ABSTRACT
Disadvantages related to CO2 pneumoperitoneum in high risk patients (anesthesiologic classification in III and IV ASA), have led to the development of the abdominal wall retractor, a device designed to facilitate laparoscopic surgery without conventional pneumoperitoneum. A case of a patient with acute cholecystitis, well-compensated liver cirrhosis, and high respiratory and cardiologic risk (ASA III class), submitted to laparoscopic cholecystectomy with gasless technique is reported.
Subject(s)
Cholecystectomy, Laparoscopic/methods , Acute Disease , Aged , Cholecystitis/complications , Cholecystitis/surgery , Cholelithiasis/complications , Cholelithiasis/surgery , Humans , Liver Cirrhosis/complications , Male , Myocardial Ischemia/complications , Respiratory Insufficiency/complications , Risk FactorsABSTRACT
A rare case of intestinal occlusion due to primary abdominal pregnancy is described. Laparoscopy revealed normal appendix and bowel obstruction by adhesion between the last ileal loop and cecum. The adhesion started from a neoformation (diameter 2 cm) localised on the mesenteric side of the ileum, about 30 cm from the ileocecal valve. A resection of the adhesion and dissection of the neoformation were performed. Laparoscopic procedures lasted 30 minutes. Histologic examination of the specimen revealed to be an ectopic pregnancy. The laparoscopic technique permitted to verify the diagnosis and perform the treatment of the abdominal pregnancy in absolute conditions of safety, maintaining the fertility of the patient (actually she is presenting a regular pregnancy).
Subject(s)
Ileal Diseases/surgery , Ileocecal Valve/surgery , Intestinal Obstruction/surgery , Laparoscopy , Pregnancy, Ectopic/complications , Abdominal Pain/etiology , Abdominal Pain/surgery , Adult , Emergencies , Female , Humans , Ileal Diseases/etiology , Intestinal Obstruction/etiology , Pregnancy , Pregnancy, Ectopic/surgery , Tissue Adhesions/etiology , Tissue Adhesions/surgeryABSTRACT
Authors report three cases of acute abdomen due a probable appendicitis and submit to laparoscopic procedure. In the first case acute abdomen was due to a bowel obstruction secondary to an ectopic pregnancy; in the second case acute appendicitis was associated with a rare congenital malformation (atresia of uterus); in third case acute abdomen was due to a rare case of torsion of accessory spleen in an adult. In all the cases laparoscopy demonstrated the elective procedure in urgency, permitting the diagnosis and the surgical treatment of acute abdomen with the post-operatory advantage of the technique.