La stenosi cicatriziale benigna dell’anastomosi colorettale: considerazioni su due casi di nostra osservazione

Nel corso del trattamento chirurgico di due pazienti affetti da ste - nosi benigna dell’anastomosi colorettale, gli Autori hanno osservato la concomitanza di tenaci aderenze del tratto anastomotico al sacro. Tale evenienza, secondo gli Autori, potrebbe costituire una delle cause di fal - limento e di maggior rischio di perforazione in corso di trattamento mediante le diverse terapie endoscopiche che, nel loro insieme, sono pur sempre da considerarsi il gold standard nella terapia delle stenosi ana - stomotiche benigne. Alla luce di tali osservazioni, gli Autori sviluppano il razionale della loro ipotesi fisiopatologica, anche in funzione della ricerca di una procedura diagnostica capace di mettere in evidenza la presenza di una tenace aderenza con strutture solide nel corso della valutazione preope - ratoria. Se ulteriori studi orientati in questo senso portassero ad un risultato soddisfacente, ciò costituirebbe un ulteriore complemento per la scelta dell’approccio terapeutico più idoneo della stenosi benigna post-anastomotica

Modified technique for performing STARR with Contour Transtar™

Stapled Transanal Rectal Resection performed using CCS-30 Contour Transtar despite its recent introduction seems to be an effective surgical procedure to treat obstructed defecation syndrome. The major constraint of this procedure is the need to open the prolapse longitudinally using the CCS-30. This is often difficult and can lead to an inadequate or spiralling resection. Our modified technique, presented in this paper, creates the prolapse opening with an electric scalpel between two Kocher clamps, placed to grab the whole prolapsed tissue at 2 and 4 o’clock, respectively. The results of the first 83 procedures confirm that this technique allows the surgeon to simplify the prolapse’s longitudinal opening and especially the first loading of the tissue between the CCS-30 jaws, which is necessary to start the circular resection, as confirmed by the absence of spiralling and major complications in this series

A new fixation-free 3D multilamellar preperitoneal implant for open inguinal hernia repair

Between September 2014 and December 2015, 32 patients with inguinal hernia were treated using a new 3D mesh in our department. This mesh is characterized by a multilamellar flower-shaped central core with a flat, large-pore polypropylene ovoid disk that has to be implanted preperitoneally. Compared with the traditional Lichtenstein procedure, we observed a shorter mean duration of surgery and a significantly lower mean visual analogue scale (VAS) postoperative pain score recorded immediately after the procedure in the 3D mesh group. The mean VAS score recoded after 4 and 8 postoperative days showed better results in the 3D mesh group than the control group. Moreover, there was reduced postoperative morbidity in the 3D mesh group than the control group, even if no patients experienced severe complications