No description available.

No description available.

A dissertation submitted to the Faculty of Medicine, University of Witwatersrand, Johannesburg for the Degree of Master of Medicine / Background To date, no randomized control trial has been performed comparing open appendicectomy (OA) to laparoscopic appendicectomy (LA) in complicated appendicitis. A systematic review and meta-analysis in 2010 concluded LA is advantageous to OA with less surgical site sepsis in complicated appendicitis; however, the level of evidence is weak (level 3a). The aim of the study was to determine whether LA is safe in the treatment of complicated appendicitis. Methods One hundred and fourteen patients were randomized prospectively to either OA or LA using a computer generated blind method. Patients who were either less than 12 years of age, had previous abdominal surgery or were pregnant were excluded. A team of senior surgeons capable of doing both OA and LA performed all procedures. Primary outcome included all-cause mortality and procedure-related mortality; secondary outcomes included intra-operative duration, rates of wound sepsis and re-intervention, length of hospital stay and re-admission rates. The trial was registered with Current Control Trials (ISRCTN92257749). Results The intra-operative duration, the rate of wound sepsis, the number of re-operations, the length of hospital stay and the rate of re-admissions between the OA and LA groups did not differ statistically. Conclusion Laparoscopic appendicectomy is safe in complicated appendicitis. / MT2016

Background and purposes: Carbon dioxide is the common gas material to establish pneumoperitoneum to provide working space for laparoscopic surgeries, but possesses risks of reduced cardiac output and hypercarbia in cases with limited cardiopulmonary reserve. For such cases, we design a novel trocar to reduce the intrabdominal pressure, so as to perform the same operation safely. Animals and Methods: The novel trocar has four flexible leaflets that can be fixed as ¡§extended status¡¨ to hold the inner surface of abdominal wall. When the trocar was tracted upward with iron wires, the abdominal wall can be elevated. The lowest pressure of pneumoperitoneum with the usage of the novel trocar was tested first. We found the pressure was dependent on the target organ. Laparoscopic cholecystectomy was performed to compare the advantage of the novel trocar over the conventional trocar because it is one of the most commonly performed surgeries. Totally 6 pigs were used. They were divided into two groups: 3 pigs as the control group receiving operation with the conventional trocars (group C) under 15 mm Hg pneumoperitoneum, and another 3 with the novel trocar (group N) under 5 mm Hg pneumoperitoneum. Results: The total operation time was significantly longer in group N but the precise dissection time was comparable with group C. No surgical complication was noted in both groups and the blood loss was minimal. The hypercarbia was of a much lesser degree in group N compared to that in group C. Conclusions: Our preliminary data show that with the novel trocar, the laparoscopic cholecystectomy could be smoothly completed under a lesser pressure of 5 mm Hg CO2 pneumoperitoneum in pigs.

Diss. (sammanfattning) Göteborg : Univ. , 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 6 uppsatser.

Made available in DSpace on 2014-06-11T19:23:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-02-28Bitstream added on 2014-06-13T19:09:48Z : No. of bitstreams: 1 barros_ffpc_me_jabo.pdf: 329671 bytes, checksum: bdb04a0347b197071ec39c3f4406a22e (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / A castração de fêmeas se mostra importante na produção animal. Porém, existem poucas técnicas de ovariectomia descritas em pequenos ruminantes. Desta forma, objetiva-se com o presente estudo propor técnicas alternativas por videolaparoscopia e avaliá-las quanto ao desconforto doloroso dos animais e consequentemente queda na produção, viabilidade e tempo de execução. Sendo assim, primeiramente descreveu-se e comparou-se a ovariectomia por laparotomia (OL), vídeo-assistida (OVA) e total vídeolaparoscópica (OTV) em ovelhas da raça Santa Inês adultas, avaliando o trans e pós-cirúrgico, e verificando o estresse causado às fêmeas por cada procedimento. Já em um segundo momento objetivou-se desenvolver e descrever uma técnica de ovariectomia por videolaparoscopia utilizando um portal laparoscópico e um sistema de ligadura pré-montada (OTVM), avaliando a sua viabilidade, o desconforto doloroso e o processo inflamatório provocado em ovelhas da mesma raça. Concluiu-se então que as técnicas OVA e OTV apresentaram grande vantagem em relação a OL por serem processos minimamente invasivos, de rápida realização e que proporcionam mínimo desconforto e ótima recuperação das ovelhas, sendo recomendado por causar mínimo estresse e decréscimo na produção animal. E que a OTVM foi viável e exeqüível para a espécie ovina, não provocando também hemorragias, estresse, desconforto doloroso e perda de peso nos animais, apesar do tempo cirúrgico ter sido maior que nas outras técnicas laparoscópicas / The castration of females is important in animal production. However, there are few techniques of ovariectomy described in small ruminants. Thus, the aim of this study was propose alternative techniques of ovariectomy by laparoscopy and evaluate the painful discomfort of the animals and consequently decrease in production, the feasibility and execution time. Therefore, at a first moment was described and compared the ovariectomy by laparotomy (OL), video-assisted (OVA) and total laparoscopic (OTV) in Santa Ines adult ewes, evaluating the transoperative and postoperative, and the stress caused to females for each procedure. In a second moment, aimed to develop and describe a technique for ovariectomy by laparoscopy using one portal and a ligation system pre-assembled (OTVM), evaluating their feasibility, the painful discomfort and the inflammatory process caused in ewes in the same breed. It was concluded that the OVA and OTV techniques had a great advantage compared to OL, once they are minimally invasive procedures, of rapid implementation and provide a minimal discomfort and great recovery of ewes, being recommended since they cause a minimal stress and decrease in animal production. The OTVM was viably and feasibly to the ovine species, not causing bleeding, stress, painful discomfort and weight loss in animals, although the surgical time have been greater than in other laparoscopic techniques

No description available.

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No description available.