Laparoscopic single site adrenalectomy using a conventional laparoscope and instrumentation.

Background And Objectives: We present a case of Laparoendoscopic Single Site Surgery (LESS) left adrenalectomy performed with a conventional laparoscope and instruments.

Methods: A 45-year-old male was diagnosed with hyperaldosteronism. Computed tomography detected a left adrenal nodule.

Completely intracorporeal retraction of the gallbladder for laparoendoscopic single site (LESS) surgery.

Laparoendoscopic single site surgery (LESS) cholecystectomy requires a creative solution to retract the gallbladder. Transabdominal suture retraction is a commonly used technique to achieve adequate exposure of the critical structures within Calot's triangle. To avoid the multiple punctures of the gallbladder and abdominal wall required by such suture retraction, we developed a novel internal retractor specifically for use during LESS cholecystectomy.

A novel laparoscopic ventral herniorrhaphy training system.

Surgical simulation offers a safe opportunity to develop the skills required for the operating room. Box trainers are an excellent low-cost training option but there are limited options for teaching laparoscopic ventral hernia repair. We developed a realistic and cost-effective box system for laparoscopic ventral herniorrhaphy that will enhance training experience before entering the operating theater.

Immune stimulatory receptor CD40 is required for T-cell suppression and T regulatory cell activation mediated by myeloid-derived suppressor cells in cancer.

Immune tolerance to tumors is often associated with accumulation of myeloid-derived suppressor cells (MDSC) and an increase in the number of T-regulatory cells (Treg). In tumor-bearing mice, MDSCs can themselves facilitate the generation of tumor-specific Tregs. In this study, we demonstrate that expression of the immune stimulatory receptor CD40 on MDSCs is required to induce T-cell tolerance and Treg accumulation.

Current recommendations on diagnosis and management of right-sided diverticulitis.

We present the case of a 52-year-old female with recurrent symptomatic ascending colon diverticulitis who ultimately underwent elective laparoscopic right hemicolectomy. The following is a case report and literature review pertaining to right colonic diverticular disease.

Laparoscopic and open reversal of Hartmann's procedure--a comparative retrospective analysis.

Background: Restoration of intestinal continuity after Hartmann's procedure has traditionally required laparotomy. This study compares our experience with laparoscopic and open reversal of Hartmann's procedure.

Study Design: All laparoscopic and open Hartmann's reversal procedures performed between January 1998 and June 2006 were reviewed.

Postoperative pain after laparoscopic ventral hernia repair: a prospective comparison of sutures versus tacks.

Background And Objectives: Mesh fixation in laparoscopic ventral hernia repair typically involves the use of tacks, transabdominal permanent sutures, or both of these. We compared postoperative pain after repair with either of these 2 methods.

Methods: Patients undergoing laparoscopic ventral hernia repair at the Mount Sinai Medical Center were prospectively enrolled in the study.

Recurrence after laparoscopic ventral hernia repair: a prospective pilot study of suture versus tack fixation.

Mesh fixation in laparoscopic ventral hernia repair requires the use of tacks and/or permanent transabdominal sutures. Sutures pass through all fascial and muscle layers of the anterior abdominal wall, whereas tacks secure the mesh simply to peritoneum. Controversy exists regarding the optimal fixation method.

Laparoscopic cortical-sparing adrenalectomy for bilateral pheochromocytoma.

A 32-year-old female with asthma was hospitalized for pneumonia in 2/06. She underwent a CT scan of the chest which revealed an incidental finding of bilateral adrenal masses. On further questioning, she admitted to palpitations and flushing.

Eikenella corrodens causing necrotizing fasciitis after an elective inguinal hernia repair in an adult: a case report and literature review.

We report an unusual case of necrotizing fasciitis in a 43-year-old man after elective inguinal hernia repair. The patient presented to the emergency department 9 days postoperatively with high fevers, tachycardia, and crepitus along his abdominal wall. He was treated with broad-spectrum antibiotics and underwent a diagnostic laparoscopy as well as a wide debridement of all necrotic tissue.

The management of 38 anastomotic leaks after 1,684 intestinal resections.

Purpose: This study was designed to evaluate the management of anastomotic leaks and assess the impact of outpatient leak presentation on clinical outcome.

Methods: Thirty-eight patients with clinical anastomotic leaks from 1,684 adult patients undergoing large and small intestinal anastomosis in a tertiary referral center between January 1, 2003 and September 1, 2005 were studied. All pediatric patients and adult patients with esophageal and gastric leaks were excluded.

Mesenteric fibromatosis masquerading as an ovarian neoplasm twenty years after Chernobyl radiation exposure.

Background: Since their initial description in 1832, desmoid tumors have been reported to occur in virtually every part of the body. Intra-abdominal desmoid tumors, or mesenteric fibromatosis, are often associated with Familial Adenomatous Polyposis mutation in a syndrome known as Gardner's Syndrome. Although sporadic cases of desmoid tumors do occur, unlike Gardner's Syndrome, they predominantly occur extra-abdominally.

Thyroidectomy remains an effective treatment option for Graves' disease.

Background: Recent experience with thyroidectomy for Graves' disease is limited. We report our current experience with thyroidectomy for Graves' disease at a tertiary hospital.

Methods: A prospective database showed 48 patients who underwent surgery for Graves' disease from April 1993 to June 2005.

Intraoperative PTH monitoring in parathyroid hyperplasia requires stricter criteria for success.

Background: Intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for multigland disease is less clear than for single-gland disease. This study assesses the role of IOPTH for hyperplasia.

Methods: A prospective database revealed 45 patients with hyperplasia undergoing parathyroidectomy utilizing IOPTH from February 1999 to August 2003.