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 847 records · Page 47Linked to original sources

PubMed1995

[Complete hysterectomy for benign pathology and laparoscopy: respective indications of laparoscopic preparation and an exclusively laparoscopic approach].

According to whether uterine artery treatment takes place vaginally or laparoscopically, laparoscopy for hysterectomy can be considered according to two modalities: laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH). The indications for laparoscopy are defined by the limits and/or contraindications of the vaginal route. LAVH is indicated in the following situations: pelvic pain syndrome where diagnosis and treatment can be made at the same time as hysterectomy; minimal endometriosis; past surgical history favouring adhesions formation; necessity to perform an oophorectomy; existence of an ovarian pathology. The elective indications for TLH are the severe pelvic adhesions, deep endometriosis and especially a limited vaginal accessibility associating with a narrow vagina and a fixed or non prolapsed uterus. Laparoscopy thus allows to reduce the number of laparotomies. When on overage three quarters of the hysterectomies (excluding cases of uterogenital prolapse) were up till now performed abdominally, laparoscopy could reduce this rate to approximately 10%.

Elective Surgical Procedures↗

PubMed1996

Complications in pediatric urological laparoscopy: results of a survey.

PURPOSES: To assess the level of activity in pediatric urological laparoscopy and its relationship to complications a survey of the membership of the American Academy of Pediatrics, Section on Urology was conducted. MATERIALS AND METHODS: An anonymous questionnaire was mailed to 251 pediatric urologists and 153 responses were recorded. RESULTS: Of the respondents 75% reported performing diagnostic and operative laparoscopy (average 54 cases). Patient age ranged from newborn to 20 years. Average case load for laparoscopy was 19 of 401 total cases yearly. More than 5,400 laparoscopic cases are represented by the reported experience. Complications were reported in 5.38% of cases (average complication rate 6.06% per practitioner). Excluding preperitoneal insufflation or subcutaneous emphysema the complication rate was 1.18%. Complications requiring surgical repair occurred in 0.39% of cases, including bowel, bladder and great vessel injury. The clearest predictor of complication rate was laparoscopic experience. The technique used to obtain pneumoperitoneum was also important in that Veress needle technique was associated with a 2.6% significant complication rate in contrast to 1.2% for open technique (p < 0.006). CONCLUSIONS: Laparoscopy is widely practiced in the pediatric urological community with a good safety record. Complications occur and important means of minimizing them are to provide for supervised experience with emphasis on the details of safe technique.

Child↗

PubMed1995

Conservative management of incidental cystotomy at laparoscopy. A report of two cases.

BACKGROUND: In the last 20 years the technique of operative laparoscopy has rapidly evolved, so the majority of gynecologic procedures can now be performed endoscopically. However, laparoscopy is still a relatively new technique, and we have much to learn about its associated complications and their management. In the English-language literature there are 15 reported cases of bladder perforation associated with laparoscopy, and 4 of them occurred with insertion of the primary trocar. CASES: Two cases are described in which incidental cystotomy occurred with primary trocar insertion during laparoscopy for infertility and chronic pelvic pain. Both patients were treated successfully with Foley catheterization. CONCLUSION: To our knowledge, nothing was written earlier about conservative management of incidental cystotomy occurring at the time of primary laparoscopic trocar insertion. This paper reports two such cases.

Adult↗

PubMed1996

Use of laparoscopy in the treatment of acute and chronic right lower quadrant pain.

Laparoscopy and the availability of procedures which can be easily performed through the laparoscope, including appendectomy, alter the surgeon's approach towards the management of right lower quadrant pain, both acute and chronic. Laparoscopy can be utilized in a variety of clinical settings, a number far greater than those patients which would otherwise be considered proper subjects for open appendectomy. Laparoscopy can be diagnostic, therapeutic, and also prophylactic. A two year experience of managing right lower quadrant pain in a rural hospital setting was reviewed; the procedure naturally lent itself to a variety of patients because of its ease, safety, and diagnostic accuracy. Chart review indicates an extraordinary degree of success in alleviating both acute and chronic symptoms; only one patient appears to have recurrent right lower quadrant pain out of our entire group. The use of laparoscopy in this manner creates a paradigm for a type of medical practice that is problem-oriented instead of specialty-oriented. The pathological status of the appendix was not the only factor that predicted patients' clinical response to the procedure.

Abdomen, Acute↗

PubMed1996

Operative laparoscopy for ovarian cysts. Excision vs. aspiration.

OBJECTIVE: To evaluate operative laparoscopy for excision vs. aspiration of ovarian cysts. STUDY DESIGN: From July 1, 1990, to June 30, 1993, 100 women under 40 years of age were subjected by the senior author to laparoscopic cyst excision, and 31 patients with similar characteristics underwent laparoscopic cyst aspiration by their attending physicians. Four-puncture laparoscopy was performed for laparoscopic cyst excision using the stripping technique, whereas two-puncture laparoscopy was employed for laparoscopic cyst aspiration. All patients underwent postoperative serial clinical examinations and ultrasound scans for the detection of recurrence. RESULTS: Four recurrences (4%) were observed in the group that underwent laparoscopic cyst excision, whereas 26 (84%) recurrences occurred in the group that underwent laparoscopic cyst aspiration (P < .0001). CONCLUSION: Provided that patients are carefully selected according to age and sonographic pattern, enucleation of adnexal masses at operative laparoscopy is the treatment of choice.

Adolescent↗

PubMed1996

[Classification of operative laparoscopy].

We are proposing a new approach in the classification of Operative Laparoscopy, divided in 3 areas: Area 1: Reproductive laparoscopy, that is exclusively to techniques of assisted reproduction, Area 2: Reconstructive laparoscopy that includes all the pathology of the female's inner organs its treatment in sterility and Area 3: Ablative laparoscopy related to the extraction of tissues and organs with gynecological pathology.

Female↗

PubMed1996

[Myomectomy: laparoscopy or laparotomy].

OBJECTIVE: The purpose of this study of 109 myomectomies is to evaluate the feasibility, limits and results in term of fertility of the laparoscopic myomectomy. MATERIAL AND METHODS: Retrospective study from January 1990 to December 1993, including 109 patients having had a myomectomy, 39 by laparotomy (35,7%) and 70 by laparoscopy. RESULTS: The average number of myomas extracted by laparoscopy and by laparotomy were 1.5 and 6.7 respectively. The diameter of the major myoma was 7 cm in the laparotomic group versus 6.2 cm in the laparoscopic group. Among 70 myomectomies approached by laparoscopy, 29 (41,4%) have necessitated a laparoconversion. The reason of this conversion was mainly the size of the myoma (superior 5 cm) in 21 cases, the number of myomas (superior 5) in 6 cases, the interstitiel location of the myoma in 1 case and a per-operative hemorrhage in 1 case. Among 109 patients having had a myomectomy, 60 (55%) desired a pregnancy including 22 patients having laparoscopy myomectomy. Among these 22 patients, 8 have been pregnant (36.4%) allowing 9 pregnancies (4 deliveries, 4 missed abortions and 1 intrauterin fetal death). CONCLUSION: Our results confirm that the laparoscopic myomectomy would have to be reserved to patients presenting to the most 4 myomas with a diameter < or = 7 cm. Results in term of fertility of the laparoscopic myomectomy are similar to these of patients having a laparoconversion.

Adult↗

PubMed1996

Prospective comparison of laparoscopy, ultrasonography and computed tomography in the staging of gastric cancer.

A total of 103 consecutive patients with gastric adenocarcinoma was assessed for intra-abdominal spread of malignancy using ultrasonography, computed tomography (CT) and laparoscopy under general anaesthesia. Histologically proven metastases were to the liver in 27 patients, lymph nodes in 49 and directly to peritoneum in 13. All modalities showed a high specificity (92-100 per cent) for each type of metastasis. Laparoscopy was more sensitive in detecting hepatic, nodal and peritoneal metastases; the relative performance of laparoscopy was best with regard to hepatic metastases. Ultrasonography and CT were particularly poor at detecting nodal and peritoneal metastases. There was no significant morbidity and no mortality associated with laparoscopy, which was more accurate in preoperative staging of gastric cancer than ultrasonography or CT.

Adenocarcinoma↗

PubMed1996

The management of dermoid cysts--a comparative study of laparoscopy and laparotomy.

The aim of our study was to compare laparoscopy with laparotomy for the removal of ovarian dermoid cysts. Thirty-eight women with benign ovarian dermoid cyst were allocated for either laparoscopy (18 patients) or laparotomy (20 patients). The two groups were compared for operative and hospitalization times and postoperative course. Operating time was longer (93.6 +/- 23.8 min) and hospitalization time significantly shorter (22.4 +/- 6.6 h) in the laparoscopy group. No complications were reported in either group. We conclude that operative laparoscopy is a safe procedure for the removal of dermoid ovarian cysts and is as effective as laparotomy.

Adolescent↗

PubMed1997

Laparoscopy during pregnancy. A survey of laparoendoscopic surgeons.

OBJECTIVE: The purpose of this study was to survey the Society of Laparoendoscopic Surgeons (SLS) for their experience with laparoscopy during pregnancy and to develop a database on the safety and complications of laparoscopy in pregnancy. STUDY DESIGN: A survey questionnaire was mailed to 16,329 laparoscopic surgeons from the SLS mailing database. Seven questions were asked: number of laparoscopic procedures in pregnancy, type of operation, gestational age, intraoperative and postoperative complications, insufflation agent and insufflation pressure. Only surgeons who had performed laparoscopic procedures in pregnancy were asked to return surveys. RESULTS: One hundred ninety-two (1.2%) surveys were returned. Complete information was available on 413 laparoscopic cases. There were five intraoperative complications, including inadvertent placement of a Veress needle into a pregnant uterus. There were 10 postoperative complications. CONCLUSION: This is the first report to specifically address the safety and complications of laparoscopy in pregnancy. This study suggests that laparoscopy may be safe during pregnancy; however, it was limited by the biases of surveys and retrospective studies.

Databases, Factual↗

PubMed1997

[Pre-therapeutic assessment of resectability in patients with upper gastrointestinal cancer. Combined use of endoscopic ultrasonography and laparoscopy].

The combined use of endoscopic ultrasonography (EUS) and laparoscopy for the assessment of resectability in patients with upper GI tract cancer was prospectively evaluated in 57 patients. Laparoscopy was able to fill the informational gap in all the patients (n = 6) where EUS failed to give a complete assessment of resectability. This study suggests that the combination of EUS and laparoscopy can reduce the need for "necessary" laparoscopies to about 10%.

Aged↗

PubMed1997

Diagnostic laparoscopy: indication and benefit.

BACKGROUND: Patients with an obscure and unrelievable abdominal condition may be forced to receive open laparotomy for diagnosis. Diagnostic laparoscopy has been suggested as an alternative to diagnostic laparotomy in selected cases. The aim of this article is to evaluate the circumstances suitable for laparoscopic diagnosis of certain abdominal conditions and the possible advantages of that approach. METHODS: Among 256 patients undergoing elective laparoscopic operations using conventionally pneumoperitoneal techniques from January 1994 to June 1995, twenty patients received diagnostic laparoscopy. The correlation between preoperative diagnosis, laparoscopic diagnosis and pathologic diagnosis as well as the outcome of laparoscopic diagnosis and treatment have been assessed. RESULTS: Major indications for diagnostic laparoscopy included acute abdominal pain (n = 4), chronic abdominal pain (n = 6), differentiating intraabdominal tumor (n = 4), staging known malignancy (n = 3) and evaluating intraperitoneal implantation (n = 3). Two of the four patients with acute abdominal conditions, one of the six patients with chronic abdominal pain. Four of the seven patients with undifferentiated/unstaged abdominal tumors and all of the three patients with intraperitoneal-implanted drainage tubes had no reasons for a further exploratory procedure, thus preventing the morbidity or mortality which might occur after unnecessary laparotomy. The duration of operation and hospitalization was shorter than the group without laparotomy. CONCLUSIONS: Diagnostic laparoscopy benefits patients by avoiding unnecessary surgery, avoiding unnecessary delay in diagnosis and treatment and shortening the operative and hospitalized period. However, it provides only an alternative not a substitute for traditional diagnostic procedures and will never lessen the importance of conventional laparotomy.

Abdomen, Acute↗

PubMed1997

[Role of laparoscopy in abdominal traumas: a case report].

The Authors report a case of abdominal traumatism by gunshot wound, presenting with retroperitoneal hematoma and hematoma of the mesocolon, treated in emergency laparoscopy. After a literature review and their case report analysis, they confirm the importance of emergency laparoscopy in hemodynamically stable patients, as well as the diagnostic value of peritoneal lavage, positive for minimal and moderate hemoperitoneum. Laparoscopy allows, as the same time in most cases, the diagnosis and the management of the lesion, while surgery is reserved to the cases of severe hemoperitoneum and perforating injuries. The use of laparoscopy in abdominal blunt injuries, has reduced the number of unnecessary laparotomies with related higher incidence of morbidity. The Authors conclude confirming the importance of this technique for its diagnostic efficacy, lower costs, minimal traumatism, and good aesthetic results as observed in the case report for the modality of the injuries, the young age and the previous sternotomy of the patient.

Abdominal Injuries↗

PubMed1997

Second-look laparoscopy for visceral ischemia facilitated by preinstalled ports.

Much of the information of a second-look laparotomy can be obtained by a second-look laparoscopy. We describe the strategy and technique of installing laparoscopy ports at the end of the primary laparotomy for visceral ischemia to facilitate a second-look laparoscopy in the ensuing 72 hours. The advantages and limitations are illustrated by three cases. The primary advantage appears to be that when second-look laparoscopy can be accomplished at a minimal cost, much of the inhibition to use it is removed. However, more experience is necessary before the procedure can be used to replace laparotomy.

Abdominal Pain↗

PubMedDate not supplied

Malignant peritoneal mesothelioma. Case-report demonstrating pitfalls of diagnostic laparoscopy.

Patients with peritoneal mesothelioma present with abdominal distension and clinical syndrome of debilitating ascites. Cytology of the peritoneal fluid obtained by laparocentesis often does not result in a diagnosis. Laparoscopy with biopsy of peritoneal nodules is a valuable method by which a histological diagnosis is established. However laparoscopy can greatly complicate the management of peritoneal mesothelioma by facilitating tumor dissemination to port sites. The patient presented was treated with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Although palliation of intra-abdominal tumor and ascites was achieved, port sites-disease required extensive resection of the abdominal wall. Our experience with this patient suggests that if a malignant source of ascites is suspected and a diagnosis is not obtained by paracentesis, laparoscopy should be used to establish a diagnosis. However, trocars should only be placed along the midline of the abdominal wall so that port sites can be excised at the time of cytoreductive surgery. This diagnostic strategy is applicable to the majority of patients undergoing laparoscopy when there is known or suspected intraabdominal malignancy.

Ascites↗

PubMed1997

Evaluation of selected cardiopulmonary and cerebral responses during medetomidine, propofol, and halothane anesthesia for laparoscopy in dogs.

OBJECTIVES: To compare the dose-sparing effect of medetomidine on the propofol induction dose and concentration of halothane for maintenance of anesthesia during laparoscopy and to provide guidelines for effective and safe use of these anesthetics in dogs to ensure desirable perioperative analgesia. ANIMALS: 14 purpose-bred dogs. PROCEDURE: Cardiopulmonary and electroencephalographic responses were determined during 2 anesthesia protocols in dogs scheduled for laparoscopy. Fifteen minutes before anesthesia induction, all dogs received atropine sulfate (0.02 mg/kg of body weight, i.m.). Seven dogs were then given propofol (6.6 mg/kg, i.v.); anesthesia was maintained with halothane in oxygen. The other dogs were given medetomidine hydrochloride (10 micrograms/kg, i.m.) 5 minutes after administration of atropine sulfate; anesthesia was then induced by administration of propofol (2.8 mg/kg, i.v.) and was maintained with halothane in oxygen. RESULTS: The halothane concentration required for laparoscopy was lower in dogs given medetomidine. Anesthetic requirements were significantly increased during abdominal manipulation in both groups. Total amplitude of the electroencephalograph in medetomidine-treated dogs was not significantly lower than that in dogs not given medetomidine. Pulmonary responses were stable throughout all procedures. The primary cardiovascular response was an increase in blood pressure associated with the medetomidine-atropine preanesthetic combination. Significant differences in total amplitude or frequency shifts (spectral edge) of brain wave activity were not associated with surgical stimulation. CONCLUSION: Lack of neurologic changes during laparoscopy supports the efficacy of either medetomidine-propofol-halothane or propofol-halothane combinations at higher concentrations to provide desirable analgesia and anesthesia in this group of dogs.

Adrenergic alpha-Agonists↗

PubMed1997

[The history of laparoscopy].

Laparoscopy has for a long time been the domain of some very few people. The first physicians to perform "coelioscopy" routinely where internists about 1920. Later, gynecologists where the ones to make the most important developments and inventions. The actual start of modern laparoscopy in surgery was the first video-endoscopic cholecystectomy, performed by the french surgeon Mouret in 1987. From this time on, laparoscopy for diagnostics and cholecystectomy became a new standard within about just five years. This article summarizes the history of laparoscopy from the ancient time to the present.

History, 18th Century↗

PubMed1998

Utility and cost-savings of diagnostic laparoscopy in low-probability gunshot wounds of the abdomen.

Gunshot wounds of the abdomen are associated with a 90% or greater incidence of intra-abdominal injury, prompting many trauma centers to routinely explore these patients via laparotomy. Increasingly, diagnostic laparoscopy has been used to evaluated the abdomen to exclude peritoneal violation by the missile. Retrospective analysis of the experience at a Level I Trauma Center with 20 isolated abdominal gunshot wound patients who did not have obvious indications for laparotomy such as peritonitis or shock is detailed. Outcome and cost analysis were compared in patients who had diagnostic laparoscopy or laparotomy. Patients who underwent diagnostic laparoscopy instead of laparotomy had a 42% reduction in operative time, a 33% reduction in hospital charges, and a reduction in hospital length of stay from an average of 3.5 days to less than one day. The only operative complication noted was in a patient who underwent laparotomy. Diagnostic laparoscopy may be used in select patients to exclude significant intra-abdominal injuries following gunshot wounds of the abdomen with reduction in health care costs and morbidity.

Abdominal Injuries↗