Objectives: We present a new surgery based on the round ligament anatomy that is called laparoscopic abdominopexy, which uses a synthetic mesh without fixation at any pelvic point. The aim of this study is to provide a step-by-step description of the laparoscopic abdominopexy technique and present the first anatomical and functional results of the procedure. Methods: This prospective cohort study included patients with apical and anterior vaginal prolapse who were subjected to laparoscopic abdominopexy. Before and after surgery, the Pelvic Organ Prolapse Quantification (POP-Q) scale, Overactive Bladder Questionnaire-Short Form (OABq-SF), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to evaluate the vaginal prolapse stage, storage, and sexual symptoms, respectively. The surgical technique is described step by step. Results: Twenty patients were included with follow-up times between 6 and 25 months. The mean surgical time was 78.4 minutes. A statistically significant improvement was observed in the Aa ( P ≤ 10 −5 ), Ba ( P ≤ 10 −5 ), C ( P = 5 × 10 −5 ), D ( P = .002) and tvl ( P = .02) POP-Q points and in OABq-SF (22.2%; P = .02). Successful surgery was observed in 100% of patients for the apical compartment and 90% of patients for the anterior compartment. Conclusion: Laparoscopic abdominopexy is a quick, safe, and reproducible surgical technique with beneficial anatomical and functional results that preserve the pelvic floor anatomy.

Obesity has been established as a risk factor for renal cell carcinoma (RCC). Recently, studies have described obesity as a probable protecting factor in the metastatic stage of RCC. In this study, we assessed the relationship between body mass index (BMI) and overall survival in patients under systemic therapy.The correlation between BMI and overall median survival was studied in 76 patients diagnosed with metastatic RCC under systemic therapy. The groups were divided into overweight and obesity (BMI > 25 kg/m2) and underweight or normal (BMI < 25 kg/m2). Statistical analysis was performed using the Cox regression model adjusted by gender.A total of 76 patients were studied: 16 women (21%) and 60 men (79%). The median BMI was 27.96 kg/m2; 24 patients (31.6%) had low BMI and 52 (68.4%) had high BMI. Median overall survival in the group with BMI > 25 kg/m2 was 17 months (95% confidence interval [CI]: 13–34 months), while in the group with BMI ≤ 25 kg/m2, it was 14 months (95% CI: 8–20 months). When adjusted by gender, the group with BMI > 25 kg/m2 presented a hazards ratio of 0.54 (95% CI: 0.30–0.96), P = 0.044 (Log Rank).A high BMI significantly acts as a protecting factor. We observed an increased overall survival of overweight and obese patients within the context of metastatic RCC under systemic treatment. These data confirm the findings published in other studies that suggest the role of lipid metabolism in this type of tumors.

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INTRODUCTION The transverse hypogastric Pfannenstiel incision is one of the possibilities for specimen extraction after a laparoscopic nephrectomy. Its advantages include low morbidity and a favorable cosmetic result. MATERIAL AND METHODS Retrospective and comparative observational study of 105 patients who underwent nephrectomy in our center. Group 1: renal extraction through Pfannenstiel incision. Group 2: renal extraction using other techniques. The presence of infection, incisional hernia and pain (visual analogue scale-VAS) was evaluated in each patient. Additionally, a telephone survey was conducted on the cosmetic results. RESULTS 105 patients: 68 group 1 (Pfannenstiel incision) and 37 group 2 (other incisions). The median size of the nephrectomy specimen was 14 cm (group 1 15cm, group 2 13cm). 27 patients (26%) had pain in the area of the hypogastric incision in the early postoperative period with a median on the VAS scale of 4 (16 group 1 vs 11 group 2). 3 patients (2.8%) presented incisional hernia (0 group 1 vs 3 group 2). 3 patients presented wound infection (0 group 1 vs 3 group 2). 70% of the patients in group 1 (48/68) answered the survey on cosmetic satisfaction: 93% were satisfied with the scar and its location. 49% of the patients in group 2 (18/37) answered the survey on cosmetic satisfaction: 83% were satisfied with the scar and its location. CONCLUSIONS The Pfannenstiel incision is a valid and safe alternative for laparoscopic nephrectomy specimen extraction with a favorable complication and cosmetic profile compared to other common techniques for nephrectomy specimen extraction.

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