Laparoscopic placement of peritoneal dialysis catheters: 7 years experience.

Background: Since 1994 we have placed all peritoneal dialysis (Tenckhoff) catheters at our hospital laparoscopically using a technique that incorporates suture fixation into the pelvis. The purpose of this study was to determine the long-term outcome of this approach.

Method: Perioperative and follow-up data for all patients undergoing placement of a peritoneal dialysis catheter at the Royal Adelaide Hospital were collected prospectively and managed on unit specific and hospital wide computerized databases.

Preoperative prediction of long-term outcome following laparoscopic fundoplication.

Background: Although long-term outcomes following laparoscopic fundoplication for gastro-oesophageal disease have now been reported as very satisfactory, a small, but important, minority of patients are unhappy with the outcome, often due to recurrent reflux symptoms or new-onset dysphagia. In this study, we sought to establish whether various parameters that can be determined before surgery, can predict the long-term outcome of surgery.

Methods: Data collected prospectively were evaluated to determine factors that were associated with outcome at 5 years following laparoscopic fundoplication.

Tumour implantation following laparoscopy using different insufflation gases.

Background: Because of the possibility of intraperitoneal seeding and port-site recurrences following laparoscopic surgery, the role of laparoscopy in cancer surgery remains controversial. Previous experimental studies have suggested that chemical, metabolic and immunological changes following carbon dioxide (CO2) insufflation may be responsible for this phenomenon. Earlier experimental studies done by the University of Adelaide Department of Surgery have also shown that helium insufflation is associated with none of the adverse changes brought about by CO2 insufflation.

Results of laparoscopic antireflux operations in patients who have Barrett's esophagus.

In most patients who have Barrett's esophagus and who are undergoing open or laparoscopic antireflux surgery, there is a significant improvement in symptom control that is equivalent to that in patients who have uncomplicated gastroesophageal reflux disease. The requirement for reoperation in patients with Barrett's esophagus may be slightly higher, although in the two laparoscopic series published to date, the rate is still only approximately 6%. How much this will increase with longer follow-up, time alone will tell, but given the good results in approximately 95% of patients operated to date, the authors do not believe that the diagnosis of Barrett's esophagus should be considered a blanket contraindication for laparoscopic antireflux surgery.

Division of short gastric vessels at laparoscopic nissen fundoplication: a prospective double-blind randomized trial with 5-year follow-up.

Objective: To determine whether division of the short gastric vessels at laparoscopic fundoplication confers long-term clinical benefit to patients.

Summary Background Data: Dividing the short gastric vessels during surgery for gastroesophageal reflux is controversial. This prospective randomized study was designed to determine whether there is a benefit in terms of patient outcome at a minimum of 5 years after primary surgery.