Pub Date : 2017-12-02DOI: 10.5812/MINSURGERY.57142
Ali Solouki, A. Khalaj, A. Pazouki
: Colon polyps are a relatively common problem which necessitates a colonoscopic polypectomy. It has its own limitations in surgery. Sessile or large polyps or those at unavailable section (ie: in mesenteric border of colon) are not suitable for a colonoscopic approach for excision. Furthermore, in colonoscopic resection, there is a frustrating risk of a colon wall perforation that not diagnosed intraoperatively. By the help of Combined Endoscopic Laparoscopic Surgery (CELS), a more aggressive polypectomy could be done while the colon wall monitored intraoperatively via laparoscopy and there is an appropriate possibility of colon wall repair if any perforation had occurred .This is a new method in diagnostic and curative surgical approaching to nonmalignant colon lesion that needs a coherent cooperation between laparoscopy and colonoscopy for performing a safe colonoscopic polypectomy.
{"title":"Combined Endoscopic Laparoscopic Surgery (CELS): A Mini Review","authors":"Ali Solouki, A. Khalaj, A. Pazouki","doi":"10.5812/MINSURGERY.57142","DOIUrl":"https://doi.org/10.5812/MINSURGERY.57142","url":null,"abstract":": Colon polyps are a relatively common problem which necessitates a colonoscopic polypectomy. It has its own limitations in surgery. Sessile or large polyps or those at unavailable section (ie: in mesenteric border of colon) are not suitable for a colonoscopic approach for excision. Furthermore, in colonoscopic resection, there is a frustrating risk of a colon wall perforation that not diagnosed intraoperatively. By the help of Combined Endoscopic Laparoscopic Surgery (CELS), a more aggressive polypectomy could be done while the colon wall monitored intraoperatively via laparoscopy and there is an appropriate possibility of colon wall repair if any perforation had occurred .This is a new method in diagnostic and curative surgical approaching to nonmalignant colon lesion that needs a coherent cooperation between laparoscopy and colonoscopy for performing a safe colonoscopic polypectomy.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131031846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-30DOI: 10.5812/MINSURGERY.57109
A. Malik, Idrees Ayoub, M. Wani, S. Bari
Background: laparoscopic treatment of hepatic hydatid disease has undergone revolution in parallel to progress in laparoscopic surgery. Controversiesabouttherolelaparoscopyinthemanagementof liverhydatidcysthavenotbeenresolvedbecauseof scarce experience worldwide. Objectives: The aim of our study was to compare surgical outcome of laparoscopic approach with open surgery for the management of hepatic hydatid disease. Methods: It was a retrospective and prospective study conducted in the department of surgery SKIMS Srinagar over a period of eight years from January 2008 to January 2016 in Sheri Kashmir institute of medical sciences Srinagar India, Srinagar. The study included all the adult patients admitted with a diagnosis of hepatic hydatid disease and the total number of patients studied was 80. All patients were pre-operatively and post- operatively treated with Albendazole. The patients were alternately taken either for laparoscopic approach or for open approach. For data that was included retrospectively patients were enrolled in either groups based upon the type of surgery they had undergone. Patients were followed for any recurrence for a period ranging from one year to six years with an average follow up period of 24 months. All the data was entered in detailed proforma and analysed. Results: Mean age of presentation was 40.27 years in open group and 38.80 years for laparoscopic group. Majority of patients (55%) presented with pain abdomen. Mean operative time was 60.43 minutes in open group and 89.80 min. for laparoscopic group. Two patients (5%) from the laparoscopic group had to be converted to open. In laparoscopic group mean hospital stay was 3.40 days whileinopengroupitwas8.73days. Meantimetoreturntoworkwas8.10daysinlaparoscopicgroupand20.70daysinopengroup. In laparoscopic group none of the patients had surgical site infection while as in open group 4 (10%) had surgical site infection. In laparoscopicgroup,biliaryleakwasseenin3(7.5%)patients,whileinopengroupitwasseenin2(5%)patients. Recurrencewasseen in2(5%)patientswhounderwentopensurgery,whileasrecurrencewasnotseeninanyof thepatientswhounderwentlaparoscopic surgery. Conclusions: Based on our encouraging results from our current study, we conclude that laparoscopic hydatid surgery is safe and feasible for selected patients in which criteria is met, motivated primarily by lower post-operative morbidity, mortality and recurrence. there was no recurrence in laparoscopic group while as in open group 5% had recurrence. Lower recurrence in our study was attributed to use of Albenda-zolepreandpostoperativelyinpatientsof hepatichydatid cysts. Variousstudies(17)haveshownzerorecurrencerates in patients treated with Albendazole pre and post operatively.
{"title":"Laparoscopic Versus Conventional Surgery for Hepatic Hydatid Disease: A Comparative Study","authors":"A. Malik, Idrees Ayoub, M. Wani, S. Bari","doi":"10.5812/MINSURGERY.57109","DOIUrl":"https://doi.org/10.5812/MINSURGERY.57109","url":null,"abstract":"Background: laparoscopic treatment of hepatic hydatid disease has undergone revolution in parallel to progress in laparoscopic surgery. Controversiesabouttherolelaparoscopyinthemanagementof liverhydatidcysthavenotbeenresolvedbecauseof scarce experience worldwide. Objectives: The aim of our study was to compare surgical outcome of laparoscopic approach with open surgery for the management of hepatic hydatid disease. Methods: It was a retrospective and prospective study conducted in the department of surgery SKIMS Srinagar over a period of eight years from January 2008 to January 2016 in Sheri Kashmir institute of medical sciences Srinagar India, Srinagar. The study included all the adult patients admitted with a diagnosis of hepatic hydatid disease and the total number of patients studied was 80. All patients were pre-operatively and post- operatively treated with Albendazole. The patients were alternately taken either for laparoscopic approach or for open approach. For data that was included retrospectively patients were enrolled in either groups based upon the type of surgery they had undergone. Patients were followed for any recurrence for a period ranging from one year to six years with an average follow up period of 24 months. All the data was entered in detailed proforma and analysed. Results: Mean age of presentation was 40.27 years in open group and 38.80 years for laparoscopic group. Majority of patients (55%) presented with pain abdomen. Mean operative time was 60.43 minutes in open group and 89.80 min. for laparoscopic group. Two patients (5%) from the laparoscopic group had to be converted to open. In laparoscopic group mean hospital stay was 3.40 days whileinopengroupitwas8.73days. Meantimetoreturntoworkwas8.10daysinlaparoscopicgroupand20.70daysinopengroup. In laparoscopic group none of the patients had surgical site infection while as in open group 4 (10%) had surgical site infection. In laparoscopicgroup,biliaryleakwasseenin3(7.5%)patients,whileinopengroupitwasseenin2(5%)patients. Recurrencewasseen in2(5%)patientswhounderwentopensurgery,whileasrecurrencewasnotseeninanyof thepatientswhounderwentlaparoscopic surgery. Conclusions: Based on our encouraging results from our current study, we conclude that laparoscopic hydatid surgery is safe and feasible for selected patients in which criteria is met, motivated primarily by lower post-operative morbidity, mortality and recurrence. there was no recurrence in laparoscopic group while as in open group 5% had recurrence. Lower recurrence in our study was attributed to use of Albenda-zolepreandpostoperativelyinpatientsof hepatichydatid cysts. Variousstudies(17)haveshownzerorecurrencerates in patients treated with Albendazole pre and post operatively.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116985018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-27DOI: 10.5812/MINSURGERY.62987
S. Çalışkan, M. Sungur
Background: Laparoscopic stone surgery has some advantages in the anatomical anomalies, comcominant of ureteropelvic junction obstruction and stone, symptomatic stone of diverticulosis, impacted large renal and ureteral stones. The results of the patients’ characteristics and complications who underwent laparoscopic surgery were evaluated and presented. Methods: The patients who were treated by laparoscopic surgery from January 2014 to June 2016 for ureteral and kidney stone were reviewed retrospectively. Transperitoneal method was performed in all patients. In this method; near 1 cm from the umbilicus was incised for to access the abdomen. CO2 was used to create pneumoperitoneum. Operation time, duration of hospitalization, the complications were recorded during and after the surgery. Results: There are 2 female and 5 male patients. The mean age of the patients and stone size was 46.28 + 15.52 years and 25.28 + 5.17 mm respectively. Average hospital stay was 4 + 3.94 days. There was no major complications Such as bleeding, injury to internal organs During surgery. One patient (% 14.28) was converted to open surgery. The mean operation time of the remaining patients was 152 + 57.61 minutes. The stone free rate was 100%. Double j stent was inserted into four patient during the operation and one patient in postoperative period. The patients who underwent pyelolithotomy did not need stent placement. Percutaneousnephrostomy was performed in one patients because of prolonged drainage and ureteral stricture (16.66%) was detected in postoperative period. Conclusions: Laparoscopic stone surgery has a high succes rate. The urologist who were taken basic training of laparoscopy can be performed succesfully.
{"title":"Laparoscopic Stone Surgery: One Surgeon Experience","authors":"S. Çalışkan, M. Sungur","doi":"10.5812/MINSURGERY.62987","DOIUrl":"https://doi.org/10.5812/MINSURGERY.62987","url":null,"abstract":"Background: Laparoscopic stone surgery has some advantages in the anatomical anomalies, comcominant of ureteropelvic junction obstruction and stone, symptomatic stone of diverticulosis, impacted large renal and ureteral stones. The results of the patients’ characteristics and complications who underwent laparoscopic surgery were evaluated and presented. Methods: The patients who were treated by laparoscopic surgery from January 2014 to June 2016 for ureteral and kidney stone were reviewed retrospectively. Transperitoneal method was performed in all patients. In this method; near 1 cm from the umbilicus was incised for to access the abdomen. CO2 was used to create pneumoperitoneum. Operation time, duration of hospitalization, the complications were recorded during and after the surgery. Results: There are 2 female and 5 male patients. The mean age of the patients and stone size was 46.28 + 15.52 years and 25.28 + 5.17 mm respectively. Average hospital stay was 4 + 3.94 days. There was no major complications Such as bleeding, injury to internal organs During surgery. One patient (% 14.28) was converted to open surgery. The mean operation time of the remaining patients was 152 + 57.61 minutes. The stone free rate was 100%. Double j stent was inserted into four patient during the operation and one patient in postoperative period. The patients who underwent pyelolithotomy did not need stent placement. Percutaneousnephrostomy was performed in one patients because of prolonged drainage and ureteral stricture (16.66%) was detected in postoperative period. Conclusions: Laparoscopic stone surgery has a high succes rate. The urologist who were taken basic training of laparoscopy can be performed succesfully.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124838270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-23DOI: 10.5812/MINSURGERY.64665
S. Yasri, V. Wiwanitkit
Dear Editor, Dengue is an important arbovirus infection that becomes the public health threaten in several countries, at present. The expansion of the endemic area to non-tropical area results in new emerging infection in several countries. The dengue is generally an acute febrile illness with hemorrhagic complication (1). The hemorrhagic complication in dengue has a wide clinical spectrum and it is sometime serious (2). The requirement of surgical management is sometimes an important concern for the surgeon. Some dengue patients with severe bleeding such as massive gastrointestinal bleeding might need surgical management and the minimally invasive surgery plays an important role in those cases. The endoscopic management is proved useful in that situation (3, 4). Nevertheless, the transfusion is usually required for correction of the hemostatic problem in those cases since only endoscopic injection treatment is usually not adequate for management (5). The recommendation on using minimally invasive surgery in dengue patient is still controversial. Some studies report that, the minimally invasive surgery in dengue patient is discouraged due to the limitation of effectiveness (6). According to a recent report from Malaysia, Ng et al. concluded that “early surgical intervention in perforated gastric ulcer is vital in preventing further complication and reducing the risk of mortality (7).” In case with suspicious hemoperitoneum due to dengue, the laparoscope approach is also reported as a safe diagnostic approach (8). In order to select a minimally invasive surgery in dengue patient, several considerations, especially patient’s condition are important. A supportive primary prevention by recombinant hemostatic agent should be considered in case with high risk (9). In case which require emergency surgery, the use of classical approach is indicated and the appropriated plan for platelet transfusion helps improve clinical outcome (10). A specific study in this issue is interesting and recommended.
{"title":"Minimally Invasive Surgery in Dengue Patient","authors":"S. Yasri, V. Wiwanitkit","doi":"10.5812/MINSURGERY.64665","DOIUrl":"https://doi.org/10.5812/MINSURGERY.64665","url":null,"abstract":"Dear Editor, Dengue is an important arbovirus infection that becomes the public health threaten in several countries, at present. The expansion of the endemic area to non-tropical area results in new emerging infection in several countries. The dengue is generally an acute febrile illness with hemorrhagic complication (1). The hemorrhagic complication in dengue has a wide clinical spectrum and it is sometime serious (2). The requirement of surgical management is sometimes an important concern for the surgeon. Some dengue patients with severe bleeding such as massive gastrointestinal bleeding might need surgical management and the minimally invasive surgery plays an important role in those cases. The endoscopic management is proved useful in that situation (3, 4). Nevertheless, the transfusion is usually required for correction of the hemostatic problem in those cases since only endoscopic injection treatment is usually not adequate for management (5). The recommendation on using minimally invasive surgery in dengue patient is still controversial. Some studies report that, the minimally invasive surgery in dengue patient is discouraged due to the limitation of effectiveness (6). According to a recent report from Malaysia, Ng et al. concluded that “early surgical intervention in perforated gastric ulcer is vital in preventing further complication and reducing the risk of mortality (7).” In case with suspicious hemoperitoneum due to dengue, the laparoscope approach is also reported as a safe diagnostic approach (8). In order to select a minimally invasive surgery in dengue patient, several considerations, especially patient’s condition are important. A supportive primary prevention by recombinant hemostatic agent should be considered in case with high risk (9). In case which require emergency surgery, the use of classical approach is indicated and the appropriated plan for platelet transfusion helps improve clinical outcome (10). A specific study in this issue is interesting and recommended.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129206566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.5812/MINSURGERY.62031
M. Rezvani
As the overweight and obesity are the significant public health concern and rises globally; scientist, surgeons, bariatrician and pharmacists are in a serious attempt to treat this syndrome by different way of approach. New medication and occasional devices are coming on board and introduced to this field. According to Noah Yuval Hariri “A Brief History of Tomorrow” in 2012 about 56 million people passed away throughout the entire world; 620,000 of them died because of human violence (war killed 120,000 people, and crime killed another 500,000). In contrast, 800,000 committed suicides happened and 1.5 million died of diabetes. He concludes that Sugar and obesity in follow is more dangerous than gun power (1). Although intra gastric balloon is not a new device in the world, it was introduced to the United States for weight loss purpose relatively in a recent time. DeBakey’s review in 1938 showed that bezoars led to weight loss (2). Free floating intragastric balloons were used by Neiben and Harboe in 1982 (3). In 1985 the Garren-Edwards Bubble was introduced as the first food and drug administration (FDA)approved device, but the approval was withdrawn seven years later because of its accompanied complication (4). Analysis of its problems led to recommendations for noninvasive design. While numbers of further developed devices were used outside of the United States, mostly in Europe and South America, the FDA did not approve any new devices until 2015 (4). The device is intended to be used in patients with a body mass index (BMI) of 30 to 40 kg/m. (5). Since intra gastric balloon became available to bariatric surgeons in the United States, over 5000 patients have been done and the number of surgery is increasing. Currently there are three FDA approved balloons in the USA. Studies have suggested that fluid is superior to air for distending gastric balloons. Inflated balloons reduce the operative volume capacity of the stomach. While the typical gastric volume is about 900 mL, an inflated balloon may take up most of the space, about 700 (+/100) mL (6). Initial side effects of the balloon are common and may consist of nausea, vomiting, reflux, and stomach cramps. Other side effects or complications could be indigestion, bloating, flatulence, and diarrhea. Rare side effects include esophagitis, gastric ulcer formation, or gastric perforation (7). The device could become deflated and slip into the lower intestines. Migration of a balloon could lead to bowel obstruction and potentially perforation (8). Gastric balloons are generally considered to be safe and effective in the short run. There could be procedurerelated side effects due to endoscopy and anesthesia. Rarely, the endoscopic placement of a balloon could lead to death. According to The US FDA there are five reports of unanticipated deaths that occurred from 2016 to the present in patients who received a liquid-filled intragastric balloon to treat obesity. Four reports involve the orbera intragas
由于超重和肥胖是一个重大的公共卫生问题，并且在全球范围内呈上升趋势;科学家、外科医生、减肥专家和药剂师都在认真尝试用不同的方法来治疗这种综合征。新的药物和偶尔出现的设备正在进入这个领域。根据诺亚·尤瓦尔·哈里里(Noah Yuval Hariri)的《明日简史》(A Brief History of Tomorrow)， 2012年全世界约有5600万人去世;其中62万人死于人类暴力(战争导致12万人死亡，犯罪导致50万人死亡)。相比之下，有80万人自杀，150万人死于糖尿病。他的结论是，糖和肥胖在随访中比枪的威力更危险(1)。虽然胃内气囊在世界上并不是一种新设备，但在美国，它是最近才被引入到减肥目的的。DeBakey在1938年的综述表明，牛粪可以减轻体重(2)。Neiben和Harboe在1982年使用了自由漂浮的胃内气球(3)。1985年，Garren-Edwards气泡作为第一个获得美国食品和药物管理局(FDA)批准的设备被引入，但由于其伴随的并发症，该批准在7年后被撤回(4)。对其问题的分析导致了对无创设计的建议。虽然许多进一步开发的设备在美国以外的地区使用，主要是在欧洲和南美，但FDA直到2015年才批准任何新设备(4)。该设备旨在用于体重指数(BMI)为30至40 kg/m的患者。(5)自从胃内球囊术在美国应用于减肥外科医生以来，已经有超过5000名患者接受了这种手术，而且手术的数量还在增加。目前，美国有三种经FDA批准的气球。研究表明，液体比空气更适合扩张胃球囊。膨胀的气球会减少胃的手术容量。典型的胃容量约为900 mL，充气球囊可能占据大部分空间，约700 (+/100)mL(6)。球囊最初的副作用很常见，可能包括恶心、呕吐、反流和胃痉挛。其他副作用或并发症可能是消化不良、腹胀、胀气和腹泻。罕见的副作用包括食管炎、胃溃疡形成或胃穿孔(7)。该装置可能会变瘪并滑入下肠。球囊的移动可能导致肠梗阻和潜在穿孔(8)。一般认为胃球囊在短期内是安全有效的。由于内窥镜检查和麻醉，可能会有手术相关的副作用。在内窥镜下放置气球很少会导致死亡。根据美国食品和药物管理局的数据，从2016年到现在，有5例接受充液胃内球囊治疗肥胖的患者意外死亡的报告。四份报告涉及orbera胃内球囊系统(Apollo Endosurgery)，一份报告涉及重塑集成双球囊系统(重塑医学)。5例患者均在球囊放置后1个月内死亡。3例患者在气囊放置后1 ~ 3天死亡。今天的安全警报已发送给医疗保健提供者，以密切监测使用充液胃内球囊系统治疗肥胖的患者。从那时起，两家公司都根据FDA的建议修改了他们的产品标签，以解决这些风险(9)。如今，FDA继续建议医疗保健提供者密切监测使用这些设备治疗的患者的并发症，并通过胃内气囊系统报告任何不良事件
{"title":"The Journey of Intragastric Balloon from Past to Today, Future Perspective","authors":"M. Rezvani","doi":"10.5812/MINSURGERY.62031","DOIUrl":"https://doi.org/10.5812/MINSURGERY.62031","url":null,"abstract":"As the overweight and obesity are the significant public health concern and rises globally; scientist, surgeons, bariatrician and pharmacists are in a serious attempt to treat this syndrome by different way of approach. New medication and occasional devices are coming on board and introduced to this field. According to Noah Yuval Hariri “A Brief History of Tomorrow” in 2012 about 56 million people passed away throughout the entire world; 620,000 of them died because of human violence (war killed 120,000 people, and crime killed another 500,000). In contrast, 800,000 committed suicides happened and 1.5 million died of diabetes. He concludes that Sugar and obesity in follow is more dangerous than gun power (1). Although intra gastric balloon is not a new device in the world, it was introduced to the United States for weight loss purpose relatively in a recent time. DeBakey’s review in 1938 showed that bezoars led to weight loss (2). Free floating intragastric balloons were used by Neiben and Harboe in 1982 (3). In 1985 the Garren-Edwards Bubble was introduced as the first food and drug administration (FDA)approved device, but the approval was withdrawn seven years later because of its accompanied complication (4). Analysis of its problems led to recommendations for noninvasive design. While numbers of further developed devices were used outside of the United States, mostly in Europe and South America, the FDA did not approve any new devices until 2015 (4). The device is intended to be used in patients with a body mass index (BMI) of 30 to 40 kg/m. (5). Since intra gastric balloon became available to bariatric surgeons in the United States, over 5000 patients have been done and the number of surgery is increasing. Currently there are three FDA approved balloons in the USA. Studies have suggested that fluid is superior to air for distending gastric balloons. Inflated balloons reduce the operative volume capacity of the stomach. While the typical gastric volume is about 900 mL, an inflated balloon may take up most of the space, about 700 (+/100) mL (6). Initial side effects of the balloon are common and may consist of nausea, vomiting, reflux, and stomach cramps. Other side effects or complications could be indigestion, bloating, flatulence, and diarrhea. Rare side effects include esophagitis, gastric ulcer formation, or gastric perforation (7). The device could become deflated and slip into the lower intestines. Migration of a balloon could lead to bowel obstruction and potentially perforation (8). Gastric balloons are generally considered to be safe and effective in the short run. There could be procedurerelated side effects due to endoscopy and anesthesia. Rarely, the endoscopic placement of a balloon could lead to death. According to The US FDA there are five reports of unanticipated deaths that occurred from 2016 to the present in patients who received a liquid-filled intragastric balloon to treat obesity. Four reports involve the orbera intragas","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130424616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.5812/MINSURGERY.57116
Mahsa Hatami, Gholamreza Mohammadi-Farsani
Background: Migraine is a common and chronic neuro-inflammatory disease with progressive and episodic headache manifesta-tion that leads to considerable disability. Many studies recognized that obesity is a risk factor for progression of migraine. Further-more,bothmigraineandobesityishighlyprevalentandimportantriskfactorsof chroniccardiovasculardisease,stroke,andother inflammatory disease. Thus, it is very important if weight loss could alleviate the migraine headache and its related comorbidities. Aim: The present review article was conducted to assess the potential effect of Bariatric surgery on improvement of migraine headaches in morbid obese patients. surgery”,“gastricBypass”;“MorbidObesity”and“Migraineheadache”forinterventionalstudiesinvestigatedtheimpactof Bariatric surgery on migraine headache. Results: The findings suggest significant improvement in headache frequency, duration, migraine-induced discomfort and migraine derived symptoms (nausea, phono and photophobia and) occurs as early as 3 months after bariatric surgery. Moreover, patients who had higher weight loss were more likely to experience a 50% or higher reduction in headache frequency, duration and severity. Conclusions: Theentireevidencessuggestpatientswithindicationsof bariatricsurgerywillbenefitfromtheimprovementsinthe Migraine headache after surgery. However, it remains unclear whether Bariatric-induced endocrine, gut-brain axis alterations, or reduction in adipokine contribute to migraine improvement, so further studies are needed to confirm and clarify these findings.
{"title":"The Effect of Bariatric Surgery on Migraine Headache in Morbid Obese Patients","authors":"Mahsa Hatami, Gholamreza Mohammadi-Farsani","doi":"10.5812/MINSURGERY.57116","DOIUrl":"https://doi.org/10.5812/MINSURGERY.57116","url":null,"abstract":"Background: Migraine is a common and chronic neuro-inflammatory disease with progressive and episodic headache manifesta-tion that leads to considerable disability. Many studies recognized that obesity is a risk factor for progression of migraine. Further-more,bothmigraineandobesityishighlyprevalentandimportantriskfactorsof chroniccardiovasculardisease,stroke,andother inflammatory disease. Thus, it is very important if weight loss could alleviate the migraine headache and its related comorbidities. Aim: The present review article was conducted to assess the potential effect of Bariatric surgery on improvement of migraine headaches in morbid obese patients. surgery”,“gastricBypass”;“MorbidObesity”and“Migraineheadache”forinterventionalstudiesinvestigatedtheimpactof Bariatric surgery on migraine headache. Results: The findings suggest significant improvement in headache frequency, duration, migraine-induced discomfort and migraine derived symptoms (nausea, phono and photophobia and) occurs as early as 3 months after bariatric surgery. Moreover, patients who had higher weight loss were more likely to experience a 50% or higher reduction in headache frequency, duration and severity. Conclusions: Theentireevidencessuggestpatientswithindicationsof bariatricsurgerywillbenefitfromtheimprovementsinthe Migraine headache after surgery. However, it remains unclear whether Bariatric-induced endocrine, gut-brain axis alterations, or reduction in adipokine contribute to migraine improvement, so further studies are needed to confirm and clarify these findings.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134019093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.5812/MINSURGERY.61046
B. Joob, V. Wiwanitkit
Dear Editor, The role of minimally invasive surgery is confirmed by previous studies. Nowadays the mini-surgery technique is applied for several medical disorders. Also it could be applied cancer treatment; the technique can also be applied. Minimally invasive surgery is usually applied for the early stage of cancer and there is high incidence of success rate of the surgery. The technique also reduced the need for long term post-operative hospitalization (1). Here, the authors discussed about the use of minimally invasive surgery in cholangiocarcinoma in our setting, Indochina where the extremely high incidence of this deadly biliary tract caner can be seen. The main problem for management of cholangiocarcinoma in Indochina is the late presentation of the case to the physicians. Patients usually have advanced disease and the surgical management is extremely hard (2). In fact, the use of minimally invasive surgery in cholangiocarcinoma is used in some other medical centers in other regions. The recent publication from Italy noted that “Minimally invasive surgery seems feasible and safe especially for intrahepatic cholangiocarcinoma (3)”. However cases in Levi Sandri et al. study, that report covers the patients with early stage with intrahepatic cholangiocarcinoma. Which is different from cases in Indochina which are usually advanced in stage. In Thailand, a country in Indochina, there are some reports on using minimally invasive surgery technique for management of cholangiocarcinoma. The aim is usually palliative treatment and the hilar cholangiocarcinoma is the main type of cancer for mini-surgical management (4). The endocscopic surgery is proved effective for this purpose (4). The success drainage for reliving of the hyperbilirubinemia in patients with advanced disease is the main advantage of the technique (5). Recently, Panpimanmas and Ratanachu-eket al. reported the first trial on “endoscopic ultrasound-guided hepaticogastrostomy for hilar cholangiocarcinoma” and showed that “It can improve the palliative treatment in hilar lesions because it’s internal drainage and far from tumor site that promote fast recovery (6).” According to this study, this technique is feasible and safe comparing to standard surgery. It was finally concluded that “Endoscopic-ultrasound-guided hepaticogastrostomy is safe and can be a good palliative option for advanced malignant biliary obstruction because it drains internally and is remote from the tumor site, promoting a long patency period of prosthesis and better quality of life (7).” This observation is concordant with the report from other centers (8, 9). Based on the case of minimally invasive surgery for management of cholangiocarcinoma in Thailand, it could be concluded that the minimally invasive surgery still plays important role in management of cancerous patients with extremely advanced disease. The main role of the minimally invasive surgery is the management of the biliary obstruction due to non-remova
{"title":"Role of Minimally Invasive Surgery in Cholangiocarcinoma","authors":"B. Joob, V. Wiwanitkit","doi":"10.5812/MINSURGERY.61046","DOIUrl":"https://doi.org/10.5812/MINSURGERY.61046","url":null,"abstract":"Dear Editor, The role of minimally invasive surgery is confirmed by previous studies. Nowadays the mini-surgery technique is applied for several medical disorders. Also it could be applied cancer treatment; the technique can also be applied. Minimally invasive surgery is usually applied for the early stage of cancer and there is high incidence of success rate of the surgery. The technique also reduced the need for long term post-operative hospitalization (1). Here, the authors discussed about the use of minimally invasive surgery in cholangiocarcinoma in our setting, Indochina where the extremely high incidence of this deadly biliary tract caner can be seen. The main problem for management of cholangiocarcinoma in Indochina is the late presentation of the case to the physicians. Patients usually have advanced disease and the surgical management is extremely hard (2). In fact, the use of minimally invasive surgery in cholangiocarcinoma is used in some other medical centers in other regions. The recent publication from Italy noted that “Minimally invasive surgery seems feasible and safe especially for intrahepatic cholangiocarcinoma (3)”. However cases in Levi Sandri et al. study, that report covers the patients with early stage with intrahepatic cholangiocarcinoma. Which is different from cases in Indochina which are usually advanced in stage. In Thailand, a country in Indochina, there are some reports on using minimally invasive surgery technique for management of cholangiocarcinoma. The aim is usually palliative treatment and the hilar cholangiocarcinoma is the main type of cancer for mini-surgical management (4). The endocscopic surgery is proved effective for this purpose (4). The success drainage for reliving of the hyperbilirubinemia in patients with advanced disease is the main advantage of the technique (5). Recently, Panpimanmas and Ratanachu-eket al. reported the first trial on “endoscopic ultrasound-guided hepaticogastrostomy for hilar cholangiocarcinoma” and showed that “It can improve the palliative treatment in hilar lesions because it’s internal drainage and far from tumor site that promote fast recovery (6).” According to this study, this technique is feasible and safe comparing to standard surgery. It was finally concluded that “Endoscopic-ultrasound-guided hepaticogastrostomy is safe and can be a good palliative option for advanced malignant biliary obstruction because it drains internally and is remote from the tumor site, promoting a long patency period of prosthesis and better quality of life (7).” This observation is concordant with the report from other centers (8, 9). Based on the case of minimally invasive surgery for management of cholangiocarcinoma in Thailand, it could be concluded that the minimally invasive surgery still plays important role in management of cancerous patients with extremely advanced disease. The main role of the minimally invasive surgery is the management of the biliary obstruction due to non-remova","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125380867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.5812/MINSURGERY.55991
O. Abed, A. Kabir, F. Jesmi, L. Janani, P. Alibeigi, M. Abdolhosseini, F. Soheilipour, A. Pazouki
Background: Laparoscopic one anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are common treatments for morbid obese patients who suffer from type 2 diabetes mellitus (T2DM). It has been hypothesized that diabetes may be resolved or improved after bariatric procedures, although the exact effect has not been well established. The present study aimed to compare remission of T2DM after LRYGB versus OAGB in this study. Methods: All diabetic obese patients, aged between 16 to 60, who referred to Hazrat Rasul Akram obesity clinic from April 2010 to March 2013 for LRYGB or OAGB were included in the present study. Pre-operative parameters, including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), and type of diabetes medication were extracted from database and recorded. Pre-operative and three months postoperative values were then compared between the groups. Results: Out of 95 eligible patients, 50 patients underwent OAGB and 45 patients had LRYGB. The two groups were homogenous in distribution of gender, mean age, weight, BMI, and FPG; however, mean HbA1C was relatively higher in LRYGB group (P = 0.05) than other group, which was non-significant after adjustment. Rate of remission was significantly higher in OAGB group than other group after three months follow-up (64.0 versus 31.1%, respectively) (P = 0.002). Conclusions: In our short-term follow-up, OAGB had a higher rate of remission of T2DM compared to LRYGB, which could be due to different baseline value of HbA1c (before surgery) between two groups. Future research is thus suggested with linger follow-up and randomized study design.
{"title":"Laparoscopic Roux-en-Y versus One Anastomosis Gastric Bypass on Remission of Diabetes in Morbid Obesity","authors":"O. Abed, A. Kabir, F. Jesmi, L. Janani, P. Alibeigi, M. Abdolhosseini, F. Soheilipour, A. Pazouki","doi":"10.5812/MINSURGERY.55991","DOIUrl":"https://doi.org/10.5812/MINSURGERY.55991","url":null,"abstract":"Background: Laparoscopic one anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are common treatments for morbid obese patients who suffer from type 2 diabetes mellitus (T2DM). It has been hypothesized that diabetes may be resolved or improved after bariatric procedures, although the exact effect has not been well established. The present study aimed to compare remission of T2DM after LRYGB versus OAGB in this study. Methods: All diabetic obese patients, aged between 16 to 60, who referred to Hazrat Rasul Akram obesity clinic from April 2010 to March 2013 for LRYGB or OAGB were included in the present study. Pre-operative parameters, including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), and type of diabetes medication were extracted from database and recorded. Pre-operative and three months postoperative values were then compared between the groups. Results: Out of 95 eligible patients, 50 patients underwent OAGB and 45 patients had LRYGB. The two groups were homogenous in distribution of gender, mean age, weight, BMI, and FPG; however, mean HbA1C was relatively higher in LRYGB group (P = 0.05) than other group, which was non-significant after adjustment. Rate of remission was significantly higher in OAGB group than other group after three months follow-up (64.0 versus 31.1%, respectively) (P = 0.002). Conclusions: In our short-term follow-up, OAGB had a higher rate of remission of T2DM compared to LRYGB, which could be due to different baseline value of HbA1c (before surgery) between two groups. Future research is thus suggested with linger follow-up and randomized study design.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124073080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.5812/MINSURGERY.60053
A. Pazouki, L. Sadati, F. Zarei, E. Golchini, Robab Fruzesh, Jalal Bakhtiary
Background: Following the widespread approval of laparoscopic procedures, which impose certain restrictions on surgeons’ movements and access to information, extensive research has been conducted on improving ergonomic conditions in this field. Ergonomic studies have indicated high levels of physical workload among laparoscopic surgeons. Objectives: Thepurposeof thisstudywastoclarifythemajorergonomicchallengesfacedbylaparoscopicsurgeon,theirfirstassis-tants, and operating room nurses. Methods: This cross-sectional study recruited 62 volunteers with different levels of experience in minimally invasive surgeries between October 2014 and June 2015. Demographic data and the musculoskeletal disorder were collected by demographic question-naireandthenordicmusculoskeletalquestionnaire(NMQ).Laparoscopiccholecystectomyproceduresandsurgicalteammembers’ position were recorded by camera then evaluated via the rapid upper limb assessment (RULA) method by ErgoIntelligence – UEA software. The data were analyzed using T-test, ANOVA Test, pearson and Kendall correlation coefficient by using Spss 16 software. Results: 60%of participates are male and 40%are female. The Mean age of male and female participates are 43.94 and37.62, respectively. There is a significant relationship between weight, height and work experience with musculoskeletal disorders and jobs and RULA score. The surgeons had the highest score in Rulla method. Pearson correlation coefficient also showed a significant relationship between age and RULA score. Conclusions: The majority of the participants complained of pain and discomfort after laparoscopy, therefore it is imperative to consider ergonomic issues during such procedures. relationship between weight and height and work experience with RULA score. Kendall’s correlation coefficient did not show a significant relationship between jobs and musculoskeletal disorders.
{"title":"Ergonomic Challenges Encountered by Laparoscopic Surgeons, Surgical First Assistants, and Operating Room Nurses Involved in Minimally Invasive Surgeries by Using RULA Method","authors":"A. Pazouki, L. Sadati, F. Zarei, E. Golchini, Robab Fruzesh, Jalal Bakhtiary","doi":"10.5812/MINSURGERY.60053","DOIUrl":"https://doi.org/10.5812/MINSURGERY.60053","url":null,"abstract":"Background: Following the widespread approval of laparoscopic procedures, which impose certain restrictions on surgeons’ movements and access to information, extensive research has been conducted on improving ergonomic conditions in this field. Ergonomic studies have indicated high levels of physical workload among laparoscopic surgeons. Objectives: Thepurposeof thisstudywastoclarifythemajorergonomicchallengesfacedbylaparoscopicsurgeon,theirfirstassis-tants, and operating room nurses. Methods: This cross-sectional study recruited 62 volunteers with different levels of experience in minimally invasive surgeries between October 2014 and June 2015. Demographic data and the musculoskeletal disorder were collected by demographic question-naireandthenordicmusculoskeletalquestionnaire(NMQ).Laparoscopiccholecystectomyproceduresandsurgicalteammembers’ position were recorded by camera then evaluated via the rapid upper limb assessment (RULA) method by ErgoIntelligence – UEA software. The data were analyzed using T-test, ANOVA Test, pearson and Kendall correlation coefficient by using Spss 16 software. Results: 60%of participates are male and 40%are female. The Mean age of male and female participates are 43.94 and37.62, respectively. There is a significant relationship between weight, height and work experience with musculoskeletal disorders and jobs and RULA score. The surgeons had the highest score in Rulla method. Pearson correlation coefficient also showed a significant relationship between age and RULA score. Conclusions: The majority of the participants complained of pain and discomfort after laparoscopy, therefore it is imperative to consider ergonomic issues during such procedures. relationship between weight and height and work experience with RULA score. Kendall’s correlation coefficient did not show a significant relationship between jobs and musculoskeletal disorders.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127434337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.5812/MINSURGERY.14053
S. Yazdani, M. Akbarilakeh
Background: Theneedforinternalizationof valuesforprofessionaldevelopmentinmedicineandsurgery,andsenseof dutylinked to the practice of the medical professionalism were recognized in Iran. With regard to the shortcomings currently existed in the curriculumof themedicaleducation,in2013,thedesignof anoperationalmodelforthecurriculumbasedonvalueswasplacedon the agenda through the PhD thesis. Objectives: The aim of this study is to develop the operational model of the value-based curriculum for medicine and surgery education with respect to indigenous values in Shahid Beheshti University of Medical Sciences, Tehran, Iran. Methods: Our value-based curriculum model was developed through qualitative ontology foundations of Hugh McKenna concept analysis. Finally we developed our operational model by comparing our domestic extracted attributes with what is existed and ex-periencedinothercountriesthroughsystematizedsearching,determinedtheprocessof valuecurriculum,thesequenceof process steps, menu and taxonomy for operationalization of each step, and recommended practices for each step for integration of values in medicine and surgery education in Iran. Results: Ten steps of curriculum model for integration of values in medicine and surgery education include: general need assessment of values, designing hierarchy system of values, need assessment of targeted learners’ values, developing value programme statement, determination of value outcomes and objectives, production of value rich content, value based teaching and learning methods, value based settings, value themes management, determination of values evaluation and assessment methods. Conclusions: This Indigenous operational model of value based curriculum proposes the process with exact sequence for the con-creteimplementationof valueseducationinmedicineandsurgery,accordancewithourcountryoffers. Theoperationalvaluebased curriculummodelwaspreparedinordertodevelopapracticalguidelineforvaluebasedexperimentsinmedicineandsurgery,helps to move from the information level and expressing factual knowledge, to the conceptual and judgment level, understanding the connections and interactions between facts and analysis them.
{"title":"The Model of Value-Based Curriculum for Medicine and Surgery Education in Iran","authors":"S. Yazdani, M. Akbarilakeh","doi":"10.5812/MINSURGERY.14053","DOIUrl":"https://doi.org/10.5812/MINSURGERY.14053","url":null,"abstract":"Background: Theneedforinternalizationof valuesforprofessionaldevelopmentinmedicineandsurgery,andsenseof dutylinked to the practice of the medical professionalism were recognized in Iran. With regard to the shortcomings currently existed in the curriculumof themedicaleducation,in2013,thedesignof anoperationalmodelforthecurriculumbasedonvalueswasplacedon the agenda through the PhD thesis. Objectives: The aim of this study is to develop the operational model of the value-based curriculum for medicine and surgery education with respect to indigenous values in Shahid Beheshti University of Medical Sciences, Tehran, Iran. Methods: Our value-based curriculum model was developed through qualitative ontology foundations of Hugh McKenna concept analysis. Finally we developed our operational model by comparing our domestic extracted attributes with what is existed and ex-periencedinothercountriesthroughsystematizedsearching,determinedtheprocessof valuecurriculum,thesequenceof process steps, menu and taxonomy for operationalization of each step, and recommended practices for each step for integration of values in medicine and surgery education in Iran. Results: Ten steps of curriculum model for integration of values in medicine and surgery education include: general need assessment of values, designing hierarchy system of values, need assessment of targeted learners’ values, developing value programme statement, determination of value outcomes and objectives, production of value rich content, value based teaching and learning methods, value based settings, value themes management, determination of values evaluation and assessment methods. Conclusions: This Indigenous operational model of value based curriculum proposes the process with exact sequence for the con-creteimplementationof valueseducationinmedicineandsurgery,accordancewithourcountryoffers. Theoperationalvaluebased curriculummodelwaspreparedinordertodevelopapracticalguidelineforvaluebasedexperimentsinmedicineandsurgery,helps to move from the information level and expressing factual knowledge, to the conceptual and judgment level, understanding the connections and interactions between facts and analysis them.","PeriodicalId":158928,"journal":{"name":"Journal of Minimally Invasive Surgical Sciences","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114090853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：