Laparoscopic Surgery Research Papers - Academia.edu (original) (raw)

2025, Fertility and Sterility

Objective: To evaluate the efficacy and safety of Adept (4% icodextrin solution) in reducing adhesions after laparoscopic gynecological surgery involving adhesiolysis. Design: Multicenter, prospective, randomized, double-blind study comparing Adept with lactated Ringer's solution (LRS). Patient(s): Four hundred two patients randomized intraoperatively to Adept (n ¼ 203) or LRS (n ¼ 199) returned for second laparoscopy within 4-8 weeks. Incidence, severity, and extent of adhesions were determined on both occasions. Main Outcome Measure(s): The primary efficacy measure defined by the Food and Drug Administration was the number of patients achieving clinical success with adhesion treatment. Other measures included incidence and American Fertility Society (AFS) scores. Result(s): Significantly more Adept patients achieved clinical success than did LRS patients (49% vs. 38%). In infertility patients, Adept demonstrated particular clinical success compared with LRS (55% vs. 33%). This was reflected in the number of patients with a reduced AFS score (53% vs. 30%) and in fewer patients with a moderate/severe AFS category score (43% vs. 14%). Safety was comparable in both groups. Most events were related to the surgery, with an increase in transient labial edema in the Adept group. Conclusion(s): This is the first randomized, double-blind trial of an adhesion reduction agent. It demonstrated that Adept is a safe and effective adhesion reduction agent in laparoscopy. (

2025

Introducción: La incidencia real de la enfermedad tromboembólica venosa (ETV) es difícil de precisar. La mayoría de los casos son asintomáticos y generalmente no se diagnostican, pero se sabe que el tromboembolismo pulmonar (TEP) es la tercera causa de muerte en el medio hospitalario. El subdiagnóstico de la patología complica el conocimiento exacto de la incidencia y no hay demasiados trabajos que evalúen la calidad de la prevención que se aplica.Objetivos: El principal fue determinar la frecuencia de la utilización de profilaxis de la ETV en los pacientes sometidos a cirugías de alto y/o mediano riesgo para la presentación de dicha patología en diferentes instituciones médicas de nuestro país. Se establecieron como objetivos secundarios evaluar la calidad de la prevención empleada y la variabilidad de la misma de acuerdo a la especialidad médica del profesional que la indica, su relación con el número de camas de la institución como criterio de complejidad de la misma y las difere...

2025, Robot 2019: Fourth Iberian Robotics Conference

Robotizing laparoscopic surgery not only allows achieving better accuracy to operate when a scale factor is applied between master and slave or thanks to the use of tools with 3 DoF, which cannot be used in conventional manual surgery, but also due to additional informatic support. Relying on computer assistance different strategies that facilitate the task of the surgeon can be incorporated, either in the form of autonomous navigation or cooperative guidance, providing sensory or visual feedback, or introducing certain limitations of movements. This paper describes different ways of assistance aimed at improving the work capacity of the surgeon and achieving more safety for the patient, and the results obtained with the prototype developed at UPC.

2025, Vascular Health and Risk Management

Purpose: Minimally invasive surgical techniques have been shown to reduce the inflammatory response related to a surgical procedure. The main objective of our study was to measure the inflammatory response in patients undergoing a totally laparoscopic versus open aortobifemoral bypass surgery. This is the first randomized trial on subjects in this population. Patients and methods: This is a substudy of a larger randomized controlled multicenter trial (Norwegian Laparoscopic Aortic Surgery Trial). Thirty consecutive patients with severe aortoiliac occlusive disease eligible for aortobifemoral bypass surgery were randomized to either a totally laparoscopic ( ) or an open surgical procedure (n=16). The inflammatory response was measured by perioperative monitoring of serum interleukin-6 (IL-6), IL-8, and C-reactive protein (CRP) at six different time points. The inflammatory reaction caused by the laparoscopic procedure was reduced compared with open surgery. IL-6 was significantly lower after the laparoscopic procedure, measured by comparing area under the curve (AUC), and after adjusting for the confounding effect of coronary heart disease (P=0.010). The differences in serum levels of IL-8 and CRP did not reach statistical significance. In this substudy of a randomized controlled trial comparing laparoscopic and open aortobifemoral bypass surgeries, we found a decreased perioperative inflammatory response after the laparoscopic procedure measured by comparing AUC for serum IL-6.

2025, Turkish Journal of Surgery

Under general anesthesia, a 1 cm supra-umbilical skin incision was done followed by Veress needle insertion for carbon dioxide insufflation up to 10-12 millimeter mercury (mmHg). Mesocolic excision was performed for colon tumors and total mesorectal excision was performed for rectal cancers. To avoid seeding and surgical site infection, a wound protector was used in all operations (Alexis® O™ Retrac-

2025, Dr. RK Mishra

Fibroids or leiomyomas are a very commonly occurring
uterine tumor affecting up to 20–25% of women. Fibroid
develops from benign transformation of a single smooth
muscle cell. The growth of myoma is dependent on many
factors. Increased estrogen stimulation alone or together
with growth hormone or human placental lactogen
appears to be the major growth regulator of fibroid.

2025, medicina

Sažetak. Ateroskleroza je sustavna bolest koja dovodi do bolesti koronarnih, karotidnih i perifernih arterija. Vodeći je uzrok smrti u razvijenim zemljama. Patofiziologija ateroskleroze ovisi o brojnim urođenim i stečenim čimbenicima. Ključno uporište za nastanak ateroskleroze je gubitak normalne funkcije endotela. Klinička istraživanja dala su brojne dokaze da snižavanje koncentracije lipida može dovesti do korisnih kvalitativnih promjena u atarosklerotskom plaku i povoljno utjecati na kliničko očitovanje bolesti. U aterosklerotskim promijenjenim krvnim žilama česti su kalcifikati koje je moguće radiološki dijagnosticirati, a služe kao pokazatelj težine i ishoda ishemijske bolesti srca. U bolesnika s kroničnim zatajenjem srca, a posebno onih koji su na dijalizi, kalcifikati u koronarnim arterijama čest su nalaz. Najčešće se dovode u vezu s dobi, trajanjem dijalize i dislipidemijom. Liječenjem bolesnika sa zatajenjem bubrega uz pomoć statina i sevelamera moguće je usporiti godišnju progresiju kalcificiranja koronarnih arterija s 30 % na 6 %. Prema podacima iz nekih istraživanja smanjenje koncentracije LDL kolesterola < 2,59 mmol/l može zaustaviti proces odlaganja kalcija ili čak dovesti do njegove regresije. Dodatna istraživanja pokazala su da smanjenje koncentracije LDL kolesterola uz istovremeno povećanje koncentracije HDL kolesterola mogu povoljno utjecati na smanjenje debljine intime i medije karotidnih arterija, kao i na smanjenje veličine plaka u koronarnim arterijama.

2025, Progress in Medical Devices

Minimally invasive surgeries are widely applied due to the advantages of small surgical wound, short postoperative recovery period, and low surgical infection rate. In minimally invasive surgery, vascular clips play a significant role in hemostasis and managing the direction of blood flow, ensuring the success of surgical procedures. The mechanical structure and manufacturing materials of vascular clips have an important influence on its clinical application effect. In this paper, we classify and summarize the mechanical structure and manufacturing materials of the currently available vascular clips worldwide, and then analyze the hemostatic coating materials of vascular clips. Besides, we also summarize the shortcomings of the existing vascular clips and propose a coat-absorbable vascular clip with future research potential.

2025

Translocation of an intrauterine device (IUD), is slightly frequent, affecting neighboring organs like the rectal sigmoid, bladder and ovaries. After uterine perforation, because of IUD migration, immediate removal of the abdominal cavity is justified. We present a case of a 38 year-old woman who had a partial perforation by an intrauterine device causing pelvic pain.

2025, Journal of Mind and Medical Sciences

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases in a multicenter and retrospective analysis that stretches over 20 years. Results and discussions. These cases have been diagnosed and treated – through different surgical methods, both classical and laparoscopic – for hepatic hydatid cysts. The paper also presents a short review of the major types of surgical procedures cited in the international literature, with a specific focus on the advantages brought by Romanian innovations in this field. Conclusions. Even though the classical open approach still assumes the first place among surgical procedures, modern laparoscopic techniques have earned a much appreciated place in providing positive results based on long-term assessment, with virtually no or only minor complications. In t...

2025

Acute odontogenic inflammation is the most frequent disease because of which patients come to the Out-Patient Clinic of Oral Surgery. In the majority

2025, Annals of Medicine and Medical Sciences

This case report outlines the effective management and outcome of a 26 years old male patient with lumbar scoliosis and multiple large left ureteric calculi with moderate hydronephrosis. The patient visited the outpatient urology department with a complaint of left flank pain persisting for four months. Imaging revealed multiple large stones in the left proximal ureter, with the largest measuring over 3 cm. Because of the anatomical complexities associated with severe lumbar scoliosis and the significant stone burden, the patient was not an ideal candidate for extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic lithotripsy (URSL). Instead, laparoscopic ureterolithotomy was successfully performed, yielding favorable results. This report examines the surgical approach, challenges, and benefits of laparoscopic ureterolithotomy in comparison to other treatment options, including percutaneous nephrolithotomy, open ureterolithotomy, extracorporeal shock wave lithotripsy, and laser lithotripsy.

2025, Dr. RK Mishra

The indications and preparation for laparoscopic liver
surgery remain the same as in open hepatic surgery.
Visualization is excellent with the laparoscope, and the
addition of laparoscopic ultrasound has been shown to
help intraoperative plans in 66% of cases when compared
to laparoscopic exploration alone. The ability of visual
inspection laparoscopy to assess resectability as opposed to
inoperability remains relatively low. It can be improved by
extended laparoscopy combined with laparoscopic contact
ultrasonography.

2025

In the evolving world latest contemporary surgical operation, laparoscopic methods have emerge as a cornerstone ultra-modern affected person care. Minimally invasive strategies not handiest make sure quicker recovery and reduced pain but additionally enhance surgical effects notably. For surgeons, gynecologists, urologists, and pediatric surgeons, today's laparoscopic capabilities is no longer non-obligatory-it is a professional necessity. some of the most fulfilling establishments devoted to laparoscopic schooling, global Laparoscopy health facility (WLH) has installed itself as a depended on center for laparoscopic schooling in India and throughout the globe. With world-class school, infrastructure, and a recognition for excellence, WLH has emerge as a beacon trendy contemporary for medical professionals aiming to excel in minimum get entry to surgery.

2025, Revista Medica Del Uruguay

Introducción: los cuadros agudos de abdomen inferior (CAAI) en la mujer son una causa frecuente de consulta en puerta de emergencia. El rol de la laparoscopía como herramienta diagnóstica y terapéutica, más aun en la mujer, se encuentra bien establecido. Permite arribar a un diagnóstico de certeza en todos los casos al visualizar la totalidad de la cavidad abdominal mediante un abordaje mínimamente invasivo, evita retrasos diagnósticos y sus consiguientes complicaciones evolutivas.

2025, PLOS ONE

The aim of this systematic review and meta-analysis is to compare robotic colectomy (RC) with laparoscopic colectomy (LC) in terms of intraoperative and postoperative outcomes. A systematic literature search was performed to retrieve comparative studies of robotic and laparoscopic colectomy. The databases searched were PubMed, Embase and the Cochrane Central Register of Controlled Trials from January 2000 to October 2014. The Odds ratio, Risk difference and Mean difference were used as the summary statistics. A total of 12 studies, which included a total of 4,148 patients who had undergone robotic or laparoscopic colectomy, were included and analyzed. RC demonstrated a longer operative time (MD 41.52, P<0.00001) and higher cost (MD 2.42, P<0.00001) than did LC. The time to first flatus passage (MD -0.51, P = 0.003) and the length of hospital stay (MD -0.68, P = 0.01) were significantly shorter after RC. Additionally, the intraoperative blood loss (MD -16.82, P<0.00001) was significantly less in RC. There was also a significantly lower incidence of overall postoperative complications (OR 0.74, P = 0.02) and wound infections (RD -0.02, P = 0.03) after RC. No differences in the postoperative ileus, in the anastomotic leak, or in the conversion to open surgery rate and in the number of harvested lymph nodes outcomes were found between the approaches.

2025, Uva Clinical Research Lab 2025 © Uva Clinical Anaesthesia and Intensive Care ISSN 2827-7198,

Obesity has emerged as one of the most pressing global health challenges, strongly associated with cardiometabolic diseases, reduced quality of life, and premature mortality. In the United States alone, nearly 40% of adults are classified as obese, with annual healthcare expenditures exceeding $147 billion. Despite advances in dietary, behavioral, and pharmacological interventions, no medical therapy has consistently demonstrated durable weight loss in patients with severe obesity. Bariatric surgery, therefore, represents the most effective and evidence-based treatment, producing sustained weight loss, reversal of metabolic syndrome, and significant reductions in long-term morbidity and mortality.
Nevertheless, obesity is frequently accompanied by multiple comorbidities—including type 2 diabetes, hypertension, obstructive sleep apnea, and psychiatric disorders—that heighten perioperative risks. For this reason, a thorough preoperative evaluation is indispensable. This process should be comprehensive and interprofessional, involving surgeons, anesthesiologists, endocrinologists, cardiologists, dietitians, psychologists, and nursing staff. The preoperative assessment addresses medical optimization, nutritional counseling, psychosocial evaluation, and anesthetic planning, while simultaneously preparing the patient for lifelong postoperative adherence.
This review explores the essential elements of preoperative workup in bariatric surgery, highlighting the interplay between patient selection, comorbidity management, and interdisciplinary collaboration. Emphasis is placed on evidence-based practices for psychological readiness, nutritional assessment, weight loss planning, laboratory and imaging investigations, and anesthetic considerations. Ultimately, the success of bariatric surgery extends beyond operative technique and relies heavily on meticulous preparation and coordinated care by a multidisciplinary team.

2025, Dr. R K Mishra

The endometriotic lesions are typically located in the pelvis but can occur at multiple sites, including the bowel, diaphragm, and pleural cavity. While endometriosis is a common and nonmalignant process, ectopic endometrial tissue and... more

The endometriotic lesions are typically located in the
pelvis but can occur at multiple sites, including the bowel,
diaphragm, and pleural cavity. While endometriosis is a
common and nonmalignant process, ectopic endometrial
tissue and resultant inflammation can cause dysmenorrhea,
dyspareunia, chronic pain, and infertility.

2025, Uva Clinical Research Lab 2025 © Uva Clinical Anaesthesia and Intensive Care ISSN 2827-7198,

Magnetic resonance imaging (MRI) is a noninvasive diagnostic modality renowned for its exceptional soft tissue resolution and expanding physiological and functional applications. Since its clinical introduction in the 1980s, MRI has become a cornerstone of medical imaging, providing detailed anatomical and functional information without exposure to ionizing radiation. MRI employs three primary types of magnetic fields—static, radiofrequency, and time-varying gradient fields—each associated with unique safety considerations. The static magnetic field can convert ferromagnetic objects into dangerous projectiles and interfere with electronic implants, while radiofrequency fields may induce tissue heating, particularly in metallic implants. Gradient magnetic fields, responsible for spatial encoding, can stimulate nerves and produce significant acoustic noise, risking hearing damage. MRI safety is particularly critical in patients with metallic foreign bodies, implanted devices, or other relative contraindications. Comprehensive pre-scan screening, staff training, and adherence to established safety protocols are essential to mitigate risks and optimize diagnostic outcomes. This review emphasizes the principles of MRI physics, potential hazards, and current safety practices, highlighting the importance of interprofessional collaboration to ensure patient and staff safety.

2025, Dr. R K Mishra

It is well-known that laparoscopy is the consequence of
advances made in the field of medical engineering. Each
surgical specialty has different requirement of instruments.
Laparoscopy was initially criticized owing to the cost of
specialized instruments and possible complications due
to these sharp long instruments. Also, it necessitated
difficult hand-eye coordination.

2025, Panamerican Journal of Trauma, Critical Care & Emergency Surgery

The National Aeronautics and Space Administration's (NASA's) history is built on a foundation of can-do strength, while pointing to the Saturn/Apollo Moon missions in the 1960s and 1970s as its apex -a sentiment that often overshadows the potential that lies ahead. The chronicle of America's civil space agenda is scattered with programs that got off to good starts with adequate resources and vocal political support but that never made it past a certain milestone review, General Accountability Office report, or Congressional budget appropriation. Over the decades since the fielding of the Space Shuttle in the early 1980s, a start-stop-restart cycle has intervened due to many forces. Despite this impediment, the workforce has delivered engineering feats such as the International Space Station and numerous Shuttle and science missions, which reflect a trend in the early days of the Exploration Age that called for massive infrastructure and matching capital allocations. In the new millennium, the aerospace industry must respond to transforming economic climates, the public will, national agendas, and international possibilities relative to scientific exploration beyond Earth's orbit. Two pressing issues -workforce transition and mission success -are intertwined. As this paper will address, U.S. aerospace must confront related workforce development and industrial base issues head on to take space exploration to the next level. This paper also will formulate specific strategies to equip space engineers to move beyond the seemingly constant start-stop-restart mentality to plan and execute flight projects that actually fly.

2025, The Israel Medical Association journal : IMAJ

BACKGROUND When a woman with an endometrioma presents with acute abdominal pain, it is unclear whether ovarian torsion should be suspected. OBJECTIVES To compare patient characteristics, imaging results, and surgical management of endometriomas in elective versus emergent surgeries. METHODS This retrospective cohort study included women treated at our institution during the period 1990-2015 who presented with histologically verified endometrioma and who underwent either planned surgery or emergent surgery due to suspected adnexal torsion. RESULTS Of 225 surgeries performed, 174 were elective and 51 emergent. Patients in the emergent group were significantly younger (33.9 ± 11.1 vs. 39.01 ± 10.9 years, P = 0.004). Abdominal pain was the main complaint of all the emergent surgery patients and the leading complaint in 21% of the elective surgery patients (P < 0.001), with right-sided predominance in both groups. Sonographic parameters were similar in both groups. Bilateral ovarian c...

2025, Surgical endoscopy

Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up. Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842). In total, 1248 patients were randomised, of which...

2025, Journal of Endourology

Purpose: To compare multidetector CT scan (MDCT) results with intraoperative findings in the detection of an inferior-pole pedicle crossing the ureteropelvic junction. Patients and Methods: Over the 2-year study period, 35 patients receiving laparoscopic pyeloplasty underwent preoperative investigation with a novel MDCT protocol in order to detect crossing vessels. Postprocessing, including maximum intensity projection, volume-rendering technique, and multiplanar reconstruction, was used in addition to standard axial views. Results: All the arteries found during laparoscopic surgery were detected by MDCT, but one radiologic false-positive was noted at the beginning of the series. Seven veins were not detected with MDCT. In the only case featuring an isolated inferior-pole vein, the aberrant vessel was identified by MDCT. Multidetector CT scanning is a highly accurate way of providing all the information necessary preoperatively concerning renal parenchymal anomalies, urinary stones, and collecting system and vessel anatomy. It helps physicians make appropriate therapeutic decisions and gives surgeons information about what they can expect during laparoscopic procedures.

2025, Dr. R K Mishra

Several factors should be considered at the time of choosing
laparoscopic instrument, including cost, availability, and
reliability. Reusable instruments are expensive initially but
in long run they are cost-effective.

2025, International Journal of Medical Science and Clinical Research Studies

Background: The gold standard treatment for calculus cholecystitis is laparoscopic cholecystectomy (LC). In the conventional laparoscopic cholecystectomy (CLC), three instruments are most useful in ensuring the critical view of safety. The two ports plus one puncture laparoscopic cholecystectomy (TPPOP LC) assisted needle grasper approach upholds the laparoscopic triangulation principles and allows an accessible critical view of safety. This technique successfully reduces port numbers while maintaining equivalent surgical outcomes.
Method: The main objective is to compare clinical outcomes of conventional and two ports plus one puncture laparoscopic cholecystectomy. This is a single-center hospital based interventional double-blinded randomized controlled trial that included 98 patients undergoing laparoscopic cholecystectomy at No. (1) Military Hospital (700 bedded) from 01/12/2019 to 31/07/2021. The patients were randomized into group A (CLC) (n = 49) and group B (TPPOP LC) (n = 49). This trial was registered in the ISRCTN registry with the registration number ISRCTN50339464.
Results: Among total of 98 patients, 46.9% were male patients and 53.1% were female patients. Mean age in group A was 49.86 ± 7.77 years and in group B was 49.33 ± 7.69 years. Mean operation time in group A was 57.9 ± 6.7 minutes and in group B was 58.5 ± 7.1 minutes, with no significant difference (p = 0.66). Although 4.1% of patients in CLC group and 12.2% in TPPOP LC group experienced bile spillage, no other major intraoperative complications were noted. A significant difference was observed at 36 and 48 hours postoperatively (VAS: 2.69 ± 1.16 in group A and 1.94 ± 0.83 in group B at 36 hours; p = 0.005 and VAS: 1.69 ± 0.92 in group A and 1.33 ± 0.63 in group B at 48 hours; p = 0.002). Postoperative minor wound infection was detected 6.1% in group A and 4.1% in group B (p = 0.64). The mean duration of the postoperative hospital stay was 5.24 ± 1.01 days in group A and 4.98 ± 0.92 days in group B (p = 0.17).
Conclusion: This clinical trial concludes that two ports plus one puncture laparoscopic cholecystectomy is as effective and safe as conventional four-port laparoscopic cholecystectomy.

2025, Dr. R K Mishra

Precision and meticulous hemostasis is essential
requirement in minimal access surgery (MAS). Endoscopic
dissection, in contrast to dissection in conventional surgery,
possesses several limitations. Three dimensional direct
visions are replaced by two dimensional indirect visions
in laparoscopic surgery. Illumination and the video image
quality are still limited despite recent advances in video
systems such as digitization and three chip endocamera.
Movement of the functional tip of laparoscopic instruments
is restricted along with the kinematics response. The loss
of tactile sensation in endoscopic surgery is yet another
limiting factor.

2025

Hysteroscopy is a procedure used to view the inside of the uterus through a telescope-like device called a hysteroscope. Hysteroscopy offers a valuable extension to the gynecologist's armamentarium. It can improve the diagnostic accuracy and can permit better treatment of uterine diseases. The hysteroscope is placed in the vagina and introduced into the uterus (Figs. 1A and B). A hysteroscope is introduced in a sheath that provides an inflow and outflow channel for insufflation of the uterine cavity. In addition, an operative channel may be present to introduce scissors, graspers, or biopsy instruments. A hysteroscopic resectoscope is similar to a transurethral resectoscope and allows entry of an electric loop to shave off tissue, for instance, to eliminate a fibroid. A contact hysteroscope is a hysteroscope that does not use distension media. Figs. 2A and B: History of hysteroscopy. (A) First hysteroscope with cystoscope of Desormeaux by Pantaleoni; (B) First hysteroscope with built-in lens to magnify the image.

2025, Dr. R K Mishra

Laparoscopic colon resections are being performed with
increasing frequency all over the world. However, the
use of minimal access surgery in colorectal surgery has
lagged behind its application in other surgical fields.
Since the first laparoscopic colectomy was described in
1991, a great deal of controversy has surrounded its use,
particularly in the management of colorectal cancer.

2025

Objective: This study aimed to critically assess the impact of surgical
safety checklists on patient outcomes across a diverse range of healthcare
settings, with an emphasis on mitigating adverse events, enhancing clinical
outcomes, and improving the overall quality of surgical care.
Methodology: A multicentre, retrospective cohort design was employed,
incorporating five hospitals that ranged from academic medical centres
to community hospitals. Data were meticulously gathered from patient
records over a two-year period, during which the surgical safety
checklist was fully integrated into surgical protocols. The study focused
on adult patients who underwent both elective and emergency surgeries
across a variety of specialties, including general surgery, orthopaedics,
neurosurgery, and cardiothoracic surgery. Stratified sampling ensured a
diverse cohort, enhancing the generalizability of the results. Statistical
analyses, both descriptive and inferential, were performed to compare
clinical outcomes between patients who underwent surgeries with the
checklist and those who did not.
Results: The findings revealed a significant improvement in outcomes for
the checklist group compared to the non-checklist group. Rates of surgical
complications, such as infections, bleeding, anaesthesia-related issues, and
organ injuries, were notably lower in the checklist group. Mortality rates
also demonstrated a marked reduction, with the checklist group exhibiting
a mortality rate of 0.39%, compared to 1.04% in the non-checklist group.
Furthermore, patients in the checklist group had shorter hospital stays,
averaging 5.2 days, in contrast to 6.8 days for those in the non-checklist
group. Recovery times were similarly reduced, with the checklist group
recovering in an average of 10.5 days, compared to 12.3 days for the nonchecklist group.

2025, TECHNOLOGY THAT CARES: THE IMPACT OF ARTIFICIAL INTELLIGENCE ON EMERGENCY MEDICINE (Atena Editora)

This study addresses the application of Artificial Intelligence (AI) in emergency care, an area of health characterized by the approach and need for quick and accurate decisions, representing a transformative opportunity for process optimization and improvement of clinical care. AI has emerged as a tool with the potential to optimize triage, predict risks and support clinical decision-making in complex scenarios. This is an integrative, qualitative, retrospective and cross-sectional literature review, which analyzed scientific articles from the PubMed and Virtual Health Library databases, published between 2020 and 2025, obtaining a total of 12 articles for analysis. The review explores the transformative potential of AI in optimization, prediction and support tasks. It highlights studies that prove its effectiveness in screening patients, tracking conditions such as cognitive impairment, predicting mortality from sepsis and personalizing treatments for conditions such as heart failure. These applications demonstrate the technology's ability to process complex data to improve the efficiency of care. However, the success of AI depends crucially on its correct integration and human supervision, in which its analyses are validated by the clinical judgment of a professional, guaranteeing the safety and quality of care.

2025, Uva Clinical Research Lab 2025 © Uva Clinical Anaesthesia and Intensive Care ISSN 2827-7198,

The abdominal examination remains a cornerstone of diagnostic medicine, offering immediate insights into gastrointestinal, hepatobiliary, vascular, and systemic pathologies. Despite technological advancements in imaging, the physical examination—culminating in the Digital Rectal Examination (DRE)—retains indispensable value in guiding diagnostic reasoning, triage, and therapeutic decision-making. This paper explores the abdominal and rectal examination in comprehensive detail, expanding on historical foundations, anatomical considerations, and advanced clinical maneuvers. The DRE, frequently underutilized in modern practice, is analyzed for its diagnostic yield in conditions ranging from anorectal disease to prostatic pathology and occult gastrointestinal bleeding. Issues of concern—including declining emphasis on bedside skills, medico-legal implications, and challenges in pediatric assessment—are critically evaluated. Furthermore, case-based evidence underscores the enduring relevance of these techniques in detecting rare or atypical conditions, influencing imaging selection, and improving patient outcomes. Finally, the role of interdisciplinary collaboration and documentation is highlighted as essential for optimizing diagnostic precision and clinical care in diverse healthcare settings.

2025

Diagnostic laparoscopy is a minimally invasive surgical
procedure that allows the visual examination of intraabdominal organs in order to detect any pathology. This
procedure allows the direct visual examination of intraabdominal organs including large surface areas of the
liver, gallbladder, spleen, peritoneum, pelvic organs, and
retroperitoneum. Biopsies, aspiration, and cultures can be
obtained, and laparoscopic ultrasound (US) may be used.

2025

Cholecystectomy is the standard treatment for gallbladder diseases, including
cholelithiasis and cholecystitis. The traditional open cholecystectomy
(OC) has been replaced in the majority of clinical contexts by laparoscopic
cholecystectomy (LC), which has become the gold standard due to
advancements in minimally invasive surgery. This review evaluates the
surgical outcomes, complications, patient recovery, cost-effectiveness, and
long-term results of LC and OC. A comprehensive analysis of both approaches
is conducted to optimize patient care and guide clinical decision-making by
examining the current literature. This study examines the relative efficacy
of laparoscopic versus open surgery in abdominal procedures, focusing on
patient recovery, complication rates, and overall surgical results. The study,
which took place at Netrokona Medical College from January 2023 to
December 2024, included 112 patients who were split into two groups: one
group had laparoscopic surgery and the other had open surgery. Some of the
most important things that were measured were pain after surgery, time to
recovery, length of stay in the hospital, and complications. The results showed
that laparoscopic surgery had far superior results. Patients in this group had
less pain after surgery (mean score: 2.1 vs. 4.3), healed faster (returned to
normal activities in 6.8 days vs. 10.5 days), and stayed in the hospital for
less time (3.2 days vs. 5.6 days) than those who had open surgery. The
laparoscopic group also had a much reduced complication rate (12% vs. 22%)
and a better patient satisfaction rate (85% vs. 70%). The statistical analysis
validated the importance of these changes, with p-values demonstrating
robust confidence in the findings. The study finds that laparoscopic surgery
leads to better patient outcomes, making it a better choice than open surgery for abdominal treatments

2025, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (l...

2025, Gomal Journal of Medical Sciences

Background: Port site hernia is a rare but potentially serious complication of laparoscopic surgeries. This study aimed to determine the frequency of port site hernias in patients undergoing laparoscopic surgery at our set up. Material & Methods: This is a prospective descriptive study conducted at Jamil laparoscopic clinic, Dera Ismail Khan, from 01/01/2011 to 31/12/2015. This study included 450 patients undergoing laparoscopic surgery. The fascial defect as well as the peritoneum was closed routinely at the umbilical port site with vicryl ‘0’ on ‘J’ shaped needle. Patients were examined for any port site hernia during their follow up visits. The frequency of port site hernia was calculated. Results: During the study period, 450 patients underwent laparoscopic procedures and out of these, 5 patients developed port site hernia during a mean follow up period of two years. Conclusion: Laparoscopic procedures are associated with an acceptably low frequency of port site hernia, provided...

2025, British Journal of Surgery

Background: Previous studies comparing laparoscopic and open surgical techniques have reported improved health-related quality of life (HRQL). This analysis compared HRQL 12 months after laparoscopic versus open surgery for rectal cancer in a subset of a randomized trial. Methods: The setting was a multicentre randomized trial (COLOR II) comparing laparoscopic and open surgery for rectal cancer. Involvement in the HRQL study of COLOR II was optional. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR38, and EuroQol -5D (EQ-5D) before surgery, and 4 weeks, 6, 12 and 24 months after operation. Analysis was done according to the manual for each instrument. Results: Of 617 patients in hospitals participating in the HRQL study of COLOR II, 385 were included. The HRQL deteriorated to moderate/severe degrees after surgery, gradually returning to preoperative values over time. Changes in EORTC QLQ-C30 and QLQ-CR38, and EQ-5D were not significantly different between the groups regarding global health score or any of the dimensions or symptoms at 4 weeks, 6 or 12 months after surgery. In contrast to previous studies in patients with colonic cancer, HRQL after rectal cancer surgery was not affected by surgical approach. Registration number: NCT0029779 ().

2025, Dr. R K Mishra

Obesity has become a major health problem in the last few
decades. Obesity is the most prevalent chronic disease of
the 21st century. The World Health Organization (WHO) has
identified obesity as one of the five leading health risks in
developed countries. WHO has reported that over a billion
people are overweight and that 300 million are clinically
obese with a projection of 3 million deaths annually
worldwide.

The radial nerve block is a highly specialized regional anesthesia technique that provides targeted anesthesia and analgesia to the dorsoradial aspect of the hand, encompassing the dorsal surfaces of the thumb, index, middle, and radial half of the ring finger. Rooted in a thorough understanding of brachial plexus anatomy and radial nerve physiology, this block has become an indispensable tool for surgical, diagnostic, and analgesic purposes. The procedure holds clinical significance in diverse scenarios ranging from management of traumatic injuries and surgical interventions of the upper limb to diagnostic evaluation of radial neuropathies and post-operative analgesia. Ultrasound-guided approaches have greatly refined its safety and efficacy, enabling precise localization, minimizing complications, and reducing anesthetic volume requirements. Indications extend beyond elective hand and forearm surgeries to include management of acute painful conditions such as burns, fractures, and lacerations, as well as the treatment of refractory neuropathic pain syndromes like radial tunnel syndrome and lateral epicondylalgia. Contraindications, while limited, require vigilant assessment to avoid systemic toxicity, infection, or neurovascular injury. Equipment and personnel requirements emphasize aseptic ultrasound-guided practice, highlighting the role of trained anesthesiologists and support staff in optimizing outcomes. Despite its relative simplicity, the block carries potential risks, including neuropraxia, hematoma formation, systemic toxicity, and myotoxicity. When weighed against systemic analgesia or procedural sedation, however, the radial nerve block offers substantial advantages, particularly within the framework of multimodal, opioid-sparing pain management strategies. This review explores the anatomical and physiological foundations, technical approaches, clinical indications, contraindications, complications, and broader healthcare implications of the radial nerve block, situating it as an essential element in contemporary anesthetic practice.

2025, Dr. R K Mishra

Appendicitis was first recognized as a disease entity in the 16th century and was called perityphlitis. McBurney first described its clinical findings in 1889. Laparoscopic appendectomy in expert hands is now quite safe and effective and... more

Appendicitis was first recognized as a disease entity in
the 16th century and was called perityphlitis. McBurney
first described its clinical findings in 1889. Laparoscopic
appendectomy in expert hands is now quite safe and
effective and considered as an excellent alternative for
patients with acute appendicitis.

2025, Revista Latinoamericana de la Papa Vol. 29, No. 1, 2025

Patients with Parkinson's disease present unique challenges in the perioperative setting due to their neurodegenerative condition, which can affect motor function and autonomic control. This case report describes the management of a 75-year-old hypertensive male with Parkinson's disease who was admitted with altered consciousness, suspected sepsis, and a ruptured septic gallbladder requiring urgent laparoscopic cholecystectomy and umbilical hernia repair. The patient was treated with combined segmental spinal epidural anesthesia, allowing for anaesthesia and effective pain control while minimizing hemodynamic and airway risks associated with general anesthesia. Initial resuscitation included non-invasive ventilation and low-dose noradrenaline support to stabilize blood pressure and oxygen saturation. The anesthesia plan prioritized regional techniques, which facilitated a smooth intraoperative course and maintained the patient's hemodynamic stability. Postoperatively, the patient required intravenous fluids and antibiotics, and by day two, noradrenaline support was discontinued. The epidural catheter was removed on day three, with the patient showing steady recovery progress. The continued use of antiparkinsonian medications throughout the perioperative period further contributed to favorable outcomes. After eight days in the hospital, the patient was discharged in stable condition. This case underscores the potential benefits of using segmental spinal anesthesia in high-risk surgical scenarios, particularly for elderly patients with complex medical histories. It supports existing literature that advocates for regional anesthesia as a viable alternative to general anesthesia in similar cases, warranting further studies to validate these findings in diverse patient populations.

2025

Activity Based Costing (ABC) techniques are designed to support advanced cost analysis in different organizations. Centred on organization activities and processes, it provides more accurate cost information on cost objects using appropriate cost drivers and constitutes a powerful costing model to improve efficiency and effectiveness in delivering products and services. ABC can be successfully appl ied also in Health Care organizations, where the patient is the main “object” of the activities performed. In addition, in can be fruitfully used ...

2025, CardioVascular and Interventional Radiology

Purpose It is known that thermal liver ablation can induce liver hypertrophy. However, exact impact in liver volume remains unclear. The aim of this study is to assess the influence of radiofrequency or microwave ablation (RFA/ MWA) on liver volume in patients with primary and secondary liver lesions. Findings can be relevant in assessing the potential extra benefit of thermal liver ablation in preoperatively performed liver hypertrophy inducing procedures, such as portal vein embolization (PVE). Methods Between January 2014-May 2022, 69 invasive treatment naı ¨ve patients with primary (n = 43) or secondary/metastatic (n = 26) liver lesions (in all segments, except in segments II/III) treated percutaneously by RFA/ MWA were included. Total liver volume (TLV), segment II ? III volume (serving as ''distant liver volume''), ablation zone volume and absolute liver volume (ALV, Robrecht R. M. M. Knapen and Remon Korenblik have contributed equally.

2025, HPB

The objective of this study was to compare the results of laparoscopic hepatectomy with those of open hepatectomy for colorectal cancer liver metastases (CCLM) using a propensity score matching (PSM) in two university hospital settings. A patient in the laparoscopic surgery group (LA) was randomly matched with another patient in the open approach group (OA) using a 1:1 allocated ratio with the nearest estimated propensity score. Patients of the LA group without matches were excluded. Matching criteria included age, gender, body mass index (BMI), American society anesthesiologists score, potential co-morbidities, hepatopathies, synchronous or metachronous lesions, size and number of CCLM, preoperative chemotherapy, minor or major liver resections. Intraoperative, postoperative data, and survival were compared in both groups. Results: From January 2012 to January 2015, a total of 242 hepatectomies were consecutively performed, of which 119 for CCLM, namely 101 in the OA group (84.9%) and 18 in the LA group (15.1%). The mortality rate was 1% in the OA group and 0% in the LA group. Prior to propensity score matching, there was a statistically significant difference favorable to the LA group regarding operative time, blood loss, length of hospital stay and the rate of medical complications. After propensity score matching, there was no difference regarding operative time or length of hospital stay. Conclusions: Laparoscopic liver resections for CCLM seem to yield short-and long-term results, which are similar to open hepatectomies, and could well be considered an alternative to open surgery and become the gold standard in carefully selected patients.

2025, World Journal of Laparoscopic Surgery with DVD

We present a case report of common bile duct injury which occurred in a patient who underwent laparoscopic cholecystectomy for cholecystitis and cholelithiasis. The patient died within 96 hours of the surgery. The case was investigated by the police as the relations of the victim alleged death due to negligence on the part of treating doctors. The clinical details, autopsy findings, report of histopathological examination and medicolegal aspects are discussed along with relevant literature.

2025, Canadian Journal of Anesthesia/Journal canadien d'anesthésie

2025, Ain-Shams Journal of Anesthesiology

Background Mechanical ventilation causes diaphragmatic atrophy and reduces diaphragmatic efficiency. Patients with diaphragmatic dysfunction have longer mechanical ventilation durations and intensive care unit stay. There is currently a scarcity of data on the effect of different modes of mechanical ventilation on diaphragmatic function and ultrasound-guided assessment of diaphragmatic efficiency. Results Sixty mechanically ventilated patients were randomly divided into four equal groups (15 each): patients were ventilated using either assist control pressure-controlled mode (group A), synchronized intermittent mandatory ventilation pressure-controlled mode (group S), bi-level-positive airway pressure mode (group B) or pressure support ventilation mode (group P). The primary outcome was to assess the diaphragmatic excursion, while the secondary outcomes were to assess the diaphragmatic thickness fraction and the duration of the ICU stay. Patients in the P group had the highest diaph...

2025, Surgical Endoscopy

Background The impact of the position of the middle colic artery (MCA) bifurcation and the trajectory of the accessory MCA (aMCA) on adequate lymphadenectomy when operating colon cancer have as of yet not been described and/or analysed in the literature. The aim of this study was to determine the MCA bifurcation position to anatomical landmarks and to assess the trajectory of aMCA. Methods The colonic vascular anatomy was manually reconstructed in 3D from high-resolution CT datasets using Osirix MD and 3-matic Medical and analysed. CT datasets were exported as STL files and supplemented with 3D printed models when required. Results Thirty-two datasets were analysed. The MCA bifurcation was left to the superior mesenteric vein (SMV) in 4 (12.1%), in front of SMV in 17 (53.1%) and right to SMV in 11 (34.4%) models. Median distances from the MCA origin to bifurcation were 3.21 (1.18–15.60) cm. A longer MCA bifurcated over or right to SMV, while a shorter bifurcated left to SMV (r = 0.4...