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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. "

"Tujuan tulisan ini adalah mendiskusikan tatalaksana teknisi pengobatan endometriosis, dengan penekanan pada peran laparoskopi operatif dan pengobatan medikamatosa"

"Tujuan tulisan ini adalah mendiskusikan tatalaksana terkini pengobatan endometriosis dengan penekanan pada peran laparoskopi operatif dan pengobatan medikamatosa. Ketepatan mendiagnosis endometriosis tanpa Laparoskopi sangat lemah, dengan positif palsu 44 % dan negatif palsu 19 %. Tersangka endometriosis yang didiagnosis tanpa laparoskopi akan ditemukan 81 % secara laparoskopi, sisanya 19 % bukan endometriosis. Disimpulkan bahwa laparoskopi sangat dibutuhkan untitk mendiagnosis dan mengobati endometriosis. Pengobalun medikamentosa efektifdalam hal merendahkan progresifitas endometriosis. (MedJ Indones 2006; 15:121-4)

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The objective of this paper is to discuss the current guidelines for treatment of endometriosis, emphasis on the role of laparoscopic surgery and medical treatment. The accuracy of diagnosis ofendometriosis without laparoscopy is very low, as a false negative rate of 19 % and a false positive rate of 44 %, when a diagnosis was made pre iaparoscopy, 81 % had the diagnosis can confirmed on laparoscopy, while 19 % did not have endometriosis. It is concluded that laparoscopy is required for evaluation ami treatment of endometriosis. Medical therapy is effective in reducing progression of endometriosis score. (MedJ Indones 2006; 15:121-4)"

"ABSTRAKDehisensi luka secara klinis diamati sebagai terbukanya kembali luka operasi yangtelah dipertautkan secara primer dan mengalami kegagalan pertautan luka padafase inflamasi. Risiko penyebab terjadinya dehisensi luka operasi pada anak adalahmultifaktorial. Salah satu faktor yang mungkin berperan adalah polimorfisme genGlutation S-transferase P1 GSTP1 . Tujuan penelitian ini adalah untuk menilaiperan faktor risiko polimorfisme genetik GSTP1 I105V terhadap terjadinyakomplikasi dehisensi luka operasi pada anak yang menjalani operasi mayor. Penelitian ini menggunakan desain studi kohort secara prospektif yang dilakukandi Pusat Pelayanan Bedah Anak RSAB Harapan Kita. Sebanyak 116 individumemenuhi kriteria inklusi. Semua subjek menjalani pemeriksaan darah rutin untukpersiapan bedah mayor, pemeriksaan rasio GSH:GSSG dan kadar senyawa proteinkarbonil untuk identifikasi stres oksidatif, serta pemeriksaan genotyping PCR ndash;RFLP. Sebanyak 30 subjek dilakukan pemeriksaan TcPO2. Hasil sebarangenotipe masing-masing Ile/Ile, Val/Val dan Ile/Val adalah 56/116 48,3 ,15/116 12,9 , dan 45/116 38,7 . Polimorfisme GSTP1 I105V menunjukkanhasil peningkatan stres oksidatif tidak berbeda bermakna dengan wildtype. Hasilpemeriksaan TcPO2pasca operasi turun lebih tajam dan berbeda bermakna padasubjek dengan genotipe Ile/Val dan Val/Val. Selain itu, polimorfisme GSTP1Ile/Val dan Val/Val pada subjek dengan komplikasi operasi anemia, hipoalbumindan sepsis, mengalami peningkatan risiko dehisensi luka dengan risiko relatifberturut-turut: RR 2,86, IK 0,647 ndash;12,66, p 0,166; RR 3, IK 1,829 ndash;10,85, p 0,037;RR 3,2, IK 2,876 ndash;11,27, p 0,015. Polimorfisme GSTP1 I105V memengaruhi peningkatan kejadian dehisensi lukapada keadaan hipoksia pasca operasi yang ditunjukkan dengan penurunan TcPO2lebih tajam, dan pada subjek dengan komplikasi hipoalbumin.

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ABSTRACTWound dehiscence is a leakage of a surgical suture at the surgical site incision.The risks associated with wound dehiscence are multifactorial. One of thepossible underlying mechanisms that increase the risk of wound dehiscence is thepresence of Glutation S transferase P1 GSTP1 I105V gene polymorphism. Theaim of this study is to evaluate the role of GSTP1 I105V genetic polymorphism inthe development of surgical wound dehiscence in pediatric patient who underwentmajor abdominal surgery.This is a prospective cohort study conducted at Harapan Kita Mother and ChildHospital. A total of 116 individuals fulfilled the criteria with 3 different genotypesincluding Ile Ile, Val Val and Ile Val, consisting of 56 116 48.3 , 15 116 12.9 and 45 116 38.7 subjects, respectively, which are stated by PCRRFLP.All subjects underwent routine blood test in preparation for surgery,GSH GSSG ratio and carbonyl protein measurement to evaluate the presence ofoxidative stress. Measurement of TcPO2 was done in 30 of subject.GSTP1 I105V polymorphism did not increase oxidative stress significantly.However, post operative TcPOmeasurement was significantly reduced inpatients with Ile Val and Val Val genotype. Furthermore, Ile Val dan Val ValGSTP1 polymorphism in subject having surgical complications anemia,hypoalbumin and septicemia , increased the risk of wound dehiscencerespectively RR 2,86, CI 0,647 ndash 12,66, p 0,166 RR 3, CI 1,829 ndash 10,85, p 0,037 RR 3,2, CI 2,876 ndash 11,27, p 0,015. Of note, the RR for septicemia were statisticallysignificant in both the group with polymorphism and in the group with nopolymorphism.GSTP1 I105V polymorphisms increases the risk of wound dehiscence in hipoxicstate showed by a decrease in post operative TcPO2 and in patients withhypoalbuminemia "