Visceral artery aneurysms as a result of arterial degenerative disease are rare (0.1–2%), and superior mesenteric artery (SMA) accounts for 3.2% of all reported series. However, mycotic SMA aneurysms (SMAAs) are even rarer, and to the best of our knowledge, this is the first report of cryptogenic mycotic aneurysm of SMA by Enterococcus faecalis (EF). We report a case of 77-year-old man with 6-week history of supra pubic/left iliac fossa pain, weight loss and fever. The computed tomography demonstrated an incidental finding of 4.4 × 3-cm SMAA with no primary foci. The subsequent serology and specimen confirmed EF. Aneurysmectomy without bypass grafting along with antimicrobial therapy resulted in full recovery of the patient.
Aim Three-dimensional laparoscopy improves the depth of perception during minimally invasive surgery, leading to better visibility and more precise dissection, and providing better clinical and surgical outcomes in complex surgical procedures. The aim of this study was to compare the pros and cons of the 3D technological systems available in our Unit for UGI surgery. Background & Methods In our Unit, we have two different 3D systems for abdominal and thoracic surgery. B Braun has the EinsteinVision 3D system with 0 and 30 degree fixed camera. Olympus produces an Endoeye Flex with an articulating tip 0 degree 3D camera as well as an Endoeye 3D 0 and 30 degree rotating camera. Advantages and disadvantages of the different 3D systems were evaluated on the basis of the experience of our senior surgeons performing routinely 3D operations. Results All surgeons agreed of the superiority of 3D vision compared to conventional 2D laparoscopy or thoracoscopy. The B Braun system is not available in an integrated operating theatre system and does not allow image rotation, but provides a full HD sharp resolution and has the advantage of a reusable camera with single use warming cover which could be used for unlimited procedures every day. The Olympus Endoeye Flex does not provide HD resolution and can be more difficult to manoeuvre, but has the advantage of the articulating tip. The Olympus Endoeye 30 degree rotating camera has a better HD resolution and the advantage of image rotation while maintaining the horizon. Conclusion Technology beyond 3D laparoscopic system has been evolving rapidly. Different products have their own strengths and weaknesses, and surgeons should be familiar with the system used.
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