Comparison of Technical Details and Short-term Outcomes of Single-incision Versus Multiport Laparoscopic Adrenalectomy.

To date, the single-incision laparoscopic surgery (SILS) technique has been applied to a wide range of general surgical procedures; however, there are still scant data and debates on adrenal procedures. The aim of this study was to compare surgical outcomes of single-incision versus laparoscopic multiport adrenalectomy. The patients were divided into 2 study groups on the basis of the surgical approach: SILS (group 1) and multiport laparoscopic surgery (group 2). Patient demographics and their perioperative and postoperative results were evaluated retrospectively from the medical records. A total of 80 patients were included in the study. There were 44 patients in group 1 and 36 patients in group 2. The average operative time, estimated blood loss, and tumor size were similar between the study groups. There were no mortalities in both groups and the mean duration of hospital stay was 3 days for both groups. Without using any single-incision access trocars and articulated instrumentation, we achieved the same surgical outcomes in our SILS adrenalectomy series compared with conventional multiport laparoscopy series in terms of postoperative short-term outcomes and cost-effectivity.

A rare complication following laparoscopic Roux & Y gastric bypass: intussusception-case report.

Obesity is a growing health problem in most parts of the world. Currently only proven long term effective treatment of obesity is bariatric surgery. Roux & Y gastric bypass together with sleeve gastrectomy are the most employed surgical techniques with acceptable metabolic and surgical complication rates. In this paper we would like to present an unexpected complication of Roux & Y gastric bypass: a retrograde intussusception located in the common limb 17 months after the surgery. As intussusception in adults usually originates from a leading point, there is no such an explanation following Roux & Y gastric bypass.

Thoracoscopic surgical approaches for treating various thoracic spinal region diseases.

AIM: Minimally invasive surgery is currently a goal for surgical intervention in the spine. The effectiveness of endoscopic thoracic spine surgery and technological improvements are two factors that are always under consideration in the practice of spinal surgery. MATERIAL AND METHODS: We present twenty-five patients whose thoracoscopic spinal surgeries were performed between 2002 and 2008 for the treatment of various spinal diseases. Eleven patients with thoracic disc herniation, five patients with traumatic thoracic spinal compressive fracture, six patients with metastatic thoracic spinal tumors and three patients with tubercular spondylitis underwent thoracoscopic spine surgery. Clinical evaluations were performed at 3, 6,12 and 24 months post-surgery. The Oswestry disability questionnaire and linear visual analog scale (VAS) were used for the evaluation of pain. RESULTS: Postoperatively, two patients had lung contusions, one patient had pneumonia and one patient had instability. There were significant initial improvements in both the Oswestry score and the VAS pain score up to 6 months (p<0.05). The average relative difference in pain scores in all groups was not significant at 12 and 24 months (p>0.05). CONCLUSION: The favorable results of thoracoscopic spinal surgery encourage its application to situations in which a conventional thoracic approach is indicated. Thoracoscopic spine surgery is applicable to all patients with various spinal diseases.

Total disc replacement in the treatment of lumbar discogenic pain with disc herniation: a prospective clinical study.

BACKGROUND: Biomechanical benefits of Total Disc Replacement (TDR) including both the restoration of normal segmental range of motion and the prevention of physiological lumbar lordosis encourage spine surgeons to perform TDR for lumbar disc disease. METHODS: A total of twenty patients (mean age: 39.5) who had degenerative disc disease with unilateral disc herniation were operated on between 2003 and 2006. Microscopic anterior lumbar discectomy with TDR placement via a transperitoneal approach were performed. Each patient was evaluated using a VAS and the Oswestry index. RESULTS: Mean ODI improved from 73.3 preoperatively to 35.0 and 20.4 at 3 and 12 months of follow-up respectively (P < 0.001). The mean VAS score improved from 8.65 preoperatively to 2.6 and 1.9 at 3 and 12 months respectively (P < 0.001). CONCLUSIONS: Results from this series are promising and indicate that placement of TDR for degenerative disc disease with lumbar disc herniation is a valuable alternative to conventional techniques. The main advantages of this application are preservation of spinal stability, early mobilization, restoration of normal segmental range of motion and elimination of problems related to intervertebral disc tissue such as discogenic pain and recurrence of disc herniation.