[A comparative study of the hospital costs for laparoscopic cholecystectomy and classical cholecystectomy].
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Anesthesia↗
Biomedical subjects
R Iorgulescu
Publications and source records attributed to R Iorgulescu.
[Transperitoneal laparoscopic right sympathectomy].
Laparoscopic lumbar transperitoneal sympathectomy represents the miniinvasive approach of laterocolic procedure Adson-Diez. It is suitable to laparoscopic surgery, has a good reproducibility and it is more advantageous than total retroperitoneal approach because of a larger working space.
Humans↗
[Intraabdominal malignant pathology missed at laparoscopic cholecystectomy].
Due to its overwhelming benefits, laparoscopic cholecystectomy represents the "gold standard" for the treatment of symptomatic gallbladder stones. Allowing us to quickly solve an easy to diagnose pathology (by ultrasonography), in some cases it may lead us to mis-diagnose some major intraabdominal pathology, perhaps by a superficial interpretation of our clinical examination and para-clinic investigation data. Studying the archives of our clinic from January 1995 up to December 2003, we found 15 cases of intraabdominal neoplasia diagnosed in the year that followed laparoscopic cholecystectomy: 7 colorectal cancers, 4 pancreatic cancers, 2 gastric carcinomas, one uterine and one adrenocortical malignancies. Among these, 6 cases were in an advanced stage--because of local invasion or distant metastases--without the possibility of radical, curative surgery. Only 4 of the 15 cholecystectomies were performed for acute cholecystitis. The average age was 56.3 years, under the age when such malignancies have the maximum incidence.
Abdominal Neoplasms↗
[Laparoscopic surgery for small bowel obstruction].
At the beginning of the laparoscopic surgery, intestinal obstruction was considered an absolute contraindication for this approach, because of the high risk of injuring the bowel. Today, the increased experience allows to apply this method in certain selected cases of small intestine obstruction. We realised a retrospective study, over a period of 7 and a half years (January 1997 - June 2004), regarding the patients admitted and treated in our department for small intestine obstruction, both by open surgery (88 cases) and by laparoscopic surgery (11 cases). We compared the preoperative characteristics of the two subgroups, highlighting the importance of a careful selection of the cases for the success of the laparoscopic approach. We analysed the postoperative evolution of these patients (return of bowel function, postoperative wound evolution, hospital stay, socioeconomic reintegration), which allowed us to draw the conclusion that some of the patients with obstruction of the small intestine may benefit from the advantages of the mini-invasive surgery.
Adult↗
[Laparoscopic treatment of transhiatal gastric hernia].
The paper is referring to the laparoscopic cure of the gastric transhiatal hernia. The first part is a short comment on the way to establish the need for surgery and to choose the adequate procedure. Then the main tactical aspects of the laparoscopic Nissen fundoplication are discussed. Finally the technique of the operation is detailed. Six patients were operated on with good results.
Cholecystectomy↗
[Right laparoscopic lumbar sympathectomy].
Laparoscopic lumbar sympathectomy was performed on a young man with thromboangiitis obliterans (Buerger's disease). The surgeons disposition, trocars placement and dissection technique are described in detail. The retroperitoneal approach was done in a manner similar to laparoscopic properitoneal hernia repair. The operation can be carried out with common laparoscopic equipment (for cholecystectomy) and offers the benefits of minimally invasive surgery.
Adult↗
[Conversions and reinterventions in laparoscopic cholecystectomy].
From the introduction of the laparoscopy in our clinic, more and more of the cholecystectomies, reaching over 50% are done by this technique. Based upon the accumulation of an already important experience, the paper tries to analyze the situations in which, during or after laparoscopic cholecystectomy, intraoperative conversions (deliberate or of necessity) or reinterventions were necessary. We present a global view of the number of these cases and also (an in detail) analysis of the causes the imposed such decisions and of the solutions adopted. The percentages of 5.55 conversions and 1.49 reinterventions seem reasonable and acceptable in comparison with the initial results published by some experience surgeons in the field of laparoscopic surgery.
Adult↗