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Biomedical subjects

C Helbling

Publications and source records attributed to C Helbling.

5 recordsLinked to original sources

Laparoscopic appendectomy using endoloops: a prospective, randomized clinical trial.

BACKGROUND: Inadequate closure of the appendix stump can lead to abscess formation or peritonitis. This prospective randomized clinical trial was performed to evaluate the number of endoloops needed in laparoscopic appendectomy. METHODS: A total of 208 patients were randomized in two groups: 109 in group 1 using one and 99 in group 2 using two proximal endoloops. The groups were compared in terms of intra- and postoperative complications. RESULTS: Postoperative complications were found in five patients (4.6%) in group 1, consisting of intraabdominal abscesses (three patients), pulmonary embolism (one patient), and persisting port-site pain (one patient). In group 2, postoperative complications were found in five patients (5.1%), consisting of intraabdominal abscesses (four patients) and prolonged percutaneous drainage (one patient). There was no significant difference between the two groups. DISCUSSION: In acute appendicitis, a minimal inflamed appendix base can be safely divided using one endoloop.

Appendectomy↗

[Incarcerated and strangulated hernias--surgical approach and management].

Acute symptomatic groin hernias with potential or definite ischemia represent a special group of all the groin hernias. The method of choice to treat these hernias has to fulfill the following criteria: 1. Easy reduction of the hernia sac and its contents without causing damage. 2. Good exposure and easy access for possible resection. 3. Safe hernia repair through the same access. According to our experience with 44 incarcerated and strangulated groin hernias operated between 1993 and 1997 and after a literature review, we took the following procedure as our routine: Posterior approach and mesh repair. We do not use a meshgraft only in the presence of colonic necrosis or peritonitis.

Adolescent↗

["Recurrent appendicitis" 19 years after perityphlitic abscess].

We report about a patient who was admitted with acute lower right quadrant pain. She underwent an undetermined operation for appendiceal abscess formation 19 years ago. Our investigations including ultrasound, CT-scan, conventional radiography and finally coloscopy revealed a pericoecal mass formation. Due to worsening of the symptoms, emergency laparotomy was performed. An inflammatory process and a partial necrosis of the coecum wall at the site of the appendix basis were identified und managed by ileocoecal resection and drainage. We took this case to review the literature concerning the treatment of appendiceal abscess and appendiceal mass, and consecutively redesigned our own treatment concept.

Abdominal Abscess↗