Single Incision Laparoscopic Peptic Ulcer Repair with the Use Extracorporeal Mishra Knot: A Case Report.

Downes, Ross O.

doi:10.21767/2254-6758.100059

Cited by 1 publication

(2 citation statements)

References 19 publications

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“…Similarly, knot tying remained a significant challenge in LSPS repair of PDU. Several knot tying techniques were proposed, including the Mishra Knot [14] and the intra-corporeal ''cross and twine'' knotting [7]. We only used conventional laparoscopic instruments to suture.…”

Section: Discussionmentioning

confidence: 99%

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Single‐Port Laparoscopic Repair of Perforated Duodenal Ulcers

2020

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Background Laparoscopic single‐port surgery has widely been introduced for the treatment of various abdominal conditions. But controversies still exist regarding its potential advantages and risks, especially for emergency surgery. The aim of this study was to evaluate the results of a single‐port laparoscopic repair using straight laparoscopic instruments for the treatment of perforated duodenal ulcers. Methods A prospective consecutive case series was conducted including all patients with a perforated duodenal ulcer who underwent a laparoscopic single‐port repair at a single institution from January 2012 to June 2018. The operation was performed through a single port using conventional straight laparoscopic instruments and intra‐corporeal knot tying techniques. Results Out of 75 patients, simple closure of the perforation without omental patch was accomplished in 96% of cases. Conversion to an open operation was required in one patient (1.3%) due to a posterior duodenal perforation, and additional trocar placement was needed in another patient (1.3%). The mean incision length was 2.0 ± 0.2 cm. The mean operation time was 63.0 ± 26.6 min. Meantime a nasogastric tube remained in place was 2.9 ± 0.8 days. Mean duration of analgesic use was 2.8 ± 0.8 days. The rate of postoperative complications was 2.7%, including two patients with wound infections. There were no instances of intestinal leak or abscess. The postoperative hospital stay was 5.7 ± 1.2 days. Conclusion Laparoscopic single‐port repair using conventional straight laparoscopic instruments with intra‐corporeal knot tying technique was safe and feasible for patients with perforated duodenal ulcers with low risk factors. This method offers results comparable to those expected with the standard multiport laparoscopic approach with the addition of improved cosmetic outcomes.

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Section: Discussionmentioning

confidence: 99%

“…With improvements in laparoscopic instruments and surgeon skills, LSPS was widely introduced into various surgical procedures such as appendectomy, cholecystectomy, and adrenalectomy. LSPS has also been reported in few patients in the treatment of PDU [7, 14]. LSPS has proven better cosmetic results [5, 6].…”

Section: Discussionmentioning

confidence: 99%