On the basis of this meta-analysis, the authors conclude that LARS is an effective and safe alternative to OARS for the treatment of proven GERD. LARS enables a faster convalescence and return to productive activity, with a reduced risk of complications and a similar treatment outcome, than an open approach. However, there is a significantly higher rate of re-operation (79%) in the LARS group.

No abstract

Actinomycosis is a rare cause of a caruncular mass previously unreported in large clinicohistopathologic studies. A 25-year-old man presented with an enlarged and irritated left caruncle and an otherwise normal ocular examination. After the patient failed to respond to conservative medical management, an excision biopsy revealed an underlying diagnosis of actinomycotic granule of the caruncle. The patient's symptoms resolved, and after 6 months of follow up there was no evidence of recurrence. Actinomycosis is a slowly progressive, chronic infection with a nonspecific clinical presentation. Diagnosis is therefore difficult and is generally made on the basis of histopathology. This case demonstrates that actinomycosis can present as a caruncular mass.

Surgical education and training is evolving as new educational techniques are developed amidst a greater societal requirement and pressure for a greater number of surgeons. The methods of delivering this education and training vary between institutions, but all have the common aim to produce effective well-rounded surgeons who are capable of providing a safe and competent service that is relevant to the society within which they work.