RESEARCH ARTICLE | |
1. | Development of Laparoscopic Surgery in our Clinic for the Last 10 Years Atilla Çelik, Ediz Altınlı, Neşet Köksal, Ömer F. Özkan, Rüştü Kurt Pages 133 - 139 INTRODUCTION: First laparoscopic cholecystectomy was done by a team consisted of our department’s surgeon in Haydarpasa Numune Training and Research Hospital at 1992. The laparoscopic procedures were increased in quantity and variety in the course of time. In this study we aimed to present the development of laparoscopic surgery in our department with quantitative data. METHODS: Records of laparoscopic operations were reviewed and classified in according to operation type from January 1997 to March 2007. Laparoscopic realization of the operation types was calculated. One decade was divided into two five years periods. First and second period was compared with each other. RESULTS: 139 laparoscopic operations were done in first period and 386 operations were done laparoscopically in second five years. Most frequent operation was cholecystectomy and the second was groin hernia repair. Laparoscopic colorectal surgery was started in 2004 and ventral hernia repair wasn’t done in the first 5 years period and was done 10% in second period. Appendectomy, hydatid cyst, band gastroplasty, ooferectomy, gastric wedge resection, perforated ulcer suturing, adrenalectomy, Nissen fundoplication and Heller myotomy are other laparoscopic procedures were realized in the second period. DISCUSSION AND CONCLUSION: Number of the laparoscopic operations are increasing in quantity and variety in the course of time. We estimate an increase in the rate of laparoscopic surgery and diversity of the laparoscopic procedures. |
2. | Outcomes of Laparoscopic Appendectomy in 950 Patients Abstract Sinan Çarkman, Bilgi Baca, Kaya Sarıbeyoğlu, Ece Kol, Adem Karataş, Fatih Aydoğan, Kemal Memişoğlu, Kağan Zengin, Nihat Yavuz, Melih Paksoy, Metin Kapan, Salih Pekmezci, Feridun Şirin Pages 140 - 147 INTRODUCTION: To present the data of patients who underwent laparoscopic appendectomy. METHODS: Between January 1997 and December 2007, medical records of the patients who underwent laparoscopic appendectomy in our emergency unit, were retrospectively evaluated. Operative data, complications and follow-up results were assessed. RESULTS: Nine hundred fifty patients, with a mean age of 28 (10-87) years underwent laparoscopic appendectomy. The preperative diagnoses were acute appendicitis and acute abdomen in 84% and 16% of the patients, respectively. Mean operation time was 42 (20-150) minutes. Operative data revealed phlegmonous (75%), gangrenous (13%) and perforated (7%) appendicitis. Appendix was macroscopically normal in 5% of the cases. Patients were operated by residents (59%) and staff surgeons (41%). Conversion rate was 7%. Mean postoperative hospital stay was 1.5 (1-10) days. Complication rate was 5% and there was no mortality. DISCUSSION AND CONCLUSION: Laparoscopic appendectomy is a safe and effective method, which is associated with shorter hospital stay and less surgical wound infection. Whole abdominal cavity can be explored easily, with the help of diagnostic laparoscopy in suspected patients. |
3. | Maternal And Fetal Near-Term Sheep Cytokine Responses To Carbon Dioxide Pneumoperitoneum Ahmet Tekin, Cüneyt Evrüke, Okan Deveci Pages 148 - 154 INTRODUCTION: It is known that carbon dioxide (CO2) pneumoperitoneum induces fetal acidosis in pregnant ewes. Our aim was to determine changes of the levels of maternal and fetal cytokines IL-6, IL-8 and TNFα following CO2 pneumoperitoneum in pregnant ewes. METHODS: Eight ewes with singleton pregnancies of 120–140 days gestation were anesthetized and intubated. The abdomen was insufflated with CO2 at 13–15 mmHg pressure for 60 min. Before and immediately after the insufflation, and 24 hours following the CO2 pneumoperitoneum, blood samples were taken from the ewes and fetuses. RESULTS: Insufflation produced modest but significant maternal arterial hypercapnia (an increase of 10.7 mmHg; P < 0.001) and acidosis (a decrease in mean pH of 0.1.04; P = 0.0005). Fetal PCO2 was increased by 15,3 mmHg on average and pH was decreased by 0.11 unit on average immediately after desufflation (both P < 0.001). No significant difference was observed in the concentration of cytokine in the maternal or fetal blood samples DISCUSSION AND CONCLUSION: Serum levels of IL-6, IL-8 and TNFα did not increased above baseline in pregnant ewes or fetuses during CO2 pneumoperineum or 24 hours later. These results suggest that respiratory acidosis does not lead to the elevation of cytokines in pregnant ewes and fetuses, which may contribute to premature labor. |
REVIEW | |
4. | Invention and Patent Ali Doğan Bozdağ Pages 155 - 161 The aim of this paper is to describe the way to achieve the patent right of our colleague who has an invention. The patent submission became easier after the beginning of Tübitak’s patent right support program. After determining the differences of the innovation to the previos inventions, the inventor can work together with a special patent office. The procedure starts with the preparation of the patent description, and submission to the authorized patent office, and continues until the achievement of the patent right. We have to increase the number of patent rights for the welfare of our country and our children. |
RESEARCH ARTICLE | |
5. | Minimally Invasive Splenectomy: Our Experience Of 71 Cases Umut Barbaros, Nihat Aksakal, Mustafa Tükenmez, Uğur Deveci, Ahmet Dinççağ, Selçuk Mercan Pages 162 - 171 INTRODUCTION: Minimaly invasive splenectomy has recently been gaining acceptance as an alternative to open splenectomy. We report in this paper our experience with laparoscopic and hand assisted laparoscopic splenectomy. METHODS: 71 patients underwent a splenectomy for a wide range of splenic disorders. Of these patients, 53 who had normal sized spleen with hematologic diseases and benign spleen pathology were treated by laparoscopy and 18 who had large spleen (≥15 cm) and suspicious malign spleen diseases were treated by hand assisted laparoscopic splenectomy. Spleen size and weight, estimated operative blood loss, conversion rate, operative time, peroperative and postoperative complications, length of stay in hospital, morbidity and mortality were recorded. RESULTS: Of 53 patients planned laparoscopic splenectomy, 48 was succesfully underwent laparoscopic splenectomy. In five cases, conversion to an open procedure was required due to bleeding. There were four postopertive complications (one deep venous thrombosis, one pancreatic fistula, one abdominal wall hematoma and one infection at the port site). Mean length of hospital stay was 2,9 days. 18 patients underwent hand assisted laparoscopic splenectomy. One intraoperative bledding complication occurred. None of patients required the conversion to open surgery. One patient developed infection at the hand assisted port site and one postopertive pancreatic fistula. Mean length of hospital stay was 4,4 days. There was no mortality. DISCUSSION AND CONCLUSION: Minimally invasive splenectomy is safe and effective procedure that reduces hospital stay and time to full recovery, low postoperative pain and complications. |