The Brescia Internationally Validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS).

Objective: To develop and update evidence-based and consensus-based guidelines on laparoscopic and robotic pancreatic surgery.

Summary Background Data: Minimally invasive pancreatic surgery (MIPS), including laparoscopic and robotic surgery, is complex and technically demanding. Minimizing the risk for patients requires stringent, evidence-based guidelines.

Effects of large-scale advection and small-scale turbulent diffusion on vertical phytoplankton dynamics.

Turbulence has been recognized as a factor of paramount importance for the survival or extinction of sinking phytoplankton species. However, dealing with its multiscale nature in models of coupled fluid and biological dynamics is a formidable challenge. Advection by coherent structures, such as those related to winter convection and Langmuir circulation, is also recognized to play a role in the survival and localization of phytoplankton.

Statistical properties of two-dimensional elastic turbulence.

We numerically investigate the spatial and temporal statistical properties of a dilute polymer solution in the elastic turbulence regime, i.e., in the chaotic flow state occurring at vanishing Reynolds and high Weissenberg numbers.

The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology.

At the time of diagnosis synchronous colorectal cancer, liver metastases (SCRLM) account for 15-25% of patients. If primary tumour and synchronous liver metastases are resectable, good results may be achieved performing surgical treatment incorporated into the chemotherapy regimen. So far, the possibility of simultaneous minimally invasive (MI) surgery for SCRLM has not been extensively investigated.

The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study.

Background: Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3-0.8%) compared to open cholecystectomy (0.

Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery.

Introduction: The incidence of anastomotic leak (AL) has not decreased over the past decades and some important grey areas remain in its definition, prevention, and management. The aim of this study was to reach a national consensus on the definition of AL and to identify key points to be applied in clinical practice.

Methods: A 3-step modified Delphi method was used to establish consensus.

The Italian National Registry for minimally invasive pancreatic surgery: an initiative of the Italian Group of Minimally Invasive Pancreas Surgery (IGoMIPS).

The value of minimally invasive pancreatic surgery (MIPS) is still uncertain, despite the growing number of publications, including reviews and meta-analyses, and the quick diffusion of these procedures worldwide. The Italian Group of Minimally Invasive Pancreas Surgery (IGoMIPS) was created under the auspices of three Scientific Societies: Associazione Italiana Studio Pancreas (AISP), Associazione Italiana Chirurgia Epato-Bilio-Pancreatica (AICEP, former IT-IHPBA), and Società Italiana di Chirurgia Endoscopica (SICE). The main aim of IGoMIPS is to develop and implement a national registry for MIPS.

Pre-operative Renal Artery Embolization in Laparoscopic Radical and Partial Nephrectomy: A Multidisciplinary Approach to Renal Tumors.

Background: Despite being widely adopted, the laparoscopic approach to radical and partial nephrectomy is still burdened by high rates of hemorrhagic complications, which require blood transfusions and conversion to open surgery with increased morbidity. While pre-operative renal artery embolization (PRAE) can prevent intraoperative blood loss and vascular injuries, its prophylactic use is still a matter of debate. This study evaluated the safety and efficacy of PRAE in overcoming the main pitfalls of laparoscopy, which are related to the absence of tactile feedback.

Do We Have Another Option to Treat Bleeding Hemorrhoids? The Emborrhoid Technique: Experience in 16 Patients.

Background: Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain.

Objective: The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia.

Reaction fronts in persistent random walks with demographic stochasticity.

Standard reaction-diffusion systems are characterized by infinite velocities and no persistence in the movement of individuals, two conditions that are violated when considering living organisms. Here we consider a discrete particle model in which individuals move following a persistent random walk with finite speed and grow with logistic dynamics. We show that, when the number of individuals is very large, the individual-based model is well described by the continuous reactive Cattaneo equation (RCE), but for smaller values of the carrying capacity important finite-population effects arise.

Side-to-Side Anastomosis In Left Hemicolectomy, Why and When: A Single-Center Experience.

Background: Laparoscopic colectomy represents a safe, effective and well-established procedure for both benign and malignant colic disease. Transanal anastomosis (TA) with a circular stapler is the most commonly performed anastomotic technique in laparoscopic left hemicolectomy (LLH). We report our experience with side-to-side anastomosis (STSA) and side-to-end anastomosis (STEA) in selected patients with both emergency and elective LLH.

Intracorporeal Anastomosis in Both Elective and Emergency Right Hemicolectomy: Our Experience.

Purpose: The aim of this study was to examine whether intracorporeal anastomosis (IA) after laparoscopic right hemicolectomy (LRH) is a safe procedure in both emergency and elective settings.

Methods: A retrospective review of all consecutive adult patients (age > 17 years) who underwent LRH from November 2014 to May 2018 at S. Andrea Hospital, La Spezia, was performed.

Particle-laden two-dimensional elastic turbulence.

The aggregation properties of heavy inertial particles in the elastic turbulence regime of an Oldroyd-B fluid with periodic Kolmogorov mean flow are investigated by means of extensive numerical simulations in two dimensions. Both the small- and large-scale features of the resulting inhomogeneous particle distribution are examined, focusing on their connection with the properties of the advecting viscoelastic flow. We find that particles preferentially accumulate on thin highly elastic propagating structures and that this effect is the largest for intermediate values of particle inertia.

International Summit on Laparoscopic Pancreatic Resection (ISLPR) "Coimbatore Summit Statements".

The International Summit on Laparoscopic Pancreatic Resection (ISLPR) was held in Coimbatore, India, on 7th and 8th of October 2016 and thirty international experts who regularly perform laparoscopic pancreatic resections participated in ISPLR from four continents, i.e., South and North America, Europe and Asia.

Celiac axis compression syndrome: laparoscopic approach in a strange case of chronic abdominal pain in 71 years old man.

Celiac Axis Compression Syndrome by the Median Arcuate Ligament is a very rare condition characterized by chronic postprandial abdominal pain (angina abdominis), nausea, vomiting, which occurs mostly in young patients. The main treatment is a surgical procedure that consists of the division of the arcuate ligament combined with the section of the close diaphragmatic crus and the excision of the celiac plexus. Actually laparoscopic management is feasible and safe.

Laparoscopic Inferior Mesenteric Artery Peeling: An Alternative to High or Low Vascular Ligation for Sigmoid Colon Cancer Resection.

Background: In sigmoid cancer, both inferior mesenteric artery high or low ligations are accepted for curative purposes. Since inferior mesenteric artery ligation could compromise blood flow to the anastomosis, potentially increasing anastomotic leakage onset, real oncological benefits and possible disadvantages related to vascular transection level are still on debate. We introduce totally laparoscopic inferior mesenteric artery peeling technique to release from the concept of lymph nodal harvesting linked to arterial transection level.

Precoagulation-assisted parenchyma-sparing laparoscopic liver surgery: rationale and surgical technique.

Background: For the treatment of both primary and metastatic liver tumors, laparoscopic parenchyma-sparing surgery is advocated to reduce postoperative liver failure and facilitate reoperation in the case of recurrence. However, atypical and wedge resections are associated with a higher amount of intraoperative bleeding than are anatomical resections, and such bleeding is known to affect short- and long-term outcomes. Beyond the established role of radiofrequency and microwave ablation in the setting of inoperable liver tumors, the application of thermoablative energy along the plane of the liver surface to be transected results in a zone of coagulative necrosis, possibly minimizing bleeding of the cut liver surface during parenchymal transection.