Department of Surgery, University of Miyazaki Faculty of Medicine, Kiyotake, Miyazaki City, Miyazaki, Japan (Drs Kai, Ikeda, Ichihara, Hamada, Nagatomo, and Nanashima).
Department of Obstetrics and Gynecology, University of Miyazaki Faculty of Medicine, Kiyotake, Miyazaki City, Miyazaki, Japan (Drs Matsuzawa, Ushijima, Furukawa, and Sameshima).

ABSTRACT

Introduction: Acute appendicitis is the most common general surgical problem during pregnancy. Laparoscopic appendectomy has been gaining widespread popularity and has been accepted as a minimally invasive surgery based on evidence for its use in appendicitis in pregnant patients. However, the gravid uterus in the third trimester and the frequent suction required for abscess drainage make the working space intractable.

Case Description: We report a case in which an AirSeal intelligent flow system (ASIFS) (CONMED Corporation, Utica, NY, USA) was useful for laparoscopic appendectomy and abscess drainage for perforated appendicitis in a 31-wk pregnant patient. ASIFS allowed successful maintenance of a working space, thus making it possible to excise the appendix at its base with double ligation and effectively drain the abscess with no maternal and fetal complications. To our knowledge, there have been no reports of the use of ASIFS in a pregnant patient. A past study reported that ASIFS could induce hypothermia compared with a conventional CO2 supply tube in patients. Although intraoperative hypo- thermia did not occur in our patient, it would be prudent to carefully avoid frequent suctioning in the short term and to warm the patient intraoperatively because maternal and fetal bodies are susceptible to change in hemodynamics.

Conclusion: Surgeons should consider the use of ASIFS before deciding to convert from laparoscopic appendectomy to an open procedure in pregnant patients.

Key Words: laparoscopic appendectomy, perforated appendectomy, third trimester, AirSeal intelligent flow system.

The post AirSeal was Useful in Laparoscopic Surgery for Perforated Appendicitis During Pregnancy first appeared on JSLS.

Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York, USA (Drs Khan, Saeed, Razdan, Ahmed, and Suman).
Department of Pathology, Harlem Hospital Center, Columbia University, New York, New York, USA (Dr Landa).
Department of Internal Medicine, Richmond University Medical Center, Staten Island, New York, USA (Dr Iqbal).

ABSTRACT

Introduction: Appendectomy is one of the most commonly performed surgical procedures in the world. Over time, complications associated with appendectomy have declined. Stump appendicitis is one of the rare delayed complications of appendectomy. It involves infection of the residual appendix tissue that can occur after a patient has undergone appendectomy in which the stump was left behind. Patients present with abdominal pain associated with nausea and vomiting. Computed tomography scanning of the abdomen is diagnostic.

Case Description: We report the case of a 21-year-old man with stump appendicitis status post laparoscopic appen- dectomy at another hospital, which was successfully treated with laparoscopic completion appendectomy.

Key Words: Stump appendicitis, Laparoscopic appendectomy, Residual appendix, Abdominal pain, Completion appendectomy.

The post Stump Appendicitis Status Post Laparoscopic Appendectomy first appeared on JSLS.

The post Rare Occurrence of Small-Bowel Volvulus Following Laparoscopic Appendectomy first appeared on JSLS.