Guidelines for the performance of minimally invasive splenectomy.

Background: Minimally invasive splenectomy (MIS) is increasingly favored for the treatment of benign and malignant diseases of the spleen over open access approaches. While many studies cite the superiority of MIS in terms of decreased morbidity and length of stay over a traditional open approach, the comparative effectiveness of specific technical and peri-operative approaches to MIS is unclear.

Objective: To develop evidence-based guidelines that support clinicians, patients, and others in decisions on the peri-operative performance of MIS.

Achieving Mastery of General Surgery Operative Skill in the Army Healthcare System.

Introduction: Operative case volumes for military surgeons are reported to be significantly lower than civilian counterparts. Among the concern that this raises is an inability of military surgeons to achieve mastery of their craft.

Material And Methods: Annual surgical case reports were obtained from seven Army military treatment facilities (MTF) for 2012-2016.

Isolated perivesicular hematoma after military parachuting.

Background: Isolated perivesicular hematomas are uncommonly described and not an injury typically reported in the literature after parachuting or skydiving.

Case Report: Herein, we described a series of three patients with isolated perivesicular hematomas sustained after military parachuting. All three patients were managed nonoperatively after a somewhat prolonged hospital course.

Laparoscopic ventral hernia repair: does primary repair in addition to placement of mesh decrease recurrence?

Background: The advent of laparoscopic ventral hernia repair (LVHR) not only reduced the morbidity associated with open repair but also led to a decrease in the hernia recurrence rate. However, the rate continues to remain significant.

Methods: A retrospective observational study was conducted on 193 patients who were treated with LVHR by two minimally invasive surgeons in a 24-month period.

Advances in transoral fundoplication for oesophageal reflux.

Background: The purpose of this review was to evaluate transoral fundoplication devices for gastro-oesophageal reflux disease that have been commercially available within the last 5 years.

Methods: Literature databases including Medline and Pubmed were searched from January 2005 to November 2010. Both blinded and unblinded randomized studies were evaluated.

Plasma levels of the beta chemokine regulated upon activation, normal T cell expressed, and secreted (RANTES) correlate with severe brain injury.

Background: The expression of the beta chemokine RANTES (regulated upon activation, normal T cell expressed, and secreted) has previously been shown to be elevated after traumatic brain injury (TBI) in animal models, but it was unknown whether the plasma level of RANTES was predictive of TBI in critically injured trauma patients.

Methods: A prospective study was conducted on 108 critically ill trauma patients. Patients were stratified by radiologic diagnosis of TBI.

Sonographic appearance of canal of Nuck hydrocele.

We present a case of a relatively uncommon entity in a 17-year-old girl who presented to the emergency department with right inguinal pain and discomfort. On sonography, she was thought to have a hydrocele of a patent processus vaginalis, although differentials could not be excluded. The hydrocele was subsequently confirmed at surgery.