Splenic Angiosarcoma: A Diagnostic Splenectomy Finding.

Splenic tumors are not frequent. Blood vessel neoplasms are a rare category of tumors and have an extremely low incidence in the spleen. This case report aims to describe a 57-year-old woman in whom a routine imaging examination had shown splenic cysts.

Impact on quality of life, weight loss and comorbidities: a study comparing the biliopancreatic diversion with duodenal switch and the banded Roux-en-Y gastric bypass.

Context: Few studies have evaluated the results of different types of bariatric surgery using the Medical Outcome Study 36 - Health Survey Short-Form (SF-36) quality of life questionnaire, the Bariatric and Reporting Outcome System (BAROS) and the reviewed Moorehead-Ardelt Quality of Life II Questionnaire (M-A QoLQ II) that is part of BAROS. The Roux-en-Y gastric bypass (RYGB) is the most common morbid obesity surgery worldwide. However, there is evidence indicating that a biliopancreatic diversion with duodenal switch (DS) is more effective than RYGB in weight loss terms.

Modified "Roux en Y" hepaticojejunostomy to permit transgastric endoscopic access.

Purpose: To present an option technique during the accomplishment of a "Roux-en-Y" hepaticojejunostomy that, allows future transgastric endoscopic access to the biloenteric anastomosis.

Methods: The side-to-side "Roux-en-Y" hepaticojejunostomy is carried through transmesocolic, retrogastric short tunnel. A distal jejunal loop of approximately 10,0 to 15,0 cm must be kept far from the anastomosis that allows its setting, without tension, in the anterior gastric wall bellow the small bending, between body and of the stomach antrum.

Effects of elevated artificial pneumoperitoneum pressure on invasive blood pressure and levels of blood gases.

Background And Objective: to evaluate the clinical, hemodynamic, gas analysis and metabolic repercussions of high transient pressures of pneumoperitoneum for a short period of time to ensure greater security for introduction of the first trocar.

Methods: sixty-seven patients undergoing laparoscopic procedures were studied and randomly distributed in P12 group: n=30 (intraperitoneal pressure [IPP] 12mmHg) and P20 group: n=37 (IPP of 20mmHg). Mean arterial pressure (MAP) was evaluated by catheterization of the radial artery; and through gas analysis, pH, partial pressure of oxygen (PaO2), partial pressure of CO2 (PaCO2), bicarbonate (HCO3) and alkalinity (BE) were evaluated.

Veress needle insertion into the left hypochondrium for creation of pneumoperitoneum: diagnostic value of tests to determine the position of the needle in unselected patients.

Objective: To assess the effectiveness of the Veress needle puncture in the left hypochondrium and the accuracy of the tests described for the intraperitoneal correct positioning of the tip of the Veress needle in an unselected population.

Methods: Ninetyone patients consecutively scheduled for Videolaparoscopy had the abdominal wall punctured in the left hypochondrium. There were no exclusion criteria.

Creation of pneumoperitoneum: noninvasive monitoring of clinical effects of elevated intraperitoneal pressure for the insertion of the first trocar.

Aim: The aim of this work is to analyze, by means of noninvasive monitoring, the clinical effects of high intraperitoneal pressure for enough time to insert the first trocar.

Methods: Sixty-seven patients without significant lung problems were randomly divided into groups P12 (n = 30, maximum intraperitoneal pressure 12 mmHg) and P20 (n = 37, maximum intraperitoneal pressure 20 mmHg). A Veress needle was inserted into the left hypochondrium for creation of pneumoperitoneum.

Intraperitoneal pressure and volume of gas injected as effective parameters of the correct position of the Veress needle during creation of pneumoperitoneum.

Objective: The aim of this work was to establish reliable parameters of the correct position of the Veress needle in the peritoneal cavity during creation of pneumoperitoneum.

Methods: The Veress needle was inserted into the peritoneal cavity of 100 selected patients, and a carbon-dioxide flow rate of 1.2 L/min and a maximum pressure of 12 mm Hg were established.

Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review.

Background: The aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature.

Methods: Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no language restriction, in the Medline, Lilacs, Embase, Scielo, and Cochrane Library databases. The following words were combined: "Veress" or "insufflation needle" or "pneumoperitoneum needle," and "complications" or "injuries" or "lesions.

Comparative study of hand sewn single layer anastomosis of dog's bowel.

Background: Two-layer intestinal anastomosis increases the inflammatory response while single-layer anastomosis results in a better wound healing. However the four main kinds of stitches which may be chosen in performing single layer intestinal sutures never before had been comparatively studied.

Aim: To compare the four more commonly used types of single layer surgical anastomosis sutures of the digestive tract.

[Evaluation of tests performed to confirm the position of the Veress needle for creation of pneumoperitoneum in selected patients: a prospective clinical trial].

Purpose: To evaluate tests performed to confirm the position of the Veress needle inserted into the left hypochondrium for creation of pneumoperitonium.

Methods: One hundred patients were submitted to laparoscopic procedure with left hypochondrium puncturing. Needle positioning tests were evaluated.

Veress needle insertion in the left hypochondrium in creation of the pneumoperitoneum.

Purpose: To test the efficacy of the puncture in the left hypochondrium as an alternative method.

Methods: Sixty-two patients randomly distributed into two groups were studied: Group LH, puncture in the left hypochondrium (n=30), and Group ML, puncture in the abdominal midline (n=32). The following were assessed: needle positioning tests, number of failed attempts at needle insertion, and time needed for creation of pneumoperitoneum.

Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs.

Purpose: Erroneous punctures and insufflations are frequent with the use of the Veress needle. Mistaken injections of gas in the preperitoneal space are not rare. The purpose of this research is to evaluate the correct positioning of the tip of the needle during creation of pneumoperitoneum.

[One layer sutures of digestive tract knotted in the lumen, in dogs: perforating stitch versus serosubmucosal suture].

Objective: To compare hand sewn digestive tract single layer anastomosis with knots tied in the lumen: total stitches versus serosubmucosal.

Methods: Six mongrel dogs were submitted to laparotomy, each one with two transversal jejunum sections, 30 and 70 cm far from Treizt angle and suture, serosubmucosal and total stitches, both with knots tied in the lumen, over the mucosa, at the posterior wall. After slaughter (7th post-operative day) was evaluated the peritoneal adhesions at posterior wall.