[Vaginal hysterectomy in non-prolapsed uterus].
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To describe the results of vaginal removal of the non-prolapsed uterus in women conventionally operated on abdominally or with the assistance of laparoscopy.At the departments of gynaecology, Herning Central Hospital and Holstebro Central Hospital, approximately one third of all hysterectomies are performed vaginally. All records of women, who had had a vaginal hysterectomy on a non-prolapsed uterus over a nineteen-month period, were reviewed retrospectively. Women, who had additional surgery, were excluded.One-hundred and thirteen patients entered. In one patient (1%) the vaginal hysterectomy was converted to an abdominal one. One fourth of the women had a uterus weighing more than 200 grams. The median operation time was 58 minutes; 73% bled less than 200 ml. Half of the women were discharged from hospital on the third postoperative day or earlier; 90% on the fifth postoperative day or earlier. During operation three accidental bladder lesions occurred, and four women needed an additional haemostatic operation. Postoperatively, 10 women (9%) suffered from a haematoma or an abscess in the vaginal vault.Vaginal hysterectomy on the non-prolapsed uterus is an operation that should be offered to a large group of women, who today are operated on abdominally or with laparoscopic assistance. The operation is quick and the patients are discharged after a few days. No advanced equipment is needed. Some women will, however, suffer from a haematoma in the vaginal vault.Keywords:
Vaginal vault
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Objective To seek the value of laparoscopy in the diagnosis and treatment of penetrating abdominal injuries.Methods We retrospectively analyzed the clinical data of 177 patients with penetrating abdominal injuries who suffered the laparoscopic treatment(86 cases) and laparotomy(91 cases) in our hospital from January 2007 to March 2011.Operation time,blood loss,intestinal function recovery time,postoperative hospital stay,wound healing or infection and postoperative complications between the two groups were compared.Results Both two groups completed the operation successfully.Laparoscopic surgery group was lower than laparotomy group in blood loss,intestinal function recovery time,postoperative hospital stay and postoperative complications.Conclusions Laparoscopic surgery is effective in penetrating abdominal injuries,with small injuries,faster postoperative recovery,short hospital stay and low postoperative complication rate,etc.In the case of no contraindications,laparoscopic surgery can be recommended in patients with penetrating abdominal injuries.
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Pre-existing fascial umbilical defects may compound problems faced during laparoscopic surgery. Detection helps in preventing bowel or omental injury and repair can be done at the same time. Postoperative port incisional hernias are not uncommon and require surgical repair.The incidence, clinical features and management of such fascial defects were studied in 2100 patients undergoing abdominal laparoscopy.The incidence of fascial defects was 18%. The hernias were symptomatic in 56.5% cases, with an overwhelming female preponderance. A supra-umbilical incision above the upper limit of the hernia was used to establish the umbilical port and through this the hernias were repaired with nonabsorbable sutures. Postoperative incisional hernias occurred in 41 patients out of a total follow-up of 1892 cases (2.16%). The common predisposing factors were wound infection, postoperative chest infection and previous existing diseases, like diabetes and connective tissue disorders. Twenty-eight patients underwent mesh plasty and 3 cases had laparoscopic Gortex mesh repair. The remaining 10 cases refused surgery.Omental fascial defects should be dealt with at the same sitting through a supra-umbilical port incision avoiding direct entry into the hernia. Use of nonabsorbable sutures is recommended. Prevention of wound infection and postoperative chest infection greatly reduces the chances of an incisional hernia.
Incisional Hernia
Umbilical hernia
Port (circuit theory)
Surgical mesh
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Objective This clinical study was undertaken to evaluate the feasibility of a laparoscopic approach for the diagnosis and treatment of congenital duodenal obstruction.Methods Ten children, aged 5 days to 10 years, underwent laparoscopic surgery. The procedure was performed using 3 or 4 trocars of 3.5mm to 5.5mm diameter. The causes of duodenal obstruction were diagnosed and operated. A standard Ladd's procedure was performed in 5 neonates with malrotation. One newborn and 2 infants with duodenal web necessitated a partial excision of the diaphragm. Two girls had superior mesenteric artery syndrome(SMAS) and underwent laparoscopic lysis of Treitz's ligament and Roux-en-Y duodenojejunostomy.Results All procedures were completed successfully. Operative times ranged from 1 to 3.5 hours. Feedings was started on postoperative day 1 to 3. Hospital stay ranged from 5 to 7 days. There was no complication.Conclusions Laparoscopy is a safe and excellent technique for the diagnosis and operative management of duodenal obstruction.
Diaphragm (acoustics)
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Objective To estimate the value of high ligation for pediatric bilateral indirect inguinal hernia by two-port laparoscopic treatment.Methods 156 patients with bilateral indirect inguinal hernia who presented in our hospital from June 2010 to December 2011 underwent simplified two-port Laparoscopic Treatment.Results High ligation of bilateral hernia sac was successfully performed with laparoscopy in all 156 patients.51 cases were in group of 0.5-2 years old with operation time of(35.0±2.2)mins and 105 cases in group of 2-7 years old with operation time of(26.5±2.5)mins.No post-operative hydrocele,testis pain and avascular necrosis were detected.Follow-up was achieved in 95 patients for 1-6 months,30 patients for 6-12 months and 23 patients for 12-15 months.No postoperative peritoneal adhesion presented.1 patient showed unilateral recurrent hernia(0.6%).Conclusion Two-pot laparoscopic high ligation of hernial sac offers many practical advantages such as simplicity of operation,minimal incision,safety,reliable effect,less complications and low recurrence rate,which is an ideal operation method and worth being recommended.
Hydrocele
Port (circuit theory)
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Abstract Background Several studies have suggested that better results are obtained after laparoscopic repair of inguinal hernia than after conventional operation. This is most obvious for bilateral and recurrent hernias but less accepted for primary unilateral hernias. Methods This was a randomized clinical trial comparing transabdominal preperitoneal laparoscopic repair with the Shouldice technique in patients with primary unilateral hernia. Some 138 patients were randomized to laparoscopic hernia repair and 130 to open surgical repair. Results The complication rates in the two groups were similar. In the laparoscopic group the patients returned to work more rapidly with a median time of 13 versus 18 days (P < 0·005) and had a shorter period of analgesia intake with a median time of 2·1 versus2·7 days (P< 0·02). The follow-up was 97·8 per cent complete. At a median of 12 months, four recurrences (2·9 per cent) were detected in the laparoscopic group and three (2·3 per cent) in the open group. Conclusion This study shows that in patients with a primary unilateral hernia laparoscopic repair results in less postoperative pain and a quicker recovery than open repair.
Hernia Repair
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Seroma
Ecchymosis
Urinary retention
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Objective:To investigate the feasibility and security of laparoscopic hysterectomy (LH) of gigantic uterus.Methods:A retrospective analysis on 87 cases of laparoscopic hysterectomy of large uterus. (the size equivalent to 1324 pregnant weeks) compared with 97 cases of transabdomnal hysterectomy (TAH) of large uterus (1323w).Results:87 of LH were successfully compared with TAH. The average duration of operation of LH more than those of TAH (P 0.01) . But in the guantity of bleeding,the postoperative morbidity rate and recovered time.The cases of LH were significantly less than those of TAH(P 0.05 ).Conclusions:LH can applied completely to cases with large uterus. LH of cases has many advantages in less loss, less pain,more quick recovery and fewer complication.
Laparoscopic hysterectomy
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To investigate the diagnosis and treatment of the complications in patients after laparoscopic adjustable gastric banding (LAGB) procedure.Retrospectively analyze the data of the 23 patients who received the LAGB procedure from June 2003 to November 2004.Of the 23 LAGB operations, 3 (13%) cases of vomiting and nausea, 1 (4.3%) case of access-port infection and 5 (21.4%) cases of food intolerance occurred. One band (4.3%) and one injection reservoir (4.3%) displaced and were removed by laparoscopy. No death and thrombo-embolism occurred.The diagnosis and treatment of complications after LAGB in morbid obesity was special, if managed properly, the result would be satisfactory.
Port (circuit theory)
Gastric banding
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