Background and aim: Favorable outcomes of laparoscopic hepatectomy (LH) over open hepatectomy (OH) have been demonstrated. LH offers less postoperative morbidity, less blood loss and shorter hospital stay, while maintaining oncological safety. Only limited evidence about outcomes of LH in elderly is currently available. Therefore, this study aimed to compare short term outcomes of LH to OH for patients >65 years. Methods: A systematic review and meta-analysis were performed according to Cochrane guidelines. Embase, PubMed, Cochrane Library, and Google Scholar were searched to identify eligible studies. Studies were included if they compared LH to OH, and focused on an elderly population, or had a majority of patients >65 years. Perioperative and postoperative outcomes were analyzed. Results: Thirteen studies with 1174 patients (LH:532, OH:642) were included for analysis. When compared to OH, elderly undergoing LH had significantly less postoperative complications (relative risk [RR]0.52; 95% confidence interval (CI):0.43-0.63), less blood loss (mean difference [MD]-198.58; 95% CI:-299.88 to −97.28), and shorter length of stay (MD-4.83; 95%CI:-7.91 to −1.84), while oncological safety was non-inferior (RR1.04; 95%CI:1.00-1.08). Conclusions: Within the elderly population LH seems to be superior to OH, concerning short-term outcomes. However, for broader applicability more trials are needed including more difficult and major resections.

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Background Transversus abdominis release (TAR) is a surgical technique used in the treatment of complex ventral hernias. The aim of this study was to compare outcomes of open (oTAR) versus robotic-assisted (rTAR) posterior component separation by TAR. Methods Consecutive patients at two European hernia centres who underwent bilateral TAR were included. The primary endpoint was the duration of postoperative hospital stay. Results Data from 90 rTAR and 79 oTAR operations were evaluated. Patient demographics were similar between groups in terms of age, sex, BMI, and co-morbidities. There were more smokers, and hernias were larger in the oTAR group (width 8.7 cm versus 10.0 cm; P = 0.031, length 11.6 cm versus 14.1 cm; P = 0.005). Duration of postoperative hospital stay was significantly shorter in the rTAR group (3.4 days versus 6.9 days; P < 0.001). Short-term serious complications (Clavien–Dindo grade III and above) were more frequent (20.3 per cent versus 7.8 per cent; P = 0.018), and there were more surgical site infections (12.7 per cent versus 3.3 per cent; P = 0.010) in the oTAR group. During a median follow-up of 19 months in the rTAR group and 43 months in the oTAR group, reoperation (4.4 per cent versus 8.9 per cent; P = 0.245), and recurrence rates (5.6 per cent versus 5.1 per cent; P > 0.009) were similar. Conclusion Patients with ventral incisional hernias who undergo bilateral rTAR had significantly shorter postoperative hospital stays and fewer short-term complications compared with patients undergoing bilateral oTAR.

The preparation and physico-chemical characterization of lyophilized polyisohexylcyanoacrylate nanoparticles loaded with dehydroemetine (DHE) for the treatment of visceral leishmaniasis disease is described. The resulting formulation was found to efficiently absorb DHE and gave very reproducible preparations with regard to the size and drug adsorption rate. Stability has been confirmed for at least 24 months. The acute toxicity of DHE was reduced in intravenous administration by its association with nanoparticles. Data concerning tissue distribution in mice showed that DHE nanoparticles were rapidly cleared from the blood stream and that they mainly concentrated in the reticuloendothelial system. Furthermore, DHE linkage to the carrier reduced the cardiac concentrations of the drug.

Background Transabdominal prostatectomy results in scarring of the retropubic space and this might complicate subsequent preperitoneal dissection and mesh placement during minimally invasive inguinal hernia repair. Therefore, it suggested that an open anterior technique should be used rather than a minimally invasive posterior technique in these patients. Methods In this single-center study, a retrospective analysis of a prospectively maintained database was performed. All patients undergoing inguinal hernia repair after previous transabdominal prostatectomy were included in this analysis, and the feasibility, safety, and short-term outcomes of open and robotic-assisted laparoscopic inguinal hernia repair were compared. Results From 907 inguinal hernia operations performed between March 2015 and March 2020, 45 patients met the inclusion criteria. As the number of patients treated with conventional laparoscopy was very low (n = 2), their data were excluded from statistical analysis. An open anterior repair with mesh (Lichtenstein) was performed in 21 patients and a robotic-assisted laparoscopic posterior transabdominal repair (rTAPP) in 22. Patient characteristics between groups were comparable. A transurethral urinary catheter was placed during surgery in 17 patients, most often in the laparoscopic cases (15/22, 68.2%). In the rTAPP group, a higher proportion of patients was treated for a bilateral inguinal hernia (50%, vs 19% in the Lichtenstein group). There were no intraoperative complications and no conversions from laparoscopy to open surgery. No statistically significant differences between both groups were observed in the outcome parameters. At 4 weeks follow-up, more patients who underwent rTAPP had an asymptomatic seroma (22.7% vs 5% in the Lichtenstein group) and two patients were treated postoperatively for a urinary tract infection (4.7%). Conclusion A robotic-assisted laparoscopic approach to inguinal hernia after previous transabdominal prostatectomy seems safe and feasible and might offer specific advantages in the treatment of bilateral inguinal hernia repairs.