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Introduction: In recent years, a new form of health has emerged, namely philosophical health. This novel concept is part of the philosophical counseling movement and relies on the philosophical method called the SMILE-PH interview, which draws heavily from continental philosophy, including phenomenology. Reflecting on the link between health and philosophy brings us to an ancient healthcare tradition that actively relies on philosophy: Chinese healthcare and its founding wuxing, or five phases ontology., Objective: The aim of this study is to interpret philosophical health from the standpoint of wuxing ontology., Methods: We used the multiple meanings of the five phases to interpret the six concepts of SMILE-PH interview method. Then, we monitored how applying the SMILE-PH involves a parent phase triggering for the counselee. Last, we focused our analysis on the triggered phase and conceptualized them into philosophical health., Results: The SMILE-PH topics are located in a specific phase, namely the Metal phase (xin), which is described by the concepts of connection, existence, identity, meaning in one's life, and spirituality. The one-phase structure of SMILE-PH fosters the triggering of its parent phase: the predominant Metal phase character of the SMILE-PH interview will promote the appearance of Earth phase answers. Conceptualizing the Earth phase into philosophical health adds the following aspects to the latter: emotional stability, the feeling of plenitude, and sharing without a transactional mindset., Conclusion: We obtained a clear perspective of the place of SMILE-PH in wuxing ontology and added a new layer to philosophical health. The other phases of wuxing ontology remain to be tested and integrated into philosophical health., (© 2023 John Wiley & Sons Ltd.)

Lumbar sympathectomy, classical surgical technique applied in conventional arteriopathy treatment, has acquired new valence by the development of laparoscopic technique. In a period of ten years (2000-2009), a number of 100 patients with different cause of arteriopathy have been operated by transperitoneal lumbar sympathectomy. Mean age was 62 years. Indication establishment has been achieved by an investigation protocol taking into account clinical and Para clinical criteria and methods. Postop evolution has been simple with very low morbidity and mortality zero. Particularly good evolution had patients in stages II and III of the disease, with missing effort claudication and repaos pain. Unfavourably results were recorded in advanced stages of disease, at diabetic patients with plenty of associated disease, therefore 9 patients suffering amputations of limbs. Results immediate and late were coordinated with stage and age of patients. Lumbar laparoscopic transperitoneal sympathectomy represents a viable alternative in artheriopathy treatment because of reduced morbidity--representing a chance for these very delicate patients.

Primary hyperparathyroidism is an uncommon disease, with late diagnosis due to insidious and various symptoms. Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism. This paper presents the clinic of disease, the necessary exams to perform in order to obtain a positive diagnosis also the case of young man with long evolution period prior to diagnosis and with severe complications at bones. Surgery represents the only valid option resulting complete healing.

Paraduodenal hernia is a rare situation, less than 400 cases being published in literature. This condition is difficult to explore, diagnose appear within an occlusive syndrome. The etiopathology involves perturbation of intestinal rotation during the intrauterine life, producing paraduodenal fossa, which generates conditions for internal hernias and occlusive situations. We present the case of a 36 years old woman with chronic epigastric pain, diagnosed as duodenal ulcer, later as acute pancreatitis and in the end as high occlusion syndrome. Open laparotomy was performed, uncovering a strangulated left paraduodenal hernia, with severe pathologic lesions of the intestinal loops. Kelotomy and pure-string suture of parietal defect was performed. Post-operative evolution has been difficult with hepatic failure with coagulopathy and diffuse intestinal hemorrhage, threatening the patient's life. Intensive care lead eventually to a favorable condition. The rarity of this disease, difficulty of diagnosis and the particular evolution were the reasons to present this rare case.

Introduction: The laparoscopic approach for umbilical hernia is more and more used, but few results are reported. The aim is to evaluate the efficacy and safety of using the Prolene mesh placed laparoscopically in umbilical hernia treatment., Material and Method: Between 2004-2006, 21 patients with umbilical hernia, aged of 34 to 77 years, were submitted to intraperitoneal application of a Prolene mesh to cover the umbilical ring. The mesh was sewed by Protack staples or transfascial stitches. Before deflating the patients, the greater omentum was interposed between the mesh and the bowel. It is notice that 8 patients were obese, 6 patients had omental or bowel adhesions to the peritoneal sac and 5 patients had ascites due to liver cirrhosis. The patients were discharged 24 to 48 hours after the operation and followed up for 6 to 12 months., Results: All patients were alive at the end of follow-up, without hernia recurrence or complications due to the Prolene mesh in the abdominal cavity. In 3 patients we registered subcutaneous seromas for 1 to 3 weeks (imposing evacuation by punction) and 5 patients kept a mildly deformed umbilical scar after the cure of large hernias., Discussions: In the literature are mentioned the techniques using composite or two-layers meshes. Prolene meshes are not agreed by some authors, for the supposed risk of bowel lesions. In our trial were no such complications., Conclusion: Laparoscopic repair using Prolene intraperitoneal mesh in umbilical hernia is a safe, efficient and rapid method, avoiding infections complications in obese or cirrhotic patients.