No abstract available.
Laparoscopy*

We report a case of a large peritoneal loose body diagnosed on computed tomography. The most common causes of a peritoneal loose body are thought to be torsion and separation of the appendices epiploicae. Peritoneal loose bodies are usually small, 0.5 to 2.5 cm in diameter. However, "giant" peritoneal loose bodies, larger than 4 cm in diameter, are an uncommon disease and present with various symptoms, and are difficult to diagnose preoperatively. Especially, abdominal large peritoneal loose bodies are frequently misdiagnosed as tumorous disease preoperatively. In our case, the loose body appeared as a round pelvic mass with central calcifications and a distinct fat plane separating it from adjacent organs. Preoperatively, we suspected a tumorous lesion from the wall of the upper rectum; however, at laparoscopy, a large peritoneal loose body was detected. An extraction of the giant peritoneal loose body was performed laparoscopically.
Laparoscopy

PURPOSE: Robotic surgery is known to provide an improved technical ability as compared to laparoscopic surgery. We aimed to compare the efficiency of surgical skills by performing the same experimental tasks using both laparoscopic and robotic systems in an attempt to determine if a robotic system has an advantage over laparoscopic system. METHODS: Twenty participants without any robotic experience, 10 laparoscopic novices (LN: medical students) and 10 laparoscopically-experienced surgeons (LE: surgical trainees and fellows), performed 3 laparoscopic and robotic training-box-based tasks. This entire set of tasks was performed twice. RESULTS: Compared with LN, LEs showed significantly better performances in all laparoscopic tasks and in robotic task 3 during the 2 trials. Within the LN group, better performances were shown in all robotic tasks compared with the same laparoscopic tasks. However, in the LE group, compared with the same laparoscopic tasks, significantly better performance was seen only in robotic task 1. When we compared the 2 sets of trials, in the second trial, LN showed better performances in laparoscopic task 2 and robotic task 3; LE showed significantly better performance only in robotic task 3. CONCLUSION: Robotic surgery had better performance than laparoscopic surgery in all tasks during the two trials. However, these results were more noticeable for LN. These results suggest that robotic surgery can be easily learned without laparoscopic experience because of its technical advantages. However, further experimental trials are needed to investigate the advantages of robotic surgery in more detail.
Laparoscopy*

Priciples of kont-tying have assumed a new and enhanced role in operative laparoscopy. The surgeon should be familiar with extracorporeal knot-tying techniques. For extracorporeal knot-tying, a knot pusher is used to properly secure the knot. But a knot pusher has some limitation for tightening of the knot. I developed an instrument which has a slit and hole.(slit for knot pushing and hole for knot tightening) for a secure knot. By using this instrument(Lee's knot presser) it is very easy and secure for knot-tying. The surgeon can confirm and control the knot tightening.
Laparoscopy

No abstract available.
Laparoscopy*

No abstract available.
Laparoscopy*

No abstract available.
Laparoscopy*

Background: Laparoscopic cholecystectomy is the first laparoscopic surgery that was performed at Cho Ray hospital in September 1992. In 2005, Quang Tri general hospital has performed successfully the first case of laparoscopic appendectomy. Objectives: To access the preliminary results of application on endoscopic surgery in Quang Tri general hospital. Subjects and method: A prospective study was conducted on 140 patients with laparoscopic surgery or retroperitoneal surgery, was performed in Quang Tri general hospital from September, 2005 to April, 2006. Results:Among 140 patients was operated, there was only one case of postoperative intestinal obstructive complication (accounted for 0.7%), no case of death. Operative aged was between 11 and 70 years old. The average surgical time was 65 minutes for cholecystectomy, 35 minutes for appendectomy, 85 minutes for ureterolithotomy, 80 minutes for gynecological diseases. 2 cases of cholecystectomy and appendectomy changed open surgery. Conclusion: Laparoscopic surgery is a safe and effective method. It can be developed in provincial hospitals. Quang Tri general hospital has successful preliminary developed the new technique.
Laparoscopy ;

Gastro-peritoneal fistula is a rare but serious complication of laparoscopic sleeve gastrectomy with significant morbidity and mortality. We present the case of a 42-year-old man who underwent laparoscopic sleeve gastrectomy for morbid obesity and presented later with a history of chronic epigastric pain and severe reflux. Upper gastrointestinal series showed the presence of a communicating fistula between the stomach and the left hemi-diaphragm and peri-splenic area.
Laparoscopy

Objective: Various techniques and instruments have been developed to provide safe and secure closure of laparoscopic wounds. Herein we describe a simple method to close laparoscopic supraumbilical wounds with the aid of a laparoscopic port. Method: This was a retrospective review of prospective data, which were from 151 patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease from December 2009 to December 2010 in Sultanah Bahiyah Hospital. A senior consultant hepato-pancreato-biliary (HPB) surgeon and two HPB trainee surgeons performed the operations. Postoperatively, all patients were followed up at 4 weeks. Results: All patients successfully underwent closure of the supraumbilical wound with the assistance of a 5mm laparoscopic port. None of the patients had incisional hernia on follow up. Conclusion: Port assisted closure of supraumbilical laparoscopic wounds is a feasible and safe technique.
Laparoscopy