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Principles of laparoscopic and robotic surgery
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
At present, work has already started on single-port laparoscopy (see above under Single incision laparoscopic surgery), in which a single port may act as a camera and have unfolding instruments that open up once they are inside the peritoneum to perform the surgery, therefore reducing the number of port sites needed. Extensive research is also being carried out in the field of NOTES. Minimising the potential contamination of the peritoneum and the ability to carry out a safe closure of the peritoneal entry site are the main technical challenges of this type of minimally invasive and essentially ‘scarless' or ‘incisionless' surgery. It is certain that there is much that is new in minimal access surgery. Only time will tell how much of what is new is truly better.
Predictors of Pain Development after Laparoscopic Adnexectomy: A Still Open Challenge
Published in Journal of Investigative Surgery, 2022
Giovanni Buzzaccarini, Péter Török, Amerigo Vitagliano, Stamatios Petousis, Marco Noventa, Ismet Hortu, Andrea Giannini, Antonio Simone Laganà
Other than complications, an optimal surgical technique should tend to the minimal pain development after the procedure. Indeed, pain related to adnexectomy should be further addressed, to reduce also recovery time as well as the opioids administration. Predictors for post-operative pain are often assessed comparing different techniques (e.g., minimally invasive approaches vs. laparotomy), aiming to find new targets of technical intervention. For instance, when comparing single-port laparoscopy with traditional laparoscopic approach, the number of trocars inserted was found associated with postoperative pain. However, a laparoscopic approach with a reduced number of trocars is associated with less space in the operative field and, possibly, the intraoperative time required could be increased [8]. Accordingly, a large systematic review and meta-analysis answered the question providing evidence about pain related to adnexal surgery when comparing single-port laparoscopy and the traditional laparoscopic approach. Indeed, the techniques presented similar pain scores [9]. These findings may suggest that the sole surgical technique can be insufficient for determining the best option in terms of pain reduction. Based on a perspective of focus-targeted medicine, the subgroup analysis on large cohorts should be always performed.
“Cecal Resection with Bipolar Sealing in a Rat Model”: A Promising Approach for Future Human Studies
Published in Journal of Investigative Surgery, 2020
Hernan A. Sanchez Trejo, Daniel Hakakian, Rolando H. Rolandelli, Andrew M. Nouri, Luca Antonioli, Zoltan H. Nemeth
The benefits of energy sealing devices are not limited to cost and time, they also extend to ease of use associated with energy sealing devices, as many surgeons are already trained in operating with them. For those new to the field, the speed with which one can be trained in the technique provides additional cost-saving and training benefits. These devices can be used in a surgical training setting in Bioskills labs where bursting pressures can be measured to assess the quality of the sealing in animal models or cadavers [9]. Given the simplicity of the application, the use of energy sealing devices has the potential to reduce the number of mini-laparotomies performed when bowel anastomosis is needed during a laparoscopic case. In addition, energy sealing devices may be more applicable when conducting single port laparoscopy (SPL) or natural orifice transluminal endoscopic surgeries (NOTES). Space is limited with these types of operations so, therefore, using one device would be beneficial [10].
Laparoscopy-assisted suprapubic salpingectomy ‘Kaya technic’ - a low-cost treatment of ectopic pregnancy
Published in Journal of Obstetrics and Gynaecology, 2019
Cihan Kaya, Ismail Alay, Ecem Eren, Ozlem Helvacioglu
Yoon et al. (2011) compared single port laparoscopy with CL for ectopic pregnancies with 30 patients in each group. They found no significant differences in operative time, complication rate or the duration of hospitalisation (Yoon et al. 2011). Marcelli et al. (2012) found that the operative time was longer for the single-incision laparoscopy, but the duration of hospitalisation was significantly shorter. In our study, we observed a shorter duration of surgery than for the CL group. We may speculate that shorter surgeries may be due to the faster aspiration of coagulum and free blood with the aspirators used in open laparotomy procedures in the pelvic cavity than for the smaller laparoscopic aspiration devices. We also observed lesser VAS scores in the LASS group and we may postulate that shorter duration of the surgery that allowing faster recovery of bowel function and abdominal distension, and less more likely due to the reduced number of skin incisions could contribute lesser pain scores.