[Use of ultrasonic surgery in laparoscopic cholecystectomy].

Introduction: Laparoscopic cholecystectomy now represents a valid alternative to traditional surgery in the treatment of gallstone diseases. For the past twenty years laparotomic cholecystectomy has represented the golden standard of gallstone treatment given its extremely low mortality rate (0.5%) and equally acceptable morbidity rate.

[Total gastrectomy: a comparison between manual and mechanical sutures].

The authors report their experience of the use of mechanical staplers in total gastrectomy. The advantages of their use can above all be seen in anastomosis, in particular in high-risk areas like esophago-jejunal anastomosis, in which there is a lower incidence of dehiscence and mortality than when manual suturing techniques are used.

[The surgical procedure in a case of accidental lesion due to impalement].

The authors describe a case of intraperitoneal anorectal injury. Such injuries now have an improved survival rate as a result undoubtedly of superior resuscitation, early operative management and early use of antibiotics. Civilian life rectal wounds are usually of the penetrating type.

[A bleeding jejunal schwannoma. The complications of a rare neoplasm of the small intestine].

The authors report a rare case of jejunal Schwannoma which appeared as hematemesis and melaena. No preoperative test, even selective angiography, enabled a correct clinical diagnosis to be made. Only after explorative laparotomy and careful palpation of the small intestine was the bleeding lesion located.

[Use of intraoperative transcystic choledoscopy in calculosis of the main bile duct].

Choledochoscopy is complementary to peroperative cholangiography in exploration of the main biliary way. Transcystic access is proposed in choledocholithiasis. The cystic duct, in fact, is frequently transitable owing to the dilatation produced by the migration of gallstones and because of the increasing miniaturisation of instruments.