Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials

Purkayastha, Sanjay; Tilney, H. S.; Georgiou, Panagiotis; Athanasiou, Thanos; Tekkis, Paris; Darzi, Ara

doi:10.1007/s00464-007-9210-3

Cited by 93 publications

(72 citation statements)

References 32 publications

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“…In a random effect model it is assumed that there is variation between studies and the calculated OR thus has a more conservative value. In surgical research, meta-analysis using the random effect model is preferable particularly because patients that are operated upon in different centres have varying risk profiles and selection criteria for each surgical technique [39]. For those studies that contained a zero in one cell for the number of events of interest in one of the two groups, we used Yates' correction.…”

Section: Methodsmentioning

confidence: 99%

Minimally invasive total hip arthroplasty: a systematic review

Cheng

Feng

Liu

et al. 2009

International Orthopaedics (SICOT)

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The purpose of this study was to compare the operative outcome between mini and standard incisions in total hip arthroplasty (THA). We identified 12 randomised or quasi-randomised control trials (RCT or qRCT) published between 1996 and 2008. Subgroup and sensitivity analyses were performed to evaluate the differences in results for surgical approach, trial quality, and follow-up duration. Operative time and blood loss were significantly reduced in the mini-incision group for studies with the posterior or posterolateral approach. Concerning postoperative complications, there were no significant differences between the two groups with no significant heterogeneity. No differences were observed between the two groups for Harris hip score and radiographic results except for cup anterversion. Although mini-incision appeared to have similar outcomes compared to standard incision, the follow-up is short-term according to current standards in THA. High-quality studies are required to compare the outcomes of these two procedures.

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Section: Methodsmentioning

confidence: 99%

Minimally invasive total hip arthroplasty: a systematic review

Cheng

Feng

Liu

et al. 2009

International Orthopaedics (SICOT)

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“…Laparoscopic cholecystectomy is the ''gold standard'' for gallbladder removal [1,2]. Attempts to decrease parietal trauma and improve cosmetic results, such as mini laparoscopic ports and lower ports number have illustrated patients' preference for these techniques [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Single Port Access Laparoscopic Cholecystectomy (with video)

et al. 2008

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Background Single port access (SPA) surgery is a rapidly evolving field due to the complexity of NOTES (natural orifice translumenal endoscopic surgery). SPA combines the cosmetic advantage of NOTES and possibility to perform surgical procedure with standard laparoscopic instruments. We report a technique of umbilical SPA cholecystectomy using standard laparoscopic instruments and complying with conventional surgical principle and technique of minimally invasive cholecystectomy. Methods Preliminary, prospective experience of SPA cholecystectomy in 11 patients (median age, 46 (range, 27-63) years) scheduled for cholecystectomy was evaluated. Diagnoses for cholecystectomy were: symptomatic gallbladder lithiasis (n = 7), previous acute cholecystitis (n = 3), and biliary pancreatitis (n = 1). Results SPA cholecystectomy was feasible in all patients (median body mass index, 24 (range, 20-34) kg/m 2 ) who were scheduled for preliminary experience using conventional laparoscopic instruments. Median operative time was 52 (range, 40-77) minutes. Intraoperative cholangiography was performed in all patients, except one, and was considered normal. No peroperative or postoperative complications were recorded. Median hospital stay was less than 24 h.Conclusions SPA cholecystectomy is feasible and seems to be safe when performed by experienced laparoscopic surgeons using standard laparoscopic instrumentation. SPA cholecystectomy may be safer than the NOTES approach at this time. It has to be determined whether this approach would benefit patients, other than cosmesis, compared with standard laparoscopic cholecystectomy.

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confidence: 99%

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

Goh

Wong

Chan

et al. 2016

smedj

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INTRODUCTIONOver the past few decades, the use of laparoscopic surgery has expanded rapidly to become the surgical approach of choice for many abdominal operations, including cholecystectomies, (1) appendicectomies, (2) adrenalectomies,colectomies (4) and gastric resections.(5,6) However, the adoption of laparoscopic surgery in the fields of liver and pancreatic surgery has been relatively slow. (7,8) Although the first laparoscopic liver and pancreatic resections were reported in the early 1990s, (9,10) widespread adoption of such operations has been hindered by the technical complexities of these procedures, and concerns about oncological margins and risk of bleeding. (8) Pancreatic surgery is among the most complex and challenging of all abdominal operations.(11) Despite rapid surgical advancements, pancreatic surgery remains a challenge and is associated with a high morbidity rate worldwide, even in highly specialised and experienced tertiary centres.(12,13) Laparoscopic pancreatic surgery was first reported by Cuschieri in 1994.(9) Since then, a growing number of studies on laparoscopic pancreatic surgeries have been published, although it has yet to gain widespread acceptance.(11) As distal pancreatectomy (DP) is not as technically demanding as pancreaticoduodenectomy, it is not surprising that most of the published studies are on the outcomes of laparoscopic DP (LDP). (14) These early studies have reported the potential benefits of using the laparoscopic approach, including decreased pain and blood loss, faster recovery, and a shorter hospital stay; the laparoscopic approach is also associated with morbidity rates that are similar to those observed with the use of the open approach. (14,15) Despite the increased adoption of LDP, there are barriers to its widespread adoption, which include the significant risk of conversion to the hand-assisted or open approach. (15,16) Robotic surgery was introduced to overcome the shortcomings of conventional laparoscopic surgery. (11,15,17) The robotic platform provides a three-dimensional, high-definition, magnified view of the operative field. It also provides the additional advantages of improved dexterity and precision due to increased freedom of movement and the elimination of tremors. (7,11) The superiority of robotic surgery over conventional laparoscopy when performing complex surgical tasks has been proven in ex vivo models. (15) However, its use in the clinical setting remains controversial, especially with regard to DP. In the first series of robotic distal pancreatectomies (RDPs), reported by Giulianotti et al in 2003, 13 patients underwent RDP. (18) Several studies on RDP have since been reported, most of which were small case series involving less than 50 patients. (17)

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Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials

Abstract: MoC appeared to have similar outcomes compared to LC, however LC did reduce the length of hospital stay. MoC is a viable and safe option for healthcare providers without the financial resources for laparoscopic equipment and appropriately trained surgical teams.

Cited by 93 publications

References 32 publications

Minimally invasive total hip arthroplasty: a systematic review

Minimally invasive total hip arthroplasty: a systematic review

Single Port Access Laparoscopic Cholecystectomy (with video)

First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases

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