SEARCH · PubMed Health

Results for “laparoscopy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources

PubMed2000

[The role of laparoscopy in the identification of peritoneal carcinosis from abdominal neoplasms. Analysis of our initial experience].

BACKGROUND: The authors reviewed the experience on the use of laparoscopy performed since January 1997 in malignant neoplasms at their institution. The aim of the study was to evaluate the real effectiveness of this procedure in the staging of abdominal neoplasms which were considered resectable at preoperative examinations and in particular in the detection of peritoneal metastases not evidenced with traditional imaging techniques. METHODS: Twenty-eight patients with malignant neoplasms: colo-rectum (15), stomach (5), pancreas (4), gallbladder (2), cardias (1), liver (1), were studied. All the patients were preoperatively examined with abdominal computed tomography (CT). In the 2 patients with gallbladder neoplasm a MR cholangiography was also performed. An explorative laparoscopy with peritoneal washing was then performed in all the patients. The diagnostic and therapeutic choices were subsequently done on the basis of laparoscopy results. RESULTS: Therapeutic approach was modified in 21% of cases, as a result of the detection of peritoneal metastases which were not evidenced with imaging examinations. On the contrary, peritoneal washing was not responsible of any preoperative evaluation. CONCLUSIONS: Laparoscopy performed in patients with abdominal neoplasms allows the detection of peritoneal micrometastases not previously evidenced through preoperative CT, thus modifying the therapeutic approach.

Abdominal Neoplasms↗

PubMedDate not supplied

Hand-assisted laparoscopy for the removal of an esophageal leiomyoma.

The patient is a 39-year-old male who presented with noncardiac chest pain. His evaluation disclosed an esophageal leiomyoma. In this paper we will demonstrate the pre-operative findings and technique for removal of a benign esophageal tumor using hand-assisted laparoscopy. The patient was discharged home 2 days postoperative and returned to work 2 weeks postoperative with complete resolution of his symptoms. Hand-assisted laparoscopy provides a postoperative course that parallels the recovery from conventional laparoscopy. Additionally, the tactile sense that a surgeon looses from conventional laparoscopy is regained by this technology.

Adult↗

PubMedDate not supplied

Staging laparoscopy for gastric cancer.

The growing role of multimodal treatment plans for advanced gastric cancer has contributed to the development of more accurate preoperative staging strategies. The high diagnostic efficacy of video-laparoscopy as regards the M factor has been reported by many; preoperative laparoscopy therefore permits to avoid unhelpful surgical exploration in case of peritoneal dissemination of tumor or liver metastases undetected by conventional staging. At Memorial Sloan Kattering Cancer Center preoperative staging laparoscopy is currently included in the diagnostic algorithm for gastric cancer. Data from a consecutive series of 103 patients demonstrated metastatic disease in 24 patients (37%) who were considered to have localized cancer by computed tomography (CT) or endoscopic ultrasonography (EUS), with an accuracy of 94% with respect to the M factor. These patients did not require open surgery. Laparoscopic washings were obtained from 127 patients with gastric cancer and a positive correlation between the extent of disease and prevalence of positive cytology was noted (T1/T2: 0%, T3/T4: 10%, M+: 59%). Our experience suggests that laparoscopy has added value in staging patients with gastric carcinoma. It appears to be a safe and effective staging modality, avoiding unnecessary explorations and providing new means of directing appropriate treatment strategy.

Algorithms↗

PubMed2001

Urologic laparoscopy.

Urologic laparoscopy initially was confined to a diagnostic role or the treatment of benign conditions. Many of these initial procedures, however, have been abandoned because they offered no significant benefit over open surgery. The treatment of urologic malignancies, however, recently has emerged as the most common indication for laparoscopic urologic surgery. Maturing data for laparoscopic radical nephrectomy, nephroureterectomy and partial nephrectomy demonstrate equivalent oncologic results. Newer applications such as laparoscopic radical prostatectomy are evolving. Despite these data demonstrating many advantages as compared with open techniques, urologists have been slow to include laparoscopy in their practice. This reluctance has been seen in other disciplines and is no doubt, at least in part, caused by the steep learning curve. Laparoscopic management of urologic malignancies is complicated and difficult to learn. In a multi-institutional review of laparoscopic complications, 71% of the complications occurred in the first 20 cases. The risk of complications and operative time significantly declines with experience, however. Higashihara et al reported a decline in laparoscopic operative time to levels comparable to open radical nephrectomy. The learning curve seems to be approximately 30 to 40 cases. The scope and practice of urology does not provide a common procedure of relatively low complexity such as the general surgical cholecystectomy or gynecologic tubal ligation to facilitate the adoption of laparoscopy by urologists. Nevertheless, evolving techniques and equipment coupled with the incorporation of laparoscopic training in residency and fellowship programs will help secure laparoscopy a prominent place in the treatment of urologic malignancy.

Adrenalectomy↗

PubMed2001

[Gasless laparoscopy].

Gasless laparoscopy is minimal invasive surgical procedure in combination with conventional abdominal surgical procedures. For installation surgical instruments are necessary two small (10 mm) noses in suprainguinal regions. In this regions the flexible 10 mm trokars are install. The patients precedence: the abort of instillation CO2 in abdominal cavity, the pain is significant less, the shoulders pain is significant less. Together with optic endoscopic increment the operation is precise and safely. Gasless laparoscopy is good at the price. Gasless laparoscopic procedure uses multiple surgical instruments. In conclusion gasless laparoscopy is advantageously than laparoscopy with CO2.

Female↗

PubMed2001

Application of ultrasonic scalpel in gynecologic operative laparoscopy.

OBJECTIVE: To investigate the applied value of the ultrasonic scalpel in gynecologic operative laparoscopy. METHODS: Gynecologic operations were performed using the ultrasonic scalpel under laparoscopy. Operative bleeding and time, perioperative body temperature and hemogram, and tissue damage were observed. RESULTS: Forty-two cases of benign gynecologic diseases were treated with the ultrasonic scalpel under laparoscopy. Among them, there were 4 hysterectomies, 9 ovarian cystectomies, 18 salpingotomies, 4 ectopic pregnancies, 3 myomectomies, 3 adhesiolysis and 1 adnexectomy. The amount of operative bleeding, operating time and the tissue injury were related to the type of operation. The minimual operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 24.77 +/- 4.71 ml, 23.39 +/- 3.01 min, 0.22 +/- 0.10 mm, 0.98 +/- 0.21 and 0.38 +/- 0.26, respectively. The maximal operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 166.7 +/- 47.18 ml, 127.2 +/- 16.99 min, 0.35 +/- 0.20 mm, 1.25 +/- 0.20 and 0.81 +/- 0.29, respectively. The levels of body temperature, white blood cells and hemoglobin before and after the operations were not statistically different (P > 0.05) except for hysterectomy (P < 0.05). CONCLUSION: The ultrasonic scalpel can be safely applied for gynecologic operative laparoscopy and should be used widely.

Blood Loss, Surgical↗

PubMed2002

[Laparoscopy in chronic pelvic pain--a retrospective clinical study].

OBJECTIVES: To analyze the laparoscopic findings in women with chronic pelvic pain (CPP). To verify the possible predictive value of the anamnestic factors for the laparoscopically established diagnosis. DESIGN: A retrospective clinical trial. SETTING: Department of Obstetrics and Gynaecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. METHODS: We realized a detailed analysis of laparoscopies for CPP performed in our clinic in the last 5 years. With the help of statistical analysis (chi 2) the possible influence of age, previous surgical intervention, history of PID, dysmenorrhea, infertility, and some other factors on endoscopic finding was verified. RESULTS: 480 laparoscopies for CPP were performed from the year 1995 to 1999. The most frequent findings were adhesions (22.3%), endometriosis (20.4%), PID (17.7%), and normal finding (17.7%). In 53% of all cases the operative laparoscopic procedure was done, most frequently the adhesiolysis (62.2%). Only one serious complication during laparoscopy was recorded (0.21%). In women younger than 30 years endometriosis was the most frequent finding (22.8%), in women older than 30 pelvic adhesions were the most often (31.9%). Diversity of findings between the groups was statistically significant (P < 0.0001). In patients with previous operation in pelvis the adhesions were found most frequently (46.2%). Diversity of findings in women with and without previous operation was also significant (P < 0.0001). In women treated for PID, pelvic inflammation was found in 25.8%, but in 22.5% the finding was negative and in 20.2% the endometriosis was diagnosed. In these subgroups (women after and without treatment of PID) the diversity of findings was not significant (P < 0.1). In infertile women, suffering from CPP, PID was found most frequently (41.2%). A suspicion of chronic appendicitis was verified in 64.3%. In patients with dysmenorrhea, as well as in women suffering from dyspareunia, endometriosis was dominant finding (30.4%, resp. 29.1%). CONCLUSION: Laparoscopy for CPP is a safe and effective method for verifying and adequate therapy of as yet hidden pathological findings. With the help of anamnestic factors some laparoscopic findings are predictable; although the sensitivity and specificity is very poor.

Adult↗

PubMed2002

Removal of intra-abdominal intrauterine device by laparoscopy.

OBJECTIVE: In this study, we aimed to evaluate the cases in which intra-abdominal intrauterine devices (IUDs) were removed by laparoscopy. METHODS: A retrospective study, from 1994 to 2000 was carried out with eight patients who underwent laparoscopy for the removal of an IUD. The patients admitted to our clinic with 'lost IUD' were examined by pelvic ultrasonography, X-ray and hysteroscopy. IUDs were found to be extrauterine but within the abdominal cavity. The IUDs were removed by operative laparoscopy. RESULTS: The mean age of the patients was 31.5 years. The mean duration of usage of IUD was 5.5 years. The IUD was located in the cavity of Douglas in four cases, in the posterior wall of the uterus (perimetrium) in one case and in the conglomerated mass bordered by the intestines in three cases. The types of the IUDs were Cu-T 380A (n = 5), Multiload (n = 1) and Lippes-Loop (n = 2). The mean laparoscopic operation time was 25 min. No major complications (intestinal or vessel injuries) or minor problems occurred. Laparotomy was not necessary in any of the eight cases. All cases were treated as out-patients and discharged on the same day. After counselling, three women requested sterilization, which was performed at the same laparoscopy session by the administration of bilateral Yoon rings, and other family planning methods were chosen by five women. There were no problems when cases were followed at the 10th and 30th postoperative days. DISCUSSION: Our results support the idea that, in cases of extrauterine but intra-abdominal IUD, laparoscopic removal of the IUD must be the first choice of therapy.

Adult↗

PubMed2002

Transvaginal hydrolaparoscopy vs. conventional laparoscopy for evaluating unexplained primary infertility in women.

OBJECTIVE: To verify the usefulness and reliability of transvaginal hydrolaparoscopy (THL) as a screening tool for evaluating infertility in women in comparison with conventional diagnostic laparoscopy. STUDY DESIGN: Sixty consecutive women with unexplained primary infertility were prospectively enrolled into the study. After examination of the whole pelvic cavity, tubal patency was evaluated and the uterine cavity studied by hysteroscopy. Immediately after THL, conventional laparoscopy was performed. Main outcome measures were the success rate of accessing the pouch of Douglas, rate of complete examinations, rate of complications and accuracy of THL in comparison with laparoscopy. RESULTS: Success rate of accessing the pouch of Douglas and performing THL was 93.3%. The rate of complete evaluation of all the pelvic structures was 76.8%. In studying tubal pathology, 77.8% agreement was found between the two techniques. Diagnosis of endometriosis was correct in 55.5% of patients. Overall, THL results correlated closely with conventional laparoscopic results in 92.86%, but the diagnostic accuracy of THL was 100% in cases of complete pelvic evaluation. CONCLUSION: THL is a feasible, reliable and safe procedure and can be considered an alternative procedure for evaluating infertility in women. In cases of incomplete pelvic evaluation or abnormal findings, conventional laparoscopy is indicated as the second step in the evaluation.

Adult↗

PubMedDate not supplied

[Role of laparoscopy with ultrasound in the staging process of pancreatic and ampullary tumors].

Computarized tomography allows proper identification and evaluation of stage in the majority patients with periampullary tumors. However, 30% of peritoneal metastases cannot be seen in image studies. The aim of the present study was to evaluate the role of laparoscopy with laparoscopic ultrasound in the staging process of pancreatic and ampullary tumor. Diagnostic laparoscopy was performed on 20 patients included in the study Mean age was 58.35 +/- 13.4 years. Twelve were males and eight females. In two patients, laparoscopy showed peritoneal metastases and ultrasound did not show extrapancreatic involvement. In five patients, there was vascular invasion without metastases. In three patients, both peritoneal metastases and vascular invasion were found, and in five there was neither vascular invasion nor metastasis. Laparoscopic findings were confirmed in a but one patient. In 14 of the 16 patients In whom peritoneal lavage was performed, microscopic exam showed a sufficient number of cells to make a diagnosis. We concluded that laparoscopy with ultrasound is useful in staging of patients with duodeno-bilio-pancreatic malignancies.

Adult↗

PubMed1992

[Laparoscopy in the gynecologic clinic].

Three thousand and twelve (3012) diagnostic laparoscopies in children, girls and women were carried out during the period 1970--1992. The age of the patients was between 6--49 years. The present studies show that laparoscopy fills up the space between the clinical investigation and laparotomy probatoria. It helps to solve in a clear way, a lot of diagnostic problems in gynecology in adult women, in gynecology of developmental age and gynecological endocrinology. There were the following indications to laparoscopy: 1. Adnexitis chronica 2. Infertility-primary and secondary. 3. Unclear tumor and pelvic infections in adolescence. 4. Primary and secondary failure of ovaries. 5. Suspicion of polycystic ovaries. 6. Second look laparoscopy. 7. Suspicion of endometriosis. 8. Suspicion of ectopic pregnancy. 9. Developmental faults of sexual organs. 10. Pubertas praecox.

Adolescent↗

PubMed1992

Laparoscopy: basic technique, instrumentation, and complications.

Laparoscopy has been an important diagnostic and therapeutic modality in gynecology for several decades. Recently, general surgeons and urologists have adopted laparoscopy to treat many disorders that formerly required an open laparotomy. Laparoscopic surgery requires additional instrumentation and skills as well as familiarity with a number of operative complications unique to laparoscopy. This overview discusses the basic equipment and instrumentation of laparoscopy and describes its possible associated complications.

Humans↗

PubMedDate not supplied

Operative laparoscopy for tubal pathology.

Tubal pathology has represented in the last years, the main indication to operative laparoscopy, mainly as a consequence of the widespread use of this technique in the treatment of the ectopic pregnancy. Furthermore, operative laparoscopy has been widely applied to the treatment of the distal tubal pathology for infertility, when IVF/ET failed or was not accepted. The Authors discuss the rationale for these applications of operative laparoscopy and also the possibility of performing by laparoscopy demolitive interventions on the tubes.

Fallopian Tube Diseases↗

PubMed1976

[Laparoscopy--current aspects].

A short survey is given on description and evaluation of progress and developmental trend of laparoscopy. Important technical improvements are the cold light via the glass fibre light conductor, optics of high value, the colour photography with electronic flash-light, colour films and colour television, new accessory instruments and belongings. Now as ever hepatomegaly and splenomegaly, jaundice, ascites, portal hypertension, suspicion of cirrhosis and metastases are regarded as main indications. The laparoscopy deserves a greater consideration in unclear abdominal symptoms, in gynaecological diseases, for the proof of the affection of liver and spleen in lymphogranulomatosis, sarcoidosis, tuberculosis (with aimed liver biopsy). The endoscopic retrograde cholangiopancreatography in the differential diagnosis of the jaundice competes with the laparoscopy, but it is not able to supersede it. The laparoscopic judgment of the pancreas and the importance of visible changes of the fine structed. Among the contraindications of the laparoscopy the hiatal hernia has lost its significance.

Abdomen, Acute↗

PubMed1992

[Value of laparoscopy in the diagnosis of liver cirrhosis and chronic hepatitis].

The purpose of the study was evaluation of laparoscopy in the diagnosis of cirrhosis and chronic hepatitis. The studied material comprised 197 cases of cholestasis in which for diagnostic-prognostic purposes laparoscopy was done. During visual observation of the abdominal cavity in 81 cases cirrhosis and in 25 chronic hepatitis was diagnosed. The reliability of the laparoscopic diagnosis was verified by the microscopic verification of the material obtained by guided biopsy of the liver or during operation. Among 81 cases of cirrhosis diagnosed during laparoscopy histological confirmation was obtained in 68 cases (83.9%). In the group of 25 cases with laparoscopic diagnosis of chronic hepatitis the diagnosis was confirmed histologically in 21 (84%) cases. The authors believe that laparoscopy extends the diagnostic possibilities in liver diseases. However reliable diagnosis can be obtained by microscopic examination of liver fragments obtained by guided biopsy or operation.

Adult↗

PubMed2003

[Laparoscopy in the diagnosis and treatment of pathologic lesions of the genitourinary tract].

OBJECTIVE: The objective of this article is retrospective analysis of laparoscopic surgery that were performed from January 2002 to December 2001 in I Ward of Gynaecology and Obstetrics of Gynaecology and Obstetrics Hospital in Warsaw. MATERIAL AND METHOD: 464 laparoscopies that were performed from January 2000 till December 2002 were analysed. Evaluation was made on the basis of: indications for surgery, kind of surgery procedure that was performed, blood loss during surgery, complications and hospitalisation period. RESULTS: The most common indication (39.86%) was non-malignant tumors of cases. Another pathologies of cases: ectopic pregnancy, endometriosis and infertility were respectively 11.21%, 3.02% and 10.34% cases diagnosed before surgery. Many procedures that have been done recently by laparotomy are now performed by laparoscopy, that is: enucleation of a cyst of adnexa, removal of an ectopic pregnancy, hysterectomy. The blood loss during surgery was evaluated on the basis of change of haemoglobin concentration in serum before and after surgery. The average blood loss was 1.2 g%. There were 39 cases of conversion of laparoscopy to laparotomy. The most common reason of conversion (16 cases out of 39) was insufficient hemostasis in the operative area or bleeding in the wound after trocar. We had noted the small amount of infections (4.5%). The average hospitalisation period after laparoscopy was 2.62 days. CONCLUSIONS: Laparoscopic procedures can be widely used in gynaecology, have the small number of complications, short hospitalisation period and allow to avoid the big postoperative wound of abdominal segments.

Female↗

PubMed1992

Laparoscopic uterine suspension as an adjunctive procedure at the time of laser laparoscopy for the treatment of endometriosis.

Uterine suspension has been advocated as an adjunctive procedure at the time of conservative surgery for endometriosis but has seldom been used at the time of CO2 laser laparoscopic treatment of endometriosis. In this study of 225 patients treated for cul-de-sac endometriosis by CO2 laser laparoscopy between 1984 and 1989 uterine suspension was performed as an adjunctive procedure at the time of laparoscopy. The result was a cumulative pregnancy rate of 80.0%. Life-table analysis was performed, and monthly fecundity rates were calculated as 15.58%, 6.29%, 17.86% and 7.89% for Revised American Fertility Society (RAFS) endometriosis stages I to IV respectively. CO2 laser laparoscopy and laparoscopic uterine suspension alleviated preoperative pelvic pain complaints in 94% of the patients. Monthly fecundity rates for RAFS stage I endometriosis, which exceeded previously reported rates following expectant management, medical management and conservative surgery, were attributed to laparoscopic uterine suspension, which had not been previously reported as an adjunct to CO2 laser laparoscopy.

Endometriosis↗

PubMed2003

The value of laparoscopy in management of abdominal trauma.

The role of laparoscopy (LS) in abdominal trauma is controversial. Concerns remain regarding missed injuries and safety. Our objective for this study was to determine the safety and better define the role of LS in abdominal trauma victims. We performed a retrospective review of all patients who sustained abdominal trauma and underwent LS in a level I trauma center. The main outcome measures were age, gender, mechanism of injury (MOI), indication for laparoscopy, presence of intra-abdominal injury (IA), therapeutic laparoscopy (TxLS), need for laparotomy, length of hospital stay (LOS), missed injuries, complications, and deaths. Forty-eight patients underwent LS (62 per cent male; average age, 28 years; MOI, 35 (85%) penetrating, 7 (15%) blunt; mean ISS, 8). At laparoscopy, 58 per cent of patients had no intra-abdominal injury. IA injury was treated with laparotomy in 14 (29%) and TxLS in 6 (13%). One patient had a negative laparotomy (2%). No injuries were missed. No patients required reoperation. There was one complication: a pneumothorax. There were no deaths. LS was most valuable in penetrating trauma, avoiding laparotomy in more than two-thirds of patients with suspected intra-abdominal injury. LS can serve as a useful adjunct for the evaluation of blunt trauma. In a level I trauma center with LS readily available, the procedure is associated with a low rate of complications and missed injury.

Abdominal Injuries↗