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Zhang L, Zhang R, Zhang J, Hu H, Chen Z, Fu Y, Li S. To use a simple hernia needle for single-port laparoscopic percutaneous inguinal hernia repair in children: a 5-year experience study. Front Pediatr 2024; 11:1298643. [PMID: 38259601 PMCID: PMC10801725 DOI: 10.3389/fped.2023.1298643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose The aim of this study is to investigate the technique and practical significance of using a simple hernia needle in single-port laparoscopic herniorrhaphy in pediatric patients. Methods The study conducted a retrospective analysis of all pediatric patients who underwent treatment for inguinal hernia using single-port laparoscopic herniorrhaphy with a simple hernia needle at Yellow River Sanmenxia Hospital from June 2018 to May 2023. The medical records of all the children were collected, and clinical characteristics, procedural information, and follow-up data were carefully reviewed. Results A total of 848 patients underwent inguinal hernia repair, with ages ranging from 7 months to 13 years (2.99 ± 2.49 years), including 756 males and 92 females. A total of 528 cases of unilateral hernia and 310 cases of bilateral hernia were reported, with intra-operative findings revealing contralateral occult hernia in 253 cases. Single-port laparoscopic herniorrhaphy was successfully completed in all patients, with no instances of conversion to open surgery. The mean operation time for unilateral hernia repair was (7.50 ± 4.80) min, while for bilateral hernia repair it was (11.55 ± 7.27) min. Five patients presented with subcutaneous emphysema, while two patients experienced a recurrence of inguinal hernia. No complications, such as scrotal hematoma, trocar umbilical hernia and testicular atrophy, were observed. The duration of the follow-up period ranged from 3 to 24 months. Conclusion The promotion and utilization of single-port laparoscopy combined with a simple hernia needle in clinical practice are justified. Our initial investigation indicates that this surgical approach is both safe and dependable for the management of pediatric inguinal hernia. The procedure presents numerous benefits, including the utilization of uncomplicated instruments, straightforward operation, a clear curative impact, minimal tissue damage, rapid recovery, and the absence of scarring.
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Affiliation(s)
- Li Zhang
- Department of General Surgery, Yellow River Sanmenxia Hospital, Sanmenxia, China
| | - Rui Zhang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Jianfa Zhang
- Department of General Surgery, Yellow River Sanmenxia Hospital, Sanmenxia, China
| | - Hailong Hu
- Department of General Surgery, Yellow River Sanmenxia Hospital, Sanmenxia, China
| | - Zihan Chen
- Department of General Surgery, Yellow River Sanmenxia Hospital, Sanmenxia, China
| | - Yanxiang Fu
- Department of General Surgery, Yellow River Sanmenxia Hospital, Sanmenxia, China
| | - Saihua Li
- Department of General Surgery, Yellow River Sanmenxia Hospital, Sanmenxia, China
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Kunitsky KD, Almajedi M, Snajdar E, Adams P, Nelson R. Single-Port Robotic-Assisted Excision of the Urachal Remnant in an Adult Female: A Case Report. Cureus 2024; 16:e53235. [PMID: 38425617 PMCID: PMC10903574 DOI: 10.7759/cureus.53235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Urachal anomalies and their associated disease processes are quite rare in pediatric populations and even rarer in adults. Although often asymptomatic, patients with symptoms can be treated with a combination of surveillance, antibiotics, and sometimes surgical resection. In this case, we describe our experience using the single-port robotic approach for the excision of a symptomatic urachal remnant. The patient presented with a chief complaint of urinary frequency, dysuria, intermittent hematuria, and right flank pain. A CT scan of the abdomen and pelvis revealed a bladder wall thickening at the dome of the bladder measuring 2.6 x 3.6 x 1.5 cm with concerns for adenocarcinoma. The patient subsequently underwent a biopsy, which was benign. The patient's symptoms persisted, and she elected to undergo surgical resection. Postoperatively, her symptoms resolved, and she was satisfied with her treatment outcome. This case exemplifies the feasibility of the single-port robotic approach to urachal remnant excision, with further applicability to simple transabdominal robotic bladder surgery.
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Affiliation(s)
| | - Mustafa Almajedi
- Department of Urology, McLaren Macomb, Mount Clemens, USA
- Department of Urology, Henry Ford Macomb, Clinton Township, USA
| | - Elizabeth Snajdar
- Department of Urology, McLaren Macomb, Mount Clemens, USA
- Department of Urology, Henry Ford Macomb, Clinton Township, USA
| | - Parker Adams
- Department of Urology, McLaren Macomb, Mount Clemens, USA
- Department of Urology, Henry Ford Macomb, Clinton Township, USA
| | - Ryan Nelson
- Department of Urology, McLaren Macomb, Mount Clemens, USA
- Department of Urology, Henry Ford Macomb, Clinton Township, USA
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Misawa A, Okubo MM, Nagae S, Yokomizo R, Aoki H, Takanashi H. Successful use of single-port laparoscopic surgery for ovarian cyst removal during pregnancy: a case series of three cases. J Surg Case Rep 2023; 2023:rjad345. [PMID: 37346456 PMCID: PMC10281701 DOI: 10.1093/jscr/rjad345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023] Open
Abstract
Pregnant patients have an increased risk of torsion compared to that seen in nonpregnant patients, and those with larger cysts undergo torsion more frequently, which can cause obstructions during labor. The risks associated with emergent surgery are higher than those with elective surgery. Laparoscopic surgery can be safely performed during pregnancy. Single-port laparoscopic surgery is reported to be a minimally invasive laparoscopic technique. We report three cases of ovarian dermoid cysts, which were successfully removed during pregnancy through elective single-port laparoscopic surgery. In all cases, imaging showed a dermoid cyst and the cyst size was greater than 6 cm. All patients requested the surgery. The ovarian cysts were successfully removed by single-port laparoscopy without additional ports and without intra- or postoperative complications. All pregnancies progressed well and delivered vaginally at full term. The single-port laparoscopic approach is useful for removing ovarian cysts during pregnancy.
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Affiliation(s)
- Akihiko Misawa
- Correspondence address. Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, 5-15-1, Honson, Chigasaki-city, Kanagawa, 253-0042, Japan, Tel: 81-46-752-1111 ext. 5238; Fax: 81-46-754-0770; E-mail:
| | - Miki Muto Okubo
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Seika Nagae
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Ryo Yokomizo
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Hiroaki Aoki
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Hiroko Takanashi
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
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Güngördük K, Gülseren V, Özdemir İA. Laparoscopic surgery of large adnexal masses (>12 cm): Single port or conventional? Asian J Endosc Surg 2023. [PMID: 36793236 DOI: 10.1111/ases.13170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/28/2022] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION We aimed to compare single-port laparoscopic surgery (SPLS) and conventional multiport laparoscopic surgery (CMLS) for large adnexal mass (AM). METHODS Patients undergoing laparoscopy (LS) due to huge AMs (≥12 cm) between 2016 and 2021 were evaluated retrospectively. The SPLS procedure was applied in 25 cases, and CMLS was performed in 32 cases. The premier result was the grade of the postoperative improvement according to the Quality of Recovery (QoR)-40 questionnaire score (24 h after the surgical procedure; postoperative day 1). Observer Scar Assessment Scale (OSAS) and Patient Observer Scar Assessment Scale (PSAS) were also evaluated. RESULTS A total of 57 cases undergoing SPLS (n = 25) or CMLS (n = 32) due to a large AM (≥12 cm) were analyzed. No meaningful distinctions in age, menopausal status, body mass index, or mass size were observed between the two cohorts. The operation time was shorter in the SPLS than CPLS cohort (42.2 ± 3.3 vs. 47.6 ± 6.2; p < 0.001). Unilateral salpingo-oophorectomy was performed in 84.0% of cases in the SPLS cohort and 90.6% of patients in the CMLS cohort (p = 0.360). The QoR-40 points were significantly higher in the SPLS than the CMLS group (154.9 ± 12.0 vs. 146.2 ± 17.1; p = 0.035). The OSAS and PSAS scores were lower in the SPLS than the CMLS group. CONCLUSION LS can be used for large cysts that are not considered to be at risk of malignancy. The postoperative recovery time was shorter in patients undergoing SPLS compared to CMLS.
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Affiliation(s)
- Kemal Güngördük
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of gynecologic oncology, Sıtkı Koçman University, Muğla, Turkey
| | - Varol Gülseren
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of gynecologic oncology, Erciyes University, Kayseri, Turkey
| | - İsa Aykut Özdemir
- Department of Obstetrics and Gynecology, Division of gynecologic oncology, Medipol University, İstanbul, Turkey
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Kim JM, Lee SM, Seol A, Song JY, Ryu KJ, Lee S, Park HT, Cho HW, Min KJ, Hong JH, Lee JK, Lee NW. Comparison of Surgical Outcomes between Single-Port Laparoscopic Surgery and Da Vinci Single-Port Robotic Surgery. J Pers Med 2023; 13:jpm13020205. [PMID: 36836439 PMCID: PMC9961794 DOI: 10.3390/jpm13020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The aim of this study is to compare the surgical outcomes of single-port laparoscopic surgery (SPLS) and single-port robotic surgery (SPRS). METHODS We retrospectively analyzed patients who underwent a hysterectomy, ovarian cystectomy, or myomectomy with SPLS or SPRS from January 2020 to July 2022. Statistical analyses were performed using the SPSS chi-square test and student's t-test. RESULTS A total of 566 surgeries including single-port laparoscopic hysterectomy (SPLH; n = 148), single-port robotic hysterectomy (SPRH; n = 35), single-port laparoscopic ovarian cystectomy (SPLC; n = 207), single-port robotic ovarian cystectomy (SPRC; n = 108), single-port laparoscopic myomectomy (SPLM; n = 12), and single-port robotic myomectomy (SPRM; n = 56). The SPRH, SPRC, and SPRM groups had a shorter operation time than the SPLS group, although the results were not statistically significant (SPRH vs. SPLH, p = 0.134; SPRC vs. SPLC, p = 0.098; SPRM vs. SPLM, p = 0.202). Incisional hernia occurred as a postoperative complication in two patients only in the SPLH group. Postoperative Hb changes were lower in the SPRC and SPRM groups than in the SPLC and SPLM groups (SPRC vs. SPLC, p = 0.023; SPRM vs. SPLM, p = 0.010). CONCLUSIONS Our study demonstrated that the SPRS had comparable surgical outcomes when compared to the SPLS. Therefore, the SPRS should be considered a feasible and safe option for gynecologic patients.
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Affiliation(s)
- Jeong-Min Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Seon-Mi Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Aeran Seol
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Jae-Yun Song
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
- Correspondence:
| | - Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Sanghoon Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Hyun-Tae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Hyun-Woong Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Kyung-Jin Min
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si 15355, Gyeonggi-do, Republic of Korea
| | - Jin-Hwa Hong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Jae-Kwan Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Nak-Woo Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si 15355, Gyeonggi-do, Republic of Korea
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Jiang L, Zhao X, Han Y, Liu K, Meng X. Giant Ovarian Cysts Treated by Single-Port Laparoscopic Surgery: A Case Series. Front Oncol 2021; 11:796330. [PMID: 34956907 PMCID: PMC8695676 DOI: 10.3389/fonc.2021.796330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background Ovarian cysts are very common diseases of the female reproductive system. Giant ovarian cysts refer to the tumors with diameters greater than 10 cm. In recent years, due to the development of clinical diagnosis, imaging modalities, and the improvement of patients’ cognition of the diseases, the occurrence of giant ovarian cysts has become rare. The purpose of this study was to show a new operation method of single-port laparoscopy to treat giant ovarian cysts. Methods We report a case series of five patients with giant ovarian cysts who underwent single-port laparoscopic surgery in the gynecology department of the Shengjing Hospital of China Medical University between June 2020 and March 2021. The inclusion criteria were ovarian cysts at least 20 cm in diameter, and cases when the tumor might be malignant were excluded. Results The patients’ mean age was 26.2years. The most common clinical presentation was progressive abdominal distension. Median size of the cysts at imaging was 39.2 cm (range 21–63 cm). All patients underwent single-port laparoscopic surgery, and none of them converted to laparotomy. On final pathological reports, two cysts were serous cystadenomas, and three were mucinous cystadenomas. All patients recovered well and were discharged on time. Conclusion Giant ovarian cysts can be treated by single-port laparoscopic surgery. In addition to the well-known advantages of laparoscopic surgery (e.g., small pelvic interference, fast postoperative recovery), it can also play the role of perfect cosmetic results, which has more advantages for young women.
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Affiliation(s)
- Lili Jiang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xinyu Zhao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Han
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kuiran Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xinyue Meng
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
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7
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Nakayama K, Yoshimura Y, Razia S, Yamashita H, Ishibashi T, Ishikawa M, Sasamori H, Sawada K, Kurose S, Sato S, Kyo S. Single-port laparoscopic surgery for ovarian cystectomy: A single-center analysis of 25 cases. Mol Clin Oncol 2021; 15:160. [PMID: 34194739 PMCID: PMC8237204 DOI: 10.3892/mco.2021.2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/07/2021] [Indexed: 11/17/2022] Open
Abstract
Innovation in gynecological surgery is constantly evolving to make procedures less invasive. Minimally invasive single-port laparoscopic surgery (SPLS) is another innovation that may further improve gynecological surgery outcomes. However, SPLS is not widely used due to the technical difficulties of the procedure. Inserting several instruments through the same incision impedes proper use of the devices. Therefore, the present study aimed to find a technique to overcome this problem and make this approach more convenient. Between March 2015 and February 2020, 25 patients were treated with SPLS by a single gynecological surgeon. The range of surgery time was 50-103 min and the mean surgery time was 67.2 min. The mean bleeding volume was small (mean, 10.1 ml). No intraoperative or postoperative complications occurred in the patients. A gel port (GelPOINT® Mini Medical Leaders) was inserted into the peritoneal cavity through a 3-cm Z-shaped intra-umbilical skin incision. Additionally, a small incision (3 mm) was made in the left medial portion of the iliac crest and a bladeless trocar (Versa One®) was inserted. Thus, crowding of the working instruments within one incision was prevented. The addition of a small diameter port (3-mm) at the wound site left practically no scar, thus making SPLS a cosmetically superior option compared with a bigger diameter port (5-mm).
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Affiliation(s)
- Kentaro Nakayama
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Yuki Yoshimura
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
- Department of Obstetrics and Gynecology, Hamada Medical Center, Hamada, Shimane 6978511, Japan
| | - Sultana Razia
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Hitomi Yamashita
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Tomoka Ishibashi
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Masako Ishikawa
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Hiroki Sasamori
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Kiyoka Sawada
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Sonomi Kurose
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Seiya Sato
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
| | - Satoru Kyo
- Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan
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Arnold AA, May V, Nanthakumaran S, Pagad S, Somagutta MR, Sridharan S, Malik BH. Reversal of Hartmann's Procedure: Evaluating Outcomes of Single-Port Laparoscopic Approach Versus Conventional Approach. Cureus 2020; 12:e11916. [PMID: 33425502 PMCID: PMC7785510 DOI: 10.7759/cureus.11916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Bowel restoration following Hartmann's procedure (HP) remains a topic of discussion and innovation. This article seeks to highlight and analyze the outcomes of conventional reversal approaches such as open surgery (OS) and conventional laparoscopic (CL) to single-port laparoscopic reversal (SPLR) approach to evaluate whether SPLR is a feasible alternative to the OS or CL approach. A PubMed search using keywords yielded 5,750 articles. After applying the inclusion/exclusion criteria, 40 articles of relevance were reviewed, and endpoints considered. These included 13 systematic reviews and 27 observational reviews, three of which identified themselves as retrospective or comparative studies. The analysis showed overwhelming support for CL over OS as a choice for HP reversal. Studies comparing SPLR to CL showed SPLR to be a safe and feasible alternative, given its significantly shorter operating times, hospitalization times, and complication rates.
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Affiliation(s)
- Ashley A Arnold
- Surgery, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Vanessa May
- Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Saruja Nanthakumaran
- Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Sukrut Pagad
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Manoj R Somagutta
- Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Saijanakan Sridharan
- Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Bilal Haider Malik
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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9
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Thambi P, Borowski DW, Sathasivam R, Obuobi RB, Viswanath YKS, Gill TS. Single-incision laparoscopic reversal of Hartmann's operation through the stoma site: comparative outcomes with conventional laparoscopic and open surgery. Colorectal Dis 2019; 21:833-840. [PMID: 30897258 DOI: 10.1111/codi.14617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 03/01/2019] [Indexed: 12/11/2022]
Abstract
AIM Restoration of bowel continuity after Hartmann's procedure (RoH) can be challenging and associated with considerable morbidity. A technique using single-incision laparoscopic surgery through the stoma site (SIL RoH) has been shown to be feasible and safe. In this study, we compared clinical outcomes of SIL RoH with conventional laparoscopic surgery (CL) and open surgery (OS). METHODS This was a retrospective analysis of a prospectively maintained database between 2007 and 2017 in a UK colorectal unit. The access technique was decided by the surgeon on a case by case basis. RESULTS A total of 106 patients underwent RoH. It was carried out for diverticular disease (n = 71, 67.6%), cancer (n = 19, 17.9%) and anastomotic leak (n = 4, 3.8%). The remainder (n = 12, 11.3%) were for miscellaneous reasons including trauma. Most RoHs were performed via OS (n = 87, 81.1%). The most common intended approaches for RoH were SIL (n = 56, 52.8%) and OS (n = 34, 32.1%) with fewer starting with CL (n = 16, 15.1%). Conversion to OS took place in five (8.9%) patients with SIL and six (37.5%) with CL (P = 0.005). Postoperative complications occurred in 17 (30.4%) for SIL, seven (43.8%) for CL and 17 (50.0%) for OS (P = 0.162). Median operating time for SIL was 146 min (range 44-389), 211 min (109-320) for CL and 211 min (85-420) for OS (P < 0.001). Median length of stay was 4 days (2-44) for SIL compared to 6 (3-34) for CL and 7 (4-34) for OS (P < 0.001). Discharge on or before day 5 was achieved in 41 (74.5%) patients for SIL compared to six (37.5%) for CL and seven (20.6%) for OS (P < 0.001). CONCLUSION Compared to OS and CL, SIL RoH appears to have shorter operating times and hospitalization, with no discernible difference in morbidity; this finding requires further evaluation in a randomized setting.
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Affiliation(s)
- P Thambi
- Department of Surgery, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-on-Tees, UK
| | - D W Borowski
- Department of Surgery, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-on-Tees, UK.,Welwitschia Hospital, Walvis Bay, Namibia
| | - R Sathasivam
- Department of Surgery, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-on-Tees, UK
| | - R-B Obuobi
- Department of Surgery, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Y K S Viswanath
- Department of Surgery, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - T S Gill
- Department of Surgery, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-on-Tees, UK
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10
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Hirano Y, Hiranuma C, Hattori M, Douden K, Yamaguchi S. Long-term oncological outcomes of single-port laparoscopic surgery for colon cancer. ANZ J Surg 2019; 89:408-411. [PMID: 30873699 DOI: 10.1111/ans.15076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/25/2018] [Accepted: 12/27/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND We retrospectively reviewed our consecutive experience from the introduction of single-port laparoscopic surgery (SPS) for colon cancer, and its 5-year oncological outcomes are evaluated. METHODS A total of 288 patients (140 males) with a mean age of 71.5 years were treated with the single-port laparoscopic colectomy for stage I, II and III colon cancers. Exclusion criteria of SPS were patients with unresolved bowel obstruction, T4b tumour, tumour perforation and severe medical illness. RESULTS In 20 patients (6.9%), we inserted an extra port mainly to transect the rectum. The median follow-up period was 52 months. The 5-year relapse-free survival rates in stage I, II and III patients were 95.8%, 80.2% and 61.6%, respectively. The 5-year overall survival rates for stage I, II and III patients were 97.4%, 85.3% and 72.9%, respectively. The 5-year cancer-specific survival rates in patients diagnosed pathologically T1, T2, T3 and T4 were 100%, 100%, 92.1% and 73.9%, respectively. CONCLUSIONS SPS colectomy can be applied to the treatment of colon cancer with good long-term oncological outcomes. However, we should pay more attention when we treat the pathologically diagnosed T4 tumours.
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Affiliation(s)
- Yasumitsu Hirano
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | | | | | - Kenji Douden
- Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
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Paik KY, Yoon SH, Kim SG. Safety and feasibility of single-port laparoscopic appendectomy as a training procedure for surgical residents. J Minim Access Surg 2018; 16:13-17. [PMID: 30178766 PMCID: PMC6945334 DOI: 10.4103/jmas.jmas_136_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Single-port laparoscopic appendectomy (SPLA) is one of the most commonly performed single-port surgeries worldwide. This study aimed to determine whether the performance of SPLA by residents without sufficient experience as operators of conventional LA (CLA) is safe and feasible. Patients and Methods: Records of patients who underwent LA between March 2017 and February 2018 at a hospital in Korea were retrospectively analysed. Patients aged <18 years or >80 years were excluded from the study. SPLA and CLA were performed by two 2nd-year residents (junior group) and three 3rd-year residents (senior group). Demographic data, perioperative variables and surgical outcomes were compared. Results: During the study period, 154 patients underwent LA (104 SPLA and 50 CLA) performed by surgical residents. No differences were found between the SPLA and CLA groups in demographic data or perioperative variables, except for the drain insertion rate. The SPLA group had significantly shorter mean operation times than did the CLA group. No significant difference was observed between the junior and senior groups in the mean operation time for LA. Perioperative outcomes were not significantly different between groups. Fewer women underwent SPLA performed by 2nd-year residents compared with SPLA performed by 3rd-year residents. However, there were no differences in other general characteristics or perioperative outcomes. Conclusions: SPLA was safe and feasible when performed by junior residents. Surgical residents with sufficient experience as assistants during laparoscopic appendectomies could perform SPLA safely. Furthermore, SPLA could serve as a teaching procedure for surgical residents.
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Affiliation(s)
- Kwang Yeol Paik
- Department of Surgery, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Seung Hoon Yoon
- Department of Surgery, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Sung Geun Kim
- Department of Surgery, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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Dhaou MB, Zouari M, Zitouni H, Jallouli M, Mhiri R. Single-port laparoscopic ovarian transposition in an 11-year-old girl. Afr J Paediatr Surg 2018; 15:146-147. [PMID: 32769367 PMCID: PMC7646686 DOI: 10.4103/ajps.ajps_1_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ovarian transposition was the first procedure proposed for children with cancer to preserve ovarian function from damage caused by abdominal and pelvic radiotherapy. In this paper, we describe the first paediatric case of single-port laparoscopic ovarian transposition.
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Affiliation(s)
- Mahdi Ben Dhaou
- Department of Pediatric Surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Zouari
- Department of Pediatric Surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Hayet Zitouni
- Department of Pediatric Surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Mohamed Jallouli
- Department of Pediatric Surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia
| | - Riadh Mhiri
- Department of Pediatric Surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia
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13
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Takeda M, Tokuoka M, Hirose H, Ide Y, Hashimoto Y, Matsuyama J, Yokoyama S, Morimoto T, Fukishima Y, Nomura T, Kodama K, Sasaki Y. Short-term outcomes following single-port laparoscopic surgery in elderly patients with colon cancer compared with younger patients. Oncol Lett 2017; 14:1595-1601. [PMID: 28789384 DOI: 10.3892/ol.2017.6344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 02/03/2017] [Indexed: 11/06/2022] Open
Abstract
Surgeons are increasingly being faced with the challenge of treating elderly patients with colon cancer. The present study therefore aimed to compare the short-term outcomes of single-port laparoscopic surgery (SILS) for elderly patients with colon cancer (≥70 years) with those in younger patients (41-69 years; control group). Among 100 patients with colorectal cancer who had been treated with single-port laparoscopic surgery between January 2011 and December 2014, 56 (56.0%) were ≥70 years of age. The results of treatment and short-term outcomes in the elderly group (n=56) were retrospectively compared with the younger patients in the control group (n=44). The sex distribution, body mass index, history of prior surgery and the American Society of Anesthesiologists physical status classification were similar between the groups. Onodera's prognostic nutritional index demonstrated significant differences between the elderly and control groups (38.3 vs. 49.8; P<0.05). No significant differences were observed in the mean length of surgery (219.5±73.5 vs. 201.4±76.5 min; P=0.43), estimated blood loss (32.2±74.5 vs. 36.1±90.2 ml; P=0.10), postoperative complications (10.9 vs. 7.1%; P=0.78), length of postoperative hospital stay (9.6±12.5 vs. 7.3±3.0 days; P=0.23) or number of harvested lymph nodes (21.8±24.3 vs. 22.5±11.3; P=0.87) between the elderly and control groups. In conclusion, the results of the present study demonstrate that SILS may be carried out feasibly in elderly patients with colon cancer.
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Affiliation(s)
- Mitsunobu Takeda
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Masayoshi Tokuoka
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Hajime Hirose
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yoshihito Ide
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yasuji Hashimoto
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Jin Matsuyama
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Shigekazu Yokoyama
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Takashi Morimoto
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yukio Fukishima
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Takashi Nomura
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Ken Kodama
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yo Sasaki
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
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Choi BJ, Jeong WJ, Kim SJ, Lee SC. Impact of obesity on the short-term outcomes of single-port laparoscopic colectomy for colorectal cancer in the Asian population: A retrospective cohort study. Medicine (Baltimore) 2017; 96:e6649. [PMID: 28700463 PMCID: PMC5515735 DOI: 10.1097/md.0000000000006649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Single-port laparoscopic surgery (SPLS) is being increasingly performed for treating colorectal cancer. Here, we aimed to assess the safety and feasibility of SPLS for colorectal cancer in obese patients through a comparison of their short-term outcomes with those of nonobese patients.A total of 323 patients who underwent SPLS for colorectal cancer at our center between March 2009 and August 2014 were enrolled. The outcomes were analyzed according to the body mass index (BMI) category: nonobese (BMI < 25), obese I (BMI: 25.0-29.9), and obese II (BMI ≥ 30).Of the 323 patients, 233 (72.1%), 80 (24.8%), and 10 (3.1%), were assigned to the nonobese, obese I, and obese II groups, respectively. The clinicopathologic patient characteristics, such as age, gender, tumor location, and previous laparotomy, were similar among the 3 groups. The mean operative time (nonobese vs obese I vs and obese II groups: 269.2 vs 270.4 vs 342.8 minutes, respectively) and estimated surgical blood loss (277.7 vs 260.5 vs 387.0 mL, respectively) were greater in the obese II group than in the nonobese and obese I groups, although the difference was not significant (P = .247 and P = .205, respectively). However, the time to passage of flatus significantly differed among the groups (P = .040); in particular, this value was significantly longer in the obese II group than in the obese I group (P = .031). None of the other parameters, including conversion to open or conventional laparoscopic surgery and intra- and postoperative morbidity, significantly differed among the 3 groups.SPLS for colorectal cancer can be safely performed in obese Asian patients with equivalent short-term outcomes as compared with that in nonobese patients. Hence, SPLS can be safely recommended for colorectal cancer in obese patients if the surgeon is experienced. Nevertheless, the technique used warrants further investigation, and a large-scale prospective study is required.
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Kang BM, Park SJ, Lee KY, Lee SH. Single-Port Laparoscopic Surgery Can Be Performed Safely and Appropriately for Colon Cancer: Short-Term Results of a Pilot Randomized Controlled Trial. J Laparoendosc Adv Surg Tech A 2017; 27:501-509. [PMID: 28061037 DOI: 10.1089/lap.2016.0467] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Single-port laparoscopic surgery (SPLS) has gained popularity due to its cosmetic benefit, and therefore, has been applied to several kinds of benign operations, such as appendectomy and cholecystectomy. The safety and suitability of SPLS for colon cancer has not been widely proved. We aimed at validating the safety, efficacy, and short-term quality of life (QOL) of SPLS compared with conventional laparoscopic surgery (CLS) in patients with colon cancer. MATERIALS AND METHODS Between June 2010 and April 2011, a total of 62 patients with pathology-proven colon cancer were randomly allocated to two groups: SPLS and CLS. Data were analyzed according to the intention-to-treat principle. RESULTS In total, there were 62 patients (35 men and 27 women) with a mean age of 63.0 years (range, 38-82). The baseline characteristics of the patients and tumor factors were well balanced between two groups. The operation time and estimated blood loss were similar, whereas intraoperative complications only occurred in three patients, all of whom were in the SPLS group. Conversion to CLS or open surgery occurred in 6 (19.4%) patients of the SPLS group. The number of harvested lymph nodes and length of proximal and distal resection margins were not statistically different between two groups. Postoperative complications and recovery of bowel function were similar in both groups, but fatal postoperative complication occurred in one case in the SPLS group. The QOL between two groups was identical in all domains until postoperative 12 months. CONCLUSIONS SPLS for colon cancer is feasible and can be performed by following oncologic principles. However, surgeons should be aware of the potential for unexpected adjacent organ injury ( ClinicalTrial.gov identifier: NCT01203969).
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Affiliation(s)
- Byung Mo Kang
- 1 Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine , Chuncheon, South Korea
| | - Sun Jin Park
- 2 Department of Surgery, Kyung Hee Medical Center, Kyung Hee University School of Medicine , Seoul, South Korea
| | - Kil Yeon Lee
- 2 Department of Surgery, Kyung Hee Medical Center, Kyung Hee University School of Medicine , Seoul, South Korea
| | - Suk-Hwan Lee
- 3 Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine , Seoul, South Korea
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Kim SJ, Choi BJ, Lee SC. Comparative analysis of outcomes after multiport and single-port laparoscopic colectomy in emergency situations: Is single-port laparoscopic colectomy safe and feasible? Asian J Surg 2016; 41:20-29. [PMID: 27592126 DOI: 10.1016/j.asjsur.2016.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/19/2016] [Accepted: 05/20/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVE Although consensus has been reached on the superiority of laparoscopy for a majority of conditions underlying acute abdominal pain, the safety and feasibility of single-port laparoscopic colectomy (SPLC) in emergency situations have not been determined. METHODS A prospective electronic database of all emergency patients who underwent either multiport laparoscopic colectomy (MPLC) or SPLC between April 2006 and December 2014 was used to compare the surgical outcomes of these operative methods. RESULTS During the study period, 31 MPLCs and 76 SPLCs were performed. These two operative methods resulted in similar operating times, transfusion amounts, lengths of stay, postoperative complications, attainment of lymph nodes, and proximal and distal cut margins. However, the SPLC group had a shorter time to first flatus (2.8±1.9 days vs. 3.8±1.5 days, p=0.005), earlier reinitiation of free oral fluids (3.2±2.1 days vs. 4.4±1.8 days, p=0.002), and lesser requirement of narcotic analgesics (2.5±3.9 times vs. 4.7±4.8 times, p=0.017). CONCLUSION SPLC could be a safe and effective alternative to MPLC, even in emergency situations when performed by surgeons who have overcome the learning curve associated with single-port laparoscopic techniques. The tendency toward earlier returns to bowel function and decreased incidence of postoperative analgesic use would be potential benefits of SPLC in emergency situations.
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Affiliation(s)
- Say-June Kim
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Byung-Jo Choi
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Sang Chul Lee
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea.
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