New advantageous tool in single incision laparoscopic cholecystectomy: the needle grasper

Introduction: During single-incision laparoscopic cholecystectomy (SILC), the gallbladder is suspended with stitches, resulting in perforation risk and difficulty in exploration. Aim: We used the needle grasper in SILC to hang and manipulate the gallbladder. Material and methods : Sixty-five patients (43 female, 22 male) who underwent SILC between December 2013 and December 2014 were analyzed retrospectively for patient demographics, duration of operation, laparotomy or conventional laparoscopy necessity, drain use, complications, and hospital stay periods. To place the SILC port (Covidien, Inc.), the needle grasper was inserted at the right upper abdominal quadrant without an incision to hang and manipulate the gall-bladder. Results : The mean age was 47.9 ±13.068 years; the mean body mass index (BMI) was 26.94 ±3.913 kg/m2. ASA scores were 1, 2, and 3. Two patients with high BMI with additional trocar use were excluded. The operations were completed without any additional trocar in 59 patients. The mean operation time was 89 ±22.41 min. Eighteen patients required a drain; all were discharged after drain removal. One patient needed re-hospitalization and percutaneous drainage and was discharged on the 9th day. Fifty-three patients were discharged on the 1st post-operative day. Eleven patients with drains were discharged on the 2nd day, and 1 was discharged on the 7th day. The mean hospital stay period was 1.26 ±0.815 days. Conclusions : The main difficulty of SILC is to manipulate hand tools because the triangulation principle of laparoscopy use is not possible in SILC. Inserting a needle grasper into the abdominal cavity at the right subcostal area to manipulate the gallbladder helps and does not leave a visible scar

Extragastrointestinal Stromal Tumor (EGIST): A 16-Year Experience of IB Cases Diagnosed at a Single Center

Background: Gastrointestinal stromal tumor (GISTs) rarely occurs outside the Gl tract as extragastrointestinal stromal tumor (EGIST). The aim of this study was to review the clinical presentation, diagnosis, and outcome of EGIST at a single center

Gastrointestinal stromal tumors: 16 years’ experience within a university hospital

Aim: the aim was to convey our 16-year experience regarding gastrointestinal stromal tumors within in a high volume university hospital. Factors that may impact on patient survival were evaluated

Gastrointestinal stromal tumors: 16 years' experience within a university hospital

Aim: the aim was to convey our 16-year experience regarding gastrointestinal stromal tumors within in a high volume university hospital. Factors that may impact on patient survival were evaluated

Evaluation of Systemic Steroid Response Via Digital Infrared Thermal Imaging (DITI) in Patients with Idiopathic Granulomatous Mastitis

Objective: The aim of this study is to evaluate the pre-treatment and post-treatment thermography images of patients who received steroid treatment with a diagnosis of granulomatous mastitis, and to determine whether the thermography device is an effective imaging method in the follow-up

Acromegaly is associated with higher frequency of female sexual dysfunction: experience of a single center

The aim of the study was to assess female sexual dysfunction (FSD), quality of life and depression status in female patients with acromegaly. Fifty-seven sexually active female patients with acromegaly disease (21 controlled, 36 uncontrolled) monitored by Cerrahpasa Medical School, Endocrinology and Metabolism out-patient clinic and age and body mass index-matched 46 healthy female subjects were included in the study. Sexual functions and status of depression in both patient and control groups were evaluated by using the Female Sexual Function Index Form (FSFI) and the Beck Depression Inventory (BDI), respectively. Quality of life was evaluated by using the Acromegaly Quality of Life (AcroQoL) Scale. Hormone levels were studied in the groups. The FSFI total score and desire, arousal, orgasm, and satisfaction domains in patients with acromegaly were significantly lower than in the healthy controls (p <= 0.0001). There was no difference between biochemically controlled and uncontrolled patients with acromegaly with respect to FSFI scores (p= 0.7). AcroQoL total score in female patients with controlled acromegaly and uncontrolled acromegaly were 46.33 +/- 16.5% and 50.13 +/- 18.21%, respectively (p= 0.53). The difference in BDI scores between controlled and uncontrolled acromegaly patients was not significant but they were significantly higher in the control group (p <= 0.0001). In the correlation analysis, a negative correlation was found between FSFI total and BDI score (r= -0.69, p< 0.001), age (r= -0.45, p< 0.001), and IGF-I (r= -0.28, p= 0.006). This study showed that sexual dysfunction and depression rates in female patients with acromegaly are higher than in healthy females

Foreign body: A sewing needle migrating from the gastrointestinal tract to pancreas

Of all ingested foreign bodies, 2.4% comprise of sewing needles. Through perforation of gastrointestinal tract, which occurs in 1% of cases, they can migrate into the liver and pancreas. Foreign bodies in pancreas should be considered in the differential diagnosis of chronic abdominal pain. Computed tomography scans provide valuable information for the localization of the lesion, which guide the surgeon during the operation. Secondary to foreign bodies that migrate to the pancreas, complications with high mortality such as pancreatitis, pseudoaneurysm, and pancreas abscess can be seen. Thus, for this patient group, diagnostic laparoscopy is recommended, considering its advantages of decreased postoperative pain, decreased wound infection, and faster recovery time. Here we present a case of a 23-year-old female patient, from whom an ingested needle that migrated from the back wall of the stomach to the pancreas was extracted by laparoscopic surgery

Increased incidence of pelvic organ prolapse in women with acromegaly

Objective: To evaluate gynecological problems of female patients with acromegaly and the relationship of these problems with the activity of the disease

Can volumetric measurement be used in the selection of treatment for inguinoscrotal hernias?

Objective: Inguinoscrotal hernias are often qualified subjectively as big, giant, scrotal, etc. In order to classify this type of hernia, objective criteria are needed. For this purpose, we aimed to introduce a scrotal volume measurement-based classification system and propose a corresponding surgical plan (open or laparoscopic surgery, anterior or posterior repair) based on volumetric data

Endoscopic diagnosis and treatment of biliary obstruction due to acute cholangitis and acute pancreatitis secondary to Fasciola hepatica infection

In the differential diagnosis of biliary obstruction with unknown etiology, biliary fascioliasis should be considered in endemic and non-endemic regions. After diagnostic evaluation, endoscopic retrograde cholangiopancreatography (ERCP) was performed for etiological evaluation and/or treatment of biliary obstruction in five patients with a mean age of 55.8 years. Endoscopic sphincterotomy and cholangiogram revealed linear filling defects in the biliary system. Fasciola hepatica parasites were extracted using balloon and basket catheters in two and three patients, respectively. No morbidity or mortality was observed. F. hepatica infection should be considered as a differential diagnosis of biliary obstruction with unknown etiology in endemic and non-endemic regions. ERCP can be the standard diagnostic and/or therapeutic procedure in cases of biliary obstruction due to fascioliasis. Due to slippery and gel-like characteristics of the parasite, use of a basket catheter in semi-opened position may be required in case of unsuccessful extraction using a balloon catheter