Evolution of technique in performance of minimally invasive colectomies.

Background: Hand-assisted laparoscopic surgery is commonly used in colorectal surgery and provides benefit in complex cases.

Objective: This study examined the minimally invasive surgical trends, patient characteristics, and operative variables unique to patients undergoing hand-assisted laparoscopic surgery.

Design: This was a retrospective medical chart review.

Colovesical fistula: not a contraindication to elective laparoscopic colectomy.

Purpose: Traditionally, diverticular fistula was thought to be a contraindication for laparoscopic colectomy. The advent of hand-assisted laparoscopy has allowed repair of a diverticular fistula to be technically feasible laparoscopically. We present our experience with laparoscopic colectomy in patients with diverticular fistulas.

Palliative approaches to the patient with breast cancer.

Despite an increasing trend towards early diagnosis of breast cancer,patients still present with locally advanced disease. Also, in some patients chemotherapy will fail, and local and regional recurrence will occur. This article outlines options for palliative care for such patients.