scholarly journals IS UMBILICAL TUBE TECHNIQUE THE BEST METHOD TO GAIN INTRAPERITONEAL ACCESS? A PROSPECTIVE ANALYSIS OF 1532 CASES

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Apoorv Shrivastava
Keyword(s):  
Rectus Sheath ◽  
Port Site ◽  
Access Port ◽  
Umbilical Incision ◽  
Institutional Review ◽  
Vertical Incision ◽  
Port Site Hernia ◽  
One Year ◽  
Good Cosmesis

Background: Intraperitoneal access in laparoscopic surgery is the first and most important step to start a procedure. Many methods have been described in literature for the same. We share our experience of umbilical tube technique using a vertical infra umbilical or supra umbilical incision for the better cosmetic result. Methods: This study is a retrospective study of laparoscopy performed for various indications. Umbilical tube technique was performed. In 1532 cases performed from July2016to January 2019. A vertical incision was used instead of a commonly performed curve incision to access the umbilical tube. A vertical incision is again taken after exposing the junction of rectus sheath and umbilical tube. Vertical incision is again taken over the tube to gain access to peritoneal cavity. The closure is done in a similar way with skin closed in subcuticular fashion. No Institutional Review Board (IRB) approval was required for this paper. Result: The technique is found to be safe, can be performed with technical ease as anatomy is well defined, good cosmesis is achieved. The longest follow up is for a period of one year. No incidence of port site hernia or infection was seen. Conclusion: The umbilical tube technique using a vertical incision is found to be safe and effective, can be reproduced with technical ease. In our opinion this method can be considered as a standard approach to intraperitoneal access. Keywords: umbilical tube, intraperitoneal access, port site infection, port site hernia. Laparoscopy.

scholarly journals RTHP-04. PEDIATRIC STEREOTACTIC RADIOSURGERY FOR BENIGN NEUROLOGIC DISEASE: A 25-YEAR INSTITUTIONAL EXPERIENCE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi210-vi210
Author(s):  
Alexander Sherry ◽  
Brian Bingham ◽  
Ellen Kim ◽  
Benjin Facer ◽  
Valentine Chukwuma ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Venous Malformation ◽  
Disease Free Survival ◽  
Neurologic Disease ◽  
Institutional Review ◽  
Median Total Dose ◽  
Institutional Experience ◽  
One Year

Abstract Long-term outcomes and sequalae of pediatric stereotactic radiosurgery (SRS) for benign neurologic disease are poorly understood. We sought to explore the efficacy and late effects of SRS in pediatric patients treated our institution. After institutional review board approval, we performed a retrospective analysis of patients age 21 or younger treated between 1990 and 2016. Covariates were summarized with descriptive statistics. 56 consecutive patients were enrolled. Patients were primarily Caucasian (n=51, 93%) males (n=30, 54%). Diagnoses included arterio-venous malformation (n=41, 73%) and functional pituitary adenoma (n=9, 16%) as well as vestibular schwannoma, craniopharyngioma, meningioma, papilloma, and ganglioglioma. Average age was 14 years (95% CI 13–16 years). SRS was often the first intervention (n=22, 44%); treatments prior to SRS included embolization (n=18, 36%) and surgery (n=10, 20%). SRS was typically single fraction (n=45, 94%) with a median total dose of 16 Gy (IQR 15–18 Gy). Most patients had no acute side effects of SRS (n=40, 87%). Median follow-up time after SRS was 12 years (IQR 6–18 years, max 26 years). 91% of patients had no late sequelae of SRS. One patient was diagnosed with radionecrosis one year after repeat SRS for residual malformation. Two patients had malformation hemorrhage. One patient with brainstem malformation developed focal weakness after ischemia from treatment effect; another patient with malformation developed seizures related to SRS edema. Over 673 patient-years following SRS, no patient developed radiation-induced malignancy or malignant transformation. Median disease-free survival after SRS was 6 years (IQR 3–13) with 66% overall local control; 84% of local failures occurred within 5 years of SRS. At last follow-up, 95% of patients remained without evidence of disease with 100% overall survival. These data support the long-term safety and efficacy of pediatric SRS.

One-Port Laparoscopic Technique for Placement of Tenckhoff Peritoneal Dialysis Catheters: Report of Seventy-Nine Procedures

2008 ◽  
Vol 28 (6) ◽  
pp. 622-625 ◽  
Author(s):  
Hossein Ashegh ◽  
Jalal Rezaii ◽  
Khalil Esfandiari ◽  
Hassan Tavakoli ◽  
Mehdi Abouzari ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Rectus Sheath ◽  
Laparoscopic Technique ◽  
Exit Site ◽  
Exit Site Infection ◽  
Catheter Survival ◽  
Catheter Migration ◽  
Bacterial Peritonitis ◽  
Port Site Hernia

Background Laparoscopic techniques for placement of peritoneal dialysis catheters are becoming increasingly popular. In this paper, we report the results of one-port laparoscopic placement of Tenckhoff catheters in 79 patients in our center. Method Videoscopic monitoring was performed via a port inserted in the left upper quadrant and the catheter was placed via a pull-apart sheath through an incision near the umbilicus. The tip and the deep cuff of the catheter were placed into the true pelvis (on the urinary bladder) and into the rectus sheath respectively. A subcutaneous tunnel was created and a point midway on the umbilico-crestal line was selected as the exit site of the catheter. Catheters were capped for 2 weeks before initiation of peritoneal dialysis. Mean duration of the operation was 25 minutes. Results Four patients died during the follow-up period, all due to other medical problems, and 4 patients underwent renal transplantation. During a 48-month follow-up, catheter-related complications were catheter migration (1.3%; month 1), dialysate leakage (1.3%; month 1), port-site hernia (3.8%; after 6 months), exit-site infection (2.5%; months 1 and 9), and bacterial peritonitis (2.5%; after 6 months). Catheter survival was 97.2% in our series. Conclusion We obtained a low complication rate and a high catheter survival rate with this one-port laparoscopic technique.

scholarly journals Use of a novel integrated port closure system - A multi-center study

2020 ◽  
Author(s):  
Qarawany Milad ◽  
Hagar Mizrahi ◽  
Surendra Ugale ◽  
Guy Pascal ◽  
David Hazzan
Keyword(s):  
Laparoscopic Surgery ◽  
Adverse Events ◽  
Port Site ◽  
Fascial Closure ◽  
Closure System ◽  
Open Label ◽  
Trocar Site ◽  
Port Closure ◽  
Port Site Hernia ◽  
One Year

Abstract Background The incidence of port site hernia (PSH) after laparoscopic surgery can reach up to 4 %. The fascial closure at the port site can be challenging in some cases.Methods A multi-center, prospective, open label study to evaluate a new integrated port closure system (Gordian TroClose™ 1200 by Gordian Surgical™), is presented.Results Fifty patients were enrolled in the study. All enrolled patients underwent laparoscopic surgery, during which at least one TroClose1200 device was used per patient. Patients were followed for two and six weeks and for one year. No port PSH related to TroClose 1200 device was diagnosed at one year of follow-up. One PSH was diagnosed at a non-TroClose1200 trocar site. The surgeons were very satisfied with the new device’s performance, with an average range of 4.8-5.0 out of 5.0 usability question being above 4.80 out of 5. No severe adverse events or device related adverse events were observed.Conclusions The TroClose 1200 is a simple, safe and friendly device that may reduce the incidence of port site hernia.

Laparoscopic Repair of Access Port Site Hernia after Lap-Band® System Implantation

2002 ◽  
Vol 12 (5) ◽  
pp. 682-684 ◽  
Author(s):  
Sergio Susmallian ◽  
Tiberiu Ezri ◽  
Ilan Charuzi
Keyword(s):  
Laparoscopic Repair ◽  
Port Site ◽  
Access Port ◽  
Lap Band ◽  
Port Site Hernia

scholarly journals Analysis of Port Site Complications & Measures to Prevent them

2021 ◽  
Vol 07 (3&4) ◽  
pp. 1-5
Author(s):  
Arun Kumar Tiwary ◽  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Port Site ◽  
Site Infection ◽  
Common Complication ◽  
Port Site Metastasis ◽  
Visceral Injury ◽  
Port Site Hernia ◽  
Minimal Complication

Background: Port site complications following elective laparoscopic surgeries are rare. Port site infection is the most common complication. Objectives: The study was conducted to analyze port site complications occurring in the patients undergoing laparoscopic surgeries and measures to prevent them. Patients and Methods: Total 408 patients who underwent various laparoscopic surgeries were included in the study. Follow up was done for 3 months postoperatively. Port site was examined for any complication. Result: Out of 408 patients 24 patients (5.88%) developed port site complications. 14 patients developed post site infection, 4 patients had port site discharge with sinus formation, 4 patients developed port site bleeding and 2 patients had port site hernia. No case of port site metastasis or visceral injury while port insertion were found. No patient had port site omental entrapment. Conclusion: Minimally invasive surgery is a safe and effective with minimal complication.

scholarly journals Use of a novel integrated port closure system - A multi-center study

2021 ◽  
Author(s):  
Qarawany Milad ◽  
Hagar Mizrahi ◽  
Surendra Ugale ◽  
Guy Pascal ◽  
David Hazzan
Keyword(s):  
Laparoscopic Surgery ◽  
Adverse Events ◽  
Port Site ◽  
Fascial Closure ◽  
Closure System ◽  
Open Label ◽  
Trocar Site ◽  
Port Closure ◽  
Port Site Hernia ◽  
One Year

Abstract BackgroundThe incidence of port site hernia (PSH) after laparoscopic surgery can reach up to 4 %. The fascial closure at the port site can be challenging in some cases.MethodsA multi-center, prospective, open label study to evaluate a new integrated port closure system (Gordian TroClose™ 1200 by Gordian Surgical™), is presented.ResultsFifty patients were enrolled in the study. All enrolled patients underwent laparoscopic surgery, during which at least one TroClose1200 device was used per patient. Patients were followed for two and six weeks and for one year. No port PSH related to TroClose 1200 device was diagnosed at one year of follow-up. One PSH was diagnosed at a non-TroClose1200 trocar site. The surgeons were very satisfied with the new device’s performance, with an average range of 4.8-5.0 out of 5.0 usability question being above 4.80 out of 5. No severe adverse events or device related adverse events were observed.ConclusionsThe TroClose 1200 is a simple, safe and friendly device that may reduce the incidence of port site hernia.

scholarly journals CONTROLLED UNDER VISION TECHNIQUE (CUTE) OF LAPAROSCOPIC PORT SITE CLOSURE

2019 ◽  
pp. 1-2
Author(s):  
Arun Singh ◽  
Sunil Kumar Singh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Simple Technique ◽  
Port Site ◽  
Fascial Closure ◽  
New Delhi ◽  
Port Site Hernia ◽  
New Challenges ◽  
Vision Technique

BACKGROUND:Various new challenges have emerged since the introduction of laparoscopic surgery. Port site hernia is one of the serious complication. Various methods have been introduced to reduce it. The aim of this article is to introduce a procedure that is easy, safe and quick to perform and will help in decreasing port site complications after laparoscopic procedure. MATERIAL AND METHOD:We have described here a simple technique for the facial closure after laparoscopic surgery over 100 patients who underwent laparoscopic cholecystectomy repair at VMMC & Safdarjung Hospital, New Delhi. RESULT:This method was used in 100 patients with no intro-operative complication, no port site hernia reported in a follow up period of 1 year. CONCLUSION:This procedure of fascial closure is safe, quick, effective and easy to perform method of facial closure.

scholarly journals A STUDY OF PORT SITE COMPLICATIONS AFTER LAPAROSCOPIC CHOLECYSTECTOMIES AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Surendra Saini ◽  
Manish Kumar Saini
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Quality Of Healthcare ◽  
Port Site ◽  
Care Hospital ◽  
Medical College ◽  
Port Site Hernia ◽  
Elective Laparoscopic Cholecystectomy

Background: Port site complications though rare, shall be evaluated and studied so as to improve the quality of healthcare. Materials and Methods: This prospective study was conducted in the Department of General Surgery, Sardar Patel Medical College & P.B.M. Hospital, Bikaner, Rajasthan. 200 patients of all age group and both sexes with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy. Result: Out of 200 patients studied only 1 patient presented with port site hernia in the follow up and 13 patients presented with port site infection. No other complication was detected   after laparoscopic cholecystectomies. Conclusion:  It is concluded that port site complications are rare in elective laparoscopic cholecystectomy and can be further reduced by proper selection of patients, and strictly following basic principles of laparoscopic cholecystectomy. Keywords: Laparoscopic surgeries, Port site infections, Complications

scholarly journals Late Deep Infections Complicating Percutaneous Pinning of Supracondylar Humerus Fractures

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Achraf H. Jardaly ◽  
Ketrick LaCoste ◽  
Shawn R. Gilbert ◽  
Michael J. Conklin
Keyword(s):  
Closed Reduction ◽  
Late Complications ◽  
Percutaneous Pinning ◽  
Institutional Review ◽  
Fractures In Children ◽  
Irrigation And Debridement ◽  
Supracondylar Humerus Fractures ◽  
Humerus Fractures ◽  
One Year

Objectives. Complications following treatment of supracondylar humerus fractures are typically seen shortly postoperatively. Late complications occurring years after percutaneous pinning are rare but can be indolent and have permanent sequelae. We present cases of children presenting with late deep infections to discuss their diagnosis and treatment. Methods. After institutional review board approval, we retrospectively reviewed records of three children who developed deep infections at least one year after percutaneous pinning of their supracondylar humerus fracture. Patient details and outcomes were analyzed. Radiographs and magnetic resonance imaging were reviewed along with each patient’s clinical course and treatment. Results. We report 3 cases of osteomyelitis and/or septic arthritis presenting at least one year after supracondylar humerus fractures treated with closed reduction and percutaneous pinning. The patients required several irrigation and debridement procedures with placement of antibiotic beads in addition to a prolonged course of antibiotics. Conclusion. Delayed deep infections can occur after closed reduction and percutaneous pinning of supracondylar humerus fractures in children. Vigilance is required to diagnose and treat such occurrences, and prolonged follow-up is needed to monitor for recurrent or intractable infections.

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