Abstract:

The liver has a central role in human metabolism and represents one of the organ systems most often affected, especially by tumor diseases. The group of colorectal carcinomas metastatically almost exclusively attacks this organ, which, according to studies by Weiss and colleagues, can be attributed to venous drainage of the intestines through the portal vein. A large number of primary tumors often cause liver metastases as well as bone, lung, and brain metastases. After curative sanitation of the primary tumor, the liver infestation has a decisive influence on survival time of affected patients in many instances.

Authors:

Thomas J. Vogl, M.D., Martin G. Mack, M.D., Ralf Straub, M.D., Katrin Eichler, M.D., Andre Roggan, M.D., Stephan Zangos, M.D., Dirk Woitaschek, M.D., Marian Böttger M.D.

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Abstract:

The high risk of hernia recurrence as reported in the literature has prompted a significant increase in use of prosthetic materials for repair of groin hernias. The speed of recovery after surgery, as well as cost and simplicity, has become a much more important consideration than in the past, now that the risk of recurrence has been lowered with modern techniques.

Authors:

Robert D. Kugel, M.D., F.A.C.S.

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Abstract:

Local hemostasis is critical for successful surgical intervention and maybe accomplished with a variety of techniques rang ng from direct pressure to lasers. Critical assessment of the clinical situation is required to determine the appropriate technology necessary to achieve effective hemostasis. As a general rule, ligatures remain the mainstay for effecting hemostasis in all but the smallest isolated vessels. Although ligatures have been in use since the first century AD, both the applications as well as their sophistication have increased dramatically. As sutures are foreign material to the human body, tissue reaction is unavoidable. This response may be mitigated, but not eliminated completely, through the use of non-absorbable sutures. The body's inflammatory response triggers a complex cascade of cellular and biochemical events that lead to fibrinogenesis and coagulation. This process, in turn, results in an increased deposition of collagen that may result in formation of adhesions.

Authors:

Steven L. Peterson, D.V.M., M.D., Patricia L. Stranahan, M.D., PhD. , Dale Schmaltz, M.S., Carolyn Mihaichuk, M.S., Ned Cosgriff, M.D.

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Abstract:

Some of the numerous anomalies of the biliary tract and its vasculature are iricompatible with life, whereas others are only medical curiosities. Many, however, are the cause of symptoms, and all are of particular concern to the surgeon who must operate in this area. An example is situs inversus totalis, an anomaly of the biliary tract that can present difficulties in management of abdominal disorders. We present a case of transposition of the viscera (situs inversus) with cholelithiasis, treated successfully with laparoscopy cholecystectomy. This article further affirms the safety and efficacy of laparoscopy in the setting of situs inversus totalis after giving due attention to the details of left-right reversal.

Authors:

Steven L. Peterson, D.V.M., M.D., Patricia L. Stranahan, M.D., PhD. , Dale Schmaltz, M.S., Carolyn Mihaichuk, M.S., Ned Cosgriff, M.D.

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Abstract:

The laparoscopic application of an adjustable silicone gastric band (Lap-Band™ System, Bioenterics, Carpinteria, CA) (Fig. 1), based on a similar device introduced by Kuzmak in 1986, is gaining widespread acceptance as a gastric restrictive procedure in treatment of morbid obesity, The advantage of an operation that does not open the gastrointestinal tract and can be performed laparoscopically is obvious. This procedure, using the laparoscopic approach, has been performed in our institutions since 1992. The goals of this article are to describe both our standardized surgical technique that minimized the morbidity rate and its results.

Authors:

Franco Favretti, M.D., Gianni Segato, M.D., Francesco De Marchi, M.D., Maurizio De Luca, M.D., Mario Lise, M.D., Guy-Bernard Cadiere, M.D., Jacques Himpens, M.D., Elie Capelluto, M.D., Quentin Gaudissart, M.D.

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Abstract:

After the first description of laparoscopic adrenalectomy was published in 1992,this method rapidly attracted widcspread interest. Similar to conventional open techniques two main approaches have been established for the minimally invasive adrenalectomy: the transabdominal and the retroperitoneal. With the transabdominal technique several different routes for exploration of the glands are possible as the patient can be operated on in a lateral, semi-lateral, or even in a supine position for both glands. Determining the best approach for the left side is further complicated because of the many possible techniques for exploration: through the gastrolienal, gastrocolic, or splenophrerric ligaments. The authors have developed a new method for the left laparoscopic adrenalectomy using the splenophrenic approach.

Authors:

Andras Papp, M.D., Andras Vereczkei, M.D., Örs Peter Horváth, M.D., D.Sc., Zoltan Szabo, Ph.D.

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