A total of 100 accidents occurring during laparoscopic surgery between 1969 and 1993 were studied. Fifty-five of the cases concerned gynaecology surgery over a 24 year period. The other 45 concerned digestive surgery over a 5 year period (1989-1993). The surgical risk was not statistically greater compared with open surgery. Overall morbidity was 1%. Overall mortality was 0.5/1000. A more precise statistical analysis was recently reported. The examination of the 100 cases was qualitative rather than quantitative. The study demonstrated an imbalance between age (mean age 38 years) in patients with major pathology initially and the gravity of the induced accidents: 26 deaths for 100 observations. These deaths were related to technology trocar, capnoperitoneum, electrocoagulation. Technical skill, cautiousness, vigilance and humility are qualities the surgeon must have to perform successful operations. The irreversible acceleration of the new surgical technique should not cloud the basic precepts of sound surgical technique.
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Gallbladder volvulus is a rare but potentially severe condition that requires urgent surgical intervention. This report presents two contrasting cases of gallbladder volvulus with distinct pathogenic mechanisms and degrees of torsion. The first case involves a 97-year-old female who presented with acute symptoms and 270° torsion, leading to complete gallbladder necrosis (Gross type II).
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2023
Division of Thoracic Surgery and Interventional Pulmonology, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
We report the rare case of a 71-year-old man with a medical history including dysphagia, gastroesophageal reflux disease, and achalasia with remote open transthoracic Heller myotomy who presented acutely with symptoms of esophageal obstruction. Sustained gastroesophageal intussusception was diagnosed with esophagogastroduodenoscopy and computed tomography. The patient underwent urgent robot-assisted laparoscopic reduction with gastropexy.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2023
Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, Texas.
Epiphrenic diverticulum develops when elevated esophageal intraluminal pressure causes herniation of the mucosa and submucosa through an area of weakness in the muscularis layer. Treatment must address both the diverticulum and the underlying esophageal dysmotility. The endoluminal functional lumen imaging probe allows measurement of the lower esophageal sphincter pressures to achieve the ideal lower esophageal sphincter distensibility that prevents postoperative gastroesophageal reflux disease as well as diverticulum recurrence.
View Article and Find Full Text PDFJCEM Case Rep
January 2025
Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo 162-8666, Japan.
A 37-year-old man presented with symptoms of polyuria and weight loss over the past year. Initial laboratory examination showed elevated blood glucose level (468 mg/dL [25.9 mmol/L]; normal reference range [RR], 75-109 mg/dL [4.
View Article and Find Full Text PDFHeliyon
January 2025
Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, 100073, China.
Background: Super-elderly patients with choledocholithiasis are considered to be at high risk for undergoing surgery. While laparoscopic transcystic common bile duct exploration (LTCBDE) is regarded as a challenging procedure for super-elderly patients with choledocholithiasis, there have been no reported cases of its use in super-elderly patients over the age of 96.
Case Summary: This case study presents the case of a 96-year-old female patient with acute calculous cholecystitis and choledocholithiasis.
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