Laparoscopic herniorrhaphy revisited.
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Hernia, Inguinal↗
Biomedical subjects
C G Posta
Publications and source records attributed to C G Posta.
Laparoscopic inguinal hernia repair with extraperitoneal double mesh technique.
Extraperitoneal laparoscopic inguinal hernia repair is a technically demanding procedure, with potential injuries to the lateral femoral cutaneous nerve and the inferior epigastric vessels. The double mesh technique developed is designed to address these issues. The procedure is a technical variation to the totally extraperitoneal laparoscopic inguinal hernia repair that avoids stapling in crucial areas and also provides a more secure inguinal floor by adjusting the second mesh to the area of weakness. Over a 20-month period 42 hernias were repaired using this technique that will be described in detail. The results are uniformly excellent with no recurrences documented during the observation period and the method is presented here for consideration in the laparoscopic repair of inguinal hernias.
Adult↗
Postoperative gangrenous peritonitis after laparoscopic cholecystectomy: a new complication for a new technique, or an old complication of delay in the diagnosis and management of acute acalculous cholecystitis in a high-risk patient.
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Acute Disease↗
Blunt preperitoneal finger dissection during extraperitoneal laparoscopic inguinal hernia repair: an effective alternative to instrumental techniques.
Extraperitoneal laparoscopic inguinal hernia repair is a technically demanding procedure that nevertheless has significant advantages over the other types of laparoscopic inguinal hernia repairs. One of the difficulties inherent to the procedure is the establishment of an adequate working space between the abdominal wall and the peritoneum. A quick and efficient method is reported here that was used in 15 consecutive patients. The method provides wide exposure without the use of any sophisticated equipment or the need for a significant learning curve. Exposure of the preperitoneal space with the dissection technique described simplifies a difficult first step and makes the extraperitoneal repair an easier undertaking.
Adult↗
Laparoscopic surgery in pregnancy: report on two cases.
Laparoscopic cholecystectomy (LC) and laparoscopic appendectomy (LA) are well-established surgical procedures. Although pregnancy initially was considered a contraindication to laparoscopic surgical procedures, successful reports of LC and LA during pregnancy have appeared in the surgical literature. Two cases are presented in this report, one LC and one LA, both in second-trimester pregnancies. Both pregnancies contained undisturbed and ended with spontaneous vaginal delivery of healthy infants. Laparoscopic surgery in pregnant patients is feasible and provides a reasonable alternative to the standard surgical approach.
Adult↗
Laparoscopic appendectomy: three-puncture technique with suspension of the appendix in nineteen cases.
Nineteen laparoscopic appendectomies by the same general surgeon are reported, using three trocar sites and suspending the appendix along the right lower quadrant trocar. This approach provides a fourth access site to the appendix without an additional port. Once the position of the appendix is stabilized, the two available ports are used to dissect around the base of the mesoappendix and place a silk ligature with extracorporeal ligating technique. All 19 procedures were completed by endoscopic means and without the use of endoscopic stapling devices, even when the mesoappendix was markedly swollen and edematous. The technique is presented here as an alterative method when performing laparoscopic appendectomy.
Appendectomy↗
Unexpected Mirizzi anatomy: a major hazard to the common bile duct during laparoscopic cholecystectomy.
Mirizzi's syndrome is described as an impaction of gallstone(s) in the infundibulum, Hartmann's pouch, or cystic duct in close proximity to the common hepatic duct, causing secondary inflammation, hepatic duct obstruction, and jaundice. This anatomical configuration can unexpectedly present itself during laparoscopic cholecystectomy without the associated clinical syndrome. Identification of the gallbladder-cystic duct junction may become impossible, leading to dangerous exposure of the common duct. The case presented here demonstrates the dangers and difficulties encountered with such anatomy. Increased awareness of this rare and unusual configuration may help in avoiding injuries to the biliary tree during laparoscopic cholecystectomy.
Adult↗
Laparoscopic management of a splenic cyst.
Laparoscopic management of a splenic cyst in a 17-year-old patient is discussed. Indications and technical aspects of the procedure are presented. The etiology of splenic cysts and treatment alternatives are discussed. A cyst-peritoneum window was performed successfully using minimally invasive techniques, with a short hospital stay and preservation of the spleen. Minimally invasive surgery provides an alternative to conventional surgical procedures on selected patients with splenic cysts.
Adolescent↗