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Objectives: To study the feasibility of using surgical procedure manager (SPM), a digital checklist platform, to standardise surgical steps of open hernia repair and monitor the operative performance. Methodology: A retrospective study on all open mesh repair of inguinal hernia under local anaesthesia from September 2019 to November 2021 at the Prince of Wales Hospital was performed. The operative outcomes of patients having operations with or without the use of SPM were compared. Procedures using SPM had operation steps shown as a digital checklist inside the theatre. The time used for each surgical step was recorded and analysed. The operative performance of the surgeons was analysed by observing the trend of the mean operation time over time. Results: A total of 123 patients were recruited, of which 52 were using the SPM. The median age of patients was 75 (range 49–93) years. A decreasing trend in the mean operation time for dissection, mesh placement, wound closure and total operation time was observed in surgeries using SPM. There was no significant difference in the operation time, theatre time, total length of stay, blood loss and readmission rate between the SPM and non‐SPM groups. The proportion of basic surgical trainees as coached surgeons in the SPM group was significantly higher (SPM = 52% vs non‐SPM = 28%, P =.07). Conclusions: The use of SPM did not significantly prolong the operation time and produce comparable operative outcomes in open hernia repair. It provided the additional advantage of standardising operation steps and monitoring the performance of surgical trainees during their training. [ABSTRACT FROM AUTHOR]

Inflammatory pseudotumour (IPT) is a spectrum of lesions which mimic malignancies in various organs. Preoperative diagnosis is often challenging. In this case report, we present two rare cases of Epstein‐Barr virus (EBV) associated IPTs and discuss the clinico‐pathological characteristics of these two entities. [ABSTRACT FROM AUTHOR]

We would like to report a case of acute appendicitis complicated with superior mesenteric venous (SMV) thrombophlebitis. A 61‐year‐old gentleman presented with abdominal pain and high fever with elevated white cell count and slightly deranged liver function and clotting profile. Besides features of acute appendicitis, a thrombus in superior mesenteric vein was demonstrated on computed tomography (CT). Patient was treated with emergency laparoscopic appendectomy, a course of antibiotics and subcutaneous enoxaparin. CT 2 months after operation showed features of resolving SMV thrombophlebitis. Mesenteric venous thrombophlebitis is difficult to diagnose as the clinical presentation is often nonspecific and it depends on the site and timing of thrombus formation. Such rare complication has to be suspected if the patient presents late or when there were high fever and deranged liver function. Prompt appendectomy and antibiotics therapy remain the essential components of treatment for acute appendicitis. The need of additional anticoagulation therapy and its optimal duration for SMV thrombophlebitis remains unclear. Nevertheless, the use of anticoagulation therapy should be weighed against the risk of bleeding complication. [ABSTRACT FROM AUTHOR]

Objectives: Intrahepatic cholangiocarcinoma (ICC) is a rare tumor of the liver. The diagnosis and treatment of it are difficult. The present study reviewed the diagnostic pathways and operative results for ICC. Methods: A retrospective analysis was made of the clinical presentation, diagnostic pathways, and operative results of 20 patients with ICC who underwent hepatectomy from 1997 to 2004 in our institute. Results: The patients were predominantly female (female : male = 15:5), and ranged in age from 41 to 74 years (median 59.8). Abdominal pain was the main presenting symptom, and hepatomegaly was the commonest physical sign. Diagnosis relied mainly on ultrasound or computed tomography. Without biopsy, only two patients were correctly diagnosed with ICC before surgery. The median size of the tumor was 6 cm (range 1.6–12 cm). Major hepatectomy was carried out in 80% of patients. The operative mortality and morbidity were 15% and 40%, respectively. The median follow up was 18.3 months. Thirteen patients (65%) had recurrences at one or more sites, including, in decreasing frequency, the liver, abdominal lymph node, lung, bone, or skin. The median survival was 17.3 months and the 1-year, 3-year, and 5-year survival rates were 60%, 45%, and 10%, respectively. Conclusions: The poor survival of patients with ICC was mainly due to the delay in diagnosis and the aggressive nature of the disease. The diagnosis of ICC relies on a high index of suspicion as there is no reliable tumor marker and imaging results are usually inconclusive. Radical hepatectomy remains the only chance of cure for ICC. The role of lymph node dissection, liver transplantation, and adjunctive chemotherapy in the treatment of patients with ICC remains to be determined. [ABSTRACT FROM AUTHOR]

The article offers information on single incision laparoscopic surgery for deroofing of liver cysts. It mentions a case of an old woman who was operated for having liver cysts using this approach. It discusses the operative technique of the case and states that the operative time was 100 minutes and blood loss was minimal. It also discusses potential benefits of using this approach which are less wound pain, a better cosmetic outcome, and problem free specimen retrieval.

The article focuses on the technique of Laparoendoscopic Single-Site Surgery (LESS) cholecystectomy using a new retraction device, the Endograb. It informs that the LESS technique has been described for cholecystectomy, appendectomy and obesity surgery. One of the limitations of the technique is the lack of retraction. It is stated that the Endograb system provides a method to enhance retraction during LESS cholecystectomy.