Laparoscopic Cholecystectomy With Harmonic Scalpel

This study suggests that the Harmonic scalpel is a safe and effective instrument for laparoscopic cholecystectomy, because it provides complete hemobiliary stasis

Atrial fibrillation detection using a novel three-vector cardiac implantable monitor: the atrial fibrillation detect study.

Aims Continuous rhythm monitoring is valuable for adequate atrial fibrillation (AF) management in the clinical setting. Subcutaneous leadless implantable cardiac monitors (ICMs) yield an improved AF detection, overcoming the intrinsic limitations of the currently available external recording systems, thus resulting in a more accurate patient treatment. The study purpose was to assess the detection performance of a novel three-vector ICM device equipped with a dedicated AF algorithm. Methods and results Sixty-six patients (86.4% males; mean age 60.4 ± 9.4 years) at risk to present AF episodes, having undergone the novel ICM implant (BioMonitor, Biotronik SE&Co. KG, Berlin, Germany), were enrolled. External 48-h ECG Holter was performed 4 weeks after the device implantation. The automatic ICM AF classification was compared with the manual Holter arrhythmia recordings. Of the overall study population, 63/66 (95.5%) had analysable Holter data, 39/63 (62%) showed at least one true AF episode. All these patients had at least one AF episode stored in the ICM. On Holter monitoring, 24/63 (38%) patients did not show AF episodes, in 16 of them (16/24, 67%), the ICM confirmed the absence of AF. The AF detection sensitivity and positive predictive value for episodes' analysis were 95.4 and 76.3%, respectively. Conclusion Continuous monitoring using this novel device, equipped with a dedicated detection algorithm, yields an accurate and reliable detection of AF episodes. The ICM is a promising tool for tailoring individual AF patient management. Further long-term prospective studies are necessary to confirm these encouraging results

SCN5A Nonsense Mutation and NF1 Frameshift Mutation in a Family With Brugada Syndrome and Neurofibromatosis

In this case series, we report for the first time a family in which the inherited nonsense mutation [c. 3946C > T (p.Arg1316*)] in the SCN5A gene segregates in association with Brugada syndrome (BrS). Moreover, we also report, for the first time, the frameshift mutation [c.7686delG (p.Ile2563fsX40)] in the NF1 gene, as well as its association with type 1 neurofibromatosis (NF1), characterized by pigmentary lesions (café au lait spots, Lisch nodules, freckling) and cutaneous neurofibromas. Both of these mutations and associated phenotypes were discovered in the same family. This genetic association may identify a subset of patients at higher risk of sudden cardiac death who require the appropriate electrophysiological evaluation. This case series highlights the importance of genetic testing not only to molecularly confirm the pathology but also to identify asymptomatic family members who need clinical examinations and preventive interventions, as well as to advise about the possibility of avoiding recurrence risk with medically assisted reproduction

Trattamento chirurgico della malattia emorroidaria con stapler circolare. Analisi e follow-up di uno studio multicentrico su 412 casi.

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Chirurgia videolaparoscopica: tecniche di apprendimento su endotrainer

Manuale didattico accompagnato da audiovisivo su supporto VS

. Laparoscopic total colectomy with ileo-rectal anastomosis for polyposis and ulcerative colitis.

Objective of the study: Since the introduction of laparoscopic colorectal surgery, several studies have demonstrated the advantages of mini-invasive segmental colon resections in the treatment of benign and malignant diseases. On the contrary the use of laparoscopy for total colectomy and proctocolectomy is not worldwide accepted first of all because of the technically challenging nature of these procedures. The aim of this report is to show the feasibility and safety of straight laparoscopic total colectomy (LTC) for polyposis (P) and ulcerative colitis (UC).Material and methods: Between January 2006 and June 2007 in our Institution 5 patients underwent to LTC with ileorectal anastomosis plus temporary loop ileostomy for P ( 2 cases) and UC (3 cases). Results: The mean age was 69.2 yrs (62-77) and in all cases the preoperative endoscopy showed the distal rectum almost without signs of disease. Mean operative time was 320 minutes and the estimated mean blood loss was 250 cc. No transfusions were necessary. No conversions occurred. The mean surgical specimen length was 100 cm. and in all acses the margins of resection were disease free. Considering the postoperative course, no morbidity and mortality occurred. The mean hospital stay was 8 days. The temporary ileostomy was suppressed in all patients within three months since the procedure. Conclusions: The analysis of our data highlights that LTC is effective and feasible even if the use of this procedure, because of its complexity, has to be reserved to well-trained laparoscopic surgeons

Trattamento chirurgico della malattia emorroidaria con stapler circolare in regime ambulatoriale o di ricovero breve

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Trattamento chirurgico della malattia emorroidaria con stapler circolare. Analisi e follow up di uno studio multicentrico su 412 casi.

Cod. CNR PT0109573