Easy modified wells method for rectal prolapse with using bilayer mesh.

Background: In recent years, many laparoscopic procedures have been reported for the treatment of rectal prolapse, and the Wells method is safe and has relatively good results for rectal prolapse, which is common in the elderly. In this report, we have developed a simpler method to perform the Wells method.

Methods: In our procedures, easy modified Wells method is performed laparoscopically, but the use of a bilayer mesh makes it easier to perform without the need to suture the retroperitoneum.

Flexible tack for ventral hernia repair.

A mesh repair of a ventral hernia from the anterior approach is relatively difficult because it is necessary to fix the edge of the mesh from the hernial orifice. We developed a flexible tack for hernia repair, and used it for five lesions in four patients. The flexible tack allowed us to fix the edge of the mesh to the abdominal wall through the peritoneum without any complications.

Ultrasound assisted percutaneous endoscopic jejunostomy.

The percutaneous endoscopic gastrostomy (PEG) cannot be performed for the patient after total gastrectomy. We design the new procedure to make jejunostomy with using an ultrasonography and a regular PEG kit. We name the procedure Ultrasound assisted Percutaneous Endoscopic Jejunostomy (USPEJ).

Personal experience of laparoscopic cholecystectomy.

Background/aims: We performed laparoscopic cholecystectomy with a surgical team consisting of the same operator and the same first assistant to evaluate a personal learning curve of laparoscopic cholecystectomy.

Methodology: In the 135 patients who underwent the laparoscopic cholecystectomy, operative complications, postoperative complications and operative time were evaluated on the basis of using different camera assistants and the chronological advancement of the same operator and the same first assistant.

Results: The average operative time was 120 +/- 54 minutes.

[Japan Surgical Society recertification: the viewpoint of surgeons in a local area].

The system of recertification is evaluated from the view point of the surgeons in a local area. The system only requires attendance at the national meeting of the Japan Surgical Society and/or meetings that are designated by the Japan Surgical Society for recertification. Half of such meetings have been held in the Kanto area over the past 10 years, resulting in an imbalance in the status of recertification between surgeons in the Kanto area and in local areas.

[Frequent chemolipiodolization and prostaglandin E1 administration for hepatocellular carcinoma with advanced liver cirrhosis].

"Frequent Chemolipiodolization & Prostaglandin E1 administration Therapy (FCPT)" which performed frequent chemolipiodolization to Hepatocellular carcinoma (HCC) and Prostaglandin E1 (PGE1) intra-hepatic arterial administration for avoiding serious liver damage by using reservoir was carried out for 7HCC cases with severe liver cirrhosis. Chemolipiodolization was performed every 4 weeks to 6 cases. PGE1 was given to all cases with 10 or 20 micrograms/4 hours every week after 7 days administration.

Rectal expander-assisted transanal endoscopic microsurgery in rectal tumors.

Rectal expander-assisted transanal endoscopic microsurgery (RE-TEM) was performed for two cases of early rectal cancer and a case of villous tumor under saddle block anesthesia. RE-TEM is the new technique for local excision of rectal tumors with a rectal expander that we developed. The rectal expander expands the rectum after insertion through the anus and provides adequate vision for microsurgery with standard video monitors.

Chemolipiodolization and prostaglandin E1 administration with use of hepatic arterial infusion port for the treatment of hepatocellular carcinoma and liver cirrhosis.

Frequent chemolipiodolization and prostaglandin E1 (PGE1) administered through a hepatic arterial infusion port were used for treatment in 2 cases of hepatocellular carcinoma (HCC) with liver cirrhosis. Chemolipiodolization was performed every 4 weeks with 6 ml lipiodol, 3 ml Optilay and 30 mg Epirubicin or 10 mg Mytomycin C. PGE1 (10 ug) was administrated to the hepatic artery once every week after the first 7 days administration.

Endoscopic findings and clinical manifestation of gastric anisakiasis.

Objectives: To identify the endoscopic findings and clinical manifestations of anisakiasis, we studied 87 cases of gastric anisakiasis.

Methods: Patient information was analyzed by means of patient records. The interval between the day of intake of Anisakis and endoscopic examination was determined in 86 cases.

Percutaneous transhepatic portacaval shunt for high-risk esophageal varices.

Percutaneous transhepatic portacaval shunt (PTPS) was performed in a patient with high-risk esophageal varices prior to sclerotherapy. PTPS was accomplished with the aid of two catheters. The first catheter was placed in the right hepatic vein under ultrasonographic guidance, and the second was placed in the portal vein.

A small pedunculated adenomatous polyp of the colon found to contain the focus of invasive carcinoma extending to the serosa: report of a case.

A small pedunculated polyp was detected among other polyps in the transverse colon of a 64-year-old man, the resected specimen of which showed an adenomatous polyp 1 cm in diameter, containing the foci of adenocarcinoma invading the submucosa, muscularis, and serosa. This case report stresses the importance of performing careful pathologic examination of resected specimens obtained from endoscopic polypectomy, even for small pedunculated colon polyps.