Annals of Bariatric Surgery
Volume:2 Issue: 4, Autumn 2013

Women with mosaic Turner syndrome (TS) bearing the presence of Y chromosome material or with complete androgen insensitivity syndrome (CAIS) is at risk of gonadal malignancy. Two patients with characteristic features of these uncommon disorders are reported, and the surgical techniques of laparoscopic gonadectomy are reviewed and discussed. The aim of the present study is to report 2 clinical cases and review the surgical aspects of laparoscopic gonadectomy.. Both patients had gonadectomy performed by laparoscopy.. Laparoscopic gonadectomy can be performed in individuals with TS and CAIS. Different surgical strategies have to be considered for gonads in different locations. Gonadectomy by laparoscopy should be considered for these young patients with clinical, psychological, and cosmetic benefits..

Distal pancreatectomy has been a standard technique for pancreatic body and tail lesions for years ago. Recently, it is being performed laparoscopically in a perfect manner. There are two common methods for this procedure. One is distal pancreatectomy with splenectomy and the other is distal pancreatectomy with spleen preservation. In patients with splenic vessels involvement, it is not recommended to save the spleen, because of existing chance of splenic ischemia. On the other hand, after splenectomy there is great chance of immune system problems and fatal infections. This report, presents a patient who underwent laparoscopic distal pancreatectomy due to cystic tumor of pancreatic body with splenic vessels involvement and ligation of them was necessary and the spleen was saved successfully with no following complications..

Videoscopic surgery is one of the most important innovations in surgery, and has brought great benefit to patients thanks to its minimally invasive character. The main objective is to promote the exchange of knowledge about videoscopic surgery and establish a surgical network with a high quality moving image over the broadband internet access.. Having the “Portable Wireless Live Video/Audio Transmission System (IMD) and using Digital Video Transport System (DVTS) and the audio and video content from the operation room or meeting room can be transmitted easily to the remote sites.. Surgeon applicants who have a computer and basic internet connection will be easily connected online to the operation and conference rooms, and follow in real time and even use it interactively.. Low-bandwidth, internet-based telemedicine is effective and inexpensive. Surgeons living in remote areas, distant countries and especially those with limited resources, can follow the videoscopic courses, meetings, and live surgeries organized by experienced centers, on their computer screen, in real-time and interactively..

Post laparoscopic cholecystectomy pain management can reduce recovery and discharge time. Non-steroidal anti-inflammatory drugs and opioids are used for this purpose.. This randomized clinical trial evaluates the efficacy of diclofenac rectal suppository for the management of postoperative pain..Patients and Forty four patients were randomized to receive either 100 mg diclofenac rectal suppository or placebo at the time of recovery and three hours later after laparoscopic cholecystectomy. Postoperative visual analogue pain scale (VAS, ranges 0 to 10 cm) and adverse reactions were recorded over a 24-hour period. If VAS score was ≥ 7, 25mg, pethedin was given intravenously as a rescue analgesic.. In both groups, VAS score was reduced in 24 hours. It was statistically lower in diclofenac group rather than placebo group in all intervals except at the time of recovery. Moreover, the mean pethedin consumption dose and the incidence of administration of postoperative rescue analgesic were statistically lower in diclofenac group. Postoperative bleeding was not statistically different between two groups.. Diclofenac rectal suppository provided simple and safe pain relief in laparoscopic cholecystectomy..

Since abdominal pregnancies are mostly complicated, they are usually managed by laparotomy, but laparoscopy is an alternative method which some surgeons perform instead of laparotomy; especially in advanced pregnancy.. We reported a 31 year old woman with last menstrual period of 18 weeks who had supra pubic pain and vaginal bleeding. After sonographic evaluations, abdominal pregnancy was diagnosed and the patient underwent laparoscopic surgery for termination of pregnancy. One year after this successful operation, the patient experienced a normal intrauterine pregnancy.. Laparoscopy is a successful alternative method of surdery for abdominal pregnancies which can be done by experienced surgeons especially at gestational age of 18 weeks..

With the advent of hystroscopic surgery, abnormalities confined to the uterine cavity such as endometrial polyps, submucous myomas, uterine septae and synechia, were supposed to be treated effectively. Diagnostic hysteroscopy is the gold standard for investigating the intrauterine diseases as it allows for biopsy and removal of lesions.. Forty premenopausal women without the history of normal vaginal delivery eligible for operative hysteroscopy were recruited. Patients were randomly assigned to receive 400 microgram vaginal misoprostol or no treatment, 10-12 hours before operative hysteroscopy. Main outcome measures were cervical width and duration of cervical dilatation.. Patients using vaginal misoprostol in treatment group had significantly greater cervical width compared with control group patients (mean: 7.85 vs. 5.80, P = 0.024).. The mean duration of cervical dilatation in misoprostol group was significantly lower than that of control group (30.50 s vs. 52.75 s, P = 0.030). The frequency of complications was similar in treatment and control groups..

Development of complications during gynecologic laparoscopic surgery depends on many factors such as history of previous laparotomies. This factor usually increases the veres and first trocar complications.. In this study, we compared all operative complications between the patients with and without previous abdominal surgery.. Patients and All operative complications due to the first trocar insertion complications were recorded for 100 women who had laparoscopic surgery history during 2005-2010, and were compared with 100 age range in control groups. Influence of different parameters on the risk of adverse complications after surgery was also taken into account.. In both case and control groups, there is no major complication due to the insertion of the first torcar or other procedures of laparoscopy. Adhesion bands were identified in 69 of cases and 24% of them were lysed during laparoscopic surgery; but abdominal wall adhesions were not observed in any patients of control group. Moreover, minor complications did not differ between cases and controls. seven percent of cases and 6% of controls required blood transfusion. There is a significant direct association between the number of previous surgery and increasing NPO days(r = 0.28, P = 0.004). Duration of postoperative hospital admission showed a significant difference between four types of surgery (P < 0.001).. Closed approach gynecological laparoscopy with careful method and preoperatively perdition of complication can be applied in patients having previous laparotomy history with inconsiderable complication increase..

Context: The current literature suggests that minimally invasive surgery is associated with faster recovery and less morbidity than open surgery. Parenchyma-sparing pancreatectomy is minimally invasive surgery, including enucleation, inferior head pancreatectomy, spleen-preserving distal pancreatectomy, and central pancreatectomy, combined pancreatectomy such as inferior head pancreatectomy plus spleen-preserving distal pancreatectomy, and subtotal distal pancreatectomy (spleen-preserving)..Evidence Acquisition: Parenchyma-sparing pancreatic resection is mainly used for benign neoplasms, including intraductal papillary mucinous neoplasm (IPMN), mucinous cystadenoma, serous cystadenoma, and small sized neuroendocrine tumors including insulinoma.. Parenchyma-sparing pancreatectomy can be applied for benign pancreatic lesions. Assistance with pancreatic stenting and/or laparoscopy is recommended in some cases to prevent from complications.. Recent advancements of surgical techniques have allowed us to perform several types of parenchyma-sparing pancreatic resection..