[Surgical treatment of primary hyperparathyroidism: how high do we place the crossbar?].

Minimally-invasive parathyroidectomy has improved to a level that has made it the operation of first choice in the treatment of primary hyperparathyroidism. A gamma probe should be used when the radio-guided technique is performed and quick intra-operative parathormone testing should be used with all other minimally-invasive techniques. This not only serves as an instrument for quality control but also improves the expertise necessary to consistently obtain good results.

The ileo neo rectal anastomosis (INRA) in patients with familial adenomatous polyposis: clinical results at two years.

Background: Ileo neo rectal anastomosis (INRA) is a promising alternative for patients with familial adenomatous polyposis (FAP) to restorative proctocolectomy with its morbidity and unpredictable functional outcome to colectomy with ileo rectal anastomosis (IRA) with the continuing risk of rectal cancer. The aims of the present study were to evaluate the function of the neorectum, to assess the morbidity and complications of the operation and to determine the incidence of neorectal polyps.

Methods: Data of all patients having INRA, including bowel function and complications, were prospectively recorded.

[Surgical treatment of primary hyperparathyroidism: minimally invasive if possible, conventional neck exploration if necessary].

Objective: To determine the results of surgical treatment of patients with primary hyperparathyroidism by means of a protocol consisting of preoperative imaging, perioperative parathormone (PTH) measurement, and a minimally invasive approach in the case of a solitary parathyroid adenoma being unequivocally identified and a conventional neck exploration in all other cases.

Design: Prospective and descriptive.

Methods: A total of 100 consecutive patients with primary hyperparathyroidism underwent neck imaging (ultrasound, CT) according to a fixed protocol.

Robot-assisted surgical systems: a new era in laparoscopic surgery.

The introduction of laparoscopic surgery offers clear advantages to patients; to surgeons, it presents the challenge of learning new remote operating techniques quite different from traditional operating. Telemanipulation, introduced in the late 1990s, was a major advance in overcoming the reduced dexterity introduced by laparoscopic techniques. This paper reviews the development of robotic systems in surgery and their role in the operating room of the future.

Diagnosing non-palpable breast disease: short-term impact on quality of life of large-core needle biopsy versus open breast biopsy.

Background: One of the alleged advantages of stereotactic large-core needle biopsy of non-palpable breast lesions is that it entails less inconvenience for the patient. In this prospective study, the quality of life of patients undergoing large-core needle biopsy was compared with that of patients undergoing open breast biopsy prior to learning the definitive diagnosis.

Methods: Thirty patients with non-palpable breast lesions underwent stereotactic large-core needle biopsy as initial diagnostic procedure (needle biopsy group).

[Gluteal abscess complicated by sepsis as the expression of Crohn's disease].

Two young women, aged 19 and 25 years, suffered from persistent perianal sepsis after local drainage of unusual gluteal abscesses. Preoperative CT scanning showed unrecognised and inadequately treated abscesses and signs of inflammatory bowel disease. Both patients underwent a reoperation: affected bowel segments were removed, stomas were created and abscesses were drained.