The Scarpa fascia is an anatomic hint in the abdominal wall, and divides the fat tissue in a superficial and a deep layer. Other publications assert that in abdominoplasty, preserve this structure and making a more superficial dissection can prevent the seroma formation, but with worse aesthetic results. We consider that repairing the defect created by suturing the Scarpa fascia we can emulate the effects in diminishing the seroma, but without the aesthetic compromise.Using the first author´s data base, we select patients that complies with the following inclusion criteria of abdominoplasty plus liposuction: women, younger than 65, with no overweight, operated between April 2004 and December 2009, divided in 2 groups, with and without Scarpa's fascia closure (that became a routine in July 2007). Two groups, 97 patients each. We measured drain content (all the drains were took away by day 3), and in subsecuent medic control if a seroma was clinically suspected, it was punctioned untill the amount of serum obtained was under 50 cc.Comparing both groups, there is statiscally significant difference between them in drainage and amount of fluid obtained by punctions; also in the number of punctions and number of patients that needed the procedure. There is no difference between groups in age, body mass index (BMI), co-morbidity or complications.We think that repairing the defect by stitching the Scarpa fascia redeems the effect of preserving it but without the aesthetic defect, and all drainages can be safely took away by day 3. Anyway, further studies are needed in order to confirm this aspect.

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We report a new surgical method in 10 patients that underwent hybrid laparo-endoscopic resection (HLER) of submucosal tumors with the combination of flexible articulated laparoscopic instruments (FALI). We have assessed technical reproducibility, safety and morbidity. Resection was completed in all cases. Mean surgical time was 60 minutes (30-85). Median tumor size was 16 mm (12-30). The more frequent location was gastroesophageal junction. No complications were observed during the procedure. Length of stay was 1 day in all cases. We have found HLER to be a safe procedure allowing margin resection and organ preservation. The addition of FALI added ease of performance in hard-to-reach tumor locations.

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