1/2. Laparoscopic wedge resection of the gastric wall for gastric benign tumour. The collaboration of the laparoscopic surgeon and the endoscopist.INTRODUCTION: By the introduction of the laparoscopy for the management of gastric pathology many techniques are applied by now. In these techniques the collaboration of the endoscopist and the laparoscopic surgeon is mandatory. AIMS OF THE STUDY: To emphasise the necessity of the collaboration of the endoscopist and the laparoscopic surgeon for the management of the gastric pathology using the double lifting and wedge resection technique. METHOD: A case of a female with 2 x 2.5 cm submucosal tumour is presented. The tumour was located in the antrum. After the onset of the general anaesthesia the gastroscope was introduced to locate the position of the tumour, the free edges of the tumour were elevated by a double lifting method and the tumour was resected by a laparoscopic linear stapler. The process of the proper resection was all through observed and directed by the view of the gastroscope. CONCLUSION: Correct wedge resection of the gastric wall can be safely performed, if the correct gastroscopic control is present. The collaboration of the endoscopist and the laparoscopic surgeon seems to be mandatory, thus avoiding the hazards arising from the use of tattooing.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. The use of halothane in a patient with asymmetrical septal hypertrophy: a case report.An elderly patient with demonstrated asymmetrical intraventricular septal hypertrophy and ventriculo-aortic pressure gradient was anaesthetized with nitrous oxide with oxygen, narcotic, and muscle relaxant for abdominal surgery. In addition to the cardiovascular variables customarily monitored, a systolic time interval (STI) measured from the Q wave of the ECG to the foot of the radial pulse (the QF interval) was calculated in milliseconds beat-to-beat by a computer. With anaesthesia, and particularly following the beginning of operation, the QF interval lengthened as an indication of either decreased cardiac inotropy or increased pressure gradient across the aortic outflow tract. When halothane 0.25 per cent was added to the anaesthetic mixture, the QF interval shortened by about 20 milliseconds without an observed change in direct arterial pressure. Since halothane is a cardiac depressant and normally lengthens the STI, it apparently relaxed the muscular stenosis of the ventricular outflow tract and reduced the pressure gradient and, subsequently, the QF interval. By measuring cardiovascular function with this STI, the beneficial action of cardiac depression from low-dose halothane was observed, which would have escaped detection by common monitoring indices.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |