Following the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level. We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have.

The findings seem to demonstrate that TL right colectomy is feasible and safe, yielding results comparable with those of the open approach but offering improved postoperative patient comfort. The limits of this retrospective comparative study do not allow definitive conclusions to be drawn despite the encouraging data for the next prospective randomized studies.

Background Urinary and sexual dysfunction are potential complications of rectal surgery for cancer. This study retrospectively evaluated the frequency of such complications after laparoscopic total mesorectal excision (LTME) with autonomic nerve preservation. Methods For this study, 50 men younger than 75 years who underwent radical LTME for mid and low rectal cancer were followed up for at least 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. Results Sexual desire was maintained by 55.6%, ability to engage in intercourse by 57.8%, and ability to achieve orgasm and ejaculation by 37.8% of the patients. Distance of the tumor from the anal verge and adjuvant or neoadjuvant treatments were the significant predictors of poor postoperative sexual function. Seven patients (14%) presented transitory postoperative urinary dysfunction, all of whom were medically treated. Tumor stage and distance from the anal verge were independently associated with the postoperative global International Prostatic Symptom Score (IPSS). No differences were observed in urinary quality of life. Conclusions In this series, LTME did not reproduce or improve on sexual and urinary dysfunction outcomes obtained in the best open TME series. Further trials are needed to evaluate functional outcome in rectal cancer patients.Keywords Urinary dysfunction Á Sexual dysfunction Á Quality of life Á Laparoscopy Á Total mesorectal excision Á Rectal cancer Laparoscopic total mesorectal excision (TME) for rectal cancer is technically feasible, offering acceptable complication rates and short-term oncologic outcomes comparable with those for open surgery [1][2][3][4][5][6][7][8]. However, quality of life (QoL) must not be forgotten in the quest for oncologic excellence. Postoperative urinary and sexual dysfunction resulting from inadvertent damage to the pelvic hypogastric and splanchnic nerves are recognized complications of rectal resection [9][10][11].Laparoscopic surgery, although technically demanding and associated with a long learning curve, has the advantage of clear visualization for the smallest structures, including the autonomic nerves. The use of the laparoscopic approach for the treatment of rectal cancer could therefore facilitate preservation of the pelvic autonomic nerves. Nevertheless, data on the functional outcome of laparoscopic TME are limited and controversial [12,13].This retrospective clinical study aimed to evaluate male sexual and functional outcomes in a consecutive series of patients who underwent laparoscopic surgery for lower and middle rectal cancer at our institutions. Materials and methodsMale patients with a diagnosis of cancer in the mid or distal rectum were identified from a prospective database of 850 patients who underwent laparoscopic colorectal resection. The site of rectal neoplasm was defined according to the

The gasless technique causes smaller alterations in serological hepatic parameters than pneumoperitoneum at 14 mmHg. By contrast, the gasless technique and low-pressure pneumoperitoneum have the same effect on hepatic function. Therefore, the use of a subcutaneous abdominal wall retractor combined with a low-pressure pneumoperitoneum is recommended for patients with severe hepatic failure. Transaminases

The authors' early experience with robotic surgery suggests that it is safe and could be an effective alternative to conventional laparoscopic surgery. The authors believe that robotic surgery, with its ability to restore the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, could allow complex procedures to be performed with greater precision and better results.