Retroperitoneal cysts are rare, usually asymptomatic, lesions. We present the case of a 42-year-old woman with an asymptomatic abdominal mass. The mass excised at our district hospital was found in the retroperitoneum. Histologically, the cyst was lined with benign Mullerian-type epithelium. The classification, aetiology and clinical manifestations of retroperitoneal cysts are discussed. Retroperitoneal cysts present as an acute abdomen in only a minority of cases. Ultrasound is the most reliable test for their detection, usually followed by computed tomography and/or an upper gastrointestinal series. Optimally, these cysts should be completely excised.
There was no clear common pattern for the management of suspected or proven CBD stones. There were three management issues in which there was a 'common practice'. These were: (i) the use of preoperative ERCP for patients with persistent jaundice or cholangitis; and the routine use of (ii) OC and (iii) postoperative ERCP to clear the CBD, assuming other methods had failed.
If only the 86 patients with invasive carcinoma and four or more axillary nodes removed at surgery are considered, the sentinel node was accurate in assessing the axillary status in 97.7% of the total patient group (2.3% false negative rate), 97.2% of those in whom sentinel nodes were successfully retrieved (2.8% false negative rate) and 94.9% of the patients with positive axillary nodes (5.1% false negative rate). Sentinel node biopsy is a valid technique providing an accurate reflection of the axillary node status and having a low false negative rate.
The smartphone box trainer is inexpensive (approximately $60) and took less than 20 minutes to build. The cost was almost entirely for the VGA adaptor. The box trainer was light, portable and easily transported to any setting that provided a computer screen. It is an inexpensive, easy-to-assemble, replicable model that benefits from the advanced technology of personal smartphones, and can be easily accessed as a useful tool in learning and improving laparoscopic techniques. Laparoscopic surgery requires different abilities to open surgery.
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