Introduction & Objective: laparoscopic management of diseases has now been accepted as a golden standard in international societies. However, there are still many studies on the newest methods of minimally invasive surgery in order to achieve the best surgical procedure with the most favorable post-operative outcomes. The purpose of this study was to compare the results of postoperative outcomes of single-port trans-umbilical laparoscopic appendectomy and single-incision two-port laparoscopic appendectomy. Materials & Methods: In this retrospective study, 77 patients participated who underwent single-port trans-umbilical laparoscopic appendectomy and single-incision two-port laparoscopic appendectomy during one year (May 2017-2018). In single-incision two-port laparoscopic appendectomy group, two 5-mm trocars were implanted in a trans-umbilically, and another hole was used for left-hand instruments. Demographic specifications, operation data, and post-operative results of groups were compared using Chi-squared test or, if necessary, Fisher test. The T-test was used to compare the average of the two target groups that were independent of each other. The significance level of the tests was considered to be 0. 05. Statistical analyses were performed using the SAS EG 5. 1 server, version 9. 3. (SAS Institute Inc., Cary, NC, USA) Results: The total average time of single-incision two-port laparoscopic appendectomy surgery was significantly lower than that of single-port trans-umbilical laparoscopic appendectomy (P = 0. 003). The average laparoscopic time was significantly lower in the single-incision two-port laparoscopic appendectomy group (P < 0. 001). The average number of postoperative analgesic drugs in the single-incision two-port laparoscopic appendectomy group was significantly lower than that of single-port trans-umbilical laparoscopic appendectomy (p = 0. 002). The average number of hospitalization post-operative days in the single-incision two-port laparoscopic appendectomy was significantly lower than that of single-port trans-umbilical laparoscopic appendectomy group (P = 0. 008). No other statistically significant difference was observed between the two groups. Conclusions: According to the findings of this study, the average number of duration of the single-incision two-port laparoscopic appendectomy was significantly lesser and thus required less pain management; also, in aesthetic point of view, its result was similar to that of single-port trans-umbilical laparoscopic appendectomy.

Ovulation induction is indicated in women with ovulation disorders. In about 90% of these women polycystic ovary syndrome (PCOS) can be diagnosed. The oral anti-oestrogen clomiphene citrate is at this moment still the treatment of first choice. The second line treatment in these clomiphene citrate resistant women may be ovulation induction with gonadotrophins or laparoscopic ovarian surgery. Ovarian surgery is an alternative treatment option for ovulation induction in women. In ovarian electrocautery multiple perforations of the ovarian surface and stroma are created. Only one large randomized controlled trial comparing a treatment strategy that started with laparoscopic electrocautery of the ovaries followed by CC and rFSH if anovulation persisted versus ovulation induction with rFSH evaluated whether gonadotrophins or laparoscopic electrocautery of the ovaries should be the treatment of choice in patients with CC-resistant polycystic ovary syndrome, especially in view of the prevention of multiple pregnancy.The cumulative rate of ongoing pregnancy after recombinant follicle stimulating hormone was 67%. With only electrocautery it was 34%, which increased to 49% after clomiphene citrate was given. Subsequent recombinant follicle stimulating hormone increased the rate to 67% at 12 months. Of the 56 (67%) ongoing pregnancies in the electrocautery group, one resulted in quintuplets in a patient also given recombinant follicle stimulating hormone, and successful embryo reduction led to the live birth of twins. Of the 57 ongoing pregnancies in the women allocated recombinant follicle stimulating hormone, eight were twin pregnancies and one was a triplet pregnancy. The major difference between the two strategies therefore indeed seems to be that multiple pregnancies can largely be prevented by treating women with electrocautery and clomiphene citrate.

Purpose: This study was to introduce the modified mini-laparoscopic surgery for renal cyst and investigate its advantages on operative time, cosmetic effect and pain reduction by comparison with laparo-endoscopic single site surgery (LESS) and conventional laparoscopic surgery. Methods and patients: Between May 2015 and October 2018, 140 consecutive patients with benign renal cyst underwent laparoscopic decortication of renal cyst. Of which, 48 cases were in mini-laparoscopic surgery group (M group), 56 cases in LESS group and 36 cases in conventional laparoscopic surgery group (C group). The operative time, blood loss, visual analog scale (VAS) and Scar Cosmesis Assessment and Rating (SCAR) Scale was recorded. Results: The mean operative time in M group (26. 08± 7. 70 min) and C group (28. 56 ± 7. 99 min). was significantly less than that in LESS group (47. 32 ± 10. 53 min) (P < 0. 01). Mean blood loss did not differ between the 3 groups (P > 0. 05). Mean VAS pain scores in M group were significantly lower than that of LESS group and C group on postoperative day (POD) 1 and 3 (P < 0. 01). The SCAR scale of POD 30 in C group (6. 25 ± 1. 0) was significantly higher than that in M group (0. 77 ± 0. 59) and LESS group (0. 98 ± 0. 70). The postoperative course was uneventful with no morbidity within 1to 6 months of follow-up. Conclusion: Modified mini-laparoscopic decortication of renal cyst have more comprehensive advantages comparing with LESS and conventional laparoscopic surgery. It is convenient and offered significant cosmetic benefit and reduced incisional pain.

Laparoscopy has made a revolution in surgical procedures and treatment of various diseases but its complications are still under investigation. Intra-abdominal visceral and vessel injuries, trocar site hernia, and leaving foreign bodies into the peritoneal cavity are among some laparoscopic surgery complications. This is a rare report of Penrose drain migration following incomplete laparoscopic Fundoplication surgery. The patient was a 47- year- old woman, who was a candidate for Touplet Fundoplication via laparoscopic approach due to refractory gastro-esophageal reflux disease (GERD). While wrapping a Penrose drain around the esophagus, the patient had a cardiorespiratory arrest. Attempts to remove the Penrose drain were unsuccessful and the surgical procedure was terminated due to patient's condition. Four months later, after a long period of dysphagia and abdominal pain, the Penrose drain was defecated via rectum.

In recent years, laparoscopy has become a popular surgical method. Laparoscopy is a minimally invasive surgery, which results in minor traumas in comparison with conventional open surgeries. There are several risk factors associated with laparoscopy based on the involved organ and the patient’s general situations. Due to the improvements of clinical approaches, laparoscopic splenectomy has been known as a gold standard method for spleen removal as a result of various diseases, such as ITP. The human spleen plays a key immunologic role in defense against a number of organisms, particularly encapsulated bacteria. The spleen can cause significant morbidity and/or hematologic disturbance if it becomes hyperfunction (hypersplenism) or hypertrophied (splenomegaly). laparoscopic surgery for cancer is also an appropriate procedure if good tissue handling techniques are maintained. In this study, we attempted to review the results obtained from recent articles about the beneficial features of the laparoscopic splenotectomy in comparison with conventional open surgery.

Purpose: To present our experience with synchronous or metachronous laparoscopic pyelolithotomy and ureterolithotomy for patients with bilateral urolithiasis. Materials and Methods: The data of all patients who underwent laparoscopic pyelolithotomy (± ureterolithotomy) for bilateral renal and/or ureteral stones from November 2009 to July 2014 were included. laparoscopic operations were performed through a transperitoneal approach. Results: 10 patients underwent laparoscopic operations for renal stones (19 kidney stones) and ureteral stones (1 ureteral stone). 4 patients underwent synchronous operations and 6 patients underwent metachronous operations. The mean ± SD of operation duration were 212 ± 51 minutes for synchronous operations and 166 ± 41 minutes for metachronous operations. Residual stone was observed 5 patients. No patient developed urinary leakage. Conclusion: laparoscopic pyelolithotomy and/or ureterolithotomy for bilateral stones is a feasible option in centers with experience in laparoscopy.

Background: Laparoscopy is one of the most common surgical procedures. General anesthesia as the only suitable technique for laparoscopic procedures is a concept of the past. A problem with modern general anesthetics is that even though patients can be awake and oriented shortly after cessation of the anesthetic. There is growing evidence suggesting that regional anesthesia has an important role to play in the care of patients undergoing laparoscopy. The key benefits of regional anesthesia include less emesis, less postoperative pain, shorter postoperative stay, improved patient satisfaction, and overall safety. The outcome of regional anesthesia depends on the creativeness of surgeons and anesthesiologists, and patient acceptance. In this study it was decided to compare spinal anesthesia with the gold standard general anesthesia for elective laparoscopic procedure in patients with infertility.Materials and Methods: A prospective descriptive study was performed on 10 cases with infertility that was candid to do Laparoscopy as a work up of infertility.The study group had no contraindication for laparoscopic surgery, spinal anesthesia and were underwent spinal anesthesia and diagnostic or Therapeutic laparoscopy consists of ovarian drilling or adhesionolysis if it was necessary. Conversion of anesthesia to general, insufflations Pain during surgery, duration of surgery and postoperative variable consists of duration of Hospital stay, presence of nausea or vomiting, use of analgesic or antiemetic and headache were Recorded.Results: The mean age of the study group was 5.7±7.2 and there was no conversion to general anesthesia. Insufflations pain was present in 3 of 10 cases (30%) that were treated with use of propofol and the mean duration of surgery was 31miutes.in regard to postoperative variable all 10 patients were discharged at same day of surgery. Two cases (20%) received one dose of analgesic after surgery and none of them developed nausea, vomiting and headache.so, there was no need to use anti-emetic.Conclusion: It seems that use of spinal anesthesia in work up of infertility cases that are underwent laparoscopy is safe and has minimal complication such as insufflations pain, but it need more study with more cases for the confirmation of this results.