Advances in Laparoscopic Surgery by Arshad M. Malik

By Arshad M. Malik

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Extra resources for Advances in Laparoscopic Surgery

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Vijan SS, Ahmed KA, Harmsen WS, et al. (2010). Laparoscopic vs open distal pancreatectomy: a single-institution comparative study. 7, pp. 616-21. Warshaw A. (1997). Techniques of preserving the spleen with distal pancreatectomy. 121, p. 974. Weber SM, Cho CS, Merchant N, et al. (2009). Laparoscopic left pancreatectomy:complication risk score correlates with morbidity and risk for pancreatic fistula. 10, pp. 2825-33. Werner J, Feuerbach S, Uhi W, Buchler MW. (2005. )Management of acute pancreatitis: from surgery to interventional intensive care.

We usually use 2x2 cm gauze piece and a surgicel is left over the sinus for a period of five minutes to curtail the crisis. The spilt stones are usually a problem in handling such gallbladders. We recommend using a sterile endobag, if available, to remove the specimen and the stones together. After removal of the specimen, the port tract should be irrigated thoroughly. Fig. 8. Acute gangrenous cholecystitis. 3 Chronic cholecystitis Handling a case of chronic cholecystitis is not easy too. The scleroatrophic cholecystitis is a challenge for the surgeon owing to a totally contracted, fibrosed and densely covered gallbladder with adhesions.

Indirect signs of bowel injury, such as digestive fluids or purulent liquids must be carefully looked for. Methylene blue administered IV or via the nasogastric tube may help to identify urologic or proximal bowel injuries. Some AA advocate laparoscopic assisted diagnostic peritoneal lavage to rule out bowel injuries trough absence of alkaline phosphatase, bile or fibers in the lavage. This concept may add to diagnostic laparoscopy sensitivity in excluding gut injuries and make most trauma surgeon more confident in adopting it.

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