Laparoscopic management of cholecystocolonic fistula: A case report and a brief literature review

Highlights • Cholecystoenteric fistula is a rare and late complication of cholelithiasis. • We report a case of cholecysto-colonic fistula with hepatic flexure management by laparoscopic approach, a 64 years old male patients with fever of an unknown origins for two months and abdominal pain. • We performed laparoscopic cholecystectomy and repaired colonic wall with intra-corporeal sutures. • The laparoscopic management of cholecystoeneteric fistula is a feasible and safe procedure but the operative strategy should be individualized.

Renal endometriosis mimicking complicated cysts of kidney: report of two cases

Endometriosis is a common gynecologic disorder characterized by ectopic endometrial tissue growth outside the uterine cavity. Although usually occurring in pelvic organs, endometrial lesions may involve urinary tract. Renal endometriosis is extremely rare and it has only occasionally been reported in the past. We report two cases of patients with renal cystic lesions, incidentally found at imaging techniques during oncologic follow-up for gastric sarcoma and melanoma, initially misinterpreted as complicated haemorrhagic cysts and then histologically characterized as renal localizations of extragenital endometriosis.

A 3D totally absorbable synthetic mesh in antireflux surgery: Gore Bio-A tissue reinforcement for hiatal hernia repairing

Introduction Hiatal hernia, defined as “transitory or stable dislocation of a part of the stomach in mediastinum through the diaphragmatic crura delimiting esophageal hiatus”. Its appearance presupposes anatomic anomalies or weakening of structures and mechanisms able to maintain esophago-gastric junction and stomach in the abdominal cavity [1]. Classically hiatal hernia was classified in four types using Hill’s classification: Type 1 hiatal hernia is associated with GERD in 50-90% of cases, in facts its presence gradually compromises esophago-gastric junction’s continence favouriting the backwater of acid secretion and its reflux in contact with esophageal mucosa during transient relaxatio…

Fixation free incisional hernia repair with a newly designed mesh with integrated bands

Introdution: Implant fixation and how to ensure adequate mesh overlap are key issues in abdominal hernia repair. A newly developed technique for ventral and incisional hernia repair using a proprietary implant with incorporated straps makes fixation unnecessary through tissue friction. This new implant allows for a broader coverage of the abdominal wall and results in simplified repair. Midterm follow- up in a cohort of patients indicates a decrease in postoperative com- plications and no recurrences to date. Matcrial and methods: A lightweight, large porous polypropylene mesh with a central body and eight radiating arms was used to repair ventral or incisional hernia. The implant was place…

Excision of ectopic adrenocortical tissue during laparoscopy for isolated tubal torsion

Ectopic adrenal tissue is an occasional finding during surgery procedures. These remnants are usually found near the primary gland or along the course of gonadal vessels consistently with embryologic development. The appearance is of a small but distinct, soft, round, yellow nodule and only cortical adrenal tissue is normally observed. We report a case of an emergency laparoscopic salpingostomy for isolated tubal torsion with excision of EAT, incidentally found in left ovarian pedicle, followed by postoperative resumption of regular menses and regression of hirsutism. Although intraoperative research of ectopic adrenal tissue is not necessary its removal is indicated in case of incidental f…

Appendiceal mucinous neoplasms: An uncertain nosological entity. Report of a case

Introduction: Appendiceal mucocele is a relatively rare condition characterized by progressive dilation of the appendix caused by intraluminal accumulation of mucoid substance. Its incidence is 0.07 - 0,63% of all appendectomies performed. Case report: We report the case of a 70-year-old man who came to our observation with gravative pain in right lower abdominal region. A computed tomography abdominal scan revealed a cystic/tubular structure like an appendicular mass with wall enhancement but without calcifications suggestive of a mucocele. Into peritoneal cavity we found profuse mucinous material with a 1,5 cm size parietal nodule. We also identified a free perforation of the cecum with c…

Laparoscopic adrenalectomy for large adrenal masses: Single team experience

Abstract Introduction Laparoscopic adrenalectomy is today considered the standard treatment for benign small adrenal tumors. An open question is the use of laparoscopy for large adrenal masses because of technical limitations and increased risk of malignancy. In this study we report our experience in laparoscopic adrenalectomy for adrenal masses larger than 6 cm. Methods Between January 2010 and December 2013 we performed 41 laparoscopic adrenalectomy. Fourteen of 41 patients (34,1%) were submitted to laparoscopic adrenalectomy for lesion >6 cm in size. All patients were submitted routinely to radiological and hormonal tests to indentify tumors characteristics. Results The patients treated …

Terminal or truncal ligation of the inferior thyroid artery during thyroidectomy? A prospective randomized trial.

Abstract Introduction Thyroidectomy is a common procedure in general and endocrine surgery. The technique of ligation of inferior thyroid artery (ITA) has been invoked as a possible cause of appearance of postoperative hypocalcemia. Methods We performed a prospective randomized study involving 184 patients undergoing total thyroidectomy to evaluate the differences of truncal ligation versus distal ligation of ITA in terms of postoperative hypocalcemia, vocal fold palsy, voice and swallowing impairment. The patients were divided into group A (trunk ligation of ITA) and group B (terminal branches ligation of ITA). Results We evaluated postoperative PTH and calcemia (immediate, 6 and 12 months…

Laparoscopic drainage of liver abscess: case report and literature review.

Aim To evaluate the safety and efficacy of the minimally invasive surgical approach (laparoscopic drainage) of liver abscesses in selected cases. Case report Male, 58 years old, from a rural area, presented with epigastric abdominal pain, fever, weight loss, loss of appetite, a palpable mass in the epigastrium and neutrophilic leukocytosis. CT revealed a complex multiloculated liver abscess in segments 2-3. Systemic antibiotic therapy alone was ineffective; percutaneous drainage was excluded due to the characteristics of the lesion. Result Given the complexity of the lesion, a laparoscopic approach was chosen involving complete drainage of the abscess, debridement and irrigation; the cavity…

Robotic versus laparoscopic sacrocolpopexy for apical prolapse: a case-control study

The apical prolapse has always been considered the most complex of the defects of the pelvic floor, for both the difficulty of the surgical corrective technique and for the high post-surgical recurrence rate. Today, the laparoscopic sacrocolpopexy can be considered the standard treatment for apical prolapse. In the last years, several author performed robotic sacrocolpopexy, obtaining positive results. So, we developed a case-control study in order to compare the surgical outcome of robotic group with a control group of laparoscopic approach in patients with symptomatic apical pro-lapsed between January 2015 and December 2015 at University Hospital Policlinico “P. Giaccone” and Ospedali Riu…

Large cavernous hemangioma of the adrenal gland: Laparoscopic treatment. Report of a case

Highlights • Identify the preoperative radiologic features of adrenal hemangioma. • We examine the better surgical approach for adrenal tumors and adrenal hemangioma. • Controindication to laparoscopic adrenalectomy.

Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

Abstract Background The spread of the SARS-CoV2 virus, which causes COVID-19 disease, profoundly impacted the surgical community. Recommendations have been published to manage patients needing surgery during the COVID-19 pandemic. This survey, under the aegis of the Italian Society of Endoscopic Surgery, aims to analyze how Italian surgeons have changed their practice during the pandemic. Methods The authors designed an online survey that was circulated for completion to the Italian departments of general surgery registered in the Italian Ministry of Health database in December 2020. Questions were divided into three sections: hospital organization, screening policies, and safety profile of…

COMPARING THE BIOLOGICAL RESPONSE OF CONVENTIONAL STATIC MESHES AND DYNAMIC RESPONSIVE IMPLANTS

Introduction: Inguinal hernia repair represent one of the most performed surgical procedure in the world. Notwithstanding the progress in prosthetic material and surgical procedures, the rate of complications remains high. Actually, chronic pain and discomfort are often source of debate among herniologists. Poor quality of tissue incorporation, such as stiff scar plaque leading to mesh shrinkage, is the typical results of conventional static implants that may lead to these adverse events. Recently, a new type of prosthesis, a 3D dynamic responsive implant, was introduced to the market. This device, designed to be positioned fixation-free, seems to induce the development of viable and more s…

Laparoscopic management of adrenal tumors: A four-year experience in a single center

AIM: Today laparoscopy is considered the first choice treatment of many adrenal tumors, although its use is still controversial for large adrenal masses and incidentally found adrenal cortical carcinoma. METHODS: From January 2009 to February 2014 we performed 42 lateral transperitoneal laparoscopic adrenalectomies. The indications for surgery were non-functioning adenoma larger than 4 cm or rapid growth and hormone-secreting tumor. The diagnosis was confirmed in all cases with computed tomography and magnetic resonance imaging and also metaiodobenzylguanidine scintigraphy if pheochromocytoma was suspected. In all cases we realized a complete preoperative hormonal study. We describe and ana…

Caecal leiomyoma detected by whole-body MRI in a patient with Hodgkin lymphoma: first case report

Introduction. Hodgkin Lymphoma (HL) is one of the most curable malignant diseases. Modern treatments, like the combined radiochemotherapy and stem cell transplantation, have increased the number of malignant disease survivors. However, HL survivors are at risk of long-term effects, including the development of solid tumors. Secondary neoplasms are a major cause of late morbidity and mortality following treatment for HL. Case report. We report the case of a male patient, treated for HL by chemotherapy, who developed a large leiomyoma of the cecum one year after the treatment. A whole-body Magnetic Resonance (WBMRI) scan performed during the follow-up allowed the detection of this incidental …

COMBINED INGUINAL HERNIA, A PROGRESSIVE PROTRUSION DISEASE

Modified fixation free plug technique using a new 3D multilamellar implant for inguinal hernia repair: a retrospective study of a single operator case series.

Aim: Implant fixation, mesh shrinkage and poor quality of tissue ingrowth are unresolved issues in modern hernia repair. Many complications reported in the literature such as bleeding, nerve entrapment, hematoma, pain, discomfort, and testicular complications, are considered to be a direct results of implant fixation. This article describes the outcomes of a procedure carried out using a handcrafted implant that addresses the issues consequent to point fixation. Methods: This was a retrospective study on the short, medium and long-term results of placing a-modified, fixation free three-dimensional polypropylene implant in 61 patients who underwent inguinal hernia repair using a novel delive…

Topic: Inguinal Hernia - Joined guidelines.

Inguinal Hernia: Crossfire Between the Meshes.