Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “laparoscopy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed2005

Impact of taurolidin and octreotide on liver metastasis and lipid peroxidation after laparoscopy in chemical induced ductal pancreatic cancer.

BACKGROUND: There is controversial discussion whether metastasis initiated by laparoscopy with carbon dioxide might be prevented by instillation of taurolidin or radical scavengers like the somatostatin analogue Octreotide. Therefore we evaluated the effects of laparoscopic lavage with taurolidin and Octreotide on liver metastasis after staging laparoscopy in ductal pancreatic cancer. METHODS: In 60 Syrian hamsters pancreatic adenocarcinoma was induced by weekly subcutanous injection of 10 mg N-nitrosobis-2-oxopropylamin/kg body weight for 10 weeks. In the 16th week laparoscopic staging biopsy by use of carbon dioxide was performed. Finally animals underwent abdominal irrigation with saline (gr.1, n = 20), taurolidin (0.5%) (gr.2, n = 20) or Octreotide (gr.3, n = 20). In week 25 animals were sacrificed, pancreas and liver were analysed. RESULTS: Size of pancreatic carcinomas was decreased in the taurolidin gr. compared to the other two groups. Furthermore the number of liver metastasis per animal was reduced after lavage with taurolidin (2 +/- 2) and Octreotide (2.5 +/- 2) compared to saline irrigation (4 +/- 4) (p < 0.05). Additionally the incidence of port site metastases was significantly reduced in the taurolidin group. Activity of antioxidative enzyme superoxide dismutase (SOD) was increased while concentration of products of lipidperoxidation was decreased in non-metastatic liver after taurolidin irrigation compared to saline or Octreotide irrigation. CONCLUSIONS: Taurolidin irrigation during laparoscopy might be a new concept to reduce the number of liver metastasis and port site metastases in pancreatic cancer.

Adenocarcinoma↗
PubMed2004

The advantages of hand-assisted laparoscopy.

The technical challenges of performing laparoscopic renal surgery require fellowship training and are associated with a steep learning curve. For the established urologist in practice, fellowship training is not a reality. As a result of these obstacles, in the late 1990s, laparoscopic renal surgery was entering the domain of the general surgeons who had a large number of laparoscopic procedures at their disposal to develop laparoscopic skills. Hand-assisted laparoscopic renal surgery is a hybrid procedure combining the most salient features of open renal surgery and laparoscopic renal surgery. By allowing the surgeons to place their non-dominant hand into the abdominal cavity, palpation and spatial orientation became possible, lessening the learning curve for laparoscopic surgery. Moreover, hand-assisted laparoscopic surgery could be applied to a variety of renal surgeries, extirpative and reconstructive, with results similar to those already achieved by standard laparoscopy. Throughout the past 5 years, hand-assisted laparoscopy has allowed urologists to incorporate laparoscopic renal surgery into their practices to the benefit of their patients and of their specialty. This review article offers a historical review of the development of hand-assisted laparoscopy and describes the procedures commonly performed today using this technique.

Cystectomy↗
PubMed1980

Technical progress in pelvic surgery via operative laparoscopy.

The development of an optimal set of instruments for perfect grasping, cutting, sucking, and ligating and of a new system to perform hemostasis by endocoaguation through a trocar sheath 7 to 11 mm in diameter permits effective laparoscopic surgery. A total of 2,000 operative laparoscopies were performed safely between 1973 and 1976. Since 1977, laparoscopic surgery has been extended to the following procedures: myomectomy (subserous), adnexectomy, ovarian cyst resection, removal of a cystoma, and tubectomy in cases of tubal pregnancy. In 82 such cases, no intraoperative or postoperative complications occurred. The normal postsurgical healing procedure has been checked during 18 second-look laparoscopies and two consecutive laparotomies. These technical advances have opened up a new era of gynecologic surgery based on operative laparoscopy.

Female↗
PubMed1980

Laparoscopy in the diagnosis and management of patients with suspected salpingo-oophoritis.

There is a potential role for laparoscopy in the management of patients with suspected salpingo-oophoritis. It would be helpful in establishing the diagnosis in patients who are admitted with a clinical diagnosis of salpingo-oophoritis. Laparoscopy also would be beneficial in the long-term evaluation of fertility of patients treated for salpingo-oophoritis. Finally, this technique will delineate the microbiologic details of patients with endosalpingitis. How frequently laparoscopy should be employed will be dependent upon findings from prospective studies.

Diagnostic Errors↗
PubMed1987

Laparoscopy--a diagnostic aid in cases of suspected appendicitis. Its use in women of reproductive age.

In women of reproductive age the usefulness of laparoscopy in diagnosing acute appendicitis was evaluated. Eighty-six women underwent diagnostic laparoscopy. There was complete visualization of the appendix in 93% of the patients. Twenty-two patients were spared laparotomy. In the nonpregnant patients, salpingitis was the disease most often confused with appendicitis. Eighty-five percent of the patients with salpingitis had the onset of symptoms within 14 days of the last menstrual period, whereas acute appendicitis was found in 86% of the patients with the onset of symptoms greater than 14 days after the last menstrual period. The onset of symptoms relative to the first day of the last menstrual period differed in these two groups of patients (p less than 0.01). Patients who were spared unnecessary laparotomy had significantly diminished hospital stays (p less than 0.001). Laparoscopy was found to be a safe and effective way to diagnose acute appendicitis in women of reproductive age, and its liberal use is recommended.

Adolescent↗
PubMed1991

The accuracy of clinical findings and laparoscopy in pelvic inflammatory disease.

The accuracy of clinical diagnosis for pelvic inflammatory disease was determined in 95 women who presented with pelvic pain to primary care physicians and then were referred to gynecologists. Laparoscopy or laparotomy with endometrial biopsy and fimbrial minibiopsy revealed that prevalence of pelvic inflammatory was 46% (44/95) and positive and negative predictive values of gynecologists were 74% (23/31) and 67% (43/64) (p = 0.0002). If histopathologic diagnosis was the standard, clinical accuracies of the gynecologists were no better than chance (p = 0.43), suggesting an expectation bias for visual diagnosis. Laparoscopy had a sensitivity of 50% (12/24) and a specificity of 80% (40/50) for salpingitis if the standard was fimbrial histopathologic diagnosis (p = 0.01). These results support the routine use of laparoscopy, supplemented when negative by endometrial and fimbrial minibiopsy, to accurately diagnose pelvic inflammatory disease.

Cervix Uteri↗
PubMed1986

Laparoscopy in the staging and planning of therapy for pancreatic cancer.

Although staging of pancreatic cancer is critical to the planning of therapy, many patients come to laparotomy with liver or peritoneal metastases not suspected or detected during conventional preoperative testing. We performed laparoscopic examinations as part of the staging evaluation of 40 patients with proved pancreatic cancer who were candidates for curative resection or intraoperative radiotherapy. In each patient, laparoscopy was the last test before laparotomy and was carried out only if all other test results were negative for metastases. In 14 of 40 patients, single, small (1 to 2 mm) metastatic nodules were detected and verified by biopsy in the liver (6 patients), on the parietal peritoneum (7 patients), and in the omentum (1 patient). It is likely that several of these lesions would have been overlooked at routine exploration. Because of the positive findings, therapy was altered in all 14 patients. None received intraoperative radiotherapy, nine who did not have jaundice were discharged without operation, three had biliary or gastric bypass only, and two were treated by percutaneous biliary stenting. Of the 26 patients who had negative findings on laparoscopic examination, the absence of gross metastasis was confirmed at laparotomy in 23. Three false-negative findings were caused by incomplete examination of the liver in two patients and a central liver lesion in one patient. Therefore, 43 percent of all patients (17 of 40) had demonstrable but unsuspected nonlocal metastases, and laparoscopic examination detected 82 percent (14 of 17) of these. The overall accuracy of laparoscopy was 93 percent and that of examination with negative findings, 88 percent. In eliminating useless laparotomy and redirecting treatment plans, laparoscopy contributes significantly both to the proper management of patients with pancreatic cancer and to increased efficiency of resource utilization.

Adenocarcinoma↗
PubMed1989

Diagnostic laparoscopy.

This report examines the value of laparoscopy as a diagnostic aid to one general surgeon. Seventy-seven consecutive patients who underwent this procedure are reported. In 31 patients, laparoscopy was performed for assessment of the cause of acute abdominal pain. Diagnosis was achieved in 28 patients (90 percent) and laparotomy was avoided in 17 (55 percent). Assessment of chronic abdominal pain in 11 patients yielded a diagnostic accuracy in 9 (82 percent) and laparotomy was avoided in 7 (64 percent). In 11 patients with abdominal trauma, diagnostic accuracy was 91 percent (10 of 11 patients) and laparotomy was not required in 6 (54 percent). In 21 patients with intraabdominal malignancy, 14 (67 percent) were accurately assessed, and in 8 (38 percent) formal exploration was spared. Three patients with obscure causes of ascites and jaundice were all accurately assessed without need for laparotomy. Based on our data, we believe the reports in the literature are reproducible by any abdominal surgeon who uses laparoscopy as a diagnostic aid in their practice.

Abdomen↗
PubMed1991

Elective diagnostic laparoscopy.

Laparoscopy developed as a science at the turn of the century, and many scientists assisted in the evolution of this technique. However, it was many years before the multiple trocar system was developed that allowed internal organs to be moved and biopsies to be obtained. This has led to the development of numerous indications for elective diagnostic laparoscopy. Adequate preparation and attention to instrumentation ensure the safety of this operation. Elective diagnostic laparoscopy is a useful adjunct to many other diagnostic modalities such as, for instance, the assessment of abdominal pain, abdominal masses, fever of unknown origin, and gastrointestinal bleeding. In many other circumstances, such as the assessment of oncology cases, this modality is superior to conventional radiology because biopsy specimens may be obtained. If the procedure is correctly performed, the diagnostic yield is extremely high and the morbidity and mortality are low. The role of this important technique should not be underestimated by today's practicing surgeon.

Adult↗
PubMed1996

Safe application of diagnostic laparoscopy during biventricular assistance.

We performed diagnostic laparoscopy in a patient who was critically unstable while on an ABIOMED BVS 5000 biventricular assist system. A relatively unique feature of the ABIOMED is the venous return being dependent only on gravity and the drawing force of venous return being the height of the inflow cannula compared with the level of the ABIOMED blood pump assembly; this did not preclude the use of pneumoperitoneum necessary for laparoscopy. The safe application of diagnostic laparoscopy in patients on a ventricular assist device is of importance in an era of increasing use of these devices and the increased potential for intraabdominal complications in this population.

Abdomen, Acute↗
PubMed1984

The role of laparoscopy in the diagnosis of ectopic pregnancy: a plea for conservative management.

This report evaluates the role of laparoscopy in patients admitted with the diagnosis of "Rule Out Ectopic". There were 186 patients admitted to the Brookdale Hospital Medical Center in the 6-year period 1974-1979 inclusive with a diagnosis of "Rule Out Ectopic" or "Possible Unruptured Ectopic". These patients were all laparoscoped. There were 157 satisfactory and 27 unsatisfactory laparoscopies. There were 71 ectopic pregnancies: 42 ruptured, 25 unruptured. Thirty-six cysts were diagnosed. The value of early laparoscopy is clearly established. Particular emphasis is placed on the diagnosis of the unruptured ectopic so that appropriate conservative management of the tube can be instituted in order to preserve potential reproductive capacity.

Female↗
PubMed1986

The accuracy of hysterosalpingography versus laparoscopy in evaluation of infertile women.

Two hundred fifteen infertile women underwent hysterosalpingography (HSG) and laparoscopy. One hundred twenty-eight patients had bilaterally patent tubes on hysterosalpingography. Thirty-one percent of these women had pelvic adhesions diagnosed by laparoscopy. Eighty-seven women had either occluded tubes or suspected pelvic adhesions on hysterosalpingography. Thirty-nine percent of these women had patent tubes without any pelvic pathology on laparoscopy. Inaccurate diagnoses limit the value of hysterosalpingography in evaluation of tubal and peritubal pathology.

Adult↗
PubMed1989

Hysterosalpingography versus laparoscopy in tubal infertility: comparison based on findings at laparatomy.

One hundred ten infertile women underwent hysterography (HSG) and laparoscopy at the Obafemi Awolowo University, Nigeria. Both techniques showed normal tubal patency in 62 (56.4%) women and abnormal pelvic pathology in 48 (43.6%). All 48 women underwent laparotomy for tuboplasty. At laparotomy, HSG and laparoscopic assessments were compared. Both techniques were comparable in the diagnosis of intratubal and distal tubal occlusion. However, laparoscopy was superior in the diagnosis of non-tubal factors and proximal tubal occlusion (P less than 0.002). It is suggested that laparoscopy should be the first procedure in the investigation of tubal infertility and only followed by HSG if the results show some abnormality.

Adult↗
PubMed1995

Cardiorespiratory changes in children during laparoscopy.

The authors prospectively examined the cardiorespiratory changes during brief laparoscopy (less than 15 minutes) in children. Intraoperative ventilatory management included a tidal volume of 12 mL/kg, with the rate adjusted to achieve an end-tidal CO2 (PETCO2) of 30 to 35 mm Hg. The initial rate and tidal volume were not changed during the procedure. Baseline measurements of heart rate, blood pressure, peak inflating pressure (PIP), PETCO2, and oxygen saturation were recorded every minute for 5 minutes before the start of the laparoscopic procedure, and every minute during the laparoscopic procedure. Fifty-five patients were enrolled in the study (age range, 1 month to 7 years; weight range, 5.2 to 31 kg). PIP increased from the baseline value of 20 +/- 2.5 to 23 +/- 3.2 cm H2O (P < .01) during laparoscopy. The increase in PIP was 5 or more in six patients, with a maximum of 7. PETCO2 increased from the baseline value of 32 +/- 3.1 to 35 +/- 4.8 mm Hg (P < .01). The PETCO2 returned to baseline within 10 minutes after completion of the laparoscopy. No increase in ventilatory parameters was required during the brief laparoscopic procedure.

Blood Pressure↗
PubMed1984

Pregnancy rates after laparoscopy for infertility.

To obtain prognostic data on the likelihood of pregnancy in infertile women with no observable abnormalities at diagnostic laparoscopy, the occurrence of pregnancy was studied in a series of 229 patients. The cumulative conception rate during a follow-up period of at most 5 yr was 50%. The probability of pregnancy proved to decline with age and duration of infertility. The cumulative conception rate during the first year after laparoscopy was approx. 30%, and there was no significant difference between the patients that were treated with respect to other sub-optimal fertility factors (subfertile group) and the patients in whom no rational treatment could be instituted (unexplained infertility group). Implications of these findings with respect to the treatment of long-term infertility are discussed. Knowledge of pregnancy rates after infertility laparoscopy seems important for the evaluation of results of therapy in unexplained infertility.

Female↗
PubMed1989

Second look laparoscopy; evaluation of two different antibiotic regimens after treatment of acute salpingitis.

In order to have their diagnoses verified, etiology determined and treatment evaluated, 64 patients with suspected acute salpingitis (AS) underwent laparoscopy during which specimens were taken. The patients were referred to groups of either a mild (16/64), a moderate (26/64), or a severe (22/64) form of salpingitis. They were then randomized to one of two groups for treatment with either doxycycline/bensylpenicillin-procain (DC/BP) or trimethoprim-sulfamethoxazole (TMP-SMZ). The results were evaluated by second-look laparoscopy 3-6 months later when adhesions and tubal passage were looked for. Isolates from the cervix were culture positive for Chlamydia trachomatis (CT) in 36/64 (56%) (9/16 with a mild form, 13/26 with moderate form and 14/22 with a severe form of salpingitis). Neisseria gonorrhoeae (NG) was isolated from the cervix in 15/64 (23%) (5/16 with a mild form, 4/26 with a moderate form and 6/22 with a severe form of the disease). Oviductal cultures for CT were found in 12/64 (19%) (1/16 with a mild form, 4/26 with a moderate and 7/25 with severe form of salpingitis). Oviductal isolates for NG were found in 2/64 (13%) (2/16 from the group with a mild form of the disease). Second-look laparoscopy revealed totally occluded oviducts in two patients from the group with a severe form of salpingitis (one from each treatment group).

Acute Disease↗
PubMed1991

The role of laparoscopy in acute pelvic infections.

54 patients presented by history, physical examination and laboratory tests with suspected pelvic inflammatory disease (PID). The use of laparoscopy as a diagnostic tool proved in 13 cases (24%) that the presumptive diagnosis was incorrect. Bacteriological studies revealed chlamydial infection in 21 of 41 cases, in 6 cases only at laparoscopy in the pelvic cavity, gonococcal in 9 of 41 cases; mycoplasmas were identified in 15 cases, being the only pathogen in 7. In 9 cases, no recognized pathogens were isolated. Polymicrobism was frequent. Follow-up studies identified 5 cases of treatment failure; 2 of Gonococcus and 3 of Chlamydia, and detected 3 cases of Chlamydia which had not been identified initially. We discuss the use of laparoscopy in the diagnosis and for follow-up and treatment of PIDs.

Acute Disease↗
PubMed1995

Cost-effectiveness of routine blood type and screen testing before elective laparoscopy.

OBJECTIVE: To evaluate the usefulness and cost-effectiveness of the routine preoperative evaluation of blood type and screen testing before laparoscopy. METHODS: A retrospective review was conducted in patients transfused with blood during or after laparoscopy over a 3-year period at Hutzel Hospital, Detroit, Michigan; Grace Hospital, Southfield, Michigan; and Bixby Medical Center, Adrian, Michigan. RESULTS: Of 7529 women receiving laparoscopic procedures, 57 required blood transfusion at laparoscopy. Medical records of the 57 patients requiring blood transfusion were evaluated as to urgency and indication. All 57 subsequent blood transfusions were found to be the result of previously identifiable problems, including ectopic pregnancy and preoperative anemia. No patient required transfusion for a vascular injury. CONCLUSION: In the absence of preoperative indications, routine preoperative type and screen testing for elective and emergency laparoscopic procedures does not enhance patient care and should be eliminated.

Blood Grouping and Crossmatching↗