Search results for "Pneumoperitoneum"
showing 10 items of 27 documents
Surgical Advances in the Treatment of Abdominal Wall Hernias
2015
In the last two decades, the surgery of the abdominal wall has experienced an important development from being considered a matter of little interest for general surgeon, to having a greater presence at scientific meetings and to being increasingly prominent in the specialist training in surgery. In 1990 the plastic surgeon Oscar Ramirez published a method to repair defects in the abdominal wall that called “Component Separation Technique” thereafter general surgeons fixed his attention on the techniques of autoplastic repair of the abdominal wall that had already developed throughout the twentieth century. This interest grows with the emergence of new prosthesis and the use of laparoscopic…
Microlaparoscopic Hernia Repair in Children
2011
Introduction. This study reports the authors’ experience with the exclusive use of 2-mm instrument sets and small diameter scopes in 100 children undergoing microlaparoscopic herniorrhaphy. Method. This prospective study was designed as a pilot feasibility study; all data related to patients and procedures were prospectively collected. A pneumoperitoneum was established, and 1.7 to 2 mm 0° or 30° scopes were introduced for visualization. Exclusively 2-mm instruments were used. Results. This study included 100 children (aged 15 days to 11 years, median age 2.3 years) undergoing microlaparoscopic hernia repair. A total of 140 hernias were treated. The average operative time for the microlapa…
Time course of cerebrovascular autoregulation during extreme Trendelenburg position for robotic-assisted prostatic surgery
2013
Trendelenburg positioning in combination with pneumoperitoneum during robotic-assisted prostatic surgery possibly impairs cerebrovascular autoregulation. If cerebrovascular autoregulation is disturbed, arterial hypertension might induce cerebral hyperaemia and brain oedema, while low arterial blood pressure can induce cerebral ischaemia. The time course of cerebrovascular autoregulation was investigated during use of the Trendelenburg position and a pneumoperitoneum for robotic-assisted prostatic surgery using transcranial Doppler ultrasound. Cerebral blood flow velocity was correlated with arterial blood pressure and the autoregulation index (Mx) was calculated. In 23 male patients, Mx was…
[Spontaneous pneumoperitoneum: a case secondary to thoracic trauma].
2007
Spontaneous pneumoperitoneum is the radiographic manifestation of free air in the peritoneal cavity without visceral perforations and peritoneal signs, and it occurs in about 10% of the cases of pneumoperitoneum. The etiology can be postoperative, thoracic, abdominal, gynecologic, idiopathic; it generally introduces a benign evolution and does not require surgical treatment but just a conservative approach. The authors describe here a case of spontaneous pneumoperitoneum secondary to thoracic trauma. This case is interesting for the occurrence of pneumoperitoneum without clinical peritoneal signs such as fever and leucocytosis, after closed thoracic trauma in absence of pneumothoracic and p…
Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after diagnostic colonoscopy for ulcerative colitis: a rare but possible complication …
2010
Dear Editor: Colonoscopy is regarded as a safe procedure, but complications may occur. The most dreaded are perforation and massive bleeding of the colon. The incidence of perforation is low but, despite increased experience with the procedure, it remains unchanged over time and in a large population study ranges from 0.6 to 1 per 1.000 procedures, depending on the centre and the data source. Few studies have assessed risk factors for colonoscopy-related bleeding and perforation. Gatto et al. have reported that there was a significant trend in the incidence of perforation with increasing age, people aged 75 years or older having a fourfold risk as compared to those aged 65–69 years; same re…
Robotic assisted prostatic surgery in the Trendelenburg position does not impair cerebral oxygenation measured using two different monitors: A clinic…
2014
Robotic assisted prostatic surgery is frequently used because of its reduced side-effects compared with conventional surgery. During surgery, an extreme Trendelenburg position and CO2 pneumoperitoneum are necessary, which may lead to cerebral oedema, can potentially reduce brain perfusion and therefore could impair cerebral oxygenation. Cerebral oxygen saturation can be measured non-invasively using near-infrared spectroscopy (NIRS).The hypothesis of the present study was that steep Trendelenburg positioning during robotic assisted prostatic surgery impairs cerebral oxygen saturation measured using two different NIRS monitors.Clinical observational study.Primary care university hospital, st…
Aussagefähigkeit der Abdomenübersichtsaufnahme in der Differenzierung der Rotavirus-negativen und Rotavirus-positiven nekrotisierenden Enterokolitis
1991
Clinical data and radiographic findings of 32 newborn suffering from necrotising enterocolitis were analysed [12 patients with rotavirus-positive necrotising enterocolitis (RV + NEC), 20 patients with rotavirus-negative necrotising enterocolitis (RV-NEC)]. The presence and degree of pneumatosis intestinalis, portal venous gas and pneumoperitoneum on abdominal radiographs were graded after Kosloske et al. according to "mild, moderate, and severe". Pneumatosis intestinalis occurred twice as often in the ascending colon in RV-NEC compared to RV + NEC, whereas the transverse colon was involved nearly as frequently as the descending colon in both groups. Portal venous gas was present in 10% of t…
Endoscopic Treatment of Iatrogenic Perforation of Sigmoid Diverticulum: A Case Report of Multidisciplinary Management
2022
Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequately planned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, an iatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-the-scope clips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammation and infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. A multidisciplinary board began management based on a conservative appr…
Mini-laparoscopy in the endoscopy unit.
2012
PURPOSE OF REVIEW: The evaluation of liver histology is an important component of the diagnosis and staging of liver diseases. The most common technique employed to sample liver tissue for decades has been percutaneous liver biopsy. Although this is a relatively well tolerated technique in the early stages of liver disease, it carries a high risk of complications, particularly hemorrhage, in patients with advanced cirrhosis. Mini-laparoscopy allows macroscopic assessment and biopsy under direct vision and therefore is a well tolerated and effective technique. RECENT FINDINGS: The major advantages of this technique are direct visualization of the liver surface, thereby allowing inspection fo…
Cholecystectomy in high-risk patients: A comparison between open cholecystectomy and laparoscopic cholecystectomy
1998
SummaryLaparoscopic cholecystectomy offers many advantages, yet patients with a history of cardiopulmonary problems are at an increased risk because of the hemodynamic and respiratory effects of pneumoperitoneum. Between June 1990 and November 1997, a laparoscopic cholecystectomy was performed on 31 high risk patients [American Society of Anesthesiology (ASA) IV] and 40 conventional cholecystectomies were performed on patients with the same operative risk (ASA IV). In total, 15.5% (n = 11) of these patients experienced intraoperative cardiopulmonary complications, occurring with approximately the same frequency in both groups. General post-operative complications were seen in 28.2% (n=20) o…