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Trauma Laparoscopy

Cynthia M Tom, Roy P Won, Scott Friedlander, Rie Sakai-Bizmark, Christian de Virgilio, Steven L Lee
Variations in the management of adolescents at children's hospitals (CHs) and nonchildren's hospitals (NCHs) have been well described in the trauma literature. However, the effects of CH designation on outcomes after common general surgical procedures have not been investigated. The purpose of this study was to compare the outcomes and costs of adolescent cholecystectomies performed at CHs and NCHs. Within the California State Inpatient Database (2005-2011), we identified 8117 cholecystectomy patients aged 13 to 18 years at CHs and NCHs...
October 1, 2018: American Surgeon
Raevin K Ravindra, Atandrila Das, Grace L Chew, Eric Daniel
Phytobezoars are a rare cause of small bowel obstruction (SBO), which consists of vegetable matter such as seeds, skins, fibres of fruit and vegetables that have solidified. We present the case of a 61-year-old man with no previous surgery who presented with central abdominal pain, nausea and vomiting. An abdominal CT scan demonstrated SBO with a transition point in the left anterior abdomen. He proceeded to a laparoscopy, which revealed multiple perforations throughout the small bowel, from the proximal jejunum to the terminal ileum...
February 3, 2019: BMJ Case Reports
Modise Zacharia Koto, Oleh Yevhenovych Matsevych, Lendo Nsakala
BACKGROUND: The diagnosis of traumatic diaphragmatic injuries (TDIs) after penetrating thoracoabdominal trauma is challenging and conventional imaging is unreliable. Laparoscopy and thoracoscopy are minimally invasive modalities of choice in the diagnosis and management of TDI. A little is known on the value of thoracoscopy with single-lumen endotracheal tube intubation (SLETI) in the diagnosis of occult diaphragmatic injuries, and how it compares with laparoscopy. METHODS: A prospective study evaluated thoracoscopy with SLETI as a diagnostic tool for occult TDI...
January 10, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Adeel Ahmed Shamim, Syed Nabeel Zafar, Wasay Nizam, Ahmad Zeineddin, Gezzer Ortega, Terrence Malcolm Fullum, Daniel Dinh Tran
Background and Objectives: The use of laparoscopy in the trauma setting is gaining momentum, with more therapeutic procedures being performed. We evaluated the use of laparoscopic splenectomy among trauma patients with data from the National Trauma Database. We compared outcomes for trauma patients undergoing laparoscopic (LS) versus open splenectomy (OS). Methods: From the National Trauma Database (2007 to 2015), we identified all patients who underwent a total splenectomy...
October 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Dirk Stengel, Johannes Leisterer, Paula Ferrada, Axel Ekkernkamp, Sven Mutze, Alexander Hoenning
BACKGROUND: Point-of-care sonography (POCS) has emerged as the screening modality of choice for suspected body trauma in many emergency departments worldwide. Its best known application is FAST (focused abdominal sonography for trauma). The technology is almost ubiquitously available, can be performed during resuscitation, and does not expose patients or staff to radiation. While many authors have stressed the high specificity of POCS, its sensitivity varied markedly across studies. This review aimed to compile the current best evidence about the diagnostic accuracy of POCS imaging protocols in the setting of blunt thoracoabdominal trauma...
December 12, 2018: Cochrane Database of Systematic Reviews
M Z Koto, O Y Matsevych, F Mosai, S Patel, C Aldous, M Balabyeki
BACKGROUND AND AIMS: Laparoscopy in blunt abdominal trauma is challenging because of multiple associated injuries, higher trauma score values and higher morbidity and mortality, as compared with patients with penetrating abdominal trauma. The aim of this study was to investigate the role of laparoscopy in the management of blunt abdominal trauma patients and to highlight related challenges. MATERIAL AND METHODS: Over a 4-year period, patients managed laparoscopically for blunt abdominal trauma were retrospectively analyzed...
December 6, 2018: Scandinavian Journal of Surgery: SJS
Erol Piskin, Mesut Ozdedeoglu, Bahtiyar Muhammedoglu, Yigit Mehmet Ozgun, Anhmet Kusdemir
PURPOSE: In this study, we compared the endocrine and cytokine reaction of the patients which laparoscopic and conventional appendectomy was done for acute appendicitis. MATERIALS AND METHOD: 50 patients who were operated for acute appendicitis in Ankara Atatürk Research and Training Hospital between the dates December 2013 and February 2014 were enrolled and grouped as either laparoscopic or conventional. Serum ACTH, IL-6 and CRP levels were obtained at induction of anesthesia and postoperative 6th hour...
November 29, 2018: Annali Italiani di Chirurgia
Salomone Di Saverio, Arianna Birindelli, Mauro Podda, Edoardo Segalini, Alice Piccinini, Carlo Coniglio, Cristina Frattini, Gregorio Tugnoli
No abstract text is available yet for this article.
November 27, 2018: Journal of Trauma and Acute Care Surgery
A Mancini, A Duramé, S Barbois, J Abba, F-X Ageron, C Arvieux
INTRODUCTION: Diaphragmatic rupture following blunt trauma occurs rarely. Classically described after high-velocity accidents, ruptures are often associated with multiple organ injuries. The diagnosis is sometimes difficult. The goal of this study was to analyze and to discuss the modalities of early radiologic diagnosis and management of these injuries. PATIENTS AND METHODS: This multicenter retrospective study included patients seen between 2009 and 2017 within the Northern Alpine Emergency Network [REseau Nord Alpin des Urgences (RENAU)]...
November 21, 2018: Journal of Visceral Surgery
Dominic Lee, Philippe Zimmern
Vesicovaginal fistula is the most commonly encountered sequela of genitourinary trauma. Although the etiology differs between developed and developing countries, the principles of fistula repair must be strictly adhered to for success. Timing and route of repair remain contentious, because of a lack of randomized data. Evaluation and management is dictated by the surgeon's experience. Minimally invasive techniques with laparoscopy and robotic technology are generating wider interest with reduced postoperative morbidity, but a transvaginal technique should be in the arsenal of all pelvic reconstructive surgeons...
February 2019: Urologic Clinics of North America
Z Zhang, D Wang, C Xu, Y Yu, Y Li, X Zhang
OBJECTIVE: To discuss and evaluate the safety and value of laparoscopy adjuvant total colorectal resection for the treatment of familial adenomatous polyposis (FAP). METHODS: From March 2010 to June 2015, 38 cases were retrospectively analyzed and divided into 2 groups, of which 17 cases used laparoscopy adjuvant total colorectal resection, and 21 cases used conventional laparotomy. Clinical data were obtained, and the safety and prognosis were observed. RESULTS: Seventeen cases using laparoscopy adjuvant total colorectal resection achieved success with no conversion to laparotomy and intraoperative complications...
November 21, 2018: Clinical & Translational Oncology
Cynthia M Tom, Roy P Won, Alexander D Lee, Scott Friedlander, Rie Sakai-Bizmark, Steven L Lee
BACKGROUND: Variations in the management of pediatric patients at children's hospitals (CHs) and non-CHs (NCHs) have been well described, especially within the trauma literature. However, little is known about the outcomes and costs of common general surgical procedures at NCHs. The purpose of this study was to evaluate the effect of CH designation on the outcomes and costs of appendectomy and cholecystectomy. METHODS: The Kids' Inpatient Database (2003-2012) was queried for patients aged under 18 y who underwent appendectomy or cholecystectomy at CHs and NCHs...
December 2018: Journal of Surgical Research
Shohei Takaichi, Tsuyoshi Takahashi, Soichiro Funaki, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Kiyokazu Nakajima, Meinoshin Okumura, Masaki Mori, Yuichiro Doki
BACKGROUND: Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of laparoscopy is rare after hepatectomy owing to the formation of scar tissue. In this case, we describe our successful attempt at laparoscopic repair of a recurrent DH after hepatectomy. CASE PRESENTATION: A 30-year-old man underwent right hepatectomy for trauma and thoracotomy via the eighth intercostal space, with direct closure of the diaphragm by suturing...
November 19, 2018: Surgical Case Reports
Dileep Ramesh Hoysal, Hemashree K
Surgical abortion is one of the leading causes of maternal mortality, constituting up to 20% of maternal deaths. Uterine perforation is a rare complication, accounting for4% of all the abortion related complications. Intestinal injury with uterine perforation following termination of pregnancy is even rare and is a potentially fatal complication with mortality of up to 10%. A 27-year-old G3P2L2 woman with 12 weeks of gestation referred to our hospital in hemorrhagic shock with a suspicion of uterine perforation following dilatation and curettage for termination of pregnancy...
October 2018: Bulletin of Emergency and Trauma
Brigitta Balogh, Tamás Kovács
INTRODUCTION AND AIM: Minimally invasive techniques are gaining popularity in pediatric surgery, confident knowledge in endoscopies is one of the main purposes of the training. This survey analyzed the laparoscopic training for pediatric surgeons. METHOD: We sent questionnaires to all trainees and pediatric surgeons specialized after 2012 by e-mail. The questionnaire focused on their opportunities for laparoscopy during the training and their subjective opinions...
October 2018: Orvosi Hetilap
Natalie Kuchen, Christian Gmuer, Othmar Schoeb
INTRODUCTION: Isolated complete transection of the small bowel is extremely rare in blunt abdominal trauma. If it occurs, it is often associated with high-energy impact, as seen in motor vehicle accidents and falls from heights. In this case, a trivial trauma due to a handlebar injury caused a complete transection of the middle jejunum. CASE PRESENTATION: A 47-year-old man walked into the emergency department with moderate abdominal pain ∼10 hours after a fall on to a bicycle's handlebar from a standing position...
October 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Doaa Ahmed Mansour, Ahmed Mohammed Elshaer, Mostafa Abd-Rahman Elshazly
PURPOSE: Abdominal shotgun injuries derive their significance from the wide range of injuries they cause. The management of this type of injury has been continuously evolving. Despite the ongoing incorporation of laparoscopy in management of abdominal trauma, there is no definite protocol raising the role of laparoscopy in such injuries. In this study, we outlined a tailored protocol in the management of penetrating abdominal shotgun injuries differing from the previous protocols which comprised either mandatory exploration or non-operative management...
September 24, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Kevin Bain, Vadim Meytes, Grace C Chang, Michael F Timoney
INTRODUCTION: Diagnostic laparoscopy (DL) is an increasingly used modality when approaching penetrating abdominal trauma (PAT). Trauma surgeons can utilize this minimally invasive technique to quickly assess for injury in hemodynamically stable patients. DL with a confirmed injury can be repaired through therapeutic laparoscopy (TL) or conversion to exploratory laparotomy (EL). This study analyzes the use of laparoscopy as a first-line therapy for hemodynamically stable patients with PAT...
September 12, 2018: Surgical Endoscopy
Oleh Yevhenovych Matsevych, Modise Zacharia Koto, Moses Balabyeki, Lehlogonolo David Mashego, Colleen Aldous
Background: Selective non-operative management (NOM) and diagnostic laparoscopy (DL) are well-accepted approaches in the management of stable patients with penetrating abdominal trauma (PAT). The aim of this pilot study was to investigate the advantages and disadvantages of early DL in stable asymptomatic or minimally symptomatic patients with PAT as opposed to NOM, a standard of care in this scenario. The secondary aim was to suggest possible indications for DL. Methods: Patients managed with DL or NOM over a 12-month period were included in this study...
September 3, 2018: Journal of Minimal Access Surgery
Areg Grigorian, Alessio Pigazzi, Ninh T Nguyen, Sebastian D Schubl, Victor Joe, Matthew Dolich, Michael Lekawa, Jeffry Nahmias
Laparoscopy accounts for > 70% of general surgical cases. Given the increased use of laparoscopy in emergent colorectal disease, we hypothesized that there would be an increased use of laparoscopic colectomy (LC) in trauma patients. In addition, we hypothesized increased length of stay (LOS) and mortality in trauma patients undergoing open colectomy (OC) vs. LC. This was a retrospective analysis using the National Trauma Data Bank (2008-2015). We included adult patients undergoing LC or OC. A multivariable logistic regression model was used for determining risk of LOS and mortality...
August 24, 2018: Updates in Surgery
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