The Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Abdominal Surgery

A retrospective study was carried in 1500 patients submitted to elective laparoscopic cholecystectomy to ascertain its feasibility in patients with previous abdominal surgery. In 411 patients (27.4%) previous infraumbilical intraperitoneal surgery had been performed, and 106 of them (7.06%) had 2 or more operations. Twenty five patients (1.66%) had previous supraumbilical intraperitoneal operations (colonic resection, hydatid liver cysts, gastrectomies, etc.) One of them had been operated 3 times. In this group of 25 patients the first trocar and pneumoperitoneum were performed by open laparoscopy. In 2 patients a Marlex mesh was present from previous surgery for supraumbilical hernias. Previous infraumbilical intraperitoneal surgery did not interfere with laparoscopic cholecystectomy, even in patients with several operations. There was no morbidity from Verres needle or trocars. In the 25 patients with supraumbilical intraperitoneal operations, laparoscopic cholecystectomy was completed in 22. In 3, adhesions prevented the visualization of the gallbladder and these patients were converted to an open procedure. In the 2 patients Marlex mesh prevented laparoscopic cholecystectomy because of adhesions to abdominal organs. We conclude that in most instances previous abdominal operations are no contraindication to laparoscopic cholecystectomy

Between activism and science: Grassroots concepts for sustainability coined by Environmental Justice Organizations

textabstractAbstract In their own battles and strategy meetings since the early 1980s, EJOs (environmental justice organizations) and their networks have introduced several concepts to political ecology that have also been taken up by academics and policy makers. In this paper, we explain the contexts in which such notions have arisen, providing definitions of a wide array of concepts and slogans related to environmental inequities and sustainability, and explore the connections and relations between them. These concepts include: environmental justice, ecological debt, popular epidemiology, environmental racism, climate justice, environmentalism of the poor, water justice, biopiracy, food sovereignty, "green deserts", "peasant agriculture cools downs the Earth", land grabbing, Ogonization and Yasunization, resource caps, corporate accountability, ecocide, and indigenous territorial rights, among others. We examine how activists have coined these notions and built demands around them, and how academic research has in turn further applied them and supplied other related concepts, working in a mutually reinforcing way with EJOs. We argue that these processes and dynamics build an activist-led and co-produced social sustainability science, furthering both academic scholarship and activism on environmental justic