Evaluasi Akseptor Minilaparotomy di RS Turen, Malang Jawa Timur

Within the frame-work of improvement program in East Java for providing Family Planning services using sterilization method, it was needed information on the development of procedure of mini-laparotomy operation. Doctors working in Turen Hospital, Malang have already developed a new procedure in conducting mini-laparotomy operation. On the basis of mformation needed for program development, the evaluation of Family Planning acceptors using mint-laparotomy in Turen Hospital should be undertaken. The main purpose of evaluation was to evaluate to what extent the feasibility of operation procedure in line wrth the standard operation. The finding showed that acceptor using mini-laparotomy were young couples, average age 30 year old, having youngest child 2 year old, having 3-4 children and the level of education of acceptors mostly elementary school. They were Moslem with the main occupatron were farmer. 75% out of acceptors were new acceptors and mostly recruited by Field Family Plannrng Workers (PLKB) and wrllrngness not to be pregnant again. In general, their physical and laboratory condition were good before the operation and no side effects during pre-medication. The process of operation was conducted by making incise 2 cm in average and 10 minutes needed for operation with external bleeding about 2-3 ml Generally, during follow up period after operation was no complication significantly

Microsurgical Technique of Simultaneous Pancreas/Kidney Transplantation in the Rat: Clinical Experience and Review of the Literature

Background: For experimental basic research, standardized transplantation models reflecting technical and immunologic aspects are necessary. This article describes an experimental model of combined pancreas/kidney transplantation (PKTx) in detail. Materials and Methods: Donor rats underwent en bloc pancreatectomy and nephrectomy. Revascularization was performed using the aorta with the superior mesenteric artery and the inferior vena cava with the portal vein. Exocrine drainage of the pancreas took place over a segment of the duodenum which was transplanted side-to-side to the jejunum. The kidney vessels were transplanted end-to-side. The ureter was anastomosed by patch technique. Postoperatively, serum parameters were monitored daily. Biopsies for histopathology were taken on days 5, 8 and 12. Results: All 12 recipients survived the combined PKTx without serious surgical complications. One thrombosis of the portal vein led to organ failure. Blood glucose levels were normal by the 3rd postoperative day. The transplanted duodenal segment showed slight villous atrophy, and the kidneys were well perfused without vascular complications. The anastomosis between ureter and bladder was leakproof. Conclusions: Excellent graft function and survival rates can be achieved due to simplified operation technique and short operation time. It may thus have high clinical relevance to immunologic issues within the scope of basic research. Copyright (C) 2009 S. Karger AG, Base

Perbandingan Teknik Operasi Mini Laparotomi Kolesistektomi Dengan Laparoskopi Kolesistektomi Pada Kolesistolitiasis Terhadap Lama Rawat Inap Di Rsup Dr. Kariadi Semarang

Latar Belakang: Kolesistolitiasis menjadi salah satu perhatian penting, dikarenakan kandung empedu sendiri merupakan tempat penyimpanan garam empedu yang bermanfaat untuk mencerna makanan yang mengandung lemak. Dalam penaganan kolesistolitiasis simptomatik dibutuhkan tindakan pembedahan dengan cara mini laparotomi kolesistektomi atau dengan cara laparoskopi kolesistektomi.Metode: Penelitian ini mengunakan desain cross sectional dengan pendekatan retrospektif. Populasi penelitian adalah pasien kolesistolitiasis dengan tindakan operasi mini laparotomi kolesistektomi atau laparoskopi kolesistektomi. Sampel penelitian diambil dari data rekam medis pasien kolesistolitiasis di RSUP Dr. Kariadi Semarang, data diambil dengan mengunakan purposive sampling dengan besaran minimal sampel sebanyak 32. sampel, dibagi menjadi 2 kelompok tindakan mini laparotomi kolesistektomi dan laparoskopi kolesistektomi. Didapatkan 96 sampel pasien kolesistolitiasis dari tahun 2009-2013 yang termasuk kriteria inklusi dengan dibagi 48 sampel tiap-tiap tindakan operasi, selanjutnya data di uji normalitas dengan uji saphiro willk bila data normal diolah dengan t test bila tidak normal mengunakan uji mann witney.Hasil: Hasil yang didapat dengan uji mann witney adalah p < 0,05Kesimpulan: Terdapat perbedaan lama rawat inap antara tindakan mini laparatomi kolesistektomi dengan laparoskopi kolesistektomi

Robot-assisted pancreaticoduodenectomy. Safety and feasibility

Background: The availability of robotic assistance could make laparoscopic pancreaticoduo- denectomy safely feasible. We herein provide a systematic review on laparoscopic robot-assisted pancreaticoduodenectomy (RAPD). Methods: Literature search was conducted on multiple databases considering articles published in English up to October 31, 2014, reporting on ten or more patients. Results: A total of 262 articles were identified. Excluding duplicates (n=172), studies not matching inclusion criteria (n=77), and studies not suitable for other reasons (n=6), a total of seven studies reporting on 312 RAPDs were eventually reviewed. These studies were either retrospective cohort studies (n=4) or case-matched studies (n=3). No randomized controlled trial was identified. Most patients undergoing RAPD were diagnosed with malignant tumors (224/312; 71.8%). RAPD was feasible in most patients. Conversion to open surgery was reported in 9.2% of the patients. A hybrid RAPD technique, employing standard laparoscopy or open surgery through a mini-incision, was adopted in most patients (178/312; 57.0%). Overall, there were six postoperative deaths at 30 days (6/312; 1.9%), including one intraoperative death caused by portal vein injury, while 137 out of 260 patients with complete information developed postoperative complications (52.7%). The mean length of hospital stay ranged from 10–29 days. Postoperative pancreatic fistula (POPF) occurred in 66 patients (66/312; 21.1%). Grade C POPF was reported in eight patients (8/312; 2.5%). The costs of RAPD were assessed in two studies, demonstrating additional costs ranging from 4,000–5,000 US dollars to 6,193 Euro. The mean number of examined lymph nodes and the rate of positive surgical margins indicate that RAPD could be an appropriate oncologic operation. Conclusion: RAPD is safely feasible. These results were obtained in selected patients and in specialized centers. RAPD should not be implemented in the occasional patient by surgeons without advanced laparoscopic skills and formal training in robotic surgery

Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal

Background: Nepal recently began teaching sexual education in the school system and has established youth friendly services in order to meet the need of increased sexual and reproductive knowledge among the youth. Objective: To examine the sexual and reproductive knowledge and perceptions among young people attending schools in Kathmandu. Method: A written questionnaire was distributed to 160 students, in a classroom environment, in four schools in Kathmandu. Results: Two thirds of the females and nearly 60% of the males knew that it was possible to get sexually transmitted infection (STI) during one sexual encounter and more than half of the students knew when in the menstrual cycle conception was more likely to occur . One third of the participants did not know that it was possible to become pregnant after having intercourse once. The males demonstrated less knowledge than the females regarding every aspect of sex and reproduction, with the exception of pregnancy prevention. Conclusion and clinical implications: For the youths in this study, it was more important to prevent unwanted pregnancies than to protect oneself from STIs. Establishment of a hotline on the internet, where personalized and confidential counselling can be offered may complement the comprehensive sexual education in schools

Giant mesenteric lymphatic malformation presenting as small bowel volvulus

Abdominal pain with bilious emesis is an ominous clinical presentation with many possible causes. We describe a previously healthy 4-year-old boy who presented with these symptoms and ultrasound findings of fluid throughout most of the abdominal cavity. Computed tomography imaging revealed a large cystic mass (21-by-13 cm) associated with a small bowel obstruction due to volvulus. A laparoscopic exploration was undertaken, revealing a large mass arising from the small intestinal mesentery and causing a segmental volvulus of the small bowel. Conversion to mini-laparotomy allowed reduction of the volvulus and segmental resection of the small bowel associated with a giant mesenteric lymphatic malformation. This case describes a rare cause of intestinal volvulus due to a mesenteric lymphatic malformation

Laparoscopy in liver transplantation: The future has arrived

In the last two decades, laparoscopy has revolutionized the field of surgery. Many procedures previously performed with an open access are now routinely carried out with the laparoscopic approach. Several advantages are associated with laparoscopic surgery compared to open procedures: reduced pain due to smaller incisions and hemorrhaging, shorter hospital length of stay, and a lower incidence of wound infections. Liver transplantation (LT) brought a radical change in life expectancy of patients with hepatic endstage disease. Today, LT represents the standard of care for more than fifty hepatic pathologies, with excellent results in terms of survival. Surely, with laparoscopy and LT being one of the most continuously evolving challenges in medicine, their recent combination has represented an astonishing scientific progress. The intent of the present paper is to underline the current role of diagnostic and therapeutic laparoscopy in patients waiting for LT, in the living donor LT and in LT recipients

Imaging in-stent restenosis: an inexpensive, reliable, and rapid preclinical model.

Preclinical models of restenosis are essential to unravel the pathophysiological processes that lead to in-stent restenosis and to optimize existing and future drug-eluting stents. A variety of antibodies and transgenic and knockout strains are available in rats. Consequently, a model for in-stent restenosis in the rat would be convenient for pathobiological and pathophysiological studies. In this video, we present the full procedure and pit-falls of a rat stent model suitable for high throughput stent research. We will show the surgical procedure of stent deployment, and the assessment of in-stent restenosis using the most elegant technique of OCT (Optical Coherence Tomography). This technique provides high accuracy in assessing plaque CSAs (cross section areas) and correlates well with histological sections, which require special and time consuming embedding and sectioning techniques. OCT imaging further allows longitudinal monitoring of the development of in-stent restenosis within the same animal compared to one-time snapshots using histology

Minimally invasive thyroid and parathyroid surgery

Since the 1980s, minimally invasive surgical techniques have attracted immense interest in all surgical specialties, including abdominal, thoracic and most recently head and neck surgery. This article aims at reviewing the emergence of minimally invasive thyroidectomy (MIT) and parathyroidectomy (MIP) and their applications to benign thyroid and parathyroid diseases respectively. For the purpose of this review, MIT and MIP will be considered separately as they deal with different pathologies