[Laparoscopic cholecystectomy in outpatient surgery clinic]. / Laparoskopická cholecystektómia v ambulantnej chirurgii.

AIM: Based on literature data and their own experience, the authors present a view that, in a selected group of patients, ambulatory laparoscopic cholecystectomy may be performed with no increased risks and with good outcomes. MATERIAL AND METHODS: The retrospective study presents a group of 93 patients, 72 females and 21 males, who underwent ambulatory laparoscopic procedures for symptomatic cholecystolithiasis in the Podlesí Hospital Centre of Miniinvasive Surgery, from January 2003 to the end of June 2006. 61.3% of the patients were in their forties and fifties, 69.9% of the patients were classified as ASA II, according to the surgical risk. Half of the patients had an ideal body weight, according to their body mass index (BMI) assessment. RESULTS: No peroperative or postoperative complications were recorded in the above, closely selected group of patients. 84 patients (90.3%) were discharged to homecare on the day of the procedure. Nine patients (9.7% required hospitalization for the first postoperative night and they were discharged the following morning, i.e. within 24 hours after the procedure. None of the subjects, discharged after the ambulatory procedure, required rehospitalization. CONCLUSION: Similarly to studies presented in the literature worldwide, the authors concluded that laparoscopic cholecystcctomy performed in the outpatient regime appears an appropriate surgical method in closely selected patient groups. In our setting, out of the total of 618 operated patients, who underwent laparoscopic cholecystectomy during the studied period, 15.4% could be managed using the above method.

[Laparoscopy in the colorectal carcinoma treatment]. / Laparoskopia v liecbe kolorektálneho karcinómu.

AIM: The authors present their experience and results with laparoscopic surgery in the colorectal carcinoma treatment in the Centre of Miniinvasive Surgery of the Podlesí-Trinec hospital. METHODOLOGY: In this retrospective study, the authors present a group of 148 patients with colorectal carcinomas operated by their team from 1st January, 2002 to 30th June, 2004. RESULTS: The authors completed resection procedures in 133 patients. In 15 patients, with respect to the extent of their disorder, the authors had to apply derivation colostomies, to construct by-pass ileotranversal anastomoses or to complete the procedures with exploration laparoscopies. CONCLUSION: Thank to miniinvasive techniques, laparoscopy has found its place also among the colorectal carcinoma treatment methods. The presented results, in accordance with other studies published in literature worldwide, present this method as a suitable one for a patient and fulfilling all criteria of the onco-surgical radicality.

[Laparoscopic therapy of inguinal hernia--transabdominal onlay mesh (TOM)]. / Laparoskopická liecba inguinálnej hernie--TOM (Transabdominal Onlay Mesh).

AIM: A presentation of the authors experience and results with the TOM (Transabdominal Onlay Mesh) when using the laparoscopic method for the inguinal hernia treatment. MATERIAL AND METHOD: The laparoscopic treatment method of the inguinal hernia has been used in the Centre of the miniinvasive surgery in Podlesí since October 1992. Until September 2003, we had operated 4910 patients, who were treated for 5399 inguinal hernias. From January 1999 to October 2003 we operated 3550 inguinal hernias in 3183 patients using the TOM method (367 hernia cases were bilateral). RESULTS: The average operation time in cases of uncomplicated hernias during unilateral surgical procedures is 21.4 minutes and during bilateral procedures is 31.5 minutes. Complications totaled 1.268% (peroperative 0.282% and postoperative 0.986%) The average patients age was 51.3 years (17-91). There were 87.8% males and 12.2% females. 96 patients were assigned to the one-day surgery programme. CONCLUSION: We believe that the use of the TOM method in the laparoscopic treatment of the inguinal hernia is grounded and that, with further development of new prosthetic materials, it will obtain a broader spectrum of applications.

[Methods of intraperitoneal placement of mesh in laparoscopic surgery of inguinal hernias (IPOM--Intraperitoneal Onlay Mesh)]. / Metoda intraperitoneálne polozené sít'ky u laparoskopické plastiky tríselné kýly (IPOM--Intraperitoneal Onlay Mesh).

BACKGROUND: Intraperitoneal onlay mesh is a new method of laparoscopic inguinal hernia repair shortening an operative time and reducing its cost, which is very safe and less burdening a patient. METHODS: 325 males and 37 females at the mean age of 47.3 years were operated on electively for symptomatic inguinal hernia by IPOM method. In all cases we used a polyester mesh impregnated with silicone. RESULTS: The mean operative time was 18 minutes for unilateral procedure and 28 minutes for bilateral one. There was no serious complication during the operation even the post-operative time and no recurrency following this type of the operation. CONCLUSION: IPOM hernioplasty can be a method of choice in the inguinal hernia repair because of this procedure is very simple, cheap and safe for a patient. We have to wait for a long-term results to validate the hitherto existing ones, even if they are very optimistic.