The applicability of laparoscopic adrenalectomy and our experience at a secondary health institution
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Objective: Since the laparoscopy education had became widespread, the advance laparoscopic procedures can be performed even at secondary public hospitals. In this study, we aimed to present our experience of the first seven years of laparoscopic transperitoneal adrenalectomy. Material And Methods: the study included 30 patients with laparoscopic transperitoneal adrenalectomy (LA) performed from October 2012 to April 2019. The retrospective assessment investigated age, sex, body mass index, adrenal mass characteristics, hormonal activity, operation duration, hemorrhage status, transfusion requirements, final pathology and complication rates. Results: Mean age was 54.3±11.5 years and mean body mass index was 25.6±2.7 kg/m2. Mean mass size was 48.5±23 mm and mean operation duration was 70.2±21.6 minutes. Mean peroperative hemorrhage amount was 41±48.8 cc, while only 2 patients required transfusion. Mean hospitalization duration was 1.3±0.88 days. None of the laparoscopic cases was converted to open surgery, and no major complications such as death recorded. Conclusion: Transperitoneal laparoscopic adrenalectomy (LA) surgery may be performed safely after adequate training for appropriate patients with low morbidity and mortality. Keywords: laparoscopy, adrenalectomy, experience, open surgery, transperitonealLaparoscopy's most important role is in the area of female infertility. This article analyzes laparoscopy under various aspects. The place of laparoscopy in infertility is examined: laparoscopy is not necessary in all cases of female infertility; when necessary it should be performed under certain conditions which are listed. The indications of laparoscopy in the case of infertility are enumerated. The reason why laparoscopy has such an important place in infertility is that it is the only investigation which allows evaluation of the fallopian tubes and ovaries; the control of the tubal permeability can be done by insufflation or hydrotubation with procedures described. Other functions of laparoscopy in infertility are listed. Laparoscopy should only be performed by experienced surgeons. The indications and results of ovarian biopsy are analyzed; a chart illustrates the findings. Biopsy by itself does not justify laparoscopy. The author believes that the patient should always receive a report of the laparoscopy. The advantages of laparoscopy after an operation for infertility are discussed. Laparoscopy should be performed on infertile women; nothing should be done that might make their infertility worse.
Female infertility
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Objective To determine the feasibility of re-operation under laparoscopy for patients with a history of laparoscopy surgery.Methods Twenty-three patients who had received laparoscopy surgery underwent re-operation under laparoscopy between March 1998 and March 2009.Their data were reviewed retrospectively.Results Among them,22 patients were operated on successfully under laparoscopy and 1 received open surgery because of failure of laparoscopy.No severe post-operative complications occurred in all patients.Conclusions With skilled laparoscopic techniques,re-operation under laparoscopy is feasible for well selected patients to obtain minimally invasive therapeutic effects.
Open surgery
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Is laparoscopy equal to laparotomy in detecting and treating small bowel injuries in a porcine model
瞄准：为在一个猪的模型诊断并且对待小肠损害(SBI ) 与剖腹术相比评估 laparoscopy 的安全和有效性。方法：28 头雌猪是 anesthetized 并且在左侧卧的位置放了。SBI 模型被向腹部的恰好更低的象限射击建立。猪然后被使随机化进剖腹术组或 laparoscopy 组。所有猪经历了平淡的探索剖腹术或 laparoscopy 评估腹的损害，特别地 SBI 的类型，地点，和数字。传统的开的外科或治疗学的 laparoscopy 然后被执行。所有猪在观察时期以内被使活着(手术后 72 h ) 。每头猪的手术后的恢复小心地被观察。结果：所有猪的重要符号在在射击以后的 1-2 h 以内是稳定的，任何一个都没立即从射击创伤或 SBI 死于猪。SBI 模型成功地在所有猪被建立并且也决定性地由探索剖腹术或 laparoscopy 与单个或多重的 SBI 诊断了。与探索剖腹术相比， laparoscopy 为诊断花了一显著地更长的时间(41.27
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Primary infertility
Female infertility
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Laparoscopy was used as an ancillary method for infrequently occurring or unconventional indications in 140 patients. Diagnostic laparoscopy was done if other clinical, laboratory and biophysical methods were inconclusive or not conclusive in due time. Under some conditions operative laparoscopy or a combined vaginal and laparoscopic approach eliminated the need for laparotomy. No special equipment is required for such diagnostic and operative laparoscopy.
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Abstract The development of granulomas over 3 days was inhibited in adrenalectomised rats when cotton pellets were implanted on the day of adrenalectomy and was potentiated when the pellets were implanted 7 days after adrenalectomy. The initial inhibitory effect of adrenalectomy was not observed when the granulomas were allowed to remain in situ for 7 days instead of 3 days and was completely reversed by treatment with corticosterone.
Corticosterone
Bilateral adrenalectomy
Pellet
Granuloma formation
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A comparative study of hysterosalpingography (HSG) and laparoscopy in the investigation of infertility is presented. From 1973-1977, 352 cases were investigated with both HSG and laparoscopy. In 57.67% of the cases there was complete agreement between HSG and laparoscopy. The study included 168 cases of unexplained infertility and 184 cases with abnormal hysterosalpingographic findings. Pelvic adhesions were demonstrated in 151 cases by laparoscopy as compared to 76 cases in which its presence was only suspected by HSG. Laparoscopy revealed a 57.14% of associated pelvic pathology in cases of unexplained fertility. The present study concludes that laparoscopy as compared to HSG is not only more informative, but also more accurate and conclusive.
Hysterosalpingography
Female infertility
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Open surgery
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The effects of adrenalectomy have been studied mainly in the rat, dog and cat, and to a lesser extent in the guinea-pig and rabbit. Scant attention, however, has been given to the study of the effects of adrenalectomy in the smaller ruminants. In 1901, Moore & Purinton investigated the survival period after adrenalectomy in two adult female goats and two kids. The kids were unilaterally adrenalectomized a few hours after birth, and the second adrenal removed 34–35 days later. Both died 49–66 hr. after completion of adrenalectomy. One of the adult goats died 8 days after removal of the second adrenal, the other remained normal and was killed 22 days after the operation. No gross adrenal tissue was found at autopsy. In sheep, the effects of adrenalectomy have been studied by Strand, Anderson & Allcroft [1934]. Five animals were successfully adrenalectomized and survived 34–60 hr. after removal of the second
Bilateral adrenalectomy
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