Laparoscopic Antegrade Sphincterotomy.

The authors describe the technique and results of laparoscopic antegrade sphincterotomy. The procedure was performed in 42 selected cases of choledocholithiasis. The indications for attempting laparoscopic antegrade sphincterotomy included impacted stones in the papilla, multiple common bile duct stones, one or more common hepatic or intrahepatic stones, dilated common bile duct requiring a drainage procedure, suspicion of papillary stenosis, whenever numerous fragments are found after lithotripsy, and as an adjunct procedure when the surgeon cannot completely remove all the stones in the bile ducts.

Laparoscopic reoperations after failed and complicated antireflux operations.

Nineteen patients underwent laparoscopic reoperations for failed or complicated antireflux operations from a total of 248 patients with gastroesophageal reflux disease who had been operated on by this approach. Sixteen had been submitted to open surgery and three to laparoscopic surgery over a period ranging from 5 days to 31 years before the study. Three patients had been submitted to two open antireflux surgeries previously.

Laparoscopic transhiatal esophagectomy with esophagogastroplasty.

Twelve patients with benign and malignant esophageal diseases were treated by transhiatal esophagectomy, without thoracotomy, using abdominal-mediastinal dissection conducted by videolaparoscopy. A cervical approach was used to retrieve the esophagus and to perform the esophagogastric anastomosis. The procedure was indicated in patients with advanced achalasia of the esophagus, severe reflux stenosis, squamous cell carcinoma, and adenocarcinoma of the esophagus.

Laparoscopic management of choledocholithiasis.

The authors report on a group of 114 patients with common bile duct (CBD) stones who were treated by laparoscopic surgery. Management through the cystic duct was considered the first option. Choledochotomy was used for those patients in which the cystic approach was not possible or was unsuccessful.

Laparoscopic antegrade sphincterotomy.

The technique of laparoscopic antegrade sphincterotomy is described. This procedure was used to clear the common bile duct in 22 selected patients with documented choledocholithiasis. Indications for attempting laparoscopic antegrade sphincterotomy included multiple common bile duct stones, one or more common hepatic or intrahepatic stones, a dilated common bile duct requiring a drainage procedure, and suspicion of papillary stenosis.

[Mitral valve replacement with porcine bioprosthesis in children. Evaluation of 29 patients during 12 years].

Purpose: To analyze the clinical result of the mitral valve substitution for the porcine bioprostheses, the incidence of dysfunction caused by calcification and its importance related to the durability of bioprostheses and also the patients' survival.

Methods: Twenty-nine children of about seven to sixteen years old were operated on from November 1977 to August 1982 and all of them received porcine bioprostheses of low profile.

Results: There were three (10.

Flankplasty: a specific treatment to improve body contouring.

A complete study of the flank region's unaesthetic distortions is reported. Comments regarding and illustrations of the different clinical appearances of local skin turgor and fat deposits are also noted. A classification of the different types of flank distortions, whether or not combined with similar problems of the surrounding regions, complete the study for the indication of correct treatment.

Laparoscopy for the nonpalpable testis: how to interpret the endoscopic findings.

We evaluated by laparoscopy 38 patients with 45 nonpalpable testes. Of 24 testes identified in the abdominal cavity 15 were atrophic, 2 had no epididymal connection and 7 were normal in appearance. Of the 38 patients 32 (84.