Randomized trial of different intraabdominal pressures and acid-base balance alterations during laparoscopic cholecystectomy.

Background: Experimental and clinical studies document risks of acid-base balance alterations toward acidosis and hypercapnia during intraperitoneal carbon dioxide insufflation. The aim of this study was to assess the influence of different insufflation pressures on arterial blood gas changes and acid-base alterations during laparoscopic cholecystectomy and immediately postoperatively.

Methods: Thirty patients were randomized to receive either 10 or 15 mmHg insufflation pressure.

[The BAR-Valtrac for the colon].

The authors present their experience with biofragmentable anastomosis in the area of the colon in 42 patients where they used a biofragmentable ring Valtrac, Davis-Geck Co. to restores continuity after resection. The authors focus their attention on the peroperative technical difficulty of construction of the anastomosis proper and on complications encountered during the immediate postoperative course.

[Incidental laparoscopic orchiectomy of intra-abdominal testis].

The authors present an incidental finding of intraabdominal testicle during laparoscopic operation for another diagnosis in an adult man. The surprising finding was managed by laparoscopy without conversion to an open procedure, adhering to rules of oncologic prevention because possible testicular cancer. Had an open approach been chosen in this patient, the intraabdominal testicle would have remained undetected.

[Pitfalls of biofragmentable anastomotic ring construction].

The authors describe the main problems of the technical implementation and construction of biofragmentable anastomoses by means of the Valtrac ring, used for anastomosis after resections in the area of the gastrointestinal tract in a total of 72 patients. The authors evaluate postoperative technical difficulties and the main aspects of the implementation proper which may be the cause of serious complications during the immediate postoperative period.

[Bar-Valtrac--a modern alternative to conventional intestinal anastomosis?].

The authors describe a modern method of intestinal anastomoses without suture after resections of the gastrointestinal tract, by means of a biofragmentable ring used in 62 patients where the continuity of the digestive tract was restored by means of BAR-Valtrac (Davis Geck Co, USA). The perspective alternative of the common manual and stapler technique BAR anastomosis is evaluated on the basis of data from the literature and the authors own clinical exoerience with regard to the main parameters of healing of the anastomosis and immediate postoperative complications, among which dehiscence of the anastomosis is, no doubt, most important.