The safety and usefulness of the single incision, transabdominal pre-peritoneal (TAPP) laparoscopic technique for inguinal hernia

Background : The safety and usefulness of the SILS-TAPP (transabdominal preperitoneal) procedure remain unclear. The aim of this study was to clarify the safety and usefulness of the SILS-TAPP procedure compared with standard laparoscopic TAPP and TEPP (totally extra-peritoneal pre-peritoneal) procedures. Patients and methods : 85 patients underwent laparoscopic inguinal hernia repairs (TEPP, 30 patients ; TAPP, 20 patients ; SILS-TAPP, 35 patients) from 2007 to 2011. The operative outcomes of the three groups were compared. Results : There was no difference in the patients’ characteristics among the three groups. The TEPP Group had a longer operation time. One patient in the SILS-TAPP group had an intraoperative complication. One patient in the TAPP group had a postoperative complication, and one patient had ileus and one had an umbilical hernia in the SILS-TAPP group. The postoperative hospital stay was not significantly different among the three groups. There were no recurrences in the TEPP group, 1 case of recurrence (5.0%) in the TAPP group, and 1 case (2.9%) in the SILS-TAPP group. Conclusions : The present findings show that the SILS-TAPP repair is safe and feasible for the repair of adult inguinal hernia

ヒダイショウセイ カンコウヘン ト シンフゼン オ トモナウ セイジン コウツウセイ インノウ スイシュ ニ タイシテ ツリアゲシキ LPECホウ オ シコウシタ 1レイ

We report Laparoscopic percutaneous extraperitoneal closure（LPEC）by lifting abdominal wall is safe and feasible for an adult communicating hydrocele with decompensated cirrhosis and heart failure. The patient was a７1-year-old man with communicating hydrocele. He has been treated for several years for alcoholic liver cirrhosis, diabetes and sick sinus syndrome. Preoperative laboratory examination showed a decrease in platelet count, liver dysfunction, hypoxemia, restrictive impairment and heart failure. Enhanced pelvic computed tomography scan revealed a continuous low density area in the right inguinal region from the scrotum. Outside of the right inferior epigastric artery and vein, the abdominal cavity and scrotum were communicated. Thus, right communicating hydrocele was diagnosed. To avoid complications due to pneumoperitoneum, LPEC with lifting abdominal wall was performed. There were no intra-and post-operative complications, and there has been no recurrence

ネパールノソサイ

京都大学0048新制・論文博士農学博士乙第1561号論農博第251号新制||農||90(附属図書館)学位論文||S45||N342(農学部図書室)2473UT51-45-U60(主査)教授 塚本 洋太郎, 教授 小林 章, 教授 長谷川 浩学位規則第5条第2項該当Kyoto UniversityDA

The natural alkaloid sanguinarine promotes the expression of heat shock protein genes in Arabidopsis

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２次錐計画のサブクラスに対する単体法的アルゴリズムにおけるピボット選択規則について

要旨あり計算推論 － モデリング・数理・アルゴリズム －原著論

When can we give general anesthesia to an infant with anticipated difficult airway management caused by facial vascular malformation?

Abstract A 13-month-old infant weighing 8.3 kg with a height of 72.3 cm visited our hospital for surgical resection of facial vascular malformation detected at birth. Because we anticipated the patient would have difficult airway management and massive perioperative bleeding, we postponed surgery to discuss the appropriate timing and general anesthesia approach with anesthesiologists at other institutions, while explaining the risk of general anesthesia and bleeding to the parents. When the patient was 21 months old and 10 kg, he started bleeding while undressing, when his lips touched his clothes. Because the cricothyroid membrane puncture kit (QuickTrach Child™ (VBM Medizintechnik GmbH, Sulz am Neckar, Germany)) can be used on infants weighing over 10 kg, we decided to give him general anesthesia. The infant was successfully intubated by Airwayscope™ and the lesion was surgically removed in accordance with the preoperative plan. The procedure took 65 min and created 8 g of bleeding. The infant had no postoperative bleeding or respiratory complications. There is no data on the timing of safe anesthesia management in infants with difficult airway management. Thus, taking the time to discuss the case with surgeons, other anesthesiologists, and the parents can be helpful