Abstract:

It is now approaching a decade since preliminary rumors of totally laparoscopic cholecystectomy emerged from France and the United States, as subsequently described by Dubois in 1990, and this seems to be an appropriate time to review the impact of laparoscopy on surgical healthcare.

Authors:

Samuel M. Andrews, M.A., M.B.B.S., M.S., F.R.C.S.; Harry J. Schneider, Jr. M.D., F.R.C.S.; Tom Bates, M.D., F.R.C.S. - Maidstone Hospital, Maidstone, England

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Abstract:

Transanal Endoscopic Microsurgery (TEM) was clinically introduced by Buess et al. In 1983 for the removal of adenomas from the rectal cavity. Later, the indications were extended to the excision of pT1 low-risk carcinomas in curative and to tumors in higher stages in palliative intent. Training courses for this method have been conducted since 1985 and several hundred surgeons have been taught this procedure in Germany and other countries. Because TEM is gaining international recognition it is worthwhile to review the complications of the method.

Authors:

Burkhard Mentges, M.D.; Gerhard Buess, M.D., F.A.C.S., F.R.C.S. - Eberhard-Karls University, Tübingen, Germany

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Abstract:

During the past half century, surgeons have demonstrated the greatest interest and have made the most concerted effort in developing innovative, comprehensive, and effective methods for providing adequate nutritional support to patients in the widest range of clinical conditions and situations. Several factors account for the continual stimulation of thoughtful surgeons and physicians to maintain or improve the nutritional status of their patients.

Authors:

Stanley J. Dudrick, M.D., F.A.C.S.; Khalique S. Zahir, M.D.; - St. Mary¹s Hospital, Waterbury, Conn.; Ronald C. Merrell, M.D., F.A.C.S. - Yale University School of Medicine, New Haven, Conn.

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Abstract:

Since laparoscopic cholecystectomy was introduced in 1987 by Phillipe Mouret, a variety of gastrointestinal operations such as laparoscopic Nissen fundoplication, herniorrhaphy, splenectomy, vagotomy, adrenalectomy, appendectomy, nephrectomy, staging of intra-abdominal neoplasms, and laparoscopic colectomy have gained popularity. The minimal invasive nature of these procedures and the reported benefits of a short hospital stay, reduced postoperative pain, and better cosmesis have encouraged investigation of new methods of access for gastric and colonic pathology untreatable by endoscopic or standard laparoscopic techniques.

Authors:

Tomás Martínez-Serna, M.D.; Charles J. Filipi, M.D., F.A.C.S. - Creighton University, Omaha, Nebr.

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Abstract:

Emphysematous gastritis and mucormycosis are two different entities and both are very rare in clinical practice. Emphysematous gastritis secondary to mucormycosis has not been described in literature so far. We would like to report such a case for the first time and review the relevant literature and clinical implications.

Authors:

Vani Savalgi, M.D., F.R.C.S., D.N.B.; Turgut Berkmen, M.D.; Vazrick Mansourian; M.D., F.A.C.S. - Hospital of St. Raphael, New Haven, Conn.

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Abstract:

It is well known that the small bowel is particularly sensitive to ischemia and reperfusion injury. In situations such as mechanical occlusion, thromboembolism, sepsis, and low flow states, it is not uncommon to subject the small bowel to transient yet potentially reversible ischemia. Surgeons involved in the treatment of this entity are often faced with the dilemma - whether to cut or not, and to what extent should the tissue be resected proximal and distal to the ischemic injury.

Authors:

Umer M. Darr, M.D.; John P. Geibel, M.D., D.Sc. - Yale University School of Medicine, New Haven, Conn.

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Abstract:

Mobile Surgery (MS) is an innovative method of delivering high quality surgical expertise and technology to underprivileged and remote areas. This is done by means of transporting a custom-built operating room in a truck and performing the operations on-site. Patients are referred to our program by rural doctors and family physicians. A screening process is completed by our surgical team, and those patients who meet our selection criteria are offered surgical treatment. Operations are meticulously performed and patients recover under our close observation in rural health centers, school rooms, or tents with our Mobile Surgical Unit (MSU) stationed adjacent to them.

Authors:

Edgar Rodas, M.D., F.A.C.S. - University of Cuenca-Equador, School of Medicine, Cuenca, Ecuador; Edgar B. Rodas, M.D. - Yale University School of Medicine, New Haven, Conn.

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Abstract:

Repair of the recurrent groin hernia remains one of the more perplexing problems encountered by the general surgeon. Surgical results have shown little improvement in the more than 100 years of modern hernia surgery. Despite the utilization of a multitude of complex and technically demanding operative procedures, such varied surgical techniques as wide dissection, detailed anatomic repair, multi-layered repair, relaxing incisions, tissue flaps, suture of living tissue, weaving of a reinforcing lattice of suture or tissue, transposition of cord, and orchiectomy, have engendered little more than increased disability and complications.

Authors:

Alan W. Robbins, M.D., F.A.C.S. ; Ira M. Rutkow, M.D., M.P.H., Dr.P.H., F.A.C.S. - The Hernia Center, Freehold, N.J.

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