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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 82-87 
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Small bowel anastomosis ; Suture technique ; Hernia stapler ; Linear stapler
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to prove that laparoscopic stapling devices can be used to create a bowel anastomosis. Three groups with n=6 pigs each were subjected to different techniques of small-bowel anastomoses. In groups I and II anastomosing of the bowel ends was carried out with singly placed staples using a hernia stapler. (Group I: Two-thirds of the circumference became inverted and one-third everted. Group II circumferentially everted). In group III triangular everted anastomoses were produced using a linear noncutting stapler. All animals survived the observation period of 14 days and were postmortally examined. Average construction time was 59 min for groups I and III and 47 min for group II. Average diameters were 14 mm, 16 mm, and 18 mm for groups I, II, and III, respectively. There were no significant differences between the techniques concerning the stability of the anastomoses as expressed by bursting pressures. There were two stenoses in group I animals caused by electrocautery during preparation of the bowel ends prior to anastomosing. Anastomotic insufficiencies or fistulas were not observed clinically or with Gastrografin studies. We conclude that anastomoses in the pig can laparoscopically be constructed by employing singly placed staples as well as a linear stapler. Further investigations of these techniques on large bowel and human specimens are required prior to their clinical use in humans.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 70 (1999), S. 1025-1030 
    ISSN: 1433-0385
    Keywords: Key words: Hernia ; Hernia ; diaphragmatic ; Morgagni-Larrey hernia ; Laparoscopy ; Charcot-Marie-Tooth disease. ; Schlüsselwörter: Hernie ; Zwerchfellhernie ; Morgagni-Larrey-Hernie ; Laparoskopie ; Charcot-Marie-Tooth-Hoffmann-Syndrom.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Wir berichten über 3 Patienten mit Morgagni-Larrey-Hernien, die zwischen 1992 und 1998 erfolgreich laparoskopisch operiert wurden. Der Verschluß des Zwerchfelldefekts erfolgte bei einem Patienten mittels Direktnaht, in den beiden anderen Fällen war eine zusätzliche alloplastische Verstärkung einmal aufgrund der Größe des Defekts und einmal aufgrund einer Muskelatrophie auf dem Boden eines Charcot-Marie-Tooth-Hoffmann-Syndroms erforderlich. Die Verläufe waren komplikationslos, die Patienten konnten zwischen dem 3. und 4. postoperativen Tag nach Hause entlassen werden. Der Nachbeobachtungszeitraum liegt zwischen 10 Monaten und 6 Jahren, alle 3 Patienten sind rezidivfrei und asymptomatisch. Wir sehen die laparoskopische Therapie als ein geeignetes und sicheres Verfahren zur Behandlung dieser seltenen Zwerchfellbrüche an. Die Ergebnisse der verschiedenen Techniken, Direktnaht oder Einsatz eines Kunststoffnetzes, werden unter Berücksichtigung der aktuellen Literatur diskutiert.
    Notes: Summary. Three patients with Morgagni-Larrey hernias are reported who underwent successful laparoscopic repair between 1992 and 1998. The hernia was closed by direct suturing in one case; in the two other cases a polypropylene mesh was used because of the size of the hernia in one case and in the other because of muscle atrophy in a patient with Carcot-Marie-Tooth disease. There were no complications, and the patients were discharged 3–4 days after surgical treatment. The current follow-up is between 10 months and 6 years; there have been no hernia recurrences and all patients are asymptomatic. We consider laparoscopic repair to be a suitable and safe procedure for treatment of Morgagni hernias. We discuss the two different techniques, direct suturing or using polypropylene mesh by reviewing the results of the current literature.
    Type of Medium: Electronic Resource
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