While both RYGB and SG procedures provide effective treatment for I-T2D patients in terms of weight loss and diabetes, incidence of complete remission for insulin-dependent patients is higher with RYGB in earlier years.

Selective surgical hernia repair, based on meticulous anamnesis and physical examination is effective in the management of chronic groin pain in athletes.

IntroductionSplenic metastasis from ovarian carcinoma generally presents as peritoneal spread with multiorgan involvement. Fewer than 30 cases of solitary parenchymal splenic metastasis from ovarian carcinoma have been published in the literature. The presentation is often asymptomatic.Case presentationAn increase in tumor marker CA-125 from 18.1 to 132.6 units/ml (normal <35 units/ml) was measured in a 56-year-old Israeli Jewish woman who had undergone, six years previously, a total abdominal hysterectomy with bilateral salpingo-oophorectomy due to right ovarian carcinoma. An abdominal computed tomography scan revealed a mass of 6×8cm at the anterior of the spleen, with close proximity to the wall of the stomach. A gastroscopy demonstrated exterior pressure on the stomach body. An open splenectomy was performed to exclude a peritoneal carcinomatosis. No intraoperative evidence of tumoral spreading in the abdominal cavity was observed, other than the spleen. The final histologic result demonstrated a high-grade carcinoma consistent with metastatic endometrioid-type ovarian carcinoma grade 3.ConclusionsThis case highlights the importance of cancer antigen 125 assessment and medical imaging in the follow-up of ovarian carcinoma. Open laparotomy, or laparoscopy, enables exclusion of a peritoneal carcinomatosis, which is more common than solitary parenchymal splenic metastasis, as was presented in the current case.

There is ongoing challenges regarding the safety of performing laparoscopic surgery with the presence of ventriculoperitoneal (VP) shunts, especially in patients treated for cancer disease. To date, only one case has been reported in the English literature. Herein, we report an additional two cases of patients with previous insertion of a VP shunt, diagnosed with colon cancer. Both our patients underwent successful laparoscopic colectomies, without clamping or removal of the VP shunt, with no reported perioperative complications or postoperative neurological deficits. Laparoscopic bowel resection for cancer, in patients with a pre-existing VP shunt, could be considered a potentially safe and feasible procedure. Furthermore, due to the increasing number of patients with VP shunts, additional case reports and investigations are warranted to further confirm safety of this procedure.