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        תוצאת חיפוש

        יוני 1999

        ג'ורג' חביב וליאון כהן
        עמ'

        Many Faces of Parvovirus

         

        George Habib, Leon Cohen

         

        Carmel Medical Center, Haifa

         

        2 women, aged 31 and 37 years, respectively, suffered from acute febrile illness due to acute infection with human parvovirus B19. 1 also had a maculopapular rash and articular symptoms after her fever stopped, a clinical picture typical of erythema infections. The other had leukopenia and thrombocytopenia and had received dipyrone. Although acute infection with human parvovirus usually occurs in childhood, it may also occur in adults, with protean manifestations.

        עמיר סולד, יוסף קלאוזנר ורישרד נקש
        עמ'

        Laparoscopic Donor Nephrectomy: Initial Experience

         

        Amir Szold, Joseph M. Klausner, Richard Nakache

         

        Advanced Endoscopic Surgery Unit, Transplantation Unit and Depts. of Surgery B-C, Tel Aviv-Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        We present our initial experience in laparoscopic nephrectomy. 6 patients were operated for a kidney donation and 2 for treatment of a benign disease. All procedures were completed successfully, with no conversion to laparotomy or intra-operative complications. Mean operating time was 210 minutes, and in the donor kidneys the mean warm-ischemic time was 165 seconds. There were 3 postoperative complications, and mean hospitalization was 3.5 days. The transplanted kidneys are all functioning.

         

        From our initial experience, laparoscopic nephrectomy appears to be both feasible and safe. Its implementation requires a combined team with experience in donor surgery and advanced laparoscopic skills. The procedure may increase the availability of living donor kidneys, due to the smaller impact on the donor compared to conventional donor nephrectomy.

        מאי 1999

        שלמה קייזר, יואלה אלוני ואילן חרוזי
        עמ'

        Laparoscopic Treatment of Small Bowel Obstruction Caused by Adhesions

         

        S. Kyzer, Y. Aloni, I. Charuzi

         

        Surgery Unit B, Wolfson Medical Center, Holon

         

        We describe our experience in 14 patients operated on for small bowel obstruction, who underwent laparoscopic adhesiolysis. In 13 (93%) the obstruction was relieved and only 1 case required conversion to open operation. Bowel activity usually resumed within 24-48 hours, and there were no remarkable intraoperative and postoperative complications. During follow-up none developed recurrent obstruction.

         

        Our experience demonstrates that laparoscopic adhesiolysis is a valid therapeutic option. Additional experience is needed to determine which types of cases are suitable for the procedure.

        אפריל 1999

        אברהים מטר, משה ולד ושמואל אלדר
        עמ'

        Laparoscopy for Common Bile Duct Stones

         

        Ibrahim Matter, Moshe Wald, Shmuel Eldar

         

        Depts. of Surgery and Urology, B'nai-Zion Medical Center, Haifa

         

        We performed 75 laparoscopic cholecystectomies during July and September 1996. In 3 men and 4 women, aged 32-87 years, there was obstructive jaundice caused by choledocholithiasis. During laparoscopy in the jaundiced patients, calculi were identified by cholangioscopy and intra-operative cholangiography. They were washed into the duodenum (confirmed cholangiographically) after intravenous glucagon injections and dilation of the papilla of Vater.

        Serum bilirubin and liver enzyme levels returned to normal within a few days. There was no operative or postoperative morbidity, nor any biliary-related systemic complications. Average postoperative hospitalization was 3 days.

        זהבי כהן, אלון יולביץ, ואדים קאפולר, ניצה נוימן ואברהם מרש
        עמ'

        Laparoscopic Spermatic Vein Ligation for Varicocele in Adolescents

         

        Zahavi Cohen, Alon Yulevich, Vadim Kapuler, Niza Newman, Abraham J. Mares

         

        Pediatric Surgery Dept., Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

         

        We report our initial experience with laparoscopic ligation of spermatic veins in the treatment of varicocele in adolescence. 19 boys, 13 to 18 years old, underwent this treatment between I 1997 and III 98. The varicocele was always on the left side. 12 complained of scrotal discomfort and pain, but in 7 it was found incidentally during routine medical examination by the family or school physician. The diagnosis was based only on physical examination.

        There has been no morbidity related to the laparoscopic procedure and all returned to normal activity within a few days. Follow-up 2-12 months after surgery showed no varicocele in any. We conclude that laparoscopy is useful in the treatment of varicocele in adolescents.

        מרץ 1999

        רונן בן-עמי, רות רחמימוב ושלמה ברלינר
        עמ'

        Danaparoid-Sodium for Dialysis in Heparin-Associated Thrombocytopenia

         

        Ronen Ben Ami, Ruth Rachmimov, Shlomo Berliner

         

        Medicine Dept. D and Anticoagulation Therapy Unit, Tel Aviv-Souraski Medical Center, and Nephrology Institute, Sheba Medical Center, Tel Hashomer

         

        Danaparoid sodium is an anticomposed of 3 glycosaminoglycans: heparan sulfate, dermatan sulfate and chondroitin sulfate. Similar to heparin, operates by activating antithrombin 3, but does not contain heparin or heparin fragments, and is therefore antigenically distinct.

        Danaparoid has been advocated as a safe and effective anticoagulant for heparin-associated thrombocytopenia. However, there is little experience in its use as a substitute for heparin in hemodialysis.

        We report 2 men, aged 82 and 73 years, respectively, who developed thrombocytopenia while undergoing hemodialysis with heparin, and who subsequently underwent successful dialysis with danaparoid. There was a rise in platelet levels in both while receiving danaparoid, and dialysis was completed without hemorrhagic or thrombotic complications. Danaparoid is a safe and effective substitute for heparin, and may be used as an anticoagulant in hemodialysis.

        יואב מינץ, דוד גויטיין ומיכאל מוג'ה-סולם
        עמ'

        Tension-Free "Plug and Patch" Inguinal Hernia Repair

         

        Y. Mintz, D. Goitein, M. Muggia-Sullam

         

        Dept. of General Surgery, Hadassah-Hebrew University Hospital, Jerusalem

         

        Inguinal hernias are common and have highly variable clinical presentations, ranging from the asymptomatic to surgical emergencies when incarcerated, sometimes necessitating bowel resection. Several techniques have been described for repair of inguinal hernias based on the unique anatomic structure of the inguinal region. In 1989 Lichtenstein and co-workers described a "tension free" repair based on using a synthetic mesh patch to reinforce the inguinal canal floor and as a plug to prevent recurrence through the internal inguinal ring. This technique has been used in many centers worldwide with good rates of success.

        אילון לחמן, אברהם שינפלד, רפאל בולדס, שמואל לוין, מיכאל בורשטיין ומיכאל שטרק
        עמ'

        Operative Laparoscopy in Pregnancy

         

        Eylon Lachman, Abraham Schienfeld, R. Boldes, Samuel Levin, Michael Burstein, Michael Stark

         

        Depts. of Obstetrics and Gynecology, Misgav Ladach Hospital, Jerusalem

         

        The development of laparoscopic surgery in gynecology and general surgery has greatly advanced over the past decade, and recently has been successfully performed in pregnancy. In the English literature we found that of the 518 cases reported (mean age 32 years) the most common was for cholecystectomy (45%), followed by operations on the adnexae (34%), appendectomy (15%) and others (6%). To these we add 3 cases of cholecystectomy and 1 of an adnexal tumor. Of all the reported cases, 33% were performed in the 1st trimester, 56% in the 2nd and 11% in the 3rd.

        This review demonstrates a definite trend to laparoscopy in pregnancy. It appears to be safe when performed by experienced surgeons, but further studies addressing safety of laparoscopic surgery during pregnancy are needed to reach definitive conclusions.

        יוסף קוריאנסקי, רון ביליק, משה שבתאי, איתמר אביגד ועמרם אילון
        עמ'

        Preliminary Report of Experience with Laparoscopic Splenectomy

         

        Joseph Kuriansky, Ron Bilik, Moshe Shabtai, Itamar Avigad, Amram Ayalon

         

        Depts. of General Surgery and Transplantation and Pediatric Surgery, Sheba Medical Center, Tel Hashomer; and Sackler School of Medicine, Tel Aviv University

         

        Laparoscopic splenectomy is effective and technically feasible for treating various hematological diseases such as idiopathic thrombocytopenic purpura (ITP), congenital sphero„cytosis, hemolytic anemia, and Hodgkin's lymphoma. An anterior approach to the vascular pedicle is usually described. However, in this approach to the splenic hilum, the dissection of the splenic artery is frequently difficult. The laparoscopic posterolateral approach involves dissection of the posterolateral attachments to the diaphragm, followed by the disection and ligation of all splenic branches near the splenic parenchyma. We used it in 9 adults and 4 children: 11 patients had ITP, 1 spherocytosis and 1 Hodgkin's lymphoma.

        This procedure was completed in 13 patients, but in 2 it had to be converted to open surgery. Mean operating time was 3 hours and mean postoperative stay 3 days. Blood transfusion was not required and there were no postoperative complications.

        Laparoscopic splenectomy is safe in both adults and children, and the posterolateral approach provides excellent visualization and allows control of the branches of the splenic vein and artery in the splenic hilum.

        פברואר 1999

        שלמה קייזר, איליה קריסטלני, מרינה אליס ואילן חרוזי
        עמ'

        Laparoscopic Repair of Inguinal Hernia Experience in 54 Consecutive Cases

         

        S. Kyzer, I. Kristalni, M. Alis, I. Charuzi

         

        Surgical Dept. B, Wolfson Medcial Center, Holon

         

        We describe our experience in 54 consecutive patients who underwent laparoscopic repair of 86 inguinal hernias. Laparoscopic repair of inguinal hernia is technically feasible, does not prolong the length of the procedure nor of hospitalization and is not accompanied by increased morbidity. Although there is not yet general agreement, in our experience and that of others, it appears that laparoscopic repair will be the preferred approach to the treatment of inguinal hernia.

        ינואר 1999

        זהבי כהן, ניצה נוימן, עדנה קורצברט, ודים קפולר ואברהם מרש
        עמ'

        Diagnostic and Therapeutic Laparoscopy for Non-Palpable Testis

         

        Zahavi Cohen, Niza Newman, Edna Kurzbart, Vadim Kapuller, Abraham J. Mares

         

        Dept. of Pediatric Surgery, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

         

        From January 1994 to July 1997, 20 boys 1.5-13 years of age underwent laparoscopic examination and treatment for non-palpable testis. In 1 there was bilateral nonpalpable testis. Only 3 had intra-abdominal testes viable for orchiopexy. In 8 atrophic testicles were removed and in 9 laparoscopic examination revealed intra-abdominal blind ending of the spermatic cord and no testicular tissue.

        We conclude that laparoscopy is a useful and safe technique for accurate diagnosis and may avoid additional intervention in treating non-palpable testes. Furthermore, intra-abdominal testes may be managed laparoscopically under the same anesthetic.

        מנשה ברזילי, אריה ביטרמן, דורית שלג-אייזנברג ונתן פלד
        עמ'

        The Fate of Gallstones "Dropped" during Laparoscopy

         

        Menashe Barzilai, Arie Bitterman, Dorit Schlag-Eisenberg, Nathan Peled

         

        Depts. of Radiology and Surgery B, Carmel Medical Center, Haifa

         

        Laparoscopic cholecystectomy is considered the procedure of choice for removing symptomatic, stone-containing gallbladders. It is estimated that in 30-40% of these operations stone(s) spill into the peritoneal cavity. It was assumed that these "dropped stones" are harmless and are dissolved and absorbed spontaneously. We present a 70-year-old woman in whom such a stone, dropped during laparoscopy, led to formation of an intraperitoneal abscess.

        דצמבר 1998

        אליעזר אלקלעי, דניאל יפה וצבי שפינדל
        עמ'

        Radiologic Appearance of "Falling Gallstones" during Laparoscopic Cholecystectomy

         

        E. Alkalay, D. Yaffe, Z. Spindel

         

        Eyn Vered Clinic and Depts. of Radiology and Surgery, Sapir Medical Center, Kfar Saba and Sackler Faculty of Medicine, Tel Aviv University

         

        Laparoscopic cholecystectomy is the "gold standard" in treating cholelithiasis. Stones are frequently lost in the peritoneal cavity during the procedure, but "missing stones" have been regarded as insignificant. However, there is accumulating evidence that untreated "lost" stones may cause complications even years after operation.

         

        We present a 65-year-old woman who presented with vague complaints, anemia and an elevated ESR. CT scan showed an infiltrating process in extra-abdominal muscles compatible with sarcoma. At operation, 2.5 years after previous laparoscopic cholecystectomy, an abscess was found which contained biliary stones. Because of their small size they were not visible on CT scan. We discuss the possible ways of handling "falling stones."

        מאי 1998

        ד' רוזין, י' קוריאנסקי, מ' שבתאי וע' אילון
        עמ'

        Laparoscopic Approach to Perforated Duodenal Ulcer

         

        D. Rosin, Y. Kurianski, M. Shabtai, A. Ayalon

         

        Dept. of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University

         

        As laparoscopy becomes more prevalent, it is being used for a growing variety of abdominal operations, both electively and as emergency treatment. We describe our preliminary experience in laparoscopic repair of perforated duodenal ulcer. 2 women and 2 men, aged 40-78 were operated over a period of 4 months and in all laparoscopic suture and omentopexy were performed with meticulous abdominal lavage. Despite somewhat longer operative time but a similar period of hospitalization, the easier post-operative course and fewer wound complications justify this technique. The effectiveness of medical treatment of peptic disease, and especially the anti-Helicobacter pylori regimen, supports the view that closure of the perforation is usually enough, and vagotomy is not needed.

        פברואר 1998

        דן בר-זהר, יניב שרר, חנה מנור, אמיר פאר, סימון שטראוס ואריאל הלוי
        עמ'

        Epidermoid Cyst of the Spleen

         

        Dan Bar-Zohar, Yaniv Sherer, Hana Manor, Amir Peer, Simon Strauss, Ariel Halevy

         

        Dept. of Surgery B and Institute of Radiology, Assaf Harofeh Medical Center, Zerifin, and Sackler Faculty of Medicine, Tel Aviv University

         

        Splenic cysts are rarely found or diagnosed. Excluding cases of trauma, the events preceding their development have not been fully understood. We describe a 22-year-old woman in her 34th week of pregnancy in whom ultrasound revealed a cystic lesion 8610 cm. in diameter in the left upper abdomen. Further imaging tests followed by laparotomy confirmed the splenic origin of the cyst. Splenectomy was performed and the lesion was histopathologically defined as an epidermoid cyst.

         

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303