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Results for “Laparoscopy--indications”

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At least 19 recordsLinked to original sources
PubMed1975

["Surgical" laparoscopy indications and value].

From 1971-1973, 1046 patients underwent laparoscopy in the gynecological department; 256 of the cases were surgical problems. In contrast to gastroenterological laparoscopy, surgical laparoscopy was performed in the operating room under general anaesthesia and everything prepared for immediate surgery. Major surgical interventions--if necessary--were performed immediately after laparoscopy. Indications for surgical laparoscopy were the following: preoperative evaluation of nature, extent and eventual metastases of tumors. Preoperative differentiation of acute and chronic appendicitis from other affections, particularly in younger female patients. Suspected intraabdominal hemorrhage of traumatic or non-traumatic origin. Evaluation of pathological palpatory findings in the abdominal cavity. Differential diagnosis of chronic relapsing intraabdominal complaints of unknown origin. Differential diagnosis of putrid, tuberculous or carcinomatous peritonitis with eventual biopsy. Preoperative evaluation of questions concerning surgery of liver, gallbladder or pancreas in connection with occlusive jaundice, hepatic cirrhosis or malignancy. The results of this study show, that by laparoscopy in over 50% of the patients, major surgical interventions could be avoided. Contraindications were primarily limited to pulmonal or cardiac insufficiency. The only complication (intestinal perforation), was adequately dealt with under the given operative conditions.

Abdomen, Acute↗
PubMed1997

Diagnostic laparoscopy: indication and benefit.

BACKGROUND: Patients with an obscure and unrelievable abdominal condition may be forced to receive open laparotomy for diagnosis. Diagnostic laparoscopy has been suggested as an alternative to diagnostic laparotomy in selected cases. The aim of this article is to evaluate the circumstances suitable for laparoscopic diagnosis of certain abdominal conditions and the possible advantages of that approach. METHODS: Among 256 patients undergoing elective laparoscopic operations using conventionally pneumoperitoneal techniques from January 1994 to June 1995, twenty patients received diagnostic laparoscopy. The correlation between preoperative diagnosis, laparoscopic diagnosis and pathologic diagnosis as well as the outcome of laparoscopic diagnosis and treatment have been assessed. RESULTS: Major indications for diagnostic laparoscopy included acute abdominal pain (n = 4), chronic abdominal pain (n = 6), differentiating intraabdominal tumor (n = 4), staging known malignancy (n = 3) and evaluating intraperitoneal implantation (n = 3). Two of the four patients with acute abdominal conditions, one of the six patients with chronic abdominal pain. Four of the seven patients with undifferentiated/unstaged abdominal tumors and all of the three patients with intraperitoneal-implanted drainage tubes had no reasons for a further exploratory procedure, thus preventing the morbidity or mortality which might occur after unnecessary laparotomy. The duration of operation and hospitalization was shorter than the group without laparotomy. CONCLUSIONS: Diagnostic laparoscopy benefits patients by avoiding unnecessary surgery, avoiding unnecessary delay in diagnosis and treatment and shortening the operative and hospitalized period. However, it provides only an alternative not a substitute for traditional diagnostic procedures and will never lessen the importance of conventional laparotomy.

Abdomen, Acute↗
PubMed1986

Clinical aspects with regard to the occurrence of an endogenous luteinizing hormone surge in gonadotropin-induced normal menstrual cycles.

A decline in serum E2 the day before laparoscopy indicated that ovulation had occurred in 16 cycles stimulated with exogenous gonadotropins for the purpose of in vitro fertilization (IVF). In contrast to 18 control cycles with rising E2 values after human chorionic gonadotropin (hCG) administration and without evidence of ovulation, the onset of the endogenous luteinizing hormone (LH) surge had been initiated. From this study, it is believed that the onset of an endogenous LH surge can be identified by the terminal preovulatory E2 pattern. Further, the incidence of an endogenous LH surge in gonadotropin-induced menstrual cycles and the present clinical approach of the Norfolk IVF program to this phenomenon are discussed.

Chorionic Gonadotropin↗
PubMed1997

Laparoscopic management of adnexal masses suspicious at ultrasound.

OBJECTIVE: To evaluate the laparoscopic management of adnexal masses suspicious at ultrasound. METHODS: In a prospective study, adnexal masses suspicious at ultrasound were managed by laparoscopy. Indications for laparotomy included general contraindications to laparoscopy, obviously disseminated ovarian cancer, and technically impossible laparoscopic treatment. After laparoscopic diagnosis, frozen sections were used to confirm a diagnosis of malignancy. Treatment was performed by laparoscopy whenever feasible. RESULTS: Over a 3-year period, 247 of the 599 adnexal masses (41.2%) treated in our department were suspicious or solid at ultrasound. Seventeen patients were evaluated by laparotomy and 230 by laparoscopy. Overall, 204 women (82.6%) were treated by laparoscopy, including seven of the 37 malignant tumors (18.9%) and 197 of the 210 benign masses (93.8%). One case of tumor dissemination occurred after a laparoscopic adnexectomy and morcellation of a grade 1 immature teratoma. CONCLUSION: Laparoscopic diagnosis of adnexal masses suspicious at ultrasound avoids many laparotomies for the treatment of benign masses and allows an improved inspection of the upper abdomen. The laparoscopic treatment of adnexal masses suspicious at surgery should be evaluated further in carefully designed prospective studies.

Adnexal Diseases↗
PubMed1995

Noninsufflative laparoscopic access.

Standard laparoscopic surgery requires maintenance of the working cavity by continual carbon dioxide insufflation and exaggerated Trendelenburg positioning. Both cardiopulmonary and metabolic adverse effects may result from these maneuvers, which may be avoided by a gasless approach to laparoscopic surgery. We investigated a new mechanical retraction system designed to maintain exposure of either intraperitoneal or retroperitoneal contents in a gasless laparoscopic cavity and assessed its performance in both laparoscopic approaches. Gasless laparoscopic surgery was attempted using the Laprolift/Laparofan system for retroperitoneal procedures: left varicocele ligation (three cases), renal biopsy (one case), extraperitoneal pelvic lymph node dissection (one case), and intraperitoneal bilateral varicocelectomy (two cases). Renal biopsy and varicocelectomy were accomplished successfully with the gasless approach and with technical ease comparable to that of the standard insufflative laparoscopic approach. Gasless pelvic lymph node dissection and intraperitoneal varicocelectomy were converted to insufflative laparoscopic or open procedures because of inadequate exposure of the pelvic contents. This early experience with gasless laparoscopy indicates that it may best be reserved for retroperitoneal urologic procedures.

Biomechanical Phenomena↗
PubMed1998

Methods of creating pneumoperitoneum: a review of techniques and complications.

The existence of numerous techniques for the creation of pneumoperitoneum at laparoscopy indicates that none have been proven totally efficacious or complication free. These methods include the standard technique of insufflation after insertion of the Veress needle via the umbilicus or less commonly via the transfundal or transforniceal routes, open laparoscopy involving dissection through the linea alba and opening of the peritoneum under direct vision, and direct trocar insertion as well as variations on these techniques. After reviewing the methods available and surveying the existing data concerning the rates of failure and complications, we conclude that no single technique can claim to be overwhelmingly superior, and that laparoscopists should, therefore, acquaint themselves with at least two of these techniques. Finally, we recommend a large-scale combined survey by the colleges of obstetricians and gynecologists and surgeons on rates of failure and complications of the varied approaches of abdominal entry for laparoscopy.

Humans↗
PubMed1980

Cervical ectopic pregnancy--case report.

A case is described of an early cervical pregnancy in a 30-year-old patient following curettage 6 months previously for an inevitable abortion. The condition was managed initially by suction aspiration, but further curettage with circumsuture of the cervix was required for delayed haemorrhage. The condition was suspected at laparoscopy and confirmed by ultrasonic scan. Laparoscopy indicated that the gestation sac was below the level of the uterine vessels, and was thus of prognostic as well as diagnostic value.

Adult↗
PubMed1986

[Open laparoscopy, a report of 12 cases in gynecology--with special reference to the diagnosis and treatment of infertility].

Open laparoscopies were performed on patients with eleven infertilities and one ectopic pregnancy in our gynecology clinic. Eight cases of endometriosis were revealed in eleven severe infertile patients. There were three cases of different findings between preoperative hysterosalpingograms and chromotubations under laparoscopies. One case of ectopic pregnancy was cured by salpingectomy after diagnostic laparoscopy. All 12 patients had N2O gas pneumoperitoneum under endo-tracheal intubated anesthesia. One case with both halothane and N2O anesthesia became temporarily hypothermic during open laparoscopy. Indications of gynecologic laparoscopy, characteristics of open laparoscopy and its comparison with closed laparoscopy are discussed.

Adult↗
PubMedDate not supplied

Laparoscopy for screening and early diagnosis of ovarian cancer.

Authors examined validity of laparoscopy for early diagnosis of ovarian cancer. They studied 144 cases of patients with benign neoplasia diagnosed by clinical examination and found ten cases of ovarian cancer by laparoscopy. They point out validity of laparoscopy indicated as a present day essential technique for early diagnosis of ovarian cancer.

Adolescent↗
PubMedDate not supplied

[Indications for laparoscopy in an internal medicine department in Dakar as indicated by echotomography].

A real time ultrasonography was set up in a senegalese hospital, resulting in a decrease of laparoscopy indications. Laparoscopy is given up for the diagnosis of liver abcess, jaundice and "abdominal masses". It must no more be included in the first step check up for hepatocellular carcinoma, because ultrasonography and cytology after puncture are enough to confirm the diagnosis. Laparoscopy remains essential for peritoneal diseases. Hepatic needle biopsy under laparoscopy control remains necessary to ensure with certainty the diagnosis of cirrhosis and especially chronic hepatitis, provided that no countraindications are found.

Abdomen, Acute↗
PubMed1994

[Laparoscopic and thoracoscopic surgery in children and adolescents].

Initial experience with laparoscopic and thoracoscopic surgery in children during the year Sept. 1992-Sept. 1993 is presented. The 36 procedures included 20 appendectomies, 3 cholecystectomies, 10 upper thoracic sympathectomies, 1 bilateral oophorectomy and 2 diagnostic laparoscopies. Indications were appendicitis, symptomatic gallstones, idiopathic primary palmar hyperhidrosis, and gonadal dysgenesis (xo/xy mosaicism) in a 13-year-old girl. 2 diagnostic laparoscopies were performed for chronic abdominal pain and for a possible retroperitoneal lesion, respectively. All procedures were successfully managed without complications. In 2 cases of acute appendicitis it was necessary to change to the open conventional technique because of technical difficulties. Duration of hospitalization for cholecystectomy and sympathectomy was significantly shorter than with the conventional surgical approach and convalescence was excellent, with less postoperative pain. As for the surgical approach in acute appendicitis, we cannot as yet decide whether or not laparoscopy is superior to the conventional technique.

Abdominal Pain↗
PubMed1997

[Complications of laparoscopy caused by trocars. Preliminary study from the national registry of the French Society of Gynecologic Endoscopy].

OBJECTIVE: To describe laparoscopic complications due to trocar insertions and to define their prevention as well as their risk factors. STUDY DESIGN: The SFEG registry of laparoscopic complications was used for our study; 26 complications due to trocar insertions were recorded to this day by the register including 12 vascular injuries, 9 bowel injuries, 3 bladder perforations and 2 incisional herinas. In order to avoid accidents of this technique, patient profile, laparoscopy indications, trocar type, diagnosis and treatment of the complications as well as the outcome must be defined. RESULTS: Whatever the operator's experience, the indication of laparoscopy and the trocar type some patients seem to have complications at laparoscopy: 70% of studied group had prior surgical treatment and 50% were over weight. However, it appeared that safety rules were not been taken into account for one-third of the trocar injuries. Consequently, laparotomy was used by the same surgeons for these complications in 89% of cases, laparotomy was delayed in 27% of the cases. CONCLUSION: In order to prevent laparoscopic complications, the surgeon must (i) inform the patients about risks which may occur, (ii) be careful, and (iii) declare each complication to a national registry such as the SFEG registry.

Adult↗
PubMed1979

[The evolution of the indications for laparoscopy between 1973 and 1977. 1,758 cases (author's transl)].

In order to avoid the misuse of laparoscopy by an unnecessary increase in the indications for the procedure the authors have reviewed the evolution of these indications in the five years between 1973 and 1977. Certain indications have stayed stable, such as chronic pain in the pelvis, masses found in the pelvis, symptoms suggestive of upper genital tract infection or of ectopic pregnancy and tubal or unexplained sterility. Stability in these indications is correct because laparoscopy and laparoscopy alone can give a precise diagnosis of the lesion and complete the clinical findings and the other methods of investigation. There are two indications which have become less frequent and these are: ovarian sterility and amenorrhoea. This is logical since more reliance has come to be placed on biological methods. Laparoscopy should be reserved in these conditions for cases where are contradictions between biological findings or where there are therapeutic failures. An increase in the indications which is very justified is in those laparoscopies which are carried out as a control of the results of tubal surgery, because there a prognosis can be given and therapy can be carried out (such as division of adhesions) and in cases of malignant tumours of the ovary which, although the procedure will give less precise information than laparotomy, has the advantage that it can be repeated from time to time.

Amenorrhea↗