Journal of Laparoendoscopic & Advanced Surgical Techniques 

About: Journal of Laparoendoscopic & Advanced Surgical Techniques is an academic journal. The journal publishes majorly in the area(s): Laparoscopic surgery & Laparoscopy. It has an ISSN identifier of 1092-6429. Over the lifetime, 4068 publications have been published receiving 53691 citations.

Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus.

Abstract: Laparoscopic cholecystectomy has become the gold standard in the care of patients with cholelithiasis. A standard laparoscopic cholecystectomy employs three trocar incisions outside the umbilicus, which are a source of potential wound complications and an undesirable cosmetic outcome. We describe here a modification of the laparoscopic cholecystectomy which utilizes two transumbilical trocars and two transabdominal gallbladder stay sutures and does not require abdominal wall incisions outside the umbilicus. When technically feasible, this technique results in superior cosmesis and may reduce postoperative wound complications.

Robots in Laparoscopic Surgery

Abstract: Background: The Da Vinci Robotic System became available at our institution in late August 2000. We decided to utilize this system to perform advanced laparoscopic procedures. Methods: This is a review of the status of robotics and its application in surgery. We report our experience using the Da Vinci system. Results: We have used the Da Vinci for 34 advanced laparoscopic cases: 7 gastric bypasses for morbid obesity, 9 Heller myotomies for achalasia, 11 donor nephrectomies, 2 gastrojejunostomies, and single cases of bilateral adrenalectomy, Nissen fundoplication, Toupet fundoplication, and cholecystectomy. No robot-related complications were noted. Conclusions: This early experience suggests that robotic surgery is a safe and effective alternative to conventional laparoscopic surgery. We believe that robotic surgery, with its ability to restore the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, will allow us to perform complex procedures with greater precision and confiden...

Laparoscopic Roux-en-Y gastric bypass: technique and 3-year follow-up.

Abstract: Background: The purpose of this study is to evaluate our experience with the laparoscopic gastric bypass. The technique, weight loss data, and complications are described. Methods: 1,500 consecutive patients were evaluated prospectively. All patients met NIH criteria for bariatric surgery. Although there have been modifications with respect to staplers, suture material, and dissection techniques, the basic anatomical construct has remained the same, including performing a completely hand-sewn gastrojejunostomy. Results: There were no anastomotic leaks from the hand-sewn gastrojejunostomy. Operative times now are consistently 60 minutes or less, although the learning curve is quite long. Average hospital stay was 1.5 days. Average excessive weight loss was 69% at one and two years and 62% at three years. Overall complication rate was 14.8%. Perioperative death rate was 0.2%. Conclusions: The laparoscopic gastric bypass is a viable alternative to traditional open techniques. It is as safe and effective and ...

Application of Haptic Feedback to Robotic Surgery

Abstract: Robotic surgical systems have greatly contributed to the advancement of minimally invasive endoscopic surgery. However, current robotic systems do not provide tactile or haptic feedback to the operating surgeon. Under certain circumstances, particularly with the manipulation of delicate tissues and suture materials, this may prove to be a significant irritation. We hypothesize that haptic feedback, in the form of sensory substitution, facilitates the performance of surgical knot tying. This preliminary study describes evidence that visual sensory substitution permits the surgeon to apply more consistent, precise, and greater tensions to fine suture materials without breakage during robot-assisted knot tying.

A brief history of endoscopy, laparoscopy, and laparoscopic surgery

Abstract: The ideas that form the framework for laparoscopic surgery were initially reported over a century ago. However, the introduction of the technique into the field of general surgery has been a relatively recent development. Laparoscopic surgery owes much of its history to the development of endoscopic technique. Early physicians such as the Arabian, Albukasim (936-1013 A.D.), and later in 1805, the Frankfurt-born physician, Phillip Bozzini, were among the first to develop methods to examine body orifices. Throughout the mid 1800's, several scientists attempted to construct endoscope-like instruments. The first effective open-tube endoscope was developed in 1853 by Desormeaux. This instrument was used to examine the urethra and the bladder. In the late 1800's, other physicians including Kussmaul and Nitze refined the original endoscopic models and began utilizing their new tools in their medical practice. Laparoscopy or endoscopically examining the peritoneal cavity was first attempted in 1901 by George Kelling who called this examining procedure "Celioscopy". In the early 1930's, the first reports of laparoscopic interventions for nondiagnostic purposes were published. Initial procedures included lysis of abdominal adhesions and diagnostic biopsies of abdominal organs under direct visualization. Throughout the 1960's and 1970's, laparoscopy became a vital part of gynecological practice. Despite these technological advances, it was not until after 1986, following the development of a video computer chip that allowed the magnification and projection of images onto television screens, that the techniques of laparoscopic surgery truly became integrated into the discipline of general surgery. The first laparoscopic cholecystectomy performed on a human patient was done in 1987 by the French physician Mouret. The rapid acceptance of the technique of laparoscopic surgery by the general population is unparalleled in surgical history. It has changed the field of general surgery more drastically and more rapidly than any other surgical milestone. This paper examines the history behind this exciting surgical technique.