No abstract

The interest on partial adrenalectomy has steadily increased over the past twenty years. Adrenal pathologies are mostly benign, making an organ-preserving procedure attractive for many patients. The introduction of minimally invasive techniques played probably an important role in this process because they transformed a complex surgical procedure, related to the difficult access to the retroperitoneal space, into a simple operation improving the accessibility to this organ. In this review we summarize the role of partial retroperitoneoscopic adrenalectomy over the years and the current indications and technique.

Introduction Laryngeal ultrasound has been increasingly used for the evaluation of the vocal cords mobility after thyroid and parathyroid surgery. The sensitivity and positive predictive value of the method are reported to be higher than 80%. Nevertheless, the visualization rate in male patients remains low; therefore, ultrasound is not attractive for the perioperative workup in those patients. In the present study, we evaluate the ability to improve the visualization rate for male patients by using a gel pad as an interface between the skin and the ultrasound probe. Methods and Materials Between December 2018 and January 2019, 92 male patients (mean age 49 years; range: 20-80 years) referred to our hospital with different thyroid pathologies received a laryngeal ultrasound without (TLUS) and subsequently with gel pad (G-TLUS). TLUS was performed by B-scan (probe 5-13 MHz, aperture 40 mm). The data were prospectively collected and statistically analyzed. ResultsThe visualization rate in the TLUS group was 35% (32 out of 92 patients). The use of the gel pad could increase the rate to 78% (p \ 0.0001). For both groups, visualization rates are lower in older patients ([ 50 years) compared to younger individuals (TLUS: 25% vs. 45%, p \ 0.05; G-TLUS: 75% vs 82%, p = 0.45). ConclusionThe gel pad significantly improves the vocal cord visualization rate in male patients and should be used routinely.

This Simplified Hernia Repair is safe and avoids additional foreign body implantation. Therefore, it is our method of choice for recurrent inguinal hernias after TEP.