scholarly journals Undescended Testes and Laparoscopy: Experience from the Developing World

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Shabir Ahmad Dar ◽  
Rajandeep Singh Bali ◽  
Yawar Zahoor ◽  
Arshad Rashid Kema ◽  
Rajni Bhardwaj
Keyword(s):  
Visual Information ◽  
Operative Time ◽  
Standard Procedure ◽  
Undescended Testes ◽  
Postoperative Wound ◽  
The Mean ◽  
Nonpalpable Testis ◽  
A Prospective Study ◽  
Laparoscopic Techniques ◽  
Laparoscopic Orchidopexy

Background. Cryptorchidism or undescended testes is the most common disorder of the male endocrine glands in children. With the advancements in laparoscopic techniques and instruments, laparoscopic orchidopexy has become the standard procedure in the management of nonpalpable undescended testes. Aim. To evaluate and determine the therapeutic role, sensitivity, and specificity of laparoscopy in localizing nonpalpable testes and the mean operative time, the conversion rate (and reasons thereof), postoperative wound infection, postoperative stay, and time taken for return to daily activities following laparoscopic orchidopexy or orchidectomy. Materials and Methods. This was a prospective study carried out in the Postgraduate Department of Surgery, Government Medical College, Srinagar, J&K, India, from May 2008 to August 2011. All patients who presented to the outpatient department with complaints of absent testes were examined, and the ones with nonpalpable testes were included in the study. Results. The mean operative time for bilateral and unilateral nonpalpable testis was 102.76 and 53.67 minutes, respectively. Minor postoperative wound infections were noted in 4 of our patients. Mean duration of hospital stay was 14.23 hrs for unilateral cases and 16.27 hrs for bilateral cases. Patients who underwent laparoscopic orchidopexy resumed their normal activities within 4 ± 1 days. Conclusion. Laparoscopy clearly demonstrates the anatomy and provides visual information upon which a definitive decision can be made for further management of the undescended nonpalpable testis.

scholarly journals Laparoscopic orchiopexy versus traditional inguinal incision orchidopexy for palpable undescended testes in cryptorchidism

2020 ◽  
Author(s):  
Shaodong Gu ◽  
Yingxun wang ◽  
Hong Luo
Keyword(s):  
Operative Time ◽  
Standard Procedure ◽  
Normal Activity ◽  
Activity Time ◽  
Undescended Testes ◽  
Exact Test ◽  
The Mean ◽  
Laparoscopic Orchidopexy ◽  
The Impact ◽  
Laparoscopic Orchiopexy

Abstract Background ： Laparoscopic orchidopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes. Nevertheless, the use of LO for palpable undescended testes still remains controversial. The aim of this study was to explore the impact of laparoscopic orchiopexy procedure on palpable undescended testes in children suffering from cryptorchidism. Methods: A retrospective study was performed for LO and traditional inguinal incision orchidopexy (TIO) carried out to treat palpable undescended testes. In total, 291 children aged 9 months to 96 months with either left or right side palpable inguinal canalicular testes were included. 170 patients received LO and 121 patients received TIO. Age, operative time and clinical outcomes of the patients were reviewed. Independent t test and Fisher’s exact test were performed by using the SPSS 25.0 software. Results: In the younger groups, the mean operative time (younger than 1 year old, 30.50±5.88 vs. 39.86±6.11 min; 1-2 years old, 34.43±6.65 vs. 40.23±8.74) and postoperative normal activity time (younger than 1 year old, 1.20±0.40 vs. 2.12±0.48 days; 1-2 years old, 1.58±0.50 vs. 2.02±0.43 days) of LO were significantly shorter than those in the TIO group ( P <0.05). The operative time of LO was significantly longer than that in the TIO group in older groups (aged>3 years old). 47 of 49 cases (95.9%) of patients aged less than 1 year old were treated by LO successfully. Among the patients aged 1-2 years, 80 of 86 cases (93.0%) successfully completed LO. Totally, 43 cases were transferred to inguinal incisions. Conclusion: LO is an appropriate choice for palpable undescended testes, especially in children younger than 2 years old. The percentage of successful LO decreased with the increasing age.

Comparison of Laparoscopic Orchiopexy and Traditional Inguinal Incision Orchidopexy for Palpable Undescended Testes in Cryptorchidism

2020 ◽  
Author(s):  
Shaodong Gu ◽  
Hong Luo ◽  
Yingxun wang
Keyword(s):  
Operative Time ◽  
Standard Procedure ◽  
Normal Activity ◽  
Activity Time ◽  
Undescended Testes ◽  
Exact Test ◽  
The Mean ◽  
One Year ◽  
Laparoscopic Orchidopexy ◽  
Laparoscopic Orchiopexy

Abstract Background Laparoscopic orchidopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes. LO for palpable undescended testes is still controversial. The aim of this study is to explore the method and effect of laparoscopic orchiopexy procedure for palpable undescended testes in children suffering from cryptorchidism.Methods A retrospective study was performed for LO and traditional inguinal incision orchidopexy(TIIO) for palpable undescended testes. Totally 220 children age ranged from 9 months to 96 months with both palpable inguinal canalicular testes were included. 170 patients received LO and 50 patients received TIIO. Patient age, operative time and clinical outcomes were reviewed. Independent t test and Fisher’s exact test were performed by SPSS 25.0 software.Results The mean operative time (30.77 ± 6.02 vs 44.76 ± 6.70 min), postoperative normal activity time (1.25 ± 0.43 vs 2.48 ± 0.68 day) of LO was significantly shorter than TIO group. (P < 0.05). 47 of 49 cases (95.9%) within 1-year-old were successfully achieved LO.Conclusion LO is an appropriate choice for palpable undescended testes, especially in younger children within one-year-old. The successful percentage of LO decreased with age growing.

DOZ047.82: Outcome of thoracoscopic repair of type C esophageal atresia: single-center experience from North Africa

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Elbarbary ◽  
A Shalaby ◽  
M Elseoudi ◽  
M Ragab ◽  
A E Fares ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophageal Atresia ◽  
Operative Time ◽  
Primary Anastomosis ◽  
Single Center Experience ◽  
Resource Setting ◽  
Thoracoscopic Repair ◽  
Type C ◽  
The Mean ◽  
A Prospective Study

Abstract Background and Aim Thoracoscopic repair of esophageal atresia is gaining popularity worldwide owing to the availability of and advances in minimally invasive instruments. This report presents our early experience of thoracoscopic esophageal atresia repair (EA/TEF) in a single institute. Methods A prospective study on short-gap type C EA/TEF was conducted at Cairo University Specialized Pediatric Hospital from April 2016. The technique was standardized in all cases: patients placed in the fully prone position, and using a 5 mm 30° scope with 3 mm instruments and carried out by four experts in minimally invasive surgery. Data was collected to include patient demographics and operative time. The main outcome was survival. Secondary outcomes were leak rate and postoperative stricture. Results Over a period of 24 months (April 2016–April 2018) 136 cases of EA/TEF were admitted. Thoracoscopy was attempted in 76 cases. Thirty cases with pure atresia or long-gap anomaly were excluded from this study for gap length, leaving 46 (60%) nonconsecutive neonates who underwent thoracoscopic repair of their short-gap EA/TEF. Five cases (10.8%) were converted to open surgery via right thoracotomy. A primary anastomosis was possible in all cases, leaving the azygos intact. The mean age at operation was 8.7 days (range 2–32), the mean weight was 2.6 kg (range 1.8–3.6), and the mean operative time was 108.3 minutes (range 80–180). In the fully thoracoscopic patients the survival was 85.4% (n = 35). An anastomotic leak occurred in 17% (n = 7); it was managed conservatively in 2 and with esophagostomy and gastrostomy in 5 cases. Followup was at one week, one and three months postdischarge. A stricture developed in 5 (16.6%) of the 30 surviving patients who kept their native esophagus. Conclusions Thoracoscopic repair is a feasible alternative even in a low-resource setting. The better outcome compared to traditional open repair in our center may be due to patient selection bias.

Incisional Hernia Risk after Hand-Assisted Laparoscopic Surgery

2012 ◽  
Vol 78 (8) ◽  
pp. 864-869 ◽  
Author(s):  
William S. Cobb ◽  
Alfredo M. Carbonell ◽  
Garrett M. Snipes ◽  
Brianna Knott ◽  
Viet Le ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Incisional Hernia ◽  
Operative Time ◽  
Group Versus ◽  
True Incidence ◽  
Hernia Formation ◽  
The Mean ◽  
Laparoscopic Techniques ◽  
Mean Time

Hand-assisted laparoscopic surgery (HALS) bridges traditional open surgery and pure laparoscopy. The HALS technique provides the necessary site for organ retrieval, reduces operative time, and realizes the postoperative benefits of laparoscopic techniques. Although the reported rates of incisional hernia should be theoretically low, we sought to determine our incidence of hernia after HALS procedures. A retrospective review of all HALS procedures was performed from July 2006 to June 2011. All patients who developed postoperative incisional hernias at the hand port site were confirmed by imaging or examination findings. Patient factors were reviewed to determine any predictors of hernia formation. Over the 5 years, 405 patients undergoing HALS procedures were evaluated: colectomy (264), nephrectomy (107), splenectomy/pancreatectomy (18), and ostomy reversal (10). The overall incidence of incisional hernia was 10.6 per cent. There were three perioperative wound dehiscences. The mean body mass index was significantly higher in the hernia group versus the no hernia cohort (32.1 vs 29.2 kg/m2; P = 0.001). The hernia group also had a higher incidence of renal disease (18.6 vs 7.2%; P = 0.018). Mean time to hernia formation was 11.4 months (range, 1 to 57 months). Follow-up was greater than 12 months in 188 (46%) of patients, in which the rate of incisional hernia was 17 per cent. The rate of incisional hernia formation after hand-assisted laparoscopic procedures is higher than the reported literature. Because the mean time to hernia development is approximately 1 year, it is important to follow these patients to this end point to determine the true incidence of incisional hernia after hand-assisted laparoscopy.

scholarly journals Single-Incision Cholecystectomy in about 200 Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Roland Raakow ◽  
Dietmar A. Jacob
Keyword(s):  
Acute Cholecystitis ◽  
Operative Time ◽  
Single Incision ◽  
Single Port ◽  
Standard Procedure ◽  
Operation Time ◽  
New Approach ◽  
Short Learning Curve ◽  
Single Incision Surgery ◽  
The Mean

Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases.Methods. Between September 2008 and March 2010, 220 patients underwent laparoscopic single-incision surgery. A single port was used for 196 patients and two conventional 5 mm and one 10 mm port in 24 cases. All operations were performed with straight instruments.Results. Single-incision surgery was successfully performed in 215 patients (98%). Three patients (1.4%) required conversion to a three-port technique and two patients (0.9%) to an open procedure. Average age of 142 women (65%) and 78 men (35%) was 47 years (range: 15–89), average ASA status 2 (range: 1–3) and BMI 28 (range: 15–49). Mean operative time was 62 minutes (range: 26–174) and 57 patients (26%) had histopathological signs of acute cholecystitis. Eleven patients (5%) developed to surgery-related complications and nine (4%) of these required a reoperation. The mean followup was 331.5 (range: 11–590) days.Conclusion. Transumbilical single-incision cholecystectomy is a feasible and safe new approach for routine cholecystectomy. After a short learning curve, operation time and complication rate are comparable with standard multiport operation. In addition, most cases of acute cholecystitis can be performed with this technique.

scholarly journals Laparoscopic Orchiopexy for the Nonpalpable Testis : 3 Years Experience

2018 ◽  
Vol 24 (2) ◽  
pp. 70-75
Author(s):  
M Nowshad Ali ◽  
M Rokeya Khatun ◽  
SMA Shahid ◽  
M Ahmed ◽  
Chinmoy Kanti Das
Keyword(s):  
Survival Rate ◽  
Operative Time ◽  
Average Operative Time ◽  
The Mean ◽  
Low Incidence ◽  
Nonpalpable Testis ◽  
The Right ◽  
Laparoscopic Orchiopexy ◽  
Abdominal Testis

We evaluated the safety and efficacy of laparoscopic orchiopexy to manage a nonpalpable intra-abdominal testis and studied the outcomes. We report our 3 years experience.Patients and methods Laparoscopic Orchiopexy was performed on 28 children (32 testicular units) for non-palpable intra-abdominal testis between 2010 and 2012. We retrospectively reviewed the medical records. The mean age was 3.4 years (range, 2.5 -11 years). Of the 28 patients, 18 (64.28 %) were on the right, 6 (21.44%) were on the left and 4 (14.28%) of bilateral. The mean follow-up period was 14.8 months (range, 3-36 months). Testicular viability and orchiopexed positioning were evaluated within 1 month and beyond 3 months.Results  Thirty one testes were descended successfully by laparoscopy. The average operative time was 41.5 ± 3.8 min. Primary laparoscopic orchiopexy done in 26 testes.Three of unilateral and 2 of bilateral testicular units underwent one -stage Fowler-Stephens Orchiopexy. One patient needs laparoscopic orchiectomy. At follow-up (mean 14.8 months), one testis atrophied and need orchiectomy. Testicular survival rate was 96.77% (30/31) and all of the testes maintained an adequate size. Twenty six (86.66%) are in an acceptable scrotal position and 4 testes (13.33%) are mid to high in the scrotum without atrophy. There was no recurrent inguinal hernia.Conclusions  Laparoscopic orchiopexy is successful for a nonpalpable intra-abdominal testis with a high testicular survival rate. The low incidence of complications and high success rate underscore the feasibility of this procedure. It is our procedure of choice for the treatment of nonpalpable testis.TAJ 2011; 24(2): 70-75

scholarly journals Laparoscopic management of Hydatid cyst

2016 ◽  
Vol 18 (3) ◽  
pp. 42
Author(s):  
Anang Pangeni ◽  
Vikal Chandra Shakya
Keyword(s):  
Minimally Invasive ◽  
Prospective Study ◽  
Hydatid Cyst ◽  
Operative Time ◽  
Energy Sources ◽  
Hydatid Cysts ◽  
Laparoscopic Management ◽  
The Mean ◽  
A Prospective Study ◽  
Surgery Department

Introduction and Objective: Hydatid cyst of the liver is a fairly common parasitic condition. We present here a series of 9 patients with hydatid cyst of the liver managed by minimally invasive surgeryMaterials and Methods: It was a prospective study in patients presenting with hydatid cyst of the liver to Surgery Department who were managed laparoscopically from January 2013 to November 2015.Result: There were 9 patients (5 males and 4 females). The mean operative time was 124+32 minutes. One patient developed mild allergy in the form of skin rashes on 3rd postoperative day, and another patient developed cholangitis which resolved on conservative management. There was no conversion.Conclusion: Laparoscopic management of hydatid cysts is possible, and looks promising provided we have advanced energy sources.

scholarly journals Transversus abdominis release versus perforator preseving anterior component separation in repair of large midline incisional hernia

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A K Abdallah ◽  
K H Gad ◽  
A A Darwish ◽  
I M Abdelmaksoud
Keyword(s):  
Postoperative Pain ◽  
Incisional Hernia ◽  
Operative Time ◽  
Component Separation ◽  
Transversus Abdominis ◽  
Wound Complications ◽  
Transversus Abdominis Release ◽  
Postoperative Wound ◽  
The Mean ◽  
Anterior Component Separation

Abstract Background Ventral hernia repair can be challenging, particularly in patients with serious comorbidity. Perforator preserving anterior component separation (ACS) by transverse skin incisions for external oblique aponeurosis release preserves both the rectus abdominis myocutaneous perforator vessels that supply the overlying skin and the connection between the subcutaneous fat and anterior rectus sheath, thereby reducing subcutaneous dead space and potentially improving overlying skin flap vascularity. Also posterior component separation via transversus abdominis release (TAR) provides effective fascial advancement while reducing wound morbidity during abdominal wall reconstructions. Both techniques give better results than classic ACS. Objectives to evaluate postoperative morbidity and recurrence rate when using transversus abdominis release technique in management of large midline incisional hernia in comparison with open perforator preserving anterior component separation. Patients and Methods the present study is a prospective study that was conducted at Ain Shams University Hospitals in Egypt, between October 2016 and October 2018. It included sixty (60) patients with large midline incisional hernia divided into two groups. First group include thirty patients who underwent transversus abdominis release with retromuscular polyprolene mesh placement. Second group include also thirty patients that underwent open perforator preserving anterior component separation and also with retromuscular placement of polyprolene mesh. Patients compared as regards operative time, length of hospital stay, postoperative pain, postoperative ileus, postoperative wound complications, rate of recurrence. Results Patients in both groups were similar with respect to age, the patients ages ranged from 20 to 70 years, with mean age in both groups around 46 years and between 20-23% have DM in each group. Perforator preserving technique has less operative time by about 40 minutes when compared with TAR technique. The postoperative pain assessment at 48hrs postoperative show that the mean pain score for TAR was (6.77 ± 1.70) and for perforator preserving group (5.47 ± 1.85). We also found that the mean hospital stay was slightly higher when performing TAR technique (5.2days) while it was (4.3days) after perforator preserving approach. There is nearly equal incidence of postoperative wound complications and also no statistically significant different rate of recurrence between two methods Conclusion both TAR and perforator preserving technique are effective and reliable method in experienced hands and if there is no special indication to one of them, the choice between both should depend on surgeon preference and experience.

scholarly journals Laparoscopic orchidopexy and its outcome in the management of nonpalpable testis

2020 ◽  
Vol 7 (8) ◽  
pp. 2605
Author(s):  
Dinesh Prasad ◽  
Savan Jivani
Keyword(s):  
Visual Information ◽  
Diagnostic Laparoscopy ◽  
Therapeutic Option ◽  
Case Series ◽  
Blind Ending ◽  
Port Site Hernia ◽  
Impalpable Testis ◽  
Scrotal Hematoma ◽  
Nonpalpable Testis ◽  
Laparoscopic Orchidopexy

Background: Management of impalpable testis represents a significant diagnostic and operative challenge. The aim of this work was to present the superior value of laparoscopy as a single tool for the diagnosis and treatment of impalpable testis.Methods: 51 patients with 58 nonpalpable were included in our study. Study design was case series. We have conducted this study at Surat Municipal Institute for Medical Education and Research, Surat. For each patient laparoscopy orchidopexy was performed and either testis or blind ending cord structure are searched for. The testis either brought down to the scrotum or removed depending on the condition. The patients were followed up for 12 months.Results: On diagnostic laparoscopy the number of testis found normal 54, followed by 3 hypoplastic and 1 atrophic. There were 8 testis found to be present at high intraabdominal (>2 cm from deep ring), 46 were present at low intra-abdominal (<2 cm from deep ring), intracanalicular 4. Postoperative complication included minor wound infection in one patient, none of them were diagnosed scrotal hematoma, port site hernia, and testicular atrophy.Conclusions: Laparoscopy seems to offer a safe and reliable diagnostic and therapeutic option to patients with nonpalpable testis. Intraabdominal dissection allows more testis to be brought down to scrotum. Laparoscopy clearly demonstrate the anatomy and provide visual information upon which a definitive decision can be made.

Phẫu thuật nội soi TAPP điều trị thoát vị bẹn

2021 ◽  
Author(s):  
Thanh Xuan Nguyen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Prospective Study ◽  
Hospital Stay ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Tapp Repair ◽  
The Mean ◽  
A Prospective Study

TÓM TẮT Đặt vấn đề: Thoát vị bẹn là một bệnh lý ngoại khoa thường gặp và có nhiều tác giả đưa ra nhiều kỹ thuật mổ khác nhau. Phẫu thuật xuyên phúc mạc tiếp cận khoang trước phúc mạc (TAPP) với nhiều ưu điểm như tiếp cận phẫu trường nội soi rộng rãi, các mốc giải phẫu rõ ràng, có thể quan sát, đánh giá và xử trí tạng thoát vị khá dễ dàng, có thể phát hiện thoát vị bẹn đối diện và xử trí những bệnh lý kèm theo trong ổ phúc mạc. Phương pháp: Nghiên cứu mô tả có theo dõi 125 bệnh nhân được chẩn đoán thoát vị bẹn tại Bệnh viện Trung Ương Huế và Bệnh viện trường Đại học Y - Dược Huế từ tháng 6/2016 đến tháng 3/2019. Kết quả: Tuổi trung bình 56,25 ± 19,06. Nam chiếm 97,6%. Thoát vị bẹn có triệu chứng 76,8%, có biến chứng 23,2%. Thoát vị bẹn 1 bên 92%, 2 bên 8%. Thoát vị bẹn ẩn đối bên phát hiện trong mổ 2,4%. TAPP 1 bên 92,8%, TAPP 2 bên 7,2%, TAPP kèm phẫu thuật khác 2,4%. Thời gian mổ trung bình 1 bên là 48,62 ± 13,05 phút, 2 bên là 66,11 ± 12,19 phút. Không có tai biến trong mổ. VAS sau mổ 24 giờ: 3,53 ± 0,56. Tụ dịch vùng bẹn sau mổ 11,2%. Thời gian nằm viện sau mổ 4,41 ± 1,25 ngày. Kết luận: Phẫu thuật TAPP là một phẫu thuật an toàn, có thể thực hiện được. Phẫu thuật TAPP có thể phát hiện và xử trí những tổn thương trong ổ phúc mạc cũng như các bệnh lý đi kèm. ABSTRACT LAPAROSCOPIC TRANS - ABDOMINAL PRE - PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans - abdominal pre - peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Methods: A prospective study was carried in 125 cases with inguinal hernia that have been treated by laparoscopic trans - abdominal pre-peritoneal (TAPP) repair. Results: The mean age was 56.25 ± 19.06 years old. 96.7% were male. 76,8% of hernia were symptomatic, and 23.3% were complicated. 92% of hernia were unilateral, 8% were bilateral, 2.4% were occult. 92.8% would perfom an unilateral TAPP repair, 7.2% bilateral TAPP repair, 2.4% simultaneous TAPP and cholecystectomy. The mean operative time was 48.62 ± 13.05 minutes for unilateral TAPP, 66.11 ± 12.19 minutes for bilateral TAPP. The mean VAS 24h post - op was 3.53 ± 0.56. Regarding postoperative complications, inguinal seroma was detected in 11,2% of cases. The mean postoperative hospital stay was 4.41 ± 1.25 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases. Keywords: Inguinal hernia, laparoscopic, trans - abdominal pre - peritoneal (tapp)

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