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"This is the first time a book about laparoscopy in emergency abdominal surgery has been published. Numerous articles have been published in specific surgical journals, but, until now, there has not been a book that collates all the aspects of this little-known field. The aim of this volume is to achieve a complete and easy presentation of all the implications associated with laparoscopy in emergency abdominal surgery. The book should be a manual that can be easily consulted by digestive, general, and specialized surgeons, especially in an emergency. The authors’ contributions are founded on evidence-based medicine, which give the book scientific credibility, but this is coupled with their experience of daily practice, which adds an important complementary dimension to evidence-based medicine. This is balanced by an emphasis on clarity and accessibility, because the ultimate aim of the book is educational. "

"The field of minimally invasive surgery (MIS) has now taken centre stage in modern clinical practice. With ever changing technologies in the field of MIS, such as robotics, there is now the need to train the surgeon to the next degree. Training by simulation, whether virtual, hybrid, or real, allows the surgeon to rehearse, learn, improve or maintain their skills in a safe and stress free environment. Simulation training in laparoscopy and robotic surgery gives a true insight into the latest educational and learning techniques for new technologies in surgery. Written by an international team of experts, this illustrated text provides advice on specialised team training, non technical skills and simulation."

"PURPOSE: To assess the safety and feasibility of laparoscopic gastrectomy (LG) for gastric cancer patients with a history of abdominal surgery (HAS).METHODS: This retrospective study analyzed data collected from gastric cancer patients with HAS, who underwent LG between 2004 and 2015. We compared the clinicopathological features that correlated with conversion to open surgery and the development of severe postoperative complications (Clavien-Dindo classification of grade III or higher).RESULTS: Of the 41 patients identified, 6 (14.6%) required conversion to open surgery. The incidence of conversion to open surgery was associated with a history of lower gastrointestinal tract surgery (p = 0.009), attempted laparoscopic total gastrectomy (p = 0.002), and excessive blood loss (p < 0.001). Severe postoperative complications developed in six patients (14.6%). Although the development of complications was associated with high postoperative serum C-reactive protein, the type of past abdominal surgery was not significantly correlated with severe complications.CONCLUSIONS: LG was feasible for gastric cancer patients with a HAS, but for those with a history of lower abdominal surgery or those who require total gastrectomy, surgeons should carefully consider the indications for LG."

"ABSTRAKPendahuluan. Pemilihan saat yang tepat untuk tindakan relaparotomi masih merupakan tantangan sehingga diperlukan pemeriksaan objektif sederhana untuk menentukan hal tersebut. Indeks Prediktif Reoperasi Abdominal IPRA diciptakan untuk menentukan saat relaparotomi. Tujuan penelitian adalah untuk mengkaji apakah IPRA dapat digunakan sebagai penentu saat relaparotomi di RSUPN dr. Cipto Mangunkusumo RSCM .Metode. Merupakan suatu penelitian deskriptif analitik potong lintang yang dilakukan pada penderita pascarelaparotomi tahun 2009-2015 di RSCM. Sampel berjumlah tiga puluh. Pada tiap sampel, delapan variabel penyusun IPRA diidentifikasi dan dievaluasi.Hasil. Kedelapan variabel penyusun IPRA kondisi emergensi, gagal ginjal, gagal nafas, nyeri perut, infeksi luka operasi, ileus, perubahan GCS, dan gejala baru pada hari keempat dapat diidentifikasi pada ketigapuluh sampel. Empat variabel dengan frekuensi tertinggi masing-masing nyeri perut, infeksi luka operasi, ileus, dan kondisi emergensi. Relaparotomi dapat dilakukan langsung pada penderita dengan skor 10 tanpa harus melakukan pemeriksaan penunjang.Konklusi. IPRA dapat digunakan sebagai suatu standar penilaian objektif sederhana dalam menentukan saat yang tepat untuk relaparotomi. Selain itu, relaparotomi dapat dilakukan pada penderita dengan skor 10 tanpa melakukan pemeriksaan penunjang. Kata kunci: IPRA, saat, relaparotom.

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ABSTRACTBackgroundDetermining the right timing of relaparotomy has always been a challenge and hence a simple objective value is required to do so. ARPI abdominal reoperative predictive index was created to decide when to reoperate. The purpose of this study was to ascertain whether ARPI could be applied as determinant of the timing of relaparotomy in our Hospital.MethodsA cross sectional descriptive study was done in 30 sample of patients who underwent relaparotomy from 2009 to 2015. Eight variables were identified and evaluated in each sample. ResultsEight variables composing ARPI can be identified thoroughly in each sample. Four variables with highest frequency were persistent symptoms on fourth postoperative day, abdominal pain, wound infection, and ileus. Relaparotomy can be performed in patients complaining abdominal pain appearing from second postoperative day and persisting for more than 4 day after operation.ConclusionsApplication of ARPI as a simple objective value to determine the right timing of relaparotomy was satisfactory. All variables are routinely checked and no additional unconventional examination needed. Furthermore, relaparotomy can be performed in patients complaining abdominal pain persisting for more than 4 days after operation which still needs further prospective research to validate. "

"Latar belakang. Komplikasi paru pascaoperasi merupakan salah satu penyebab penting morbiditas dan mortalitas pascaoperasi yang berkaitan dengan anestesia dan pembedahan. Pengaturan ventilasi mekanis berpengaruh terhadap munculnya komplikasi paru pascaoperasi. Penelitian ini bertujuan meneliti pengaruh volume tidal 6 mL/kg dan 10 mL/kg dengan menggunakan PEEP 6 cmH2O terhadap penanda fungsi paru yaitu PaO2/FiO2.Metode. Penelitian ini bersifat uji klinis acak senter tunggal terhadap pasien yang menjalani operasi abdominal mayor elektif di Rumah Sakit Cipto Mangunkusumo pada bulan November 2014 sampai April 2015. Sebanyak 52 subyek diambil dengan metode consecutive sampling. Subyek diacak dalam 2 kelompok yaitu kelompok yang medapat volume tidal 6 mL/kg dengan PEEP 6 cmH2O dan volume tidal 10 mL/kg dengan PEEP 6 cmH2O. Keluaran primer adalah pemeriksaan fungsi paru menggunakan rasio PaO2/FiO2. Keluaran sekunder adalah komplikasi paru (pneumonia, atelektasis, ARDS, gagal napas), komplikasi ekstraparu (SIRS, sepsis, sepsis berat), dan mortalitas dalam 28 hari pascaoperatif.Hasil. Kedua grup memiliki karakteristik dasar dan intraoperatif yang sama. Tidak ditemukan perbedaan yang bermakna rasio PaO2/FiO2 antara kelompok VT-6 mL/kg dengan VT-10 mL/kg, baik pada awal operasi (p=0,14), akhir operasi (p=0,44), hari pertama pascaoperasi (p=0,23), dan hari kedua pascaoperasi (p=0,39). Tidak ada perbedaan bermakna keluaran sekunder berupa kompikasi paru sampai hari ke-7 pascaoperasi, ekstraparu sampai hari ke-7 pascaoperasi, dan mortalitas dalam 28 hari pascaoperasi antara kedua kelompok.Simpulan. Volume tidal-6 sampai volume tidal-10 dengan PEEP6 cmH2O aman untuk dipakai pada pasien yang menjalani operasi abdominal mayor.

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Background. Postoperative pulmonary complications are one of the important causes of postoperative morbidity and mortality associated with anesthesia and surgery. Mechanical ventilation settings influence the emergence of postoperative pulmonary complications. The aim of this study is to investigate the influence of tidal volume 6 mL/kgBW and 10 mL/kgBW with PEEP 6cmH2O to pulmonary function which is measured by the ratio of PaO2 / FiO2.Methods. This study is a single center randomized clinical trial on patients undergoing elective major abdominal surgery at Cipto Mangunkusumo Hospital in November 2014 to April 2015. A total of 52 subjects were taken with consecutive sampling method. The subjects were randomized into two groups: the group receiving tidal volume 6 mL/kgBW with PEEP 6 cmH2O and the group receiving tidal volume of 10 mL/kgBW with PEEP 6 cmH2O. The primary output is the assessment of pulmonary function using the ratio of PaO2/FiO2. Secondary outputs are pulmonary complications (pneumonia, atelectasis, ARDS, respiratory failure), extrapulmonary complications (SIRS, sepsis, severe sepsis), and mortality within 28 days postoperative.Results. The two intervention groups had similar characteristics at baseline. There are no significant PaO2 / FiO2 ratio differences between the VT - 6 mL/kgBB with VT - 10 mL/kgBB, at the start of the operation (p=0,14), the end of surgery (p=0.44), the first postoperative day (p=0,23), and the second postoperative day (p=0,39) . There is no significant difference in the secondary outcomes in form of pulmonary complications until postoperative day 7, extrapulmonary complications until postoperative day 7, and in 28-days postoperative mortality between the two groups.Conclusions : Tidal volume of 6 to 10 mL/kg with PEEP 6 cmH2O are safe for use in patients undergoing major abdominal surgery."

"[ABSTRAK Infeksi daerah operasi merupakan hal yang harus diperhatikan oleh para ahli bedah mengingat tingginya morbiditas dan mortalitas pada pasien yang menderita infeksi daerah operasi Penulis ingin melakukan analisa secara garis besar bagaimana infeksi daerah operasi terutama pada infeksi daerah operasi pada operasi dengan golongan operasi bersih dan bersih tercemar Dilakukan penelitian retrospektif terhadap semua pasien divisi bedah digestif FKUI RSCM dari september 2012 hingga Juli 2014 Pasien dinilai berdasarkan kondisi preoperatif intraoperatif dan pasca operatif Dari data yang terhimpun selama penelitian di dapatkan 57 pasien menderita infeksi daerah operasi Delapan persen dari seluruh total operasi bedah digestif Keganasan kolorektal adenocarcinoma kolorektal menempati urutan pertama 22 39 Didapatkan 2 kasus yang merupakan operasi dengan tipe operasi bersih Didapatkan 17 kasus yang merupakan operasi dengan tipe bersih terkontaminasi Kata kunci Infeksi Daerah Operasi Pembedahan abdominal ABSTRACTSurgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery , Surgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery ]"