Endometriosis is the presence of endometrial-like tissue outside the uterine cavity, which most commonly affects peritoneal surfaces, ovaries and uterine ligaments. Even it is quite rare, endometriosis may affect the vulva, vagina, rectovaginal septum or perineal region, generally secondary to obstetric or surgical trauma. In this case report, we present a patient with perineal endometriosis in an episiotomy scar. Diagnostic tools used included transvaginal and endorectal ultrasonography (USG), magnetic resonance imaging (MRI) and biopsy. The endometriotic mass was wide-excised together with episiotomy scar. The recovery was uneventful with excellent functional and esthetic results. Six months after operation, woman is asymptomatic. According to the literature and our own experience, wide excision of endometriotic tissue seems to be the best chance of cure with satisfactory functional results and should be recommended.
Introduction: Adhesions are the reason for bowel obstruction in 80% of the cases. In well selected patients the adhesive ileus laparoscopic treatment has multiple advantages which include the shorter hospitalization period, earlier food taking, and less postoperative morbidity rate. Case report: Here we have a patient in the age of 35 hospitalized at the clinic due to occlusive symptoms. Two years before an opened appendectomy had been performed on him. He underwent the treatment of exploration laparoscopy and laparoscopic adhesiolysis. Dilated small bowel loops connected with the anterior abdominal wall in the ileocecal region by adhesions were found intraoperatively and then resected harmonically with scalpel. One strangulation around which a small bowel loop was wrapped around was found and dissected. Postoperative course was normal.
Surgery of the gallbladder has evolved tremendously over the last century. Laparoscopic cholecystectomy is the gold standard for gallbladder removal and the most common laparoscopic procedure worldwide. In recent times, innovative techniques of natural orifice transluminal endoscopic surgery (NOTES) and transumbilical single-port (TUSP) or single-incision laparoscopic surgery (SILS), have been applied in gallbladder removal as a step towards even more less-invasive procedures. We report a 49-year-old woman with calculosis which were submitted to a single-port transumbilical laparoscopic cholecystectomy, first time done on the Surgical Clinic of Tuzla, and first time in Bosnia and Herzegovina.
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