11. Hospital Stay and Costs Some of the reported benefits of MIMVS include decreased intensive care unit a and total hospital length of stay, faster physical rehabilitation, selleck chemicals and decreased overall hospital resource use [35, 40, 81, 82]. MIMVS is a cost-effective and cost-saving strategy for mitral valve repair and replacement compared with the traditional approach with lower cost driven largely by a decreased length of stay [80]. 12. Conclusions MIMVS has been proven to be a feasible alternative to the conventional full sternotomy approach with low perioperative morbidity and short-term mortality. Reported benefits of MIMVS include decreased postoperative pain, improved postoperative respiratory function, reduced surgical trauma, and greater patient satisfaction.

Finally, compared to standard surgery, MIMVS demonstrated comparable efficacy across a range of long-term efficacy measures such as freedom from reoperation and long-term survival. Acknowledgment The authors gratefully thank MRS Judith Wilson for the English revision of the paper.
Iatrogenic perforation represents an uncommon yet potentially life-threatening complication during colonoscopy [1, 2]. Traditionally, patients have required open surgery with either primary repair of the perforation or bowel resection with or without ostomy creation [1, 3, 4]. Although these procedures are an effective approach, they often require large open incisions and may be associated with high complication rates, such as wound infection and hernias [1, 4]. In addition, the open approach usually results in slower recovery with longer hospital stay [5�C7].

Minimally invasive colorectal surgery represents an efficacious alternative to the open approach, utilizing smaller incisions and resulting in diminished postoperative pain, earlier recovery, and lower postoperative morbidity [5�C9]. Laparoscopic intervention has more recently been reported for the definitive treatment of acute colonoscopic perforations. This approach has shown to be a viable option, resulting in enhanced recovery in comparison to open primary colorrhaphy [5�C7]. We began utilizing minimally invasive surgical (MIS) technique for repair of colonoscopic perforations in an effort to provide a safe and efficacious alternative to an open procedure. Our aim was to assess and report our initial experience with laparoscopic primary repair of acute colonic perforations during colonoscopy.

2. Patients and Methods Between October 2008 and March 2010, consecutive patients presenting with acute iatrogenic colonic perforation during colonoscopy were evaluated. Laparoscopic surgical repair of the perforations was performed by one of three board-certified colorectal surgeons (A. Mahmood, T. B. Pickron, and E. M. Hass) with extensive experience in minimally Cilengitide invasive procedures.