ABSTRACT
We have done a randomised prospective observational study to compare the efficiency of two port laparoscope assisted open appendectomy versus three port laparoscopic appendectomy. Total 50 patients have been participated in the study (25 cases with two port and 25 cases with three ports). In this study two port laparoscope assisted appendectomy found simpler than three port laparoscopic appendectomy and requires less expertise and equipments, less operative time with shorter hospital stay. So it can be interpreted that the two port laparoscopic assisted open appendectomy is cost effective.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the changes of the two- pore K channel TASK-1 in diabetic rats with myocardial injury.</p><p><b>METHODS</b>Thirty-six SD rats were divided into normal group (N), diabetes at 4 weeks (DM 4W) group, and diabetes at 8 weeks (DM 8W) group. The cardiac functions of the rats were determined using cardiac ultrasonography, and the body weight and heart weight of the rats at different time points were measured to calculate the heart/body weight ratio (HW/BW). Myocardial fibrosis in the rats was assessed using Masson's staining. The protein expression of TASK-1 in the myocardium was detected using Western blotting. Whole- cell patch clamp technique was used to record the action potential duration (APD) and twopore domain potassium channel TASK- 1 current in acutely isolated rat ventricular myocytes. meanwhile, The inhibition of TASK-1 current was observed by the TASK-1 specific inhibitor ML-365.</p><p><b>RESULTS</b>Compared with the normal group, the diabetic rats showed significantly increased HW/BW ( < 0.05), end- diastole left ventricular diameter (LVIDd), end- systolic left ventricular diameter (LVIDs), and TASK-1 protein expression, with obviously decreased left ventricular diameter shortening rate (FS) and ejection fraction (EF) ( < 0.01). Masson staining showed that in diabetic rats, the collagen fibers were thickened, interwoven into a network with uneven arrangement and increased deposition. Compared with DM 4W group, the rats in DM 8W group exhibited progressive increases in LVIDd, LVIDs, HW/BW, and TASK-1 expression ( < 0.01 or 0.05); FS and EF were further decreased ( < 0.01). Masson staining showed worsened morphological changes of the myocardium with increased deposition. Compared with that in the normal group, the current of TASK- 1 in diabetic rats at 8 weeks was significantly reduced ( < 0.01) and the duration of action potential was extended ( < 0.05). The TASK-1 current was successfully inhibited by ML-365.</p><p><b>CONCLUSIONS</b>Diabetes can induce myocardial fibrosis and aggravate myocardial injury possibly in relation to changes in the protein expression and current of the two-port potassium channel TASK-1.</p>
ABSTRACT
AIM:To evaluate the feasibility and advantages of two-port 27-gauge pars plana vitrectomy for treatment of recurrent retinal detachment in silicone oil dwelling eyes.METHODS:A retrospective study.Two-port 27-gauge pars plana vitrectomy was performed in 7 eyes with recurrent retinal detachment without remove of silicone oil.Proliferative membrane peeling, endolaser treatment, and drainage of subretinal fluid were performed.Scleral bulking was performed if necessary.RESULTS:Sucessful retina re-attachment was accomplishied in all eyes.No visually significant intraoperative complication occurred.All eyes expericend quick recoveray of visual acuity and mild postoperative irritation.One eye developed a recurrent inferior retinal detchment in 20d after the surgery using non-remove technique, and recovered after conventional silicone oil removal and retinal reattachment surgery.CONCLUSION:Two-port 27-gauge pars plana vitrectomy is an efficacious (and potentially cost-efficient) method to treat early stage recurrent retinal detachment in silicone oil dwelling eyes.
ABSTRACT
Background: Laparoscopic appendicectomy has become the preferred procedure for treating appendicitis in last 10-15 years. The reasons are laparoscopy provides a better visualization of the operating field, pelvic organs like ovaries can be visualized in female patients, causes less postoperative pain, needs lesser hospital stay, gives faster recovery and most importantly a better cosmetic scar. The standard laparoscopic appendicectomy needs 3 ports to be introduced into the abdomen. Many modifications were introduced recently like SILS (Single port/Incision Laparoscopic Surgery), NOTES (Natural Orifice Transluminal Endoscopic Surgery), TUSPLA (Trans Umbilical Single Port Laparoscopic Appendicectomy), etc. with an intention to decrease the postoperative pain, decrease the hospital stay and give better cosmetic outcome. We present a series of twelve cases of laparoscopic appendicectomy performed using two ports and a needle instead of third port, which when performed successfully gives a better cosmetic outcome as the third port is avoided. Aims and objectives: The aim of the study was to assess the feasibility of two ports needle assisted laparoscopic appendicectomy. Materials and methods: This was an observational study done on a total number of 42 laparoscopic appendicectomies performed by a single operating team between June 2015 and May 2016. Two port appendicectomy were attempted. But, the procedure could be successfully performed in only 12 cases because of various reasons. Results: Out of 42 cases TPNAA could be performed successfully in 12 procedures. 30 cases needed regular 3 port procedure because of various reasons. Conclusion: TPNAA is a modification of regular three port appendicectomy and is a simple procedure and gives a better cosmetic outcome which can be performed in selected cases.
ABSTRACT
OBJECTIVES: Although more and more video‑assisted thoracoscopic surgery (VATS) lobectomies via two‑port have been performed to treat early‑stage nonsmall‑cell lung cancer (NSCLC) in recent years, concern remains whether it can achieve satisfactory adequacy of lymphadenectomy. This retrospective study was aimed to evaluate the adequacy of lymphadenectomy by VATS via two‑port, compared with three‑port. MATERIALS AND METHODS: The clinical and pathological data of patients who underwent VATS lobectomy via two‑port or three‑port with systematic lymphadenectomy for clinical early‑stage NSCLC were reviewed. As the main evaluation criterion, the number of mediastinal nodes and node stations, and the total number of nodes and node stations was compared by approach. RESULTS: 1872 patients with NSCLC underwent VATS lobectomy, 1086 via a two‑port approach and 786 through a three‑port approach. In the two‑port and three‑port groups, the baseline patient characteristics were similar, and there was no significant difference in the mean number of dissected mediastinal lymph nodes (MLNs) (12.3 ± 2.2 and 13.1 ± 1.7, P > 0.05) and the mean number of dissected MLN stations (3.5 ± 0.7 and 3.4 ± 0.8, P > 0.05). Meanwhile, the mean total number of dissected lymph nodes (24.1 ± 4.2 and 25.7 ± 4.3, P > 0.05) and the mean total number of dissected lymph node stations (6.8 ± 1.3 and 6.9 ± 1.1, P > 0.05) were also similar. Otherwise, in terms of postoperative complications, there was no obvious difference in the two groups. CONCLUSIONS: The adequacy of lymphadenectomy including MLN dissection by VATS via two‑port is similar to that via three‑port for patients undergoing lobectomy for clinical early‑stage NSCLC.
ABSTRACT
Objetivo: Presentar nuestra experiencia en apendicectomías laparoscópicas a 2 puertos (15-5mm), utilizando un dispositivo elaborado con material de quirófano: puerto en guante simplificado, en el servicio de Cirugía General del Hospital Dr. Leopoldo Manrique Terrero. Métodos: Estudio prospectivo, observacional. Fueron intervenidos 15 pacientes con la técnica de apendicectomía laparoscópica a 2 puertos (15-5 mm), utilizando un dispositivo puerto en guante simplificado entre septiembre del 2012 y abril del 2013. Se analizó edad, sexo, tiempo quirúrgico, estancia hospitalaria, complicaciones, conversión a otra técnica, y los efectos estéticos. Resultados: Predominó el sexo masculino (73%), la edad promedio fue 29 años, el tiempo quirúrgico promedio fue de 46 min, el tiempo de hospitalización fue de 24 horas, no hubo conversión a otra técnica, no hubo complicaciones, los resultados estéticos fueron valorados en escala subjetiva como muy bueno. Conclusión: La técnica de apendicectomía laparoscópica a 2 puertos constituye una alternativa quirúrgica segura y confiable, perfectamente reproducible en nuestro medio, además de tener similar costo que la laparoscopia tradicional, aportando beneficios adicionales estéticos y sin utilizar instrumental especial(AU)
Objective: To present our experience in two ports laparoscopic appendectomies (15-5 mm), using a device elaborated totally with operating room supplies: simplified glove port. Study performed at General Surgery Service of Hospital Dr. Leopoldo Manrique_Terrero, Caracas. Methods: This is a prospective, observational study. Fifteen patients were operated by two ports laparoscopic appendectomy technique (15-5 mm), using a simplified glove port, between September, 2012 and April, 2013. It was analyzed age, gender, operative time, hospital stay, complications, conversion to other technics and aesthetic purposes. Results: Males were predominated in 73%, the average age was 29 years, surgical time average was 46 min. Hospital stay was 24 hours, without intraoperative complications. The aesthetic results were assessed in very good as subjective scale. Conclusion: The technique two-port laparoscopic appendectomy is a safe and reliable alternative surgical, perfectly reproducible in addition to our average cost similar to traditional laparoscopic, providing additional aesthetic benefits without using instrumental special(AU)
Subject(s)
Humans , Male , Female , Adult , Appendectomy , Laparoscopy , Operating Rooms , Appendicitis , General Surgery , Harbor Sanitation , Equipment and SuppliesABSTRACT
OBJECTIVE: This study was conducted to compare the surgical outcomes between two-port access and four-port access laparoscopic ovarian cystectomy. METHODS: Four hundred and eighty nine patients who had received two-port access laparoscopic ovarian cystectomy (n=175) and four-port access laparoscopic ovarian cystectomy (n=314) in Chungnam National University Hospital from January 2009 to August 2012 were analyzed retrospectively. The data were compared between the bilaterality of the cysts and cyst diameter of less than 6 cm and 6 cm or more. RESULTS: There were no significant differences in patient's age, parity, body weight, body mass index and history of previous surgery between the two-port and four-port access laparoscopy group. Bilaterality of ovarian cysts was more in fourport access laparoscopy group (13.7% vs. 32.5%, P=0.000). There were no significant differences in operation time, hemoglobin change, hospital stay, adhesiolysis, transfusion, and insertion of hemo-vac between the two-port and four-port access laparoscopy group for size matched compare. However additional analgesics were more in four-port access laparoscopy group for unilateral ovarian cystectomy. CONCLUSION: Two-port access laparoscopic surgery was feasible and safe for unilateral and bilateral ovarian cystectomy compare with four-port access laparoscopic surgery.
Subject(s)
Female , Humans , Analgesics , Body Mass Index , Body Weight , Cystectomy , Laparoscopy , Length of Stay , Ovarian Cysts , Parity , Retrospective StudiesABSTRACT
PURPOSE: In spite of its safety and fesibility, it is not completely certain whether two-port laparoscopic cholecystectomy can be applied for the same indications as four-port cholecystectomy. METHODS: We retrospectively analyzed the prospectively collected data of the patients who had undergone either two-port or four-port laparoscopic cholecystectomy at the Department of Surgery, Daejeon St. Mary's Hospital between March 2007 and August 2009. A total of 341 patients were included. For our two-port cholecystectomy, combining a transumbilical wound retractor with a surgical glove on which there was a 11 mm trocar and two pipes were attached comprised an umbilical common channel, and another port was inserted through the epigastrium. The overall procedure was similar to four-port laparoscopic cholecystectomy. RESULTS: The patients were classified into the four-port group (n=261) and the two-port group (n=80) according to the operative method. All the two-port cholecystectomies were followed by four-port procedures. The operative indications for these two procedures were identical. No significant difference was observed for the mean operation time, the conversion rate, the postoperative hospital stay and the complications between each group. Multivariate analysis revealed that the factors making two-port surgery longer than the 75 percentile of the overall operation time were the development of intraoperative complications (RR 14.3; p=0.005; C.I. 2.255-90.853), a operation for the patients who visited the emergency room (RR 10.4; p=0.012; C.I. 1.684-63.798), open conversion or making additional port(s) (RR 9.9; p=0.032; C.I. 1.219-80.958) and a body-mass index greater than 25 (RR 5.5; p=0.025; C.I. 1.244-24.731). CONCLUSION: This study documents that our two-port laparoscopic cholecystectomy seems to have the potential to replace the conventional four-port laparoscopic cholecystectomy.
Subject(s)
Humans , Alkanesulfonic Acids , Cholecystectomy , Cholecystectomy, Laparoscopic , Emergencies , Gloves, Surgical , Intraoperative Complications , Length of Stay , Multivariate Analysis , Piperazines , Prospective Studies , Retrospective Studies , Surgical InstrumentsABSTRACT
PURPOSE: In spite of its safety and fesibility, it is not completely certain whether two-port laparoscopic cholecystectomy can be applied for the same indications as four-port cholecystectomy. METHODS: We retrospectively analyzed the prospectively collected data of the patients who had undergone either two-port or four-port laparoscopic cholecystectomy at the Department of Surgery, Daejeon St. Mary's Hospital between March 2007 and August 2009. A total of 341 patients were included. For our two-port cholecystectomy, combining a transumbilical wound retractor with a surgical glove on which there was a 11 mm trocar and two pipes were attached comprised an umbilical common channel, and another port was inserted through the epigastrium. The overall procedure was similar to four-port laparoscopic cholecystectomy. RESULTS: The patients were classified into the four-port group (n=261) and the two-port group (n=80) according to the operative method. All the two-port cholecystectomies were followed by four-port procedures. The operative indications for these two procedures were identical. No significant difference was observed for the mean operation time, the conversion rate, the postoperative hospital stay and the complications between each group. Multivariate analysis revealed that the factors making two-port surgery longer than the 75 percentile of the overall operation time were the development of intraoperative complications (RR 14.3; p=0.005; C.I. 2.255-90.853), a operation for the patients who visited the emergency room (RR 10.4; p=0.012; C.I. 1.684-63.798), open conversion or making additional port(s) (RR 9.9; p=0.032; C.I. 1.219-80.958) and a body-mass index greater than 25 (RR 5.5; p=0.025; C.I. 1.244-24.731). CONCLUSION: This study documents that our two-port laparoscopic cholecystectomy seems to have the potential to replace the conventional four-port laparoscopic cholecystectomy.
Subject(s)
Humans , Alkanesulfonic Acids , Cholecystectomy , Cholecystectomy, Laparoscopic , Emergencies , Gloves, Surgical , Intraoperative Complications , Length of Stay , Multivariate Analysis , Piperazines , Prospective Studies , Retrospective Studies , Surgical InstrumentsABSTRACT
Objective To explore the feasibility of tw o- port laparoscopy in the treatment of congenital hypertrophic pyloric stenosis. Methods A total of 21 infants with confirmatively diagnosed con genital hypertrophic pyloric stenosis were given a two-port laparoscopic pylorom yotomy. The procedure was performed using two trocars: a 5 mm trocar at the lowe r border of the umbilical ring was placed for the insertion of camera, and a 3 m m trocar was introduced below the costal margin at the midclavicular line to pas s the hook electrode and curved forceps. Results No conversion s to open surgery were required. The operation time was 23~65 min (mean, 31.3 mi n). The patients were discharged from hospital at 4~6 postoperative days. No com plications occurred. Follow-up for 2~7 months (mean, 3.2 months) showed a norma l development in all the 21 patients. Conclusions Two-port lap aroscopic treameat for congenital hypertrophic pyloric stenosis in infants is ef fective.
ABSTRACT
Objective To evaluate the feasibility of trans-umbilicus two-port laparoscopic procedures in pediatric surgery.Methods Sixty children (age, 3 months～14 years; mean, 3.5 years) with indirect inguinal hernia and 40 children (age, 2.5～14 years; mean, 6.3 years) with appendicitis underwent supra-high ligation and appendectomy, respectively, by using mini laparoscope from January 2003 to December 2003. During the supra-high ligation, the camera and forceps were respectively introduced via the left and right side of umbilical ring, and a hernial-ring needle with suture was brought in at the site of body surface projection of internal ring to apply external knotting. During the appendectomy, laparoscopic instruments were put through the site of right McBurney’s point, and explorations for contralateral hernia or other digestive tract malformations were applied simultaneously. Results All the operations were completed smoothly. The mean operating time was 8.5 min and 55.7 min in hernia repair (per side) and appendectomy, respectively. The mean postoperative hospital stay was 1～2 days in children with indirect inguinal hernia and 5～7 days in children with appendicitis. Follow-up for 3～12 months showed no recurrence of hernia except for 1 case of intraoperatively misdiagnosed latent hernia, which relapsed 2 months after the surgery. Postoperative abdominal cavity infection took place in 2 cases of perforated appendicitis. Conclusions Trans-umbilicus two-port laparoscopic technique is simple to perform, safe and minimally invasive. The technique has fewer complications and gives satisfactory cosmetic results, being highly recommended.