Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection of Double Adenomas and May Minimise the Risk of Recurrent Surgery.

Background. Minimally invasive parathyroidectomy (MIP) is increasingly replacing the traditional bilateral neck exploration in the treatment of primary hyperparathyroidism (PHP). Intraoperative PTH (IOPTH) measurement has recently been introduced as a useful adjunct in confirming successful excision of abnormal parathyroid gland.

Neoadjuvant chemotherapy in breast cancer.

Background: Neoadjuvant chemotherapy for breast cancer was originally used in locally advanced inoperable disease in order to achieve surgical resection. It was then extended to operable breast cancer with a view to downstaging tumours to facilitate breast-conserving surgery. Increasingly, it is being considered as a treatment for earlier-stage disease.

Selective cholangiography in 600 patients undergoing cholecystectomy with 5-year follow-up for residual bile duct stones.

Background: The need for cholangiography to identify possible bile duct stones in all patients undergoing cholecystectomy is controversial.

Aims: To assess the results of a policy for selective pre-operative endoscopic retrograde cholangiography (ERC) in patients undergoing laparoscopic cholecystectomy and to determine the incidence of postoperative symptomatic bile duct stones.

Patients And Methods: Between 1993 and 1998, 600 patients underwent laparoscopic cholecystectomy under one consultant surgeon.

Laparoscopic excision of the urachus.

Embryologically, the urachus represents the obliterated alantois in the form of a fibrous cord extending from the dome of the bladder to the umbilicus. Incomplete obliteration can result in the formation of an umbilical sinus, fistula, cyst, or abscess in the infraumbilical area. The traditional treatment of a residual urachus is surgical resection of the entire tract from the dome of the bladder to the umbilicus through a lower midline incision.