BACKGROUND:The indications for bariatric surgery revision are weight loss failure, complications or weight regain so laparoscopic one anastomosis gastric bypass (LOAGB) is a promising revisional bariatric procedure for failed laparoscopic sleeve gastrectomy (LSG). AIM OF STUDY:The aim was to evaluate LOAGB as a revisional bariatric procedure for failed LSG regarding weight loss, improvement in comorbidities and complications.

Background and aim Benign breast diseases are one of the most common diseases in females. An important goal in its treatment should be cosmesis, so a new minimally invasive technique has advanced. One of these techniques is the transaxillary endoscopic resection. The aim of this study was to assess the feasibility, safety, operative time, postoperative pain, hospital stay, and cosmetic outcome of this transaxillary approach. Methods This study was carried out on 40 female patients presented with benign breast tumors in the surgical oncology unit at the General Surgery Department, Tanta University Hospital during the period from January 2018 to January 2019. The patients included in the study aged ≥18 years, had solitary or multiple benign breast tumors, located at any breast quadrant. The patients subjected to transaxillary endoscopic excision of the tumors. Results The age of the patients ranged from 20 to 49 years with a mean age of 32 years. 60% of the lesions located in the upper half of the breast. Fibroadenoma was the most common finding in 80% of the patients, 60% of the patients had solitary tumor. The operative time ranged from 42 to 105 minutes with a mean of 61.4 minutes. 88.8% of the patients considered the cosmetic outcome excellent. Conclusion Endoscopic transaxillary excision of benign breast tumors is safe, feasible and has excellent cosmetic outcomes with high patient's satisfaction.

Background: Surgical excision was the definitive procedure performed for symptomatic benign breast tumors to alleviate anxiety regarding potential for growth or malignancy as well as physical discomfort. However, the efficacy and safety of endoscopic removal of benign breast disease is still a matter of debate. Aim of the Study:The aim of this study is to evaluate feasibility, safety and cosmetic results of endoscopic excision of fibroadenoma of the breast. Patients and Methods:A total of 10 patients underwent endoscopic fibroadenoma excision between June 2016 and August 2017 at General Surgery Department in Tanta University Hospital. Patients with recurrent fibroadenoma, multiple swelling or suspicious breast masses were excluded. Cosmetic results, cancer incidence (histopathological surprise), complication rates, and post-operative pain were evaluated.Results: Detailed location of fibroadenoma were in the upper outer quadrant of the breast (n=4, 40%), central supraareolar lesion (n=3, 30%), and the same presentation for upper inner, lower outer and lower inner lesions (n=1, 10%). Conversion to open technique occurred in two patients (20%). Cosmetic results were excellent in 7 patients (87.5%) and good in one patient (12.5%). Post-operative pain was mild in seven patients (70%) and moderate in three patients (30%). We observed no intra operative bleeding or nerve injury. Subcutaneous emphysema occurred in 3 patients (30%). There was no post-operative seroma, hematoma, wound infection, skin burn nor breast deformity in all cases.Conclusion: Endoscopic resection of breast fibroadenoma is safe and technically simple and is associated with an excellent cosmetic results and a low incidence of complications. Furthermore, it seems to be the optimal procedure, when surgery for benign breast disease is indicated, as endoscopic breast surgery has the advantages of elimination of scars from breast and avoid excess injury of breast tissue. 2861 2862 Endoscopic Resection of Breast Fibroadenoma tomically contiguous space, provides surgical access to the breast [8-10] .

Background: Inguinal hernia is one of the most common surgeries done all over the world. Chronic groin pain is one of the most annoying problems after mesh hernioplasty. This study aimed at evaluating the incidence of chronic groin pain and numbness occurring after prophylactic ilioinguinal neurectomy, as compared to its preservation during Lichtenstein’s inguinal hernioplasty. Methods: This prospective randomized study involved 90 patients complaining of inguinal hernias admitted to the department of general surgery, Tanta university hospitals during the study period. Our patients were divided randomly in two equal groups. (Group A) patients were subjected to Lichtenstein hernia repair with ilioinguinal neurectomy while (group B) patients were subjected to Lichtenstein hernia repair with nerve preservation. Post-operatively the incidence of groin pain and numbness were assessed in all patients. The pain was evaluated using a visual analogue scale. Whereas numbness was examined by the monofilament test and evaluated in comparison to the opposite side.Results: In the present study, the incidence of pain was higher in nerve preservation study group whereas, numbness was not a major complication after prophylactic ilioinguinal nerve division and did not add to patient morbidity.Conclusions: Prophylactic ilioinguinal nerve division could be an appropriate and beneficial solution for chronic groin pain after the Lichtenstein procedure and may be added as a surgical step during the classic procedures for hernia repair. Also, numbness was not a major complication after the prophylactic division of the ilioinguinal nerve and did not add to the patient morbidity.

Aim Oncoplastic breast surgery involves reconstruction of the resection defect by either volume displacement or volume replacement. Glandular flap insertion is an easy, quick, and acceptable method to correct breast defects after breast conserving surgery (BCS). The value of the omentum in extraperitoneal reconstruction was not appreciated until the mid‐20th century. The aim of this study was to assess the aesthetic outcome after immediate breast reconstruction with either glandular flap or laparoscopic‐harvested omental flap in early breast cancer after BCS. Patients and Methods This study was conducted on 44 patients with early breast cancer in the Surgical Oncology Unit, General Surgery Department, Tanta University Hospital during the period from October 2018 to May 2019. All patients underwent breast conserving surgery followed by immediate breast reconstruction by either glandular flap (group I; 20 patients) or omentoplasty (group II; 24 patients). The operative time, postoperative complications, the length of hospital stay, and aesthetic outcome were compared between the two groups. Results The operative time in group I ranged from 90 to 120 minutes with a mean time of 113 minutes, whereas that in group II ranged from 110 to 160 minutes with a mean of 133 minutes. The hospital stay in group I ranged from 4 to 5 days with a mean of 4 days, whereas that in group II it ranged from 4 to 6 days with a mean of 5 days. In group I, two patients (10%) developed wound seroma and two patients (10%) developed fat necrosis, whereas in group II, eight patients (33.3%) developed fat necrosis and two patients (8.3%) developed epigastric incisional hernia with no wound seroma reported. Concerning the aesthetic outcome evaluated using patient's self‐evaluation, in group I, 70% of the patients were satisfied with the overall aesthetic results and 30% were dissatisfied, whereas in group II, 91.7% of the patients were satisfied and 8.3% were dissatisfied. With regard to the aesthetic outcome evaluated based on objective assessment with the Breast Cancer Conservation Treatment Cosmetic results software (BCCT.core), in group I, excellent results were obtained in 20% of cases, good results in 40% of cases, fair results in 20% of cases, and poor results in 20% of cases, whereas in group II, excellent results were obtained in 41.7% of cases, good results in 33.3% of cases, fair results in 16.7% of cases, and poor results in 8.3% of cases. No local recurrence or distant metastasis was reported. Conclusion The glandular flap has shorter operative time and requires less extensive surgery than the omental flap. The omental flap has the potential to recreate a soft, naturally ptotic breast shape that is ideal for matching with the contralateral breast.