Surgical laparoscopy, endoscopy & percutaneous techniques (SURG LAPARO ENDO PER )


Surgical Laparoscopy Endoscopy & Percutaneous Techniques is designed for surgeons who are committed to providing patients with the best, least invasive treatment appropriate for their condition.Six times a year, this revolutionary journal brings you updates on what is happening now...and what is on the horizon. You will hear about the latest clinical advances and the most exciting new academic research. You see the latest training techniques in use today and you even get detailed descriptions of operative procedures.The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.

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    Surgical Laparoscopy Endoscopy & Percutaneous Techniques website
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    Surgical laparoscopy, endoscopy & percutaneous techniques, Surgical laparoscopy, endoscopy, and percutaneous techniques
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Publications in this journal

  • Surgical laparoscopy, endoscopy & percutaneous techniques 01/2011;
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    Surgical laparoscopy, endoscopy & percutaneous techniques 03/2010; 20(2):65.
  • Surgical laparoscopy, endoscopy & percutaneous techniques 01/2010;
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    Surgical laparoscopy, endoscopy & percutaneous techniques 09/2009; 19(5):396.
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    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2009; 19(4):e161.
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    Surgical laparoscopy, endoscopy & percutaneous techniques 01/2009; 19(1):1.
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    ABSTRACT: With the availability of endoscopy and its inherent use as a diagnostic and therapeutic modality, many surgeons and gastroenterologists are able to use this tool to remedy a wide range of gastrointestinal pathologies. The literature is replete with anecdotal endoscopic therapeutic strategies ranging from epinephrine injection, to use of cautery or argon plasma coagulation. This case report highlights the use of endoscopic hemoclips which were successfully applied in the acute postoperative period for a bleeding vessel at a fresh anastomotic site. The article allows for a brief discussion of plausible endoscopic treatment strategies available to the surgeon faced with a similar situation.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):299-300.
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    ABSTRACT: Laparoscopic technique has proven to be a safe and feasible alternative to open mesh repair in the treatment of ventral hernias. It has been seen that the recurrence rate is the same as with open repair but with lesser morbidity. For the repair of ventral hernia with laparoscopy, mesh is placed intraperitoneally. The most common approach for intraperitoneal fixation of the mesh is by using a combination of transfascial sutures and tackers. This paper describes a new technique for intraperitoneal fixation of the mesh using sutures. Adhesions to the previous scar are taken down. Mesh is anchored to the abdominal wall using 4 transfascial sutures at the 4 corners of the mesh. Fixation of the mesh between the transfascial sutures is performed by a new technique using continuous sutures. Fixation of the mesh with tacks is not required. This is a novel technique for fixation of the mesh to the abdominal wall intraperitoneally during laparoscopic repair of ventral hernia. Tackers are not required for the fixation of mesh.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):277-9.
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    ABSTRACT: Acute cholecystitis (AC) and acute pancreatitis are 2 potentially life-threatening complications of gallstone disease. There are national guidelines for the treatment of gallstone pancreatitis, but none exist for the management of AC. Consequently, the management of AC is subject to great variation. To establish the preferred management of uncomplicated AC and adherence to the guidelines for management of mild gallstone pancreatitis among all consultant general surgeons working in Scotland. A national postal survey of all 192 consultant general surgeons in Scotland. One hundred thirty-five responses were received from surgeons, a response rate of 70%. One hundred twenty-six were suitable for further analysis. For uncomplicated AC, 55 (44%) perform urgent laparoscopic cholecystectomy (LC), 29 (23%) perform same admission LC after clinical improvement. Thirty-eight (30%) perform interval LC after discharge. Within this group, 15 surgeons (12% of all replies analyzed) manage AC conservatively at least partly owing to insufficient operating time or equipment when on call. Factors found to increase the likelihood of carrying out same admission LC are undertaking regular laparoscopic work (P<0.001) and having a specialist upper gastrointestinal or vascular interest. In mild gallstone pancreatitis, 74 (58%) perform same admission LC, 21 (17%) would perform sphincterotomy, 3 (2%) would perform one of these, depending on the patient and 5 (4%) would refer to an upper gastrointestinal colleague. Uncomplicated AC and mild gallstone pancreatitis are conditions managed by all subspecialties within general surgery in Scotland. The majority of surgeons (67%) now manage AC by same admission LC, although those not performing regular elective laparoscopy are significantly less likely to do so. Of those who manage conservatively, more than a third report lack of resources as being the reason. For mild gallstone pancreatitis, the majority of surgeons in Scotland (61.5%) perform urgent LC in accordance with current guidelines. A significant proportion of surgeons (17%) carry out endoscopic retrograde cholangiopancreatography as first line in all patients despite this being recommended only for those unfit for surgery.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):242-7.
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    ABSTRACT: Although polyps of the extrahepatic biliary system are rare, an awareness of their potential existence is important as they may closely mimic choledocholithiasis clinically and radiologically but require distinct measures for successful management. This report describes the presentation and successful laparoscopic transcystic management of this infrequently encountered condition. It also explores the literature and discovers the numerous potential presenting features of common bile duct calculi and the spectrum of possible management options.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):290-3.
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    ABSTRACT: To evaluate a new laparoscopic technique for the treatment of indirect inguinal hernias. Using the rabbit model of indirect inguinal hernia, nitinol U-clips (Medtronic Inc, Minneapolis, MN) were applied to the edges of the internal inguinal ring to close the defect and induce a scar. The procedure required only a "needle-scope" and a 3-mm needle holder. Ten male New Zealand rabbits were divided in 2 groups: A=experimental (n=8 animals) and B=control (n=2 animals). Group A underwent laparoscopic placement of clips on day 1, with subsequent laparoscopic assessment on days 15, 30, and 60, and euthanized for histologic assessment on days 90 (n=4) and 120 (n=4). Group B underwent laparoscopy on day 0 (to confirm the presence of the hernias) and were euthanized on day 120. All treated inguinal hernias developed a thick layer of fibrous tissue around the clips and were completely closed (8 out of 8). At day 15 after surgery, all clipped areas showed some fibrosis, and at day 30, the clips were totally covered by scar tissue. The fibrosis involved not only the clips, but also a surrounding area of 2 to 3 cm. Mean operative time was 39 minutes (from skin incision to skin closure), and the mean time for clip placement was 2 minutes. The use of nitinol U-clips proved to be a simple, safe, and effective technique for the laparoscopic treatment of inguinal hernias in this animal model, which has a remarkable correlation with the anatomy of human pediatric indirect inguinal hernias.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):280-2.
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    ABSTRACT: The aim of our study was to review our experience and to determine a predictive model of factors for unanticipated admissions after ambulatory laparoscopic cholecystectomy (LC). Between January 1999 and June 2003, 410 consecutive LCs were performed as outpatient procedures. We performed univariate analysis and logistic regression models of preoperative and intraoperative variables. The scoring system developed allowed calculating the ambulatorization probability of LC in each patient. Validation and calibration of the model were realized by means of Hosmer-Lemeshow test. Three hundred sixty-three patients were strictly ambulatory (86.8%). Forty-two patients required overnight admission (10.2%), most of them because of social factors, and 5 patients were admitted. Predictive factors related to overnight stay or admission were: age of patient over 65 years [P=0.021; odds ratio (OR)=2.225; 95% confidence interval (CI), 1.130-4.381], operation duration superior to 60 minutes (P=0.046; OR=2.403; 95% CI, 1.106-5.685), and "dissection difficulty" intraoperative score superior to 6 (P=0.034; OR=3.063; 95% CI, 1.086-8.649). The right classification index of the predictive system was 91.7%, reaching a sensibility of 99.7% and specificity of 31.9%. Outpatient LC is safe and feasible. Age of the patient, operation duration, and complexity of surgical dissection during LC are independent factors influencing ambulatorization rate.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):248-53.
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    ABSTRACT: To assess the feasibility and safety of radiofrequency ablation (RFA) with hand-assisted laparoscopic surgery (HALS) for hepatocellular carcinoma (HCC) in the caudate lobe with severe liver dysfunction. HCC in the caudate lobe remains one of the most difficult locations where various treatments tend to pose problems regarding the optimal surgical approach. The technique of HALS has thus been proposed as a useful method for performing a safe RFA therapy. For this study, we assessed the feasibility and safety of RFA with HALS for the treatment of HCC in the caudate lobe with liver dysfunction. Between July 1999 and February 2005, 5 patients who suffered from HCC in the caudate lobe were indicated for RFA. The percutaneous puncture was difficult and all patients have severe liver dysfunction with viral chronic hepatitis. Therefore, RFA was assisted by an inserted hand through a minimal skin incision under laparoscopic inspection. An intraoperative endoscopic ultrasound examination was performed before RFA to determine the tumor region. The hand-assisted minimal dissection around the caudate lobe was required to detect tumor and avoid injuries of other tissues. RFA for HCC was performed using a cooled-tip (Radionics Inc, Burligton, MA) connected to a RF generator under the programmed cyclic impedance. The surgical procedures consisted of 5 RFA to tumors in the caudate lobe with HALS, which was performed safely, and a postoperative computed tomography scan revealed a sufficient ablation in all patients. There was no operative mortality but 1 patient had minor bile leakage, which was treated conservatively, and all patients recovered and thus were eventually discharged. One patient had local recurrence after 3 months, 3 patients had tumor recurrences in another segment after 6 months. At a mean follow-up 32.2 months, all patients were still alive. RFA with HALS is considered to be a safe and feasible technique for HCC in the caudate lobe with liver dysfunction.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):272-6.
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    ABSTRACT: We report a case of colitic cancer detected by target biopsies at surveillance colonoscopy in a patient with long-standing and extensive ulcerative colitis. At first, the detected colitic cancer was removed by endoscopic mucosal resection as the patient refused surgical resection. However, total proctocolectomy with an ileal-J-pouch anal anastomosis was performed additionally after informed consent had been obtained from the patient, as the resected specimen included invasive cancer histologically. Surprisingly, histologic examination of the surgical specimens revealed another flat invasive colitic cancer and 2 microcarcinoids, which were not detectable by preoperative colonoscopy or by macroscopic investigation of the surgically resected specimen. The occurrence of carcinoid in patients with ulcerative colitis has been reported only sporadically. In addition, coexistence of colitic cancer and carcinoids is extremely rare. Cases of this rare combination reported previously in the English literature are summarized and discussed.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):304-7.
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    ABSTRACT: The case of a 3-year-old child who underwent open antireflux surgery for severe gastroesophageal reflux is presented. One month after the procedure, the child presented with abstinence from feeds, and vomiting after food intake. Esophagogastroscopy ruled out pathology in the area around the wrap. Upper gastrointestinal contrast studies demonstrated a kinking of the duodenal loop. Laparoscopy revealed severe adhesions between the duodenum and liver with kinking of the duodenum. The adhesions were taken down with careful dissection using hooked laparoscopic scissors. The symptoms subsided immediately after surgery and the further course and follow-up examinations were uneventful. The complication of mechanical ileus due to hepatoduodenal adhesions with severe kinking of the duodenum after antireflux surgery and with successful laparoscopic management has never been reported to date.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):288-9.
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    ABSTRACT: The esophagus is a common site for foreign bodies (FBs) because of areas of physiologic narrowing. Dentures pose special problems, especially if they are impacted. We present a case of a "smiling" foreign body in the proximal esophagus. The patient was an 80-year-old man with a history of dysphagia and swallowed dentures. Thoracoscopic removal was performed successfully as an endoscopic removal had failed and the patient had an uneventful postoperative recovery. He was discharged on the seventh postoperative day. Coins are the most commonly ingested FBs. Swallowing of dentures is found mostly in elderly patients. If endoscopic removal is not possible, then a minimally invasive surgery is an alternative. Swallowing of dentures is rare, and its thoracoscopic removal has not been reported so far. Using thoracoscopy, all the benefits of a minimally invasive surgery can be used. Minimally invasive techniques have been found to be very useful in the removal of intraluminal FBs, especially when conservative measures fail. Prevention of such incidents should be emphasized.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):325-8.
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    ABSTRACT: A 72-year-old orthotopic cardiac transplant recipient with multiple, previously resected, cutaneous squamous cell carcinoma (SCC) presented with invasive SCC of the urinary bladder. At surgery, clot retention was managed with clot evacuation and continuous bladder irrigation to facilitate dissection. Laparoscopic cystoprostatectomy and bilateral pelvic lymph node dissection with extracorporeal ileal conduit urinary diversion were performed in 6 hours without complication. This approach minimized blood loss and allowed sufficient time out of steep Trendelenberg to reequilibrate the patient's cardiovascular system. Final pathology revealed SCC with perivesical fat invasion. This immunocompromised patient remains disease free 2 months after resection.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):319-21.
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    ABSTRACT: Subcutaneous emphysema after laparoscopic surgery is not uncommon but infection of the subcutaneous space because of gas forming organisms causing emphysema after a laparoscopic procedure is an extremely rare entity. We report a case of infective subcutaneous emphysema after laparoscopic rectopexy.
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):308-9.
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    ABSTRACT: Although the role of minimally invasive techniques in pancreatic surgery remains controversial, resection of the left pancreas for benign or endocrine lesions has been universally adopted as a routine technique over the last few years. This study was undertaken to assess feasibility and safety of minimal access resections of distal pancreas in benign, endocrine, and malignant diseases. Operative time, conversion rate, adequacy of dissection, respect for oncologic principles, morbidity rate, and short-term outcomes were analyzed. From the years 2002 to 2007, 14 patients affected by pancreatic neoplasm of body/tail region were approached by minimally invasive technique. Nine patients were affected by malignant neoplasms and distal splenopancreatectomy was successfully achieved by laparoscopy in 6. Five patients were affected by endocrine neoplasms; distal pancreatectomy with preservation of spleen and splenic vessels was achieved laparoscopically in 3, whereas 2 needed conversion to laparotomy. Four patients developed pancreatic leak after transection by linear cutting stapler plus oversewing, whereas no leak was observed within 30 days from surgery after transection by linear stapler with Seamguard reinforcement of the staple line (P<0.05 with Fisher exact test).
    Surgical laparoscopy, endoscopy & percutaneous techniques 07/2008; 18(3):254-9.

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