9/21/2023 0 Comments Simple suture with omental patch![]() Carbon dioxide pneumoperitoneum (12 mmHg) was established through an umbilical incision with a Veress needle or Hasson technique, whereas a 0- or 30-degree-angled laparoscope was introduced through the 11-mm port. The surgeon and the camera operator stood on the patient's left side with an assistant on the other side. The patients were placed in a 15- to 20-degree reverse Trendelenburg position. Depending on the personal experiences and skill, 27 patients underwent simple closure by the author (B.-C.L.), whereas the other 91 underwent repair using an omental by other surgeons. Eighteen patients with big perforation and/or technical difficulties were converted to open method, while the remaining 118 patients (22.8% PPU patients) eventually underwent laparoscopic repair and were included in this study. For the prevention of selection bias of patients who did or did not undergo the laparoscopic method, patients with shock, generalized peritonitis, previous upper-abdominal surgery, nonjuxtapyloric gastric ulcers, perforations >12 mm, and concomitant ulcer bleeding or gastric outlet obstruction were excluded. ![]() ![]() From January 2010 to December 2014, 518 patients with a clinical diagnosis of PPU underwent surgery in our department of them, 136 underwent the laparoscopic approach. This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital. ![]()
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