ABSTRACT
AIM: To study surgical features of laparoscopic adrenalectomy in patients with large adrenal neoplasms. MATERIAL AND METHODS: The results of 32 laparoscopic adrenalectomy procedures were analyzed in patients with adrenal neoplasms over 5 cm. The control group consisted of 67 patients with adrenal neoplasms up to 5 cm. RESULTS: There were significant differences in duration of operations (96.3±13.44 min vs. 67.2±11.07 min; p<0.05) and some postoperative variables. Postoperative morbidity was similar (9.4% vs. 7.5%; p>0.05). CONCLUSION: Laparoscopic adrenalectomy for adrenal neoplasms from 5 to 8-9 cm is feasible, effective and safe surgical procedure.
Subject(s)
Adrenal Gland Neoplasms/surgery , Adrenalectomy/methods , Adrenal Gland Neoplasms/pathology , Feasibility Studies , Humans , LaparoscopyABSTRACT
AIM: To study feasibility, effectiveness and safety of minimally invasive video-assisted parathyroidectomy in patients with primary hyperparathyroidism; to define the advantages and disadvantages of this technique compared with conventional open surgery. MATERIAL AND METHODS: The study includes the results of 33 minimally invasive video-assisted parathyroidectomies performed in patients with primary hyperparathyroidism. The control group included 36 patients who underwent conventional open surgery. RESULTS: There were significantly increased time of surgery in the main group (41.2±12.7 min vs. 28.4±10.9 min, p<0.05), decreased need for postoperative analgesia (1,2±0.3 vs. 1.9±0.5 days, p<0.05) and significantly longer postoperative scar (1.8±0.2 vs. 6.2±0.5 cm, p<0.01). Incidence of complications was similar in both groups (6.1% vs. 8.3%, p>0.05). CONCLUSION: Minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism is feasible, safe and effective intervention that improves early postoperative course and cosmetic outcomes.
Subject(s)
Hyperparathyroidism, Primary/surgery , Minimally Invasive Surgical Procedures , Parathyroid Glands/surgery , Parathyroidectomy , Video-Assisted Surgery , Adult , Female , Humans , Hyperparathyroidism, Primary/diagnosis , Male , Middle Aged , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/methods , Operative Time , Outcome and Process Assessment, Health Care , Parathyroid Glands/pathology , Parathyroidectomy/adverse effects , Parathyroidectomy/methods , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Russia , Video-Assisted Surgery/adverse effects , Video-Assisted Surgery/methodsABSTRACT
Endovideosurgical hernioplasty was performed in 3020 patients. Complex forms of inguinal hernias were diagnosed in 280 of them. These forms included: bilateral and combined inguinal hernias, inguinoscrotal hernias, sliding hernias, fixed and irreducible inguinal hernias, recurrent inguinal hernias after traditional herniorrhaphy and recurrent hernias after endovideosurgical hernioplasty. Original technical maneuvers are described, indications and contraindications were established, complications and results of treatment of patients with inguinal hernias were analyzed and evaluated. Recommendations are given for the treatment of patients with complex forms of hernias.
Subject(s)
Hernia, Inguinal/surgery , Laparoscopy/methods , Video Recording , Follow-Up Studies , Humans , Male , Prosthesis Implantation/instrumentation , Retrospective Studies , Surgical Mesh , Treatment OutcomeABSTRACT
On the basis of an experience with 1800 operations of endovideosurgical hernioplasty in patients with inguinal and femoral hernias, the authors analyze the frequency and character of complications after such operations. Complications were noted in 37 (2.05%) patients. The most frequent complication was injury of the vessels. It could be liquidated in all the cases using laparoscopic technology. In three cases hollow organs were injured. In these cases laparotomy was used. The laparoscopic hernioplasty, if all details are fulfilled thoroughly, is a minimally invasive and effective method of treatment of inguinal and femoral hernias. The frequency of recurrences after these interventions is considerably less than that after traditional operations.
Subject(s)
Hernia, Femoral/surgery , Hernia, Inguinal/surgery , Video-Assisted Surgery/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Blood Vessels/injuries , Female , Humans , Incidence , Intestine, Large/injuries , Male , Middle Aged , Retrospective Studies , Round Ligament of Uterus/injuries , Urinary Bladder/injuriesABSTRACT
Laparoscopy was used in differential diagnostics of acute appendicitis in 524 female patients. Acute gynecological diseases were diagnosed in 123-of them, inflammatory processes in appendages being most frequent. The laparoscopic technology allowed not only to avoid diagnostic errors in all the cases, but also to take all necessary surgical measures. The effectiveness of laparoscopic operations for acute gynecological diseases was confirmed by the absence of complications and recovery within short terms.
Subject(s)
Appendicitis/diagnosis , Appendicitis/surgery , Genital Diseases, Female/diagnosis , Genital Diseases, Female/surgery , Laparoscopy , Acute Disease , Adult , Anesthesia, Intravenous , Diagnosis, Differential , Female , Humans , Middle Aged , Pregnancy , Pregnancy, Ectopic/diagnosis , Pregnancy, Ectopic/surgeryABSTRACT
The first experience with using laparoscopic extraperitoneal hernioplasty with implant Prolene" in 300 patients since November 1992 is analyzed. The analysis of the original method of laparoscopic extraperitoneal hernioplasty has shown its efficiency and safety for patients with inguinal hernias (recurrences were noted in 2,3%).
Subject(s)
Hernia, Inguinal/surgery , Laparoscopy/methods , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Laparoscopes , Male , Middle Aged , Pneumoperitoneum, Artificial , Polypropylenes , Recurrence , Surgical Mesh , Suture TechniquesABSTRACT
Laparoscopic technology was applied as diagnostic method in 608 patients, 50 patients have undergone laparoscopic appendectomy. There were no diagnostic errors in laparoscopy application. Laparoscopic technology allowed to perform appendectomy quite safely and without any complications. This method permitted considerably reduce terms of treatment of the acute appendicitis patients and quickly restore their ability to work.
Subject(s)
Appendectomy/methods , Appendicitis/surgery , Laparoscopy/methods , Acute Disease , Adult , Anti-Bacterial Agents/administration & dosage , Appendectomy/instrumentation , Appendectomy/statistics & numerical data , Appendicitis/diagnosis , Diagnosis, Differential , Evaluation Studies as Topic , Female , Humans , Intraoperative Care , Laparoscopes , Laparoscopy/statistics & numerical data , Male , Peritonitis/prevention & controlABSTRACT
In 1992-1994 laparoscopic hernioplasty was performed in 403 patients with inguinal (371) and femoral (32) hernias. Mean duration of hospital-stay 2.3 days, period of incapacity 9.7 days. Complication were encountered in 25 (3.7%) patients, including perforation of the small intestine and commissural ileus for which laparotomy had to be performed. Recurrent hernias occurred in 7 (1.7%) patients in periods of 2 weeks to 1.5 month due to poor fixation of the implant and choice of an inadequate operative method.
