1995 Fiscal Year Final Research Report Summary
CLINICAL AND EXPERIMENTAL STUDY ABOUT THE LAPAROSCOPIC THERAPY FOR ADHESIVE ILEUS
| Project/Area Number |
06671256
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Fukui MEDICAL SCHOOL |
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Principal Investigator |
NAKAGAWA Takao DEPARTMENT OF EMERGENCY MEDICINE,ASSOCIATE PROFESSOR., 医学部付属病院, 助教授 (40075578)
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| Co-Investigator(Kenkyū-buntansha) |
SUGA Hiroyasu DEPARTMENT OF EMERGENCY MEDICINE,ASSISTANT., 医学部付属病院, 助手 (10266752)
NISHIURA Teruhiro DEPARTMENT OF EMERGENCY MEDICINE,ASSISTANT., 医学部付属病院, 助手 (50273024)
HIRAIZUMI Taiji DEPARTMENT OF EMERGENCY MEDICINE,FORMER ASSISTANT., 医学部付属病院, 助手 (10173212)
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| Project Period (FY) |
1994 – 1995
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| Keywords | ADHESIVE ILEUS / LAPAROSCOPIC THERAPY / LAPAROSCOPIC ADHENSIOLYSIS / NEW INTESTINAL GRASPING / NEEDLE LAPAROSCOPY / STANDARD LAPAROSCOPY / ACUTE ABDOMEN / MINILAPAROTOMY |
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| Research Abstract |
The present study was made to establish laparoscopic adhesiolysis procedural approach to adhesive ileus. Procedural problems represent complication of 1) intestinal contused laceration with intestinal grasping forceps and 2) intestinal damage on adhensiolysis, each. For the solution of 1), we devised such an intestinal grasping forces as is designed not to increase above a definite pressure the pressure of the above forceps-adjusting handle at hand, and this made it possible to prevent contused laceration or supertraction of the intestinal wall. For the solution of 2), which is most important for establishing the laparoscopie adhensiolysis procedure, we examined its solution approach from its clinical results. We have so far tried the laparoscopie adhensiolysis on 17 cases of adhesive ileus, 6 of which succeeded in adhensiolysis not with intestinal grasping forceps but with electric knife or scissors under laparoscopic observation. Of 11 cases of adhensiolysis with electric knife or sc
… More
issors under intestinal traction with intestinal grasping forceps, 4 (36.4%) presented intestinal perforations under adhensiolysis. Any one of the above perforations required perforation repair via small laparotomy following the completion of adhensiolysis. The postoperative course was favorable in all cases without recurrence of ileus so far. The above clinical results led to the conclusion that the intestinal perforation under adhensiolysis may be ascribable greatly to the use of intestinal grasping forceps and that good operative results may be obtained through several cm small laparotomy for the intestinal perforation. Therefore, judging from the fact that experimental measurement of the influence of electric knife or scissors on the tracted intestinal canal has a little interest for establishing laparoscopie adhensiolysis procedure, the experimental design was stopped. In view of our experience in using the needle type laparoscopy of 3 mm in extemal diameter now under development by Olympus Co., Ltd., the laparoscopic adhensiolysis using this needle type laparoscopy was thought to be not only very easy procedurally and less invasive compared with standard type laparoscopy, but also useful for the improvement in safety. Less
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