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At least 1,225 records · Page 68Linked to original sources
PubMed2005

[Enteral versus parenteral administration of a single dose of profenid after gynecological laparoscopy].

The aim of our study is to compare analgesic effect of single dose Profenid (Sanofi-Aventis)--100 mg administered per rectum or intravenously in woman endured gynecological laparoscopy (LS). We have evaluated 40 woman (divided into two groups each one of 20) sustained planned laparoscopy in department of gynaecology. The effect of administered Profenid over the postoperative pain has been estimated after standard general anaesthesia due to different objective and subjective parameters. As a result of our study we consider that postoperative analgesia with Profenid applied intravenously or by suppository is effective enough method for postoperative analgesia after laparoscopy in gynecology.

Administration, Rectal↗
PubMed1979

Ketamine--HCl--diazepam anesthesia for laparoscopy.

Laparoscopy was performed on 150 patients under ketamine-HCl-diazepam anesthesia via intravenous drip infusion. No psychomotor disturbances were noted during the emergence phase. No complications occurred during the procedures, neither from the surgical nor from the anesthesiologic point of view. No alarming stimulation of the cardiovascular system was noted. The patients became responsive within a short time, but a state of strong sleepiness remained for several hours. Therefore, ketamine-HCl-diazepam anesthesia does not appear suitable for outpatient laparoscopies but is a valuable alternative to other methods of anesthesia for laparoscopy.

Adolescent↗
PubMedDate not supplied

Laparoscopy shortens length of stay in patients with gastric electrical stimulators.

BACKGROUND: Gastric electrical stimulation has been proven effective for drug-refractory gastroparesis. Placement of stimulator leads and device usually requires a laparotomy, although laparoscopic placement has also been used. METHODS: To compare laparotomy with laparoscopy, we examined 36 patients, 18 undergoing laparoscopy and 18 undergoing laparotomy, matched for primary diagnosis and health resource usage. We compared baseline symptoms, length of surgery, length of postoperative hospital stay, gastric emptying, and health resources in each of the 2 groups over time, to see what variables, if any, differed. RESULTS: Baseline symptoms, gastric emptying, and health resource usage were similar. Operative times were also similar, but length of stay declined from a mean of 6.4 days for laparotomy to 1.1 days for laparoscopy. Long-term outcome, via symptoms, gastric emptying, and health resource utilization were comparable between the 2 groups. CONCLUSION: Laparoscopic placement of gastric electrical stimulator leads and device is associated with shorter lengths of postoperative hospital stay. However, the patients who underwent laparotomy had higher vomiting scores and more previous abdominal surgeries at baseline, and higher long-term mortality at follow-up, suggesting that they may be more ill, as a group, than the laparoscopic patients. Laparoscopic placement of devices may be preferable when technically feasible.

Adult↗
PubMed2005

Antibiotics prophylaxis in laparoscopy.

OBJECTIVE: This study was to determine which prophylactic antibiotic regimen is most effective in reducing the incidence of infectious morbidity in women undergoing laparoscopy. DESIGN: Randomized, nonblinded comparative study of a single preoperative dose of first generation cephalosporins vs. the control group which did not receive the antibiotic. METHODS: The operations were performed using standard technique. Women (n = 450) with indication for laparoscopy were randomly allocated to two groups. Group 1 (n = 200) received the single dose in first generation cephalosporins and group 2 (n = 250) did not receive it. Both groups were followed up during 7 days for detection of signs of wound infection, idiopathic fever, peritonitis and urinary tract infection, and respiratory tract. Prevalence of postoperative infection, mean hospital stay. RESULTS: Women completing the study (n = 450) were distributed into group 1 (n = 200) and group 2 (n = 250). No significant difference was found either in the prevalence of postoperative infection or in the mean hospital stay. No death occurred. Each patient was assessed daily until discharge to evidence wound infection, idiopathic fever, peritonitis and urinary tract infection, and respiratory tract. Hospital stay did not differ significantly between groups (p>0.005). CONCLUSION: In our setting, the administration of a single dose of 2 g of first generation cephalosporins before laparoscopy for prevention of infection is clinically equivalent to control group. Single dose of 2 g of first generation cephalosporins appears to offer no added benefit over control group.

Adult↗
PubMed1979

[The indications for laparoscopy in malignant tumours of the ovary (author's transl)].

The diagnosis of a malignant ovarian tumour can be made laparoscopically. It is particularly indicated in cases of ascites occurring by itself due to a neoplasm or of undiagnosed origin, and in cases of infiltration of the pelvic nodes or when a small abdominal mass, whether it is isolated or associated with ascites, is found. This particularly of value when a cytological examination of the ascitic fluid does not indicate the diagnosis. Laparoscopy is a means by which the degree of spread of abdomino-pelvic lesions can be discerned in cases where the malignant nature of the ovary is known, but where the prognoses for its removal, either immediately or after several cures with chemotherapy, are doubtful and where the degree of spread has not been correctly and precisely determined at the first surgical intervention. Therefore laparoscopy can complete the information obtained from pelvic examinations and avoid the need for carrying out an exploratory laparotomy, but is gives less information than this latter does about the degree of spread in the pelvis and in the abdomen. So, laparoscopy is a means by which repeated control of the results of therapy which is more thorough than clinical examination can be assured, particularly because it acts as a check on peritoneal cytology. Although its interpretation can be very difficult and its reliability is a relative one, the latter is a good criterion of follow-up.

Ascitic Fluid↗
PubMed2005

[Laparoscopy-assisted radical gastrectomy: a report of 71 cases].

OBJECTIVE: To investigate the feasibility and safety of laparoscopy-assisted radical gastrectomy for gastric cancer. METHODS: Seventy-one patients with gastric cancer received laparoscopy-assisted radical gastrectomy for gastric cancer. Among them radical total gastrectomy was performed in 8 cases, proximal partial gastrectomy in 16 cases, proximal partial gastrectomy combined with splenectomy in 3 cases, and distal partial gastrectomy in 44 cases. RESULTS: Sixty-nine cases had laparoscopic-assisted surgery performed successfully, but 2 cases were converted to open surgery. The mean operation time was (343 +/- 52) min for total gastrectomy, (268 +/- 62) min for proximal gastrectomy, (312 +/- 64) min for proximal gastrectomy combined with splenectomy, and (283 +/- 44) min for distal gastrectomy respectively. The mean volume of blood loss was (267 +/- 220) ml in total gastrectomy, (150 +/- 103) ml in proximal gastrectomy, (333 +/- 116) ml in proximal gastrectomy combined with splenectomy, (139+/- 84) ml in distal gastrectomy respectively. The mean numbers of harvested lymph nodes were (34.3 +/- 11.8). The mean time was (4.1 +/- 1.1) d for gastrointestinal function recovery, (3.5 +/- 1.0) d for patient's taking general activity, (5.0 +/- 1.2) d for taking liquid food. The short-term efficiency was obvious. CONCLUSION: Laparoscopy-assisted radical gastrectomy is a feasible, safe and minimally invasive treatment and can achieve the same outcomes as the open operation.

Adult↗
PubMed1979

[The indications for laparoscopy in the diagnosis of hemoperitoneum (author's transl)].

In consideration of the well-known difficulties associated with the precise diagnosis of hemoperitoneum, the authors offer their personal experience in support of laparoscopy as a diagnostic aid in such dramatic events. They review 23 cases of emergency laparoscopy performed in the First Institute of Clinical Surgery of the University of Catania between January 1978 and January 1979. Recalling that the procedure was applied to patients as young as 3 and as old as 80, they confirm the opinion expressed from other quarters, namely that laparoscopy is an essentially harmless and rapid procedure conducive to very accurate diagnosis in view of appropriate planning of therapeutic treatment.

Adult↗
PubMed2005

Microsurgery versus laparoscopy in distal tubal obstruction hysterosalpingographically or laparoscopically investigated.

OBJECTIVE: To compare pregnancy rates after laparotomic microsurgical or laparoscopic distal tuboplasty. DESIGN: Two hundred and twenty-four women with infertility due to distal tubal occlusion were randomized to be treated with either laparotomy or laparoscopy from 1987 to 2001 at the Institute of Gynaecology and Obstetrics, University of Rome, "La Sapienza". RESULTS: The results were evaluated taking into account the type of surgical approach, the severity of tubal damage and of adhesions. After a 24-month follow-up period, the overall pregnancy rate obtained with microsurgery was 43.7%, of which 33.3% were term pregnancies, 5.0% abortions, and 5.0% ectopic pregnancies. After laparoscopy, the overall pregnancy rate was 41.6%, of which 29.1% were term pregnancies, 8.3% abortions and 3.9% ectopic pregnancies. No significant differences was observed between the two groups in terms of fertility rate (chi-square 0.016, p = 0.9003). CONCLUSIONS: Laparotomy plus microsurgery and laparoscopy were equally effective in restoring fertility in women with comparable tubal damage. The severity of the damage is a critical factor for the results.

Adult↗
PubMed1991

[Laparoscopy in penetrating abdominal injuries].

An experience with treatment of 138 patients with penetrating punctured-incised wounds of the abdominal cavity has shown advantages of laparoscopy in diagnostics of the character of injuries of internals. Laparoscopy used in cases with difficult diagnosis allowed to give up operative interventions in 53.8% of patients. High diagnostic value and relative safety of laparoscopy make it possible to widely use this method in wounds of the abdomen.

Abdominal Injuries↗
PubMed2006

[Complications of retroperitoneal laparoscopy based on a series of 500 cases].

OBJECTIVE: To evaluate the complications of retroperitoneal laparoscopy for upper urinary tract surgery. METHODS: From 1994 to 2003, 500 retroperitoneal laparoscopy procedures were performed: 143 radical nephrectomies, 104 simple nephrectomies, 95 adrenalectomies, 47 ureteropelvic junction plasties, 44 partial nephrectomies, 22 nephroureterectomies, 20 cyst resections, 9 diverticulectomies, 8 lymphadenectomies, 4 pyelotomies and 4 ureteric procedures. The standardized technique uses 5 trocars. RESULTS: There were 23 conversions (4.60%): 5 for retroperitoneal adhesions, 11 for intraoperative bleeding, 7 for technical impossibility. 14 patients (2.8%) required surgical revision: 5 urinomas and 2 urocutaneous fistulas treated by ureteric drainage, 2 deep abscesses, 2 cases of secondary bleeding, 2 colostomies for gastrointestinal fistula after colonic injury, 1 incisional hernia on a trocar orifice. There were postoperative 2 deaths (0.4%) due to septic shock and haemorrhagic shock. 21 patients (4.2%) presented medical postoperative complications: haematoma, hyperthermia, phlebitis and pulmonary infections. 15 patients (3%) were transfused. The most frequent complications occurred after partial nephrectomies and the most serious complications occurred after radical nephrectomies. CONCLUSION: The complication rate is low. Retroperitoneal laparoscopy allows reproducible and effective upper urinary tract surgery, but it is not recommended in patients with a history of retroperitoneal surgery.

Adrenalectomy↗
PubMedDate not supplied

Laparoscopic sentinel node mapping for colorectal cancer using infrared ray laparoscopy.

BACKGROUND: Sentinel lymph node (SN) mapping by dye injection on conventional laparoscopy (CL) is often precluded by the presence of mesenteric adipose tissue in patients with colorectal cancer. SN mapping on CL was compared with that on infrared ray laparoscopy (IRL) during laparoscopy-assisted colectomy (LAC). PATIENTS AND METHODS: Forty-eight patients with colorectal cancer who underwent LAC were enrolled. The tumor was identified by intra-operative fluoroscopy with marking clips. The tumor was stained intra-operatively by peritumoral injection of indocyanine green dye. SNs were observed by CL and by IRL. RESULTS: In all 48 patients, dye injection and tumor localization during LAC were successful. The identification of SNs on IRL was approximately five times better than that on CL. There were no false-negative cases in T1 and T2 disease by IRL. CONCLUSION: SN mapping on IRL is superior to that on CL. SN mapping by IRL might be feasible for T1 and T2 tumors.

Adult↗
PubMed1991

Management of an impalpable testis: the role of laparoscopy.

The use of laparoscopy through a small infraumbilical incision permits noninvasive exploration of the pelvic fossae. The vas deferens as well as the spermatic vessels can be identified either with the testicle or as a blind ending. Twenty-six laparoscopies were performed on 19 patients with unilateral impalpable testis and 7 with bilateral impalpable testis. In this small series, laparoscopy was found to be the best method of locating the impalpable testis, and, depending on the laparoscopic findings, no further surgery or a simple inguinal exploration or abdominal incision is needed for the management of this condition.

Adolescent↗
PubMedDate not supplied

Bedside diagnostic laparoscopy in the intensive care unit: a 13-year experience.

BACKGROUND: Frequently, critically ill patients suffer from intraabdominal pathology, such as sepsis or ischemia, either as a cause of a critical illness or as a complication from another illness requiring an intensive care unit (ICU) admission. These complications are associated with high rates of morbidity and mortality (between 50% to 100%). The diagnosis of these problems can be difficult in these very ill patients because it may require transport of unstable patients to additional departments outside the ICU setting. One option in the diagnosis of these difficult patients is bedside laparoscopy, as it avoids patient transport, is very accurate, and maintains ICU monitoring. METHODS: From 1991 to 2003, 13 patients underwent bedside diagnostic laparoscopy in the ICU to diagnose intraabdominal pathology in critically ill patients. All the procedures were done at the bedside in the ICU with the patient under local anesthesia and intravenous sedation. RESULTS: Mean procedure time was 36 minutes (range, 17 to 55). Mean patient age was 75.5 years (range, 56 to 86). There were 8 males and 5 females. Forty-six percent of the patients were diagnosed with mesenteric necrosis and died within 48 hours with no further testing or procedures. One patient with massive fecal contamination died the same day. Thirty percent of patients had a normal intraabdominal examination; of these, 2 died of unrelated illnesses and 2 survived their nonabdominal illness. Fifteen percent were diagnosed with acute acalculous cholecystitis as a complication of their ICU illness, which resolved satisfactorily. No intraoperative complications occurred with the ICU procedure. CONCLUSION: Bedside diagnostic laparoscopy in the ICU is feasible, safe, and accurate in the assessment of possible intraabdominal problems in properly selected, critically ill patients.

Aged↗
PubMed2006

[First abdominal access in gynecological laparoscopy: which method to utilize?].

The choice of the technique to enter the peritoneal cavity, during a laparoscopy, depends on a lot of variables which hinder a standardized method and, actually, it appears impossible to show, with certainty, the best method to choose for the first abdominal access in gynecological laparoscopy. The preference for one or another technique depends on the operator experience, school and speciality of the surgeon, laparoscopical upgrading and the work environment; many surgical techniques are not yet used due the limits and fears of some surgeons to change the preference in first access approaching and for the lack of operating versatility by a method or another one. A review of the scientific literature, underlines that the major problems during the first laparoscopical abdominal access are two, vascular and intestinal and their percentage is variable. In this paper we describe the large range of methods for open and closed laparoscopy and for direct access, that permit to perform a first abdominal laparoscopical access, and their major possible problems.

Abdominal Wall↗
PubMed2006

[Laparoscopy or laparotomy in the treatment of ovarian teratomas?].

BACKGROUND: Mature cystic teratomas (dermoid cyst), are the most common germ cell tumours of the ovary in women of reproductive age. They are usually asymptomatic until they reach considerable size. Frequently, ultrasonography is diagnostic. MATERIALS AND METHODS: 81 patients who had surgery in 3rd Departament of Gynecology and Obstetrics, University of Medicine, Lódź, from 2000 to 2005 for benign cystic teratomas were analyzed. RESULTS: 86 teratomas were removed from 81 patients. 31 patients had surgery via laparoscopy and 50 via laparotomy. The mean age was found to be 34,5 years. 39 patients were asymptomatic. The tumours diameter ranged from 1 to 19 cm. In 46 cases there were cystectomies performed sparing fragments of healthy ovarian tissue, in 24 cases ovariectomies and in 11 panhysterectomies were made. All removed lesions histologically appeared benign cystis ovarian teratomas without any signs of malignancy. CONCLUSIONS: The teratomas are composed of mature tissues derived from the three germ cell layers. In our study histologic examination revealed 16 cases of neurogenic tissue. One of the possibility of ovarian teratoma's treatment is operative laparoscopy. When the laparoscopy is not possible or inadvisable, the laparotomy is still irreplaceable.

Adult↗
PubMed1991

[Laparoscopy for the diagnosis of endometriosis: analysis of 254 cases].

Two-hundred and fifty-four cases of pelvic endometriosis were diagnosed by laparoscopy from January 1979 through December 1986 in our hospital. The diagnosis was correct in 94.5% of the cases. Biopsy of the peritoneal lesions with aspiration of the chocolate cysts under laparoscopy has improved the diagnostic accuracy. Laparoscopy is an ideal procedure not only for diagnosing and staging endometriosis, but also for predicting the reproductive potential of infertile patients and planning future treatment.

Adult↗
PubMed1991

[Laparoscopy in acute pancreatitis in previously operated-on patients].

The results of laparoscopy performed in 108 patients with acute pancreatitis previously operated on the abdominal organs and anterior abdominal wall are analysed. The technique of investigation has its peculiarities: choice of the points for introduction of a manipulator and laparoscope, circumscribed pneumoperitoneum, moving of a patient on the operating table. In previously operated patients, laparoscopy is not contraindicated, but it should be performed by an experienced endoscopist. Operated on were 16 patients. Nine died. There were no complications and lethal outcomes related to laparoscopy.

Abdominal Muscles↗
PubMed1991

[Validity of laparoscopy in the diagnosis of digestive system diseases].

Laparoscopy, a diagnostic procedure used in Gastroenterology, Surgery and Gynecology is a safe and effective method allowing direct vision of the contents of the abdominal cavity. Since the introduction of different imaging techniques, indications of laparoscopy have decreased. However, it is still useful in the evaluation of peritoneal diseases, liver disease, lymphoma and granulomatosis. The usefulness of laparoscopy is limited in the diagnosis of jaundice, cysts and abdominal masses.

Adolescent↗