Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Polymeric Clips for Stump Closure in Laparoscopic Appendectomy(2017) Parlakgumus, Alper; Ezer, Ali; 0000-0002-3834-9924; 29056133; AAJ-8558-2021Many different techniques are used to perform laparoscopic appendectomy in terms of locations of trocars and closure of the appendiceal stump. They include mechanical endostaplers, endoligature, metal clips, bipolar endocoagulation, polymeric clips and intracorporeal sutures. The method of choice for appendiceal stump closure should be inexpensive and easy to perform. Non-absorbable polymer clips is an acceptable option for this purpose. Polymeric clips provide considerable cost savings as compared with endoscopic staplers, and are easy to apply in comparison to suture ligature techniques. In this study, we aimed to investigate outcomes of appendectomy carried out by using polymeric clips in 123 patients without any intraabdominal collection of pus or abscess. As such, the authors found polymeric clips to be safe, cheap and effective for stump closure in laparoscopic appendectomy.Item Single-port Hysterectomy: Robotic Versus Laparoscopic(2018) Gungor, Mete; Kahraman, Korhan; Dursun, Polat; Ozbasli, Esra; Genim, Canan; 28429119This study evaluated the feasibility and safety of robotic single port hysterectomy and laparoscopic single port hysterectomy, and to compare the perioperative parameters of the two systems. Twenty patients underwent robotic single port hysterectomy and 25 patients underwent laparoscopic single port hysterectomy. All hysterectomies were successfully performed via a single port and there were no conversions to conventional multi-port laparoscopy, multi-port robotic, open surgery, or vaginal surgery. The median operative time and hysterectomy time in robotic and laparoscopic groups were 90 vs. 90 min (P 0.74), 57.5 vs. 60 min (P 0.17), respectively. The median estimated blood loss was 40 ml in the robotic group and 50 ml in the laparoscopic group (P 0.77). No operative and post-operative complications were observed in the two groups. The median time to discharge from the hospital was one day for both techniques (P 0.17). Robotic and laparoscopic single port systems are feasible and safe for hysterectomy operation in terms of operative time, conversion to laparotomy or multiport laparoscopy/robotic rates, complication rates, and postoperative results in the hands of experienced surgeons. The possible benefits of robotic single port surgery compared with conventional laparoscopy should be evaluated in further randomized controlled studies.Item Importance of Laparoscopy in Predicting Complete Cytoreduction at Advanced Stage Ovarian Cancer(2022) Durdag, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Serbetcioglu, Gonca Coban; Ozmete, Ozlem; Ezer, Ali; Celik, Husnu; https://orcid.org/0000-0003-4335-6659Purpose Laparoscopy has been used in evaluation of ovarian cancer to assess the extent and surgical resectability of the disease, and to avoid futile laparotomy, where primary cytoreduction is not suitable. Aim of this study is to investigate the contribution of laparoscopy in predicting 'no gross residue' in advanced stage ovarian cancer. Methods Data of advanced stage ovarian cancer patients, who underwent diagnostic laparoscopy for prediction of complete cytoreduction due to an alternative model, are analyzed retrospectively. Accordingly, in the absence of obvious mesenteric retraction or extensive tumoral implants on small intestine in laparoscopic assessment, cases were deemed surgically resectable, and the operation was continued with laparotomy to achieve complete cytoreduction. Clinical features of the patients, surgical details, complete and optimal cytoreduction rates, and perioperative complications were evaluated. Results Out of 243 patients with advanced stage ovarian/tubal/peritoneal cancer, laparoscopy was performed at 93 patients, 77 of whom underwent primary cytoreduction subsequently. Complete cytoreduction (no gross residue) and optimal cytoreduction (< 1 cm residual tumor) rates were 75.3 and 100%, respectively. None of the patients had suboptimal surgery. Morbidity and mortality rates were acceptable. Conclusion Laparoscopic evaluation prior to cytoreductive surgery can highly contribute to prediction of complete or optimal cytoreduction in suitable patients. However, experience and skills of the surgeon, as well as technical equipment of the center, may affect surgery; therefore, the model to predict residual tumor should be individualized according to the set up and the surgical team of each center.Item Laparoscopic para-aortic lymphadenectomy: Technique and surgical outcomes(2021) Durda, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Yaginc, Didem Alkas; Simsek, Seda Yuksel; Celik, Husnu; 0000-0003-4335-6659; 0000-0001-5874-7324; 0000-0001-8309-3537; 0000-0003-1185-9227; 32961327; AAI-8400-2021; AAK-2461-2021; AAL-1923-2021Objective: Pelvic and para-aortic lymph node dissection is an important part of staging surgery. Aim of this study is to evaluate perioperative outcomes of patients, who underwent laparoscopic para-aortic lymphadenectomy for gynecological cancer in a single center over a period of 7 years, based on body mass index (BMI), and to present the surgical technique in steps. Methods: Data of patients who underwent para-aortic lymphadenectomy at gynecological oncology department of a tertiary center in between March 2013 and July 2020 were analyzed retrospectively. Patients were evaluated in two groups according to their BMI (< 30 kg/m(2) as non-obese and >= 30 kg/m(2) as obese groups). Surgical technique is described in steps. Perioperative outcomes of the two groups were evaluated. Results: A total of 230 patients were included in the study. BMI was >= 30 at 58.46 % of the patients. Perioperative features were not significantly affected by the patient's BMI with the presented surgical technique, however, collected para-aortic lymph node numbers were higher in the group with BMI <30, though sufficient number of lymph nodes were achieved in both groups. Conclusion: Although some technical difficulties may be encountered, laparoscopic para-aortic lymphadenectomy is feasable in gynecologic oncological surgery independent of BMI. However, surgical experience is important. (C) 2020 Elsevier Masson SAS. All rights reserved.