Combined Flexible URS and percutaneous ‘through and through’ puncture of an intra-renal cyst with internalisation of drainage, to treat calyceal obstruction and recurrent stones
Publication date: Available online 21 January 2020Source: Urology Case ReportsAuthor(s): Joseph Santiapillai, Sachin AgrawalAbstractA 61 year old gentleman had a large renal cyst, thought to be causing a ‘pseudo-hydrocalyx’ leading to recurrent stones. Definitive treatment with laparoscopic deroofing was planned, however intra-operatively this was abandoned due to complex anatomy and scared adherent tissue. Patient went on to have a flexible ureteroscopy and ‘through and through’ puncture of an intrarenal cyst with PCNL to treat his stones and renal cyst simultaneously. CT scan 12 months later showed no new stone formation and no residual cyst. Percutaneous puncture of a renal cyst combined with flexible ureteroscopy is an effective method when treating large renal cysts.
ConclusionsSubstantial agreement exists among experts regarding many strong recommendations for the best early management of severe abdominal trauma.
In conclusion, gas under the diaphragm can be related to non-bowel-related gynaecological pathology, but it vital to rule out sinister causes.
ConclusionIt is crucial to understand the correct management of perforated appendicitis with abscess to avoid serious complications.
Background: Nesidioblastosis and insulinoma are disorders of the endocrine pancreas causing endogenous hyperinsulinemic hypoglycemia. Their coexistence is very unusual and treatment represents a still unresolved dilemma.Case Description: The patient was a 43-year-old Caucasian woman, with a 2-year history of repeated severe hypoglycemic events. The diagnostic work-up was strongly suggestive of insulinoma and the patient was submitted to surgical treatment carried out laparoscopically under robotic assistance. However, surgical exploration and intraoperative ultrasonography failed to detect a pancreatic tumor. Resection was...
CONCLUSIONS: The laparoscopic approach can be feasible in well-selected and stable patients, but we have to take into consideration that the conversion rate can be high and this surgery should be performed by experienced surgeons. PMID: 31980152 [PubMed - as supplied by publisher]
ConclusionAppendicular endometriosis can present as a submucosal tumor in the cecum without any abdominal symptoms. Appendicular endometriosis should be considered in the differential diagnosis of ileocecal submucosal tumor. Single-incision laparoscopic ileocolectomy was useful procedure for cecum tumor resection.
ConclusionIndex LPNs among ICG-bearing lymph nodes in pelvic sidewall were clearly identified and completely removed by matching with their corresponding 3D reconstruction images. Further studies and long-term oncologic outcomes are required to determine the real impact of dual image guidance in LPND.Graphical abstract
CONCLUSIONS AND CLINICAL RELEVANCE: A nonlinear increase in abdominal working space was observed with increasing IAP. Depending on the type of procedure and visual access requirements, IAPs> 8 mm Hg may not provide a clinically important benefit for laparoscopy in rabbits. PMID: 31887092 [PubMed - in process]
ConclusionEarly diagnostic imaging with CT while a patient is symptomatic can aid in making an accurate diagnosis. Laparoscopic repair can be safely used with good outcome in the context of an incarcerated obturator hernia.
ConclusionsOur case suggests that gallbladder hemorrhage needs to be considered a possible complication for patients on direct oral anticoagulants.