ABSTRACT
A toracotomia persiste como a abordagem clássica para cirurgia dos divertículos de esôfago. Seguindo a evolução das técnicas cirúrgicas minimamente invasivas, apresenta-se neste relato um procedimento alternativo, onde a abordagem laparoscópica transhiatal foi a opção terapêutica para um divertículo esofágico epifrênico. Devido aos resultados apresentados, sugere-se que a videolaparoscopia deva ser considerada como importante opção em centros com experiência em cirurgia videolaparoscópica avançada.
Thoracotomy remains as the classic approach to surgery for esophageal diverticula. Following the evolution of minimally invasive surgical techniques, this report presents an alternative procedure, where the approach of transhiatal laparoscopy was the therapeutic option for an epiphrenic esophageal diverticulum. Due to the results presented, it is suggested that laparoscopy should be considered as an important option in centers with experience in advanced laparoscopic surgery.
Subject(s)
Humans , Male , Aged , Diverticulitis , Diverticulum, Esophageal , LaparoscopyABSTRACT
OBJECTIVES: Natural orifice translumenal endoscopic surgery (NOTES) represents the first step toward scar-less surgery. The objective of this study is to evaluate early clinical results of transvaginal cholecystectomy using a new technique. METHODS: Institutional review board approval was obtained and transvaginal NOTES cholecystectomy was performed in 12 women for cholelithiasis. A 2-channel videoendoscope was inserted in the abdominal cavity through a posterior colpotomy. Two 3-mm trocars were inserted deep in the umbilicus, and a 10-mm trocar was placed through the colpotomy parallel to the endoscope. Dissection was performed with endoscopic instruments combined with 3-mm laparoscopic instruments. RESULTS: Mean operative time was 125.8 minutes. All procedures occurred without intraoperative complications or conversions, except for 1 vulvar laceration. There were no postoperative complications in the clinical follow-up. CONCLUSION: Transvaginal NOTES is a feasible and safe alternative for cholecystectomy in this preliminary clinical experience, allowing good cosmetic benefits and low analgesic requirement.
Subject(s)
Cholecystectomy/methods , Cholelithiasis/surgery , Laparoscopy , Vagina/surgery , Body Mass Index , Cholelithiasis/pathology , Cohort Studies , Colpotomy , Feasibility Studies , Female , Humans , Suture Techniques , Treatment Outcome , Umbilicus/surgeryABSTRACT
Relata-se um caso de esofagite por monília, sem evidências de qualquer fator de risco classicamante descrito. Apresenta-se uma revisäo da literatura abrangendo a patogênese, os principais desencadeantes, formas clínicas, diagnóstico diferencial e terapêutica
