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  • 1
    Electronic Resource
    Electronic Resource
    The normal menstrual cycle has no effect on gastric emptying (1985)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 92 (1985), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Recent studies have demonstrated that orocaecal transit time is prolonged both in the luteal phase of the ovulatory cycle in normal women and during pregnancy, but have made no attempt to differentiate between the individual effects of gastric emptying and small intestinal transit. We have assessed the effect of the normal menstrual cycle on gastric emptying of solids and liquids in 10 women, using a dual isotope scintigraphic technique. In each subject gastric emptying was measured on 2 days: first during the follicular phase (day 8–10) and then during the luteal phase (day 18–20) of one ovulatory menstrual cycle (where day 1 was the first day of menstrual bleeding). Measures of solid and liquid gastric emptying did not change significantly between the follicular and luteal phases indicating that the normal menstrual cycle has no effect on gastric emptying.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1985.tb01458.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    A reply (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 51 (1996), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1996.tb07730.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Peri-operative outcome for day-case laparoscopic and open inguinal hernia repair (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This study documents the results obtained in 30 day patients undergoing open hernia repair under local infiltration block with patient-controlled sedation (group A) and 29 day patients undergoing laparoscopic hernia repair under general anaesthesia (group B). The mean operating time was less in group A (44.8min) compared with group B (66.6min) (p 〈 0.0001). Similarly, stage 1 recovery room times were longer in group B (98.1 min) than group A (45.1 min) (p 〈 0.0001). Time to discharge for group A (139.1 min) was significantly shorter than group B (224.2 min) (p 〈 0.002), with more peri-operative complications occurring in group B and greater analgesic requirements. An open inguinal hernia repair under local infiltration block is the optimal approach for unilateral non-recurrent herniae as a day surgical procedure. These results have important cost and efficiency implications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb15108.x
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    A randomized controlled trial of laparoscopic extraperitoneal hernia repair as a day surgical procedure (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 495-500 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Inguinal hernia — Herniorrhaphy — Hernioplasty — Day surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: A randomized controlled trial was conducted in a day surgery setting comparing a standardized variant of the Shouldice hernioplasty with extraperitoneal laparoscopic herniorrhaphy. Methods: The laparoscopic repair was technically challenging, evidenced by conversion from extraperitoneal to transabdominal repairs in 6.25% of patients. It was free from the inherent dangers of intraperitoneal laparoscopy. Surgical morbidity was low and comparable to that for patients randomized to the open repair. Results: Outcome following laparoscopic extraperitoneal herniorrhaphy varied depending on the parameter measured. It was comparable to the open repair with respect to postoperative activity levels and the number of days required for return to work but inferior to the open repair in terms of operation time and time to hospital discharge. The extraperitoneal approach was superior to the open repair with respect to postoperative pain levels and analgesic requirements. No attempt was made to compare recurrence rates due to the short follow-up period. Conclusions: Laparoscopic extraperitoneal herniorrhaphy should not supercede conventional hernia repair until subjected to further trials with the aid of larger study populations and greater technical expertise; the results of long-term recurrence rates are awaited.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649910097
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Humidified gas prevents hypothermia induced by laparoscopic insufflation (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 101-105 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Humidified insufflation — Hypothermia — Laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This experimental study evaluated whether humidification of warmed insufflated CO2 during laparoscopic procedures would resolve the problem of laparoscopy-induced hypothermia. Methods: Changes in core temperature were quantified over a 3-h period of high-flow CO2 insufflation in a randomized, controlled trial of five pigs. Each animal was anesthetized and studied on three occasions under standardized conditions, acting as its own control by insufflation with no gas compared with insufflation by cool dry gas and heated humidified gas. Results: Core temperatures after insufflation with heated humidified gas were no different from that of controls. After insufflation with cool dry gas, core temperature dropped by 1.8°C, which was significantly more than the 0.6°C drop experienced by control animals and those insufflated with heated humidified gas (p 〈 0.01). Calculations of the heat expended in evaporation of water were also performed. The temperature drop due to water evaporation alone in pigs insufflated with cool dry gas was calculated to be 1.5°C. This compares favorably with the measured 1.2°C temperature difference between these animals and the control group. Conclusions: The majority of heat lost during laparoscopic insufflation is due to water evaporation, and laparoscopic hypothermia may be prevented by using heated and humidified gas insufflation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900914
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    A randomized controlled trial of laparoscopic extraperitoneal hernia repair as a day surgical procedure (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 495-500 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Inguinal hernia ; Herniorrhaphy ; Hernioplasty ; Day surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: A randomized controlled trial was conducted in a day surgery setting comparing a standardized variant of the Shouldice hernioplasty with extraperitoneal laparoscopic herniorrhaphy. Methods: The laparoscopic repair was technically challenging, evidenced by conversion from extraperitoneal to transabdominal repairs in 6.25% of patients. It was free from the inherent dangers of intraperitoneal laparoscopy. Surgical morbidity was low and comparable to that for patients randomized to the open repair. Results: Outcome following laparoscopic extraperitoneal herniorrhaphy varied depending on the parameter measured. It was comparable to the open repair with respect to postoperative activity levels and the number of days required for return to work but inferior to the open repair in terms of operation time and time to hospital discharge. The extraperitoneal approach was superior to the open repair with respect to postoperative pain levels and analgesic requirements. No attempt was made to compare recurrence rates due to the short follow-up period. Conclusions: Laparoscopic extraperitoneal herniorrhaphy should not supercede conventional hernia repair until subjected to further trials with the aid of larger study populations and greater technical expertise; the results of long-term recurrence rates are awaited.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00188393
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    Pain after laparoscopy (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 445-448 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Pain — Review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: In the context of the much-heralded advantages of laparoscopic surgery, it can be easy to overlook postlaparoscopy pain as a serious problem, yet as many as 80% of patients will require opioid analgesia. It generally is accepted that pain after laparoscopy is multifactorial, and the surgeon is in a unique position to influence many of the putative causes by relatively minor changes in technique. Methods: This article reviews the relevant literature concerning the topic of pain after laparoscopy. Results: The following factors, in varying degrees, have been implicated in postlaparoscopy pain: distension-induced neuropraxia of the phrenic nerves, acid intraperitoneal milieu during the operation, residual intra-abdominal gas after laparoscopy, humidity of the insufflated gas, volume of the insufflated gas, wound size, presence of drains, anesthetic drugs and their postoperation effects, and sociocultural and individual factors. Conclusions: On the basis of the factors implicated in postlaparoscopy pain, the following recommendations can be made in an attempt to reduce such pain: emphathically consider each patients' unique sociocultural and individual pain experience; inject port sites with local anesthesia at the start of the operation; keep intra-abdominal pressure during pneumoperitoneum below 15 mmHg, avoiding pressure peaks and prolonged insufflation; use humidified gas at body temperature if available; use nonsteroidal anti-inflammatory drugs at the time of induction; attempt to evacuate all intraperitoneal gas at the end of the operation; and use drains only when required, rather than as a routine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901011
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    Paper (German National Licenses)
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  • 8
    Electronic Resource
    Electronic Resource
    A randomized controlled trial assessing the benefit of humidified insufflation gas during laparoscopic surgery (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 106-108 
    Details
    ISSN: 1432-2218
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We conducted a randomized controlled trial during laparoscopic cholecystectomy to determine the extent of heat preservation and postoperative pain reduction using humidified carbon dioxide (CO2) gas insufflation instead of standard dry insufflation gas. Methods: Forty consecutive patients were randomized. Twenty patients received humidified CO2, and 20 control patients received standard CO2 insufflation. A sample of 16 patients from each group was evaluated for postoperative pain levels. Results: No adverse effects from the humidification of insufflated gas were observed. There was no significant difference in core body temperature between the two groups for this brief operation. Pain, as assessed by the Analogue Pain Score (APS) was significantly less for the group with humidified gas insufflation than for the control group at 6 h postoperatively as well as on the 1st, 2nd, and 3rd postoperative day and at follow-up 10 days after the operation. In the humidified group, the mean time to return to normal activities was significantly less—5.9 days, as compared to 10.9 days in the control group. Conclusions: The use of humidified insufflation gas reduces postoperative pain following laparoscopic cholecystectomy, but except for these relatively brief procedures, the heat-preserving effect of humidified gas insufflation is not significant.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900915
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    Paper (German National Licenses)
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  • 9
    Electronic Resource
    Electronic Resource
    Cholecystocholangiography vs cystic duct cholangiography during laparoscopic cholecystectomy (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 299-301 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Cholecystectomy ; Intraoperative cholangiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intraoperative cholangiography performed during laparoscopic cholecystectomy provides an exact picture of the biliary anatomy. It may prevent iatrogenic bile duct injury and detect unsuspected common duct stones. Laparoscopic cannulation of the cystic duct can be difficult and time-consuming. We therefore evaluated the simpler technique of cholecystocholangiography by direct puncture and filling of the gallbladder with contrast medium. This technique was compared with cystic duct cholangiography in a prospective controlled trial of 69 patients. Cystic duct cholangiography (n=38) showed significantly better results than cholecystocholangiography (n=31) with optimal visualization of the biliary tree in 29 cases (76%) and seven cases (22%), respectively. The failure rate was 8% and 52%, respectively. Delineation of the cystic duct junction is important in order to prevent bile duct injury. The anatomy in this region was clearly delineated in 34 cases (89.5%) using cystic duct cholangiography but only in 11 cases (35.5%) with cholecystocholangiography. Cystic duct cholangiography revealed unsuspected common duct stones in three cases; however, choledocholithiasis was missed by cholecystocholangiography in at least two patients. Cystic duct cholangiography is clearly the optimal technique. In situations of unclear anatomy in which safe dissection of the cystic duct is not possible, cholecystocholangiography remains a useful alternative.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00590957
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    Paper (German National Licenses)
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  • 10
    Electronic Resource
    Electronic Resource
    Hypothermia induced by laparoscopic insufflation (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 791-796 
    Details
    ISSN: 1432-2218
    Keywords: Hypothermia ; Laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypothermia is a common postsurgical problem, yet information documenting the impact of laparoscopy on perioperative heat balance is scarce. This paper quantifies the changes in core temperature over a 3-h period of high-flow CO2 insufflation in a randomized, controlled trial of six pigs. Each animal was anesthetized and studied on three occasions under standardized conditions, acting as its own control via insufflation with no gas compared with insufflation by cold gas and warmed gas. Insufflation of CO2 gas at high-flow rates over a prolonged period of time results in a significant fall in core temperature. The provision of warmed rather than cold insufflated gas confers no protection against changes in core temperature during laparoscopic surgery due to the small amount of heat required to warm the gas to body temperature. A much greater effect is the latent heat required to saturate the insufflated gas. Most of the hypothermic effect is due to this, and could be minimized by humidifying the flow.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00190083
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    Paper (German National Licenses)
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