Emergency Laparoscopy

This book provides up-to-date evidence on laparoscopic emergency surgery and supplies concrete advice on when and how to approach patients laparoscopically in an emergency setting. All the diseases elegible for emergency laparoscopy are addressed, and for each disease recommendations, levels of evidence, and technical key points are discussed and analyzed. Diagnostic flow charts are included for cases in which laparoscopy turns out to be the final diagnostic step and the first therapeutic one. Furthermore, problematic and positive aspects of the laparoscopic approach from the anesthesiologic point of view are fully explored. Finally, a useful overview of current practice in hospitals across the world is provided, highlighting the varying applications in relation to different medical “cultures”, skills, resources, and healthcare systems.

This is the first time a book about laparoscopy in emergency abdominal surgery has been published. Numerous articles have been published in specific surgical journals, but, until now, there has not been a book that collates all the aspects of this little-known field. The aim of this volume is to achieve a complete and easy presentation of all the implications associated with laparoscopy in emergency abdominal surgery. The book should be a manual that can be easily consulted by digestive, general, and specialized surgeons, especially in an emergency. The authors’ contributions are founded on evidence-based medicine, which give the book scientific credibility, but this is coupled with their experience of daily practice, which adds an important complementary dimension to evidence-based medicine. This is balanced by an emphasis on clarity and accessibility, because the ultimate aim of the book is educational. We hope this book will be frequently consulted, in depth, not only by specialist practitioners, but also by undergraduate students, new graduates and surgeons in training.

The global population is aging rapidly, and as a result emergency abdominal surgery for acute abdomen in the elderly has become a global issue. Demographic changes in the population have also altered the profile of emergency abdominal surgery, with typical causes of acute abdomen in the elderly including acute cholecystitis, incarcerated hernia, bowel obstruction and appendicitis. In these patients, recovery from surgery is often complicated, leading to longer hospital stays compared with younger patients. Laparoscopy in the emergency setting is well established and offers a number of advantages over open surgical approaches, such as reduced postoperative pain, length of hospital stay and complication rates. While laparoscopic surgery for acute diverticulitis has become more widespread, in other conditions, like small bowel obstruction and perforated peptic ulcer, laparotomy is still used in about 70% of cases. Further, despite the urgent need for knowledge regarding surgical treatment of acute abdomen in the elderly, there is still a lack of evidence in this relevant clinical field. This book analyzes the management strategies and critically evaluates the outcomes of laparoscopic emergency surgery for acute abdomen in the elderly according to the principles of evidence-based medicine. Discussing each topic clearly, and promoting the use of emergency laparoscopy in elderly patients, the book is intended for young general surgeons and surgeons in training with at least a basic knowledge of surgery for acute abdomen. It is also useful as a quick reference tool during on-call shifts.

This book is novel in that it is a single volume offering useful practical tips in the performance of the broad range of procedures used by gastroenterologists, interventional radiologists and surgeons in the current management of complicated abdominal emergencies and traumatic injuries. Emphasis is placed on practical tips which could be life-saving. The contributors are experienced staff members from the National University Hospital, Singapore. Through a step-by-step narrative and an abundance of medical illustrations, the contributors impart to the reader how best to perform and overcome difficulties encountered in the management of complicated abdominal emergencies. Learning is enhanced by video clips of procedures recorded live, in the DVD-ROM that accompanies the book. Contents:Role of the Accident & Emergency Department (Chiu Li Qi and Malcolm R Mahadevan)Perioperative Management of Patients with Complicated Abdominal Emergencies (Ngiam Kee Yuan)Non-Variceal Upper Gastrointestinal Haemorrhage and Endoscopic Management (Eric Wee Wei Loong and Christopher Khor Jen Lock)Upper Gastrointestinal Variceal Haemorrhage and Endoscopic Management (Eric Wee Wei Loong and Christopher Khor Jen Lock)Interventional Radiology in the Management of Gastrointestinal Haemorrhage (Lenny Tan)Bleeding Peptic Ulcer — Surgical Management (Ti Thiow Kong)Surgical Management of Upper Gastrointestinal Perforations (Surendra Kumar Mantoo and Jimmy Bok Yan So)Management of Complications Following Bariatric Surgery (Asim Shabbir and Chih-Kun Huang)Surgery for Appendicitis (Tan Tse Kuang Charles)Emergency Surgery for Perforative Sigmoid Colonic Diverticulitis (Cheong Wai Kit, Bettina Lieske and Frances Sheau Huei Lim)Surgical Management of Obstructive Colorectal Malignancy (Bettina Lieske, Cheong Wai Kit, and Frances Lim Sheau Huei)Surgical Management of Acute Cholecystitis (Davide Lomanto and Iyer Shridhar Ganpathi)ERCP in the Management of Cholangitis and Bile Duct Injuries (Lim Lee Guan and Ho Khek Yu)Surgical Management of Bile Duct & Pancreatic Emergencies (Alfred Kow Wei Chieh and Krishnakumar Madhavan)Laparoscopic Drainage of Liver Abscess (Stephen Chang Kin Yong and Liza Tan Bee Kun)Interventional Radiology in the Management of Intra-Abdominal Abscess (Anil Gopinathan, Quek Swee Tian and Lenny Tan)Management of Gynaecological Emergencies (Fong Yoke Fai and Chua Yao Dong)Ureteric Injuries (Heng Chin Tiong)Ruptured and Leaking Abdominal Aortic Aneurysms (Benjamin Chua Soo Yeng and Peter Ashley Robless)Management of Severe Blunt Abdominal Injury (Philip Iau and Mikael Hartman)Abdominal Wall Reconstruction and Closure (Wei Chen Ong, Jane Lim and Thiam Chye Lim)Abdominal Emergencies in Children (Vidyadhar Mali, Dale L S K Loh and K Prabhakaran)Instrumentation and Techniques in Emergency Laparoscopy Surgery (Davide Lomanto, Amit Agarwal, Vipan Kumar and Rajat Goel) Readership: Surgeons under training and consultants in surgery; gastroenterologists, and radiologists. Keywords:Abdominal Emergencies Laparoscopic & Open Surgery;Therapeutic Endoscopy & Interventional Radiology

General Section. Progress in laparoscopy (new instruments, technical innovations, integration between laparoscopy and sonography). Special Section. Traditional and present indications for laparoscopy. Laparoscopy inliver diseases. Oncological lapaoscopy (diagnosis, staging and follow-up for malignant tumors). Emergency laparoscopy.

This text aims to provide a comprehensive review of general emergency surgery, the branch of medicine that treats patients presenting to the hospital with a wide variety of emergency conditions. It includes a section focusing on clinical aspects, management, logistics, patient cohorts and perioperative considerations in the context of general emergency surgery and trauma. Other sections describe various conditions and diseases in specific anatomical structures to enable readers to easily find the information they need. Written and edited by international experts and opinion leaders in the field, this book is a valuable reference resource for general and emergency surgeons, trauma surgeons, emergency physicians and nurses. It will also be of interest to residents, students and all other healthcare professionals involved in the management of emergency surgical patients.

The first edition of this "Emergency Surgery-Handbook" provides a brief and useful account of emergency surgical disorders' essential features. This book is handy for interns, residents, and casualties medical officers as they can refer to this accessible book not to miss the diagnosis. This concise book cannot replace the well-established textbooks, but it gives a clinician sufficient information to manage the emergency. The book covers basic principles and provides essential information on the diagnosis and management of acute surgical conditions and wound care, fluids management, sutures, and antibiotics. It also includes how to minimize post-operative wound dehiscence (10 Pearls of Wound Closure) along with pre-operative and post-operative care. The text covers the field of general surgery and covers the basic needs of the undergraduate as far as the surgical specialties are concerned. This handbook covers newer topics like abdominal compartment syndrome, Emergency Diagnostic laparoscopy in acute abdomen. This book has defined Pearls of wound closure to minimize post-operative wound dehiscence which is a deadly complication and affect the physical and mental health of patients as well as of operative surgeon as said by Moshe Schein ~ "There are few things more embarrassing to a surgeon than the sight of his recently operated patient, his abdomen gaping, and the gut spilling out all around."