Introduction: Natural orifice transluminal endoscopic surgery (NOTES) is an emerging technique, which allows to performed surgical procedures avoiding any surgical scars. However there are some problems due to the lack of equipment available for these procedures. The aim of these study is to present our initial experience with the transvaginal nephrectomy NOTES using standard laparoscopic instruments.
Material And Methods: Two female patients 23 and 29 years old, both of them with diagnosis of recurrent urinary tract infection and renal atrophy. A transvaginal simple nephrectomy was performed using a transvaginal Access for the camera port and two abdominal work ports of 10 and 3 mm.
Results: Total operation room time was 120 min in the first case and 40 min. in the second with an average blood loss of 200 cc. There were no perioperative complications, and both patients was discharged 36 hours after the surgery
Conclusion: Laparoscopic nephrectomy with transvaginal NOTES assistance is technically feasible with the use of standard laparoscopic instruments. Special Access trocars and instruments development for this procedure will allow to perform a pure technique without the use of abdominal incisions.
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http://dx.doi.org/10.1016/s0210-4806(09)74229-9 | DOI Listing |
Updates Surg
January 2025
Department of Surgical Sciences, General Surgery and Center for Minimally Invasive Surgery, University of Torino, Corso A.M. Dogliotti 14, 10126, Turin, Italy.
Laparoscopic repair is the preferred surgical treatment for symptomatic Large Hiatal Hernia (LHH). However, data on long-term outcomes are limited. This study aims to evaluate the 20-year follow-up results of laparoscopic LHH repair in a high-volume experienced tertiary center.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Anaesthesiology, China-Japan Friendship Hospital, Beijing, Beijing, China.
Introduction: Nociception monitoring has recently gained recognition as a valuable tool for guiding intraoperative opioid administration. Several nociception monitors, including the Surgical Pleth Index, the Index of Consciousness (IoC) and the Nociception Level, have been introduced for managing intraoperative analgesia. While these technologies show promise in initial applications, the effectiveness of IoC2 in guiding pain management during anaesthesia, particularly in elderly patients who require precise opioid use, remains unclear.
View Article and Find Full Text PDFClin Nutr ESPEN
January 2025
School of Graduate, Tianjin University of Traditional Chinese Medicine, No.10 Poyang Lake Road, Tuanbo New City West, Jinghai District, Tianjin, China.
Background & Aims: The effectiveness of preoperative carbohydrate loading(PCL) on postoperative insulin resistance(IR) is controversial. In addition, the effect of different doses of carbohydrates on postoperative IR is also controversial. Therefore, this study aimed to investigate the efficiency of PCL on postoperative IR and the optimal regimen for the effect on postoperative IR.
View Article and Find Full Text PDFAnesth Analg
January 2025
From the Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University of Geneva, Geneva, Switzerland.
Background: The rapid advancement of minimally invasive surgical techniques has made laparoscopy a preferred alternative because it reduces postoperative complications. However, inflating the peritoneum with CO2 causes a cranial shift of the diaphragm decreasing lung volume and impairing gas exchange. Additionally, CO2 absorption increases blood CO2 levels, further complicating mechanical ventilation when the lung function is already compromised.
View Article and Find Full Text PDFSurg Endosc
January 2025
Department of Anesthesiology and Reanimation, Faculty of Medicine, Istınye University Medicalpark Gaziosmanpasa Hospital, Istanbul, Turkey.
Background: The aim of our study is to compare the effect of the 30° reverse Trendelenburg position combined with the beach chair position on respiratory parameters in laparoscopic sleeve gastrectomy (LSG) with the 30° reverse Trendelenburg position alone.
Material And Method: Fifty patients with body mass index > 30 were included in the study. The patients were divided into two groups; in the control group, the standard 30° reverse Trendelenburg.
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