Budget Impact Analysis of a Biosynthetic Mesh for Incisional Hernia Repair.

Purpose: With the development of newer prostheses for hernia repair, it is nowadays difficult to understand the total cost of managing patients treated with these advanced medical devices, especially in the complex abdomen, in which various complications may occur. The aim of this study was to determine the economic implications of these prostheses in order to inform decision making in the management of incisional hernia repair.

Methods: A budget impact analysis model was developed to evaluate the economic consequences related to the management of patients undergoing complex (Centers for Disease Control and Prevention wound class II-III or Ventral Hernia Working Group grade 2/3) incisional hernia repair through biosynthetic, synthetic, or biological meshes, from the hospital perspective in Italy.

[Aorto-oesophageal fistula due to an aortic endovascular prosthesis: case report and state of the art].

Aorto-oesophageal fistula is a rare and often fatal condition due to pathologies of the aorta and oesophagus. Recently, a new aetiology for aorto-oesophageal fistulas has been detected, namely, decubitus of an aortic endovascular prosthesis positioned in the presence of aneurysms. The symptoms are those of Chiari's triad: (1) chest pain and/or dysphagia (2) haematemesis (3) massive haematemesis.

[Treatment of neoplastic stenosis of the left colon: presurgical expandable metal stent vs emergency surgery. Comparison of results and survival rates].

In recent years there has been a substantial increase in the use of self-expandable metal stent endoprostheses for preoperative "bridge to surgery" treatment of obstructive colorectal cancer. Stent insertion for malignant tumours is still controversial because of the increased risk of metastasis and regional advance of the cancer. We compared the short-term results and long-term survival times with preoperative stent insertion vs emergency surgery without stents.

[Early stoma closure in colorectal resections after endoscopic monitoring of the anastomosis. Clinical results].

The need for a protection of a colo-colonic or colorectal anastomosis (by a colostomy or ileostomy) does not always encounter a general consensus except in selected clinical settings such as a low or ultra-low colorectal anastomosis or a colo-colonic or colorectal anastomosis after resection for acute disease. Commonly, a protective stoma is closed within 3-6 months after x-ray or endoscopic monitoring of the anastomosis. We believe in the importance of an open debate on the timing of bowel reconstruction and on the ways of monitoring the anastomosis.

[Direct electric conduction glove for laparoscopic surgical instruments. Preliminary results of a prototype].

The authors present their prototype of a system for electrical conduction in direct contact with laparoscopic tools, devised, designed and produced by them at the Politecnico di Torino Department of Mechanical Engineering. The system consists of a two-sided plate, one side being a non-conducting adhesive surface to stick to the surgical glove and the other a thin, flexible conductor shell. The authors used the instrument with surgical tools with metal handles during 4 laparoscopic procedures.

[Cholecystobiliary fistula: laparoscopic treatment with an endostapler].

The Authors report a case of cholecystobiliary fistula due to cholelithiasis and bile duct lithiasis, treated laparoscopically with an endostapler. In view of the rarity of this condition, we believe it may be useful to discuss the diagnostic work-up in the light of the diagnostic and therapeutic measures currently available. We also review the literature with a view to defining the existing classifications of cholecystobiliary fistulas.

[Thread-passer for laparoscopic use. Preliminary results with a prototype].

The Authors present their prototype of a thread-passer for laparoscopic use, devised, designed and produced by them. The prototype was made at the Politecnico di Torino, Department of Mechanical Engineering. This tool consists of a rod measuring 12 mm in diameter, with a curved dove-tailed slotted end to lodge and pass the surgical thread.