Abstract:

Acute pancreatitis is a disease with a significant morbidity and mortality. It has been reported as the principal diagnosis in 2% of hospital admissions with abdominal pain in the UK. The incidence is in the range of 200 to 300 cases per million population per year, but it is probably increasing. The overall mortality rate is 10 to 12%. The management of the disease and its complications requires close co-operation between surgeon, radiologist and gastroenterologist. There have been a number of improvements in the management of acute pancreatitis in the last decade.

Authors:

Stuart W.T. Gould, B.Sc, F.R.C.S, Geoffrey Glazer, M.S., F.R.C.S., F.A.C.S.

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Abstract:

In 1942,Hughes performed the first thoracoscopic removal of sympathetic ganglia. Two years later Goetz and Marr reported on cases that had undergone thoracoscopic sympathectomy. In the 1950s, Kux performed more than 1,400 thoracoscopic sympathectomies and vagotomies. Interest in thoracoscopic sympathectomy increased in the 1980s and now it is the treatment of choice for severe axillary and palmar hyperhidrosis.

Authors:

Mark George, F.R.C.S., John Rennie, F.R.C.S.

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Abstract:

The incidence of rectal cancer in the US is 45,000 per ann um. The 5-year survival is between 40 and 70%. This has not improved over the last 50 years despite improvements in techniques, the aid of new technology (surgical stapling devices in particular) and safer anesthesia.

Authors:

Paul S. Carter, M.D., R.J. Leicester, M.D.

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Abstract:

The first description of the laparoscopic approach to colorectal cancer resection was in 1991. Today, the exact role of laparoscopic colorectal cancer surgery remains undefined and awaits the results of multicenter randomized controlled trials. Most authors agree that pending these results, such surgery should be performed only in specialist centers and on study populations. This hesitant adoption of the laparoscopic modality in colorectal cancer surgery is in stark contrast to the speed and enthusiasm with which laparoscopic cholecystectomy was adopted without a randomized controlled trial. Adapting laparoscopic techniques to malignant disease requires confirmation that the laparoscopic approach conforms to the principles of surgical oncology: adequacy of resection margins, wide clearance of lymph nodes fields, and the avoidance of iatrogenic tumor dissemination.

Authors:

B.J. Mehigan, M.B., A.F.R.C.S.I., J.E. Hartley, M.D., F.R.C.S., J.R.T. Monson, M.D., F.R.C.S.I., F.R.C.S., F.A.C.S.

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Abstract:

Uterine fibroids are common benign tumors of the uterus and a major public health problem. Between 20 and 25% of women over 35 years of age are estimated to have fibroids. Three subtypes of fibroids are recognized depending on their relationship to the myometrium, namely, submucosal, subserosal and intramural. Fibroids are frequently asymptomatic, but may be associated with menorrhagia, dysmenorrhea, pregnancy loss or infertility. They are composed predominantly of smooth muscle, with a variable amount of connective tissue, and they have a characteristic smooth white whorled appearance on cross sectional examination.

Authors:

Kunle O. Odunsi, M.D., M.R.C.O.G., Thomas J. Rutherford, M.D., Ph.D., David L. Olive, M.D., Frank Bia, M.D., Vinita Parkash, M.D., Janice Brown, M.D., Tony G. Zreik, M.D.

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Abstract:

In 1910, Professor H. C. Jacobaeus first described thoracoscopy. He used a modified cystoscope to inspect the pleural cavity. He described his two cannula techniques, one for the light source, and the other for viewing. Later on, the technique was improved, and a single cannula provided the light source and an optic telescope. With the advent of video assisted thoracoscopy, the procedure has gone full circle; once again, two cannulae are used - one to give us a video assisted telescopic picture and the second cannula is used for operational purposes.

Authors:

Syed S. Hassan, F.R.C.S.

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