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Simultaneous Laparoscopic Band Removal and Sleeve Gastrectomy: Case Report and Review of Literature.

Yoon Young CHOI ; Yong Jin KIM ; Kyung Yul HUR

Journal of Minimally Invasive Surgery.2012;15(1):23-25. doi:10.7602/jmis.2012.15.1.23

More attention has been paid to bariatric surgery due to an increase in the obese population in Korea. Laparoscopic adjustable gastric banding (LAGB) is the most popular procedure for weight-loss but the complication rate may increase with time. Revision surgery is needed if there are complications or the weight is regained after LAGB, and a laparoscopic sleeve gastrectomy could be performed in the case of band failure. Successful band removal and sleeve gastrectomy wereperformed simultaneously without complications.
Bariatric Surgery ; Gastrectomy ; Korea ; Obesity, Morbid

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Laparoscopic Resection for the Treatment of Symptomatic Remnant Huge Cystic Duct with Stone after Laparoscopic Cholecystectomy.

Yong Hoon KIM ; Keun Soo AHN ; Koo Jeong KANG ; Tae Jin LIM

Journal of Minimally Invasive Surgery.2012;15(1):19-22. doi:10.7602/jmis.2012.15.1.19

During laparoscopic cholecystectomy, the cystic duct is frequently divided closer to the gallbladder to avoid iatrogenic injury to the common bile duct. Postcholecystectomy syndrome can be considered if the patient complains of right upper abdominal discomfort after cholecystectomy. We report a case of a laparoscopic resection for the treatment of a symptomatic remnant huge cystic duct with stones after a previous laparoscopic cholecystectomy. A 46-year-old male was admitted to our hospital due to right upper quadrant abdominal pain. Five years earlier, the patient had undergone a laparoscopic cholecystectomy under the diagnosis of acute calculous cholecystitis but he subsequently suffered from intermittent right upper abdominal pain and fever. An abdominal computed tomography scan revealed a stone in a dilated remnant cystic duct. A laparoscopic remnant cystic duct resection was performed and apathologic diagnosis was made with chronic calculus cystic duct inflammation. The patient was discharged without complications and has been doing well without recurrent symptoms.
Abdominal Pain ; Calculi ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Common Bile Duct ; Cystic Duct ; Fever ; Gallbladder ; Humans ; Inflammation ; Laparoscopy ; Male ; Middle Aged ; Postcholecystectomy Syndrome

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Laparoscopic Resection of a Bronchogenic Cyst Presenting as a Retroperitoneal Tumor.

Kwang Soon KIM ; Yun Ju JO ; Yong Ok HONG ; Byung Seok LEE ; Dong Hee KIM

Journal of Minimally Invasive Surgery.2012;15(1):16-18. doi:10.7602/jmis.2012.15.1.16

A bronchogenic cyst is regarded as a developmental abnormality of the primitive foregut, which typically occurs in the mediastinum. The cystis normally diagnosed in relation to respiratory problems or recurrent infections in children. In adulthood, it is a rare pathology, and its diagnosis is usually incidental. Moreover, subdiaphragmatic and retroperitoneal locations are exceptionally rare. A 60-year old woman presented with an incidental left retroperitoneal mass that was suspected of being a non-functioning retroperitoneal tumor. After evaluating the general radiologic and endocrinologic work up for a retroperitoneal tumor, a laparoscopically complete resection was performed with primary repair of the attached diaphragm. The surgically resected cyst measured 7x5x5 cm and was filled with mucin material. Histologically, the cyst wall was lined by a ciliated pseudostratified or tall columnar epithelium without dysplastic changes. The diagnosis of a bronchogenic cyst in the retroperitoneum was confirmed. We present this case with a review of the relevant literature.
Bronchogenic Cyst ; Child ; Diaphragm ; Epithelium ; Female ; Humans ; Laparoscopy ; Mediastinum ; Mucins

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Comparison of Inguinal Hernia in both Sexes and Laparoscopic Surgery for Female Patients.

Choon Sik CHUNG ; Jeong Eun LEE ; Sang Hwa YU ; Dong Keun LEE

Journal of Minimally Invasive Surgery.2012;15(1):11-15. doi:10.7602/jmis.2012.15.1.11

PURPOSE: Unlike males, inguinal hernia surgery in females is an uncommon surgical procedure. The efficacy of laparoscopic surgery for female hernia must be proven. This study compared the clinical characteristics of male and female hernia as well as the efficacy of laparoscopic surgery with that of open surgery in female hernia. METHODS: From March 2007 to February 2011, one surgeon (C.S.) at the authors' institution operated on 965 patients (male/female=884/81) who were each more than 19 years old. The female patients were divided into the laparoscopic (n=67, TEP/TAPP=66/1) and open surgery groups (n=14). RESULTS: The mean age of the female patients was lower than that of the male patients. The incidence of bilateral and direct hernia was higher in the male patients but the incidence of femoral hernia was higher in the female patients (0.6 vs. 8.6%, p<0.001). Among the 81 female patients, the mean age of the patients with femoral hernia was higher than that of the patients with other types of hernia (56.4+/-12.5/43.0+/-15.1, p<0.026). The operation times and pain scores of the two groups 7 days after surgery were comparable. CONCLUSION: The findings revealed a higher incidence of femoral hernia in the female patients than male patients. Patients with a femoral hernia were older than those with other types of hernia. Therefore, laparoscopic surgery must be considered for elderly female patients who have a high incidence of femoral hernia.
Aged ; Female ; Hernia ; Hernia, Femoral ; Hernia, Inguinal ; Humans ; Incidence ; Laparoscopy ; Male

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Single Port Laparoscopic Appendectomy in Pediatric Patients: A Preliminary Experience.

Taehoon KIM ; Dae Yeon KIM ; Min Jeng CHO ; Seong Chul KIM ; In Koo KIM

Journal of Minimally Invasive Surgery.2012;15(1):7-10. doi:10.7602/jmis.2012.15.1.7

PURPOSE: The authors retrospectively compared single-port laparoscopic appendectomy (SPLA) with conventional laparoscopic appendectomy (CLA) in terms of the perioperative outcomes in pediatric patients. METHODS: Cases of laparoscopic appendectomy between December 2009 and July 2010 were retrospectively reviewed. The demographic data, operating time, pathology of the appendix, hospital stay and surgical morbidities were compared. RESULTS: Ten patients underwent SPLA and 57 underwent CLA. The mean age of the CLA and SPLA groups were 11.2 and 10.6 years, respectively. The pathology of the appendix showed that relatively more severe cases were included in the CLA group. There were 2 cases of a post operative intra-abdominal abscess and 2 cases of an umbilical wound infection in the SPLA group. Therefore, the SPLA group showed a significantly higher surgical morbidity rate (p=0.003) and hospital stay (p=0.05). The mean operation time of the SPLA and CLA group was 88.1+/-30.1 and 71.6+/-26.3 minutes, respectively; the mean operation time of the SPLA group was slightly longer (p=0.054). On the other hand, surgical morbidity and the mean operation time showed a decreasing tendency in the latter half of 10 cases. CONCLUSION: The initial experience of SPLA in pediatric patients shows a higher complication rate and longer hospital stay than CLA. On the other hand, the complication rates and operation time have been decreasing. The clinical outcomes are expected to improve after going through a learning curve.
Abdominal Abscess ; Appendectomy ; Appendix ; Child ; Hand ; Humans ; Learning Curve ; Length of Stay ; Retrospective Studies ; Wound Infection

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Laparoscopic Primary Closure: A Better Method of Treatment in Perforated Peptic Ulcer Disease than Open Repair.

Gyou Ra LEE ; Jong Kyung PARK ; Sung Geun KIM ; Seung Hye CHOI ; Sang Seob YUN ; Seong LEE ; Hee Yong KWAK

Journal of Minimally Invasive Surgery.2012;15(1):1-6. doi:10.7602/jmis.2012.15.1.1

PURPOSE: Perforation is a dreadful complication of peptic ulcer disease requiring immediate management. This study examined the feasibility of laparoscopic primary closure in perforated peptic ulcer disease to allow an earlier return to normal life. METHODS: This study reviewed our experience retrospectively with 72 consecutive patients treated with the simple closure of a perforated peptic ulcer disease in our hospital from December 2002 to January 2011. Thirty five patients were treated laparoscopically and the rest underwent open surgery. The operative time, nasogastric tube utilization, abdominal drain usage, time to oral feeding, hospital stay, postoperative complications and recurrence in both groups were compared. A student's t-test was used to make the comparisons. A p value<0.05 was considered significant. RESULTS: The operative time, use of nasogastric tubes, and abdominal drainage were similar in both groups. After laparoscopic surgery, the patients showed an earlier return to normal oral feeding and discharge than the open surgery group (4.17+/-0.62 vs. 5.03+/-2.34 days, p=0.040, 8.63+/-1.96 vs. 10.24+/-3.59 days, p=0.021, respectively). The decreased handling of tissue in laparoscopic surgery led to less wound infection (0 in laparoscopic surgery vs. 3 in open) and postoperative ileus (0 vs. 2). CONCLUSION: Laparoscopic repair of a perforated peptic ulcer is a safe and feasible treatment that offers early oral feeding and a shorter postoperative hospital stay.
Drainage ; Handling (Psychology) ; Humans ; Ileus ; Laparoscopy ; Length of Stay ; Operative Time ; Peptic Ulcer ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Wound Infection

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Clinical Effectiveness of Laparoscopic Adrenalectomy.

Ohjoon KWON ; Sang Kuon LEE ; Jaseong BAE

Journal of Minimally Invasive Surgery.2013;16(3):74-79.

PURPOSE: A laparoscopic approach, rather than conventional laparotomy, is the well-accepted first choice for excision of an adrenal or perinephric retroperitoneal mass. The purpose of this study was to investigate the factors that affect surgical outcomes and analyze the clinical effectiveness of this surgical treatment modality. METHODS: We conducted a retrospective analysis of 62 patients who underwent laparoscopic adrenalectomies from September 2007 to February 2013. These operations were performed by a single surgeon. Demographic characteristics, operative data, tumor characteristics, and surgical outcomes were analyzed. RESULTS: Of 62 patients, 21 were men and 41 were women. The mean operative time was 151.16+/-48.58 minutes and the mean amount of blood loss was 179.51+/-161.66 ml. There were two cases of metastatic adrenal tumors that were resected completely with prolonged survival. There was one case of recurrence during the postoperative period. Preoperatively, it was only a tumor measuring 3.5 cm without evidence of malignancy. Postoperative complications occurred in three patients. However, there was no case of conversion to laparotomy. Previous history of open abdominal operation did not affect post-operative outcomes. CONCLUSION: Laparoscopic approach for adrenal tumors is indicated regardless of its type or past history of abdominal surgery. Unless greater than 10 cm, relatively large tumors can be safely removed using this method. In particular, due to the possibility of malignant potential, aggressive surgical intervention is recommended for tumors measuring between 3 and 5 cm. Use of a laparoscopic approach is associated with low risk of surgical complication and the benefits outweigh the disadvantages.
Adrenal Gland Neoplasms ; Adrenalectomy ; Female ; Humans ; Laparoscopy ; Laparotomy ; Male ; Operative Time ; Postoperative Complications ; Postoperative Period ; Recurrence ; Retrospective Studies

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Comparative Analysis of Laparoscopic Versus Open Appendectomy for Perforated Appendicitis in Children Under 12 Years Old at a Single Institute.

Jun Ho CHO ; Jin Soo PARK ; Il Dong KIM ; Ki Ho KIM ; Byung Sun SUH ; Sang Wook KIM ; Hye In LIM ; Kook Hyeon JUNG ; Byeong Geon JUNG

Journal of Minimally Invasive Surgery.2013;16(3):69-73.

PURPOSE: The purpose of this study is to evaluate the outcome of laparoscopic (LA) vs. open appendectomy (OA) in children under 12 years old with perforated appendicitis. METHODS: We reviewed the medical files of 156 children who underwent LA (n=96), OA (n=59), and conversion (CO) (n=1), and compared duration of operation, length of hospital stay, incidence of wound infection, mechanical ileus, intra-abdominal abscess (IAA), and re-admission. RESULTS: Compared to OA, LA resulted in longer duration of operation (58.32+/-17.105 min vs. 44.27+/-18.735 min; p=0.001), but fewer wound infections (2.1% vs. 10.2%; p=0.054), and fewer cases of mechanical ileus (0% vs. 5.1%; p=0.053). No differences in the length of hospital stay (5.85+/-1.824 days vs. 6.10+/-3.027 days; p=0.526), IAA (2.1% vs. 1.7%; p=1.000), or re-admissions (2.1% vs. 5.1%; p=0.369) were observed. CONCLUSION: We report that although LA showed an association with longer duration of operation compared to OA, it is superior to OA with regard to incidence of wound infection and mechanical ileus.
Abdominal Abscess ; Appendectomy ; Appendicitis ; Child ; Humans ; Ileus ; Incidence ; Length of Stay ; Wound Infection

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Comparison of Two Methods of Laparoscopic Single Port Appendectomy and Conventional Three Port Laparoscopic Appendectomy.

Eun Young KIM ; Hyung Ook KIM ; Hung Dai KIM ; Jun Ho SHIN ; Byung Ho SON ; Won Joon CHOI

Journal of Minimally Invasive Surgery.2013;16(3):62-68.

PURPOSE: Acute appendicitis is a type of abdominal disease that requires emergency surgery. Over the past three decades, laparoscopic appendectomy has become the standard operation for acute appendicitis. The aim of this paper is to compare the methods of single port appendectomy and conventional appendectomy and to illustrate the advantages of single port appendectomy. METHODS: The first group of patients underwent single port appendectomy using a surgical glove (Group 1), and those in the second group underwent surgery using the TriPort system (Group 2). The third group of patients underwent conventional three port surgery (Group 3). Questionnaires regarding patient satisfaction with scars were administered via telephone interview. Patient characteristics, histopathological data, postoperative data, and satisfaction score were analyzed by t-test and Pearson chi2 test. RESULTS: A statistically significant difference in satisfaction scores was observed among the three groups. Overall, patients in the single port group using a surgical glove would be more likely to recommend the procedure to friends and family than would patients in the other two groups. Better cosmetic results were achieved for both groups of patients who underwent laparoscopic single port appendectomy, compared to those who underwent conventional three port laparoscopic appendectomy, with statistically significant difference. CONCLUSION: Laparoscopic single port appendectomy using a surgical glove is a feasible and safe procedure and shows no differences in terms of risk, such as postoperative complication, compared to a conventional three-trocar technique. Use of this method resulted in better satisfaction compared with the other two groups, illustrating its cosmetic improvement.
Appendectomy ; Appendicitis ; Cicatrix ; Cosmetics ; Emergencies ; Friends ; Gloves, Surgical ; Humans ; Interviews as Topic ; Patient Satisfaction ; Postoperative Complications ; Surveys and Questionnaires

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Comparison of Clinical Outcomes between the Hem-o-lok Clip and Endoloop Ligature in Securing the Base of the Appendix.

Young Chan KIM ; Tae Kyung HA

Journal of Minimally Invasive Surgery.2013;16(3):56-61.

PURPOSE: There are various techniques for securing the base of the appendix during performance of laparoscopic appendectomy. Many studies have reported that Endo-GIA is useful for securing the base of the appendix; however, it is costly. Many hospitals now use Endoloop ligature (ELL) for securing the base of the appendix. Many studies have demonstrated the many advantages of the Hem-o-lok clip (HLC) for securing the base of the appendix. The aim of this study is to compare the surgical outcomes of securing the base of the appendix between HLC and ELL during performance of laparoscopic appendectomy. METHODS: A retrospective cohort study was conducted for comparison between HLC and ELL for securing the base during performance of laparoscopic appendectomy. From May 2008 to October 2011, 102 patients underwent laparoscopic appendectomy performed by a single surgeon. Thirty one patients were excluded for various reasons. In 38 patients, the base of the appendix was secured by HLC, and in 33 patients, ELL was applied. Data included age, sex, body mass index (BMI), cost of materials, preoperative white blood count (preoperative WBC), preoperative c-reactive protein (preoperative CRP), preoperative fever, operation time, hospital days, diameter of the appendiceal base, number of perforated appendicitis, and intraoperative or postoperative complication. RESULTS: HLC was used in 38 patients, with a meanage of 36.4 years old. ELL was applied in 33 patients, with a meanage of 19.3 years old. Significant difference in age of patients was observed between the groups (p<0.001). The groups were comparable with regard to sex, BMI, preoperative WBC, preoperative CRP, preoperative fever, operation time, hospital stay, diameter of the appendiceal base, perforated appendicitis, and intraoperative or postoperative complication. The cost of six HLCs was 32,940 won, and that for one ELL was 29,610 won, therefore, there was no significant difference in the cost of material between the tw o groups of patients. CONCLUSION: Except for age, no difference was observed between the two groups. If a single HLC set is available for securing the base of the appendix, there will be a significant difference of the material cost between the two groups. ELL is more useful for securing the appendiceal base, with a larger diameter, which is inappropriate for use of HLC.
Appendectomy ; Appendicitis ; Appendix ; Body Mass Index ; C-Reactive Protein ; Cohort Studies ; Fever ; Humans ; Length of Stay ; Ligation ; Postoperative Complications ; Retrospective Studies

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