IntroductionDespite dating more than 30 years after the first laparoscopic appendectomy,
ileocecal appendix resection is still performed by laparotomy in more than 90% of
cases, in our country.AimTo describe a technique for laparoscopic removal of the ileocecal appendix with
three portals, at low cost and very good aesthetic appearance.TechniqueThree incisions, one umbilical and two suprapubic are made; permanent material
used comprises: grasping forceps, hook, scissors, needle holders, three metal
trocars and four other usual instruments, and a single strand of cotton. There is
no need to use of operative extractors bags, clips, endoloops, staples or bipolar
or harmonic energy instruments. Allows triangulation and instrumentation in the
conventional manner.ConclusionThe proposed technique is safe and reproducible, easily teachable, at very low
cost and can be applied in general hospitals with conventional laparoscopic
equipment.
-Background -Mechanical lifting of the abdominal wall, a method based on traction and consequent elevation of the abdominal wall, is an alternative procedure to create enough intra-abdominal space necessary for videolaparoscopic
Traumatic diaphragmatic hernia is rare, but is of utmost importance due to its high morbidity and mortality. It is markedly important in patients with blunt abdominal trauma, and diagnosis is difficult because of the numerous associated injuries. A patient with few symptoms of chronic traumatic diaphragmatic hernia is described, who underwent surgery due to a gastric volvulus. Laparoscopic surgery permits repair of these injuries through an abdominal approach, avoiding a thoracic incision or selective intubation.
We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.
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