A modified Aptos needle appeared to allow an easy, simple, safe method for fascial closure of trocar sites.

Segmental lateral internal sphincterotomy is a safe, easy, and effective procedure and not associated with risk of incontinence for the treatment of chronic anal fissure.

No abstract

Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region; and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, that is minimally invasive with no morbidity, a low risk of complication and easy to learn. Methods: Sixty seven patients with pilonidal disease were subjected to excision and partial closure procedure, from November 2006 to March 2010 at General Surgery Department, Zagazig University Hospital, Zagazig University, Egypt. The mean age was 27.5 years. Complete but close excision of all diseased tissues was achieved. Then, the wound partially was closed from the deepest parts only by multiples buried vertical mattress sutures by using Lasheen’s needle, and left the superficial wound parts to heal by second intention. The follow up period was ranged from 14 - 39 months (mean 27 months). Results: The mean hospital stay was 12 hours, mean operation time was 30 minutes and mean time to return to normal activity was 8 days (range 7 - 12 days). Nine cases show superficial wound infection and one case of recurrence. Conclusion: Excision and partially closure technique by using Lasheen’s needle for pilonidal diseases is minimal invasive and less morbidity, easy to learn and has favorable results regarding to return to normal activity, rate of recurrence and cosmetically acceptable

BACKGROUND Hepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated. AIM To evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC. METHODS Between June 2013 and June 2018, 167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study. Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study. The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations. RESULTS The patients' mean age was 36 ± 8 years, and males predominated (67.1%). The most common hepatobiliary diagnostic method was liver biopsy (85.6%), followed by Magnetic resonance cholangiopancreatography (63.5%), Antineutrophil cytoplasmic antibodies (62.5%), abdominal ultrasonography (35.9%), and Endoscopic retrograde cholangiopancreatography (6%). The most common hepatobiliary symptom was Primary sclerosing cholangitis (PSC) (62.3%), followed by fatty liver (16.8%) and gallbladder stone (10.2%). 66.4% of patients showed a stable course after surgery. Progressive or regressive courses occurred in 16.8% of each. Mortality was 6%, and recurrence or progression of symptoms required surgery for 15%. Most PSC patients (87.5%) had a stable course, and only 12.5% became worse. Two-thirds (64.3%) of fatty liver patients showed a regressive course, while one-third (35.7%) showed a stable course. Survival rates were 98.8%, 97%, 95.8%, and 94% at 12 mo, 24 mo, 36 mo, and at the end of the follow-up. CONCLUSION In patients with UC who had LRP, there is a positive impact on hepatobiliary disease. It caused an improvement in PSC and fatty liver disease. The most prevalent unchanged course was PSC, while the most common improvement was fatty liver disease.