Orientador: Maria Aparecida Coelho de Arruda Henry / Resumo: Em 40 coelhos machos foram realizados estudos eletromanométricos do esôfago segundo a técnica de puxada intermitente da sonda e infusão contínua dos catéteres com água destilada. Estes estudos permitiram a análise de dois parâmetros: amplitude da pressão no EIE (mmHg) e comprimento do EIE em condições basais (momento 1). Neste momento foi também realizada avaliação do peso corpóreo dos animais. Os 40 animais foram divididos em quatro grupo de 10, na dependência do procedimento cirúrgico realizado: Grupo 1: Fundoplicatura total laparotômica Grupo2 : Laparotomia mediana e dissecção da transição gastroesofágica Grupo 3: Fundoplicatura total laparoscópica Grupo 4: Pneumoperitôneo e dissecção da transição gastroesofágica No momento 2 (uma semana após os procedimentos cirúrgicos) foram realizados estudos eletromanométricos do esôfago e avaliação ponderal em todos os animais. Nos animais do grupo 1 (fundoplicatura laparotômica) foi observado aumento da amplitude da pressão e do comprimento do EIE (p<0,05). Naqueles do grupo 2 não foi observada alteração da amplitude e do comprimento do EIE (p>0,05). Nos coelhos do grupo 3 houve aumento da amplitude da pressão e do comprimento do EIE (p<0,05). Nos animais do grupo 4 não foi observada alteração dos parâmetros acima citados (p>0,01). Com relação ao peso corpóreo, foi observada redução do mesmo (p<0,05) apenas nos coelhos submetidos a fundoplicatura laparotômica (Grupo 1). Nos demais animais (Grupos 2, 3 e 4) não houve qualquer alteração do peso corpóreo na avaliação realizada uma semana após os procedimentos cirúrgicos (momento 2) / Abstract: Electromanometric studies of the esophagus were registered in 40 male rabbits, through the pull through technique and continuous infusion of the catheters with distilled water. These exams allowed us to measure the pressure width (mmHg) and the length (cm) of the lower esophageal sphincter (LES) in basal conditions (moment 1). The 40 animals were divided into four groups of 10, according to surgical procedure: Group 1: open total fundoplication Group 2: Median laparotomy and dissection of the gastroesophageal junction Group 3: laparoscopic total fundoplication Group 4: pneumoperitonium and dissection of the gastroesophageal junction. In moment two (one week after surgery) electromanometric studies of the esophagus and weight evaluation were performed in every animals. In group 1 (open fundoplication) an increase of pressure width and of LES was observed (p<0,05). In group 2, the pressure width and length of LES didn't present any alteration (p>0,05). In group 3 an increase of pressure width and length of LES was observed (p<0,05). In group 4, the pressure width and length LES didn't present any alteration (p>0,05). In respect to the weight evaluation, a decrease was observed in rabbits submitted to open fundoplication (p<0,05). In other animals (groups 2, 3 and 4) the weight didn't present any alteration in evaluation performed one week after surgery (moment 2) / Mestre

Submitted by CAIO DE FARIA TIOSSO null (caiotiosso@hotmail.com) on 2016-03-02T13:27:32Z No. of bitstreams: 1 tese definitiva pos PDF.pdf: 1935262 bytes, checksum: f8468503f23144f98facaedbd4067d40 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-03-04T13:02:28Z (GMT) No. of bitstreams: 1 tiosso_cf_dr_jabo.pdf: 1935262 bytes, checksum: f8468503f23144f98facaedbd4067d40 (MD5) / Made available in DSpace on 2016-03-04T13:02:28Z (GMT). No. of bitstreams: 1 tiosso_cf_dr_jabo.pdf: 1935262 bytes, checksum: f8468503f23144f98facaedbd4067d40 (MD5) Previous issue date: 2016-02-22 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Nos últimos anos a cirurgia minimamente invasiva vem ganhando cada vez mais adeptos por demonstrar vantagens inigualáveis em comparação à cirurgia convencional o que vem estimulando o desenvolvimento de instrumentais inovadores com potenciais aplicações na medicina veterinária. O presente estudo objetivou avaliar a técnica de portal único (SILSTM) para ovário-histerectomia videoassistida em cadelas, comparando-a à técnica laparoscópica videoassistida por “single-port” via endoscópio com canal de trabalho e com a técnica por celiotomia, verificando a curva de aprendizado, resposta inflamatória e comportamental, complicações trans-cirúrgicas e a perda sanguínea dos animais submetidos a estas técnicas. Foram avaliadas 30 fêmeas caninas, alocadas em três grupos com 10 animais em cada: ovário-histerectomia convencional por celiotomia (GI), ovário-histerectomia laparoscópica videoassistida por um único portal utilizando endoscópio com canal de trabalho (GII) e ovário-histerectomia laparoscópica com uso do dispositivo SILSTM (GIII). Foram avaliados os tempos cirúrgicos médios, numero de complicações trans e pós-cirúrgicas nos diferentes grupos, a intensidade da dor pós-operatória mediante aplicação da escalas de dor de Universidade de Melbourne, Glasgow e Morton e os níveis séricos da proteína C reativa e Interleucina-6 durante as primeiras 72 horas após o término dos procedimentos. A media de tempo obtidos foram de 30,20±6,41min para o grupo GI, 60,30±19,15 min para o grupo GII e 119,42±32,78 min para o grupo GIII. No GII ocorreram três complicações que não necessitaram de conversão da técnica cirúrgica e uma que necessitou de conversão e o GIII apresentou três complicações que necessitaram de conversão para a técnica aberta. Quanto ao sangramento transoperatório o grupo GI obteve a partir das gazes laparoscópicas uma média de 16,00±6,04g, o grupo GII 2,61±3,18g e o grupo GIII 3,79±1,78g. Ao final das 24 horas iniciais de avaliação, 90% dos animais do GI necessitaram de resgate analgésico, enquanto no GII e GIII, as porcentagens foram de 0% e 14,3%, respectivamente. As duas técnicas videoassistidas demonstram-se seguras e eficazes mesmo com a ocorrência de complicações. Os níveis de IL-6 e CRP atingem seu pico máximo em 12 e 24 horas respectivamente, e o aumento dessas parece estar diretamente relacionada ao tempo de cirurgia e não trauma gerado. O maior grau álgico observado nos pacientes do grupo GI demostra que a dor em procedimentos de OVH esta relacionada a manipulação visceral e a tração do pedículo ovariano. / Over the last few years, minimally invasive surgery is gaining more followers, by showing unparalleled advantages in front of conventional surgery. This fact has been stimulating the development of new instruments, potentially applicable on Veterinary Medicine. The current study aimed to evaluate the feasibility of a single portal technique (SILSTM) to ovariohysterectomy video assisted in bitches, comparing it to a video assisted technique by single-port using an endoscopy with work channel, and with celiotomy, assessing the learning curve, inflammatory and behavioral response, surgical complications and blood loss from animals subjected to these techniques. Thirty female dogs were evaluated, divided into 3 groups with 10 animals each (n=10): ovariohysterectomy by celiotomy (GI), laparoscopic ovariohysterectomy video assisted through a single-port using an endoscope with working channel (GII), and laparoscopic ovariohysterectomy using the SILSTM device (GIII). Mean surgical time, number of complications during and after surgery, pain level after surgery, and serum levels of C-reactive proteins (CRP) an Interleucin-6 (IL-6), were evaluated. Mean surgical times plus/minus standard deviations (SD) in minutes were 30.20±6.41, 60.30±19.15, and 119.42±32.78 for GI, GII and GIII, respectively. On GII, were noted three complications that didn’t need to be converted to celiotomy and one that needs, while GIII presented three complications that needed to be converted to celiotomy. Regarding blood loss, medians plus/minus SD in grams were 16.00±6.04, 2.61±3.18, and 3.79±1.78 for GI, GII and GIII, respectively. Twenty-four hours after the end of the procedures, 90% of animal from GI needed analgesic rescue, while in GII and GIII the values were 0% and 14.3%, respectively. Both video assisted techniques showed themselves secure and effectives, even with complications occurring. IL-6 and CRP levels showed a peak respectively on 12 and 24 hours after the procedures, and these increases seemed to be related with surgical time and not with injuries caused. The higher pain scores observed on GI animals showed that pain on ovariohysterectomy procedures is directly related with visceral manipulation and pulling the ovarian pedicle. / FAPESP: 2012/25061-0

Made available in DSpace on 2014-06-11T19:23:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2001Bitstream added on 2014-06-13T20:30:33Z : No. of bitstreams: 1 motta_dcp_me_botfm.pdf: 1151223 bytes, checksum: 1d7fefba88005a4773d3d06cae669504 (MD5) / Em 40 coelhos machos foram realizados estudos eletromanométricos do esôfago segundo a técnica de puxada intermitente da sonda e infusão contínua dos catéteres com água destilada. Estes estudos permitiram a análise de dois parâmetros: amplitude da pressão no EIE (mmHg) e comprimento do EIE em condições basais (momento 1). Neste momento foi também realizada avaliação do peso corpóreo dos animais. Os 40 animais foram divididos em quatro grupo de 10, na dependência do procedimento cirúrgico realizado: Grupo 1: Fundoplicatura total laparotômica Grupo2 : Laparotomia mediana e dissecção da transição gastroesofágica Grupo 3: Fundoplicatura total laparoscópica Grupo 4: Pneumoperitôneo e dissecção da transição gastroesofágica No momento 2 (uma semana após os procedimentos cirúrgicos) foram realizados estudos eletromanométricos do esôfago e avaliação ponderal em todos os animais. Nos animais do grupo 1 (fundoplicatura laparotômica) foi observado aumento da amplitude da pressão e do comprimento do EIE (p<0,05). Naqueles do grupo 2 não foi observada alteração da amplitude e do comprimento do EIE (p>0,05). Nos coelhos do grupo 3 houve aumento da amplitude da pressão e do comprimento do EIE (p<0,05). Nos animais do grupo 4 não foi observada alteração dos parâmetros acima citados (p>0,01). Com relação ao peso corpóreo, foi observada redução do mesmo (p<0,05) apenas nos coelhos submetidos a fundoplicatura laparotômica (Grupo 1). Nos demais animais (Grupos 2, 3 e 4) não houve qualquer alteração do peso corpóreo na avaliação realizada uma semana após os procedimentos cirúrgicos (momento 2) / Electromanometric studies of the esophagus were registered in 40 male rabbits, through the pull through technique and continuous infusion of the catheters with distilled water. These exams allowed us to measure the pressure width (mmHg) and the length (cm) of the lower esophageal sphincter (LES) in basal conditions (moment 1). The 40 animals were divided into four groups of 10, according to surgical procedure: Group 1: open total fundoplication Group 2: Median laparotomy and dissection of the gastroesophageal junction Group 3: laparoscopic total fundoplication Group 4: pneumoperitonium and dissection of the gastroesophageal junction. In moment two (one week after surgery) electromanometric studies of the esophagus and weight evaluation were performed in every animals. In group 1 (open fundoplication) an increase of pressure width and of LES was observed (p<0,05). In group 2, the pressure width and length of LES didn’t present any alteration (p>0,05). In group 3 an increase of pressure width and length of LES was observed (p<0,05). In group 4, the pressure width and length LES didn’t present any alteration (p>0,05). In respect to the weight evaluation, a decrease was observed in rabbits submitted to open fundoplication (p<0,05). In other animals (groups 2, 3 and 4) the weight didn’t present any alteration in evaluation performed one week after surgery (moment 2)

A quantitative descriptive study was conducted to establish professional nurses’ and patients’ knowledge and understanding of laparoscopic surgery and to determine whether nurses are sufficiently knowledgeable to disseminate adequate information about laparoscopic surgery to patients. Two state hospitals based in KwaZulu-Natal where laparoscopic surgery is done were selected and the respondents were selected through convenience sampling. Data were collected by administering questionnaires to theatre nurses (n=39), ward nurses (n=87) and patients (n=42) scheduled for laparoscopic surgery. The SPSS version 15 for Windows was used to compute the results. The findings revealed that the professional nurses were not sufficiently knowledgeable about laparoscopic surgery to give adequate information to patients and the patients themselves were not fully informed about all aspects of laparoscopic surgery including the possibility of conversion to open surgery, complications and advantages and after care. There is therefore a dire need for improvement of patient education to assist patients gaining optimal recovery / Health Studies / M.A. (Health Studies)

A quantitative descriptive study was conducted to establish professional nurses’ and patients’ knowledge and understanding of laparoscopic surgery and to determine whether nurses are sufficiently knowledgeable to disseminate adequate information about laparoscopic surgery to patients. Two state hospitals based in KwaZulu-Natal where laparoscopic surgery is done were selected and the respondents were selected through convenience sampling. Data were collected by administering questionnaires to theatre nurses (n=39), ward nurses (n=87) and patients (n=42) scheduled for laparoscopic surgery. The SPSS version 15 for Windows was used to compute the results. The findings revealed that the professional nurses were not sufficiently knowledgeable about laparoscopic surgery to give adequate information to patients and the patients themselves were not fully informed about all aspects of laparoscopic surgery including the possibility of conversion to open surgery, complications and advantages and after care. There is therefore a dire need for improvement of patient education to assist patients gaining optimal recovery / Health Studies / M.A. (Health Studies)

INTRODUÇÃO: Cerca de 20% da população é portadora de colelitíase, sendo esta afecção a principal causa abdominal de internação hospitalar em países desenvolvidos. Considerando-se que somente nos Estados Unidos são realizadas cerca 700.000 colecistectomias a cada ano, pode-se estimar a importância do problema para a saúde pública. A diminuição do número de incisões tem o potencial de reduzir o trauma cirúrgico e oferecer melhor resultado estético. OBJETIVOS: Descrever técnica de colecistectomia laparoscópica com duas incisões (CL2i) utilizando apenas material convencional, sem aumentar complicações, nem tempo operatório, oferecendo a mesma segurança da colecistectomia videolaparoscópica convencional. MÉTODO: Série prospectiva de casos consecutivos, comparada a outra série histórica de casos operados pela técnica laparoscópica convencional (CLC). A CL2i foi realizada com 3 portais em 2 incisões, sendo dois na incisão umbilical e outro no epigástrio. Foram operados 72 pacientes (36 em cada grupo) pelo mesmo cirurgião. RESULTADOS: Não houve diferença estatística entre os grupos quanto sexo, média de idade, índice de massa corpórea (IMC) e tempo de internação. Os procedimentos foram classificados pelo cirurgião de acordo com o grau de dificuldade e não houve diferença entre as séries (p < 0,05). Ocorreram complicações menores em 5,6% (n = 2) procedimentos em cada grupo. Não houve diferença entre as médias de tempo operatório (p= 0,989), que foram de 49 (IC95% 42 a 56) min na CLC e 40 (IC95% 35 a 44) min na CL2i. Não houve necessidade de portais adicionais em nenhum caso, nem de conversão para cirurgia aberta. CONCLUSÕES: A técnica de colecistectomia laparoscópica com duas incisões (CL2i) é factível, segura e com bom resultado estético, permitindo operar utilizando apenas instrumental laparoscópico convencional, sem aumentar tempo operatório ou risco de complicações / INTRODUCTION: About 20% of the population has cholelithiasis and this is the main abdominal cause of hospitalization in developed countries. Considering that only in the United States about 700,000 cholecystectomies are done each year, it is possible to estimate the importance of the problem for public health. Decreasing the number of incisions can reduce surgical trauma and offer better aesthetic results. OBJECTIVE: To describe a two-incision laparoscopic cholecystectomy technique (TILC) using only conventional material, without increasing complications, nor operative time, offering the same safety as conventional laparoscopic cholecystectomy. METHOD: A consecutive and prospective case series, compared to another historical series operated by conventional laparoscopy cholecystectomy (LC). The TILC was performed with 3 trocars in 2 incisions, two trocars in umbilical incision and one in epigastrium. A total of 72 patients were operated on by the same surgeon (36 in each group). RESULTS: There were no significant differences between groups for gender, mean age, body mass index (BMI) or length of hospital stay. The procedures were classified by the surgeon according to surgical difficulty and there was no difference between the series (p < 0.05). There were minor complications in 5.6% (n = 2) procedures in each group. There were no differences between means of operative time (p = 0.989), which were 49 (95% CI 42 to 56) min in LC and 40 (CI 95% 35 to 44) min in TILC. There was no need for additional portals in any case, nor for conversion to open surgery. CONCLUSIONS: Two-incision laparoscopic cholecystectomy (TILC) is feasible, safe and with good aesthetic result, using the same instruments of LC, without increasing operative time or complications

INTRODUÇÃO: Cerca de 20% da população é portadora de colelitíase, sendo esta afecção a principal causa abdominal de internação hospitalar em países desenvolvidos. Considerando-se que somente nos Estados Unidos são realizadas cerca 700.000 colecistectomias a cada ano, pode-se estimar a importância do problema para a saúde pública. A diminuição do número de incisões tem o potencial de reduzir o trauma cirúrgico e oferecer melhor resultado estético. OBJETIVOS: Descrever técnica de colecistectomia laparoscópica com duas incisões (CL2i) utilizando apenas material convencional, sem aumentar complicações, nem tempo operatório, oferecendo a mesma segurança da colecistectomia videolaparoscópica convencional. MÉTODO: Série prospectiva de casos consecutivos, comparada a outra série histórica de casos operados pela técnica laparoscópica convencional (CLC). A CL2i foi realizada com 3 portais em 2 incisões, sendo dois na incisão umbilical e outro no epigástrio. Foram operados 72 pacientes (36 em cada grupo) pelo mesmo cirurgião. RESULTADOS: Não houve diferença estatística entre os grupos quanto sexo, média de idade, índice de massa corpórea (IMC) e tempo de internação. Os procedimentos foram classificados pelo cirurgião de acordo com o grau de dificuldade e não houve diferença entre as séries (p < 0,05). Ocorreram complicações menores em 5,6% (n = 2) procedimentos em cada grupo. Não houve diferença entre as médias de tempo operatório (p= 0,989), que foram de 49 (IC95% 42 a 56) min na CLC e 40 (IC95% 35 a 44) min na CL2i. Não houve necessidade de portais adicionais em nenhum caso, nem de conversão para cirurgia aberta. CONCLUSÕES: A técnica de colecistectomia laparoscópica com duas incisões (CL2i) é factível, segura e com bom resultado estético, permitindo operar utilizando apenas instrumental laparoscópico convencional, sem aumentar tempo operatório ou risco de complicações / INTRODUCTION: About 20% of the population has cholelithiasis and this is the main abdominal cause of hospitalization in developed countries. Considering that only in the United States about 700,000 cholecystectomies are done each year, it is possible to estimate the importance of the problem for public health. Decreasing the number of incisions can reduce surgical trauma and offer better aesthetic results. OBJECTIVE: To describe a two-incision laparoscopic cholecystectomy technique (TILC) using only conventional material, without increasing complications, nor operative time, offering the same safety as conventional laparoscopic cholecystectomy. METHOD: A consecutive and prospective case series, compared to another historical series operated by conventional laparoscopy cholecystectomy (LC). The TILC was performed with 3 trocars in 2 incisions, two trocars in umbilical incision and one in epigastrium. A total of 72 patients were operated on by the same surgeon (36 in each group). RESULTS: There were no significant differences between groups for gender, mean age, body mass index (BMI) or length of hospital stay. The procedures were classified by the surgeon according to surgical difficulty and there was no difference between the series (p < 0.05). There were minor complications in 5.6% (n = 2) procedures in each group. There were no differences between means of operative time (p = 0.989), which were 49 (95% CI 42 to 56) min in LC and 40 (CI 95% 35 to 44) min in TILC. There was no need for additional portals in any case, nor for conversion to open surgery. CONCLUSIONS: Two-incision laparoscopic cholecystectomy (TILC) is feasible, safe and with good aesthetic result, using the same instruments of LC, without increasing operative time or complications

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background Rectovaginal endometriosis accounts for 5-10% of cases of endometriosis and constitutes one of the forms of deep infiltrating endometriosis. . Deep infiltrating endometriosis involving the bowel is most frequently encountered in the rectovaginal septum and is considered to be the most severe form of the disease and the most difficult to treat surgically owing to its invasive nature. There are currently no studies on this topic pertaining to a South African context. Study Objective To document the outcomes in 112 patients undergoing laparoscopic surgery for rectovaginal endometriosis. Methods A retrospective audit of 112 women undergoing laparoscopic surgery for rectovaginal endometriosis at Vincent Pallotti's Aevitas Fertility Clinic was undertaken. Eligibility was established by identifying women from a surgical database based on medical aid coding as well as a review of individual case notes. Patients were telephonically contacted to gather any missing information and to assess further outcomes. Design Classification Study number S11/11/036. This study was approved by the Health Research Ethics Committee at Stellenbosch University and was conducted according to ethical guidelines and principles of The International Declaration of Helsinki, South African Guidelines for Good Clinical Practice and the Medical Research Council (MRC) Ethical Guidelines for Research. Setting Vincent Pallotti’s Aevitas Reproductive Medicine Clinic Patients 112 consecutive patients suffering from rectovaginal endometriosis Interventions: Laparoscopic surgery for treatment of deep infiltrating, namely rectovaginal endometriosis Measurements and Main Results Primary outcome: Complications of laparoscopic surgery for rectovaginal endometriosis included one patient requiring a blood transfusion (0,9%), three cases of rectovaginal fistula (2,7%), two bowel injuries (1,8%)-detected and managed intra-operatively , one ureteric injury (0,9%), one pelvic abscess (0,9%) and the need for three urgent re-operations (2,68%). Secondary outcome: Of the 71 patients desiring fertility 39 (54,9%) fell pregnant of which 27 (69,2%) were spontaneous. Conclusion To our knowledge this is the first study assessing surgical outcomes in the management of deep infiltrating endometriosis from South Africa. These outcomes are in keeping with complication rates quoted in the international literature. Most of the surgery was performed using the shaving technique, in keeping with international trends, whilst fourteen cases required the performance of a segmental resection owing to extensive disease. In trained hands laparoscopic surgery is a valid management option in the management of rectovaginal endometriosis. / AFRIKAANSE OPSOMMING: Agtergrond Vyf tot tien persent van alle endometriose gevalle kan toegeskryf word aan rektovaginale endometriose. Dit word beskou as een van die vorme van diep infiltrerende endometriose. Diep infiltrerende endometriose van die derm kom meestal in die rektovaginale septum voor en word as die ernstigste vorm van die siekte beskou. Dit is die moeilikste om chirurgies te behandel weens sy indringende aard. Daar is tans geen studies beskikbaar oor hierdie onderwerp in die Suid-Afrikaanse konteks nie. Doel van die studie Om die uitkomste te dokumenteer van 112 pasiënte wat laparoskopiese chirurgie vir rektovaginale endometriose ondergaan het. Metodes 'n Retrospektiewe oudit is by Vincent Pallotti se Aevitas Fertiliteitskliniek gedoen van 112 vroue wat laparoskopiese chirurgie vir rektovaginale endometriose ondergaan het. Geskikte pasiënte is geïdentifiseer vanaf 'n chirurgiese databasis gebaseer op mediese kodering, sowel as vanaf 'n oorsig van pasiënt notas. Pasiënte is telefonies genader om ontbrekende inligting in te samel en verdere uitkomste te evalueer. Klassifikasie Ontwerp Studie nommer S11/11/036. Hierdie studie is deur die Gesondheids Navorsing Etiese Komitee van die Universiteit van Stellenbosch goedgekeur en uitgevoer volgens die etiese riglyne en beginsels van die Internasionale Verklaring van Helsinki, Suid-Afrikaanse Riglyne vir Goeie Kliniese Praktyk en die Mediese Navorsingsraad (MNR) se Etiese Riglyne vir Navorsing. Instelling Vincent Pallotti se Aevitas Reproduktiewe Medisyne Kliniek Pasiënte 112 agtereenvolgende pasiënte met rektovaginale endometriose. Ingrepe: Laparoskopiese chirurgie vir die behandeling van diep infiltrende, rektovaginale endometriose. Resultate Primêre uitkoms: Komplikasies van laparoskopiese chirurgie vir rektovaginale endometriose het ingesluit: een pasiënt wat 'n bloedoortapping benodig het (0,9%), drie gevalle van rektovaginale fistels (2,7%), twee dermbeserings (1,8%) - intraoperatief gediagnoseer en herstel, een ureter besering (0,9%), een bekkenabses (0,9%) en drie dringende herhaal operasies (2,68%). Sekondêre uitkoms: Van die 71 pasiënte wat fertiliteit verlang het: 39 (54,9%) het swanger geraak, waarvan 27 (69,2%) spontaan was. Gevolgtrekking Sover ons kennis strek, is dit die eerste Suid-Afrikaanse studie waar daar na die chirurgiese uitkomste in die behandeling van diep infiltrerende endometriose gekyk is. Hierdie uitkomste stem ooreen met internasionale literatuur in terme van komplikasie syfers. Die meeste van die operasies is uitgevoer met behulp van die skeer-tegniek, in ooreenstemming met internasionale tendense, terwyl veertien gevalle segmentele reseksies vereis het weens uitgebreide siekte. In goed opgeleide hande is die laparoskopiese behandeling van rektovaginale endometriose ‘n geldige behandelings opsie.

published_or_final_version / Community Medicine / Master / Master of Public Health

Traditional laparoscopic surgery continues to require significant training on the part of the surgeon before entering the operating room. Augmented Reality (AR) has been investigated for use in visual guidance in training and during surgery, but little work is available investigating the effectiveness of AR techniques in providing the user better awareness of depth and space. In this work we propose several 2D AR overlays for visual guidance in training for laparoscopic surgery, with the goal of aiding the user's perception of depth and space in that limiting environment. A pilot study of 30 subjects (22 male and 8 female) was performed with results showing the effect of the various overlays on subject performance of a path following task in the Computer Assisted Surgical Trainer (CAST-III) system developed in the Model Based Design Lab. Deviation, economy of movement, and completion time are considered as metrics. Providing a reference indicator for the nearest point on the optimal path is found to result in significant reduction (p < 0.05) in subject deviation from the path. The data also indicates a reduction in subject deviation along the depth axis and total path length with overlays designed to provide depth information. Avenues for further investigation are presented.