ABSTRACT
INTRODUCTION: Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be life-threatening both for the mother and fetus. Surgical approach is recommended in this complicated disease to prevent morbidity and mortality. During COVID-19 pandemic, additional precautions are needed when dealing with abdominal complaints. PRESENTATION OF CASE: We present a 37-year-old female patient, pregnant at 22 weeks gestational age, who complained of fever, diffuse abdominal pain, and shortness of breath. Laboratory examination results revealed anemia, leukocytosis and an increase in amylase level. SARS-CoV-2 antibody is non-reactive. Imaging strongly suggested cholelithiasis and cholecystitis. The patient was given antibiotics for three days but there was no significant improvement. Open cholecystectomy with subcostal (Kocher) incision was performed. Patient was released from the hospital without post-operative complications. DISCUSSION: Treatment of gallstone induced severe acute cholecystitis with acute pancreatitis during pregnancy is challenging with the surgical complications. In the second and third trimester of pregnancy, it is more difficult to perform laparoscopic cholecystectomy because of the size of uterus. Laparoscopic procedure is also not recommended in early Covid-19 pandemic period. Therefore, open cholecystectomy with Kocher incision becomes the surgery of choice to avoid preterm birth. CONCLUSIONS: Based on our case, open cholecystectomy with Kocher incision is a safe and effective procedure for pregnant patients with cholelithiasis, cholecystitis, and pancreatitis.
ABSTRACT
OBJECTIVE: COVID-19 pandemic has made impact both in clinical and educational settings. The number of surgeries has decreased; thus, the surgery videos of all cases are important for both documentation and education. This study aimed to compare three kinds of cameras in recording digestive surgery. METHODS: We compared three cameras: Panasonic HV-770 Full HD Camcorder, Sony FDR-X3000 Action-cam, and Ordro EP7 Hands-Free FPV Camera. Each camera was used in several recording for superficial and visceral digestive surgeries and we compared the following: operation field, image focus, surgeon's comfort, practicality, and record settings. RESULTS: Camcorder needs 10-15 min to set up and longer dismounting time, has steady vantage view and focus, good image quality, can be zoomed, but the recording may be obstructed by the surgeon's head. Action camera needs 5-10 min to set up and the dismounting time was equal between Camcorder and Ordro. Action camera depicts surgeon's vision, however, zoom could not be applied while recording. Sony FDR-X3000 used in this study had good image quality, but the use of this camera in a long surgery may generate neck stiffness due to its weight. Ordro EP7 was comfortable in any surgery but it had inferior image quality compared to the others. CONCLUSIONS: Panasonic HC-V770 and Sony FDR X3000 had good image quality, where camcorder excelled in longer surgeries due to its comfort, action-cam excelled for shorter surgeries due to ease of use and settings. Ordro EP7 was the most comfortable among all but has lowest image quality.
ABSTRACT
BACKGROUND: Surgical recording has become very important for digestive surgery skill training in the COVID-19 pandemic. In addition to high quality recordings, the directions of vantage points are also important. To assist our vantage point for our camera, we frequently use a laser pointer to increase accuracy in the shooting range. MATERIALS AND METHODS: We recorded surgery more than 2 h with a fixed top-mounted Panasonic HC-V770 camcorder and otherwise with an action-cam Sony FDR. We installed a laser Pointer TaffLED Tactical Red Dot Laser Gun Picatinny Mount Airsoft Rifle HJ 11. We compared focus field video recordings with and without laser pointer guiding. We divided them into four groups: head mounted with, head mounted without, top mounted with and top mounted without. We recorded a total of five digestive surgery cases of superficial, visceral, and deep visceral procedures for each group after adjusting the laser pointer direction to the center of the cameras' focus. RESULTS: The laser pointer on camcorder Panasonic HC-V770 can assist recording on operation fields to prevent the field of view from being blocked by movement of an object compared to either camera without laser pointer. The head mounted Sony FDR-X3000 action-cam can easily depict surgeon's eye while recording and be controlled by the slightest movement of the surgeon's head by tracking with a red dot. CONCLUSION: From either mounting, the laser pointer aided in focusing the surgical field of view and could increase visibility for surgical recording.