Showing 13 results for Laparoscopy
R Behdani ,
Volume 58, Issue 1 (4-2000)
Abstract
Over a period of 4 years 325 infertile women were evaluated by diagnostic by laparoscopy, which included 250 cases of primary and 75 cases of secondary infertility. The aim of the present study was to find out the probable causes of infertility by collecting qualitative and quantitative data from laparoscopy results of the secondary infertility group so as to give precautions for decreasing the predisposing factors. The results of this study showed that pelvic adhesion was the most frequent pathologic findings (57 cases), which could be due to complication of PID or surgical trauma. 14 cases had other problems and only 4 cases showed no apparent pathological anomalies.
Peyvandi H, Talebpoor M, Begam Orang Z, Ahmadi Amoli H, Motalebi N, Hallaj Mofrad H.r, Molavi B, Asheri H,
Volume 64, Issue 9 (9-2006)
Abstract
Background: Performing traditional autopsy mostly seems to be unpleasant in dead persons' relatives' opinion. This study aimed to determine the accuracy of laparoscopic examination of intra abdominal organs in comparison to the traditional autopsy in trauma victims.
Methods: From December 2004 to September 2005, 50 fresh cadavers of blunt trauma victims were studied in less than 24 hours from death time. Intraperitoneal and retroperitoneal organs were first evaluated by laparoscope and then the traditional autopsy was performed as gold standard. The organs were assessed regarding impairment and its grade in both ways. Diagnostic accuracy of laparoscope was determined for each case with 95% confidence interval using Fisher's exact test.
Results: The values of overall and distinct accuracy of laparoscopic examination for intraperitoneal and retroperitoneal organs were significantly comparable with traditional autopsy. The accuracy of laparoscopic evaluation of intraperitoneal and retroperitoneal organs were 90% (95% CI of 81.7% to 94.8%) and 92% (95% CI of 84.7% to 96%) respectively in comparison to open autopsy. The overall accuracy of laparoscopic examination was 84% (95% CI of 74.3% to 90.5%).
Conclusion: The sensitivity and specificity of laparoscopic examination for intraperitoneal but not retroperitoneal organs were acceptable in comparison to open autopsy. Laparoscopic examination seems to be an eligible substitute for the traditional autopsy in assessment of intraperitonel organs.
Talebpour M, Yagoobi A, Zargar M,
Volume 65, Issue 5 (8-2007)
Abstract
Background: Laparoscopic hernioplasty is a standard technique with increasing interest of patients and surgeons. Bilateral hernioplasty can be performed by laparoscopy as well. The aim of this study is to show laparoscopic bilateral hernioplasty is an acceptable method and use of eye-shaped mesh getting the best result.
Methods: In 54 cases with bilateral inguinal hernia, under general anesthesia laparos-copic reconstruction with eye-shaped prolene mesh performed. All cases of recurrent, big, direct, indirect and femoral hernia were entered in the study.
Results: Seven of 54 cases were female. Four cases (male) had direct hernia, four female had femoral hernia and remaining of the study group had indirect form. Direct hernia 4 case (male), femoral hernia 4 (female) and remaining were indirect hernia. Operation performed without any complications in all cases. In 12 cases sac of hernia was too much enlarged so technique of bridge at the base of sac used. In five cases diameter of defect was more than 2 centimeter. In three of them defect repaired by suture before mesh insertion. Postoperative complications were seroma at distal of mesh in 23 cases (absorbed during 3 weeks spontaneously), reaction to mesh in one case (mesh and protack removed after 3 months of operation. Conservative management was ineffective and anterior repair performed), recurrence in one case (after 2 months of operation due to displacement of mesh in big direct hernia). Post operative hospital stay was 1.3 day (mean time). Painless movement and mobilization was obvious after 48 hours.
Conclusion: Laparoscopic bilateral hernioplasty using eye-shaped prolene mesh is an acceptable method with good results especially in indirect hernia. In direct hernia, repair of defect by suturing and fixation of mesh is preferred.
Dorostan N, Askarpour Sh, Askaree M, Paziar F, Hoseinikhah H,
Volume 66, Issue 2 (5-2008)
Abstract
Background: Acute appendicitis is one of the most common abdominal emergencies. Many studies comparing the two routes of open and laparoscopic appendectomy have been performed comparing the duration of each operation, duration of hospitalization, amount of post-operative pain medication required and infectious complications were the most commonly evaluated factors.
Methods: This clinical trial study, performed between March 2005 and March 2006 at Golestan and Imam Khomayni hospitals in Ahvaz, Iran, included 100 patients. Open appendectomy and laparoscopic appendectomy were carried out on 50 patients each. Duration of surgery and hospitalization, amount of pain medication and infectious complications were compared, with chi-square, ANOVA and t-test used for statistical analysis.
Results: The average length of hospital stay for laparoscopic appendectomy was 44.48 hours and for open appendectomy was 54.80 hours (p<0.01). The average of amount of pain medication for laparoscopic appendectomy was 2.40 doses and for open appendectomy was 30.46 doses (p<0.01). The laparoscopic and open procedures averaged 31.8 and 35.2 minutes, respectively (p=0.5). Only one (2%) laparoscopic case had infection, while four (8%) open appendectomy subjects suffered from this complication. Patients who underwent laparoscopic appendectomy had no intra-abdominal abscesses.
Conclusions: Duration of hospitalization was statistically much shorter using the laparoscopic appendectomy than that of the open procedure (P<1%). The amount of pain medication administered was also statistically less in the laparoscopic procedure (P<1%). However, the amount of time to complete each procedure was not statistically different. Most importantly, complications such as wound infection and intra-abdominal abscess were remarkably less using laparoscopy. We recommend laparoscopic appendectomy over open appendectomy.
Keshvari A, Jafari- Javid M, Najafi I, Chaman R, Nouri Taromloo Mk,
Volume 66, Issue 7 (10-2008)
Abstract
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Background: Chronic peritoneal dialysis
is a safe method for the treatment of end-stage renal failure. Worldwide,
patients on chronic peritoneal dialysis constititute approximately 15%
of the total number of patients on dialysis. In Iran, very few people have access
to chronic peritoneal dialysis, which is targeted by the Ministry of Health. This
lack of access is primarily due to the high occurrence of mechanical
complications. Improving catheterization procedures is an important way to
extend the use of peritoneal dialysis in Iran. Thus, a prospective study was
implemented to evaluate the outcome of a new laparoscopic technique for the insertion
of peritoneal dialysis catheters under local anesthesia.
Methods: A
total of 115 catheters (two-cuff, swan-necked, coiled) were
inserted into the peritoneal cavity of 109
patients with end-stage chronic renal failure during a 16-month
period. The method of insertion was a two-port laparoscopic technique with
local anesthesia and sedation. All patients were followed for 12
to 28 months. We prospectively evaluated mechanical
and infectious complications and survival rates of the catheters.
Results: The
average age of the patients was 51.5 years (range: 15-84
years) 54.8% of these patients were female. The overall
one-year and two-year catheter survival rates using this approach were 88%
and 73%, respectively. Event-free catheter survival
was 35%. The most common infectious and mechanical
complications were peritonitis in 52
cases (45.2%) and temporary dialysate leakage in 10
cases (8.7%) respectively.
Conclusion: Laparoscopic insertion of
peritoneal dialysis catheter with local anesthesia is a safe and simple
procedure, giving reasonable rates of catheter survival and complications.
Samiee H, Tavoli Z, Ghanbari Z, Poormand Gh, Taslimi Sh, Eslami B, Tavoli A,
Volume 67, Issue 9 (12-2009)
Abstract
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Background: Stress incontinence
is the most common type of urinary incontinence which has been treated by
different surgical techniques. The objectives of our study were to compare the
laparoscopic Burch colposuspension with Trans- obturator Tape (TOT) procedure.
Methods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash
hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT). Patient information was using obtained demographic,
I-QOL (Which contained 22 questions), UDI-6 (urinary symptoms), ISI (Severity of urinary
incontinence) questionnaires and urodynamic test.
Results: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was
determined by no urinary leakage during stress and were analyzed urodynamic evaluation
was 75% in laparoscopic and 84.2% in TOT (p=0.53). Result of ISI questionnaire with showing the subjective cure rate following surgery had
no significant difference between two groups (p=0.23). UDI-6 questionnaire was used to compare the
result of both groups before and after surgery and showed that the improvement
in Urgency was significant in TOT in compare to Burch
(p=0.04). I-QOL score significantly increased in both groups after six months of operation
(p<0.05). But the
differences were not statistically significant.
Conclusion: Based on our results subjective
and objective cure rate were not significantly different between TOT and laparoscopic Burch
colposuspension.
Soltani R, Pazouki A, Shirali A,
Volume 69, Issue 8 (11-2011)
Abstract
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Background: The aim of this study was to compare operating time and short-term
complications of laparoscopic transabdominal preperitoneal hernia repair during
reperitonealization in Trendelenburg versus reverse-Trendelenburg positions.
Methods : Thirty-nine patients with inguinal hernia were enrolled in this clinical
trial. Study was done in Milad and Rasoul Akram hospitals in Tehran, Iran,
during 2008-2010. The patients neither were pregnant nor did they have any signs of
peritonitis, strangulation, perforation or infection. Moreover, they had a Body
Mass Index (BMI) below 35 kg/m2 and were physically fit for general anesthesia. The
participants were divided into two groups by block randomization. The first (20) and the second (19) groups of patients underwent
laparoscopic herniorrhaphy in Trendelenburg and reverse-Trendelenburg positions.
Respectively all the operations were performed by one surgeon. The patients were
visited one day and one week after the surgery.
Results : Most frequent complications were rupture in peritoneal repair in 9 patients (23%), skin site bleeding in one
patient (2.6%), and peritoneal tension in 33 patients (84.6%) patients. Duration of surgery and peritoneal repair took a significantly
longer time in Trendelenburg versus the reverse-Trendelenburg position. There were
no differences in duration for returning to work or resumption of daily activities
between the two groups. Pain in the first day following surgery was
statistically more severe in the Trendelenburg group.
Conclusion: This
study demonstrated that reverse-Trendelenburg position took less time for herniorrhaphy
and peritoneal repair than Trendelenburg position, although the complications
were the same.
Nasrin Moghadami Tabrizi , Khadijeh Adabi , Azra Azmoodeh , Sepideh Nekuei, Babak Dabirashrafi, Kamyar Dabirashrafi, Batool Ghorbani Yekta,
Volume 71, Issue 4 (7-2013)
Abstract
Background: Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF (In vitro fertilization) cycle following laparoscopic unilateral cystectomy of endometrioma.
Methods: In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary.
Results: The mean age (±SD) of patients was 32.3 (±3.4). The mean (±SD) diameter of excised ovarian endometrioma was 42.4 (±10.4) mm. Interval since ovarian surgery to induction ovulation was 2.7 (±2.6) years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was 2.5 (±1.2) with the range of 1 to 5 and in the control ovary 3.9 (±1.4) with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one (P<0.001).
Conclusion: Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.
Leila Sadati , Ehsan Golchini , Abdolreza Pazouki , Fatemeh Jesmi , Mohadeseh Pishgahroudsari ,
Volume 72, Issue 4 (7-2014)
Abstract
Background: Nowadays, new methods are emerging each month for a better operation with fewer complications. Laparoscopic surgery have remarkable advantages, Compared to open, such as smaller incision, less manipulation of the digestive system, less postoperative pain, fewer wound complication and faster discharge from the hospital. Therefore it is preferred by patients and surgeons and is replacing the traditional open surgical methods. However, any operation causes significant panic for patients and lack of knowledge about the surgical method is found to cause poor surgical outcomes, such as recovery time after the surgery we evaluated the effect of preoperative education on the recovery time of laparoscopic cholecystectomy candidates.
Methods: This randomized clinical control trial was performed at Imam Khomeini and Alborz Hospitals in Karaj from February 2010 till January 2011. Using randomized sampling method, 100 female candidates for laparoscopic cholecystectomy were divided into two equal groups of case and control. The case group received detailed information about operating room’s condition, surgical equipment, anesthesia method, advantages and disadvantages of laparoscopic procedures, and patient’s role in self-care at recovery, whilst the control group received no education before the surgery. The two groups were compared regarding recovery time based on Aldrete modified checklist and mean time to reach the Aldrete consciousness score of 9 and the incidence of nausea was assessed among them.
Results: The analysis showed that there was a significant difference between the mean time to reach Aldrete consciousness modified checklist score of 9 between the case and control group (18.04±3.87 vs. 29.66±5.44, respectively, P<0.001), therefore the case group had shorter recovery time than the control group. 10 of the case group (20%) and 3 of the control group (6%) had nausea after recovery (P=0.037, OR=0.255 (CI 95%: 0.066-0.992)).
Conclusion: Preoperative education of patients can significantly decrease the recovery time after laparoscopic cholecystectomy surgery. Therefore, it is strongly recommended to include the preoperative education in routine care of laparoscopic cholecystectomy patients for better surgical outcomes.
Shahram Seyfi, Ali Zahedian , Farshad Hasanzadeh Kiabi,
Volume 75, Issue 2 (5-2017)
Abstract
Background: Postoperative pain is one of the most common complications following laparoscopic cholecystectomy. Because the majority of the analgesic drugs including opioids and nonsteroidal anti-inflammatory drugs have many side effects, using drugs with lesser side effects is beneficial. The aim of this study was to evaluate the effect of N-acetylcysteine on the pain after laparoscopic cholecystectomy.
Methods: In a randomized clinical trial, in two university-affiliated teaching hospitals in Babol City (Shahid Beheshti and Shahid Yahyanezhad Hospitals), Iran, from August 2015 to March 2015, a total number of 38 patients with age of 20-50 years, who were candidates for laparoscopic cholecystectomy with American Society of Anesthesiologists Class-I were chosen and randomly assigned into two groups. The night before operation, 1200 mg oral N-acetylcysteine is given to intervention group. Also, they received 600 mg IV N-acetylcysteine in the morning before operation. In the control group, two vitamin C effervescent tablets as placebo were given at night before operation and 3 ml sterile water as placebo was injected in the morning of operation. Amount of pethidine consumption and the changes in hemodynamic in two groups was recorded and analyzed at 24 hours after operation.
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Results: The average of patients age was not significant different between two groups (P=0.23). Average of pain score in placebo group was 3.5 and in N-acetylcysteine group was 2.7 that it was not significant difference between two groups (P=0.06). Average of pethidine consumption in placebo group was 52 mg and in N-acetylcysteine group was 29 mg in 24 hours, that the difference was statistically significant between two groups (P=0.01)
Conclusion: As the results of the study, it can be concluded that the anti-inflammatory effects N- acetylcysteine can inhibit the function of lipoproteins and prostaglandins, reduced glutathione peroxidase and dismutase has been restored and can be used to treat pain or analgesic dose reduction. In this study the N-acetylcysteine has reduced pain after laparoscopy and analgesic dose of mepridine.
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Alireza Sarmadi, Ahmad Kachoei, Mostafa Vahedian, Enayatollah Noori , Mojdeh Bahadorzadeh, Amrollah Salimi , Mohammad Hossein Assi,
Volume 79, Issue 9 (12-2021)
Abstract
Background: Cholecystectomy is one of the most common abdominal surgeries and its preferred method is laparoscopy. The difficulty of laparoscopic cholecystectomy in diabetic patients is not clear and the preferred method of cholecystectomy in these patients is still under controversy. Therefore, this study was performed to evaluate the difficulty of laparoscopic cholecystectomy in diabetic and non-diabetic patients.
Methods: This retrospective analytical study was performed in Shahid Beheshti Hospital and Forghani Educational and Medical Center from April 2019 to April 2020. Samples were easily selected and 86 people in two groups of diabetic and non-diabetic patients were included in the study. All patient records were reviewed based on inclusion and exclusion criteria for factors such as age, sex, diet, duration of surgery, bleeding, adhesions, and open surgery, and finally, diabetes as a risk factor. It was compared between the two groups. Data were analyzed in SPSS software version 22, an independent t-test was used to analyze quantitative data and the chi-square test was used to analyze qualitative data. In this study, a significance level of less than 0.05 was considered.
Results: Abdominal scar, palpable gallbladder and gallstone were not significantly different between the two groups (P=0.33). But the history of cholecystectomy attacks was significantly different between the two groups (P<0.05). Laboratory values were not significant (P>0.05) . Hard operations in diabetic patients were more than nondiabetic
patients and even two cases of open surgery were seen in the group of diabetic
patients, but there was no significant relationship (P=0.09). Intraoperative bleeding was
statistically significant between the two groups (P=0.02), But adhesion during the
operation was not related (P=0.38).
Conclusion: Finally, our study showed that diabetes can be a predictive risk factor for the difficulty of cholecystectomy.
Hamidreza Shetabi, Behzad Nazemroaya , Mohsen Abron ,
Volume 80, Issue 11 (2-2023)
Abstract
Background: In this study, the effect of intravenous dexamethasone on pain, nausea and vomiting after laparoscopic ovarian surgery was investigated.
Methods: This randomized clinical trial was conducted from June 2019 to March 2019 on patients undergoing laparoscopic ovarian cystectomy in Beheshti Hospital, Isfahan. In this study, 88 patients aged 18 to 45 years were included in the study. Patients were randomly divided into two groups receiving dexamethasone (D) and normal saline (S). Two minutes before induction of anesthesia, the first group received 8 mg (2 ml) of dexamethasone and the second group received normal saline (2 ml). The duration of surgery and stay in recovery, the frequency of pain and nausea and vomiting, the need for analgesic and anti-nausea drugs, and the cardiovascular response during the study were evaluated and recorded.
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Results: No significant difference was seen in terms of demographic characteristics between the two groups (P>0.05). The frequency of pain during recovery (P=0.4) was not significantly different between the two groups, but at 2 hours (P=0.005), 12 hours (P<0.001) and 24 hours after the operation (P=0.005) (P=0) was significantly lower than S group. The frequency of nausea in group D during recovery (P=0.003), 2 hours later (P<0.001), and 12 hours (P=0.002) was significantly lower than group S, but 24 hours after the surgery, there was no significant difference between the two groups (P=0.15). During recovery, there was no vomiting in both groups (P=1), the frequency of vomiting in 2 hours (P=0.003), 12 hours (P<0.002) and 24 hours after the operation (P=0.48) in group D was lower than S. At the time of the study, the dose of diclofenac and metoclopramide received in group D patients was lower than group S. There was no significant difference in cardiovascular response between the two groups during the study (P>0.05).
Conclusion: Dexamethasone with a dose of 8 mg before induction of anesthesia can be effective in reducing pain, nausea and vomiting after laparoscopic ovarian surgery and reducing the need for analgesics and anti-nausea drugs.
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Yasamin Kaheni, Ali Mirsadeghi, Mohammad Ali Raisolsadat , Mohammad Javad Ghamari , Mohammad Barhemmat , Tooraj Zandbaf,
Volume 81, Issue 4 (7-2023)
Abstract
Background: Due to the prevalence of laparoscopic cholecystectomy, controlling common problems after this surgery is essential. This study aimed to determine the factors affecting pain after laparoscopic cholecystectomy.
Methods: In this cross-sectional study, 222 patients over 18 years old with symptomatic gallstones who underwent laparoscopic cholecystectomy from March 2021 to February 2022 in Mashhad Medical Sciences of Islamic Azad University Hospitals, were included. The amount of analgesic received after surgery was the same for all patients (Acetaminophen 1 gram intravenously every 8 hours and diclofenac 100 mg rectal every 8 hours). Demographic information of patients, body mass index, history of abdominal surgery, duration of surgery, carbon dioxide pressure, type of surgery (elective or emergency), number of surgical incisions, and pain intensity six and 24 hours after surgery (using a visual analog scale) were collected, and finally, the findings were statistically analyzed by SPSS version 26.
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Results: Out of 222 patients, 179 cases were women (80.6%), and their average age and body mass index were 44.68±12.27 years and 27.08±4.7 kg/m2, respectively. In our study, 110 people (49.5%) had a history of abdominal surgery, of which cesarean section was the most common delete. Pain six and 24 hours after the operation was more common in women than in men, and surgery with three incisions was more painful than surgery with four incisions (P<0.05). In patients with a history of surgery, the pain was greater in six hours after surgery (P<0.05). Pain 24 hours after the operation in patients with gas pressure less than or equal to 14mmHg was greater than in patients with gas pressure greater than 14 mmHg (P<0.05). Pain six and 24 hours after surgery according to age, body mass index, type of surgery (emergency or elective), and duration of surgery had no statistically significant difference (P>0.05).
Conclusion: In our study, female gender, use of three incisions for surgery, and history of previous surgery were associated with more pain after laparoscopic cholecystectomy.
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