Introduction Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress. Aim To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI). Material and methods A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery. Results A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated 1 day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286). Conclusions Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.

Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

Introduction Patients with acute cholecystitis who are unsuitable for cholecystectomy undergo conservative treatment or percutaneous transhepatic gallbladder drainage. As these two methods are not always successful, further treatment options are needed. One increasingly popular method is endoscopic ultrasound-guided gallbladder drainage (EUSGBD), whereby stents are placed so as to create a permanent fistula connecting the gallbladder to the stomach or the duodenal bulb, thus enabling drainage of its contents to the gastrointestinal tract. Aim To present our early experience with EUSGBD for the treatment of cholecystitis in patients who are not suitable for cholecystectomy. Material and methods The procedure was performed in 5 patients with acute cholecystitis. Two patients also had symptoms of biliary obstruction due to pancreatic head cancer. An ultrasound endoscope was used to create a fistula between the gallbladder and the stomach or between the gallbladder and the duodenal bulb, in which a self-expandable metallic stent (SEMS) was placed. Results All procedures were performed with no perioperative complications. In all patients, the clinical symptoms of cholecystitis subsided within 3–15 days. In those patients who also showed symptoms of biliary obstruction, these symptoms subsided within 3–6 days following the procedure. Conclusions The EUSGBD seems to be an effective and safe treatment for acute cholecystitis in patients unsuitable for cholecystectomy. It can also be used to treat jaundice caused by obstruction of the common bile duct, when no other methods can be used. The method is particularly promising in cases of concurrent acute cholecystitis and common bile duct obstruction.

Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is subject to debate. Main concerns regard the type of suction to use (continuous, intermittent, or variable), the wound-packing material, or the exact pressure to apply. Typically, an optimum pressure range of -80 to -125 mmHg is indicated. Following bone resection in diabetic foot patients, the surgical wound is left open, which often entails bleeding from the resection site. In these cases, the start of NPWT was typically delayed by 24-48 hours -during that time a pressure dressing was applied -and NPWT was only started once bleeding had ceased. In order to initiate NPWT as soon as possible, we decided to start it at a higher negative pressure than usual, i.e. -180 mmHg, expecting that this would stop the bleeding. Only then would we reduce the negative pressure. This paper presents the course of NPWT with high negative pressure values after an amputation in 2 diabetic foot patients. In both cases, our assumptions were confirmed. The patients did not bleed, the drained volume did not exceed 30 ml (which seems clinically insignificant) in the first 40 minutes of treatment. Later, with negative pressure at -120 mmHg, no bleeding into the dressing was observed. Following the treatment (which lasted for 9 days), the wounds granulated normally, with no signs of inflammation. Applying VAC dressing using high negative pressure values to bleeding wounds immediately after surgery may stop the bleeding, enabling immediate initiation of NPWT.