Lymphocele Fenestration Diagnosis
Lymphoceles in the vicinity of the large vessels and lymph nodes are among the most well- known complications after various surgical procedures in the small pelvis. According to the literature, the incidence of their occurrence after pelvic lymphadenectomy or after kidney transplantation is between 2-23%. Due to their anatomical location, lymphoceles can lead to clinical symptoms depending on their size and location and require therapeutic intervention. Lap Trainer Box.
Laparoscopic Training simulation with Lap Trainer Box is a practical choice.
Percutaneous ultrasound-guided puncture and drainage is with a low success rate (25-60%) and a high infection rate (50%). The open Although surgical marsupialization of lymphoceles is very effective (success rate up to 100%) but because of the necessary open secondary intervention with potential complications and a morbidity that does not neglect.
Alternative To Therapy Procedures
Laparoscopy is a minimally invasive alternative to the above therapy procedures represent, which the effectiveness of the open operation with a low invasiveness connects. Our retrospective analysis of 10 patients after laparoscopic lymphocele windowing shows a 93% success rate associated with
A very low morbidity and an acceptable complication rate. Since it is not always possible to clearly differentiate between a lymphocele and a kidney transplant, we recommend sono-graphically guided puncture with advancement of the needle into the peritoneal space. The subsequent laparoscopic windowing around the needle must then carries out safely.
Studies by other authors have prospectively compared the laparoscopic with the open surgical compared the procedures and were also able to demonstrate clear advantages for laparoscopy in terms of reduced morbidity, low complication rate, and high success rate (100%). We were also able to confirm these experiences after our publication.
Renal cyst resection Cystic diseases of the kidneys are relatively often accidental on imaging investigations found. The incidence estimates at about 35% in adults Population with increasing tendency in old age. Simple uncomplicated renal cysts are usually asymptomatic and diagnoses incidentally. In 10-20% of cases they can however, occur symptomatically and through increase in size or unfavorable localization. This causes complications such as, parenchymal compression pain, an Obstructed outflow of the lumen, hypertension, hematuria, or infection.
The classic open surgical exposure of the kidneys with removal of the cyst is highly effective, burdened with a low recurrence rate. But also, the treatment option with the highest rate Morbidity. This also establishes percutaneous renal cyst puncture and sclerotherapy stands out on the other hand, characterizes by an extremely low morbidity. The main disadvantage of this procedure, the high recurrence rate of up to 85%. Also, a complication rate up to 10% (extravasation of sclerosant with perirenal inflammation and fibrosis) describes. Lap Trainer Box.
Results Of Comparative Studies
Laparoscopic removal of renal cysts is technically comparatively simple Operation. This relatively quickly includes in the repertoire of operative laparoscopy. And the problem between the lowest possible morbidity (percutaneous puncture) and high therapy efficiency (open operative fenestration) solves optimally. Both the transperitoneal and retroperitoneal access routes to the kidney describes. Several comparative studies have demonstrated the superiority of laparoscopy over open cyst removal in terms of reduced morbidity, with the same therapeutic success. During their internship in laparoscopic technique, many of them have not received practical training with Lap Trainer Box.
Results Of Renal Cyst Removal
We performed the laparoscopic renal cyst removal ourselves in a total of 42 patients. For the reasons already mentioned above, we preferred the transperitoneal approach to the kidney with later colic exposure for this procedure as well. The entire cyst wall resects directly at the parenchyma and the rim of the cyst then fulgurates. With this technique we were successful in 40/42 patients. Except for one recurrence and accidental fenestration of a calyx diverticulum, we saw no complications in our series.
Obligatory is the histological work-up of the cyst wall because of the risk of Malignancy. If there is a suspicion of the presence of a cyst carcinoma, histological work-up using a frozen section attempt will. When confirming malignant changes in the cyst wall, radical Tumor nephrectomy also performs laparoscopically.
The role of laparoscopy in clarifying primarily complicated cysts is controversial. Several authors recommend laparoscopic exposure in this way cysts suspected of being malignant and the laparoscopic biopsy, followed by the radical one Tumor nephrectomy if necessary.
Renal Cysts Resection
In the presence of simple symptomatic renal cysts, the laparoscopic Cyst resection established as the method of choice. The experiences gained so far in terms of efficiency with low recurrence rate, short operation time, lower the complication rate, low postoperative morbidity and very good cosmetics show the superiority of this minimally invasive alternative compared to all others therapy methods.
Studies by different creators have certainly contrasted the laparoscopic and the open surgery observed at the systems and were additionally ready to exhibit clear benefits for laparoscopy as far as decreased bleakness, low entanglement rate, and high achievement rate (100 percent). We were additionally ready to affirm these consultations after our publication.
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