Changes in T-lymphocytes' viability after laparoscopic versus open cholecystectomy.

Laparoscopic surgery results in decreased immune and metabolic stress response compared to open surgery. Our aim was to evaluate the suspension of host immune defense in terms of apoptosis, necrosis, and survival of peripheral T-lymphocytes in patients undergoing laparoscopic versus open cholecystectomy. Apoptosis, necrosis and viability of peripheral T-lymphocytes were measured preoperatively and postoperatively by means of flow cytometry in 27 patients undergoing laparoscopic cholecystectomy and 25 undergoing open cholecystectomy.

The effect of laparoscopic sleeve gastrectomy on the antireflux mechanism: can it be minimized?

Background: Laparoscopic sleeve gastrectomy (LSG) is a promising procedure for the treatment of morbid obesity. The stomach is usually transected near the angle of His; hence, the lower esophageal sphincter (LES) may be affected with consequences on postoperative gastroesophageal reflux disease (GERD). The purpose of this study was to examine the effect of LSG on the LES and postoperative GERD.

Incidence, risk factors, and outcome of portal vein thrombosis after laparoscopic-assisted splenectomy in β-thalassemia patients: a prospective exploratory study.

Background: Portal vein system thrombosis (PVT) is an infrequent but potentially serious complication after laparoscopic splenectomy. Patients with β-thalassemia are at higher risk as they have splenomegaly and hypercoagulability.

Subjects And Methods: Forty-eight β-thalassemia patients who underwent hand-assisted laparoscopic splenectomy or laparoscopic splenectomy were studied prospectively with pre- and postoperative Doppler ultrasonography or computed tomography scanning.

C-reactive protein, white blood cells, and neutrophils as early predictors of postoperative complications in patients undergoing laparoscopic sleeve gastrectomy.

Background: Early detection and treatment of complications after laparoscopic sleeve gastrectomy (LSG) are mandatory. This study aimed to evaluate C-reactive protein (CRP), white blood cell (WBC) count, and neutrophil (NEU) count in relation to the early diagnosis of major surgical complications after LSG.

Methods: A prospective study of 177 patients who underwent LSG during 2008-2011 was performed.

Novice surgeons versus experienced surgeons in laparoendoscopic single-site (LESS) surgery: a comparison of performances in a surgical simulator.

Introduction: During the past years, there has been increasing interest in simulation-based training of technical skills especially in laparoscopy. The purpose of this study was to compare the performances of novice and experienced laparoscopic surgeons on a LESS simulator.

Methods: The study recruited 20 surgeons classified into two groups: group NS consisted of ten residents without any laparoscopic experience, and group ES consisted of ten surgeons with experience in conventional laparoscopy (performed >90 laparoscopic cholecystectomies) but without any experience in LESS surgery.

Prospective comparative study of the efficacy of staple-line reinforcement in laparoscopic sleeve gastrectomy.

Background: Staple-line reinforcement has been used with promising results in laparoscopic gastric bypass in order to reduce leakage, increase staple-line integrity, and diminish staple-site bleeding. The purpose of this study was to determine if staple-line reinforcement with bovine pericardial strips reduces surgical complications of laparoscopic sleeve gastrectomy (LSG).

Methods: This is a prospective comparative study of all patients who underwent LSG by a standard operative team in an 18-month period.

Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing two different techniques. Preliminary results.

Background: Sleeve gastrectomy involves the creation of small gastric reservoir based on lesser curvature of the stomach, which is fashioned by a longitudinal gastrectomy that preserves the antrum and pylorus together with its vagal innervation. The main complications in the early postoperative course are bleeding and gastric leak. In order to reduce these complications the staple line can be reinforced in many different ways.

Education and teaching laparoscopic surgery in Europe: present constraints and role of the European Association for Endoscopic Surgery.

As we move on to the second decade of the 21st century, many changes in education and, particularly, in training future surgeons, have come to pass. Several of these changes are the result of a natural evolution in teaching methods, but others have been dictated by global modifications in the educational and social systems reigning throughout the Western culture. The recent evolution to less aggressive therapy and, in particular, surgical techniques, attests to the desire to decrease patient harm.

Routine abdominal drains after laparoscopic sleeve gastrectomy: a retrospective review of 353 patients.

Complications after laparoscopic sleeve gastrectomy (LSG) are usually silent and difficult to interpret. Our purpose was to evaluate the utility of routine placement of intraperitoneal drains at the end of LSG in detection and management of postoperative complications. This is a retrospective study of all patients that underwent LSG by a standard operative team in a 3-year period.

Clinical implications of sleeve gastrectomy as a source of spleen infarction or ischemia.

Splenic arterial demarcation has been observed during laparoscopic sleeve gastrectomy (LSG). The present study aims to detect its actual incidence during LSG and clarify its clinical significance. This is a prospective observational study of 287 consecutive patients that underwent LSG by the same surgical team over 3 years.

A virtual reality simulation curriculum for intravenous cannulation training.

Objectives: Although virtual reality (VR) simulators play an important role in modern medical training, their efficacy is not often evaluated using learning curves. In this study, the learning curves of novice and intermediate users were elicited during a VR simulation-based curriculum for intravenous (IV) cannulation.

Methods: This was a prospective observational study of subjects undergoing training using a VR model of IV cannulation.

Optimal trocar placement for ergonomic intracorporeal sewing and knotting in laparoscopic hiatal surgery.

Background: Trocar placement presently is mostly empiric. Our goal was to define simple distances from bony landmarks to locate the optimal ergonomic placement of manipulation trocars for access to the lower esophagus and hiatal orifice, for suture placement, and knotting of the gastric fundus and crura. Hypothesizing that the ideal ergonomic principles of a manipulation angle of 60°, an elevation angle (α(e)) of 30° to 60°, and an intracorporeal/extracorporeal length ratio (I/E) of working instruments close to 1:1 are interrelated by simple trigonometric functions, the variations of each of these parameters were calculated in a dependent manner for 2 standard lengths of needle holders: 48.

Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: markers of susceptibility in radiotherapy?

Objective: Negative bcl-2 and HLA-DR protein expression have been associated with responsiveness to adjuvant radiotherapy in surgically treated parotid cancer patients. The aim of this study was to investigate the prognostic significance of bax, cytochrome c, and caspase-8 protein expression in a group of surgically treated patients to determine whether they also suggest markers of responsiveness to adjuvant radiotherapy.

Study Design: Historical cohort study.

Prospective appraisal of a 2-day training course on laparoscopic sleeve gastrectomy: the ELTC experience.

Background: The increasing role of laparoscopic sleeve gastrectomy (LSG) in the treatment of morbid obesity dictates the need for greater acquaintance with this type of surgery. This study was designed to evaluate the impact of a 2-day LSG course and a 4-day laparoscopic bariatric mini-training program on the knowledge and training gained by participating surgeons.

Methods: A total of 73 trainees (31 residents and 42 surgeons) completed a question survey immediately after completion of the respective courses.

Laparoscopic cholecystectomy for cholelithiasis in a patient with myotonic dystrophy.

Myotonic dystrophy (DM) is a rare autosomal dominant inherited neuromuscular disease involving several systems. The anesthetic method of choice remains uncertain. The risk of perioperative complications, particularly pulmonary and cardiac complications, in these patients is of major concern.

Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year.

Background: The aim of the study is to look at laparoscopic sleeve gastrectomy as a procedure with intent to cure morbid obesity. Secondary endpoints are related to the safety profile of the procedure.

Methods: This is a prospective clinical study conducted in a single university surgical clinic.

Use of rituximab in combination with conventional chemotherapy for the treatment of non-Hodgkin's lymphoma of the head and neck.

Background: Rituximab, an anti-CD20 chimeric monoclonal antibody that specifically depletes mature B cells, is an effective single agent in the treatment of relapsed or refractory indolent lymphomas, and has been shown to improve the survival rate of elderly patients with diffuse large-B-cell lymphoma when used in combination with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP).

Patients And Methods: The combined effect of rituximab and CHOP has been comparatively studied against CHOP alone in 18 elderly patients with non-Hodgkin's lymphoma of the head or neck treated in the 1st Department of Otolaryngology at Hippokration Hospital between January 1998 and January 2004.

Results: Response rates were 91% and 100% in patients treated with rituximab plus CHOP and with CHOP alone, respectively.