Bruno Benini | PubMed Health

PubMed2004

Gallbladder strangulation within an incisional hernia.

We describe here the first case in the literature of gallbladder strangulation within an incisional hernia. A patient with a history of rectal cancer operation presented with a "surgical abdomen" and a palpable right upper quadrant mass at the site of the previous colostomy. At surgery, a strangulated gallbladder was found in the subcutaneous tissue. Cholecystectomy was performed, and patient recovery was uneventful. If gallbladder strangulation is suspected, the surgeon should avoid forceful attempts at hernia reduction, as this may cause rupture of the gallbladder and subsequent contamination.

Aged↗

PubMedDate not supplied

[Hand-assisted videolaparoscopic surgery of the abdominal aorta: preliminary experience with the first 9 cases].

Laparoscopic surgery decreases postoperative pain, shortens hospital stay, and returns patients to full functional status more quickly than open surgery in a variety of surgical procedures. This study was undertaken to evaluate laparoscopic techniques as applied to aortic surgery. Nine patients underwent elective hand-assisted laparoscopic surgery, 8 for obliterative disease and 1 for an aneurysm of the abdominal aorta. Five patients had a left aorto-femoral bypass, 3 patients an aorto-bifemoral bypass, and 1 patient an aorto-aortic bypass after aneurysmectomy. There were no laparotomic conversions and all procedures were completed with transperitoneal hand-assisted laparoscopic surgery. Mean aortic clamping time was 39 minutes and mean operative time 194 minutes. Mean blood loss was 500 ml and the mean postoperative hospital stay was 4.2 days without major complications. At control examinations all grafts were patent. Hand-assisted laparoscopic aortic surgery is feasible, safe, and effective. In selected cases it may be a valid surgical procedure in addition to conventional and endovascular surgery. The advantages observed in our patients were minimal tissue trauma, less postoperative pain and faster postoperative recovery.

Adult↗