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    A new method in laparoscopic sleeve gastrectomy: Reverse trendelenburg with right lateral tilt position prior to trocar entry
    (International Scientific Information, Inc., 2017) Koç, Okay; Şahiner, İbrahim Tayfun; Ekiz, Feza
    Background: The primary aim of this study was to evaluate the effectiveness of patient positioning prior to trocar entry in laparoscopic sleeve gastrectomy. Material/Methods: The records of 300 patients that had a laparoscopic sleeve gastrectomy surgery at Aydin State Hospital from January 2015 until January 2017 were analyzed retrospectively. First, 140 patients who had been placed in the surgical position after the entry of trocars (PAET) were included as the first group, and 160 patients who had been placed in the surgical position before entry of trocars (PBET) were included as the second group. A comprehensive analysis based on the comparison of age, gender, body mass index (BMI), duration of total anesthesia, and incompleteness rate of operations between the two groups was performed. Results: The PAET group was composed of 111 females (79.3%) and 29 males (20.7%). The averages of age, BMI, and duration of anesthesia for this group were 36.84, 46.3 kg/m 2 , and 161.56 minutes, respectively. The PBET group was composed of 123 females (76.9%) and 37 males (23.1%). The averages of age, BMI, and duration of anesthesia of this second group were 38.8, 47.4 kg/m 2 , and 120.8 minutes, respectively. In the PAET group, the operations for four patients (2.9%) were never completed; in the PBET group, there was no uncompleted operations (p=0.046). Conclusions: PBET is an effective method which both shortens the operation time and decreases the rate of uncompleted operations. © Med Sci Monit.
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    A new variant of double common bile duct associated with choledochal cyst
    (Oxford Univ Press, 2020) Nuamah, Nabil M.; Ekiz, Feza; Kartal, Gulbiz; Sunamak, Oguzhan; Sahiner, Ibrahim Tayfun
    Extrahepatic bile duct duplication is a rare biliary anomaly often associated with conditions like cholecysto-choledocholithiasis, choledochal cyst and malignancy. Precise preoperative diagnosis using conventional radiologic imaging still remains a challenge and use of existing classification system is equally confusing. A female patient diagnosed with choledochal cyst by magnetic resonance cholangiopancreatography was found to have an associated new variant of double common bile duct during surgery. The variant discovered could not be classified by existing classification systems and was missed by preoperative imaging. Recognition of existence of this anomaly that warrants careful dissection during biliary surgery is necessary to avoid inadvertent biliary injury as preoperative diagnosis still remains a challenge. Review of existing classification systems is required to include newly discovered variants.