Single-incision laparoscopy using standard laparoscopic instruments appears to be a safe and feasible technique for malignant disease requiring right hemicolectomy. Randomized, prospective trials are ongoing to prove the benefits of this technique and to compare its oncological outcome measures with those of conventional laparoscopy. In our experience, a low-profile port with a wide intra-abdominal range of motion is most preferable.

The peritoneal surface remains an important failure site for patients with gastrointestinal and gynecologic malignancies. In the past, oncologists regarded peritoneal carcinomatosis as an incurable component of an intra-abdominal malignancy. During the last two decades, novel therapeutic approaches have emerged for peritoneal carcinomatosis patients. We report the first case of peritoneal carcinomatosis emerging from an extra-adrenal, intra-abdominal paraganglioma. This 49-year-old male was treated with cytoreductive surgery and hyperthermic intraperitoneal perioperative chemotherapy. Paragangliomas are rare tumors of neural crest-derived chromaffin cells and can originate either from the sympathetic or from the parasympathetic ganglia. It has been estimated that as many as 10% of the paragangliomas arise outside the adrenal glands. This case represents an unreported presentation of paraganglioma. Two possible origins of this malignancy, and the applied therapy, are discussed. We report the feasibility of cytoreductive surgery plus hyperthermic intraperitoneal perioperative chemotherapy in the treatment of this malignancy.

Complex shoulder fractures, with lesions in different parts of the shoulder girdle, are a challenging pathology for diagnosis, classification, and treatment. In this technical note we present 2 cases of such complex fractures. We discuss the difficulty of classifying these types of lesions. Although most classification systems focus on 1 element of the shoulder girdle, we underline the need of a system that describes the shoulder girdle as a whole and that allows to classify the magnitude of injury types of these complex structures, addressing both the scapula and the superior shoulder suspensory complex. We present a stepwise surgical approach for the complex combination of a glenoid fracture and a high-grade acromioclavicular luxation. It is a rare surgical setup combining open and arthroscopic techniques to receive an anatomic reduction.S capular fractures are uncommon. They account for only 1% of all fractures, 3% of all shoulder-girdle injuries, and 5% of all shoulder fractures. 1 The scapular body and spine are involved in approximately 50% of all the scapular fractures, with the remainder involving the glenoid cavity [approximately 10% (Goss 1 ) to 38% (Jaeger et al 2 )], the glenoid neck (approximately 25%), and fractures of the acromial and coracoid processes (approximately 7% each). 1 Diagnosis depends mainly on radiographic examinations of the shoulder. When the glenoid is involved, additional imaging by 3-dimensional computed tomography (3D-CT) scan is strongly recommended to accurately analyze the glenoid surface. Treatment modalities of scapular fractures depend on the fracture's location, pattern, and displacement on the one hand and the patient's age, demands, and comorbidity on the other. 1 In contrast to fractures of the scapular body, which are mostly treated conservatively, fractures involving the glenoid are more often in need for surgery. 2 This is because this type of scapula fracture can result in joint instability and implies a risk of posttraumatic arthrosis accompanied by pain and limited function. 2 Classification of scapular fractures can be useful for documentation and uniformity between series, and also for a systematic approach and management of these fractures. A number of scapular fracture classification systems are available. 1-7 A comprehensive scapula classification system has recently been developed as a collaborative effort between the AO Foundation and the Orthopaedic Trauma Association. 2 However, analyzing a combined trauma of a scapular fracture with a lesion of the superior shoulder suspensory complex (SSSC) becomes more difficult.In this technical note we describe our approach in 2 cases of combined scapular fractures. Diagnosis was obtained by performing CT scanning with 3-dimensional reconstructions. This surgical treatment consists of a new stepwise approach, effectively combining different surgical techniques. To obtain a stable result with optimal joint surface congruity, we use both minimal invasive and arthroscopic techniques for reduction and fixation of the gl...