AIM: To study the transcolonic extraction of the proximally resected colonic specimens by colonoscopic assistance at laparoscopic colonic surgery. METHODS: The diagnoses of our patients were Crohn's disease, carci...AIM: To study the transcolonic extraction of the proximally resected colonic specimens by colonoscopic assistance at laparoscopic colonic surgery. METHODS: The diagnoses of our patients were Crohn's disease, carcinoid of appendix and adenocarcinoma of cecum. We preferred laparoscopic total mesocolic resections. Colon and terminal ileum were divided with endoscopic staplers. A colonoscope was placed per anal and moved proximally in the colon till to reach the colonic closed end under the laparoscopic guidance. The stump of the colon was opened with laparoscopic scissors. A snare of colonoscope was released and the intraperitoneal complete free colonic specimen was grasped. Specimen was moved in to the colon with the help of the laparoscopic graspers and pulled gently through the large bowel and extracted through the anus. The open end of the colon was closed again and the ileal limb and the colon were anastomosed intracorporeally with a 60-mm laparoscopic stapler. The common enterotomy orifice was closed in two layers with a running intracorporeal suture.RESULTS: There were three patients with laparoscopic right-sided colonic resections and their specimens were intended to remove through the remnant colon by colonoscopy but the procedure failed in one patient(adenocarcinoma) due to a bulky mass and the specimen extraction was converted to transvaginal route. All the patients had prior abdominal surgeries and had related adhesions. The operating times were 210, 300 and 500 min. The lengths of the specimenswere 13, 17 and 27 cm. In our cases, there were no superficial or deep surgical site infections or any other complications. The patients were discharged uneventfully within 4-5 d and they were asymptomatic after a mean 7.6 mo follow-up(ranged 4-12). As far as we know, there were only 12 cases reported yet on transcolonic extraction of the proximal colonic specimens by colonoscopic assistance after laparoscopic resections. With our cases, success rate of the overall experience in the literature was 80%(12/15) in selected cases. CONCLUSION: Transcolonic specimen extraction for right-sided colonic resection is feasible in selected patients. Both natural orifice surgery and intracorporeal anastomosis avoids mini-laparotomy for specimen extraction or anastomosis.展开更多
Objective: to explore the therapeutic method and effect of gynecological transumbilical single-port laparoscopy. Methods: a total of 140 patients who received umbilical single-port laparoscopic treatment in gynecology...Objective: to explore the therapeutic method and effect of gynecological transumbilical single-port laparoscopy. Methods: a total of 140 patients who received umbilical single-port laparoscopic treatment in gynecology department of our hospital from November 2019 to January 2021 were randomly selected as the research object. They were divided into two groups according to the coin toss method. There were 70 patients in the observation group and 70 patients in the control group. The patients in the control group were treated with conventional treatment, while the patients in the observation group were treated with comprehensive treatment. The perioperative indicators of the two groups were evaluated. Results: the time of getting out of bed, duration of postoperative pain, postoperative fever time and hospital stay in the observation group were shorter than those in the control group (P 0.05). Conclusion: in the process of gynecologic transumbilical single-port laparoscopic treatment, comprehensive treatment measures can effectively improve the perioperative related indicators, which is a better therapeutic scheme.展开更多
文摘AIM: To study the transcolonic extraction of the proximally resected colonic specimens by colonoscopic assistance at laparoscopic colonic surgery. METHODS: The diagnoses of our patients were Crohn's disease, carcinoid of appendix and adenocarcinoma of cecum. We preferred laparoscopic total mesocolic resections. Colon and terminal ileum were divided with endoscopic staplers. A colonoscope was placed per anal and moved proximally in the colon till to reach the colonic closed end under the laparoscopic guidance. The stump of the colon was opened with laparoscopic scissors. A snare of colonoscope was released and the intraperitoneal complete free colonic specimen was grasped. Specimen was moved in to the colon with the help of the laparoscopic graspers and pulled gently through the large bowel and extracted through the anus. The open end of the colon was closed again and the ileal limb and the colon were anastomosed intracorporeally with a 60-mm laparoscopic stapler. The common enterotomy orifice was closed in two layers with a running intracorporeal suture.RESULTS: There were three patients with laparoscopic right-sided colonic resections and their specimens were intended to remove through the remnant colon by colonoscopy but the procedure failed in one patient(adenocarcinoma) due to a bulky mass and the specimen extraction was converted to transvaginal route. All the patients had prior abdominal surgeries and had related adhesions. The operating times were 210, 300 and 500 min. The lengths of the specimenswere 13, 17 and 27 cm. In our cases, there were no superficial or deep surgical site infections or any other complications. The patients were discharged uneventfully within 4-5 d and they were asymptomatic after a mean 7.6 mo follow-up(ranged 4-12). As far as we know, there were only 12 cases reported yet on transcolonic extraction of the proximal colonic specimens by colonoscopic assistance after laparoscopic resections. With our cases, success rate of the overall experience in the literature was 80%(12/15) in selected cases. CONCLUSION: Transcolonic specimen extraction for right-sided colonic resection is feasible in selected patients. Both natural orifice surgery and intracorporeal anastomosis avoids mini-laparotomy for specimen extraction or anastomosis.
文摘Objective: to explore the therapeutic method and effect of gynecological transumbilical single-port laparoscopy. Methods: a total of 140 patients who received umbilical single-port laparoscopic treatment in gynecology department of our hospital from November 2019 to January 2021 were randomly selected as the research object. They were divided into two groups according to the coin toss method. There were 70 patients in the observation group and 70 patients in the control group. The patients in the control group were treated with conventional treatment, while the patients in the observation group were treated with comprehensive treatment. The perioperative indicators of the two groups were evaluated. Results: the time of getting out of bed, duration of postoperative pain, postoperative fever time and hospital stay in the observation group were shorter than those in the control group (P 0.05). Conclusion: in the process of gynecologic transumbilical single-port laparoscopic treatment, comprehensive treatment measures can effectively improve the perioperative related indicators, which is a better therapeutic scheme.
