Laparoscopic General Surgery Research Articles

Laparoscopy and major retroperitoneal vascular injuries (MRVI).

Injury to major retroperitoneal vessels is a potential serious complication of laparoscopy occurring when the Veress needle or trocar is inserted. This report is a review of major retroperitoneal vascular injuries (MRVI) occurring during laparoscopy, as these injuries have not been well documented in the literature. A retrospective, observational review of general surgical laparoscopy cases was conducted over a 3.5-year period in three community, university-affiliated hospitals. We identified 4 MRVI in 3591 laparoscopic procedures. These cases were critically analyzed and compared. The incidence of MRVI was approximately 0.1%. All cases occurred with the closed (blind) insertion technique of Veress needle and primary trocar insertion technique with disposable "safety" shield trocars. All patients sustaining MRVI had acute hypotension introperatively and significant blood loss necessitating postoperative transfusions. Recognition and rapid conversion to laparotomy are keys to enhancing outcome. There is significant potential for morbidity and mortality with laparoscopic MRVI, although each patient in this series was discharged without obvious short-term problems. The advantages of an open approach for primary trocar insertion are numerous and should alleviate the risk of MRVI associated with general laparoscopic surgery.

A year of laparoscopic general surgery at RNH Haslar

Laparoscopic general surgery at RNH Haslar started in October 1992. A review of the procedures undertaken in the first year (October 1992-October 1993) and comparison with some published series is presented.

The radiologist's role in the new era of laparoscopic general surgery.

The radiologist's role in the new era of laparoscopic general surgery.

Atlas of Laparoscopic Surgery

It is inevitable, with the popularity of laparoscopic cholecystectomy, that an atlas of laparoscopic techniques should be published by one of the pioneers in laparoscopic surgery. The authors' original goal was to cover only laparoscopic cholecystectomy; however, it was expanded to cover other techniques in the area of general laparoscopic surgery. The text associated with the atlas is detailed and is perhaps the cost-redeeming part of the work. The illustrations of port placement are good; the intra-abdominal illustrations, however, are inferior. We believe some of this is related to the transfer of these images to the videotape and also because there tends to be a motion effect on some of the illustrations. The descriptions of laparoscopic cholangiography are quite in-depth and thorough. However, we found the illustration for common bile duct exploration not very helpful. The remainder of the text covers laparoscopic techniques for appendectomy, peptic ulcer disease management, left

Guidelines for granting of privileges for laparoscopic (peritoneoscopic) general surgery

Guidelines for granting of privileges for laparoscopic (peritoneoscopic) general surgery

1991 Scientific session and postgraduate course: advances in laparoscopic general surgery

1991 Scientific session and postgraduate course: advances in laparoscopic general surgery

1991 scientific session and postgraduate course: advances in laparoscopic general surgery

1991 scientific session and postgraduate course: advances in laparoscopic general surgery

Training, credentialling, and granting of clinical privileges for laparoscopic general surgery

Despite the lack of scientific data comparing it with traditional open operations, laparoscopic surgery has gained rapid acceptance and implementation by general surgeons. Individual hospitals, which have the responsibility for developing their own privileging criteria, are searching for guidance as to the amount and type of additional training required to grant clinical privileges in laparoscopic general surgery. Laparoscopic surgery involves techniques different from those learned during general surgery residency training. Therefore, until such techniques are regularly included in general surgery residency programs, additional training for and granting of separate privileges in laparoscopic surgery are appropriate. Adequate training for surgeons already experienced in abdominal and biliary tract surgery can be acquired through a preceptorship in diagnostic laparoscopy, attending a course in laparoscopic surgery that includes both didactic instruction and live animal experience, assisting with the procedures in humans, and being proctored and certified as competent by an experienced general surgeon.