Journal of Minimally Invasive Surgical Sciences Journal of Minimally Invasive Surgical Sciences J Minim Invasive Surg Sci http://www.minsurgery.portal.tools 2251-7022 2251-7030 10.5812/minsurgery. en jalali 2019 4 24 gregorian 2019 4 24 3 1
en Robotic Assisted Minimally Invasive Surgery, a Novel Innovation in Surgery Robotic Assisted Minimally Invasive Surgery, a Novel Innovation in Surgery editorial editorial Robotics;Laparoscopy;Health Robotics;Laparoscopy;Health http://www.minsurgery.portal.tools/index.php?page=article&article_id=16249 Abdolreza Pazouki Abdolreza Pazouki Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2166555447 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2166555447 Fatemeh Jesmi Fatemeh Jesmi Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, IR Iran
en Adhesions after Laparoscopic Ovarian Drilling in the Treatment of Women with Polycystic Ovary Syndrome: Should it be a Concern? Adhesions after Laparoscopic Ovarian Drilling in the Treatment of Women with Polycystic Ovary Syndrome: Should it be a Concern? review-article review-article Context

In order to restore ovulation, puncturing ovaries with a needle powered by electricity, under laparoscopic observation, in women with anovulatory infertility with polycystic ovarian syndrome is called laparoscopic ovarian drilling (LOD). Although peri-adnexial adhesion after the surgery is inevitable, there is lack of evidence regarding the clinical significance. The objective of the present study is to review the available literature in order to determine the rate of periadnexial adhesions following LOD, and to assess the effect of these adhesions on pregnancy rates.

Evidence Acquisition

Electronic search of MEDLINE and EMBASE for English-language and non-English-language articles from 1984 to 2012 and manual search of bibliographies from identified articles were evaluated. Sixteen articles were found to be eligible to obtain main outcome measures. Post-operative adhesion rates were reported to be 0-100% (mean 35.5%, 95%CI: 30.8-40.4) while pregnancy rates after the procedure in these articles were 35-87% (mean 64.3% 95%CI: 58.2-70.7) of the cases.

Results

There were no correlation between the adhesion rates and pregnancy rates (Spearman's rho=.055, P=.858). None of the preventive measures during or after the procedure were found to be effective in reducing the rate of post-operative adhesions, thereby increasing the pregnancy rates. The incidence of peri-adnexial adhesions after LOD might not be associated with adverse reproductive outcomes.

Conclusions

Until more effective, safer and non-invasive treatments become available, LOD is a relatively safe and effective second-line procedure in anovulatory infertile women with PCOS resistant to clomiphene citrate.

Context

In order to restore ovulation, puncturing ovaries with a needle powered by electricity, under laparoscopic observation, in women with anovulatory infertility with polycystic ovarian syndrome is called laparoscopic ovarian drilling (LOD). Although peri-adnexial adhesion after the surgery is inevitable, there is lack of evidence regarding the clinical significance. The objective of the present study is to review the available literature in order to determine the rate of periadnexial adhesions following LOD, and to assess the effect of these adhesions on pregnancy rates.

Evidence Acquisition

Electronic search of MEDLINE and EMBASE for English-language and non-English-language articles from 1984 to 2012 and manual search of bibliographies from identified articles were evaluated. Sixteen articles were found to be eligible to obtain main outcome measures. Post-operative adhesion rates were reported to be 0-100% (mean 35.5%, 95%CI: 30.8-40.4) while pregnancy rates after the procedure in these articles were 35-87% (mean 64.3% 95%CI: 58.2-70.7) of the cases.

Results

There were no correlation between the adhesion rates and pregnancy rates (Spearman's rho=.055, P=.858). None of the preventive measures during or after the procedure were found to be effective in reducing the rate of post-operative adhesions, thereby increasing the pregnancy rates. The incidence of peri-adnexial adhesions after LOD might not be associated with adverse reproductive outcomes.

Conclusions

Until more effective, safer and non-invasive treatments become available, LOD is a relatively safe and effective second-line procedure in anovulatory infertile women with PCOS resistant to clomiphene citrate.

Peri-adnexal Adhesions;Laparoscopic Ovarian Drilling;Polycystic Ovarian Syndrome;Pregnancy Rate Peri-adnexal Adhesions;Laparoscopic Ovarian Drilling;Polycystic Ovarian Syndrome;Pregnancy Rate http://www.minsurgery.portal.tools/index.php?page=article&article_id=10729 Murat Api Murat Api Obstetrics and Gynecology Department, Adana Numune Education and Research Hospital, Adana, Turkey; Obstetrics and Gynecology Department, Adana Numune Education and Research Hospital, Adana, Turkey. Tel: +90-5424241807, Fax: +90-2163622280 Obstetrics and Gynecology Department, Adana Numune Education and Research Hospital, Adana, Turkey; Obstetrics and Gynecology Department, Adana Numune Education and Research Hospital, Adana, Turkey. Tel: +90-5424241807, Fax: +90-2163622280
en Indications and Considerations in Minimally Invasive Video-Assisted Thyroidectomy Indications and Considerations in Minimally Invasive Video-Assisted Thyroidectomy research-article research-article Background

The phrase “minimally invasive” is used loosely due to the wide range of surgical options and generally means a procedure not involving a large open incision. In 1998, Dr. Paolo Miccoli at the University of Pisa developed a technique of minimally invasive video-assisted thyroidectomy (MIVAT) for patients presenting with small thyroid nodules. The procedure involves a smaller incision, limited exposure, and endoscopic magnification to better visualize the smaller surgical field. From this point, thyroidectomy or hemi-thyroidectomy is performed using endoscopic instrumentation. Indications were initially limited to single, small non-malignant thyroid nodules, however the indications have gradually expanded since this surgery’s initial implementation.

Objectives

We feel that this article provides an up-to-date research on the MIVAT procedure, while highlighting its rapidly expanding indications and excellent outcomes.

Patients and Methods

The current patient selection criteria includes small thyroid nodules (<35 mm in diameter), a relatively normal thyroid gland (about <25 cubic cm), no evidence of severe thyroiditis, and no previous neck surgery or radiation.

Results

The advantages of MIVAT compared with conventional thyroidectomy include improved cosmetic results, less postoperative pain and reduced hospital stay without any difference in safety, completeness or morbidity compared with the conventional approach. The primary drawback appears to be an increased operative time, which can be reduced as the surgeon becomes more comfortable with the procedure.

Conclusions

As shown in the literature, MIVAT is a safe and effective alternative in the treatment of some thyroid diseases within the selection criteria. With the same level of complications, it offers a few significant advantages over the conventional thryoidectomy.

Background

The phrase “minimally invasive” is used loosely due to the wide range of surgical options and generally means a procedure not involving a large open incision. In 1998, Dr. Paolo Miccoli at the University of Pisa developed a technique of minimally invasive video-assisted thyroidectomy (MIVAT) for patients presenting with small thyroid nodules. The procedure involves a smaller incision, limited exposure, and endoscopic magnification to better visualize the smaller surgical field. From this point, thyroidectomy or hemi-thyroidectomy is performed using endoscopic instrumentation. Indications were initially limited to single, small non-malignant thyroid nodules, however the indications have gradually expanded since this surgery’s initial implementation.

Objectives

We feel that this article provides an up-to-date research on the MIVAT procedure, while highlighting its rapidly expanding indications and excellent outcomes.

Patients and Methods

The current patient selection criteria includes small thyroid nodules (<35 mm in diameter), a relatively normal thyroid gland (about <25 cubic cm), no evidence of severe thyroiditis, and no previous neck surgery or radiation.

Results

The advantages of MIVAT compared with conventional thyroidectomy include improved cosmetic results, less postoperative pain and reduced hospital stay without any difference in safety, completeness or morbidity compared with the conventional approach. The primary drawback appears to be an increased operative time, which can be reduced as the surgeon becomes more comfortable with the procedure.

Conclusions

As shown in the literature, MIVAT is a safe and effective alternative in the treatment of some thyroid diseases within the selection criteria. With the same level of complications, it offers a few significant advantages over the conventional thryoidectomy.

Thyroidectomy; Surgical Procedures; Minimally Invasive; Endoscopy Thyroidectomy; Surgical Procedures; Minimally Invasive; Endoscopy http://www.minsurgery.portal.tools/index.php?page=article&article_id=12224 William A. Stokes William A. Stokes College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA; College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA. Tel/Fax: +80-36226720 College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA; College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA. Tel/Fax: +80-36226720 Eric W.Cerrati Eric W.Cerrati Department of Otolaryngology, New York City University School of Medicine, New York, USA Department of Otolaryngology, New York City University School of Medicine, New York, USA Eric J.Lentsch Eric J.Lentsch Hollings Cancer Center and Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA Hollings Cancer Center and Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
en Comparing Outcomes of Two Methods of Bariatric Surgery (LSG and LAGB) in Southern Iran Comparing Outcomes of Two Methods of Bariatric Surgery (LSG and LAGB) in Southern Iran research-article research-article Background

Since morbid obesity is known as a major cause of psychosocial problems beside its common adverse effects like cardiovascular and metabolic diseases, a lot of researches have been performed to find an effective treatment including surgery. Surgical methods were improved by invention of minimal invasive surgeries. Laparascopic Sleeve Gastrectomy (LSG) and Laparascopic Adjustable Gastric Banding (LAGB) are the methods which have become common in most of developed countries.

Objectives

Due to cultural, economic and social differences between our country and developed countries, we have designed this research to compare the efficacy and complication of these two methods six months after operation in hospitals affiliated to Shiraz University of Medical Sciences.

Patients and Methods

Documents of patients operated with one of these two methods were reviewed, and necessary information was inserted in prepared forms. We called patients if further information was needed. Then this data was analyzed with Chi Square 2Sample Independent T- test and Paired T Test by SPSS 16 software.

Results

Seventy patients were operated with LSG and 25 with LAGB. The Mean weight of LSG group was 120.73 and 120 for LAGB. The Mean weight loss in LSG was 29.99 and 19.60 in LAGB. There was no statistically significant difference regarding early complications between the two methods; although, long term complications such as gastric stenosis and band displacement were statistically more in LAGB.

Conclusions

It seems that both LSG and LAGB are efficient in weight loss but LSG can lead to more weight loss, better correction of blood pressure and less long term complications.

Background

Since morbid obesity is known as a major cause of psychosocial problems beside its common adverse effects like cardiovascular and metabolic diseases, a lot of researches have been performed to find an effective treatment including surgery. Surgical methods were improved by invention of minimal invasive surgeries. Laparascopic Sleeve Gastrectomy (LSG) and Laparascopic Adjustable Gastric Banding (LAGB) are the methods which have become common in most of developed countries.

Objectives

Due to cultural, economic and social differences between our country and developed countries, we have designed this research to compare the efficacy and complication of these two methods six months after operation in hospitals affiliated to Shiraz University of Medical Sciences.

Patients and Methods

Documents of patients operated with one of these two methods were reviewed, and necessary information was inserted in prepared forms. We called patients if further information was needed. Then this data was analyzed with Chi Square 2Sample Independent T- test and Paired T Test by SPSS 16 software.

Results

Seventy patients were operated with LSG and 25 with LAGB. The Mean weight of LSG group was 120.73 and 120 for LAGB. The Mean weight loss in LSG was 29.99 and 19.60 in LAGB. There was no statistically significant difference regarding early complications between the two methods; although, long term complications such as gastric stenosis and band displacement were statistically more in LAGB.

Conclusions

It seems that both LSG and LAGB are efficient in weight loss but LSG can lead to more weight loss, better correction of blood pressure and less long term complications.

Morbid Obesity;Bariatric Surgery;Developing Countries Morbid Obesity;Bariatric Surgery;Developing Countries http://www.minsurgery.portal.tools/index.php?page=article&article_id=12307 Seyed Hossein Hosseini Seyed Hossein Hosseini Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Ahmad Izadpanah Ahmad Izadpanah Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/ Fax: +98-7112306972 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/ Fax: +98-7112306972 Seyed Vahid Hosseini Seyed Vahid Hosseini Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Hossein Shabahang Hossein Shabahang Mashhad University of Medical Sciences, Mashhad, IR Iran Mashhad University of Medical Sciences, Mashhad, IR Iran Elaheh Ashrafi Elaheh Ashrafi Shiraz University of Medical Sciences, Shiraz, IR Iran Shiraz University of Medical Sciences, Shiraz, IR Iran Ali Reza Safarpour Ali Reza Safarpour Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Abbas Rezaianzadeh Abbas Rezaianzadeh Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Zahra Zabangirfard Zahra Zabangirfard Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
en Port Site Interparietal Hernia After Laparoscopic Splenectomy: A Case Report Port Site Interparietal Hernia After Laparoscopic Splenectomy: A Case Report case-report case-report

Laparoscopic trocar site interparietal hernia is a rare type of incisional hernia, which has been rarely reported. This type of hernia is usually observed when the fascia or peritoneum is not repaired or not completely closed. This complication may lead to some serious problems. We aimed to report a case of port site interparietal hernia after laparoscopic splenectomy.

Laparoscopic trocar site interparietal hernia is a rare type of incisional hernia, which has been rarely reported. This type of hernia is usually observed when the fascia or peritoneum is not repaired or not completely closed. This complication may lead to some serious problems. We aimed to report a case of port site interparietal hernia after laparoscopic splenectomy.

Laparoscopy;Hernia;Splenectomy Laparoscopy;Hernia;Splenectomy http://www.minsurgery.portal.tools/index.php?page=article&article_id=7748 Sajjad Noorshafiee Sajjad Noorshafiee Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Ghodratollah Maddah Ghodratollah Maddah Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Fatemeh Naghavi Riyabi Fatemeh Naghavi Riyabi Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Mohsen Abdollahi Mohsen Abdollahi Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Abbas Abdollahi Abbas Abdollahi Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118022677, Fax: +98-5118525255 Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118022677, Fax: +98-5118525255
en Perioperative Management of Bariatric Surgery in a Patient with Transposition of the Great Arteries Following an Atrial Level Switch Perioperative Management of Bariatric Surgery in a Patient with Transposition of the Great Arteries Following an Atrial Level Switch case-report case-report Introduction

Patients with palliated congenital heart disease may present later in life for major, non-cardiac surgical procedures. Although alternative surgical techniques are now available for the treatment of the transposition of the great arteries (TGA), an atrial level baffle (Mustard or Senning procedure) was previously performed. Long-term adverse effects of the atrial level switch include myocardial dysfunction, rhythm disturbances requiring pacemaker placement, pulmonary hypertension and baffle obstruction.

Case report

We present a 23-year-old woman, who had undergone an atrial level switch during infancy for palliation of TGA and now presents for laparoscopic vertical sleeve gastrectomy for the treatment of obesity.

Conclusions

The long term end-organ effects of an atrial level switch for TGA are reviewed and the perioperative of these patients is discussed.

Introduction

Patients with palliated congenital heart disease may present later in life for major, non-cardiac surgical procedures. Although alternative surgical techniques are now available for the treatment of the transposition of the great arteries (TGA), an atrial level baffle (Mustard or Senning procedure) was previously performed. Long-term adverse effects of the atrial level switch include myocardial dysfunction, rhythm disturbances requiring pacemaker placement, pulmonary hypertension and baffle obstruction.

Case report

We present a 23-year-old woman, who had undergone an atrial level switch during infancy for palliation of TGA and now presents for laparoscopic vertical sleeve gastrectomy for the treatment of obesity.

Conclusions

The long term end-organ effects of an atrial level switch for TGA are reviewed and the perioperative of these patients is discussed.

Transposition of Great Arteries, Congenital Heart Disease, Bariatric Surgery Transposition of Great Arteries, Congenital Heart Disease, Bariatric Surgery http://www.minsurgery.portal.tools/index.php?page=article&article_id=7834 Nicole Elsey Nicole Elsey Departments of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio Departments of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio Chris McKee Chris McKee Departments of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio Departments of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio Marc Michalsky Marc Michalsky Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, Ohio Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, Ohio Joseph D. Tobias Joseph D. Tobias Departments of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio; Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio. Tel: +614-7224200, Fax: +614-7224203 Departments of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio; Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio. Tel: +614-7224200, Fax: +614-7224203
en Intraluminal Clot Formation Causing Obstruction After Laparoscopic Roux-en-Y Gastric Bypass Intraluminal Clot Formation Causing Obstruction After Laparoscopic Roux-en-Y Gastric Bypass case-report case-report Abstract

Bowel obstruction is a known complication after bariatric surgery especially Roux-en-Y gastric bypass. The known etiologies include internal hernia, jejunojejunostomy stricture, ileus, intussusceptions, superior mesenteric artery syndrome, incarcerated port site hernia, and adhesions. Blood clot is a rare cause of small intestinal obstruction after laparoscopic Roux-en-Y gastric bypass surgery. We elucidate a rare case of small bowel obstruction after Roux-en-Y gastric bypass due to blood clot in about 90 cm distant from ileocecal valve.

Abstract

Bowel obstruction is a known complication after bariatric surgery especially Roux-en-Y gastric bypass. The known etiologies include internal hernia, jejunojejunostomy stricture, ileus, intussusceptions, superior mesenteric artery syndrome, incarcerated port site hernia, and adhesions. Blood clot is a rare cause of small intestinal obstruction after laparoscopic Roux-en-Y gastric bypass surgery. We elucidate a rare case of small bowel obstruction after Roux-en-Y gastric bypass due to blood clot in about 90 cm distant from ileocecal valve.

Bezoars;Gastric Bypass;Intestinal Obstruction Bezoars;Gastric Bypass;Intestinal Obstruction http://www.minsurgery.portal.tools/index.php?page=article&article_id=8471 Abdolreza Pazouki Abdolreza Pazouki Abdolreza Pazouki, Minimally Invasive Surgery Research Center, Hazrat Rasoul Medical Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Abdolreza Pazouki, Minimally Invasive Surgery Research Center, Hazrat Rasoul Medical Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Ali Jangjoo Ali Jangjoo Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118022664, Fax: +98-5118525255 Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118022664, Fax: +98-5118525255 Mohammad Ali Pakaneh Mohammad Ali Pakaneh Abdolreza Pazouki, Minimally Invasive Surgery Research Center, Hazrat Rasoul Medical Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Abdolreza Pazouki, Minimally Invasive Surgery Research Center, Hazrat Rasoul Medical Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
en Intrahepatic Glissonian Approach in laparoscopic Right Hepatectomy Intrahepatic Glissonian Approach in laparoscopic Right Hepatectomy case-report case-report Introduction

Laparoscopic surgery is still uncommon for major liver resections. The intrahepatic Glissonian approach is a fast and secure way to control the hepatic pedicle.

Case Presentation

A patient diagnosed with stenosing sigmoid adenocarcinoma (T3 N1 M+) (N+, positive lymph nodes, M+ positive metastatic desease)with synchronous liver metastases in segments 7 (8 mm), 6-7 (6 cm) and 3 (12 mm) was recruited to the study. Laparoscopic sigmoidectomy was performed; after a partial response to neoadjuvant chemotherapy, a right hepatectomy was performed. Surgery was performed in the modified Lloyd Davies position by placing 5 trocars. The hepatic pedicle was controlled by the intrahepatic individualized section of the right Glissonian anterior and posterior pedicles. The operation lasted for 5 hours. No intraoperative or postoperative complications occurred. The patient was discharged from the hospital on the fourth postoperative day. The final histopathology showed metastatic colorectal adenocarcinoma in segments 6-7 with right hepatic vein involvement and tumor-free margins.

Conclusions

Although this approach is beneficial, it should be performed by experienced surgeons. We believe that this technique is faster, safer, easier and more reproducible than hilar dissection. This approach can help develop the use of minimally invasive surgery for major liver resections.

Introduction

Laparoscopic surgery is still uncommon for major liver resections. The intrahepatic Glissonian approach is a fast and secure way to control the hepatic pedicle.

Case Presentation

A patient diagnosed with stenosing sigmoid adenocarcinoma (T3 N1 M+) (N+, positive lymph nodes, M+ positive metastatic desease)with synchronous liver metastases in segments 7 (8 mm), 6-7 (6 cm) and 3 (12 mm) was recruited to the study. Laparoscopic sigmoidectomy was performed; after a partial response to neoadjuvant chemotherapy, a right hepatectomy was performed. Surgery was performed in the modified Lloyd Davies position by placing 5 trocars. The hepatic pedicle was controlled by the intrahepatic individualized section of the right Glissonian anterior and posterior pedicles. The operation lasted for 5 hours. No intraoperative or postoperative complications occurred. The patient was discharged from the hospital on the fourth postoperative day. The final histopathology showed metastatic colorectal adenocarcinoma in segments 6-7 with right hepatic vein involvement and tumor-free margins.

Conclusions

Although this approach is beneficial, it should be performed by experienced surgeons. We believe that this technique is faster, safer, easier and more reproducible than hilar dissection. This approach can help develop the use of minimally invasive surgery for major liver resections.

Hepatectomy;Laparoscopy;Neoplasm Metastasis Hepatectomy;Laparoscopy;Neoplasm Metastasis http://www.minsurgery.portal.tools/index.php?page=article&article_id=11347 Jose F Noguera Jose F Noguera Consorcio Hospital General Universitario de Valencia, Spain; Consorcio Hospital General Universitario de Valencia, Valencia, Spain. Tel: +34 961972000, Fax: +34 96197292 Consorcio Hospital General Universitario de Valencia, Spain; Consorcio Hospital General Universitario de Valencia, Valencia, Spain. Tel: +34 961972000, Fax: +34 96197292 Gonzalo Martin Gonzalo Martin Consorcio Hospital General Universitario de Valencia, Spain Consorcio Hospital General Universitario de Valencia, Spain Jose Munoz Jose Munoz Hospital Son Llàtzer, Palma de Mallorca, Spain Hospital Son Llàtzer, Palma de Mallorca, Spain Jose C Vicens Jose C Vicens Hospital Son Llàtzer, Palma de Mallorca, Spain Hospital Son Llàtzer, Palma de Mallorca, Spain Jose V Roig Jose V Roig Consorcio Hospital General Universitario de Valencia, Spain Consorcio Hospital General Universitario de Valencia, Spain
en Endoscopic Excision of Angular Dermoid in a Pediatric Patient: a Case Report Endoscopic Excision of Angular Dermoid in a Pediatric Patient: a Case Report case-report case-report

A 10 year old boy presented with swelling on the temporal side of the left eyebrow since birth. With the diagnosis of angular dermoid, we chose subcutaneous endoscopic excision for its treatment, as direct excision of dermoid cysts of the eyebrow might have caused a prominent facial scar for him, which can be completely avoided with an endoscopic approach that places the incision in the hair-bearing portion of the scalp.

A 10 year old boy presented with swelling on the temporal side of the left eyebrow since birth. With the diagnosis of angular dermoid, we chose subcutaneous endoscopic excision for its treatment, as direct excision of dermoid cysts of the eyebrow might have caused a prominent facial scar for him, which can be completely avoided with an endoscopic approach that places the incision in the hair-bearing portion of the scalp.

Dermoid Cysts;Endoscopy;Pediatrics Dermoid Cysts;Endoscopy;Pediatrics http://www.minsurgery.portal.tools/index.php?page=article&article_id=11389 Rahul Kumar Gupta Rahul Kumar Gupta Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India; Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India. Tel/Fax: +91-9833112941 Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India; Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India. Tel/Fax: +91-9833112941 Abhaya Gupta Abhaya Gupta Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Paras Kothari Paras Kothari Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Krushna Kumar Kesan Krushna Kumar Kesan Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Kedar Mudkhedkar Kedar Mudkhedkar Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India Department of Pediatric Surgery, LTMMC and LTMGH Sion, Mumbai, India
en Single Incision Lift Laparoscopic Surgeries [Sills]: Taking Modern Surgery to the Poor Single Incision Lift Laparoscopic Surgeries [Sills]: Taking Modern Surgery to the Poor case-report case-report

Laparoscopic surgery is now an integral part of the operative repertoire. Single-incision laparoscopic surgery (SILS) is a new technique developed for performing operations without a visible scar. Pneumoperitoneum, as a necessary precondition of laparoscopic procedures, represents the restriction of the surgeon's freedom of movement and can lead to rare but typical complications. The Single Incision Lift Laparoscopic surgery is advantageous. We presented our experience of 194 surgeries carries out this method since March 2012. This procedure is ideal in rural areas because it is cheap, safe and simple.

Laparoscopic surgery is now an integral part of the operative repertoire. Single-incision laparoscopic surgery (SILS) is a new technique developed for performing operations without a visible scar. Pneumoperitoneum, as a necessary precondition of laparoscopic procedures, represents the restriction of the surgeon's freedom of movement and can lead to rare but typical complications. The Single Incision Lift Laparoscopic surgery is advantageous. We presented our experience of 194 surgeries carries out this method since March 2012. This procedure is ideal in rural areas because it is cheap, safe and simple.

Appendectomy;Laparoscopy;Abdominal Wall Appendectomy;Laparoscopy;Abdominal Wall http://www.minsurgery.portal.tools/index.php?page=article&article_id=11465 Gnanaraj Jesudian Gnanaraj Jesudian Karunya Community Hospital, Karunya University, Coimbatore, India; Karunya Community Hospital, Karunya University, Coimbatore, India. Tel/Fax: +91-9500127271 Karunya Community Hospital, Karunya University, Coimbatore, India; Karunya Community Hospital, Karunya University, Coimbatore, India. Tel/Fax: +91-9500127271