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1.
Surg Endosc ; 34(11): 4857-4865, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-31754852

RESUMEN

BACKGROUND: Three-dimensional (3D) laparoscopy improves technical efficacy in laboratory environment, but evidence for clinical benefit is lacking. The aim of this study was to determine whether the 3D laparoscopy is beneficial in transabdominal preperitoneal laparoscopic inguinal hernia repair (TAPP). METHOD: In this prospective, single-blinded, single-center, superior randomized trial, patients scheduled for TAPP were randomly allocated to either 3D or two-dimensional (2D) TAPP laparoscopic approaches. Patients were excluded if secondary operation was planned, the risk of conversion was high, or the surgeon had less than five previous 3D laparoscopic procedures. Patients were operated on by 13 residents and 3 attendings. The primary endpoint was operation time. The study was registered in ClinicalTrials.gov (NCT02367573). RESULTS: Total 278 patients were randomized between 5th February 2015 and 23rd October 2017. Median operation time was shorter in the 3D group (56.0 min vs. 68.0 min, p < 0.001). 10 (8%) patients in 3D group and 6 (5%) patients in 2D group had clinically significant complications (Clavien-Dindo 2 or higher) (p = 0.440). Rate of hernia recurrence was similar between groups at 1-year follow-up. In the subgroup analyses, operation time was shorter in 3D laparoscopy among attendings, residents, female surgeons, surgeons with perfect stereovision, surgeons with > 50 3D laparoscopic procedures, surgeons with any experience in TAPP, patients with body mass indices < 30, and bilateral inguinal hernia repairs. CONCLUSION: 3D laparoscopy is beneficial and shortens operation time but does not affect safety or long-term outcomes of TAPP.


Asunto(s)
Hernia Inguinal/cirugía , Herniorrafia/métodos , Imagenología Tridimensional/métodos , Laparoscopía/métodos , Cirugía Asistida por Computador/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Estudios Prospectivos , Método Simple Ciego , Mallas Quirúrgicas
2.
World J Surg ; 30(10): 1922-4, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16983467

RESUMEN

BACKGROUND: Managing the abdominal compartment syndrome associated with severe acute pancreatitis by the open abdomen method is associated with considerable morbidity and resource utilization. METHODS: A technique of subcutaneous anterior abdominal fasciotomy is described for the first time in two patients with severe acute pancreatitis. RESULTS: Following the procedure, the intra-abdominal pressure decreased from 30 mmHg immediately to 23 mmHg and to a sustained level of 12-14 mmHg in the first patient, and from 35 mmHg immediately to 23 mmHg and to a sustained level of 14-19 mmHg in the second patient. CONCLUSIONS: The subcutaneous anterior abdominal fasciotomy is a promising method for safe and effective abdominal decompression with sustained effect and avoiding the morbidity associated with the alternative open abdomen techniques.


Asunto(s)
Pared Abdominal , Síndromes Compartimentales/cirugía , Fasciotomía , Laparoscopía/métodos , Pancreatitis Aguda Necrotizante/complicaciones , Adulto , Síndromes Compartimentales/diagnóstico , Síndromes Compartimentales/etiología , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad
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