Single-Port Transumbilical Laparoscopic Appendectomy: A Preliminary Multicentric Comparative Study in 87 Patients with Acute Appendicitis

Introduction. Laparoscopic appendectomy (LA) has been performed in many approaches such as open, laparoscopic and recently Single Port Access (SPAA). In order to elucidate its potential advantages, we compared the two laparoscopic approaches. Methods. 87 patients were included in a multicentric study for suspected appendicitis in order to perform (SPAA) appendectomy or laparoscopic appendectomy (LA). All outcomes, including blood loss, operative time, complications, and length of stay and pain were recorded prospectively. Results. There were 46 patients in the SPAA group and 41 in the LAG with a mean operative time of 40,4 minutes in the SPAA group and 35,0 minutes in the LA group. Only one patient was converted to an open approach. We described only 2 complications. Pain was graded 2,8 in the SPAA group and 2,9 in the LA group, according to the AVS after 24 hours. Patients in the SPAA Group were more satisfied (7,5 versus 6,9) (P < 0.05). Same results were found for the cosmetic result (8,6 versus 7,4) (P < 0.05). Conclusion. Using the single port approach feasible and safe. The true benefit of the technique should be assessed by new randomised controlled trials

Pure SILS Floppy Nissen Fundoplication with Hiatal Repair: A Case Report

Background. Single-incision laparoscopic surgery has recently became popular on behalf of inventing less invasive procedures. In this paper, we present a case of Pure SILS Nissen Fundoplication. Patient and Methods. In February 2010 a 29-year old male patient with a 4 cm sliding hiatus hernia presenting with reflux symptoms had undergone a standard floppy Nissen Fundoplication with a hiatus repair via single 2 cm incision in umbilicus. Results. The procedure had obeyed the standard natural orifice surgery rules, and no needlescopic assistance for any stage of the operation was used so to be a pure single-incision procedure. The operation lasted for 120 minutes without any need of conversion, and the patient was discharged the following day of operation. Conclusion. In the recent time, hybrid single incision laparoscopy techniques have been defined with the use of extra-abdominal supplements for retraction of liver or stomach for Nissen procedure. In addition the main issue in single-incision upper GI and/or hiatus surgery is still the retraction of liver. We succeeded to retract the left lobe of liver through the incision and completed the operation without any need for supplemental access besides the umbilical incision till the end. SILS Hiatus Surgery can be safely and effectively done but the issue needs further clinical studies to state the efficacy when compared to standard laparoscopy

Single Incision Laparoscopy in Solid Organ Surgery: Is there a limit?

BackgroundSingle incision laparoscopic surgery is recently became popular on behalf of inventing less invasive procedures. In this paper, we present the first cases of SILS pancreas, SILS liver resection and SILS splenectomy cases.Patients and MethodsBetween January 2009 and January 2010, Among total 32 patients of single incision laparoscopic surgery (SILS) patients, 13 cases have undergone SILS solid organ surgery composed of pancreatectomy (n=1), liver resection (n=2) and splenectomies (n=10).ResultsIn 10 cases splenectomies, in one case distal pancreatosplenectomy, and in two cases liver resection were performed. The most common splenectomy indication was idiopathic trombocytopenic purpura, distal pancreatosplenectomy indication was renal cell cancer metastases, and liver resection indications were left hepatic masses(adenoma, hemangioma) in segment 1 and 2. Single incision laparoscopic surgery was performed successfully in 13 patients of solid organ pathologies. In a patient was converted to open procedure.ConclusionTo our knowledge, SILS in liver, pancreas and spleen were thr first cases in lietarture. In experienced centers, single incision laparoscopic surgery is could be performed successfully. However, to be able reveal the differences between Standard laparoscopic surgery and SILS, prospective randomized comparative studies are required.Keywords: Single incision, Laparoscopy, Surgery Background Single incision laparoscopic surgery is recently became popular on behalf of inventing less invasive procedures. In this paper, we present the first cases of SILS pancreas, SILS liver resection and SILS splenectomy cases. Patients and Methods Between January 2009 and January 2010, Among total 32 patients of single incision laparoscopic surgery (SILS) patients, 13 cases have undergone SILS solid organ surgery composed of pancreatectomy (n=1), liver resection (n=2) and splenectomies (n=10). Results In 10 cases splenectomies, in one case distal pancreatosplenectomy, and in two cases liver resection were performed. The most common splenectomy indication was idiopathic trombocytopenic purpura, distal pancreatosplenectomy indication was renal cell cancer metastases, and liver resection indications were left hepatic masses(adenoma, hemangioma) in segment 1 and 2. Single incision laparoscopic surgery was performed successfully in 13 patients of solid organ pathologies. In a patient was converted to open procedure. Conclusion To our knowledge, SILS in liver, pancreas and spleen were thr first cases in lietarture. In experienced centers, single incision laparoscopic surgery is could be performed successfully. However, to be able reveal the differences between Standard laparoscopic surgery and SILS, prospective randomized comparative studies are required.Keywords: Single incision, Laparoscopy, Surgery

Single Incision Laparoscopic Splenectomy: The First Two Cases

Single incision laparoscopic procedures are presumed to be as a step towards pure natural orifice transluminal endoscopic surgery. However, loss of requirement of any perforation of visceral organ and endoscopic equipment make this technique more popular and easily performable. Herein we report two splenectomy cases where single incision surgery (SILS) technique was performed

Comparison of the clinical outcomes of self-gripping mesh versus staple fixation mesh in laparoscopic inguinal hernia repair

AIM: Inguinal hernia repairs are the most common operations performed in general surgery practice worldwide. Different surgical techniques, mesh types and different fixation methods have been developed for hernia repair. The aim of this study was to compare the clinical results of staple fixation and self-gripping meshes used in laparoscopic inguinal hernia repair. MATERIAL AND METHOD: Forty patients who presented with inguinal hernia between January 2013 and December 2016 and underwent laparoscopic hernia repair were analyzed. The patients were divided into two groups according to used staple fixation (SF group, n = 20) and self-gripping (SG group, n = 20) meshes. Operative and follow-up data of both groups were analyzed and compared in terms of operative time, postoperative pain levels, complications, recurrence, and patient satisfaction. RESULTS: The groups were similar in terms of age, sex, BMI, ASA score, and comorbidities. The mean operative time of SG group (52.75 +/- 17.58 min) was significantly lower than SF group (64.75 +/- 16.66 min) (p = 0.033). The mean postoperative 1st hour and 1st week pain scores was lower in SG group. Long-term follow-up revealed a single case of recurrence in the SF group, and none of the cases in either group had chronic groin pain. CONCLUSION: In conclusion, in our study where we compared two mesh types in laparoscopic hernia surgeries, it was concluded that self-gripping mesh is a fast, effective and safe mesh similar to polypropylene mesh, which can be used without increasing recurrence and postoperative pain rates, when applied by experienced surgeons

Minimally invasive surgery in the treatment of splenosis

Splenosis has been serious etiologic reason in the recurrence of benign hematologic diseases after elective open or laparoscopic splenectomy. Although, the incidince of splenosis in patients splenectomized for trauma is high, as long as they are asymptomatic, they do not require surgical treatment. Herein, we report a case of idiopathic thrombocytopenic purpura recurrence due to splenosis 5 years after the initial laparoscopic splenectomy. Laparoscopic treatment of splenosis was performed successfully