Search results for "Paros"
showing 10 items of 478 documents
Prospective Randomized Comparison of Minilaparoscopy and Percutaneous Liver Biopsy
2007
Liver cirrhosis represents an advanced stage of hepatic fibrosis characterized by distortion of organ architecture and formation of regenerative nodules. Retrospective series reported percutaneous liver biopsy to miss cirrhosis in about 30%. The aim of this study was to prospectively compare diagnostic sensitivity regarding the detection of cirrhosis and the complication rates of percutaneous versus minilaparoscopic liver biopsy in chronic liver disease.Eight hundred fifty-seven patients were randomized to percutaneous (415) or to minilaparoscopic liver biopsy (442). Macroscopic liver evaluation was documented as normal, fibrosis, or cirrhosis. Liver specimens were assessed blindly accordin…
Diagnosis of Liver Cirrhosis
2005
Background/goals Liver cirrhosis, the final stage of chronic liver disease, is characterized by an unfavorable prognosis and an increased risk of hepatocellular carcinoma and also requires an appropriate management. Laparoscopy, the gold standard in the diagnosis of cirrhosis, is hampered by its invasiveness. Therefore, a noninvasive method for diagnosing liver cirrhosis would be of great benefit. Study A consecutive series of 100 patients, sent to our gastroenterological unit for diagnostic laparoscopy, underwent a standardized ultrasonographic examination prior to laparoscopy. Results Conventional ultrasonographic examination revealed a sensitivity of 55% and a specificity of 86% in the d…
Laparoscopic treatment for esophageal achalasia: experience at a single center
2013
Background. Achalasia is a not frequent esophageal disorder cha- racterized by the absence of esophageal peristalsis and incomplete re- laxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. Patients and methods. We conducted a retrospective study of pa- tients with esophageal achalasia. In the period 2010-2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of Introduction Achalasia is a not frequent esophageal motor disor- der that affects both the body of the esophagus and the lower esophageal sphincter (LES). It…
Implication of the Examining Pathologist to Meet the Oncologic Standard of Lymph Node Count after Laparoscopic Lymphadenectomy
2010
<i>Objective:</i> The lymph node number as benchmark in oncologic operations depends on the patient’s anatomy, surgeon’s skill and pathologist’s accuracy. The influence of the pathologist is barely evaluated. <i>Methods:</i> A retrospective analysis of lymph node numbers after 700 laparoscopic lymphadenectomies in correlation to the examining pathologists was done. Three surgeons from the same department performed all operations at 2 campi, where 2 separate pathology institutions exist. Lymph node specimens were assigned randomly to any of the 62 involved pathologists. <i>Results:</i> The mean number of lymph nodes was equal for all surgeons. Lymph node s…
Mini-Laparoscopically Guided Percutaneous Gastrostomy and Jejunostomy
2003
Abstract Background: Percutaneous endoscopic tube placement can be problematic under certain circumstances: absence of transillumination of the abdominal wall, percutaneous jejunostomy in patients with a PEG tube and recurrent aspiration, enteral feeding access after gastrectomy, and obstruction of the upper GI tract. As an alternative in these problematic situations, a technique was developed for placing feeding tubes under visual control by using mini-laparoscopy. Methods: Placement of a feeding tube with mini-laparoscopy with the patient under conscious sedation was considered for 17 patients in whom standard PEG placement was impossible. Techniques used were the following: combined mini…
Endoluminal therapy of GERD with a new endoscopic suturing device
2005
Background Endoscopic, endoluminal therapy might be an alternative treatment option in light of the costs of proton pump inhibitor therapy and possible complications after laparoscopic surgery. The aim of the current study was to assess the efficacy and the safety of a new endoluminal suture device (ESD) in pig models and humans. Secondly, 3 and 6 months' follow-ups were performed, and possible complications and their management were evaluated. Methods In the preclinical phase of the study, suturing procedures were practiced and evaluated in 8 pig models (Erlanger Endo Trainer). In the clinical phase, 20 patients with mild esophagitis, small or no hiatal hernia, and signs of abnormal acid e…
Laparoscopic adrenalectomy: preoperative data, surgical technique and clinical outcomes
2019
Background: laparoscopic adrenalectomy has become the standard treatment for adrenal lesions. The better clinical outcoms of laparoscopic technique are valid for treatment of small benign masses (< 5-6 cm), instead there are still open questions in literature regarding the correct management of larger lesions (> 6 cm) or in case of potentially malignant adrenal tumors. The aim of this study is to evaluate the outcomes of laparoscopic adrenalectomy in a referral surgical department for endocrine surgery. Methods: at the University Hospital Policlinico "P. Giaccone" of Palermo between January 2010 and December 2017 we performed a total of 81 laparoscopic adrenalectomy. We created a retr…
Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study
2016
Abstract Introduction Laparoscopic adrenalectomy is today considered the gold standard of treatment for adrenal tumors. The development of high definition cameras does not eliminate the major limitation of two-dimensional (2D) laparoscopy: lack of depth perception and loss of spatial orientation. Tree-dimensional (3D) HD laparoscopy was developed as an alternative to conventional 2D laparoscopy. Methods We report our experience with use of 3D vision system for laparoscopic adrenalectomy. Between January 2009 and March 2015 we performed a total of 52 laparoscopic adrenalectomies. In this case-control study we considered 13 laparoscopic adrenalectomies performed with three-dimensional (3D) vi…
Prediction of complexity and complications of laparoscopic liver surgery: The comparison of the Halls‐score to the IWATE‐score in 100 consecutive lap…
2020
BACKGROUND The development of laparoscopic liver surgery is slower than in other disciplines. Two different scoring systems have been proposed to estimate difficulty of laparoscopic liver resections (LLR) preoperatively. The aim of this analysis was to compare these two scores in an independent patient cohort regarding the predictability of morbidity. METHODS All LLRs performed between 01/2011 until 01/2019 were identified from our prospective institutional database. Patient characteristics as well as intra- and postoperative data were analyzed. Postoperative complications were graded according to Dindo-Clavien classification. Difficulty of LLR was classified using IWATE- and Halls-score. R…
The Laparoscopic Approach to Control Intractable Pelvic Neuralgia: From Laparoscopic Pelvic Neurosurgery to the LION Procedure
2007
OBJECTIVE: To present different aspects and advantages of the laparoscopic approach to the pelvic nerves aimed at treating intractable pelvic neuralgia. METHODS: We report on a nonconsecutive series of 7 patients with different types and etiologies of chronic pelvic neuralgia, all of whom underwent laparoscopy. In all 7 cases, the neuralgia was refractory to medical management and had profound socioeconomic consequences for the patients. RESULTS: Techniques of laparoscopic transperitoneal neurolysis of several pelvic somatic nerves are described but also our technique of laparoscopic implantation of neuroprothesis for neuromodulation on somatic pelvic nerves or on autonomic pelvic nerves as…