A 69‐year‐old woman was referred to our department with complaints of abdominal discomfort in the standing position. She had undergone robot‐assisted radical cystectomy and ileal conduit urinary diversion for bladder cancer 10 months earlier. Abdominal CT revealed a parastomal hernia. Laparoscopic parastomal hernia repair using the Pauli technique was performed successfully with no recurrence after a 4‐month follow‐up. Although there are concerns about potential mesh‐related complications and long‐term results, this novel approach can be a successful option for parastomal hernia repair. As far as we know, this is the first English‐language report on the application of Pauli parastomal hernia repair combined with a pure laparoscopic approach.

Right-sided blunt traumatic diaphragmatic injury (TDI) is a rare injury that is rarely repaired by the minimally invasive approach in the acute setting. Laparoscopic repair of right-sided TDI is challenging because the liver often obstructs access to the injury site. Herein, we report a case wherein acute right-sided blunt TDI was successfully repaired using a combined laparoscopic and thoracoscopic approach. A 30-year-old man presented with shortness of breath after falling on his back while jumping on a snowboard. CT revealed a right-sided TDI. As the patient was haemodynamically stable, laparoscopic repair was planned. Laparoscopy revealed a right-sided diaphragmatic rupture. As the posterior portion was covered by the liver and difficult to access, we added trocars in the chest cavity and closed the diaphragmatic defect with a thoracic approach. A combined laparoscopic and thoracoscopic approach can repair right-sided diaphragmatic injury by a minimally invasive approach even in the acute setting.

Abstract“Bridged-IPOM” of Leblanc has been introduced in the 1990s [1]. IPOM is still the mainstay of the repair of ventral hernia, but it has not been without limitation. Adhesive bowel obstruction, mesh erosion, enterocutaneous fistula, and chronic pain are due to tight mesh fixations [2]. Extraperitoneal mesh placement offer advantages: the retromuscular positioning of the mesh permits the integration of both sides, providing the repair with superior tensile strength and costly coated mesh is unnecessary. Nevertheless, the laparoscopic extraperitoneal approach continues to pose limitation in available degree of freedom and significant ergonomic challenge to the operating surgeons.

BackgroundThe oncological effectiveness of preoperative radiotherapy for locally advanced colon cancer is unclear. We report a case of pathological complete response in a patient with locally advanced ascending colon cancer after preoperative radiotherapy following failure of chemotherapy.Case presentationA 65-year-old Japanese woman presented with malaise and hematochezia. A computed tomography (CT) revealed a tumor in the ascending colon which seemed to infiltrate the adjacent structures. She was diagnosed with locally advanced ascending colon cancer stages T4b, N2a, M0, and IIIC. We selected modified FOLFOX6 with panitumumab as neoadjuvant chemotherapy. However, we discontinued the chemotherapy after the 8th cycle because of disease progression and severe adverse effects. The patient then underwent radiotherapy of 60 Gy in 30 fractions, resulting in significant tumor size reduction. One month after the radiotherapy, we performed a right hemicolectomy with multivisceral resection without complications. Histopathologically, we found no residual cancer cells in the resected specimen. The patient remains alive and has not required additional therapies for 24 months, as there are no signs of recurrence.ConclusionsThe present case suggests that preoperative radiotherapy might be an effective treatment options for locally advanced colon cancer.

The perforated ulcers were treated by open gastrectomy or simple suture until 1937 then Graham introduced the method using a free omental graft, which is called the “Graham patch procedure” [1]. This procedure has long been a golden standard of surgical treatment for perforated peptic ulcers. The idea of laparoscopic treatment had arisen in the 1990s, and the comparison of superiority between laparoscopy and open surgery has long been discussed [2].