Identification of patients with high level of fear of hospitalisation by this instrument should help clinicians to administer measures which may decrease fear and prevent avoidance of healthcare utilisation.

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SUMMARY -Th e bilayer patch device (Ethicon, Prolen Hernia System®) for inguinal hernia repair has a connector that acts as a ‚plug' in the internal inguinal ring. Th e position of this ‚plug' component may be responsible for higher incidence of chronic pain and intestinal damage. We assumed that changing the position of the connector of a bilayer patch device (PHS ® ) and placing it medially in Hesselbach triangle would contribute to lower incidence of chronic pain and would not result in intestinal damage, with good clinical outcome following indirect inguinal hernioplasty. Th is retrospective study included 73 patients with 76 indirect inguinal hernias, who underwent the procedure of modifying the position of the bilayer patch device in the 2005-2015 period. Th e mean age of the patients was 57 years. Th ree patients had early postoperative complications (3.95%), two of which had postoperative seroma and one had postoperative pain. Th ree patients (3.95%) had late postoperative complications. One patient (1.32%) had chronic pain. Th ere was one recurrence (1.32%) and one patient (1.32%) needed the mesh removed due to discomfort. Th e 'plug free' position of the connector of a bilayer patch device in patients with indirect inguinal hernioplasty is a safe procedure with low rate of chronic pain, no intestinal damage, and standard low recurrence.

Introduction This paper presents a case of a patient with a benign splenic cyst, which was removed by way of partial resection of the spleen. Case outline The patient's benign cyst in the lower pole of the spleen was excised using single Cooltip TM radiofrequency ablation electrode (Cool-tip RF Ablation System, Covidien TM , Dublin, Ireland). More than half of the spleen was excised without setting stitches to the splenic parenchyma and without any other hemostyptics. This way, the function of the spleen was preserved, which was proven with scintigraphy and computed tomography two years after the intervention. Conclusion Radiofrequency ablation system with internally cooled needles can be used successfully and without any consequences to the organ, especially in case of large benign splenic cysts, when it is necessary to preserve the function of the spleen.

Laparoscopic gastric sleeve (LGS) resection in super-obese patients (BMI > 50 kg/m) is a challenging procedure. We have developed a unique approach and technique for LGS with no buttress stapling and without oversewing. After 102 operations there have been no leaks and late complications.