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Material & methods: This is a 81 years old lady with hypothyroidism who was operated 3 years ago. In the previous surgery an onlay mesh placement was performed. The patient developed a symptomatic recurrent incisional hernia that impaired her quality of life. The patient was operated under general anesthesia. A Rives procedure was planned. The main goals of the retromuscular repair were achieved and are explained during the video: dissection of the sac delimiting the borders of the defect, removal of the previous onlay mesh that was completely integrated in the scar, dissection of the retromuscular space leaving the posterior sheath attached to the sac, closure of the posterior rectus sheath, dissection of the "fatty triangle" of Conze extending it more than 8 cm from the defect and dissecting the retropubic preperiotoneal space beyond the arquate line. In this case, a large-pore 30 x 20 cm self-gripping mesh made of polyester and polylacti acid was used as tissue reinforcement. The anterior aponeourosis was completely close in the midline without tension. No drains were used.

Lymphangiomatosis is a rare syndrome that can affect different organs, although simultaneous splenic and adrenal involvement is exceptional. We report the case of a young female with a symptomatic massive splenomegaly and no-nhypersecreating bilateral adrenal masses incidentally discovered that represented a diagnostic challenge. The management of adrenal incidentalomas is controversial, as the presence of large sized bilateral masses are highly indicative of malignancy. Despite the different diagnostic techniques available, it is sometimes impossible to reach an accurate preoperative diagnosis. Elective splenectomy and left adrenalectomy were performed, preserving the functioning of the right adrenal gland, radiologically similar to the left one, to prevent the development of definitive adrenal insufficiency. Postoperative evolution has been favourable without initial increase of the size of the right adrenal lesion. However, the persistence of this mass obligated long-term follow-up and shall assist us in better understanding the behavior of this bening lesion.

To evaluate the clinical course, diagnostic approach, therapeutic measures and results, in a series of 13 patients with colonic bleeding diverticula.From 1973 to 1995, 72 patients were admitted with the diagnosis of lower gastroin testinal bleeding. Thirteen presented a colonic diverticula bleeding. Mean age was 65.2 years. Medical history, symptoms, diagnosis, treatment (conservative or surgical) and pathology were recorded.Main bleeding time was 3 days. Eight patients needed blood transfusion. All patients underwent colonoscopic examination and it was diagnostic in every patient. Four patients underwent surgery: one case, because of massive hemorrhage and the other three cases due to bleeding recurrence. Pancolectomy was performed in one patient, ileal resection in another and the other two were treated with a sigmoidectomy and a left hemicolectomy. Pathology analysis corroborated colonic diverticula diagnosis. There was no postoperative mortality. Bleeding recurrence did not occur either in postoperative period or in the follow-up.Colonic diverticular bleeding usually stops spontaneously, obtaining high rates of preoperative diagnosis with colonoscopy. Less than a third of the cases requires surgical resection.

"● " Video 1). Endoscopic ultrasonography showed a heterogeneous lesion suggesting muscular layer necrosis. The patient was successfully treated surgically by subtotal gastrectomy. Pathological examinations confirmed a diagnosis of aberrant pancreas (● " Fig. 2). Heterotopic pancreas is the presence of pancreatic tissue lying outside of its normal location and lacking anatomic or vascular connections with the pancreas [1]. It is located in the antrum in 85%–95% of cases, and it is usually asymptomatic but may become clinically evident depending on the size, location, and the pathological changes [2]. In some cases, because the findings on imaging studies are not specific for aberrant pancreas, its preoperative definitive diagnosis is difficult [3]. The definitive diagnosis of aberrant pancreas is attained on histopathological examination and it should always be considered in the differential diagnosis of gastric masses.