Tri Huu Nguyen1, Thanh Nhu Dang2, Thomas Schnelldorfer3,4. 1. Department of Digestive Surgery, Hue University School of Medicine and Pharmacy, Hue City, Vietnam. trihuunguyen@huemed-univ.edu.vn. 2. Department of Digestive Surgery, Hue University School of Medicine and Pharmacy, Hue City, Vietnam. 3. Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA. 4. Department of Biomedical Engineering, Tufts University, Medford, MA, USA.
Abstract
BACKGROUND: Laparoscopic single-port surgery has widely been introduced for the treatment of various abdominal conditions. But controversies still exist regarding its potential advantages and risks, especially for emergency surgery. The aim of this study was to evaluate the results of a single-port laparoscopic repair using straight laparoscopic instruments for the treatment of perforated duodenal ulcers. METHODS: A prospective consecutive case series was conducted including all patients with a perforated duodenal ulcer who underwent a laparoscopic single-port repair at a single institution from January 2012 to June 2018. The operation was performed through a single port using conventional straight laparoscopic instruments and intra-corporeal knot tying techniques. RESULTS: Out of 75 patients, simple closure of the perforation without omental patch was accomplished in 96% of cases. Conversion to an open operation was required in one patient (1.3%) due to a posterior duodenal perforation, and additional trocar placement was needed in another patient (1.3%). The mean incision length was 2.0 ± 0.2 cm. The mean operation time was 63.0 ± 26.6 min. Meantime a nasogastric tube remained in place was 2.9 ± 0.8 days. Mean duration of analgesic use was 2.8 ± 0.8 days. The rate of postoperative complications was 2.7%, including two patients with wound infections. There were no instances of intestinal leak or abscess. The postoperative hospital stay was 5.7 ± 1.2 days. CONCLUSION: Laparoscopic single-port repair using conventional straight laparoscopic instruments with intra-corporeal knot tying technique was safe and feasible for patients with perforated duodenal ulcers with low risk factors. This method offers results comparable to those expected with the standard multiport laparoscopic approach with the addition of improved cosmetic outcomes.
BACKGROUND: Laparoscopic single-port surgery has widely been introduced for the treatment of various abdominal conditions. But controversies still exist regarding its potential advantages and risks, especially for emergency surgery. The aim of this study was to evaluate the results of a single-port laparoscopic repair using straight laparoscopic instruments for the treatment of perforated duodenal ulcers. METHODS: A prospective consecutive case series was conducted including all patients with a perforated duodenal ulcer who underwent a laparoscopic single-port repair at a single institution from January 2012 to June 2018. The operation was performed through a single port using conventional straight laparoscopic instruments and intra-corporeal knot tying techniques. RESULTS: Out of 75 patients, simple closure of the perforation without omental patch was accomplished in 96% of cases. Conversion to an open operation was required in one patient (1.3%) due to a posterior duodenal perforation, and additional trocar placement was needed in another patient (1.3%). The mean incision length was 2.0 ± 0.2 cm. The mean operation time was 63.0 ± 26.6 min. Meantime a nasogastric tube remained in place was 2.9 ± 0.8 days. Mean duration of analgesic use was 2.8 ± 0.8 days. The rate of postoperative complications was 2.7%, including two patients with wound infections. There were no instances of intestinal leak or abscess. The postoperative hospital stay was 5.7 ± 1.2 days. CONCLUSION: Laparoscopic single-port repair using conventional straight laparoscopic instruments with intra-corporeal knot tying technique was safe and feasible for patients with perforated duodenal ulcers with low risk factors. This method offers results comparable to those expected with the standard multiport laparoscopic approach with the addition of improved cosmetic outcomes.
Authors: Flore Vărcuş; Mircea Beuran; Ioan Lica; Claudiu Turculet; Adrian Valentin Cotarlet; Stefan Georgescu; Dan Vintila; Dan Sabău; Alexandru Sabau; Constantin Ciuce; Vasile Bintintan; Eugen Georgescu; Razvan Popescu; Cristi Tarta; Valeriu Surlin Journal: World J Surg Date: 2017-04 Impact factor: 3.352
Authors: Piotr Budzyński; Michał Pędziwiatr; Agata Grzesiak-Kuik; Michał Natkaniec; Piotr Major; Maciej Matłok; Maciej Stanek; Mateusz Wierdak; Marcin Migaczewski; Magdalena Pisarska; Andrzej Budzyński Journal: Wideochir Inne Tech Maloinwazyjne Date: 2015-09-11 Impact factor: 1.195