Feasibility, safety and short-term efficacy of laparoscopic surgery in the treatment of early stage cervical cancer and in the treatment of early stage cervical cancer and endometrial carcinoma
Hysterectomy is one of the most common surgical procedures performed in the United States, with more than 600,000 completed annually [1]. This procedure may be performed transabdominally (by open or laparoscopic technique), or transvaginally, with the open abdominal route considered to be the most invasive and most morbid. The laparoscopic approach is associated with shorter hospital stay, decreased wound morbidity, and less pain [2, 3]. Despite this fact, still around 65–70% of hysterectomies are performed through an abdominal incision [1]. Our study aimed to compare operative outcomes of the minimally invasive interventions of robot-assisted total laparoscopic hysterectomy (RLH) to straight stick total laparoscopic hysterectomy (TLH) at 2 community hospitals.
Objective. To evaluate the safety and efficacy of Keyless Abdominal Rope-Lifting Surgery (KARS), for tubal sterilization procedures in comparison with the conventional CO2 laparoscopy. Material and Methods. During a one-year period, 71 women underwent tubal ligation surgery. Conventional laparoscopy () and KARS () were used for tubal sterilization. In KARS, an abdominal access pathway through a single intra-abdominal incision was used to place transabdominal sutures that elevated the abdominal wall, and the operations were performed through the intraumbilical entry without the use of trocars. In CO2 laparoscopy, following the creation of the CO2 pneumoperitoneum a 10 mm trocar and two 5 mm trocars were introduced into the abdominal cavity. Tubal sterilizations were performed following the creation of the abdominal access pathways in both groups. The groups were compared with each other. Results. All operations could be performed by KARS without conversion to CO2 laparoscopy or laparotomy. The mean operative time of the two groups was not significantly different (). Intra- and postoperative findings including complications, bleeding, and hospital stay time did not differ between groups (). Conclusion. KARS for tubal sterilization seems safe and effective in terms of cosmesis, postoperative pain, and early hospital discharge.
Introduction. Single-access laparoscopic surgery (SALS) has been successfully introduced for colectomy surgery; however, for mid to low rectum procedures such as total mesorectal excision, it can be technically complicated. In this study, we introduced a single-access technique for rectum cancer operations without the use of other instruments. Aims. To show the short-term results of single-access laparoscopic rectal surgery in terms of pathologic results and immediate complications. Settings and Design. Prospective study. Materials and Methods. We selected middle rectum to anal canal cancer patients to undergo single-access laparoscopic rectal resection for rectal cancer. All patients had total mesorectal excisions. An umbilical incision was made for the insertion of a single multichannel port, and a mesocolic window was created to identify the inferior mesenteric artery and vein. Total mesorectal excision was performed. There were no perioperative complications. The mean operative time was 269 minutes; the median hospital stay was 7 days; the mean wound size was 5.5 cm; the median number of harvested lymph nodes was 15; and all patients had intact mesorectal capsules. Statistical Analysis Used. Mean, minimum–maximum. Conclusion. Single-access laparoscopic surgery for rectal cancer is feasible while oncologic principles and patient safety are maintained.
