All complications related to the direct trocar insertion technique were minor and these complications did not affect the success of surgery. We concluded that the direct trocar technique for initial access in laparoscopic bariatric surgery provides safe and quick entry into the peritoneal cavity.
Splenic artery aneurysms are very rare causes of acute abdomen but are important to recognize since they carry high rate of mortality when ruptured. The aim of this study was to present a middle aged man with sudden onset of abdominal pain. Being previously on steroid treatment due to sarcoidosis, the patient developed hypovolemic shock during work-up in diagnostic imaging and went on emergency laparatomy. The source was identified as a ruptured splenic artery aneurysm. Splenectomy en bloc with the aneurysmatic distal splenic artery was performed, and he was discharged uneventfully. Despite rare, it is important to recognize splenic artery aneurysm in the emergency department, and immediate intervention is required to save the patient.
Adequate retraction greatly simplifies laparo-endoscopic single site cholecystectomy. New retraction techniques will enable wider use of this novel minimally invasive approach. Further work is needed to investigate the advantages of this new technique.
Cecal diverticulum of colon is a relatively rare and benign condition in the western world. The reported frequency is approximately 1 in 300 appendectomies. They are usually asymptomatic but it may cause inflammatory, hemorrhagic, or perforatory complications. It is often clinically indistinguishable from acute appendicitis. The diagnosis is almost made intraoperatively. We present a 21-year-old female patient who admitted to our emergency unit with right lower quadrant abdominal pain. Diagnostic laparoscopy was performed due to suspicious acute appendicitis. During exploration, an inflammatory mass originated from cecum was noticed. Laparoscopic right hemicolectomy was performed due to suspicious malignant mass. The postoperative course was uneventful. Although radiologic techniques are improved; the diagnosis of solitary cecal diverticulum is difficult. The choice of surgical therapy is controversial. The therapy is ranged from a simple diverticulectomy to right hemicolectomy. Diagnostic laparoscopy can help the surgeon in the diagnosis of right lower quadrant pain and therapy of solitary cecal diverticulitis.
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