O ver the last 15 years, the incidence of brain and spinal cord injuries among ice hockey players has increased. 1 A recent study involving players in junior leagues found that, in the 2009/10 hockey season, the incidence of game-related concussions was 7 times higher than the highest rate previously reported in 1998/99. 2 Brain injuries frequently result from aggressive bodychecking 3 and account for 15% of injuries among players 9-16 years of age. 4,5 In a study of a community-based hockey program involving boys aged 9-15 years, hostile aggressive acts, which have an intention to do harm, 6 were the primary cause of injury in one-third of games in which an injury resulted.7 Among high school students in Minnesota who played varsity ice hockey, those who played to relieve aggression were 4 times more likely than other players to experience a concussion.8 These findings highlight the association between aggressive behaviour and injury in ice hockey. However, little is known about what can be done to reduce this behaviour to create a safer environment for the sport.Existing reviews about reducing injury in sport have primarily assessed equipment or risk factors associated with injury.9−11 Recent systematic reviews highlighted the risks of bodychecking and renewed calls for policies to disallow bodychecking among youth playing ice hockey. 3,12 We conducted a systematic review to assess the effectiveness of interventions designed to reduce aggressive acts and related injuries among ice hockey players. We were particularly interested in evaluating the effectiveness of rule changes, educational interventions and behavioural modification in reducing aggressive acts and related injuries. Methods Data sourcesWe searched 8 electronic databases for potentially relevant articles published from the time

Introduction: We compared the outcomes of single-incision, robotassisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system. Methods: We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA). Results: Patient demographics were similar between the two groups. Mean operating time was similar among the single and multi-port groups (225.2 min vs. 198.9 minutes [p=0.33]). There was no significant difference in length of hospital stay in either group (86.2 hr vs. 93.2 hr [p=0.76]). There was no difference in success rates or postoperative complications among groups. Conclusions: Single-port robotic pyeloplasty is non-inferior to multiple-incision robotic surgery in terms of operative times, hospitalization time, success rates, and complications. Verifying these results with larger cohorts is required prior to the wide adoption of this technique. Ongoing objective measurements of cosmesis and patient satisfaction are being evaluated.