A surgical model for isolating the pig liver in vivo for gene therapy.

Several studies report results that suggest the need of vascularization blocking for efficient gene transfer to the liver, especially in nonviral gene therapy. In this study, we describe a surgical strategy for in vivo isolation of the pig liver, resulting in a vascular watertight organ that allows the evaluation of several gene injection conditions. The hepatic artery and portal, suprahepatic and infrahepatic cava veins were dissected. Then, liver vascularization was excluded for 5-7 min. In that time, we first injected 200 ml saline solution containing the p3c-eGFP plasmid (20 µg/ml) simultaneously through two different catheters placed in the portal and cava veins, respectively. Vital co…

The use of an endostapler in the treatment of supralevator abscess of intersphincteric origin.

Aim This technical note describes the use of an endostapler for the definitive treatment of supralevator abscess upward from an intersphincteric origin. Method A two-stage treatment was performed. First an endoanal drainage was performed by inserting a mushroom catheter in the supralevator abscess cavity. In the second stage transanal unroofing of the fistula was performed with an endostapler. Results Since 2011, three patients have been treated in this way. After 2 years of follow up, none of the patients had recurrence of the abscess or been referred for anal incontinence. Conclusion The use of an endostapler in the treatment of supralevator abscess of intersphincteric origin may be an al…

Técnicas reconstructivas tras amputación abdominoperineal extraelevadora del recto o exenteración pélvica: mallas, plastias y colgajos

Perineal wound complications after abdomino-perineal rectal resection are frequent and clinically relevant for their impact on the length of hospitalization, costs, patients' quality of life and oncologic results. With the diffusion of the preoperative radiotherapy and the gradual shift to the extra-elevator technique, the perineal morbidity rate has increased. Many series describing different techniques of primary closure of the perineal defect have been published, but high-quality clinical studies, indicating which is the best option, are missing. A biologic mesh, associated if possible to an omentoplasty, seems to be sufficient to close the perineal defect after extra-elevator abdomino-p…

Anatomical strategy for complete laparoscopic mesocolic excision for splenic flexure colonic cancer - a video vignette

Progrip self-gripping mesh in Rives-Stoppa repair: Are there any differences in outcomes versus a retromuscular polypropylene mesh fixed with sutures? A “case series” study

Highlights • The Rives-Stoppa technique is an excellent repair in midline incisional hernia. • Prospective comparative analysis between retromuscular Self-gripping mesh and PPL fixed with sutures. • Self-gripping mesh is related to less postoperative pain the first 48 h after repair. • There were more postoperative hematomas in Non-Progrip group. • There were no differences in hernia recurrence in both groups.

Low RNA translation activity limits the efficacy of hydrodynamic gene transfer to pig liver “in vivo”

Background Hydrodynamic gene delivery has proved an efficient strategy for nonviral gene therapy in the murine liver but it has been less efficient in pigs. The reason for such inefficiency remains unclear. The present study used a surgical strategy to seal the whole pig liver in vivo. Methods A solution of enhanced green fluorescent protein (eGFP) DNA was injected under two different venous injection conditions (anterograde and retrograde), employing flow rates of 10 and 20 ml/s in each case, with the aim of identifying the best gene transfer conditions. The gene delivery and information decoding steps were evaluated by measuring the eGFP DNA, mRNA and protein copy number 24 h after transf…