Minimally invasive adrenalectomy: a multicenter comparison of transperitoneal and retroperitoneal approaches.

Minimally invasive adrenalectomy (MIA) is both feasible and safe with either transperitoneal or retroperitoneal entry. However, only a few studies have rigorously compared these two techniques. The aim of the current study is to compare transperitoneal and retroperitoneal adrenalectomy to detect significant differences in patient selection and perioperative outcomes.

[Minimally invasive adrenalectomy: transperitoneal vs. retroperitoneal approach].

Laparoscopic adrenalectomy is now regarded as the procedure of choice for most adrenal glands presenting surgical pathology. The primary adrenal-specific contraindication to laparoscopic adrenalectomy today is the presence of a large adrenal mass with evidence of local infiltration or venous invasion. We used our multicentre experience to compare the transperitoneal (TLA) and retroperitoneal (RLA) minimally invasive approaches.

[Adenocarcinoma of pancreas with situs viscerum inversus totalis].

A case of adenocarcinoma of the head of the pancreas in a patient with situs viscerum inversus totalis, an association described for the third time in literature, is reported. The possible coexistence of malformations of transposed organs and the specular anatomosurgical situation requires particular attention in the diagnosis and preoperative evaluation as well as a careful reorientation of the surgical perspective and a correct surgical conduct.

Improved device for sutureless aortic anastomosis applied in a case of cancer.

To reduce the time needed for clamping or circulatory arrest (or both) during substitution of a prosthesis for the thoracic aorta, we developed an expandable device that can be used with any commercially available prosthetic graft to enable sutureless aortic anastomosis. Improvements upon a previous version of the device include the use of nickel-titanium alloy (Nitinol) instead of stainless steel. This, together with an improved wire-looping design, now enables continuous control of diameter, even when the device is in contact with blood.