Search results for "APAR"
showing 10 items of 848 documents
Laparoscopic En Bloc Right Diaphragmatic Peritonectomy for Diaphragmatic Endometriosis According to the Sugarbaker Technique
2016
Abstract Study Objective To evaluate the feasibility of a novel laparoscopic procedure for complete eradication of diaphragmatic endometriosis (DE). Design A retrospective multicenter study (Canadian Task Force Classification II-2). Setting University tertiary referral centre. Patients A consecutive series of 9 women with DE. Interventions Laparoscopic en bloc eradication using Sugarbaker's peritonectomy technique with or without diaphragmatic resection for DE. All surgical procedures were performed by the same surgeon in 2 tertiary referral centers (Charite University, Berlin, Germany, and Catholic University of the Sacred Heart, Foundation John Paul II, Campobasso, Italy). Measurements an…
Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institut…
2016
Abstract Study Objective To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. Design Retrospective cohort study (Canadian Task Force classification II-2). Setting Multi-institutional study performed in 6 referral gynecologic oncology units. Patients Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach. Interventions All patients with limited carcinomatosis and/or…
Laparoscopic Management of External Iliac Artery Injury Using Yasargil Clamps and Intracorporeal Suture
2011
Presented is a case report of laparoscopic repair of an external iliac artery injury using titanium Yasargil clamps and intracorporeal suture during lymphadenectomy. Yasargil clamps were introduced and placed, 1 distal and 1 proximal to the lesion. The vascular injury site was identified and repaired using intracorporeal sutures. Laparoscopic staging was completed successfully. No sign of thrombosis or vascular occlusion was detected. The patient was discharged on postoperative day 4 to receive adjuvant therapy. Laparotomy is the accepted way of managing major vascular injuries during laparoscopy. However, in controlled circumstances, with availability of Yasargil clamps and a surgeon exper…
Definition of a dynamic laparoscopic model for the prediction of incomplete cytoreduction in advanced epithelial ovarian cancer: Proof of a concept
2015
Abstract Objective To develop an updated laparoscopy-based model to predict incomplete cytoreduction (RT>0) in advanced epithelial ovarian cancer (AEOC), after the introduction of upper abdominal surgery (UAS). Patients and methods The presence of omental cake, peritoneal extensive carcinomatosis, diaphragmatic confluent carcinomatosis, bowel infiltration, stomach and/or spleen and/or lesser omentum infiltration, and superficial liver metastases was evaluated by staging laparoscopy (S-LPS) in a consecutive series of 234 women with newly diagnosed AEOC, receiving laparotomic PDS after S-LPS. Parameters showing a specificity≥75%, PPV≥50%, and NPV≥50% received 1 point score, with an additional…
Minilaparoscopic aortic lymphadenectomy.
2015
Abstract Study Objective To show the feasibility of performing aortic lymphadenectomy with 3-mm instruments in gynecologic malignancies. Patient A 43-year-old, multiparous patient with serous ovarian cancer grading 2, Federation Internationale de Gynecologie et d'Obstetrique stage IC (intraoperative spillage). Intervention The patient was accidentally diagnosed with ovarian cancer after a right adnexectomy performed for an ovarian cyst. Once referred to our center, a delayed surgical staging was planned including total hysterectomy, left adnexectomy, aortic and pelvic lymphadenectomy, peritoneal biopsies, and total omentectomy. Minilaparoscopy was believed to be feasible to achieve it. Meas…
How Technology Can Impact Surgeon Performance: A Randomized Trial Comparing 3-Dimensional versus 2-Dimensional Laparoscopy in Gynecology Oncology
2016
This randomized clinical trial (Canadian Task Force classification I) aimed to compare 2-dimension (2-D) versus 3-dimensional (3-D) laparoscopic hysterectomy and pelvic lymphadenectomy in endometrial and cervical cancer patients. Between December 2014 and March 2015, 90 patients were enrolled: 29 (32.2%) with early or locally advanced cervical cancer after neoadjuvant treatment and 61 (67.8%) with early-stage endometrial cancer. Patients were randomly assigned to undergo 2-D (Group A, n = 48 [53.3%]) or 3-D (Group B, n = 42 [46.7%)]) laparoscopy. Baseline characteristics were superimposable in the 2 groups. Median operative time was similar in the 2 groups. Median estimated blood loss durin…
Laparoscopic Sentinel Lymph Node Detection After Hysteroscopic Injection of Technetium-99 in Patients With Endometrial Cancer
2015
Background and Objectives Endometrial cancer (EC) has an increasing incidence worldwide. Despite the unequivocal prognostic importance of nodal status, systematic lymphadenectomy is associated to elevated morbidity. Sentinel lymph node (SLN) biopsy is designed to avoid extensive nodal dissection and provide crucial oncologic information. The goal of this prospective study was to determine the feasibility, safety, and accuracy of laparoscopic SLN biopsy in EC obtained through hysteroscopic injection of technetium-99 (Tc-99). Methods From January 2008 to December 2012, a total of 42 women with EC were included in the study. We injected 20 mBq of Tc-99 hysteroscopically underneath the tumor mi…
Laparoscopic aortic lymphadenectomy in left-sided inferior vena cava
2020
Transposition of the inferior vena cava (IVC), also known as left-sided IVC (LS-IVC), is a rare congenital variant which results from regression of the right supracardinal vein and persistence of the left supracardinal vein in embryonic development.[1 2][1] LS-IVC occurs in 0.2–0.5% of the general
Laparoscopic management of interstitial pregnancy: the "purse-string" technique
2012
We report five cases of interstitial pregnancy, treated between 2004 and 2010, to evaluate surgical and obstetric outcome of laparoscopic cornual resection with a "purse-string" technique. A hemostatic suture was passed at the base of the mass in a purse-string fashion prior to resection, to minimize intraoperative blood loss. Subsequent pregnancies were analysed, with a mean follow-up time of 48 months. The mean operating time was 39 min and mean blood loss 47 mL. Three of four patients who desired children delivered at term uneventfully. Laparoscopic cornual resection with a "purse-string" technique appears to be useful for treatment of early interstitial pregnancy. The technique ensures …
Open mini-invasive cholecystectomy in high risk elderly. A review of 121 consecutive procedures.
2011
INTRODUCTION: the report describes the features of a low cost, open mini-invasive procedure for cholecystectomy in a sample of 121 consecutive high risk elderly (ASA score 3 to 5). PATIENTS AND METHODS: the surgery is performed through a 3 - 4 cm right subcostal skin incision. An optimal exposition of the operating field was achieved thanks to an innovative three valve retractor. RESULTS: a mean hospital stay of 3,02 days, low complication rate and 2,4% mortality are the results of the described procedure. CONCLUSIONS: in high risk elderly the results are extremely encouraging, particularly in comparison with both laparoscopic and traditional open cholecystectomy. The open minisurgical chol…