three myocardial infarctions; the patient had minimal pain that allowed for a quick return to ambulation. This procedure is minimally invasive and appeared to simplify the postoperative period in our patient. It could become the procedure of choice for certain patients with aortoiliac disease.

Anastomosis, Surgical↗
PubMed1992

Endolaparoscopic palliation of pancreatic cancer.

Two patients with advanced pancreatic cancer were palliated for both duodenal and biliary obstruction without laparotomy. The techniques of endoscopic biliary stent and laparoscopic gastrojejunostomy are described. This combination achieved rapid palliation with minimum morbidity. Patients with advanced pancreatic cancer and a limited life expectancy benefit greatly from the shortened hospital stay and convalescence this manner of treatment offers.

Adult↗
PubMed1991

A new technique of surgical treatment of chronic duodenal ulcer without laparotomy by videocoelioscopy.

We performed truncal posterior right vagotomy with lesser curve anterior gastric myotomy by videocoelioscopy on 10 patients (5 men and 5 women, ranging in age from 19 and 54 years, with a mean age of 32 years). All had a long history of chronic duodenal ulcer with a mean duration of symptoms of 3.8 years. The mean length of the operation was 60 minutes (range: 55 to 110 minutes). There was no morbidity, and all patients were discharged after 5 days. The acid secretion tests under basal conditions and under insulin stimulation preoperatively and 1 month postoperatively showed a mean decrease in the basal output of 79.3% and a mean decrease of 83.04% in the maximal output. The fibroscopic control at the second postoperative month showed a complete healing of the ulcer in nine patients and a residual ulcer scar in one. No patients had any abdominal complaints. Right truncal vagotomy and anterior lesser curve seromyotomy by videocoelioscopy is an efficient and elegant method of treating chronic duodenal ulcer, but it needs thorough experimental practice.

Adult↗
PubMed1991

Laparoscopic fenestration of biliary cysts.

We describe a new technique of biliary cyst fenestration using a videolaparoscopic approach. From June 1989 to October 1990, laparoscopic fenestration was performed for four symptomatic solitary cyst and one polycystic liver disease patients, without any morbidity. Mean hospital stay was short: 6.8 days (range of 3-14 days). No recurrence was observed on ultrasound controls with a mean follow-up of 6.4 months (range of 2-15 months). Laparoscopic fenestration for symptomatic biliary cysts is a simple, effective, and minimally invasive procedure.

Adult↗
PubMed1990

[Treatment of duodenal ulcer by posterior trunk vagotomy and anterior fundic seromyotomy under video-laparoscopy. Preliminary note with presentation of a film].

Posterior vagotomy associated with anterior fundic seromyotomy, as proposed by Taylor in 1979 and widely used since then, has been performed under video laparoscopic monitoring in 6 patients with inveterate chronic duodenal ulcer. The procedure described here produced no complications in the immediate postoperative period and early progress in the controlled healing of the ulcer and the reduction of acidity, which can be compared to those of the same procedure with laparotomy.

Adult↗
PubMed1988

[Hydatid cyst of the pancreas responsible for chronic recurrent pancreatitis].

Hydatid cyst of the pancreas is a rare localization of hydatidosis. It raises diagnostic problems which can only be solved by section of the surgical specimen. An exceptional case of hydatid cyst of the pancreatic tail which resulted in chronic recurrent pancreatitis, and a review of the literature, enable to put hydatidosis on the list of causes of pancreatitis.

Adult↗
PubMedDate not supplied

Laparoscopic vagotomy for chronic duodenal ulcer disease.

Two laparoscopic procedures for treatment of chronic duodenal ulcer are described: bilateral truncal vagotomy with balloon pyloric dilatation and posterior truncal vagotomy with anterior lesser curve seromyotomy. The first procedure is simple to perform and easily reproducible, but the latter is preferred because it respects the physiology of the stomach. Thirty-six patients were operated on over a period of 18 months with good results comparable to those with open surgery. The indications for surgery were intractable chronic duodenal ulcers resistant to optimal medical therapy. There was no perioperative morbidity or mortality, and recurrent ulcers have not been demonstrated during early postoperative follow-up. The proper role of laparoscopic surgery in the arsenal of treatment of duodenal ulcers is unclear. The method of laparoscopic vagotomy requires rigorous experimental evaluation in specialized centers before widespread clinical application. Future multicentric prospective studies with long-term follow-up are necessary to assess the results of this innovative therapy of acid-peptic disease.

Adult↗