Mastectomy Without Drains Reduces Cost with No Detriment to Patient Outcome.

Introduction  Use of drains after mastectomy remains highly variable. This study aimed to establish whether simple mastectomy managed without a drain would cost less than the same procedure managed with a drain and whether there would be any difference in complications. Methods  Prospective data were collected on all patients undergoing simple mastectomy ± sentinel lymph node biopsy over sixteen months.

A new technique of extreme lateral positioning for laparoscopic splenic flexure mobilization.

Aim: This aim of this study was to describe a novel positioning technique that assists in the expeditious mobilization of the splenic flexure without the need for redraping or compromise of port placement.

Method: A prospective case series was studied to evaluate the technique and its ability to facilitate splenic flexure mobilization.

Results: The technique was used in 12 patients.

Transvaginal repair of recurrent pouch-vaginal fistula.

Aim: Pouch-vaginal fistula is an uncommon but unpleasant complication. The chance of successful repair with various surgical procedures is around 50% and the early promise of collagen button plugs was not followed by good long-term results. We report a series of patients who underwent transvaginal repair of pouch-vaginal fistula after failed collagen plugs accompanied by a video to show the operative technique.

Laparoscopic excision of a retrorectal schwannoma.

Retrorectal tumors are uncommon and are usually managed by open surgical excision. Recent advances in laparoscopic techniques have led to the use of laparoscopy for a variety of problems in colorectal surgery, including the excision of retrorectal tumours. This case report, which describes the laparoscopic excision of a benign schwannoma arising from the second sacral nerve root, highlights the benefits of accurate preoperative diagnosis with MR imaging and the advantages of a laparoscopic approach while pointing out principles that should be adhered to when using this approach.

Laparoscopic restorative proctocolectomy with and without previous subtotal colectomy.

Introduction: Laparoscopic techniques have been applied to the procedure of restorative proctocolectomy (RPC). The aim of this study was to compare the outcomes of patients after laparoscopic ileal pouch-anal anastomosis (IPAA) with restorative proctocolectomy (RPC) and without previous colectomy [restorative proctectomy (RP)] and to highlight some technical tips.

Method: Data were collected prospectively from all patients who underwent laparoscopic IPAA from July 2006 to December 2007.