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Introduction: Retrorectal tumors (RRTs) are rare and often surgically excised due to the risk of malignant degeneration and compressive or obstructive symptoms. The approach for excision has traditionally been based on tumor location and performed using either a transabdominal or perineal approach depending on the position of the tumor. The advent of minimally invasive surgery, however, has challenged this paradigm. Here, we determined the applicability and potential advantages of a laparoscopic transabdominal approach in a series of 23 patients with RRTs. Material and methods: We included 23 patients presenting with RRTs treated at the Surgical Gastrointestinal Unit at Hospital de Sant Pau that were registered prospectively since 1998. The preoperative evaluation consisted of colonoscopy, CT scan and/or MRI, mechanical bowel lavage, and antibiotic therapy. Signed consent was obtained from all patients for a laparoscopic transabdominal approach unless the tumor was easily accessible via a perineal approach. In case of recurrence, a transanal endoscopic microsurgery (TEM) approach was considered. Surgical details, immediate morbidity, and short- and long-term outcomes were recorded. Results: Of the 23 RRT cases evaluated, 16 patients underwent a laparoscopic transabdominal approach and 6 underwent a perineal approach. No patients required conversion to open surgery. In the laparoscopic transabdominal group, the mean operating time was 158 min, the average postoperative hospital stay was 5 days, and postoperative morbidity was 18%. Three patients had recurrent RRTs, two of the three underwent surgical reintervention. The third patient was radiologically stable and close follow-up was decided. Conclusion: Our results show that laparoscopic transabdominal excision of RRT is a safe and effective technique, offering the potential advantages of less invasive access and reduced morbidity. This approach challenges the traditional paradigm of excision of these infrequent tumors based solely on tumor location and offers a viable alternative for the treatment of these infrequent tumors. [ABSTRACT FROM AUTHOR]

This report intends to show the use of tissue conditioners on esthetic and functional removable partial dentures, placed by the technique of direct relining immediately after surgery to protect the surgical wound and aid the cicatrization. [ABSTRACT FROM AUTHOR]

The Manning industry known as the recruiter and selector of Filipino seafarers to foreign ship-owners for the purpose of manning their oceangoing commercial vessels is on the crossroads in ensuring that the Philippines known as the manning capital of the world would sustain the market leadership of the Philippines in the global ship-crewing industry by constructively addressing a complex of internal issues that threaten competitiveness. While such is a perfectly legitimate aspiration, the larger goal must equally pay attention to the enormous pressures imposed by the external environment, mainly the matter of competition and non-traditional opportunities which emerge within the manning sector, including its direct links with the global maritime industry in which it thrives. The seafarers, predominantly men in the deck and engine positions but joined by a significant number of women in cruise ships, are deployed through the manning companies which select, hire and train them by virtue of contracts with the overseas operators or owners. Filipino seafarers are widely acknowledged by foreign ship-owners, called principals, for their ability to sail and operate merchant ships of all types with efficiency, safety, and general cost-effectiveness. This paper presents an analysis of the strengths, weaknesses, opportunities, and threats that are facing the Philippine Manning Industry for the year 2014-2015. [ABSTRACT FROM AUTHOR]

Introduction: The European Association of Endoscopic Surgeons (EAES) conducted this study aiming to identify the top research questions which are relevant to surgeons in Minimal Access Surgery (MAS). This is in order to promote and link research questions to the current clinical practice in MAS in Europe.Methods: Using a systematic methodology, (modified Delphi), the EAES members and leadership teams were surveyed to obtain consensus on the top research priorities in MAS. The responses were categorized and redistributed to the membership to rate the level of importance of each research question. The data were reported as the weighted average score with a scale from 1 (lowest agreement) to 5 (highest agreement).Results: In total, 324 of 2580 (12.5%) of the EAES members and the leaders responded to the survey and contributed to the final consensus. The ranked responses over the 80th percentile identified 39 research priorities with rating ranged from 4.22 to 3.67. The top five highest ranking research priorities in the EAES were centered on improving training in MAS, laparoscopic surgery for benign upper gastrointestinal conditions, integration of novel technology in OR, translational and basic science research in bariatric surgery and investigating the role of MAS in rectal cancer.Conclusion: An EAES research agenda was developed using a systematic methodology and can be used to focus MAS research. This study was commissioned by the European Association for Endoscopic Surgery (EAES). [ABSTRACT FROM AUTHOR]

This paper introduces MAAP, its curriculum and research and extension initiatives including but not limited to one of MAAP latest best practices in introducing GIS to its community (internal and external) who share similar passion for MET innovation. The various GIS-based accomplishments led and shared by MAAP as part of its Research and Extension Services (RES) initiatives are presented namely: several GIS-based papers presented and published both local and international; GIS-based project proposals for campus management enhancement prepared for MAAP, Bataan Peninsula State University (BPSU), Lyceum University of the Philippines ( LPU) and Catanduanes State University (CSU); capability Training on GIS for MAAP community and other interested institutions; and Commission on Higher Education (CHED) and Department of Science and Technology (DOST)- endorsed National 3-day GIS Conference are also discussed. There are 78 proposed GIS-based research project workshop outputs currently being implemented by 20 higher educational institutions (HEIs) in the Philippines, 17 of which are applicable to any maritime education and training institutions (METIs). MAAP has six on-going GIS- based special academic research and development projects which this paper intends to share to co-AMFUF members. [ABSTRACT FROM AUTHOR]

10.1007/s00268-020-05839-x. 33179126 2 Sun X, Liu Z, Selim M, Huang Y. Hand-assisted laparoscopic splenectomy advantages over complete laparoscopic splenectomy for splenomegaly. 10347290 9 Huang Y, Wang XY, Wang K. Hand-assisted laparoscopic splenectomy is a useful surgical treatment method for patients with excessive splenomegaly: a metaanalysis. [Extracted from the article]

The development of operative laparoscopic surgery is linked to advances in ancillary surgical instrumentation. Ultrasonic energy devices avoid the use of electricity and provide effective control of small- to medium-sized vessels. Bipolar computer-controlled electrosurgical technology eliminates the disadvantages of electrical energy, and a mechanical blade adds a cutting action. This instrument can provide effective hemostasis of large vessels up to 7 mm. Such devices significantly increase the cost of laparoscopic procedures, however, and the amount of evidence-based information on this topic is surprisingly scarce. This study compared the effectiveness of three different energy sources on the laparoscopic performance of a left colectomy. The trial included 38 nonselected patients with a disease of the colon requiring an elective segmental left-sided colon resection. Patients were preoperatively randomized into three groups. Group I had electrosurgery; vascular dissection was performed entirely with an electrosurgery generator, and vessels were controlled with clips. Group II underwent computer-controlled bipolar electrosurgery; vascular and mesocolon section was completed by using the 10-mm Ligasure device alone. In group III, 5-mm ultrasonic shears (Harmonic Scalpel) were used for bowel dissection, vascular pedicle dissection, and mesocolon transection. The mesenteric vessel pedicle was controlled with an endostapler. Demographics (age, sex, body mass index, comorbidity, previous surgery and diagnoses requiring surgery) were recorded, as were surgical details (operative time, conversion, blood loss), additional disposable instruments (number of trocars, EndoGIA charges, and clip appliers), and clinical outcome. Intraoperative economic costs were also evaluated. End points of the trial were operative time and intraoperative blood loss, and an intention-to-treat principle was followed. The three groups were well matched for demographic and pathologic features. Surgical time was significantly longer in patients operated on with conventional electrosurgery vs the Harmonic Scalpel or computed-based bipolar energy devices. This finding correlated with a significant reduction in intraoperative blood loss. Conversion to other endoscopic techniques was more frequent in Group I; however, conversion to open surgery was similar in all three groups. No intraoperative accident related to the use of the specific device was observed in any group. Immediate outcome was similar in the three groups, without differences in morbidity, mortality, or hospital stay. Analysis of operative costs showed no significant differences between the three groups. High-energy power sources specifically adapted for endoscopic surgery reduce operative time and blood loss and may be considered cost-effective when left colectomy is used as a model. [ABSTRACT FROM AUTHOR]

Comments on the advantages of laparoscopic splenectomy approach for the treatment of thrombotic thrombocytopenic purpura (TTP). Controversy of the usefulness of splenectomy for TTP; Overview of the laparoscopic splenectomy; Outcome of the surgical treatment.