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Objective: The magnification technique offered by surgical loupe is a new method that enhances visualization and helps head and neck surgeons with recurrent laryngeal nerve (RLN) and parathyroid glands identification. This study aimed to assess the safety and efficacy of using binocular surgical loupes in thyroidectomy procedures. Material and Methods: Eighty patients with thyroid nodules who underwent thyroidectomy procedure were divided randomly into two comparable groups, group A subjected to thyroidectomy by using binocular magnification loupe, group B underwent conventional thyroidectomy without using magnification. Patients’ demographics, operation time, and postoperative morbidities were recorded. All cases had preoperative and postoperative vocal cords assessment by video laryngoscopy. Pathology, laboratory, and radiology investigations were also conducted. Results: Out of 80 patients, there were 58 females and 22 males. Benign thyroid pathology was found in 74 patients and malignant pathology in 6 patients. The mean operating time was 106 min in group A compared to 138.5 min in group B. The mean amount of intraoperative bleeding was 30 ml in group A while 50 ml in group B. There were no cases of the external branch of the superior laryngeal nerve in both groups; there was better identification in group A. There was only one patient who suffered from a temporary RLN injury in group A, while three cases of temporary and one case of permanent RLN injury were recorded in group B. Permanent hypoparathyroidism was diagnosed in only one patient in group B. Conclusion: The utilization of binocular surgical loupe magnification in thyroid surgery is considered a safe and effective maneuver that has the advantages of decreasing the overall operating time and significantly reducing postoperative complications.

Background Appendicular schistosomiasis (AS) is an uncommon cause of acute appendicitis that can only be diagnosed histopathologically. There are few reports of AS and its histopathological profile is unclear in Egypt. Therefore, we aimed to evaluate the prevalence and clinicopathological, profile of AS among patients presented with acute appendicitis for proper management and to reduce the health burden of the disease. Methods This is a retrospective study performed at a university hospital comprising all patients with pathological confirmation of appendiceal Schistosomiasis after appendectomies between 2017 and 2021. All data were extracted from patient’s files including age, sex, residence, main patient’s complaint, Alvarado scores, and laboratory data. The histopathological specimens were reviewed by the histopathologist in this study and special stains were done when indicated. Results The prevalence of AS was 1.07% (20/1870), all of them were adults or old age with a mean age of 39.25, 80% of cases were males. The most frequent clinical presentation in our patients was abdominal pain in the right iliac fossa (96%) with a mean duration of symptoms of 2.5 days. At the time of the operation, two patients had perforations, with no recorded mortality. Only 20% showed gross unusual foci, and lymphoplasmacytic infiltration was seen in 90% of cases. All patients were advised to postoperative praziquantel therapy. Conclusion Histopathological evaluation for schistosomiasis in all surgically removed appendix is recommended in endemic areas for middle and old ages and comprehensive postoperative follow-up with praziquantel therapy is required to ensure disease eradication and prevent further complications. Highlights

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Article informationBackground: Mesh-related infection after open ventral hernia repair is a clinical dilemma in abdominal wall hernia surgery, especially in the bacterial resistance era.The management of such a problem usually needs complete mesh excision, which results in a high recurrence rate. Objective: The goals of the current study were to evaluate the efficacy of negative pressure wound therapy [NPWT] in infected mesh preservation. Patients and Methods: This prospective study was carried out from January 2017 to December 2019. A total of twenty-four cases with mesh exposure after ventral hernia repair was involved in our study. Patients were categorized into two comparable groups, Group I: VAC was applied for the preservation of the infected mesh, Group II: conventional wound care dressing was used. Patients' demographics, types of hernia, wound diameter, and the outcomes of each technique were recorded in the study. Results: Out of 24 patients there were 9 males and 15 females, the mean age was 42 years. Types of hernias were 15 paraumbilical hernias, 6 incisional hernias, and 3 recurrent hernias. The wound size in group I ranged from18 x 11 cm -8.5 x 5 cm and in group II ranged from 16.5 x10 cm -7 x 5. In Group I, the mesh salvage was accomplished in 11 cases [91.7%] and the wound closed with 2ndary suturing and only 1 [8.3%] patient need partial mesh excision. While In Group II, mesh salvage was accomplished in 5 cases [41.7%] however, 7 [58.3%] patients needed radical en-bloc mesh excision. All the cases had followed up for 6 months. Conclusion: NPWT/VAC therapy has excellent and promising outcomes in the preservation of infected prosthesis.

Background: Laparoscopic sleeve gastrectomy (LSG) is a simple procedure; however, postprocedural hemorrhage and/or leak remain the most troublesome outcomes. To prevent these serious complications, some surgeons have recommended the necessity to support the staple-line (SL). The target of the existing work was to estimate the occurrence rate of SL leak or hemorrhage after LSG with using and without using V-Loc running sutures to support the SL.