Use of a circular stapler in the treatment of haemorrhoidal disease was safe, and was associated with fewer complications than conventional haemorrhoidectomy.
The use of laparoscopy for the management of acute intestinal obstruction is increasing. It has potential advantages over classic laparotomy. The objective of the current study was to evaluate the feasibility and outcome of laparoscopic management of small intestinal obstruction. A retrospective review of 30 children admitted for attempt of laparoscopic management of acute intestinal obstruction was performed. Their mean age was 6.7 +/- 1.73 years. Of the 30 laparoscopic attempts, 20 (66.7%) were performed successfully, whereas 10 patients (33.3%) needed a conversion to laparotomy because of inadequate laparoscopic visualization in 6 cases, gangrenous bowel in 2 cases, and inability to relieve the obstruction laparoscopically in 2 cases. There were no intra-or postoperative complications in the laparoscopic group. The mean operative time for the laparoscopic release of intestinal obstruction was 68 +/- 12.32 minutes and 102 +/- 9.67 minutes for the converted cases. The mean time of return of bowel function and mean hospital stay in the laparoscopic release of intestinal obstruction were significantly shorter. The study showed that laparoscopic release of intestinal obstruction in children is worthy of attempting initially. It is a feasible, effective, and safe alternative to laparotomy for most patients with acute intestinal obstruction.
The object of the present study was to assess the value and outcome of needlescopy in the treatment of inguinal hernia (IH) in 150 children operated upon in Al-Mishary Hospital, Riyadh, between October 1997 and October 1999. Their ages ranged between 6 and 96 months, (mean 61.6 +/- 28.32 months). There were 130 males and 20 females; 81 (54%) presented with a right-sided IH and among these patients a hidden contralateral hernia was diagnosed in 12 cases (8%). A left-sided IH was present in 30 (20%) bilateral IHs in 19 cases (12.66%), a recurrent hernia in 15 (10%), and an incarcerated hernia in 5 (3.33%). All patients were subjected to needlescopic herniotomy using a 2.7-mm telescope and two 2-mm needle holders to close the internal ring with a 4/0 PDS suture. The mean duration of surgery was 20.6 +/- 4.65 min for unilateral and 26.4 +/- 1.6 min for bilateral hernia repair. The mean hospital stay was 18 +/- 3.23 h. The study showed that laparoscopic closure of the internal ring in children is feasible, easy, and preferable to open surgery. The fact that laparoscopy can diagnose a hidden contralateral hernia is an additional advantage.
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