Journal of Laparoendoscopic & Advanced Surgical Techniques (J LAPAROENDOSC ADV S )

Publisher: Mary Ann Liebert

Journal description

A bimonthly peer-reviewed journal for practicing surgeons on the surgical techniques that encompass laparoscopy, endoscopy, and advanced surgical technology in all surgical disciplines. It is the first journal to focus on these techniques both in general surgery and in areas of specialization which include gastroenterology, gynecology, ENT, and cardiovascular and thoracic surgery.

Current impact factor: 1.19

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.187
2012 Impact Factor 1.066
2011 Impact Factor 1.4
2010 Impact Factor 1.198
2009 Impact Factor 1.012
2008 Impact Factor 0.912
2007 Impact Factor 0.606
2006 Impact Factor 0.718
2005 Impact Factor 0.648
2004 Impact Factor 0.862
2003 Impact Factor 1.127
2002 Impact Factor 0.873
2001 Impact Factor 1.069
2000 Impact Factor 0.783
1999 Impact Factor 0.787
1998 Impact Factor 0.098

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.18
Cited half-life 4.40
Immediacy index 0.31
Eigenfactor 0.01
Article influence 0.33
Website Journal of Laparoendoscopic & Advanced Surgical Techniques website
Other titles Journal of laparoendoscopic & advanced surgical techniques. Part A, Journal of laparoendoscopic and advanced surgical techniques
ISSN 1092-6429
OCLC 36334866
Material type Periodical, Internet resource
Document type Journal / Magazine / Newspaper, Internet Resource

Publisher details

Mary Ann Liebert

  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
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  • Conditions
    • Author's final version or publisher's version/PDF
    • Publisher's version/PDF may be used
    • On author's personal website, institution's intranet, or institutional repository
    • Authors may deposit in funder's designated repository after 12 months
    • Set statement to accompany deposit (see policy)
    • Publisher copyright and source must be acknowledged
    • NIH authors will have their final paper, (post peer review, copy-editing and proof-reading) deposited in PubMed Central on their behalf
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: As a new surgical technique, extralevator abdominoperineal excision (eLAPE) is recommended for the treatment of low rectal cancer. The patient's position is changed to a prone jackknife position before extralevator excision is performed via the perineal approach. Whether the extralevator excision can be completed through a transabdominal route under laparoscopy is controversial. This study was designed to introduce a modified technique of laparoscopic-assisted eLAPE and to evaluate the feasibility and safety of this technique. With no change of position, laparoscopic eLAPE was performed in 12 patients with low rectal cancer through a transabdominal route between February 2012 and August 2013. There was no case with bowel perforation and positive circumferential resection margins among these 12 patients. The mean operative time was 177.1 minutes, and the mean intraoperative blood loss was 92.5 mL. The mean time to passing of first flatus was 2.3 days, and the mean postoperative hospital stay was 7.5 days. There was no case with bladder dysfunction. No patients suffered from sexual dysfunction during the follow-up period. Without the change of the patient's position, eLAPE can be performed through a transabdominal route by the laparoscopic approach. The procedure of the former eLAPE is simplified without compromising oncologic outcome.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: The detection rate of differentiated thyroid cancers, especially the papillary subtype, is rapidly increasing, and these malignancies have an excellent prognosis. Surgery remains the cornerstone of treatment, and numerous innovations in surgical techniques have been made in the past decade. Laparoscopic thyroidectomy is being gradually recognized as a safe and effective surgical procedure with good cosmetic results. Revision thyroidectomy is routinely performed via the open approach and rarely via laparoscopy. Three-dimensional laparoscopy offers advantages over two-dimensional laparoscopy in terms of visualization of the operative field and surgical manipulation and has been used at multiple surgical sites, but is rarely used in thyroid surgery. We present the first case of three-dimensional laparoscopic revision thyroidectomy, which was successfully performed through an anterior chest approach in a young, unmarried woman who was pathologically confirmed to have papillary thyroid cancer after an initial laparoscopic partial thyroidectomy performed 10 days prior to the revision surgery.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Background: Mobilization of the thyroid during an endoscopic thyroidectomy (ET) via a breast approach was originally carried out from the lower pole to the upper pole (upward approach). Here, we applied a modified circular approach to achieve better exposure of the surgical field, in which the path of thyroid mobilization started from the isthmus and resembled a circle. The purpose of this study is to evaluate the safety and feasibility of the circular approach compared with the upward approach. Patients and Methods: From December 2008 to June 2013, 144 patients who underwent attempted ET via a breast approach were enrolled in this study, and their clinical outcomes were evaluated. Results: In total, 141 of 144 procedures were successfully performed under endoscopy, including 60 (42.6%) via the upward approach and 81 (57.4%) via the circular approach. The mean operating time was significantly shorter in the circular approach group than in the upward approach group (90.6 minutes versus 112.5 minutes for hemithyroidectomy; 109.5 minutes versus 133.2 minutes for subtotal thyroidectomy; P<.05). Furthermore, the incidence of the transient recurrent laryngeal nerve palsy decreased in the circular approach group compared with the upward approach group (2.5% versus 13.3%; P<.05). Conclusions: These results seem to indicate that the circular approach is a better method of mobilizing the thyroid, especially for large nodules located in the lower pole of the thyroid. This approach may provide a better view of the surgical field, reduced operating times, and fewer postoperative complications.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Aim: The aim of this study was to review the indications and the results of percutaneous endoscopic gastrostomy (PEG) procedures in Icelandic children. Patients and Methods: A retrospective review of all pediatric PEG procedures performed in Iceland in 1999-2010 was conducted. Diagnosis, demographics, complications, and body mass index were recorded. Results: Ninety-eight children (51 girls) were included. Median age was 2 years (range, 1 month-17 years). The most common diagnosis was neurological disease (56%). Median length of stay was 4 days (range, 1-189 days). Extended length of stay was not related to PEG. Before surgery, median body mass index (BMI) was 14.5 kg/m(2) (range, 9.8-20.8 kg/m(2)), and the median BMI-for-age z-score was -1.4 (range, -5.9 to 3.0). One year after surgery, median BMI was 15.3 kg/m(2) (range, 11.2-22.1 kg/m(2)), and median BMI-for-age z-score was -0.5 (range, -5.1 to 3.8). The median weight increased significantly in 1 year by 1.0 standard deviation (P<.0001; 95% confidence interval, -1.4820 to -0.7387). One hundred sixty-six complications were recorded in 65 children; 96% were minor, with the most common being granuloma formation (19%) and superficial skin infection (25%). The rate of infection was not statistically different between those who received preoperative antibiotics versus no antibiotics (P=.296). Major complications were peritonitis (n=3), esophageal tear (n=1), buried bumper (n=1), and malposition of the gastrostomy tube (n=1). Median follow-up was 47 months (range, 1-152 months). Fourteen children died (at 1 month to 3 years), but no deaths were related to PEG insertion. Twenty-seven children were without gastrostomy at follow-up. Twelve children (14%) underwent fundoplication later; 11 of them were neurologically impaired. Conclusions: PEG is a safe technique with a high complication rate, but the majority of complications are minor and easily treatable. Gastrostomy is sometimes temporary. Enteral feeding results in significant weight gain in 1 year.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Introduction: The aim of this study was to assess if there is a relationship between the outcome of laparoscopic splenectomy (LS) procedures and the size of the spleen, the learning curve, or the method of specimen retrieval. Patients and Methods: Between January 1, 2002 and December 31, 2013, 70 LS procedures were performed at our department. Based on the weight of the removed spleen, patients were divided into three groups: Group 1, <350 g (n=32); Group 2, 350-1000 g (n=15); and Group 3, >1000 g (n=7). The role of the learning curve was also analyzed with the first 20 surgeries considered as the learning period. The specimen was retrieved with morcellation through the lateral port site in 54 cases, whereas in 11 cases, the large spleen was retrieved through a Pfannenstiel incision. Results: The mean duration of surgery was 122 minutes. When considered by spleen weight, durations for Groups 1-3 were 117, 128, and 134 minutes, respectively. When considered by the learning curve, durations for learning and later periods were 149 and 111 minutes, respectively (P=.002). After the learning period, larger spleens were removed (208 versus 519 g; P=.02), and there were fewer conversions. The mean postoperative hospital stay was 5.1 days. In the 11 cases where the specimen was retrieved through a Pfannenstiel incision, the mean duration of surgery was 108 minutes, and the mean spleen weight was 1032 g. Conclusions: Our study supports that the proposal that LS is safe and has numerous advantages, even in the case of massive splenomegaly. Our results were mainly affected by the spleen size and the learning curve.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Objective: To describe a novel surgical technique, laparoscopic stepwise-cut double initial stay suture (LASDISS) pyeloplasty for ureteropelvic junction obstruction (UPJO). Additionally, we evaluated the safety and short-term results. Materials and Methods: This was a nonrandomized study with a series of 6 patients with UPJO, operated on between March 2012 and August 2013. Perioperative and short-term outcomes were evaluated. In brief, a "T shape cut" was performed from the dilated pelvis to the ureter. The initial stay suture was placed between the lower edge of the pelvis and the distal end of the spatulated anterolateral part of the ureter. The pelvis was closed with a continuous suture starting from the opened upper edge of the pelvis that was secured after leaving enough space for ureteral anastomosis. The second initial stay suture was placed after passing the ureter and pelvis two times. The dilated part of the renal pelvis and the stenotic segment were excised. A double-J stent was inserted. The remaining space between the two initial sutures was closed with these continuous sutures. Results: We performed the LASDISS pyeloplasty technique in all cases. Median operation time was 177 minutes (range, 100-290 minutes). Mean follow-up was 7.5 months (range, 3-18 months). The mean pre- and postoperative split renal function on diuretic renography was 33% (range, 25%-56%) and 42% (range, 30%-52%), respectively. Conclusions: The LASDISS pyeloplasty surgical technique represents a safe and effective option in surgical treatment of UPJO.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Background: Laparoscopic adrenalectomy is the gold standard procedure for most adrenal masses. However, long-term data regarding this procedure are limited. We report our institution's experience with laparoscopic adrenalectomy, determine if this procedure results in durable weight loss and resolves hypertension, diabetes mellitus, or hyperlipidemia, and identify predictors of pathology in nonfunctioning tumors. Materials and Methods: We retrospectively reviewed laparoscopic adrenalectomies performed for adrenal masses between May 2000 and September 2010 by nine surgeons at a single institution. Data gathered included demographics, body mass index (BMI), preoperative and postoperative imaging and biochemical testing results, length of stay, complications, pathology, medications, and resolution of hypertension, diabetes, or hyperlipidemia. Results: We removed 96 adrenal glands in 95 patients. Their average age was 55.6 years. The average length of stay was 1.8 days. Average BMI was 32.9 kg/m(2) preoperatively and 31.9 kg/m(2) postoperatively (P=.46). We experienced no conversions to open procedure and no perioperative mortality. Minor complications occurred at a rate of 1.2%. Indications for adrenalectomy were nonfunctioning tumor (n=35), pheochromocytoma (n=18), aldosteronoma (n=17), subclinical Cushing's syndrome (n=15), Cushing's syndrome (n=9), and sex hormone-secreting tumor (n=1). Hypertension improved or resolved in 63% of patients with Cushing's syndrome, 56% with aldosteronoma, and 47% with pheochromocytoma. When adrenalectomy was performed for nonfunctioning tumors, neoplasia was identified in 22.9% of patients. The most predictive factors for neoplasia were previous history of cancer and abnormal appearance on computed tomography, magnetic resonance imaging, or positron emission tomography scan. Conclusions: Laparoscopic adrenalectomy is a safe procedure with a low complication rate and short hospital stay. Hypertension improves in the majority of patients with Cushing's syndrome and aldosteronoma and just under the majority of those with pheochromocytoma. In our study, abnormal radiologic appearance was a better predictor of neoplasia than size.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Introduction: Some degree of inadequate weight loss or recidivism is seen with all bariatric surgical approaches. To combat this, some authors have suggested placing a reinforcing ring around gastric bypass pouches or gastric sleeves. The aim of this study was to assess the initial feasibility and efficacy of silicone-banded laparoscopic sleeve gastrectomy (LSG). Materials and Methods: All cases of silicone-banded LSG performed at our center were retrospectively identified. Patient demographics, perioperative parameters, and postoperative outcomes were extracted and analyzed. Results: Thirteen patients (7 females, 6 males) were identified and analyzed. Preoperatively, patients had a mean age of 56.0±8.3 years, a mean body mass index (BMI) of 53.7±8.5 kg/m(2), and a median of seven comorbidities. All cases were completed laparoscopically by one surgeon, with a mean operative time of 140.7±25.7 minutes and a mean estimated blood loss of 56.9±30.6 mL. There were no mortalities. The only intraoperative complication was a respiratory arrest after extubation, and this patient recovered fully. Postoperatively, 2 patients (15.4%) experienced a complication: one had a pulmonary embolism requiring brief re-admission, and the other had a syncopal episode from a second-degree atrioventricular block. No long-term complications were encountered. One patient was lost to follow-up. At a median follow-up of 16 months (range, 6-27 months), the mean BMI of the cohort was 38.7±7.9 kg/m(2), which corresponded to a mean excess weight loss (EWL) of 54.8±19.6%. Conclusions: This report provides initial evidence that silicone-banded LSG is feasible and can be performed with minimal morbidity and significant EWL at short-term follow-up.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Aim: To define the role of laparoscopy for treating malrotation in children. Materials and Methods: The Ladd procedure (9 laparoscopic [lap-Ladd], 17 open [open-Ladd]; n=26) was performed in children up to and including 30 days of age (neonatal [Group N]) and older (Group C). These groups were compared retrospectively. Results: Group N (n=14) comprised 3 lap-Ladd and 11 open-Ladd patients. Group C (n=12) comprised 6 lap-Ladd and 6 open-Ladd patients. No case had ischemic bowel preoperatively. Intestinal volvulus was confirmed in 3 of 3 lap-Ladd and 9 of 11 open-Ladd patients in Group N, compared with 5 of 6 lap-Ladd and 6 of 6 open-Ladd patients in Group C (P=not significant). Mean operating times were significantly longer for lap-Ladd patients (130.7 minutes versus 81.1 minutes in Group N and 119.2 minutes versus 74.2 minutes in Group C). Conversion to an open-Ladd procedure was necessary in 1 of 3 patients in Group N and 1 of 6 patients in Group C (P=not significant). Complications arose in open-Ladd patients, bowel obstruction in Group N (1 of 11), and mesenteric chylorrhea in Group C (1 of 6). There was recurrence in 1 of 3 lap-Ladd patients in Group N. Mean time to recommence feeding was earlier for lap-Ladd patients (P=not significant). Length of hospitalization was similar in Group N but was shorter for lap-Ladd patients in Group C (P=not significant). Conclusions: Although lap-Ladd appears to be a safe procedure, it cannot be recommended for the treatment of malrotation in neonates.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Purpose: Robot-assisted radical cystectomy (RARC) was first introduced in 2003. Although there have been modifications to the surgical techniques over the years, in every published RARC series the surgical robot is invariably docked between the patient's legs. We evaluated the use of a side-docking approach in RARC. Patients and Methods: Ten RARCs using a side-docking technique were performed at a single institute between February 2013 and February 2014. The patients' clinical notes and operative findings were reviewed. The results were compared with results from RARCs using the conventional central-docking method from our historical cohort. Results: There were no significant arm collisions in the side-docking RARC procedures. The perineum was readily accessible in all cases that used the side-docking method. A simultaneous urethrectomy was performed in 1 case with a side-docking approach. The median operative times were 417.5 minutes (range, 345-515 minutes) and 405.0 minutes (range, 330-500 minutes) in the central-docking and side-docking groups, respectively. There were no statistically significant differences in operation time, transfusion rate, complication rate, or hospital stay between the two groups. Conclusions: A side-docking approach in RARC provides better perineal access with the advantage of allowing simultaneous urethrectomy and transvaginal retrieval of the specimen without compromising the dexterity and precision of the robotic surgical system.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 02/2015;
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    ABSTRACT: Abstract Background: Appendicular stump closure is a crucial step during laparoscopic appendectomy. Recently, endoclips (ECs) have been described for ligation of the appendicular stump. The objective of this review was to compare outcomes with EC versus endoligature (EL) for appendiceal stump closure during laparoscopic appendectomy. Materials and Methods: A literature search of Medline, Embase, Cochrane Database, and Google Scholar was performed to identify studies comparing use of EL versus EC in laparoscopic appendectomy between January 1992 and September 2013. Reviews of each study were conducted, and data were extracted. The random-effects model was used to combine data, and between-study heterogeneity was assessed. Results: Seven of the 101 identified studies met the inclusion criteria: four randomized controlled trials and three case controlled series. For the primary outcome of perioperative and postoperative complications, there was no significant difference between the EC versus EL groups. No differences were noted in length of hospital stay. However, a significant reduction in operative time was observed with EC as opposed to EL (standardized mean difference=-0.90, 95% confidence interval=-1.26 to -0.54, P=.001). Moreover, EC procedures were less expensive than EL procedures. Conclusions: EC application in the management of appendiceal stump during laparoscopic appendectomy appears to be simple, efficacious, safe, and a cost-effective alternative.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Purpose: Thoracoscopic lobectomy in infants requires advanced minimally invasive skills. Simulation-based education has the potential to improve complex procedural skills without exposing the patient to undue risks. The study purposes were (1) to create a size-appropriate infant lobectomy simulator and (2) to evaluate validity evidence to support or refute its use in surgical education. Materials and Methods: In this Institutional Review Board-exempt study, a size-appropriate rib cage for a 3-month-old infant was created. Fetal bovine tissue completed the simulator. Thirty-three participants performed the simulated thoracoscopic lobectomy. Participants completed a self-report, 26-item instrument consisting of 25 4-point rating scales (from 1=not realistic to 4=highly realistic) and a one 4-point Global Rating Scale. Validity evidence relevant to test content and response processes was evaluated using the many-facet Rasch model, and evidence of internal structure (inter-item consistency) was estimated using Cronbach's alpha. Results: Experienced surgeons (observed average=3.6) had slightly higher overall rating than novice surgeons (observed average=3.4, P=.001). The highest combined observed averages were for the domain Physical Attributes (3.7), whereas the lowest ratings were for the domains Realism of Experience and Ability to Perform Tasks (3.4). The global rating was 2.9, consistent with "this simulator can be considered for use in infant lobectomy training, but could be improved slightly." Inter-item consistency for items used to evaluate the simulator's quality was high (α=0.90). Conclusions: With ratings consistent with high physical attributes and realism, we successfully created an infant lobectomy simulator, and preliminary evidence relevant to test content, response processes, and internal structure was supported. Participants rated the model as realistic, relevant to clinical practice, and valuable as a learning tool. Minor improvements were suggested prior to its full implementation as an educational and testing tool.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Purpose: Laparoscopic duodenal atresia (DA) repair is a relatively uncommon pediatric operation requiring advanced minimally invasive skills. Currently, there are no commercial simulators available that address surgeons' needs for refining skills associated with this procedure. The purposes of this study were (1) to create an anatomically correct, size-relevant model and (2) to evaluate the content validity of the simulator. Materials and Methods: Radiologic images were used to create an abdominal domain consistent with a full-term infant. Fetal bovine tissue was used to complete the simulator. Following Institutional Review Board exempt determination, 18 participants performed the simulated laparoscopic DA repair. Participants completed a self-report, six-domain, 24-item instrument consisting of 4-point rating scales (from 1=not realistic to 4=highly realistic). Validity evidence relevant to test content and response processes was evaluated using the many-facet Rasch model, and evidence of internal structure (inter-item consistency) was estimated using Cronbach's alpha. Results: The highest observed averages were for "Value as a training and testing tool" (both observed averages=3.9), whereas the lowest ratings were "Palpation of liver" (observed average=3.3) and "Realism of skin" (observed average=3.2). The Global opinion rating was 3.2, indicating the simulator can be considered for use as is, but could be improved slightly. Inter-item consistency was high (α=0.89). Conclusions: We have successfully created a size-appropriate laparoscopic DA simulator. Participants agreed that the simulator was relevant and valuable as a learning/testing tool. Prior to implementing this simulator as a training tool, minor improvements should be made, with subsequent evaluation of additional validation evidence.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Introduction: The aim of this report is to present our technique of laparoscopic simple oblique duodenoduodenostomy (LSOD) and its results in management of congenital duodenal obstruction (CDO) in children. Patients and Methods: Medical records of patients with the diagnosis of CDO undergoing LSOD at our center from March 2009 to December 2013 were reviewed. The LSOD used one infra- or transumbilical 5-mm port for the camera and two 3-mm ports for instruments. After mobilization of the distant part of the duodenum, a 5-0 polydioxanone seromuscular suture was placed on the duodenal wall proximal and distal to the obstruction and tacked to the anterior abdominal wall for traction. The lower duodenum was incised longitudinally distal to the traction suture. The upper duodenum incision was placed away from the traction suture and extended downward obliquely. The duodenoduodenostomy was performed as a "simple" anastomosis. Results: Forty-eight patients were identified with a median age at operation of 11 days. The median weight at operation was 2650 g. Duodenal atresia and annular pancreas were found in 81.2% and 18.8% of patients, respectively. The median operative time was 90 minutes. There was no conversion to open surgery, anastomotic leakage, or stenosis. The median time from the operation to initial oral feeding was 4 days. Of the 48 patients, 97.9% were discharged in good health with a median postoperative hospital stay of 7 days Conclusions: The LSOD technique is safe and efficacious and can be a viable option in the management of select cases of CDO in children at experienced centers.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Introduction: Diagnosis of metastatic breast carcinoma to the internal mammary lymph nodes is important both as a prognostic factor and for planning adjuvant chemoradiotherapy. Establishing lymph node dissection is often performed by Chamberlain's procedure, which involves intercostal incision with spreading of the pectoralis and the intercostal muscles and can be associated with complications, including bleeding from the internal mammary artery or damage to intercostal vessels and nerves. A technique is presented for video-assisted thoracoscopic internal mammary node dissection using both sentinel node evaluation and dissection. Patients and Methods: This technique was performed on 2 female patients undergoing internal mammary node evaluation after they presented with invasive ductal breast carcinoma. Results: Video-assisted dissection of the thoracoscopic internal mammary lymph nodes was successfully performed with no intraoperative complications. The postoperative course was uneventful. Conclusions: This approach can avoid damage to the internal mammary artery and intercostal spaces while providing useful information for the guidance of further therapy and achieving local control if clinically indicated.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Background: Postcholecystectomy syndrome has been a long-standing source of frustration for surgeons. The objective of this study was to assess the feasibility and safety of laparoscopic remnant cholecystectomy (LRC) and laparoscopic transcystic common bile duct (CBD) exploration (LTCBDE) when adopted as the management for gallbladder/cystic duct remnant with stones and choledocholithiasis (GRSC) after cholecystectomy. Patients and Methods: This is a retrospective study of 11 patients who underwent surgeries for GRSC: the first 4 patients (Group 1) underwent open remnant cholecystectomy and CBD exploration, whereas the last 7 patients (Group 2) underwent LRC with LTCBDE successfully. Demographic data and perioperative parameters were analyzed and compared between the two groups. Results: All 11 patients had undergone cholecystectomy for symptomatic gallstone diseases. These patients had a mean age of 62 years. The time interval between cholecystectomy and the diagnosis of GRSC ranged from 4 years to 23 years (mean, 13 years). There was a significant reduction in postoperative hospital stay (5.00±1.41 versus 2.14±1.77 days, P=.034) and blood loss (35.00±10.00 versus 14.29±7.87 mL, P=.011) in Group 2 compared with Group 1. The 30-day morbidity rate was 9.1%. At a mean follow-up of 24 months (range, 6-45 months), no symptoms had recurred, and no mortality was recorded in this study. Conclusions: LRC and LTCBDE for GRSC are safe and feasible and could be offered as a choice in centers performing advanced laparoscopic procedures.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Objective: The aim of this study was to clarify the role of thoracoscopic plication for diaphragmatic eventration after surgery for congenital heart disease (CHD) in children. Patients and Methods: We retrospectively reviewed the medical charts of pediatric patients who had undergone thoracoscopic plication of diaphragmatic eventration after surgery for CHD between 2008 and 2013 at our department. Results: Five patients were identified during the study period. The median age and body weight of the patients were 7.6 months and 6.6 kg, respectively. The associated CHDs were pulmonary artery atresia in 3 patients, truncus arteriosus in 1 patient, and double-outlet right ventricle in 1 patient. Four patients needed preoperative mechanical respiratory support. At operation, all the patients received CO2 insufflation (4 mm Hg), and single-lung ventilation was attempted in 3 patients using a bronchial blocker. A sufficient operative field was maintained by CO2 insufflation in all the patients regardless of single-lung ventilation. The procedure was not converted to open operation in any patient. Postoperative extubation was performed in the operating room in 1 patient, on the day of operation in 2 patients, and on postoperative Days 1 and 2 in 2 patients. Air embolism was not observed in any of the patients. Diaphragmatic eventration did not recur in any of the patients after thoracoscopic plication. Conclusions: Thoracoscopic plication is a safe and effective procedure for pediatric diaphragmatic eventration after surgery for CHD. Considering the sufficient operative field maintained by CO2 insufflation, single-lung ventilation using a bronchial blocker would be unnecessary for this procedure. With its safety and good outcome, early thoracoscopic plication is a good treatment option for pediatric patients with symptomatic diaphragmatic eventration after surgery for CHD.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;
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    ABSTRACT: Abstract Here, we report the case of a 26-year-old woman suffering from nutcracker syndrome with concurrent disabling pelvic congestion syndrome. She was given the minimally invasive treatment of left renal vein transposition with the Da Vinci(®) robotic system (Intuitive Surgical, Sunnyvale, CA), followed the next day by a gonadal vein and pelvic varicose embolization using a robotic intraluminal navigation with the Magellan™ robotic system (Hansen Medical, Mountain View, CA). The procedure was uneventful, and the patient had good results at 6 months of follow-up, including a patent left renal vein and complete relief of symptoms.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2014;