Laparoscopic surgery is a new abdominal surgical procedure which helps the patients in many ways like less hospital stay, faster recovery and reduced pain. The main disadvantage in this surgical procedure is the reduc...Laparoscopic surgery is a new abdominal surgical procedure which helps the patients in many ways like less hospital stay, faster recovery and reduced pain. The main disadvantage in this surgical procedure is the reduced haptic perception by the surgeons due to the usage of laparoscopic instrument to handle tissues which in turn cause damage of it as compared to an open surgery. The primary aim of this investigation was to compare the pinch force applied during two different methods of laparoscopic grasping: Finger and Palm grasp. A low cost force sensing resistor tailor made for the grasper tip was designed and fabricated for quantifying the grasper tip force in the study. The results indicate more pinch force was applied during palm grasp as compared to finger grasp so as to prevent the slippage of the tissues from the jaws of the laparoscopic graspers.展开更多
AIM: To compare simple ligation vs stump invagination during open appendicectomy for uncomplicated acute appendicitis on the risk of postoperative complications. METHODS: A meta-analysis was conducted on randomised co...AIM: To compare simple ligation vs stump invagination during open appendicectomy for uncomplicated acute appendicitis on the risk of postoperative complications. METHODS: A meta-analysis was conducted on randomised controlled trials comparing the two stump closure methods in open appendicectomy. Databases searched were Pub Med, EMBASE and Cochrane Library databases. Included were those studies focusing on inflamed and suppurative appendicitis while perforated and gangrenous appendix was excluded. We also excluded retrospective case-control studies, commentaries, historical technical articles, or trials involving laparoscopic appendicectomies. The outcome of the meta-analysis was to find eventual differences in theincidence of postoperative ileus and wound infections between the two techniques of stump invagination. RESULTS: Seven studies were included corresponding to 1468 patients. Postoperative complications consisted in wound infections(7%), ileus(4%), pyrexia(2%), vomiting(1%), obstructions from adhesions(0.1%). No cases of peritonitis, fecal fistulas(stump leaks), abdominal abscesses or wound dehiscences were reported. Postoperative ileus within the first 72 h was four times more frequent with stump invagination compared to simple ligation(OR: 4.06; 95%CI: 2.14-7.70; P < 0.0001). No significant differences were noted for wound infections(OR: 1.24; 95%CI: 0.83-1.87; P = 0.30) while for the remaining complications the incidence was extremely low in both groups. There was a high homogeneity on results(Q value for heterogeneity of postoperative ileus P = 0.17; Q value for heterogeneity of wound infections P = 0.98). CONCLUSION: Stump invagination does not seem to prevent infective complications but is associated with an increased risk of postoperative ileus in uncomplicated cases. Appropriate studies on complicated appendicitis should now evaluate the influence of the two techniques in this higher-risk subgroup.展开更多
文摘Laparoscopic surgery is a new abdominal surgical procedure which helps the patients in many ways like less hospital stay, faster recovery and reduced pain. The main disadvantage in this surgical procedure is the reduced haptic perception by the surgeons due to the usage of laparoscopic instrument to handle tissues which in turn cause damage of it as compared to an open surgery. The primary aim of this investigation was to compare the pinch force applied during two different methods of laparoscopic grasping: Finger and Palm grasp. A low cost force sensing resistor tailor made for the grasper tip was designed and fabricated for quantifying the grasper tip force in the study. The results indicate more pinch force was applied during palm grasp as compared to finger grasp so as to prevent the slippage of the tissues from the jaws of the laparoscopic graspers.
文摘AIM: To compare simple ligation vs stump invagination during open appendicectomy for uncomplicated acute appendicitis on the risk of postoperative complications. METHODS: A meta-analysis was conducted on randomised controlled trials comparing the two stump closure methods in open appendicectomy. Databases searched were Pub Med, EMBASE and Cochrane Library databases. Included were those studies focusing on inflamed and suppurative appendicitis while perforated and gangrenous appendix was excluded. We also excluded retrospective case-control studies, commentaries, historical technical articles, or trials involving laparoscopic appendicectomies. The outcome of the meta-analysis was to find eventual differences in theincidence of postoperative ileus and wound infections between the two techniques of stump invagination. RESULTS: Seven studies were included corresponding to 1468 patients. Postoperative complications consisted in wound infections(7%), ileus(4%), pyrexia(2%), vomiting(1%), obstructions from adhesions(0.1%). No cases of peritonitis, fecal fistulas(stump leaks), abdominal abscesses or wound dehiscences were reported. Postoperative ileus within the first 72 h was four times more frequent with stump invagination compared to simple ligation(OR: 4.06; 95%CI: 2.14-7.70; P < 0.0001). No significant differences were noted for wound infections(OR: 1.24; 95%CI: 0.83-1.87; P = 0.30) while for the remaining complications the incidence was extremely low in both groups. There was a high homogeneity on results(Q value for heterogeneity of postoperative ileus P = 0.17; Q value for heterogeneity of wound infections P = 0.98). CONCLUSION: Stump invagination does not seem to prevent infective complications but is associated with an increased risk of postoperative ileus in uncomplicated cases. Appropriate studies on complicated appendicitis should now evaluate the influence of the two techniques in this higher-risk subgroup.
