Insulinomas are the most common functioning endocrine tumors of the pancreas. Most of them are well-differentiated tumors, with benign or uncertain behavior at the time of diagnosis. Surgery is considered to be the only curative treatment modality. We present the first case report of a 75-year-old woman with functioning insulinoma of the pancreatic body, which was destroyed by laparoscopic-assisted radiofrequency ablation. Hypoglycemic paroxysms disappeared immediately after surgery. The postoperative course was uneventful. The patient was discharged on the eighth postoperative day. There was a new onset of diabetes mellitus, without any further hypoglycemic paroxysm from surgery to the present-4 months. Laparoscopic-assisted radiofrequency ablation is shown to be a feasible and safe method for the treatment of functioning pancreatic insulinoma.
- MeSH
- diferenciální diagnóza MeSH
- inzulinom diagnóza chirurgie MeSH
- katetrizační ablace metody MeSH
- laparoskopie metody MeSH
- lidé MeSH
- nádory slinivky břišní diagnóza chirurgie MeSH
- pankreatektomie metody MeSH
- počítačová rentgenová tomografie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- audiovizuální média MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
The major postoperative complication after open and laparoscopic distal pancreatectomy is pancreatic fistula. Different operative techniques have been tested to minimize this unpleasant complication. We evaluated a new technique for pancreatic stump reinforcement with synthetic glue after laparoscopic distal pancreatectomy. Ten female domestic pigs were divided into 2 groups; in group A (n=5), the pancreas was transected using an EndoGIA stapler, whereas in group B (n=5), the pancreas was transected using a Ligasure device and the pancreatic stump was reinforced with a hydrogel sealant. The clinical postoperative course was uneventful in all the cases. No differences were observed in pancreatic remnant healing between the groups, and only minor microscopic alterations of the healing process were found in the groups. The technique using Ligasure transection reinforced by the hydrogel sealant seems to be comparable with the standard transection technique using the stapler.
- MeSH
- chirurgické staplery MeSH
- hojení ran fyziologie MeSH
- laparoskopie MeSH
- ligace MeSH
- pankreas fyziologie chirurgie MeSH
- pankreatektomie metody MeSH
- PEG-DMA hydrogel terapeutické užití MeSH
- prasata MeSH
- zvířata MeSH
- Check Tag
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
The authors describe their technique of laparoscopic right hepatectomy as a short video clip (supplementary video http://links.lww.com/SLE/A4). This approach is based on a detailed anatomic dissection and interruption of hilar structures and hepatic vein before liver transection.
- MeSH
- audiovizuální záznam MeSH
- cholecystektomie MeSH
- hemostáza MeSH
- hepatektomie přístrojové vybavení metody MeSH
- játra chirurgie MeSH
- krvácení při operaci prevence a kontrola MeSH
- laparoskopie MeSH
- lidé MeSH
- peroperační doba MeSH
- ultrasonografie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: The aim of the study was to show the diagnostic potential of laparoscopy using fluorescein dye and ultraviolet light in acute bowel ischemia. MATERIALS AND METHODS: The study involved 12 domestic pigs. Under general anesthesia, the peripheral branch of the superior mesenteric artery was embolized using polyvinyl-alcohol microparticles. Two hours after the embolization, optical filters were placed into the laparoscopic set to produce ultraviolet light. Fluorescein dye was given intravenously, and the bowel was inspected. Clips were placed on the border of the ischemia that was visualized with fluorescein. Resection of the ischemic part of the bowel and anastomosis of the viable parts were carried out using laparoscopic linear cutting staplers. After 24 hours, a laparoscopic second-look procedure was carried out to verify the viability of the anastomosis. RESULTS: The method was in all cases able to recognize intestinal ischemia and reliably differentiate ischemic bowel segments from viable bowel. Microscopic analysis of the ischemic specimens showed beginning ischemic changes of the bowel tissues. CONCLUSIONS: The method should be considered a valuable diagnostic procedure both for diagnostics of early stage of acute bowel ischemia and for second-look procedures.
- MeSH
- arteria mesenterica superior radiografie MeSH
- financování organizované MeSH
- fluorescein diagnostické užití MeSH
- fluorescenční barviva diagnostické užití MeSH
- ischemie diagnóza MeSH
- laparoskopie MeSH
- modely nemocí na zvířatech MeSH
- střeva krevní zásobení MeSH
- terapeutická embolizace MeSH
- zvířata MeSH
- Check Tag
- ženské pohlaví MeSH
- zvířata MeSH
We present a case of a 54-year-old woman who underwent a successful partial laparoscopic resection of a secondary inflamed esophageal duplication cyst localized in the lower posterior mediastinum. Laparoscopic approach was used for the surgical treatment of the intrathoracic esophageal duplication cyst for the first time. The standard surgical treatment uses thoracotomy or thoracoscopy, but the localization of the cyst in the lower mediastinum enables also the laparoscopic approach as it is demonstrated. Moreover, laparoscopy minimizes the risk of postoperative inflammatory complications in the pleural cavity especially after the surgery of secondary inflamed cysts.
