Laparoscopic Appendectomy in Italy: An Appraisal of 26,863 Cases

Objective: To evaluate the practice of laparoscopic appendectomy (LA) in Italy. Methods: On behalf of the Italian Society of Young Surgeons (SPIGC), an audit of LA was carried out through a written questionnaire sent to 800 institutions in Italy. The questions concerned the diffusion of laparoscopic surgery and LA over the period 1990 through 2001, surgery-related morbidity and mortality rates, indications for LA, the diagnostic algorithm adopted prior to surgery, and use of LA among young surgeons (<40 years). Results: A total of 182 institutions (22.7%) participated in the current audit, and accounted for a total number of 26863 LA. Laparoscopic surgery is performed in 173 (95%) institutions, with 144 (83.2%) routinely performing LA. The mean interval from introduction of laparoscopic surgery to inception of LA was 3.4 ± 2.5 years. There was an emergent basis for 8809 (32.8%) LA procedures (<6 hours of admission); 10314 (38.4%) procedures were performed on an urgent basis (<24 hours of admission); while 7740 (28.8%) procedures were elective. The conversion rate was 2.1% (561 cases) and was due to intraoperative complications in 197 cases (35.1%). Intraoperative complications ranged as high as 0.32%, while postoperative complications were reported in 1.2% of successfully completed LA. The mean hospital stay for successfully completed LA was 2.5 ± 1.05 days. The highest rate of intraoperative complications was reported as occurring during the learning curve phase of their experience (in their first 10 procedures) by 39.7% of the surgeons. LA was indicated for every case of suspected acute appendiceal disease by 51.8% of surgeons, and 44.8% order abdominal ultrasound (US) prior to surgery. A gynecologic counseling is deemed necessary only by 34.5% surgeons, while an abdominal CT scan is required only by 1.5%. The procedure is completed laparoscopically in the absence of gross appendiceal inflammation by 83%; 79.8% try to complete the procedure laparoscopically in the presence of concomitant disease; while 10.4% convert to open surgery in cases of suspected malignancy. Of responding surgeons aged under 40, 76.3% can perform LA, compared to 47.3% surgeons of all age categories. Conclusions: The low response rate of the present survey does not allow us to assess the diffusion of LA in Italy, but rather to appraise its practice in centers routinely performing laparoscopic surgery. In the hands of experienced surgeons, LA has morbidity rates comparable to those of international series. The higher diagnostic yield of laparoscopy makes it an invaluable tool in the management algorithm of women of childbearing age; its advantages in the presence of severe peritonitis are less clear-cut. Surgeons remain the main limiting factor preventing a wider diffusion of LA in our country, since only 47.3% of surgeons from the audited institutions can perform LA on a routine basis.

On the problems of object restoration and image extrapolation in optics

In this paper we consider the problems of object restoration and image extrapolation, according to the regularization theory of improperly posed problems. In order to take into account the stochastic nature of the noise and to introduce the main concepts of information theory, great attention is devoted to the probabilistic methods of regularization. The kind of the restored continuity is investigated in detail; in particular we prove that, while the image extrapolation presents a Hölder type stability, the object restoration has only a logarithmic continuity. © 1979 American Institute of Physics.

Extraction of polydispersity information from photon correlation data

Photon correlation spectroscopy (PCS) is a light-scattering technique for particle size diagnosis. It has been used mainly in the investigation of hydrosol particles since it is based on the measurement of the correlation function of the light scattered from the Brownian motion of suspended particles. Recently this technique also proved useful for studying soot particles in flames and similar aerosol systems. In the case of a polydispersed system the problem of recovering the particle size distribution can be reduced to the problem of inverting the Laplace transform. In this paper we review several methods introduced by the authors for the solution of this problem. We present some numerical results and we discuss the resolution limits characterizing the reconstruction of the size distributions. © 1989.

Object Restoration Beyond the Rayleigh Limit in the Presence of Noise

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On the regularization of linear inverse problems in Fourier optics

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Ill-posed Inverse Problems and Logarithmic Continuity in Electromagnetics

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Resolution beyond the diffraction limit for regularized object restoration

We propose a new formulation of Miller's regularization theory, which is particularly suitable for object restoration problems. By means of simple geometrical arguments, we obtain upper and lower bounds for the errors on regularized solutions. This leads to distinguish between ' Holder continuity ' which is quite good for practical computations and ` logarithmic continuity ' which is very poor. However, in the latter case, one can reconstruct local weighted averages of the solution. This procedure allows for precise valuations of the resolution attainable in a given problem. Numerical computations, made for object restoration beyond the diffraction limit in Fourier optics, show that, when logarithmic continuity holds, the resolution is practically independent of the data noise level. © 1980 Taylor & Francis Group, LLC.

The Stability of Inverse Problems

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Ill-Posedness, Regularization and Number of Degrees of Freedom

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Superresolution and number of degrees of freedom in inverse diffraction with subwavelength sources

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Number of degrees of freedom in inverse diffraction

The problem of inverse diffraction from plane to plane is considered in the case where a finite aperture exists in the boundary plane. Singular values and singular functions for the problem are introduced, and the number of degrees of freedom is defined in terms of the distribution of the singular values. Numerical computations are presented for the one-dimensional problem, and it is shown that the effect of evanescent waves disappears at a distance of approximately one wavelength from the boundary plane, even when the dimension of the slit is comparable with the wavelength of the diffracted field. © 1983 Taylor & Francis Group, LLC.

Stability and Resolution in Electromagnetic Inverse Scattering - Part I

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Iterative inversion of experimental data in weighted spaces

We present iterative algorithms for solving linear inverse problems with discrete data and compare their performances with the method of singular function expansion, in view of applications in optical imaging and particle sizing.

Positive regularised solutions in electromagnetic inverse scattering

Fredholm integral equations of the first kind are the mathematical model common to several electromagnetic, optical and acoustical inverse scattering problems. In most of these problems the solution must be positive in order to satisfy physical plausibility. We consider ill-posed deconvolution problems and investigate several linear regularization algorithms which provide positive approximate solutions at least in the absence of errors on the data.

Applied Inverse Problems in Optics

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