The results indicate that implantation of the nerve prosthesis allows for good and effective neural regeneration. This new and simple treatment option for peripheral nerve injuries can be performed in any hospital with surgical facilities as it does not involve the demanding microsurgical suture technique that can only be performed in specialized centers.

Background Peripheral nerve defects (PND) often cause lifelong physical disability, and the available treatment options are often not satisfactory. PND are usually bridged with an autologous nerve transplant or a nerve guidance conduit (NGC), when coaptation as preferred technique is not possible. The aim of this experimental study was to determine the effectiveness of a novel NGC for regeneration in the treatment of PND. Materials and methods A conduit made of gelatin with an innovative interior structure was tested for the repair of a 6-mm gap versus direct microsurgical suture repair without gap. Results We found that bridging the defect with this conduit was as effective as direct microsurgical coaptation without a defect. Conclusions This nerve conduit, effective in bridging neural defects, appears as an alternative to autologous nerve grafts, avoiding the problems related to nerve graft harvesting, host–donor differences in diameter, mismatches in number and pattern of fascicles, cross-sectional shape and area, and morbidity of the donor area.

Background: Symptoms of obstruction in the intestinal tract involve the small intestine in three quarters of cases and the large intestine in one-quarter. The most common causes of an acute small intestinal obstruction are postoperative adhesions (64.8%) and strangulated hernias (14.8%). The overall incidence of postoperative small bowel obstruction is 4.6%. Because it offers a conservative and targeted means of removing the obstruction, laparoscopy is increasingly used for acute small bowel obstruction.With proper selection of patients, the success rate is very high. This work presents the selection criteria, technique and results for a three-year period.Methods: Twenty-one patients, 13 men and 8 women aged 28 to 69 years, underwent surgery between January 2008 and December 2010. Selection criteria for a laparoscopic procedure were anesthesia risk of not more than ASA 3, diameter of the dilatated loop of small intestine of not more than 5 cm, radiological image of a change in caliber as an indication of a focal passage disorder, exclusion of paralytic ileus, and no history of diffuse peritonitis. The patients underwent surgery in general anesthesia. The approach for the first trocar was umbilical in 18 cases and in the right or left flank in three cases, but always with open technique. Three trocars were always used.Results: In 7 patients, there was an isolated band from a previous operation, usually an appendectomy; in 5 cases there were postoperative adhesions and a band.

Background: According to the basic idea of minimally invasive surgery, reduction of surgical trauma, the caliber of instruments in needlescopic surgery is reduced to a few millimeters. The reduction in caliber can reduce power transmission to the instruments and impair view and light of the optic, which can cause limitations in its application. This study aimed to analyze the technique and results of needlescopic laparoscopy using the example of cholecystectomy.Methods: From 2007 to 2010, 124 patients underwent needlescopic and 130 conventional laparoscopic cholecystectomy. The trocar sites were always the same as for conventional laparoscopic cholecystectomy; a 10 mm trocar was introduced transumbilically in open technique and a total of three 2 mm trocars were used on the epigastrium and the right subcostal space. Intraoperative cholangiography was routine as in conventional laparoscopy.Results: All procedures were completed laparoscopically. Three cases (2.4%) required conversion to conventional laparoscopy. In 11 cases (9%), intraoperative cholangiography could not be performed. In 6 patients (5%), there were intraoperative complications such as opening of the gallbladder with spilling of the stones. The bile duct was never injured and there were no reoperations; hemoglobin never fell below 11 g/dl. There was significantly less need for analgesics in the first 3 days than with conventional laparoscopic cholecystectomy. Patient satisfaction was scored as 10 (very good) on a scale from 1-10 by 117 patients (94%).Conclusions: In contrast to NOTES and single port surgery, minilaparoscopy adheres to the basic principles of laparoscopy. With selected patients, needlescopic technique reduces postoperative pain, and has a better cosmetic result with higher patient satisfaction.