Safety considerations in laparoscopic surgery: A narrative review

Madhok, Brij; Nanayakkara, Kushan Dhanuja Liyanage; Mahawar, Kamal

doi:10.4253/wjge.v14.i1.1

Cited by 28 publications

(32 citation statements)

References 122 publications

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“…Since the advent of laparoscopy in 1910 by Jacobus from Sweden, its utilization has made it superior to laparotomy in the management of many diseases [ 1 , 2 ]. Currently, this technology is widely used for diagnostic [ 3 ] and therapeutic purposes [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Port Site Consequences After Laparoscopic Cholecystectomy Using an Open Versus Closed Approach of Pneumoperitoneum

Sultan¹,

Ali²,

Ghareeb³

2022

Cureus

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Introduction: Laparoscopic surgery is the standard method for cholecystectomy, and pneumoperitoneum is performed either in a closed or open technique. However, exposure to the consequences of the port site may increase the patient's morbidity. Therefore, this study was conducted to compare both approaches in terms of complications at the port site of each procedure and potential risk factors.Methods: A prospective study was conducted in the department of surgery, in hospitals affiliated with Kirkuk and Diyala governorates in Iraq, from January 2019 to March 2022. The participating patients (200) were electively divided into two groups, each group comprising 100 patients. The pneumoperitoneum was established in the first group by an open technique (Hasson) while in the second group it was by using a closed technique (Veress needle). A comparison was made between the two techniques for intraoperative and postoperative complications that may have occurred due to port insertion up to 18 weeks.Results: According to the results, the highest percentage was for the following: females (84.0%), ages between 50 and 59 years (43.5%), and body mass index (BMI) range 25-30 kg/m 2 (49.0%). No significant difference was observed between those variables for the two surgical techniques (p-value > 0.05). No death was recorded in the study. Consequences at the port site were observed in 10.5% of patients, the majority reported in the open approach (8.5%) as follows: bleeding (3.0%), hematoma (2.0%), wound infection (1.5%), hernia (1.5%), and vascular injury (0.5%).Conclusions: Thus, we concluded that port site complications are lowest in closed laparoscopic surgery which was not shown to be statistically significant but values showed less complications. Furthermore, samples could be used to gain a good statistical significance.

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Section: Introductionmentioning

confidence: 99%

Port Site Consequences After Laparoscopic Cholecystectomy Using an Open Versus Closed Approach of Pneumoperitoneum

Sultan¹,

Ali²,

Ghareeb³

2022

Cureus

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“…Generally, the level of intra-abdominal pressure (IAP) during laparoscopy has not been considered in ERAS protocols, though it may have a significant impact on surgical outcomes [ 8 ]. It is still common practice to perform surgeries with a standard IAP of 12–15 mmHg, but there is evidence to suggest that this may affect pain and reduce kidney and liver perfusions, thus being potentially detrimental to the patient [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Low Intra-Abdominal Pressure with Complete Neuromuscular Blockage Reduces Post-Operative Complications in Major Laparoscopic Urologic Surgery: A before–after Study

Brusasco

Germinale

Federico

et al. 2022

JCM

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Most urological interventions are now performed with minimally invasive surgery techniques such as laparoscopic surgery. Combining ERAS protocols with minimally invasive surgery techniques may be the best option to reduce hospital length-of-stay and post-operative complications. We designed this study to test the hypothesis that using low intra-abdominal pressures (IAP) during laparoscopy may reduce post-operative complications, especially those related to reduced intra-operative splanchnic perfusion or increased splanchnic congestion. We applied a complete neuromuscular blockade (NMB) to maintain an optimal space and surgical view. We compared 115 patients treated with standard IAP and moderate NMB with 148 patients treated with low IAP and complete NMB undergoing major urologic surgery. Low IAP in combination with complete NMB was associated with fewer total post-operative complications than standard IAP with moderate NMB (22.3% vs. 41.2%, p < 0.001), with a reduction in all medical post-operative complications (17 vs. 34, p < 0.001). The post-operative complications mostly reduced were acute kidney injury (15.5% vs. 30.4%, p = 0.004), anemia (6.8% vs. 16.5%, p = 0.049) and reoperation (2% vs. 7.8%, p = 0.035). The intra-operative management of laparoscopic interventions for major urologic surgeries with low IAP and complete NMB is feasible without hindering surgical conditions and might reduce most medical post-operative complications.

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“…During the Mann Ki Baat programme (June 2019), the Honourable Prime Minister of India called on the Indian people to band together and launch a Jan Andolan for water conservation, similar to the Swachh Bharat Mission. Jal Shakti Abhiyan, a water conservation and security campaign launched in July 2019 by the newly formed Jal Shakti Ministry under the guidance of the Prime Minister of India [70].…”

Section: Jal Shakti Abhiyanmentioning

confidence: 99%

Urban Resiliency towards Climate Change

Debangshi

Ghosh

Tiwari

et al. 2022

IJECC

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India will experience massive urbanization in the coming decades, with the country's urban population expected to double by 2050. Climate change is a major threat to urban systems all over the world. Its consequences are expected to worsen over the next few decades. The consequences of climate changes are more in urban areas than rural due to rapid urbanization, health issue, decreasing water level and industrialization etc. Climate change consequences such as increased rainfall intensity, storm surges, temperature fluctuation and flooding are expected to have a global impact on urban health, sustainability, coastal areas, urban infrastructure, migrants, ecosystems and urban water use. On the other hand, humanity able to take collective action to mitigate the severity of these impacts. Mitigation and adaptation strategies, such as climate resilient agriculture, rooftop farming, extreme weather mitigation, resilient water use and so on, will almost certainly be required to deal with these effects. It is encouraging to note that urban planning has the potential to play a key role in developing and implementing adaptive responses in urban systems. The benefit of urban planning is sustainable and required some urban planning regimes around the world which include, plan-making, stakeholder engagement, development management and design standards to make a better and greener urban ecosystem.

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Safety considerations in laparoscopic surgery: A narrative review

Cited by 28 publications

References 122 publications

Port Site Consequences After Laparoscopic Cholecystectomy Using an Open Versus Closed Approach of Pneumoperitoneum

Port Site Consequences After Laparoscopic Cholecystectomy Using an Open Versus Closed Approach of Pneumoperitoneum

Low Intra-Abdominal Pressure with Complete Neuromuscular Blockage Reduces Post-Operative Complications in Major Laparoscopic Urologic Surgery: A before–after Study

Urban Resiliency towards Climate Change

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