In thin and very thin patients of any age category with no more than one previous abdominal operation, DTI is a safe alternative to the VN technique and is associated with fewer minor complications. In terms of major complications, there is no difference between the two techniques. Either technique of access is acceptable Thin and very thin patients undergoing laparoscopy, on condition that the basic principles of laparoscopic surgery are complied with.

We believe that laparoscopy is not an alternative to physical examination/good clinical judgment or to conventional noninvasive diagnostic methods in treating the patient with symptoms of an acute abdomen. However it must be considered an effective option in treating patients in whom these methods fail and as a challenging alternative to open surgery in the management algorithm for abdominal emergencies.

Direct trocar insertion was found to be a fast, safe, and reliable alternative to traditional techniques for establishment of pneumoperitoneum.

On the basis of our initial experience, miniTAPP hernioplasty with a fibrin glue is feasible, effective, and easy to perform in experienced hands, with good results without higher risk of recurrence. In addition, the fibrin fixation method seems to decrease postoperative neuralgia and reduced the incidence of postoperative seromas and hematomas.

On the basis of this initial experience, TAPP hernioplasty with a Surgisis mesh affixed with fibrin glue is feasible, easy to perform, and effective in experienced hands, with good results. The well known characteristics of a minimally invasive and gentle approach, together with the type of mesh implanted and fixation using glue, might explain the encouraging results of this experience. Therefore, this type of mesh might be tailored to not only the sportsman or the patient with a contaminated surgical field, but may also be used in young patients, where there is a fear of leaving behind a long-term foreign body.

Even if limited by its retrospective design, the reported experience shows that minilaparoscopic surgery may be a safe and effective approach to colon pathology. The described features make minilaparoscopy a challenging alternative to laparoscopy for colon disease. If proven to be cost effective without undue risk, as long as adequate training is obtained and proper preparation is observed, minilaparoscopy may become a standard surgical approach for selected patients.

Background: Laparoscopy has became as the preferred surgical approach to a number of different diseases because it allows a correct diagnosis and treatment at the same time. In abdominal emergencies, both components of treatment -exploration to identify the causative pathology and performance of an appropriate operation -can often be accomplished via laparoscopy. There is still a debate of peritonitis as a contraindication to this kind of approach. Aim of the present work is to illustrate retrospectively the results of a case-control experience of laparoscopic vs. open surgery for abdominal peritonitis emergencies carried out at our institution.

Two cases of pediatric acute abdomen owing to omental infarction are described in this paper, which were successfully treated laparoscopically. Owing to the objective rareness and absence of typical symptoms, the diagnosis was often neither made nor considered preoperatively. For other emergency situations, laparoscopy has been shown to be both a diagnostic and a therapeutic tool of a rare pathology found also in the pediatric patients.