The role of laparoscopy in acute care surgeryhtyanar
The document discusses the role of laparoscopy in acute care surgery. It summarizes that laparoscopy can be used both diagnostically and therapeutically for a variety of non-trauma and trauma abdominal emergencies. Physiologic and technical contraindications to laparoscopy are mentioned. Studies are referenced showing laparoscopy has advantages over open surgery such as less post-operative pain, shorter hospital stays, and lower complication rates for conditions like appendicitis, acute cholecystitis, and perforated peptic ulcers. Emergency laparoscopy is also discussed as an option for pregnant patients and for diagnosing and treating mesenteric ischemia, diaphragmatic injuries, and hollow viscus injuries
Postoperative peritonitis after elective surgery htyanar
Postoperative peritonitis after elective surgery can lead to increased morbidity and mortality. Early diagnosis and treatment of the underlying cause, along with a multidisciplinary approach, can help increase survival rates. Source control through drainage of abscesses or debridement of infected tissue is important to manage intra-abdominal infections. Antimicrobial therapy should be used as an adjunct to source control.
Mesenteric ischemia laparoscopic second lookhtyanar
Acute mesenteric ischemia has a high mortality rate ranging from 40-100% and the mean overall mortality is 74%. Second-look laparotomy was traditionally used to assess intestinal viability after surgery for acute mesenteric ischemia but has disadvantages like duplicating risks of complications and increasing hospital stay. Laparoscopic second-look procedures can minimize these risks with benefits like examining the anastomosis, assessing intestinal viability and motility, and being performed minimally invasively with fewer trocars. The timing of second-look procedures is unclear but they may be done 24-48-72 hours after the initial surgery or thrombolytic treatment.
1) Retroperitoneal endoscopic necrosectomy and NOTES pancreatic necrosectomy are minimally invasive techniques for treating infected pancreatic necrosis as an alternative to open necrosectomy.
2) The document describes various management techniques for infected pancreatic necrosis including percutaneous drainage, endoscopic approaches, laparoscopic debridement, and retroperitoneal approaches.
3) Case studies demonstrate the use of techniques like transgastric endoscopic necrosectomy, retroperitoneal necrosectomy, and endoscopic cystogastrostomy to treat infected pancreatic necrosis.
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