The authors describe and discuss a new method of minimally invasive surgery--hand-assisted laparoscopic surgery. For the analysis they used recent data from the literature and their own experience. The main advantage is greater safety, better diagnosis by palpation and better preparation in the abdominal cavity. The main disadvantage is the cost of the method.

• MeSH
• laparoskopie metody   MeSH
• laparoskopy MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Single incision laparoscopic surgery (SILS) is a common alternative to classical laparoscopic surgery. However, material costs of SILS significantly limit the spreading of this method to most of surgical departments in the Czech Republic. Therefore we introduced DILS, which is technically more difficult than 3- to 4-incision laparoscopy but comparable cost-wise and its result approaches the cosmetic effect of SILS. METHODS: We describe the technical approach for DILS. We evaluate our own group of patients who were operated on in 2012-2014. RESULTS: Nine minor complications evaluated as Clavien-Dindo grade I-IIIb were seen in the group of 64 patients undergoing laparoscopic cholecystectomy, appendectomy or TAPP operation of groin hernias using DILS method. DILS-cholecystectomy was converted to multiple-ports laparoscopy 4 times. CONCLUSION: In our group, DILS did not present a higher complication rate than laparoscopic surgery using multiple incisions. This method is well-regarded by the patients in terms of its aesthetic results, and economically it is more advantageous than SILS. KEY WORDS: minimally invasive surgery - SILS - double incision laparoscopic surgery.

• MeSH
• apendektomie metody   MeSH
• chirurgická rána MeSH
• cholecystektomie laparoskopická metody   MeSH
• estetika MeSH
• fyzický vzhled těla MeSH
• inguinální hernie chirurgie   MeSH
• laparoskopie metody   MeSH
• lidé MeSH
• operace kýly metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

The author describes new laparoscopic instruments for blunt dissection of tissue, that also make an abdominal wall suture more simple. The instruments are very simple from the technical point of view. They can be manufactured even under very basic conditions. By using these instruments it is possible to spare more advanced and expensive standard laparoscopic instruments as well. They make it possible for the accurate and sensitive tissue dissection. Forestalling thus an injury to biliary duct, the worse complication in laparoscopic operations, to occur. The instrument has been regularly used in clinical practice and proved good.

• MeSH
• laparoskopy * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• gynekologie přístrojové vybavení   MeSH
• laparoskopy * MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Laparoscopy is one of the diagnostic tools available for the complex clinical decision-making process in advanced ovarian, fallopian tube, and peritoneal carcinoma. This article presents the results of a survey conducted within the European Network of Gynaecological Oncology Trial (ENGOT) group aimed at reviewing the current patterns of practice at gynecologic oncology centers with regard to the evaluation of resection in advanced ovarian, fallopian tube, and peritoneal carcinoma. METHODS: A 24-item questionnaire was sent to the chair of the 20 cooperative groups that are currently part of the ENGOT group, and forwarded to the members within each group. RESULTS: A total of 142 questionnaires were returned. Only 39 respondents (27.5%) reported using some form of clinical (not operative) score for the evaluation of resection. The frequency of use of diagnostic laparoscopy to assess disease status and feasibility of resection was as follows: never, 21 centers (15%); only in select cases, 83 centers (58.5%); and routinely, 36 centers (25.4%). When laparoscopy was performed, 64% of users declared they made the decision to proceed with maximal effort cytoreductive surgery based on their personal/staff opinion, and 36% based on a laparoscopic score. To the question of whether laparoscopy should be considered the gold standard in the evaluation of resection, 71 respondents (50%) answered no, 66 respondents (46.5%) answered yes, whereas 5 respondents (3.5%) did not provide an answer. CONCLUSIONS: This study found that laparoscopy was routinely performed to assess feasibility of cytoreduction in only 25.4% of centers in Europe. However, it was commonly used to select patients and in a minority of centers it was never used . When laparoscopy was adopted, the treatment strategy was based on laparoscopic scores only in a minority of centers.

• Klíčová slova
• fallopian tube neoplasms, laparoscopes, ovarian neoplasms, peritoneal neoplasms, surgical procedures, operative,
• MeSH
• chirurgická onkologie statistika a číselné údaje   MeSH
• cytoredukční chirurgie * MeSH
• gynekologie statistika a číselné údaje   MeSH
• laparoskopie statistika a číselné údaje   MeSH
• lidé MeSH
• nádory vaječníků diagnóza   chirurgie   MeSH
• nádory vejcovodů diagnóza   chirurgie   MeSH
• peritoneální nádory diagnóza   chirurgie   MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

• MeSH
• bezpečnost vybavení MeSH
• design vybavení MeSH
• hepatektomie přístrojové vybavení   metody   MeSH
• katetrizační ablace přístrojové vybavení   metody   MeSH
• krvácení při operaci prevence a kontrola   MeSH
• laparoskopie přístrojové vybavení   metody   MeSH
• laparoskopy * MeSH
• prasata MeSH
• senzitivita a specificita MeSH
• techniky in vitro MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• dopisy MeSH

The results assembled in a group of 260 patients subjected to laparoscopic cholecystectomy without i.v. cholangiography (0.38% residual stones, entirely successful perioperative endoscopic treatment, no biliary lesion) confirm that a low incidence of residual cholelithiasis, elimination of revision on account of concrements in the bile duct and absence of biliary lesions can be achieved without obligatory preoperative cholangiography even in a non-selected clinical group. When therapeutic "splitting" is used, peroperative selective cholangiography is not necessary.

• MeSH
• cholangiografie * MeSH
• cholecystektomie laparoskopická * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

UNLABELLED: Total laparoscopic hysterectomy (TLH) could be performed in the place of either Total abdominal hysterectomy or Vaginal hysterectomy, thus, there are not any special indications for this procedure. In recent times there has been developed a specially designed uterine manipulator which renders this procedure safe. This manipulator eliminates the necessity of ureteral dissection and also the necessity of incising through the uterosacral ligaments. This last aspect also causes an improvement in support of the vaginal vault. Hysterectomy of this type enables the surgeon to continue laparoscopically in the correction of the enterocoele by means of Moschowitz-McCall culdoplasty. OBJECTIVE: To evaluate indications, results and complications of 27 Total laparoscopic hysterectomies performed from 1/97-6/98. DESIGN: Prospective study. METHODS: 27 patients have undergone TLH (type IV of hysterectomy according to Clermont Ferrand classification). For the surgery a KOH manipulator (RUMI) was used. A pneumooccluder was used in order to prevent the loss of pneumoperitoneum. The most often encountered indications were menorrhagia, cervical dysplasia and fibroid uterus. An additional indication in some of the patients was the presence of enterocoele. Mean age was 42.5 years (35-52). RESULTS: Mean operating time was 92 min. +/- SD. Mean uterine weight 154 g +/- 25 SD. Mean blood loss 140 ml. No complications were noted. Mean length of hospitalization was 3.6 days. CONCLUSIONS: According their early experience the authors are convinced that it is safely possible for a gynaecological surgeon to ad TLH to his surgical armamentarium on condition that, he is well familiar with the performance of laparoscopically assisted vaginal hysterectomy. The early results with TLH are encouraging.

• MeSH
• dospělí MeSH
• hysterektomie * škodlivé účinky   přístrojové vybavení   MeSH
• laparoskopie * škodlivé účinky   MeSH
• laparoskopy MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• gynekologická onemocnění diagnóza   MeSH
• laparoskopie metody   MeSH
• laparoskopy MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• laparoskopy * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH