Subject(s)
Colonic Neoplasms , Fever of Unknown Origin , Lymphoma/complications , Egypt , Humans , Male , Middle AgedABSTRACT
BACKGROUND: As general surgeons perform a growing number of laparoscopic operations in increasingly specialized environments, the ability to obtain expert advice during procedures becomes more important. Technological advances in video and computer communications are enabling surgeons to procure expertise quickly and efficiently. In this article, we present laparoscopic procedures completed through an intercontinental telementoring system and the first telementored laparoscopic procedures performed aboard a naval vessel. METHODS: Video, voice, and data streams were linked between the USS Abraham Lincoln Aircraft Carrier Battlegroup cruising the Pacific Ocean and locations in Maryland and California, creating the Battlegroup Telemedicine (BGTM) system. Three modes of BGTM communication were used: intraship, ship to ship, and ship to shore. RESULTS: Five laparoscopic inguinal hernia repairs were completed aboard the Lincoln under telementoring guidance from land-based surgeons thousands of miles away. In addition, the BGTM system proved invaluable in obtaining timely expertise on a wide variety of surgical and medical problems that would otherwise have required a shore visit. CONCLUSIONS: Successful intercontinental laparoscopic telementoring aboard a naval vessel was accomplished using "off-the-shelf" components. In many instances, the high risk and cost of transporting patients to land-based facilities was averted because of the BGTM system. Also, the relationship between the on-site and telementoring surgeon was critical to the success of this experiment. Long-distance telementoring is an invaluable tool in providing instantly available expertise during laparoscopic procedures.
Subject(s)
Hernia, Inguinal/surgery , Laparoscopy , Military Personnel , Ships , Telemedicine/methods , Adult , Evaluation Studies as Topic , Humans , MaleABSTRACT
Nineteen patients with intestinal tuberculosis were admitted to the Abbassia Fever Hospital in the period 1991-1997. Fever, abdominal pain, diarrhea, and weight loss were the most common symptoms. Small bowel radiology and colonoscopy were helpful in establishing the diagnosis. The difficulties in diagnosing tuberculous enteritis and the need to consider seriously the possibility of this disease in such patients is most important and is discussed.
Subject(s)
Fever of Unknown Origin/microbiology , Intestinal Diseases/diagnosis , Intestinal Diseases/drug therapy , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Gastrointestinal/drug therapy , Abdominal Pain/microbiology , Adolescent , Adult , Antitubercular Agents/therapeutic use , Barium Sulfate , Biopsy , Child , Colonoscopy , Contrast Media , Diarrhea/microbiology , Egypt/epidemiology , Feces/microbiology , Female , Humans , Intestinal Diseases/complications , Intestinal Diseases/epidemiology , Male , Middle Aged , Patient Admission/statistics & numerical data , Treatment Outcome , Tuberculin Test , Tuberculosis, Gastrointestinal/complications , Tuberculosis, Gastrointestinal/epidemiology , Weight LossABSTRACT
One hundred twenty-nine patients with extra-pulmonary tuberculosis admitted at the Abbassia Fever Hospital, NAMRU-3 during a seven year period (1991 to 1997) are described. Tuberculous peritonitis was diagnosed in 35 patients, tuberculous lymphadenitis in 32, intestinal tuberculosis in 19, genito-urinary tuberculosis in 14, skeletal tuberculosis in 13, disseminated miliary tuberculosis in 11, and splenic tuberculosis in 5 patients. The clinical picture included fever, and weight loss accompanied by anaemia and an elevated erythrocyte sedimentation rate in all patients.
Subject(s)
Fever of Unknown Origin/microbiology , Tuberculosis/complications , Tuberculosis/diagnosis , Adolescent , Adult , Anemia/microbiology , Biopsy , Blood Sedimentation , Child , Egypt/epidemiology , Female , Humans , Male , Middle Aged , Patient Admission/statistics & numerical data , Peritonitis, Tuberculous/diagnosis , Tomography, X-Ray Computed , Tuberculosis/blood , Tuberculosis/epidemiology , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Lymph Node/diagnosis , Tuberculosis, Miliary/diagnosis , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Splenic/diagnosis , Tuberculosis, Urogenital/diagnosis , Weight LossABSTRACT
OBJECTIVE: To report the first known and documented laparoscopic hernia repair onboard an aircraft carrier (USS Abraham Lincoln). MATERIALS AND METHODS: We present a case report of a 23-year-old healthy male seen in our Medical Department in pain with a clear mass on the right groin area. The sailor was scheduled for elective repair using a single-chip, 0 degree laparoscope from Stryker Company. RESULTS: Laparoscopic hernia repair was performed with complete recovery and immediate return to his usual duties onboard the aircraft carrier. CONCLUSIONS: Laparoscopy is not a new concept in surgery, but the performance of this surgical modality onboard a nuclear warship is a landmark event that will maximize naval operational readiness.
