فهرست مطالب

Annals of Bariatric Surgery
Volume:3 Issue: 1, Winter 2014

  • تاریخ انتشار: 1392/12/01
  • تعداد عناوین: 10
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  • Abdolreza Pazouki *, Fatemeh Jesmi Page 1
  • Murat Api * Page 2
    Context: In order to restore ovulation, puncturing ovaries with a needle powered by electricity, under laparoscopic observation, in women with anovulatory infertility with polycystic ovarian syndrome is called laparoscopic ovarian drilling (LOD). Although peri-adnexial adhesion after the surgery is inevitable, there is lack of evidence regarding the clinical significance. The objective of the present study is to review the available literature in order to determine the rate of periadnexial adhesions following LOD, and to assess the effect of these adhesions on pregnancy rates..Evidence Acquisition: Electronic search of MEDLINE and EMBASE for English-language and non-English-language articles from 1984 to 2012 and manual search of bibliographies from identified articles were evaluated. Sixteen articles were found to be eligible to obtain main outcome measures. Post-operative adhesion rates were reported to be 0-100% (mean 35.5%, 95%CI: 30.8-40.4) while pregnancy rates after the procedure in these articles were 35-87% (mean 64.3% 95%CI: 58.2-70.7) of the cases..
    Results
    There were no correlation between the adhesion rates and pregnancy rates (Spearman''s rho=.055, P=.858). None of the preventive measures during or after the procedure were found to be effective in reducing the rate of post-operative adhesions, thereby increasing the pregnancy rates. The incidence of peri-adnexial adhesions after LOD might not be associated with adverse reproductive outcomes..
    Conclusions
    Until more effective, safer and non-invasive treatments become available, LOD is a relatively safe and effective second-line procedure in anovulatory infertile women with PCOS resistant to clomiphene citrate..
    Keywords: Peri, adnexal Adhesions, Laparoscopic Ovarian Drilling, Polycystic Ovarian Syndrome, Pregnancy Rate
  • William A. Stokes *, Eric W.Cerrati, Eric J.Lentsch Page 3
    Background
    The phrase “minimally invasive” is used loosely due to the wide range of surgical options and generally means a procedure not involving a large open incision. In 1998, Dr. Paolo Miccoli at the University of Pisa developed a technique of minimally invasive video-assisted thyroidectomy (MIVAT) for patients presenting with small thyroid nodules. The procedure involves a smaller incision, limited exposure, and endoscopic magnification to better visualize the smaller surgical field. From this point, thyroidectomy or hemi-thyroidectomy is performed using endoscopic instrumentation. Indications were initially limited to single, small non-malignant thyroid nodules, however the indications have gradually expanded since this surgery’s initial implementation..
    Objectives
    We feel that this article provides an up-to-date research on the MIVAT procedure, while highlighting its rapidly expanding indications and excellent outcomes..Patients and
    Methods
    The current patient selection criteria includes small thyroid nodules (<35 mm in diameter), a relatively normal thyroid gland (about <25 cubic cm), no evidence of severe thyroiditis, and no previous neck surgery or radiation..
    Results
    The advantages of MIVAT compared with conventional thyroidectomy include improved cosmetic results, less postoperative pain and reduced hospital stay without any difference in safety, completeness or morbidity compared with the conventional approach. The primary drawback appears to be an increased operative time, which can be reduced as the surgeon becomes more comfortable with the procedure..
    Conclusions
    As shown in the literature, MIVAT is a safe and effective alternative in the treatment of some thyroid diseases within the selection criteria. With the same level of complications, it offers a few significant advantages over the conventional thryoidectomy..
    Keywords: Thyroidectomy, Surgical Procedures, Minimally Invasive, Endoscopy
  • Seyed Hossein Hosseini, Ahmad Izadpanah *, Seyed Vahid Hosseini, Hossein Shabahang, Elaheh Ashrafi, Ali Reza Safarpour, Abbas Rezaianzadeh, Zahra Zabangirfard Page 4
    Background
    Since morbid obesity is known as a major cause of psychosocial problems beside its common adverse effects like cardiovascular and metabolic diseases, a lot of researches have been performed to find an effective treatment including surgery. Surgical methods were improved by invention of minimal invasive surgeries. Laparascopic Sleeve Gastrectomy (LSG) and Laparascopic Adjustable Gastric Banding (LAGB) are the methods which have become common in most of developed countries..
    Objectives
    Due to cultural, economic and social differences between our country and developed countries, we have designed this research to compare the efficacy and complication of these two methods six months after operation in hospitals affiliated to Shiraz University of Medical Sciences..Patients and
    Methods
    Documents of patients operated with one of these two methods were reviewed, and necessary information was inserted in prepared forms. We called patients if further information was needed. Then this data was analyzed with Chi Square 2Sample Independent T- test and Paired T Test by SPSS 16 software..
    Results
    Seventy patients were operated with LSG and 25 with LAGB. The Mean weight of LSG group was 120.73 and 120 for LAGB. The Mean weight loss in LSG was 29.99 and 19.60 in LAGB. There was no statistically significant difference regarding early complications between the two methods; although, long term complications such as gastric stenosis and band displacement were statistically more in LAGB..
    Conclusions
    It seems that both LSG and LAGB are efficient in weight loss but LSG can lead to more weight loss, better correction of blood pressure and less long term complications..
    Keywords: Morbid Obesity, Bariatric Surgery, Developing Countries
  • Sajjad Noorshafiee, Ghodratollah Maddah, Fatemeh Naghavi Riyabi, Mohsen Abdollahi, Abbas Abdollahi * Page 5
    Laparoscopic trocar site interparietal hernia is a rare type of incisional hernia, which has been rarely reported. This type of hernia is usually observed when the fascia or peritoneum is not repaired or not completely closed. This complication may lead to some serious problems. We aimed to report a case of port site interparietal hernia after laparoscopic splenectomy..
    Keywords: Laparoscopy, Hernia, Splenectomy
  • Nicole Elsey, Chris Mckee, Marc Michalsky, Joseph D. Tobias * Page 6
    Introduction
    Patients with palliated congenital heart disease may present later in life for major, non-cardiac surgical procedures. Although alternative surgical techniques are now available for the treatment of the transposition of the great arteries (TGA), an atrial level baffle (Mustard or Senning procedure) was previously performed. Long-term adverse effects of the atrial level switch include myocardial dysfunction, rhythm disturbances requiring pacemaker placement, pulmonary hypertension and baffle obstruction..Case report: We present a 23-year-old woman, who had undergone an atrial level switch during infancy for palliation of TGA and now presents for laparoscopic vertical sleeve gastrectomy for the treatment of obesity..
    Conclusions
    The long term end-organ effects of an atrial level switch for TGA are reviewed and the perioperative of these patients is discussed..
    Keywords: Transposition of Great Arteries, Congenital Heart Disease, Bariatric Surgery
  • Abdolreza Pazouki, Ali Jangjoo *, Mohammad Ali Pakaneh Page 7
    Bowel obstruction is a known complication after bariatric surgery especially Roux-en-Y gastric bypass. The known etiologies include internal hernia, jejunojejunostomy stricture, ileus, intussusceptions, superior mesenteric artery syndrome, incarcerated port site hernia, and adhesions. Blood clot is a rare cause of small intestinal obstruction after laparoscopic Roux-en-Y gastric bypass surgery. We elucidate a rare case of small bowel obstruction after Roux-en-Y gastric bypass due to blood clot in about 90 cm distant from ileocecal valve..
    Keywords: Bezoars, Gastric Bypass, Intestinal Obstruction
  • Jose F. Noguera *, Gonzalo Martin, Jose Munoz, Jose C. Vicens, Jose V. Roig Page 8
    Introduction
    Laparoscopic surgery is still uncommon for major liver resections. The intrahepatic Glissonian approach is a fast and secure way to control the hepatic pedicle..
    Case Presentation
    A patient diagnosed with stenosing sigmoid adenocarcinoma (T3 N1 M+) (N+, positive lymph nodes, M+ positive metastatic desease)with synchronous liver metastases in segments 7 (8 mm), 6-7 (6 cm) and 3 (12 mm) was recruited to the study. Laparoscopic sigmoidectomy was performed; after a partial response to neoadjuvant chemotherapy, a right hepatectomy was performed. Surgery was performed in the modified Lloyd Davies position by placing 5 trocars. The hepatic pedicle was controlled by the intrahepatic individualized section of the right Glissonian anterior and posterior pedicles. The operation lasted for 5 hours. No intraoperative or postoperative complications occurred. The patient was discharged from the hospital on the fourth postoperative day. The final histopathology showed metastatic colorectal adenocarcinoma in segments 6-7 with right hepatic vein involvement and tumor-free margins..
    Conclusions
    Although this approach is beneficial, it should be performed by experienced surgeons. We believe that this technique is faster, safer, easier and more reproducible than hilar dissection. This approach can help develop the use of minimally invasive surgery for major liver resections..
    Keywords: Hepatectomy, Laparoscopy, Neoplasm Metastasis
  • Rahul Kumar Gupta *, Abhaya Gupta, Paras Kothari, Krushna Kumar Kesan, Kedar Mudkhedkar Page 9
    A 10 year old boy presented with swelling on the temporal side of the left eyebrow since birth. With the diagnosis of angular dermoid, we chose subcutaneous endoscopic excision for its treatment, as direct excision of dermoid cysts of the eyebrow might have caused a prominent facial scar for him, which can be completely avoided with an endoscopic approach that places the incision in the hair-bearing portion of the scalp..
    Keywords: Dermoid Cysts, Endoscopy, Pediatrics
  • Gnanaraj Jesudian * Page 10
    Laparoscopic surgery is now an integral part of the operative repertoire. Single-incision laparoscopic surgery (SILS) is a new technique developed for performing operations without a visible scar. Pneumoperitoneum, as a necessary precondition of laparoscopic procedures, represents the restriction of the surgeon''s freedom of movement and can lead to rare but typical complications. The Single Incision Lift Laparoscopic surgery is advantageous. We presented our experience of 194 surgeries carries out this method since March 2012. This procedure is ideal in rural areas because it is cheap, safe and simple..Keywords: Appendectomy; Laparoscopy; Abdominal Wall.1. Introduction.Today, laparoscopic surgery is an integral part of the operative repertoire. It has broadened gynecological and general surgery by continuously providing new indication areas. Laparoscopy is regarded as the major trend of the century and a revolution in surgical technology. Single-incision laparoscopic surgery (SILS) is a new technique developed for performing operations without a visible scar and has become an area of active research and interest within general surgeons’ community. SILS may further reduce the trauma of surgery leading to reduced port site complications and postoperative pain. Despite many advantages of minimally invasive surgeries like less pain, short hospital stay, less blood loss, etc., the laparoscopic surgeries are not popular in rural areas because of its high cost. In recent times, however, the problems associated with laparoscopic surgeries with gas have been the subject of discussions and this leads to the development of Gas less laparoscopic surgeries. We described our experience with Single Incision gasless Lift Laparoscopic surgeries that has the advantages of laparoscopy and open surgeries and does away with the drawbacks of laparoscopic surgeries. We presented the feasibility of the procedures in rural areas..