Laparoscopic splenectomy: learning curve comparison between benign and malignant disease.

Background: New surgical techniques should be formally evaluated for feasibility and safety. As a model for this evaluation, this study examines the authors' institution's experience with splenectomy for benign and malignant hematologic disease since the introduction of laparoscopic splenectomy (LS) in 1996. The authors present the evaluation of the recognized surgeon/institutional learning curve using CUSUM (cumulative sum) analysis.

Ketorolac analgesia for inguinal hernia repair is not improved by peripheral administration.

Purpose: It has been suggested that ketorolac, a non-steroidal anti-inflammatory drug (NSAID) available for parenteral use, may result in prolonged (24 hr) postoperative analgesia through a peripheral mechanism when added to local anesthetic infiltration. Our objective was to assess this effect by controlling for systemic absorption of the drug.

Methods: This randomized, double-blind trial studied 40 men undergoing elective inguinal hernia repair under spinal anesthesia.