LGBP is a good surgical technique for the management of morbid obesity and has clear advantages over OGBP, such as a reduction in abdominal wall complications and a shorter hospital stay. The midterm weight loss is similar with both techniques. One inconvenience is that LGBP has a more complex learning curve than other advanced laparoscopic techniques, which may be associated with an increase in postoperative complications.

Of 99 patients with 117 gastrointestinal bezoars, 69 had undergone previous surgery, the most common operation being bilateral truncal vagotomy with pyloroplasty (55 patients). An excessive intake of vegetable fibre was found in 38 patients and poor mastication in 27. Thirty bezoars presented with gastric symptoms and patients had endoscopy as the diagnostic technique; 87 caused symptoms of intestinal obstruction with the diagnosis made by plain abdominal radiography. Medical treatment by enzymic or endoscopic fragmentation was used for 17 of 30 gastric bezoars; surgery was required in the remainder. Intestinal bezoars causing obstruction can be fragmented and 'milked' to the caecum. The stomach should be explored for associated gastric bezoars.

We believe that subtotal colectomy is the treatment of choice for obstructed left-sided colonic carcinoma. Segmental resection with intraoperative colonic irrigation is more appropriate than subtotal colectomy only in patients with carcinomas of the rectosigmoid junction or with previous anal incontinence to avoid the appearance of postoperative diarrhea.

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Ventral hernia repair is still a difficult problem for surgeons because of the high recurrence rate and possible postoperative complications. Repairs with a prosthesis have reduced the recurrence rate, but the anterior approach still involves high morbidity and a long hospital stay. The purpose of this article was to evaluate the results of laparoscopic surgery on ventral hernias using a new double-layer mesh in an intra-abdominal position. A retrospective analysis was performed of the first 20 patients undergoing laparoscopic surgery for ventral hernia (75% incisional and 25% umbilical) with intra-abdominal prosthetic repair using a double-layer mesh consisting of three-dimensional multifiber polyester on one side and a hydrophilic resorbable nonstick collagen membrane on the other (Parietex composite, Sofradim, Villefranche sur Saone, France). The procedure was done on an outpatient basis in 85% of the cases. There was no morbidity or mortality. During a mean follow-up period of 10 months we found no infections, rejections, fistulas, recurrences, or alterations in bowel function. Laparoscopic repair of ventral hernias is an efficient alternative to open repair, with a low morbidity rate and short hospital stay. The double-layer mesh is safe for intra-abdominal use.