The finding of a vermiform appendix in the case of an inguinal hernia that extends below the midpoint of the inner thigh when the patient is in a standing position is defined as giant left-sided Amyand’s hernia. It is a very rare case and significantly challenging in terms of preoperative diagnosis and surgical management. Here we present our experience with a case of a giant left-sided Amyand’s hernia that was followed up for 2 months.

Laparoscopic inguinal herniorrhaphy has become widely accepted as an effective alternative to the treatment of hernias with the anterior approach. It has success rates identical to those of the conventional method and quickens recovery by decreasing time until return to work or physical activities. With the introduction of single incision laparoscopic surgery (SILS), there has been an exponential increase in the number of SILS hernia repair. It probably represents the single most exciting innovation in laparoscopic surgery of the last 2 decades. The main premise of SILS is the use of completely blunt ports, which will negate the risks of bowel and vascular injuries, less wound, less postoperative pain, cosmetically more favorable and lower the recurrent rate.

Background: Liver is the most injured organ in abdominal trauma. Nonoperative treatment (NOM) is increasingly being adopted as the initial management strategy. The aim of this study was to evaluate the results of operative and conservative management of patients with blunt liver injury treated in a single institution.Methods: A retrospective study, analyzing patients admitted from 2011-2015 with the diagnosis of liver trauma, was performed. The patients were classified according to the intention to treatment: Group I, NOM; Group II, operative management and Group III, fail in NOM management. We analyzed demographic data, injury classification, associated injuries, transfusions, shock, liver function test, lactate level, and mortality rates.Results: Over the five years period, 68 patients were recorded, 45 were successful (S-NOM) and 18 were failed (F-NOM). No differences in age, sex or initial hemodynamics were found between S-NOM and F-NOM. The F-NOM patients were more seriously injured, more acidotic, required transfusion, had more fluid collection at FAST, had worse transaminase level and higher mortality rate. Grade of liver injuries was the independent risk factor of failure in nonoperating management of blunt liver trauma with the cut-off point is 3.66.Conclusions: Non-operative management of blunt liver injuries is successful in some cases. Patients with more severe injury tend to have an operation. High-grade blunt liver injuries always present with a worse condition and require an operation.

Introduction: Operative laparoscopy has advanced progressively since 1987 after laparoscopic cholecystectomy by means of four trocars. One of the main advantages of laparoscopic surgery over traditional open surgery is that it often requires a shorter hospital stay than traditional open surgery. Compared to conventional laparoscopic surgery, single incision laparoscopic surgery (SILS) has more benefits. In this article, we review laparoscopic surgery with single incision. Materials and methods: Literature review was performed on newly minimal invasive approach for laparoscopic surgery. Results: Single incision laparoscopic surgery has advantages in minimizing the invasiveness of surgical incision, reducing the number of incisions and the associated possible wound morbidities. This includes the reduced risks of wound infection, pain, bleeding, organ injury, and port site hernia. Even though SILS is recognized to be a more complicated procedure and costly, patients are experiencing less pain and almost scarless wound. Conclusion: Single incision laparoscopic surgery is an exciting new approach in the field of laparoscopic surgery.