Re: Laparoscopic ureteroneocystostomy.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
A Gershman
Publications and source records attributed to A Gershman.
Laparoscopic vesicoureteroplasty in children: initial case reports.
OBJECTIVE: To determine the feasibility of performing laparoscopic vesicoureteroplasty in children. METHODS: Two pediatric patients, a two-year-old boy and a five-year-old girl, underwent laparoscopic vesicoureteroplasty for vesicoureteral reflux. Operating time was two hours fifteen minutes and three hours fifteen minutes, respectively. RESULTS: The reflux was successfully corrected without morbidity, and they required only short hospitalization (23 hours) and exhibited decreased peri- and post-operative pain as well as improved cosmesis. CONCLUSIONS: These cases represent the first implementation of this technique in humans. We stress that this is a preliminary report and suggest that this technique deserves further study.
Child, Preschool↗
Laparoscopic renal surgery in children.
A total of 17 laparoscopic renal procedures was performed in children, including nephrectomy (10), nephroureterectomy (4), partial nephrectomy (2) and giant renal cyst excision (1). Patient age ranged from 4 months to 11 years (average age 34 months). The average operating time was 2 hours and 15 minutes, ranging from 1 hour 50 minutes to 2 hours 45 minutes. The usual period of hospitalization was 23 hours, with the longest being 36 hours for 2 patients. No complications ensued. Despite the decreased working space in children, laparoscopic renal surgery offers compelling advantages, including short hospitalization, less perioperative and postoperative pain, improved cosmesis, earlier return to normal unrestricted activities and early return to work for the parents. Methods to accomplish renal laparoscopic surgery safely in children are detailed.
Child↗
Laparoscopic seromyotomy (auto-augmentation) for non-neurogenic neurogenic bladder in a child: initial case report.
An eight-year-old boy with lifelong urinary incontinence secondary to non-neurogenic neurogenic bladder underwent successful laparoscopic seromyotomy (auto-augmentation) with resultant cure of his incontinence. The ability to perform this laparoscopically with its seventy-minute operating time, decreased hospital stay, and improved cosmesis militates for its consideration before a standard augmentation is performed.
Child↗
Laparoscopic choledochoscopy: an effective approach to the common duct.
With increasing acceptance of routine cholangiography during laparoscopic cholecystectomy (for confirmation of anatomy) there has been increased identification of common duct calculi. A technique of laparoscopic transcystic common duct stone extraction is described and early clinical results are presented. Successful stone extraction was accomplished in 39 out of 41 consecutive attempts by one surgical team. Two cases required choledochotomy. There were four complications including hyperamylasemia (2), minor wound infection (1), and incidental pneumothorax (1). Recommendations regarding safety and indications are presented. Initial evaluation suggests laparoscopic transcystic stone extraction is safe and effective.
Adolescent↗
Percutaneous endoscopic implantation of Automatic Implantable Cardioverter/Defibrillator (AICD): an animal study of a new nonthoracotomy technique.
The Automatic Implantable Cardioverter/Defibrillator (AICD) prevents death due to malignant ventricular arrhythmias but requires thoracotomy for the implantation of the preferred two-patch lead system. The purpose of this study was to develop and test a new percutaneous endoscopic method of the AICD lead implantation without the need for open chest surgery. A high resolution video endoscopy system and currently available endoscopic instrumentation were used to develop pleural-pericardial dissection technique in 7 pigs and to endoscopically implant custom-made AICD patches in 20 pigs. An examining 10 mm rigid endoscope inserted in the 6th intercostal space in the anterior axillary line provided direct visual control for endoscopic dissection of the parietal pleura from the pericardium, delivery, and implantation of the AICD patches. This was successfully carried out through two trocars (10 and 11 mm) inserted into the pleural-pericardial space via the subxyphoid approach in 18 of 20 pigs. Effective patch positioning was confirmed by attaining a defibrillation threshold of 20J or less in 13 pigs. Of those, three required lead polarity reversal, and three others required lead repositioning to lower defibrillation thresholds to 20J or less. In three pigs, defibrillation thresholds of 30J or higher were required. Defibrillation was unsuccessful in two pigs due to patch malfunction. The authors conclude that percutaneous endoscopy is a feasible method of AICD lead implantation.
Animals↗
Laparoscopic cholecystectomy: instrumentation and technique.
Laparoscopic cholecystectomy is rapidly evolving as a therapeutic modality for the treatment of gallstone disease. The technical details of this procedure and the method by which the gallbladder is dissected and removed are critical to the safe, effective execution of the procedure. Our technique has been developed through extensive practice in porcine models and through experience with more than 250 patients. To perform laparoscopic cholecystectomy we employ a high-resolution video endoscopy system, two high-resolution color monitors, a high-flow CO2 insufflator, a 300 W Xenon light source, electrocautery and/or lasers, and an endoscopic suction-irrigation system. This equipment permits the surgeon to obtain a clear field of view within the abdomen. With these tools, appropriately designed for laparoscopic surgery, including a laparoscope, graspers, dissectors, cholangiography equipment, scissors, and clip appliers, the surgeon can remove the gallbladder without opening the abdomen. The procedure requires the induction of a CO2 pneumoperitoneum, insertion of four trocars, and placement of a grasping retractor to set the operative field. An additional retractor placed on Hartmann's pouch provides countertraction for dissection of the hilum. Careful dissection around the cystic duct and cystic artery with a combination of electrocautery and blunt dissection allows the surgeon to skeletonize the cystic duct and artery. After intraoperative cholangiography confirms the anatomy, the cystic artery and cystic duct are clipped and divided. Electrocautery or laser techniques can be used to perform retrograde dissection of the gallbladder from the liver bed and insure hemostasis. The gallbladder is detached and removed intact through the large trocars. This basic technique can be applied in a wide variety of patients with cholelithiasis. The surgeon proficient in this technique may apply it to a broad range of patients with gallbladder disease.
Cholecystectomy↗
Laparoscopic pelvic lymphadenectomy.
Explore the source record for details and available documents.
Adenocarcinoma↗