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ResumenIntroducciónLa enfermedad diverticular del colon es común en occidente. Posterior al primer episodio de diverticulitis, muchos pacientes se beneficiarán con terapia médica, pero de un 10 a un 20% de los casos desarrollarán abscesos, obstrucción, fístula.ObjetivoDescribir el tratamiento laparoscópico de las fístulas sigmoidovesicales secundarias a enfermedad diverticular.Material y métodosEstudio retrospectivo observacional de 10 pacientes consecutivos de 2011 a 2015 los cuales fueron sometidos a: 1) resección de fístula colovesical y cierre primario de vejiga y sigmoides o 2) sigmoidectomía laparoscópica técnica NOSE (extracción transanal del espécimen y anastomosis colorrectal, con cierre primario de vejiga).ResultadosSe operaron en total 10 pacientes en un periodo de tiempo de febrero de 2011 a febrero de 2015. Edad promedio 60.7(49-71)años. Se realizó sigmoidectomía con anastomosis primaria a 4 pacientes, resección y cierre primario a 6 pacientes, tiempo quirúrgico 140.4(80-210) minutos, sangrado 195(80-210) ml, tiempo para iniciar la vía oral 4.3 días (3–5) días. A todos los pacientes se les dejó el drenaje 10 días y la sonda transuretral dos semanas. Hasta ahora ninguno ha presentado recidiva de las fístulas o datos compatibles con estenosis de anastomosis intestinal.ConclusionesExisten reportes sobre el uso de la laparoscopia para el tratamiento de fístulas colovesicales demostrando resultados aceptables. Pocos son los estudios que se enfocan exclusivamente en fístulas colovesicales, generalmente los reportes incluyen fístulas de otros tipos también (colovaginales y colocutáneas). Las fístulas colovesicales son una patología que puede ser resuelta vía laparoscópica de manera eficaz segura.AbstractBackgroundDiverticular disease of the colon is common in the western world. After the first episode of diverticulitis, many patients benefit from medical therapy, but 10-20% develop abscesses, obstruction, or fistula.AimTo describe the laparoscopic treatment of sigmoidovesical fistula secondary to diverticular disease.Material and methodsAn observational, retrospective study was conducted on 10 consecutive patients within the time frame of 2011-2015 that had undergone: 1) colovesical fistula resection and primary closure of the bladder and sigmoid colon or 2) laparoscopic sigmoidectomy with the NOSE technique (transanal extraction of the specimen and colorectal anastomosis with primary closure of the bladder).ResultsTen patients were operated on within the time frame of February 2011 and February 2015. The mean age of the patients was 60.7(49-71) years. Sigmoidectomy with primary anastomosis was performed on 4 patients and resection and primary closure on 6 patients. Surgery duration was 140.4 (80-210) min, blood loss was 195 (80-210) ml, and length of time before beginning oral diet was 4.3 (3–5) days. The drain was left in place in all the patients for 10 days and the transurethral catheter for 2 weeks. Up to the present time, none of the patients has presented with fistula recurrence or data consistent with intestinal anastomosis stricture.ConclusionsReports on the use of laparoscopy for the treatment of colovesical fistulas have demonstrated acceptable results. Only a few studies concentrate exclusively on colovesical fistula; in general the reports include other types of fistula (colovaginal and colocutaneous), as well. Colovesical fistula is a pathology that can be resolved safely and efficaciously through laparoscopy.

Objective: To assesss the inappropriate use of causal language in studies on obesity and nutrition. Methods: Titles and abstracts of 525 peer-reviewed papers in the 4 leading journals in the fields of obesity and nutrition were scrutinized for language implying causality in observational studies published in 2006. Results: Such misleading language appeared in 161 papers (31%) independent of funding source. Remarkably 49% of studies lacking statistically significant primary outcomes used misleading language compared to 29% of those with p values ≤0.05 (chi square p < 0.001). Exculpatory language was present in the body of the text in 19%; of the 161 studies. Conclusion: We suggest that editors and reviewers evaluate submissions for misleading reporting.

In recent years, scientific interest on friction stir welding (FSW) has grown more and more since such a joining technique allows one to weld lightweight alloys that are rather difficult to weld or even “unweldable” with the classic fusion welding operations. Furthermore, few industrial applications of the process are already known in different manufacturing fields. In this paper, the optimization problem of a FSW lap joint for automotive applications is investigated, taking into account process parameters such as the tool rotating speed and the tool feed rate; a numerical gradient technique is applied for the optimization procedure reducing the number of experimental tests to be developed.

Objectifs L’objectif de cette video est de demontrer que l’utilisation d’une pince robotisee Dexterite est compatible avec l’abord laparoscopique mono-trocart. Le mono-trocart est source de conflits entre les instruments et les instruments robotises ont un encombrement exterieur non negligeable laissant presager une incompatibilite entre ces deux approches. Methodes Nous avons acquis depuis 2009 l’experience de la laparoscopie mono-trocart pour de multiples interventions urologiques et nous avons donc choisi de tester l’utilisation de ciseaux et porte aiguille robotises pour la realisation d’une promontofixation avec double bandelette anterieure et posterieure chez une patiente (65 ans, 65 kg, 160 cm) presentant une hysterocele. Resultats Nous demontrons la compatibilite de la voie d’abord mono-trocart et de la pince robotisee Dexterite utilisee dans cet essai. Cet instrument offre une bonne qualite de dissection et de suture. Les conflits sont limites. L’intervention s’est deroulee dans des conditions tres satisfaisantes. Duree operatoire de 146 min. Conclusion Nous pensons que cette nouvelle instrumentation pourrait permettre d’elargir les indications de l’abord mono-trocart en apportant une solution supplementaire a la resolution de certains conflits. La courbe d’apprentissage de la laparoscopie mono-trocart pourrait egalement s’en trouver raccourcie.