Totally Laparoscopic Resection for Low Sigmoid and Rectal Cancer Using Natural Orifice Specimen Extraction Techniques.

Background: A minilaparotomy for specimen extraction during laparoscopy occasionally results in postoperative wound complications. We have performed a totally laparoscopic resection for early colorectal cancer using the natural orifice specimen extraction technique.

Methods: From 2008 to 2013, we have performed a totally laparoscopic resection for clinical stage I and IIA low sigmoid colon and rectal cancers.

Early Effects of Sleeve Gastrectomy on Obesity-Related Cytokines and Bile Acid Metabolism in Morbidly Obese Japanese Patients.

Background: Laparoscopic sleeve gastrectomy (LSG) has wide-ranging positive effects on adipocytokine metabolism, bile acid profile, and chronic low-grade inflammation related to obesity. However, the early temporal changes in these markers following LSG have not been well investigated. This study aimed to evaluate the early effects of LSG on adipocytokines, bile acid profile, and inflammatory markers.

[A case of rapidly progressing treatment-resistant colorectal neuroendocrine carcinoma].

We performed primary lesion resection in a 48-year-old man diagnosed with sigmoid colon cancer showing multiple liver metastases and extensive lymph node metastases. Endocrine cell carcinoma was diagnosed from an excised specimen. In the early postoperative period, orbital metastases and thoracic spine metastasis were detected, while the multiple liver metastases and lymph node metastases worsened markedly.

A new simple navigation for anatomic liver resection under intraoperative real-time ultrasound guidance.

Anatomic liver resection is indispensable for liver surgeons. However, recognition of the precise intrahepatic resectional plane is difficult because intrahepatic Glissonean branches cannot be visualized. We have devised a new surgical procedure to accurately determine the resectional plane of deep parts of the liver.

Lesser omental hernia after total colectomy: report of a case.

Lesser omental hernia is a rare type of hernia that can cause intestinal obstruction. To our knowledge, there are only 16 documented cases of lesser omental hernia, including the present case. The subject of this case report was a 42-year-old man with a history of total colectomy for colon perforation caused by Crohn's disease 15 years earlier, who presented with epigastralgia and vomiting.

Cystic duct with no visible signal on magnetic resonance cholangiography is associated with laparoscopic difficulties: an analysis of 695 cases.

Background/aims: We investigated the association between the magnetic resonance cholangiography (MRC) results and surgical difficulties and bile duct injuries during laparoscopic cholecystectomy (LC).

Methods: MRC was performed on 695 consecutive patients before LC. We divided the patients into two groups (visible cystic duct group and "no signal" cystic duct on MRC group) and compared them with regard to the length of the operation, conversion rate to open cholecystectomy (OC) and rate of bile duct injury.

Noninsulinoma pancreatogenous hypoglycemia syndrome: a rare case of adult-onset nesidioblastosis.

The most common cause of hyperinsulinemic hypoglycemia in adults is insulinoma. Nesidioblastosis is a rare, but well-recognized disorder of persistent hyperinsulinemic hypoglycemia in infancy, but adult-onset nesidioblastosis associated with hyperinsulinemic hypoglycemia, termed noninsulinoma pancreatogenous hypoglycemic syndrome (NIPHS), has been reported. Here, we describe an extremely rare case of NIPHS in an elderly man.

A crescent-shaped sparing proximal to a liver tumor may indicate underlying portal tumor thrombus.

A primary or metastatic liver tumor sometimes blocks portal venous flow and causes a focal sparing in the fatty liver. We herein report a case of segmental sparing due to the portal tumor thrombus extending from the metastatic liver tumor. The present case demonstrates characteristic computer-associated tomographic findings, a distal oval hypodense tumor with proximal "crescent-shaped sparing", which may indicate underlying portal tumor thrombus at the apex of the sparing.