A mortalidade materna associada ao aborto revela as condições sociais da mulher. Este estudo, exploratório-descritivo, tem o objetivo de identificar o perfil das mulheres que tiveram morte associada ao aborto no Estado de Santa Catarina, no período de 1996 a 2005. As fontes para a coleta dos dados foram: o Sistema de Informações sobre Mortalidade e o Sistema de Informações sobre os Nascidos Vivos, do Ministério da Saúde do Brasil. Foram encontradas 31 mortes maternas associadas ao aborto; destas, 51,61% ocorreram em mulheres casadas; 38,71% das mulheres tinham de 1 a 8 anos de escolaridade, e para 48,39% o grau de instrução foi registrado como ignorado. Os dois valores mais elevados da razão de mortalidade materna foram encontrados na Região Oeste, 5,148, e na Região Norte, 4,761.

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Laparoscopy is considered the gold standard approach to perform left lateral sectionectomy (LLS). Furthermore, laparoscopy for cirrhotic patients can reduce intraoperative bleeding and postoperative morbidity when compared to open surgery. Although robotic surgery is feasible for both minor and major liver resections, it remains a work in progress and only few series reported this approach for cirrhotic patients. We reported two cases of 62-year-old men, both with hepatitis C virus and alcoholic cirrhosis, but with compensated liver functions (MELD 9-10 and Child-Pugh A5-A6). The patients were diagnosed with a single lesion in the left lobe. Robotic LLS was performed using intraoperative ultrasound to confirm findings of pre-operative image, and linear staplers were used to control left lobe inflow and outflow. The specimens were removed through Pfannenstiel incision in both patients. Both procedures followed the same standardization. The total operative time was 250 and 151 min with estimated blood loss of 100 and 70 ml, respectively, for cases 1 and 2. The procedures were made without Pringle maneuver and postoperative course was uneventful with hospital discharge at third and fourth postoperative day, respectively. The pathology examination confirmed a 2.5- and 4.5-cm hepatocellular carcinoma, respectively; both presented negative margins and cirrhosis. Robotic LLS seems to be as feasible as conventional laparoscopic approach as a stepwise procedure in a robotic learning curve for liver resection. Its benefits can also be offered to selected cirrhotic patients.

Results: Shorter length of stay was observed in the early LC group (4.0 days versus 4.5 days. The mean total provider cost for early LC was RM 2532, and RM 2751 for elective LC. This difference was mostly seen in the consumable cost (i.e investigations and operating equipment) with p < 0.05. Operative outcome was statistically similar in each group in terms of conversion rate (23.1% vs. 18%), post-operative complications (11.5% vs 4.5%) and readmission rate (7.7% vs. 4.5%) with p > 0.05. However the operative time was statistically longer in the early LC group (134.2 + 48.5 minutes) versus elective group (105.9 + 40.1 minutes)(p = 0.032). Conclusion: The average provider's cost for early LC was statistically similar when compared to elective LC with comparable safety profile. Early LC should still be the preferred treatment option for patients with acute cholecystitis if adequate facilities and expertise is available.

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Introduction: Although liver laparoscopy has become a useful approach for minor resections, it seems that lesions in upper and posterior segments still represent technical challenges. We report robotic approach for these lesions. Methods: Consecutive patients who underwent liver resection for solitary lesions in posterior and upper segments by daVinci Ò SI robot, and by the same team. All patients were placed in oblique left lateral position and reverse Trendelenburg to access the posterior and upper segments; five trocars were used (3 of 8 mm and 2 of 12 mm), and surgical specimens were removed through Pfannestiel incisions. Results: From April 2016 to April 2017, five female patients undergone robotic non-anatomical resections of colorectal liver metastases were reported. Clinicopathological, operative and postoperative data are summarized in the Table 1. Briefly, 4 patients presented isolated lesions in posterior segments and 1 patient in VII/VIII location, and the mean size was 2.3 cm. The difficulty score system (Iwate criteria) ranged from 2 to 6. Intraoperative ultrasound was used in all procedures and confirmed isolated lesions and their anatomical relations. Neither blood transfusion nor Pringle maneuver were necessary. One patient (20%) presented complication (pulmonary embolism e Dindo-Clavien grade 2). Conclusion: The putative benefits of robotic approach arises from the articulate arms allowing the use of mono and bipolar energy to help both exposition and liver parenchyma transection. They were useful even with the use of non-articulated harmonic scalpel. It seems that robotic approach is a valid option to potentially overcome the drawbacks of laparoscopy for those segments.