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  • 1
    Electronic Resource
    Electronic Resource
    Laparoscopic splenectomy for ITP (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 991-995 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Spleen — Splenectomy — Laparoscopy — ITP — Idiopathic thrombocytopenic purpura — Thrombocytopenia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: A comparison of safety, efficacy, and cost of laparoscopic splenectomy (LS) vs open splenectomy (OS) for idiopathic thrombocytopenic purpura (ITP) was performed. Methods: The records of 49 consecutive patients who underwent splenectomy for ITP (31 LS and 18 OS) at a large metropolitan teaching hospital between 3/91 and 8/95 were reviewed. Morbidity, mortality, hospital stay, operative time, blood loss, time to oral fluid intake, direct costs, and operating room (OR) costs were analyzed. Results: Age, sex, comorbidity, and spleen size were similar in both groups. LS was successful in 94% of patients in whom it was attempted. Operative times showed a learning curve for LS, with average times for the last ten cases (94 ± 35 min) significantly shorter than for the first ten (p= 0.01) and also shorter than for OS (103 ± 45 min). Postsurgical hospital stay was 2.9 ± 1.3 days for LS and 6.9 ± 3.0 days for OS (p 〈 0.001). Patients tolerated an oral diet 1.2 ± 0.5 days after LS and 3.2 + 0.7 days after OS (p 〈 0.001). Direct hospital cost was $5,509 ± 3,636 for LS and $9,031 ± 12,752 for OS. In the LS group, six patients (21%) had accessory spleens identified and removed, compared with two patients (11%) in the OS group. Platelet counts did not respond in two (7%) patients in the LS group, but no accessory spleens were identified by nuclear scan. One major complication occurred in the LS group. There were no cases of splenosis or mortality in either group. Conclusions: LS is a safe and effective treatment for ITP, with significantly shorter postoperative hospital stay than OS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900221
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Laparoscopic trans-cystic-duct common-bile-duct exploration (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 1389-1394 
    Details
    ISSN: 1432-2218
    Keywords: Trans-cystic-duct extraction ; Commonbile-duct exploration ; Common-bile-duct stones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One thousand seventy-one consecutive laparoscopic cholecystectomies were performed. Routine cholangiography was employed with a 99% success rate. One hundred thirty patients were found to have common duct stones (CBDS). In 48 (37%) patients they were unsuspected. One hundred eleven patients underwent attempted trans-cystic-duct extraction techniques (TCD-CBDE). One hundred three (93%) were successful. The following techniques were employed: 101—biliary endoscopy, 23—ampullary balloon dilation, 2—fluoroscopic basket retrieval. The average operative time was 136 min. The average postsurgical stay was 3.7 days. There were 19 (17%) complications—6 (5%) major. There were 4 retained stones (2 intentional) and 1 death. Patients over 65 years of age had more complications and patients with unsuspected CBDS under 65 years of age had the fewest. TCD-CBDE is a safe, effective way to extract common duct calculi. Endoscopy and basket stone retrieval was the primary technique employed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187342
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Laparoscopic splenectomy (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 931-933 
    Details
    ISSN: 1432-2218
    Keywords: Spleen ; Splenectomy ; Laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Laparoscopic splenectomy was attempted in 16 patients and was performed successfully in 13 (81%) patients with the diagnosis of idiopathic thrombocytopenic purpura (ITP), AIDS-related thrombocytopenia, Hodgkin's disease, or lymphoma. The operative time averaged 157 min, and autologous transfusion was required in four patients. The postsurgical stay averaged 3 days in patients with completely laparoscopic splenectomies and 4 days in patients whose spleens were removed through small counterincisions. No major complications secondary to the procedure itself occurred postoperatively. Conversion to open operation was necessary in three (19%) patients because of bleeding or splenomegaly. With careful selection of patients and mastery of the technique, laparoscopic splenectomy can be safely performed on normal or slightly enlarged spleens. The advantages are less pain, shorter hospitalization, and reduced disability as compared to “open” splenectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00843476
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Laparoscopic transcystic choledochoscopy (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 310-314 
    Details
    ISSN: 1432-2218
    Keywords: Transcystic choledochoscopy ; Endoscopic sphincterotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Preoperative prediction of common bile duct stones (CBDS) is imprecise. Cholangiography during laparoscopic cholecystectomy (LC) is the best method for detection of CBDS. Treatment of most stones detected at LC can be safely accomplished using transcystic choledochoscopy and stone extraction. This technique is applicable in nearly 90% of patients with CBD calculi. It may be preferable to endoscopic sphincterotomy (ES) in younger patients and is probably equivalent to ES in patients over 65 years of age.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00590960
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Incidence of complications following laparoscopic hernioplasty (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 16-21 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Hernioplasty ; Technique ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Smaller individual series on the outcome of laparoscopic hernioplasty techniques have been reported. This study reports on the complications of 3,229 laparoscopic hernia repairs performed by the authors in 2,559 patients. The TAPP (transabdominal preperitoneal) technique was the most frequently performed: 1,944 (60%). The totally preperitoneal technique was performed 578 (18%) times. The IPOM (intraperitoneal onlay mesh) repair was performed 345 (11%) times. The plug-and-patch technique was used 286 (9%) times and simple closure of the hernia defect without mesh was used in 76 (2%) repairs. Overall, there were 336 (10%) complications: 17 (0.5%) major and 265 (8%) minor. There were 54 (1.6%) recurrences, with a mean follow-up of 22 months. The TAPP technique had 19 (1%) recurrences and 141 (7%) complications. There were four bowel obstructions in this subgroup from herniation of small bowel through the peritoneal closure and trocar sites. The totally preperitoneal technique had no recurrence and 60 (10%) complications. The IPOM group had 7 (2%) recurrences and 47 (14%) complications. The plug-and-patch technique had 26 (9%) recurrences and 24 (8%) complications. The simple closure of the internal ring had 2 (3%) recurrences and 10 (13%) complications. Laparoscopic hernioplasty is not without complications. Training, experience, and attention to technique will prevent some of these complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187878
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    Paper (German National Licenses)
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