Pub Date : 2024-07-30DOI: 10.4103/jmas.jmas_103_24
Aditya Sharma, Vivek Srivastava, Brij Bhushan Singh, Mumtaz Ahmad Ansari
Abstract: A Spigelian hernia is an uncommon, atypical protrusion of the peritoneum or abdominal contents via a defect (Spigelian fascia), consisting of the internal oblique aponeuroses and the transversus abdominis. With a frequency ranging from 0.12% to 2% of all abdominal wall hernias, Spigelian hernias are extremely rare. It usually arises from a condition that increases intra-abdominal pressure, the degeneration of the abdominal aponeurotic layers or trauma to the abdominal wall. Herein, we present a case series of patients with varying presentations of Spigelian hernia who presented, who were promptly diagnosed and who were managed successfully with laparoscopic surgical repair.
{"title":"A case series analysis of spigelian hernia: A diagnostic dilemma and its successful laparoscopic repair.","authors":"Aditya Sharma, Vivek Srivastava, Brij Bhushan Singh, Mumtaz Ahmad Ansari","doi":"10.4103/jmas.jmas_103_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_103_24","url":null,"abstract":"<p><strong>Abstract: </strong>A Spigelian hernia is an uncommon, atypical protrusion of the peritoneum or abdominal contents via a defect (Spigelian fascia), consisting of the internal oblique aponeuroses and the transversus abdominis. With a frequency ranging from 0.12% to 2% of all abdominal wall hernias, Spigelian hernias are extremely rare. It usually arises from a condition that increases intra-abdominal pressure, the degeneration of the abdominal aponeurotic layers or trauma to the abdominal wall. Herein, we present a case series of patients with varying presentations of Spigelian hernia who presented, who were promptly diagnosed and who were managed successfully with laparoscopic surgical repair.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-30DOI: 10.4103/jmas.jmas_344_23
Magan Mehrotra, Chukka Gautam Kumar
Introduction: Small and medium sized primary midline ventral hernias are best treated by pre-peritoneal mesh placement. This helps in prevention of complications related to intra-peritoneal mesh placement. The challenges we face while performing laparoscopic transabdominal pre-peritoneal (TAPP) procedure can be overcome by robot-assisted TAPP (rTAPP), and we present our initial experience with the same. We describe the surgical technique used in rTAPP using the relatively new SSI Mantra platform for primary midline ventral hernia repair and evaluate its feasibility and present the outcomes.
Patients and methods: we performed rTAPP for primary midline ventral hernia repair in 10 patients from July 2023 to September 2023. Demographic patient data, hernia characteristics and peri-operative outcomes were measured.
Results: A total of 10 patients underwent elective rTAPP for primary midline ventral hernia, of which 7 were male and 3 were female. The average defect size was 3.2 cm. The average operative time was 113 min. All the patients were discharged within 24-36 h after the procedure. There were no deaths. No post-operative complications such as haematoma, clinically significant seroma, deep or superficial wound infection or recurrence were noted within 30 days.
Conclusion: rTAPP is a technically feasible procedure for the repair of small- and medium-sized midline ventral hernias with defect sizes up to 5 cm. SSI Mantra robotic platform provides the same benefit that other conventional robotic platforms provide at a much lesser cost. Further studies looking at the cost-benefit ratio are required to substantiate the above.
{"title":"Initial experience of SSI Mantra robot-assisted Transabdominal pre-peritoneal repair of primary ventral hernias.","authors":"Magan Mehrotra, Chukka Gautam Kumar","doi":"10.4103/jmas.jmas_344_23","DOIUrl":"https://doi.org/10.4103/jmas.jmas_344_23","url":null,"abstract":"<p><strong>Introduction: </strong>Small and medium sized primary midline ventral hernias are best treated by pre-peritoneal mesh placement. This helps in prevention of complications related to intra-peritoneal mesh placement. The challenges we face while performing laparoscopic transabdominal pre-peritoneal (TAPP) procedure can be overcome by robot-assisted TAPP (rTAPP), and we present our initial experience with the same. We describe the surgical technique used in rTAPP using the relatively new SSI Mantra platform for primary midline ventral hernia repair and evaluate its feasibility and present the outcomes.</p><p><strong>Patients and methods: </strong>we performed rTAPP for primary midline ventral hernia repair in 10 patients from July 2023 to September 2023. Demographic patient data, hernia characteristics and peri-operative outcomes were measured.</p><p><strong>Results: </strong>A total of 10 patients underwent elective rTAPP for primary midline ventral hernia, of which 7 were male and 3 were female. The average defect size was 3.2 cm. The average operative time was 113 min. All the patients were discharged within 24-36 h after the procedure. There were no deaths. No post-operative complications such as haematoma, clinically significant seroma, deep or superficial wound infection or recurrence were noted within 30 days.</p><p><strong>Conclusion: </strong>rTAPP is a technically feasible procedure for the repair of small- and medium-sized midline ventral hernias with defect sizes up to 5 cm. SSI Mantra robotic platform provides the same benefit that other conventional robotic platforms provide at a much lesser cost. Further studies looking at the cost-benefit ratio are required to substantiate the above.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-07-24DOI: 10.4103/jmas.jmas_402_23
Ajil Antony, Santhosh Kumar Ravindran, N P Jayan, S Yadukrishna, Robbins Sebastian, Akshay Kumar, Shwetha Shyamkumar
Background: Median arcuate ligament syndrome (MALS), also known as Dunbar syndrome or celiac artery (CA) compression syndrome, is a rare condition characterized by persistent post-meal or post-exercise abdominal discomfort, often more pronounced during expiration. Additional symptoms include nausea, vomiting, and weight loss.
Aims and objectives: To document the clinical presentation, diagnostic process, and treatment outcomes of seven patients diagnosed with MALS and to evaluate the effectiveness of surgical release of the median arcuate ligament (MAL) over a follow-up period of at least six months.
Materials and methods: The study included seven patients diagnosed with MALS from 2019 to 2021. Diagnosis was based on the presence of chronic abdominal pain and associated symptoms, absence of alternative diagnoses after various clinical assessments, and angiographic evidence of CA compression. The primary treatment involved surgical decompression of the CA by releasing the MAL through either open or laparoscopic techniques.
Results: All seven patients underwent successful surgical release of the MAL. The patients were followed up for at least six months post-surgery. The study evaluated the persistence of symptoms and the need for additional interventions such as revascularization techniques.
Conclusion: Surgical release of the MAL is the primary treatment for MALS, providing relief for many patients. However, long-term follow-up is essential as some patients may continue to experience symptoms post-surgery, necessitating further interventions.
背景:正中弓状韧带综合征(MALS)又称邓巴综合征或腹腔动脉(CA)压迫综合征,是一种罕见的疾病,其特征是进餐后或运动后持续性腹部不适,通常在呼气时更为明显。其他症状包括恶心、呕吐和体重减轻:记录七名被确诊为 MALS 患者的临床表现、诊断过程和治疗结果,并在至少六个月的随访期内评估手术松解正中弓形韧带(MAL)的效果:研究对象包括2019年至2021年期间确诊的7名MALS患者。诊断依据是存在慢性腹痛和相关症状、各种临床评估后无其他诊断结果以及血管造影显示 CA 受压。主要治疗方法是通过开腹或腹腔镜技术释放MAL,对CA进行手术减压:结果:所有七名患者都成功接受了 MAL 释放手术。术后对患者进行了至少六个月的随访。研究评估了症状的持续情况以及是否需要采取其他干预措施,如血管重建技术:结论:手术松解 MAL 是治疗 MALS 的主要方法,可缓解许多患者的症状。结论:手术松解 MALS 是治疗 MALS 的主要方法,可缓解许多患者的症状,但长期随访至关重要,因为一些患者在术后可能会继续出现症状,需要进一步干预。
{"title":"Performing median arcuate ligament release surgery in celiac artery compression syndrome: Insights from a tertiary care hospital.","authors":"Ajil Antony, Santhosh Kumar Ravindran, N P Jayan, S Yadukrishna, Robbins Sebastian, Akshay Kumar, Shwetha Shyamkumar","doi":"10.4103/jmas.jmas_402_23","DOIUrl":"10.4103/jmas.jmas_402_23","url":null,"abstract":"<p><strong>Background: </strong>Median arcuate ligament syndrome (MALS), also known as Dunbar syndrome or celiac artery (CA) compression syndrome, is a rare condition characterized by persistent post-meal or post-exercise abdominal discomfort, often more pronounced during expiration. Additional symptoms include nausea, vomiting, and weight loss.</p><p><strong>Aims and objectives: </strong>To document the clinical presentation, diagnostic process, and treatment outcomes of seven patients diagnosed with MALS and to evaluate the effectiveness of surgical release of the median arcuate ligament (MAL) over a follow-up period of at least six months.</p><p><strong>Materials and methods: </strong>The study included seven patients diagnosed with MALS from 2019 to 2021. Diagnosis was based on the presence of chronic abdominal pain and associated symptoms, absence of alternative diagnoses after various clinical assessments, and angiographic evidence of CA compression. The primary treatment involved surgical decompression of the CA by releasing the MAL through either open or laparoscopic techniques.</p><p><strong>Results: </strong>All seven patients underwent successful surgical release of the MAL. The patients were followed up for at least six months post-surgery. The study evaluated the persistence of symptoms and the need for additional interventions such as revascularization techniques.</p><p><strong>Conclusion: </strong>Surgical release of the MAL is the primary treatment for MALS, providing relief for many patients. However, long-term follow-up is essential as some patients may continue to experience symptoms post-surgery, necessitating further interventions.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"318-325"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-07-24DOI: 10.4103/jmas.jmas_84_23
Mohamed Alanwar, Mamdouh Elsharawy, Alaa Brik, Islam Ahmady, Dina Said Shemais
Introduction: Uniportal video-assisted thoracoscopic surgery (U-VATS) has recently become an alternative approach for many minimally invasive thoracic procedures, but although its surgical effectiveness has been proven, still its feasibility and safety are debated and unclear. the objective of this study was to compare the safety and perioperative outcomes of U-VATS versus multiportal VATS (M-VATS).
Patients and methods: This was a comparative follow-up randomised controlled clinical trial, carried out on 36 randomly selected eligible patients, and fulfilling the inclusion and exclusion criteria for VATS, they were assigned randomly into two groups: Study Group I including 18 patients undergoing U-VATS with conventional treatment using standard chest tube drainage and Control Group II including 18 patients undergoing M-VATS) with the same conventional treatment using standard chest tube drainage and served as a comparable control group.
Results: Patients in the U-VATS Group 1 had faster operation time, and with reduced blood loss, pleural drainage and post-operative hospitalisation, they also experienced lower average post-operative pain score on comparison with those in M-VATS Group II (P < 0.001), respectively. For either group, there were no hospital deaths or infections. There was no noticeable difference between the two groups in terms of the number of resected lymph nodes or the rates of intraoperative or post-operative complications (P > 0.05).
Conclusion: U-VATS is feasible and safe in eligible selected patients with favourable short-term perioperative outcomes (operative time, duration of pleural drainage, post-operative pain, early ambulation, duration of hospital stay as well as the risk of perioperative complications), and it can be considered the preferred approach in minimally invasive thoracic procedures that open up for the possibility of fast-track thoracic surgeries.
简介单孔视频辅助胸腔镜手术(U-VATS)近来已成为许多微创胸腔镜手术的替代方法,但尽管其手术效果已得到证实,其可行性和安全性仍存在争议且不明确。本研究的目的是比较U-VATS与多孔VATS(M-VATS)的安全性和围手术期结果:这是一项比较性随访随机对照临床试验,随机选取了 36 名符合 VATS 纳入和排除标准的患者,将他们随机分为两组:研究组 I 包括 18 名接受 U-VATS 并使用标准胸管引流术进行常规治疗的患者,对照组 II 包括 18 名接受 M-VATS 并使用标准胸管引流术进行同样常规治疗的患者,作为可比对照组:结果:与 M-VATS II 组相比,U-VATS 1 组患者的手术时间更短,失血量、胸膜引流和术后住院时间也更短,术后平均疼痛评分也更低(P < 0.001)。两组均无住院死亡或感染病例。两组在切除淋巴结数量、术中或术后并发症发生率方面没有明显差异(P > 0.05):U-VATS对符合条件的患者是可行且安全的,其短期围手术期结果(手术时间、胸膜引流时间、术后疼痛、早期下床活动、住院时间以及围手术期并发症的风险)良好。
{"title":"Safety and perioperative outcomes of uniportal versus multiportal video-assisted thoracoscopic surgery.","authors":"Mohamed Alanwar, Mamdouh Elsharawy, Alaa Brik, Islam Ahmady, Dina Said Shemais","doi":"10.4103/jmas.jmas_84_23","DOIUrl":"10.4103/jmas.jmas_84_23","url":null,"abstract":"<p><strong>Introduction: </strong>Uniportal video-assisted thoracoscopic surgery (U-VATS) has recently become an alternative approach for many minimally invasive thoracic procedures, but although its surgical effectiveness has been proven, still its feasibility and safety are debated and unclear. the objective of this study was to compare the safety and perioperative outcomes of U-VATS versus multiportal VATS (M-VATS).</p><p><strong>Patients and methods: </strong>This was a comparative follow-up randomised controlled clinical trial, carried out on 36 randomly selected eligible patients, and fulfilling the inclusion and exclusion criteria for VATS, they were assigned randomly into two groups: Study Group I including 18 patients undergoing U-VATS with conventional treatment using standard chest tube drainage and Control Group II including 18 patients undergoing M-VATS) with the same conventional treatment using standard chest tube drainage and served as a comparable control group.</p><p><strong>Results: </strong>Patients in the U-VATS Group 1 had faster operation time, and with reduced blood loss, pleural drainage and post-operative hospitalisation, they also experienced lower average post-operative pain score on comparison with those in M-VATS Group II (P < 0.001), respectively. For either group, there were no hospital deaths or infections. There was no noticeable difference between the two groups in terms of the number of resected lymph nodes or the rates of intraoperative or post-operative complications (P > 0.05).</p><p><strong>Conclusion: </strong>U-VATS is feasible and safe in eligible selected patients with favourable short-term perioperative outcomes (operative time, duration of pleural drainage, post-operative pain, early ambulation, duration of hospital stay as well as the risk of perioperative complications), and it can be considered the preferred approach in minimally invasive thoracic procedures that open up for the possibility of fast-track thoracic surgeries.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"294-300"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jmas.jmas_377_23
Young-Dong Yu, Karim J Halazun, Rohit Chandwani, Benjamin Samstein
Introduction: Minimally invasive liver resection (MILR) is performed for other gastrointestinal applications. At our centre, all liver resections are systematically performed using a minimally invasive approach. This study aimed to describe our experience in minimising open surgery and emphasised the importance of minimally invasive surgery.
Patients and methods: We retrospectively reviewed 260 patients who underwent liver surgery and compared the surgical outcomes between the open and MILR groups.
Results: A total of 154 patients (68%) underwent MILR. The proportion of patients who underwent prior abdominal surgery and resection was higher in the open surgery group. However, the proportion of patients with liver cirrhosis was similar between the two groups. The MILR group was superior in terms of operative time, blood loss, Pringle manoeuvre rate and mean hospital stay. In addition, major complication and bile leak rates were lower in the MILR group. No significant differences in the tumour size, number of lesions or underlying liver pathology were observed between the two groups.
Conclusion: Acceptable outcomes can be achieved even when the minimally invasive approach is considered the primary option for all patients who require liver resection. Minimally invasive tools are necessary for the modern practice of liver surgery; therefore, laparoscopic or robotic surgery should be included in the armamentarium of liver surgeons.
{"title":"Minimally invasive tools are necessary for the modern practice of liver surgery.","authors":"Young-Dong Yu, Karim J Halazun, Rohit Chandwani, Benjamin Samstein","doi":"10.4103/jmas.jmas_377_23","DOIUrl":"10.4103/jmas.jmas_377_23","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive liver resection (MILR) is performed for other gastrointestinal applications. At our centre, all liver resections are systematically performed using a minimally invasive approach. This study aimed to describe our experience in minimising open surgery and emphasised the importance of minimally invasive surgery.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed 260 patients who underwent liver surgery and compared the surgical outcomes between the open and MILR groups.</p><p><strong>Results: </strong>A total of 154 patients (68%) underwent MILR. The proportion of patients who underwent prior abdominal surgery and resection was higher in the open surgery group. However, the proportion of patients with liver cirrhosis was similar between the two groups. The MILR group was superior in terms of operative time, blood loss, Pringle manoeuvre rate and mean hospital stay. In addition, major complication and bile leak rates were lower in the MILR group. No significant differences in the tumour size, number of lesions or underlying liver pathology were observed between the two groups.</p><p><strong>Conclusion: </strong>Acceptable outcomes can be achieved even when the minimally invasive approach is considered the primary option for all patients who require liver resection. Minimally invasive tools are necessary for the modern practice of liver surgery; therefore, laparoscopic or robotic surgery should be included in the armamentarium of liver surgeons.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-01-19DOI: 10.4103/jmas.jmas_265_23
Bakhtawar Awan, Mohamed Elsaigh, Beshoy Effat Elkomos, Azka Sohail, Ahmad Asqalan, Safa Owhida Mousa Baqar, Noha Ahmed Elgendy, Omnia S Saleh, Justyna Malgorzata Szul, Anna San Juan, Mohamed Alasmar, Mohamed Mustafa Marzouk
Abstract: Being one of the most common abdominal surgical procedures, numerous techniques have been adapted to decrease post-operative pain post cholecystectomy. However, the efficacy of intravenous (IV) lidocaine in managing post operative pain after LC is still controversial, according to many recent studies. This study aims to detect the effectiveness of IV lidocaine compared to other medications in managing post-operative pain. PubMed, Scopes, Web of Science and Cochrane Library were searched for eligible studies from inception to June 2023, and a systematic review and meta-analysis was done. According to eligibility criteria, 14 studies (898 patients) were included in our study. The pooled results of the included studies showed that the pain score after 6, 12 and 24 h after the surgery was significantly lower in those who received IV lidocaine as a painkiller (Visual Analogue Scale [VAS] 6H, mean difference [MD] = -1.20, 95% confidence interval [CI] = -2.20, -0.20, P = 0.02; I2 = 98%, VAS 12H, MD = -0.90, 95% CI = -1.52, -0.29, P = 0.004; I2 = 96% and VAS 24H, MD = -0.86, 95% CI = -1.48, -0.24, P = 0.007; I2 = 92%). In addition, IV lidocaine is associated with a significant decrease in the opioid requirement after the surgery (opioid requirements, MD = -29.53, 95% CI = -55.41, -3.66, P = 0.03; I2 = 98%). However, there was no statistically significant difference in the incidence of nausea and vomiting after the surgery between the two groups (nausea and vomiting, relative risk = 0.91, 95% CI = 0.57, 1.45, P = 0.69; I2 = 50%). Lidocaine infusion in LC is associated with a significant decrease in post operative pain and in opioid requirements after the surgery.
摘要:胆囊切除术是最常见的腹部外科手术之一,目前已采用了许多技术来减轻胆囊切除术后的疼痛。然而,根据最近的许多研究,静脉注射利多卡因在控制胆囊切除术后疼痛方面的疗效仍存在争议。本研究旨在检测静脉注射利多卡因与其他药物相比在控制术后疼痛方面的有效性。研究人员检索了 PubMed、Scopes、Web of Science 和 Cochrane Library 中从开始到 2023 年 6 月符合条件的研究,并进行了系统回顾和荟萃分析。根据资格标准,我们的研究共纳入了 14 项研究(898 名患者)。纳入研究的汇总结果显示,接受静脉注射利多卡因作为止痛药的患者在术后 6、12 和 24 小时后的疼痛评分明显较低(视觉模拟量表 [VAS] 6H,平均差 [MD] = -1.20, 95% confidence interval [CI] = -2.20, -0.20, P = 0.02; I2 = 98%, VAS 12H, MD = -0.90, 95% CI = -1.52, -0.29, P = 0.004; I2 = 96% and VAS 24H, MD = -0.86, 95% CI = -1.48, -0.24, P = 0.007; I2 = 92%)。此外,静脉注射利多卡因与术后阿片类药物需求量的显著减少有关(阿片类药物需求量,MD = -29.53,95% CI = -55.41,-3.66,P = 0.03;I2 = 98%)。然而,两组患者术后恶心和呕吐的发生率无统计学差异(恶心和呕吐,相对风险 = 0.91,95% CI = 0.57,1.45,P = 0.69;I2 = 50%)。在 LC 中输注利多卡因可显著减少术后疼痛和术后对阿片类药物的需求。
{"title":"The use of lidocaine infusion in laparoscopic cholecystectomy: An updated systematic review and meta-analysis.","authors":"Bakhtawar Awan, Mohamed Elsaigh, Beshoy Effat Elkomos, Azka Sohail, Ahmad Asqalan, Safa Owhida Mousa Baqar, Noha Ahmed Elgendy, Omnia S Saleh, Justyna Malgorzata Szul, Anna San Juan, Mohamed Alasmar, Mohamed Mustafa Marzouk","doi":"10.4103/jmas.jmas_265_23","DOIUrl":"10.4103/jmas.jmas_265_23","url":null,"abstract":"<p><strong>Abstract: </strong>Being one of the most common abdominal surgical procedures, numerous techniques have been adapted to decrease post-operative pain post cholecystectomy. However, the efficacy of intravenous (IV) lidocaine in managing post operative pain after LC is still controversial, according to many recent studies. This study aims to detect the effectiveness of IV lidocaine compared to other medications in managing post-operative pain. PubMed, Scopes, Web of Science and Cochrane Library were searched for eligible studies from inception to June 2023, and a systematic review and meta-analysis was done. According to eligibility criteria, 14 studies (898 patients) were included in our study. The pooled results of the included studies showed that the pain score after 6, 12 and 24 h after the surgery was significantly lower in those who received IV lidocaine as a painkiller (Visual Analogue Scale [VAS] 6H, mean difference [MD] = -1.20, 95% confidence interval [CI] = -2.20, -0.20, P = 0.02; I2 = 98%, VAS 12H, MD = -0.90, 95% CI = -1.52, -0.29, P = 0.004; I2 = 96% and VAS 24H, MD = -0.86, 95% CI = -1.48, -0.24, P = 0.007; I2 = 92%). In addition, IV lidocaine is associated with a significant decrease in the opioid requirement after the surgery (opioid requirements, MD = -29.53, 95% CI = -55.41, -3.66, P = 0.03; I2 = 98%). However, there was no statistically significant difference in the incidence of nausea and vomiting after the surgery between the two groups (nausea and vomiting, relative risk = 0.91, 95% CI = 0.57, 1.45, P = 0.69; I2 = 50%). Lidocaine infusion in LC is associated with a significant decrease in post operative pain and in opioid requirements after the surgery.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"239-246"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-01-09DOI: 10.4103/jmas.jmas_78_23
Jinyu Dai, Jian Li, Xiaobing Sun
Introduction: This study aimed to investigate the feasibility of applying laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia in children.
Patients and methods: From December 2017 to November 2018, we recruited 20 children, who were aged 1-6 years old, with indirect inguinal hernia. At the time of admission, the participants had already developed an indirect inguinal hernia for 6 months to 1 year. A simple transection and partial resection of hernia sac was performed at the internal ring on each of the recruited children. The procedure was conducted under laparoscopy. Two 5-mm trocars were placed on either side of the umbilicus, one for the camera and the other for a surgical instrument. Another trocar was placed on the right abdomen. Laparoscopic camera curved forceps, and scissors were placed. Along the unclosed internal ring, the peritoneum was cut in a circular fashion to transect the hernia sac and dissociate it from the distal end. About 1-2 cm of the hernia sac was resected.
Results: The operation was successfully completed in all 20 cases, who did not experience any complications, such as the absence of spermatic cord, vas deferens injury, scrotal swelling and incision infection. The children were discharged 1 day after the operation. In the post-operative follow-up for the first 3-4 years, recurrence and testicular atrophy did not occur in the study participants.
Conclusion: The short-term results obtained from this study showed that the application of laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia is feasible. Long-term results and further observation are needed for validation.
{"title":"Laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia: A preliminary observation.","authors":"Jinyu Dai, Jian Li, Xiaobing Sun","doi":"10.4103/jmas.jmas_78_23","DOIUrl":"10.4103/jmas.jmas_78_23","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the feasibility of applying laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia in children.</p><p><strong>Patients and methods: </strong>From December 2017 to November 2018, we recruited 20 children, who were aged 1-6 years old, with indirect inguinal hernia. At the time of admission, the participants had already developed an indirect inguinal hernia for 6 months to 1 year. A simple transection and partial resection of hernia sac was performed at the internal ring on each of the recruited children. The procedure was conducted under laparoscopy. Two 5-mm trocars were placed on either side of the umbilicus, one for the camera and the other for a surgical instrument. Another trocar was placed on the right abdomen. Laparoscopic camera curved forceps, and scissors were placed. Along the unclosed internal ring, the peritoneum was cut in a circular fashion to transect the hernia sac and dissociate it from the distal end. About 1-2 cm of the hernia sac was resected.</p><p><strong>Results: </strong>The operation was successfully completed in all 20 cases, who did not experience any complications, such as the absence of spermatic cord, vas deferens injury, scrotal swelling and incision infection. The children were discharged 1 day after the operation. In the post-operative follow-up for the first 3-4 years, recurrence and testicular atrophy did not occur in the study participants.</p><p><strong>Conclusion: </strong>The short-term results obtained from this study showed that the application of laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia is feasible. Long-term results and further observation are needed for validation.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"266-270"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2023-09-14DOI: 10.4103/jmas.jmas_112_23
K Ganesh Shenoy, Srikanth Gadiyaram, B S Ramesh
Abstract: We herein report a rare case of duodeno-duodenal intussusception (IS) presenting with obstruction caused by tubulovillous adenoma in an adult with malrotation that was managed by a novel laparoendoscopic hybrid technique. This was done by passing transjejunal nasogastric tube (NG) through one of the ports and manoeuvring it towards the IS. Two hundred and fifty millilitre of saline was flushed by aseptosyringe with pressure connected to the NG. This hydrostatic reduction technique resulted in distension of the jejunal and duodenal loop achieving reduction of IS. Intraoperative endoscopy was performed to exactly localise the mass lesion. The duodenum was kocherised and was delivered through a 4-cm transverse incision. Anterior duodenotomy was performed; the mass was excised; and duodenotomy was closed transversely. An extensive literature search did not show any case report of duodenoduodenal IS being managed by this technique. The combination of novel retrograde decompression and intraoperative endoscopy helped us to manage this rare case by this novel technique.
{"title":"Novel laparo-endoscopic hybrid technique of management of a rare case of duodeno-duodenal intussusception.","authors":"K Ganesh Shenoy, Srikanth Gadiyaram, B S Ramesh","doi":"10.4103/jmas.jmas_112_23","DOIUrl":"10.4103/jmas.jmas_112_23","url":null,"abstract":"<p><strong>Abstract: </strong>We herein report a rare case of duodeno-duodenal intussusception (IS) presenting with obstruction caused by tubulovillous adenoma in an adult with malrotation that was managed by a novel laparoendoscopic hybrid technique. This was done by passing transjejunal nasogastric tube (NG) through one of the ports and manoeuvring it towards the IS. Two hundred and fifty millilitre of saline was flushed by aseptosyringe with pressure connected to the NG. This hydrostatic reduction technique resulted in distension of the jejunal and duodenal loop achieving reduction of IS. Intraoperative endoscopy was performed to exactly localise the mass lesion. The duodenum was kocherised and was delivered through a 4-cm transverse incision. Anterior duodenotomy was performed; the mass was excised; and duodenotomy was closed transversely. An extensive literature search did not show any case report of duodenoduodenal IS being managed by this technique. The combination of novel retrograde decompression and intraoperative endoscopy helped us to manage this rare case by this novel technique.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"345-348"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-01-09DOI: 10.4103/jmas.jmas_253_23
Ganesh Shenoy, Marina Thomas, B S Ramesh
Abstract: Median arcuate ligament (MAL) syndrome or celiac artery (CA) compression syndrome previously treated mainly by vascular surgeons using the open approach is now being increasingly performed by general surgeons with training in advanced laparoscopy. Although this approach has all the advantages of minimal access surgery, the procedure is fraught with serious complications like injury to major vascular structures during dissection. Vascular injury by far is the major cause of conversion to open procedure. Herein, we report a laparoscopic repair of iatrogenic CA injury by intra-corporeal suturing during MAL release. We also elaborate the causes, the preventive measures that can be applied to avoid such catastrophic occurrences in future. To the best of our knowledge, this is the first report of a laparoscopic repair of CA bleed during MAL release.
摘要:弧中韧带(MAL)综合征或腹腔动脉(CA)压迫综合征以前主要由血管外科医生采用开放式方法治疗,现在越来越多地由受过高级腹腔镜培训的普通外科医生实施。虽然这种方法具有微创手术的所有优点,但手术过程中充满了严重的并发症,如剥离过程中对主要血管结构的损伤。到目前为止,血管损伤是转为开腹手术的主要原因。在此,我们报告了一例在 MAL 释放过程中通过体外缝合对先天性 CA 损伤进行腹腔镜修复的手术。我们还详细阐述了原因以及可用于避免今后发生此类灾难性事件的预防措施。据我们所知,这是第一例在腹腔镜下修复MAL松解过程中CA出血的报告。
{"title":"Laparoscopic repair of iatrogenic celiac artery injury during median arcuate ligament release: A retrospection and tips at troubleshooting.","authors":"Ganesh Shenoy, Marina Thomas, B S Ramesh","doi":"10.4103/jmas.jmas_253_23","DOIUrl":"10.4103/jmas.jmas_253_23","url":null,"abstract":"<p><strong>Abstract: </strong>Median arcuate ligament (MAL) syndrome or celiac artery (CA) compression syndrome previously treated mainly by vascular surgeons using the open approach is now being increasingly performed by general surgeons with training in advanced laparoscopy. Although this approach has all the advantages of minimal access surgery, the procedure is fraught with serious complications like injury to major vascular structures during dissection. Vascular injury by far is the major cause of conversion to open procedure. Herein, we report a laparoscopic repair of iatrogenic CA injury by intra-corporeal suturing during MAL release. We also elaborate the causes, the preventive measures that can be applied to avoid such catastrophic occurrences in future. To the best of our knowledge, this is the first report of a laparoscopic repair of CA bleed during MAL release.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"359-362"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-07-24DOI: 10.4103/jmas.jmas_302_23
Muhammed Said Dalkılıç, Merih Yılmaz, Mehmet Gençtürk, Hasan Erdem, Abdullah Şişik
Abstract: The revisional surgical techniques for managing weight regain after laparoscopic Roux-en-Y gastric bypass have lacked a clear gold standard. Various methods such as pouch minimising, gastroenterostomy narrowing and distalization have been described, but none have consistently achieved optimal success. This study introduces a combined revision technique that enables the reassessment of both alimentary limb and biliopancreatic limb lengths based on the individual patient's total bowel length. This approach aims to promote effective weight loss while minimising the pouch and gastroenterostomy.
{"title":"An alternative combined revision of Roux-en-Y gastric bypass: Cover all aspects (of failure)!","authors":"Muhammed Said Dalkılıç, Merih Yılmaz, Mehmet Gençtürk, Hasan Erdem, Abdullah Şişik","doi":"10.4103/jmas.jmas_302_23","DOIUrl":"10.4103/jmas.jmas_302_23","url":null,"abstract":"<p><strong>Abstract: </strong>The revisional surgical techniques for managing weight regain after laparoscopic Roux-en-Y gastric bypass have lacked a clear gold standard. Various methods such as pouch minimising, gastroenterostomy narrowing and distalization have been described, but none have consistently achieved optimal success. This study introduces a combined revision technique that enables the reassessment of both alimentary limb and biliopancreatic limb lengths based on the individual patient's total bowel length. This approach aims to promote effective weight loss while minimising the pouch and gastroenterostomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"20 3","pages":"356-358"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11354954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}