Laparoscopic ventral hernia repair: outcomes in primary versus incisional hernias: no effect of defect closure.

Purpose: Supposing divergent aetiology, we found it interesting to investigate outcomes between primary (PH) versus incisional (IH) hernias. In addition, we wanted to analyse the effect of defect closure and mesh fixation techniques.

Methods: 37 patients with PH and 70 with IH were enrolled in a prospective cohort-study, treated with laparoscopic ventral hernia repair (LVHR) and randomised to ± transfascial sutures.

Surgical treatment of epiphrenic oesophageal diverticulum.

Background: Epiphrenic diverticula occur in the lowermost 10 cm of the oesophagus. The main symptoms are dysphagia, regurgitation and pain when swallowing food. The main purpose of the survey was to evaluate the department's results for surgical treatment of this rare and distressing condition.

Course in basic surgical skills.

Background: The Basic Surgical Skills (BSS) course provides an introduction to basic surgical techniques. The course was held in Norway for the first time in 2009. This study was carried out to evaluate the learning outcomes of the course.

Laparoscopic repair of incisional hernia in solid organ-transplanted patients: the method of choice?

Due to immunosuppressive (IS) therapy, incisional hernias are overrepresented in the organ-transplanted (Tx) population with larger defects, a high rate of recurrence, and a tendency toward more seromas and infectious problems. Thirty-one Tx/IS patients with a control group of 70 non-IS patients with incisional hernia (6/7 recurrences) were included in a prospective interventional study. Both cohorts were treated with laparoscopic ventral hernia repair (LVHR).

A national survey on temporary and delayed abdominal closure in Norwegian hospitals.

Introduction: Temporary abdominal closure (TAC) is included in most published damage control (DC) and abdominal compartment (ACS) protocols. TAC is associated with a range of complications and the optimal method remains to be defined. The aim of the present study was to describe the experience regarding TAC after trauma and ACS in all acute care hospitals in a sparsely populated country with long transportation distances.

Endoscopic sealing of pancreatic fistulas: four case reports and review of the literature.

We report four patients with pancreatic fistulas that failed to respond to conservative treatment. The fistulas were closed by endoscopic injection of N-butyl-2-cyanoacrylate (Histoacryl) diluted with an oily contrast agent (Lipiodol). A literature review revealed 32 similar cases in which endoscopic treatment with fibrin sealants (n = 11) or cyanoacrylate (n = 21) was used to close the fistulas.

[A 68-year-old woman with iron deficiency anemia].

A 68-year-old woman with iron deficiency anemia (due to gastrointestinal bleeding) was evaluated. Over a period of two years she received iron supplementation perorally and intravenously, as well as multiple blood transfusions, but the hemoglobin level did not exceed 10 g/dL. The investigations included upper endoscopy, duodenoscopy with side optical view, ileocolonoscopy, capsule endoscopy, antegrad single-balloon enteroscopy and conventional angiography of the abdominal vessels.

[A patient with acute abdominal pain and known cardiovascular disease].

Background: Emphysematous cholecystitis (EC) is a serious variant of acute cholecystitis (AC), with gas-forming bacteria in the biliary system and the surrounding tissues. The pathogenesis of EC is assumed to be ischemia. EC is associated with diabetes mellitus and arteriosclerosis; has a higher mortality rate and a more rapid progression than AC, but has initial clinical findings, similar to those in AC-patients.

[Anti-reflux surgery in Norway].

Background: The aim of this study was to investigate the incidence of gastro-oesophageal antireflux surgery in Norway from 1999 to 2003, in comparison with the 1990 to 1998 period.

Material And Methods: Operation codes for laparoscopic and open antireflux surgery were compiled from the Norwegian Patient Registry for analysis of incidence rates, geographic variations, postoperative hospital stay and rates of readmission.

Results: The incidence rates of antireflux operation in 1999-2003 were 18.

Outpatient laparoscopic splenectomy: patient safety and satisfaction.

Background: We assessed the feasibility of outpatient laparoscopic splenectomy, as performed by an experienced laparoscopic term and combined with optimal anesthesia.

Methods: Inclusion criteria in the study was limited to patients not hospitalized before the procedure who had hematological or neoplastic indications for splenectomy and were classified as American Society of Anesthesiologists (ASA) I-III. They received general intravenous anesthesia with propofol and remifentanil and were given keterolac, propacetamol, droperidol, and ondansetron as prophylaxis against postoperative pain and nausea.

Outpatient laparoscopic surgery: feasibility and consequences for education and health care costs.

Background: The purpose of this paper is to describe the outcome of ambulatory laparoscopic cholecystectomy (LC), antireflux surgery, adrenalectomy and splenectomy and possible implications for surgical education and health care costs.

Methods: Prospective, observational study 1994-2003.

Results: The success rate of ambulatory treatment was 83.

[Laparoscopic fundoplication for gastroesophageal reflux disease].

Background: In 1995 we introduced laparoscopic technique as routine for fundoplication for gastro-esophageal reflux disease.

Material And Methods: 222 patients were scheduled for laparoscopic fundoplication; the operation was completed laparoscopically in 219 patients. They all had an observation period of one year as a minimum; 205 patients returned a follow-up questionnaire.

[Laparoscopic cholecystectomy].

Gallbladder stones are common, but most persons with stones are asymptomatic. The symptoms of gallbladder stones are usually characteristic. They are often associated with other types of abdominal symptoms, which are not affected by cholecystectomy.

[Outpatient laparoscopic fundoplication for gastroesophageal reflux disease].

Background: Day-case laparoscopic fundoplication for gastro-oesophageal reflux disease was introduced in January 1997.

Material And Methods: Inclusion criteria were ASA grade 1-2, living within 30 minutes by car from the hospital, or staying over in the patient hotel the first night, with company. Initially, only selected patients were offered day-case treatment; later it was adopted as routine.

[Laparoscopic treatment of splenic cysts].

Splenic cysts are uncommon. The symptoms are usually vague, but complications such as haemorrhage, rupture and infection may occur. The majority of splenic cysts are seen in children and young adults.

[Secretin stimulated magnetic resonance cholangiopancreatography in diseases of the biliary and pancreatic ducts].

Background: MRCP has replaced ERCP as the diagnostic tool in diseases in the biliary and pancreatic ducts. Secretin increases the secretion to ducts, and this has been reported to improve MRCP image quality.

Material And Methods: We report our experience with S-MRCP in our first 20 patients.

Outpatient laparoscopic adrenalectomy in patients with Conn's syndrome.

Background: [corrected] We set out to record the operative times of an experienced laparoscopic team and assess the feasibility of outpatient laparoscopic adrenalectomy when optimal anesthesia was also offered to all patients.

Methods: The study included 13 patients with aldosterone/cortisone hypersecretion and/or adrenal gland tumors, excluding those with pheochromocytoma. They had to live within 30 min travel from the hospital, and adult company had to be present at home.

[Establishment of routines for elective laparoscopic surgery].

Background: During the autumn of 1999, elective laparoscopic cholecystectomy was introduced as a new surgical procedure in the Central Hospital Østfold, Askim. A prospective evaluation of perioperative patient logistics and patient satisfaction was performed.

Material And Methods: 214 patients were evaluated in the ambulatory; 116 of them were scheduled for operation.

Day-case laparoscopic fundoplication for gastro-oesophageal reflux disease.

Background: Based on a series of successful outpatient laparoscopic cholecystectomies, day-case laparoscopic fundoplication for gastro-oesophageal reflux disease was introduced in January 1997. The initial results are reported.

Methods: Inclusion criteria were American Society of Anesthesiologists grade I-II, living within 30 min travel from the hospital, and adult company at home.

[Choledochal cysts in adults].

Based on a case report, we describe choledochal cysts in adults. Choledochal cysts are rare, and are often overlooked. The aetiology is unknown.