By Ferdinando Agresta, Antonello Mirabella (auth.), Vincenzo Mandalà (eds.)
This is often the 1st time a publication approximately laparoscopy in emergency belly surgical procedure has been released. quite a few articles were released in particular surgical journals, yet, beforehand, there has no longer been a publication that collates the entire features of this little-known box. the purpose of this quantity is to accomplish an entire and simple presentation of all of the implications linked to laparoscopy in emergency stomach surgical procedure. The e-book may be a guide that may be simply consulted via digestive, normal, and really good surgeons, in particular in an emergency. The authors’ contributions are based on evidence-based medication, which provide the booklet medical credibility, yet this can be coupled with their event of day-by-day perform, which provides a big complementary size to evidence-based drugs. this is often balanced by means of an emphasis on readability and accessibility, as the final target of the publication is academic. we are hoping this booklet could be usually consulted, extensive, not just through expert practitioners, but additionally through undergraduate scholars, new graduates and surgeons in education.
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Additional resources for The Role of Laparoscopy in Emergency Abdominal Surgery
Example text
This is evidentt in some studies where there was a high proportion of patients at risk. Katkhouda et al. [38] present 10 patients in a state of shock (equal to 22% of the total); Robertson et al. [39] present 17 patients (47% of cases) with ASA III-IV, of which 11 underwent laparoscopy. The systematic review by Lunevicius and Morkevicius [8] reached the same conclusions that the laparoscopic approach, which involves an extended operating time compared to the open technique, was not recommended for patients with high risk factors.
24 A. Mirabella et al. 12 Hospitalization i li i All studies have reported favorable results for laparoscopy in terms of postop hospitalization period or at any rate no worse than those after traditional surgery [7-11]. This is highlighted in the 3 most important systematic reviews by Lau (3 studies out of 13 favorable and 10 with comparable results) [7], Lunevicius and Morkevicius (4 studies out 15 favorable and 11 comparable) [8] and Sanabria et al. (1 study out of 3 favorable and 2 comparable) [6].
One 5 mm trocarr is positioned in the epigastric site to lift the liver and if necessary the gall bladder. The other two trocars are usually positioned in the left abdominal quadrant, on the mid-clavicular line above the umbilical transverse line and on the right side in a position which is diametrically opposite on the projection of the abdominal wall of the transpyloric region. There are other variants in the positioning of the trocars, but the one described seems to best satisfy the requirements of ergonomics and triangulation between optics and trocars which are responsible for the uneventful outcome of the laparoscopy.