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At least 1,171 records · Page 65Linked to original sources
PubMed2000

[Clinical study on endometrial ovarian cyst treated by integrated laparoscopy and Chinese herbal medicine].

OBJECTIVE: To investigate a new method of integrated laparoscopy with Chinese herbal medicine (CHM) in treating endometrial ovarian cyst. METHODS: One hundred and fifty-two patients with endometrial ovarian cyst were randomly treated with three therapies: Integrated laparoscopy with CHM (combination group), CHM (TCM group) and Danazol (WM group). To compare the clinical efficacy and side-effects of the three groups and to elucidate the therapeutic mechanism by detecting the serum CA125 reproductive endocrine hormone, plasma PGF1 alpha, PGE2 etc. RESULTS: The shrinking rate and disappearance rate of the cysts, and markedly effective rate of combination group were obviously higher than those of TCM group and WM group (P < 0.05, P < 0.01). The pregnancy rate of combination group was also higher than that of WM group (P < 0.05). Few side-effects were the most prominent advantage for combination group and TCM group. After treatment, the plasma PGF1 alpha lowered remarkably, serum p.o. increased and CA125 reduced obviously (P < 0.01, P < 0.05). CONCLUSION: The integrated laparoscopy and CHM combination therapy is a new method in treating endometrial ovarian cyst with significant efficacy, minimal adverse effect and maximal preservation of reproductive function.

Adult↗
PubMed1998

[The use of laparoscopy in urology: report of 141 cases].

OBJECTIVE: To modify laparoscopy in urology. METHOD: From May 1992 to Nov. 1996, 141 patients (110 males and 31 females) were subjected to laparoscopy in the treatment of urological diseases. The age of the patients ranged from 9 to 76 years (mean 39 years). Five patients had nephrectomy, 12 adrenalectomy, 48 renal cyst resection, 61 high ligation of internal spermatic vein, 5 pelvic staging lymphadenectomy, 9 orchiectomy, and 1 removal of bladder diverticulum. RESULT: The rate of successful operation was 95.7% and that of complications was 2.22%. The mean hospitalization was 4.9 +/- 4.1 days. CONCLUSION: Laparoscopy can be used widely in clinical practice.

Adolescent↗
PubMed2002

[Ultrasonographic and biochemical screening of adnexal masses before operative laparoscopy].

BACKGROUND: The object of our study was to evaluate how reliable ultrasonographic and biochemical screening of adnexal masses are in the selection of patients eligible for operative laparoscopy. METHODS: The study was performed at the First Clinic of Obstetrics and Gynecology, University of Rome La Sapienza, Italy. Eighty-seven women of 36.8 +/- 12 years of age, who underwent operative laparoscopy between January 1999 and January 2000 to remove an adnexal lesion, were enrolled. These adnexal lesions had been previously diagnosed on the basis of a pelvic ultrasonographic imaging; this was performed because of follow-up procedure or pelvic pain. The lesions were evaluated preoperatively according to Sassone echographic scoring system. The CA-125 level was determined in 58 patients. RESULTS: Surgery was successful in all 87 cases. In one case the operative laparoscopy had to be turned into laparotomy since the histologic examination revealed an atypical proliferative mucinous cystoadenoma. Sassone total average echographic score was 6.0 +/- 1.7; this is below the discriminant cut-off for malignancy (9). The only case in which Sassone score reached 10 was an atypical cystoadenoma. The CA-125 level was higher than 35 IU/ml (cut-off of this marker) in 13.7% of the patients; these were all affected by endometriosis or had a hemorrhagic corpus luteum. In the patient with atypical cystoadenoma, the CA-125 level was within normal range (29.1 UI/ml). The post-operative period was uneventful in all cases but one, in which the occurrence of pulmonary thromboembolism required a prolonged hospitalization. CONCLUSIONS: The use of Sassone echographic scoring system proved to be very useful and effective in the selection of the patients. Tumor markers are relevant factors only if their evaluation is accompanied by an accurate anamnesis and is supported by the findings of abdominal and transvaginal ultrasonography.

Adnexal Diseases↗
PubMed2002

Laparoscopy in gynecologic emergencies.

Laparoscopy is ideal for the diagnosis of acute pelvic pain and the treatment of gynecologic emergencies. It is as safe and effective as laparotomy for the treatment of ectopic pregnancy, ovarian cysts, dermoid cysts, and adnexal torsion. Treatment with laparoscopy results in shorter hospital stay and faster recovery. Future fertility is not compromised and in some cases may be improved with laparoscopic treatment. There are also studies suggesting that laparoscopy can be used safely for the diagnosis and treatment of gynecologic emergencies in the first and second trimester of pregnancy.

Algorithms↗
PubMedDate not supplied

[Laparoscopy in abdominal emergencies. Indications and limitations].

Laparoscopy, which has been well known as a diagnostic procedure for more than a century, has recently established itself as an important therapeutic procedure in several branches of surgery. In the present study the authors report on 221 patients over a 10-year period (1991-2001), admitted to hospital with a diagnosis of acute abdomen or abdominal trauma. All patients were submitted to emergency laparoscopic surgery; 128 patients (57%) presented acute appendicitis, 40 (18%) acute cholecystitis, 13 (6%) occlusive ileus, 10 (5%) adnexal pathologies, 9 (4%) perforation of abdominal viscera, 3 (1.4%) acute diverticulitis, 3 (1.4%) subdiaphragmatic abscesses, 3 (1.4%) intestinal infarction, 2 (0.8%) other diseases and 10 (5%) abdominal trauma. The operation was completed laparoscopically in 192 cases (87%), while conversion to laparotomy proved necessary in 29 cases (13%). The morbidity of the cases completed laparoscopically was 3%, the mortality 0.5%, and the mean hospital stay 4 days. Advantages of laparoscopy (shorter hospital stay, rapid postoperative recovery and faster return to social activities) emerge from the present study and are confirmed by the literature. The possibility of combining a diagnostic procedure with curative therapy suggests that laparoscopy may have an important role in emergency surgery, demonstrating its efficacy also in acute abdominal syndromes. Nevertheless, emergency laparoscopic surgery is still a technically difficult procedure that needs to be performed by an expert surgical team.

Abdomen, Acute↗
PubMedDate not supplied

[Incisional hernias after operative laparoscopy].

The objective of this study was to determine the possible risk factors of incisional hernias after operative laparoscopy. Complications involving the abdominal wall, particularly incisional hernias, were not expected when laparoscopic procedures were first introduced. With the increasing number of laparoscopies in the abdominal surgery, more incisional hernias were observed. Of the approximately 3,145 patients who underwent laparoscopy from march 1993 through march 2000 in the First Surgical Clinic Iassy, a total of 15 hernias occurred, which is an incidence of 0.477%. There were no acute complications, such as small bowel obstruction, secondary to herniation through the trocars. Risk factors such as chronic bronchitis or weight increase, which give rise to abdominal pressure, were present in some cases. Precautions such as fascial suturing must be taken to reduce the incidence of this minor complication of laparoscopic surgery.

Adult↗
PubMed2002

[Laparoscopy in pregnant women].

In the study current opinions of performing laparoscopy in pregnant women suffering from some either acute abdominal diseases or adnexal pathology have been presented. Based on the latest literature, intra- and postoperative complications of laparoscopy have been analyzed by the authors. Both advantages and disadvantages of laparoscopy in pregnancy have been estimated.

Adnexal Diseases↗
PubMedDate not supplied

Robotics, telesurgery and telementoring--their position in modern urological laparoscopy.

OBJECTIVES: Laparoscopic surgery in general is handicapped by the reduction of the range of motion from six to four degrees of freedom. This has a major impact on technically difficult procedures such as laparoscopic radical prostatectomy. Solutions for this problems include the understanding of the geometry of laparoscopy with sophisticated training programs, but lie also in newly developed surgical robots, computer simulators and telementoring. This article evaluates the value of these alternatives based on own experiences and an analysis of the current literature. METHODS: Own experiences with robot-assisted surgery include 406 laparoscopic radical prostatectomies using a voice-controlled camera-arm (AESOP) as well as 6 telesurgical interventions with the Da Vinci-system. Additionally, substantial experimental studies have been performed focussing on the geometry of laparoscopy and new training concepts such as perfused pelvitrainers and computer simulation. Moreover, the current literature of the last 10 years on telesurgery and telementoring has been reviewed. RESULTS: The geometry of laparoscopy includes the angles between the instruments which have to be in a range of 25 degrees to 45 degrees; the angles between the instrument and the working plane that should not exceed 55 degrees; and the angle between the shaft of the needle holder and the needle which has to be adapted according to the anatomical situation in range of 90 to 110 degrees. 3-D-systems did not yet proved to be effective due to handling problems such as shutter glasses, video-helmets or reduced brightness. At the moment, there are only two robotic surgical systems (ZEUS, Da Vinci) in clinical use for telesurgery, of which only the Da Vinci provides stereovision and all six degrees of freedom (DOF). In the meantime, more than 200 laparoscopic radical prostatectomies have been performed with this system. Until now, however, there was no evidence of any advantages over the conventional laparoscopic approach. The ZEUS in combination with the telecommunication system SOKRATES is the only device enabling to realize telemanipulation and telementoring over long distances (i.e. transatlantic). CONCLUSION: Robotic surgery represents a turning point of surgical research. However, broad use of robotic systems is limited mainly because of the high investment and running costs. Whereas there will be a clear role of audio-visual telementoring in future training concepts, the need of telemanipulation/telesurgery has not yet been clarified. New technological concepts promote the development of hand-held mechanical manipulators (i.e. 6-DOF-needle-holder) used in combination with mono-tasking computerized robots (i.e. AESOP) resulting in a significant cost reduction.

Computer Simulation↗
PubMed2002

[Possibilities in diagnostic laparoscopy of acute appendicitis].

Results of diagnostic laparoscopy in acute appendicitis suspects are presented. Laparoscopy allowed examination of the appendix in 96.5% cases, to make final diagnosis in 92.5% and to avoid surgery in 31.2% cases. Larger application of diagnostic laparoscopy in patients suspected of acute appendicitis will reduce significantly rate of diagnostic mistakes, complications and unwarranted appendectomies.

Acute Disease↗
PubMed1975

Value of laparoscopy in hepatobiliary disease.

A prospective study was made of the value of laparoscopy in hepatobiliary disease. The pathology was accurately diagnosed by laparoscopy alone in 21 out of 33 consecutive cases of cholestatic jaundice (36% failure rate). Laparoscopy gave a slightly better diagnostic yield for secondary tumour deposits than hepatic scintiscanning, and the simultaneous use of both procedures reduced the false negative rate to 2/18 (11%). Laparoscopic liver biopsy was superior to blind percutaneous biopsy in the retrieval of secondary malignant tissue, but it had no obvious advantage over the latter when performed on patients with diffuse disease (cirrhosis) or primary hepatic tumours.

Adult↗
PubMed2003

[Diagnostic laparoscopy in non traumatic abdominal emergencies].

The development of video-laparoscopic techniques and surgical experience in this field have led to a resurgence of laparoscopy diagnostic purposes and have made it often the first action of surgical therapy with totally mini-invasive procedure. The purpose of this paper is to underline the clinical pictures of non traumatic acute abdomen that can profit from laparoscopy diagnostic ally and in related problems. The authors, in their initial experience of management of the urgency with laparoscopic approach, hold that laparoscopy can be not only the key to clarify a preoperative diagnostic doubt, but can reveal especially in some situations, such as pelvic pathologies in women of childbearing age the most correct surgical approach.

Abdomen, Acute↗
PubMed2003

[Bleeding caused by the trocar insertion through the umbilicus as a rare complication of laparoscopy].

The report of case in which bleeding from the anterior abdominal wall vessels occurred after the trocar insertion through the umbilicus. Directly after trocar removing there was insignificant bleeding from the trocar incision. Despite initial hemostasis with a suture ligation a postoperative blood loss and peritonitis syndrome necessitated transfusion and diagnostic laparoscopy. No vessel injury was localised during the subsequent laparoscopy. The bleeding originated from the trocar incision--a small artery was injured. The hemostasis suture was fastened. The reported case is a unique example of a laparoscopic complication. The umbilicus seemed to be a very safe localisation for the first trocar insertion--there are no reports of appearance of abdominal vessels within the umbilicus. Besides the suture ligation usually ensures an effective hemostasis--the diagnostic laparoscopy or laparotomy is are performed in exceptional situations.

Abdominal Wall↗
PubMed2003

The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy.

OBJECTIVE: To study the efficacy of ginger in prevention of nausea and vomiting after outpatient gynecological laparoscopy. STUDY DESIGN: Double blind randomized controlled trial. SETTING: Department of Obstetrics and Gynecology, Thammasat Hospital, Faculty of Medicine, Thammasat University. MATERIAL AND METHOD: From January, 2001-December, 2001, 80 patients who underwent outpatient gynecological laparoscopy were randomly allocated into group A (n = 40) and group B (n = 40). The patients in group A received 2 capsules of ginger (1 capsule contain 0.5 g of ginger powder) 1 h before the procedure while the patients in group B received the placebo. The visual analogue nausea scores (VANS) and vomiting times were evaluated at 2, 4 and 24 hours after operation. RESULT: There was a significant difference in the incidence of the nausea between group A [12 (30%)] and group B [23 (57.50%)]. The VANS was lower in group A than in group B at 2 and 4 hours (p < 0.05). No difference of VANS at 24 hours was found in both groups. Incidence and frequency of vomiting in group A were lower than group B but there were not statistically different. CONCLUSION: From our data, ginger is effective in prevention of nausea after outpatient gynecological laparoscopy.

Administration, Oral↗
PubMed2003

Laparoscopy and small bowel obstruction in children.

Three issues are studied: 1. What is well-known about post-operative small bowel obstructions. The cost of this pathology, the complications associated (blood loss, enterocutaneous fistulas, major bowel resections, abdominal wall damages, death), the distribution of adhesions in the abdominal cavity, and previous surgeries. 2. Small bowel obstructions happen after laparoscopy and the incidence is more than 1% of patients: herniation of the small bowel through a trocar site, herniation of the omentum through a trocar site, peritoneal defect, spillage of stones and stercolitis. Suggestions to avoid small bowel obstruction after laparoscopy include the use of smaller trocars whenever possible, repairing the fascia under direct vision, carefully desufflating the abdominal cavity, avoiding bleeding, spilled stones and staples and washing the abdominal cavity at the end of the surgical procedure. 3. The treatment of small obstruction is feasible by laparoscopy, reliability, and results are studied with a multicentric GECI (Groupe d'Etude en Coelioscopie Infantile) and literature series. We obtained good results for 2/3 children.

Child↗
PubMed1992

The selective use of fine catheter peritoneal cytology and laparoscopy reduces the unnecessary appendicectomy rate.

The effect of a management protocol incorporating the selective use of fine catheter peritoneal cytology (FCPC) and laparoscopy on the unnecessary appendicectomy rate was studied in adult patients (> or = 16 years) treated at one district general hospital over an 11-month period. Appendicectomy was performed on 62 adult patients managed according to this protocol, six (10%) of whom had a histologically normal appendix and no other acute condition requiring surgery. A further 57 patients underwent appendicectomy after standard clinical assessment and investigation without the use of FCPC or laparoscopy. Nineteen (33%) of these patients had a histologically normal appendix removed, with no other acute condition requiring surgical treatment. The selective use of FCPC and laparoscopy significantly reduced the unnecessary appendicectomy rate from 33% to 10% (chi 2 = 10.0, P < 0.005). The more widespread use of these techniques in patients with suspected appendicitis is therefore recommended.

Abdomen, Acute↗
PubMed1992

[The role of laparoscopy in assessing the resectability of cancer of the esophagus and proximal stomach].

Laparoscopic findings obtained in patients with cancer of the thoracic part of the esophagus (321) and proximal part of the stomach (383) were analysed. As a result of laparoscopy, unjustified surgery was withheld in 14.9 and 19.3% of cases, respectively. Tumor resectability in the laparoscopy negative group was 92.8 and 84.5% for cancer of the lower and mid-third of the esophagus, respectively, and 76.2% for cancer of the proximal part of the stomach. Laparoscopy yielded false-negative results in 1.9% of cases and failed to be instrumental in diagnosis-in 4.5%.

Cardia↗
PubMed1992

[Diagnostic laparoscopy in the gynecology clinic at the academy of medicine in Białystok during the years 1989-91].

The authors present the results of 1056 diagnostic laparoscopies carried out from 1989 to 1991 in the Clinic of Gynecology of Medical School in Białystok. Sterility was the leading indication for diagnostic laparoscopies in 92.7% of patients. Suspicion of ectopic pregnancy was the reason of 44 laparoscopies. 46.5% of diagnosed infertile women had adhesions in pelvis post inflammation or surgery. 10.6% of them had massive pelvic adhesions and the tubes were damaged without any chance for surgical correction. The endometriosis was found in 15% of infertile women, and 17% of patients had no pelvic pathology.

Adult↗
PubMed1992

[Ambulatory laparoscopy as an alternative to hospitalization].

Laparoscopy is a new way of activity in gynecological diagnostics and therapy, but it is still hardly acceptable in our country. It is caused by long-lasting habits of performing traditional and more invasive treatment. One of directions in development of gynecological diagnostics is performing laparoscopy in out-patient conditions, or in conditions close to hospital in out-patients units. Our study shows the range of indications to performing this kind of procedures. Possible late complications after laparoscopy are described, which in author's opinion should not be a contraindication to performing these procedures.

Ambulatory Care↗