Tailored Approach in Adrenal Surgery: Retroperitoneoscopic Partial Adrenalectomy.

The interest on partial adrenalectomy has steadily increased over the past twenty years. Adrenal pathologies are mostly benign, making an organ-preserving procedure attractive for many patients. The introduction of minimally invasive techniques played probably an important role in this process because they transformed a complex surgical procedure, related to the difficult access to the retroperitoneal space, into a simple operation improving the accessibility to this organ.

Intraoperative imaging for remnant viability assessment in bilateral posterior retroperitoneoscopic partial adrenalectomy in an experimental model.

Background: A surgical approach preserving functional adrenal tissue allows biochemical cure while avoiding the need for lifelong steroid replacement. The aim of this experimental study was to evaluate the impact of intraoperative imaging during bilateral partial adrenalectomy on remnant perfusion and function.

Methods: Five pigs underwent bilateral posterior retroperitoneoscopic central adrenal gland division (9 divided glands, 1 undivided).

Optimal dilation time for combined small endoscopic sphincterotomy and balloon dilation for common bile duct stones: a multicentre, single-blinded, randomised controlled trial.

Background: Endoscopic sphincterotomy is the established treatment for common bile duct stones. Balloon dilation offers an alternative. Prolonged dilation (300 s) with a 10 mm diameter balloon decreases the occurrence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).

Self-Gripping Meshes for Lichtenstein Repair. Do We Need Additional Suture Fixation?

Background: The Lichtenstein repair is a frequently used treatment of inguinal hernias. In recent years, there has been an increasing tendency to apply self-gripping meshes (s.g).

Rare cause of acute pain in the left upper abdominal quadrant.

We report a case of a 45-year-old man with acute pain in the left upper abdominal quadrant. Extensive diagnostic workup remained inconclusive. An exploratory laparotomy revealed herniation of the entire ascending colon, together with a part of the terminal ileum through the foramen of Winslow into the bursa omentalis.

Thoracoscopic removal of mediastinal hyperfunctioning parathyroid glands: personal experience and review of the literature.

Background: The presence of a mediastinal hyperfunctioning parathyroid gland is a rare condition that occurs in about 1% to 2% of cases. We present our experience with video-endoscopic parathyroidectomy and a review of the literature.

Methods: In seven patients (four male, three female; age 28-67 years) mediastinal hyperfunctioning parathyroid glands were removed by the thoracoscopic route (VATS).

A novel method for reconstruction in laparoscopic pancreaticoduodenectomy: an experience of 13 cases.

Laparoscopic pancreaticoduodenectomy (LPD) is a challenging operation to general surgeon. Up to date, only about 135 cases have been reported, 16 cases in China, 119 cases outside China. The reconstruction of alimentary system is a key procedure to ensure success of the whole surgery.

Cervical scarless endoscopic thyroidectomy: Axillo-bilateral-breast approach (ABBA).

Background: Neck surgery is one of the latest applications of minimally invasive surgery. We applied a new technique for totally endoscopic thyroidectomy, the axillo-bilateral-breast approach (ABBA). This approach does not leave a scar on the neck.

Has the introduction of laparoscopic Heller myotomy altered the treatment paradigm of achalasia?

Although surgical myotomy is well established as the most effective and durable treatment for achalasia, wide acceptance of this procedure as a first-line treatment has been hampered by perceived invasiveness and morbidity. Laparoscopic myotomy has significantly reduced surgical trauma and morbidity while maintaining effectiveness. The effect of laparoscopic myotomy on the treatment pattern for achalasia is not currently known.

Laparoscopic resection for rectal cancer: outcomes in 194 patients and review of the literature.

Background: There are few reports on laparoscopic rectum resection demonstrating its feasibility and efficacy in patients with rectal cancer. Most patient series are small, and results must be considered preliminary and medium-term. Our large prospective conducted study aimed to assess the effectiveness of a totally laparoscopic resection for rectum carcinoma with emphasis on perioperative and long-term oncological outcomes.

Endoscopic treatment of large primary adrenal tumours.

Background: Endoscopic adrenalectomy has become the treatment of choice for small benign adrenal tumours but should not be used for malignant lesions. It is debatable whether large and therefore potentially malignant primary adrenal tumours should be removed by minimally invasive techniques.

Methods: Three hundred and eighty primary adrenal tumours in 368 patients (142 male and 226 female; mean(s.

Laparoscopic surgery for colon and rectal cancer.

Use of laparoscopic resection for colorectal malignancy has raised concerns regarding local cancer control and the lack of long-term results. Most reported data are preliminary and medium-term results, at best. The aim of this study is to analyse all patients who underwent a laparoscopic resection for colorectal cancer at our department between November 1992 and July 2003.