FROM THE 16th SLS ANNUAL MEETING AND ENDO EXPO 2007, SAN FRANCISCO, CALIFORNIA, SEPTEMBER 5–8, 2007
Best Scientific Paper—Gynecology
Staging of Advanced Ovarian Cancers: Interest in Thoracoscopy
Submitted by Anne-Sophie Bats, MD, Sandra Cohen-Mouly, MD, Reda Souilamas, MD, Cherazade Bensaid, MD, Marie Junger, MD, Florence Larousserie, MD, Fabrice Leceru, MD, PhD
Thoracoscopy can improve the staging of ovarian cancer and allow the changing of therapeutic management of patients with advanced ovarian cancer associated with pleural effusion. Eight thoracoscopies were performed on the right side and 3 on the left side. One of them was stopped for refractory hypoxemia. Pleural effusion recurred in only one case. Of these 11 patients, 4 women had pleural metastases diagnosed by thoracoscopy, whereas the thoracic CT scan was normal; 3 patients were classified in the 4th stage of cancer because of pleural effusion, but thoracoscopy confirmed the diagnosis due to negative biopsies. In 2 patients, the pleural disease was more severe than was the abdominal extension. These women were recommended for chemotherapy.
Best Scientific Paper—Urology
Comparative Review of Laparoscopic and Robotic-assisted Radical Cystectomy with Ileal Conduit Urinary Diversion
Submitted Matthew N. Simmons MD, PhD, Inderbir S. Gill, MD, MCh
No uniform reporting methods are available to compare outcomes data for laparoscopic partial nephrectomy (LPN); therefore, outcomes data are limited. We used a standardized complications reporting system to analyze complications in a contemporary cohort of 200 patients from an LPN database of over 500 patients. Thirty-five (17.5%) patients had complications. The overall complication rate was 19%. Of the complications, 20% were grade I, 42% were grade II, 26% were grade III, and 2.6% were IV. No grade V complications occurred. Compared with the first 200 patients in our LPN cohort, this contemporary cohort had significant decreases in overall, urologic, and hemorrhagic complication rates despite an increase in tumor complexity. Increased experience with advanced laparoscopic techniques has allowed for a significantly reduced complication rate after contemporary laparoscopic partial nephrectomy (LPN), which now appears comparable to that of open partial nephrectomy. We advocate the development of a standardized complication reporting system.
Best Scientific Paper—Multispecialty
Experimental Studies of Peroral Transgastric Abdominal Surgery: Tubectomy, Hysterectomy. Is it the Next Minimal Invasive Approach?
Submitted by Stefanos Chandakas, MD, MBA, PhD, Chris Feretis, MD
Peroral transgastric surgery, a less invasive type of surgery, is technically feasible and safe in a porcine model and needs to be studied further. We performed incisionless endoscopic peroral transgastric procedures on 10 anesthetized pigs, which included peritoneoscopy, liver biopsy (1), cholecystectomy (6), fallopian tube excision (1), and hysterectomy (1). In 4 animals, peritoneoscopy liver biopsy and cholecystectomy were performed successfully without intraoperative complications. In survival studies, 6 of the 10 pigs that underwent cholecystectomy, tubectomy, and hysterectomy had uncomplicated recover at 4 to 6 weeks.
Best Scientific Paper—General Surgery
Laparoscopic-assisted Colonoscopic Polypectomy: Long-term Results
Submitted by Morris E. Franklin, Jr, MD, Guillermo Portillo, MD, Jefrey L. Glass, MD, John J. Gonzalez, Jr, MD
A combined endoscopic-laparoscopic approach offers a valid alternative for treating difficult colonic polyps and eliminates the morbidity of a segmental resection. Long-term follow-up demonstrates that this technique is safe and effective. A total of 190 polyps were removed as follows: 112 right colon (59%), 23 transverse (12%), 12 left colon (7%), and 33 rectosigmoid (22%). In 96% of patients, laparoscopic-monitored colonic polypectomies were performed successfully. Full-thickness resection was required in 4% of patients because of technique problems and positive margins. In a mean follow-up of 74 months, there have been no recurrences.