RESUMO
El verdadero esófago corto es una entidad que causa mucha controversia entre los cirujanos. Se han publicado estudios acerca de su diagnóstico y tratamiento laparoscópico, sin que a día de hoy existan publicaciones del tratamiento con abordaje robótico. Presentamos, en forma de caso clínico, nuestra experiencia en cirugía robótica de hernia de hiato con verdadero esófago corto tratada con gastroplastia de Collis y fundoplicatura de Toupet. La cirugía robótica en el verdadero esófago corto puede facilitar la disección mediastínica y permitir una técnica de sutura más precisa. Son necesarios estudios para comparar los resultados a largo plazo de esta técnica quirúrgica entre el abordaje laparoscópico convencional y el abordaje robótico
The true short esophagus is an entity of controversy among surgeons. Studies have been published about its diagnosis and laparoscopic treatment, without existing to date, publication of the treatment with robotic approach. We present, as a case report, our experience in robotic surgery for hiatal hernia with true short esophagus treated with Collis gastroplasty and Toupet fundoplication. Robotic surgery on the true short esophagus can facilitate mediastinal dissection and allow a more accurate suture technique. Studies are needed to compare the long-term results of this surgical technique between the conventional laparoscopic approach and the robotic approach
Assuntos
Humanos , Feminino , Idoso , Doenças do Esôfago/cirurgia , Gastroplastia/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Doenças do Esôfago/diagnóstico , Fundoplicatura/métodos , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/etiologia , Hérnia Hiatal/diagnóstico por imagem , Hérnia Hiatal/cirurgia , Laparoscopia/métodos , Tomografia Computadorizada por Raios X/métodosRESUMO
The true short esophagus is an entity of controversy among surgeons. Studies have been published about its diagnosis and laparoscopic treatment, without existing to date, publication of the treatment with robotic approach. We present, as a case report, our experience in robotic surgery for hiatal hernia with true short esophagus treated with Collis gastroplasty and Toupet fundoplication. Robotic surgery on the true short esophagus can facilitate mediastinal dissection and allow a more accurate suture technique. Studies are needed to compare the long-term results of this surgical technique between the conventional laparoscopic approach and the robotic approach.
Assuntos
Doenças do Esôfago/cirurgia , Gastroplastia/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Idoso , Doenças do Esôfago/diagnóstico , Feminino , Fundoplicatura/métodos , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/etiologia , Hérnia Hiatal/diagnóstico por imagem , Hérnia Hiatal/cirurgia , Humanos , Laparoscopia/métodos , Tomografia Computadorizada por Raios X/métodosRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Anastomose Cirúrgica/métodos , Íleo/cirurgia , Obesidade Mórbida/cirurgia , Procedimentos Cirúrgicos Robóticos/métodosRESUMO
BACKGROUND/AIMS: The most optimal treatment for acute cholecystitis in high risk patients and severe acute cholecystitis remains still controversial. We review the outcomes of a two step treatment with percutaneous cholecystostomy and delayed laparoscopic cholecystectomy (DLC). METHODOLOGY: We collected data prospectively from January 2004 to April 2010 from 26 patients that underwent percutaneous transhepatic CT-guided cholecystostomy and DLC. RESULTS: Percutaneous transhepatic CT-guided cholecystostomy was achieved in all cases with no complications. There was just one catheter dislodgement. Most of patients, 92%, improved after drainage. There was one case of mortality. Laparoscopic cholecystectomy was achieved in 88% of patients with no mortality, and a low rate of morbidity (7.6%) and of conversion to open surgery. Pre-operative percutaneous cholangiogram showed additional and useful information in 55.5% of patients. CONCLUSIONS: Two-step minimally invasive treatment combining percutaneous transhepatic CT-guided cholecystostomy and DLC is safe and feasible and report low morbi-mortality rates.