Robot-Assisted Laparoscopic Repair of Extraperitoneal Ureteral Inguinal Hernia with Mesh Placement.

Ureter involvement within indirect hernias is a rare phenomenon usually identified incidentally during herniorrhaphy. Even more rare are extraperitoneal ureteral inguinal hernias, which represent about 20% of these cases and are characterized by a substantial amount of extraperitoneal fat in the hernia defect, the absence of a peritoneal sac, and associated with hydroureteronephrosis and nephroptosis. To date, repair of ureteral inguinal hernias has been performed exclusively using open surgical techniques.

Treatment of nonadhesive bowel obstruction following gastric bypass.

Background: Bowel obstruction secondary to internal hernias following laparoscopic and open gastric bypass is well reported. The number of gastric bypasses being performed in the United States continues to increase. As many patients undergo surgery at centers geographically distant from their home, increasing numbers of patients will present to their local emergency rooms with abdominal complaints that will need to be addressed by general surgeons who are not performing bariatric surgery.

Midline laparotomy and right retroperitoneal dissection is an alternative exposure for routine aortic surgery.

Background: In most atlases of vascular surgery, laparotomy and right retroperitoneal dissection with reflection of the right colon and a wide Kocher maneuver is either briefly described as an alternative exposure for the abdominal aorta under special circumstances or not described at all. This approach offers certain advantages over the two more commonly described and widely used exposures, however, and should be considered for use in both routine and complex cases. The author reports his experience with the use of midline laparotomy and right retroperitoneal dissection (MLRRD) for elective aortic operations.

Surgeon experience with laparoscopic-assisted colorectal surgery in Washington State.

Purpose: To describe the current practice and opinions held by surgeons performing colorectal surgery in Washington regarding laparoscopic colorectal surgery.

Methods: After attempting to identify all surgeons with hospital privileges in colorectal surgery in Washington, a survey was sent to 303 surgeons. The survey asked about the surgeon's practice, volume of colon surgery in the preceding year, the number of laparoscopic colon resections ever performed, the surgeon's opinion on the future practice of laparoscopic colorectal surgery, and whether faced with the personal need to undergo colon resection at the present time, would the surgeon elect to have laparoscopic or open colon resection.

Combined laparoscopic-assisted right hemicolectomy and low anterior resection for synchronous colorectal carcinomas.

Background: Two cases of combined laparoscopic- assisted right hemicolectomy and low anterior resection for malignancy are presented to illustrate the technical aspects of performing two concurrent laparoscopic-assisted bowel resections with sequential anastomosis. Although there are similarities with laparoscopic-assisted total proctocolectomy, the need for complete mesenteric dissection in two areas, removal of two separate specimens containing malignancy, and the need for two anastomoses raise unique technical considerations which include port placement, sequence of dissection, choice of specimen extraction sites, specimen handling, and sites for extracorporeal anastomosis.

Methods: Operative notes, operative videotapes, and hospital inpatient and outpatient records were reviewed for both patients.

Thoracoscopic bleb resection selectively combined with pleurectomy for complicated spontaneous pneumothorax.

Objective: To evaluate the short and long term results of video-assisted thoracoscopic surgery for complicated pneumothorax.

Design: Retrospective study.

Setting: General hospital, Linz, Austria.

Safety, efficacy, and cost of pancreaticoduodenal resection in a specialized center based at a community hospital.

Objective: To determine whether pancreaticoduodenal resection (PDR) for benign and malignant disease can be performed safely, efficiently, and economically at a 50-bed community hospital.

Design: Retrospective review of 39 consecutive PDRs performed in an 18-month period. Indications for surgery, length of hospital stay, complications, and patient charges were analyzed.

Videothoracoscopy for the management of mediastinal mass lesions.

Background: The indications for video-assisted thoracoscopy have steadily expanded during recent years and include now the management of various mediastinal disorders.

Methods: Until now we have used videothoracoscopy for the diagnosis or treatment of mediastinal mass lesions in 28 patients. The indication for the procedure was bilateral or unilateral mediastinal adenopathy in 16, a suspected malignant anterior mediastinal mass lesion in six, and a presumable benign tumor of the posterior or anterior mediastinum in six patients.

Selective use of ERCP in patients undergoing laparoscopic cholecystectomy.

With the advent of laparoscopic cholecystectomy (LCH) various strategies have been proposed for the management of common bile duct (CBD) stones. In a consecutive series of 1140 patients subjected to LCH, preoperative endoscopic retrograde cholangiopancreatography (ERCP) was attempted in 128 patients (11.2%) and successfully accomplished in 121 (94.

Laparoscopic removal of dislocated ventriculoperitoneal shunts. Report of two cases.

In two patients the dislocated abdominal catheter of a ventriculoperitoneal (VP) shunt was successfully removed from the abdominal cavity by laparoscopy. Avoiding laparotomy, only two small abdominal incisions were necessary to insert the laparoscope and the grasping forceps. Postoperative course was uncomplicated except for protrusion of a part of the greater omentum through the umbilical incision in one patient.