[TULC - total umbilical laparoscopic cholecystectomy].

Background: Except for some few cases only symptomatic cholecystolithiasis constitutes an indication for operative treatment. The gold standard meanwhile has been the laparoscopic cholecystectomy, because the method shows good results with short hospital stay. Recently there has been an intensive discussion about combination of laparoscopic techniques with natural body orifice using surgery (NOTES).

[Ascending varicose vein phlebitis--classification and therapy].

Ascending varicophlebitis can cause pulmonary embolism by entering the deep venous system. Classification into four stages permits a differentiated therapeutic strategy: if the thrombus reaches or enters the deep venous system, immediate surgery consisting of crossectomy, resection of the saphenous vein, radical excision of all varicosed veins and ligature of insufficient perforating veins are indicated.

[Simultaneous vascular and endovascular surgery of complex vascular diseases].

Complex vascular disease requires combined, intraoperative endovascular and reconstructive therapy. Hereby, transprosthetic, transluminal angioplasty is particularly well suited for this purpose. The 5-year patency rate after combined inguinal patch plasty and femoral balloon dilation (n = 58) was 70%.

[Combined interventions in transfemoral stent implantation in infra-renal abdominal aortic aneurysm].

The transluminally placed endovascular graft (TPEG) is a novel method for the treatment of abdominal aortic aneurysms (AAA). Aortobiiliacal application requires three anchor sites and can often not be performed in cases of aneurysm, occlusion, or elongation of the iliac arteries. Here the aorto-uniiliacal stent implantation combined with crossover bypass provides an alternative procedure, and thus broadens the therapeutic endovascular spectrum.

[Severe craniocerebral trauma].

In medical services where acute accident patients are encountered, general and traumatic surgeons are faced with the problem of treating severe head and brain injuries. In the Department of Surgery at the University Hospital in Munich, we have been performing neurotraumatological treatment since 1983. We had 162 patients with severe head and brain injuries, 95 intracerebral contusional bleeding, 8 depression fractures, and 3 hygromas.