The prevailing dogma in tissue engineering is cell-centric. One shortcoming of this approach is the failure to provide the implanted cells with a suitable in vivo microenvironment that promotes tissue reconstruction. Extracellular matrix (ECM)-based scaffolds provide a three-dimensional microenvironment that can promote constructive and functional tissue remodeling rather than inflammation and scarring even in the absence of any implanted cells. The objective of this study was to determine the ability of an ECM-based scaffold to facilitate functional restoration of the distal gastrocnemius musculotendinous junction in a canine model after complete resection of the tissue. Within 6 months, vascularized, innervated skeletal muscle that was similar to normal muscle tissue had formed at the ECM-scaffold implantation site. This neo-tissue generated 48% of the contractile force of contralateral musculotendinous junction and represents the first report of de novo formation of contractile, vascularized, and innervated skeletal muscle in situ after significant tissue loss.

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VATS of early-stage thymoma appears safe and feasible and was associated with a shorter hospital stay. The oncologic outcomes were comparable in the open and VATS groups during intermediate-term follow-up. Additional follow-up is required to evaluate the long-term results of thoracoscopic thymectomy for early-stage thymoma.

LRGPEH performed in our minimally invasive center of excellence resulted in a durable repair with a high degree of satisfaction and preservation of GERD-related QoL at a median follow-up of over 6 years.

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Laparoscopic right hemicolectomy and transvaginal extraction is a safe and effective procedure that can be added to the armamentarium of surgeons performing laparoscopic colon surgery. This technique may provide both an attractive way to reduce abdominal wall morbidity and a bridge to pure natural orifice transluminal endoscopic surgery for colon surgery.

Objectives-Surgical resection is the preferred treatment in selected patients with pulmonary metastases. In high-risk patients, radiofrequency ablation (RFA) may offer an alternative option. RFA may be used either alone or in combination with surgical resection as a lung parenchymalsparing approach. Our objectives were to evaluate the intermediate term outcomes after RFA and to determine the prognostic variables associated with outcome in patients with pulmonary metastases Methods-Thoracic surgeons evaluated and performed RFA under computed-tomography (CT) guidance or in combination with surgical resection as a lung parenchymal-sparing modality. Patients were monitored in the thoracic surgery clinic for recurrence and survival.Results-Twenty-two patients {10 men, 12 women; median age 63 years (37-88)} underwent RFA. The primary cancer was colorectal in 9 (41%), renal in 2 (9%), sarcoma in 4 (18%) and other in 7 (32%) patients. CT-guided RFA was performed as a sole modality of treatment in 17 patients (77%), and in combination with surgical resection in 5 (23%) patients. There were no procedure-related mortalities. At a mean follow-up of 27 months (13.3-53.6 months), 9 patients are alive. The median survival was 29 months (CI 9.1-33.8). Size of the lesion was an important prognostic variable associated with overall and disease-free survival (P<0.05).Conclusions-Our experience indicates that RFA is safe in this group of pulmonary metastases patients with reasonable results. Surgery remains the standard for resectable patients, but RFA offers an alternative option in selected patients or may be used as a parenchymal-sparing approach in combination with surgical resection in selected patients.

A left aberrant gallbladder is a rare presentation that requires awareness of biliary anatomy and selective use of intraoperative cholangiography to assist in safe laparoscopic gallbladder resection.