Laparoscopic techniques have evolved from predominantly diagnostic to extensive operative procedures. Surgical techniques traditionally performed in an open fashion are being conducted laparoscopically with increasing frequency. With these developments, the indications for laparoscopic suturing have increased accordingly. Caution is required to avoid breaking or losing a needle during extracorporeal suturing. We describe the breakage and subsequent recovery of 1.5 mm segments of surgical needles during a laparoscopic myomectomy and a total laparoscopic hysterectomy. Most current research has focused on preventative and detection strategies for lost needles; however, there are no known methods of completely preventing occurrences of these unforeseen events. In this paper, we discuss a literature review of needles lost during laparoscopic surgery.

Renal pelvis rupture during pregnancy is rare. Although the most common cause is urolithiasis, no cases of pregnant women with ureterorenal stones have been reported. We report on a 33-year-old pregnant woman with renal pelvis rupture and a stone at the ureteropelvic junction with an abrupt onset of severe flank pain at 37 weeks' gestation. Transabdominal ultrasonography revealed bilateral hydroureters with right predominance and an anechoic space around the right kidney. Computed tomography (CT) revealed a renal stone at the ureteropelvic junction of the right kidney, a low-density area around the kidney on the same side, and bilateral hydronephrosis, which led to the diagnosis of pelvis rupture, urolithiasis, and perirenal urinary extravasation of the right kidney. Although there are potential adverse effects from radiation on fetuses and neonates, CT can be a useful diagnostic modality especially in such cases of acute abdominal pain from non-obstetric causes during pregnancy.

Duplication cysts of the alimentary tract are uncommon congenital lesions that can occur anywhere along the path between the oral cavity and the anus, with a reported incidence of 1 in 20,000. Treatment is dependent upon the patient' s age, whether the lesion is cystic, tubular, or in communication with the true intestinal lumen, and whether one or more anatomic locations are involved. Duplication cysts are diagnosed most frequently in children younger than 2 years. In

Purpose: This study aimed to investigate the use of colostomies to alleviate gastrointestinal symptoms in patients with end-stage gynecologic cancer presenting with malignant bowel obstruction (MBO). Material and Methods: We retrospectively investigated 12 patients undergoing palliative colostomy for MBO due to end-stage gynecological cancer. Two main areas were assessed: i. postoperative complications, the duration of postoperative oral intake, and the postoperative survival; and ii. The effect of the patient's preoperative general condition and nutritional status on postoperative vital prognosis using the palliative prognostic (PaP) score and the prognostic nutritional index (PNI), respectively. Results: Postoperative oral intake was possible for 10 of the 12 patients. The median length of oral intake was 42 (6-150) days and the median duration of postoperative survival after colostomy was 54.5 (14-217) days. All patients died due to disease progression. For the 8 patients in the group with PaP scores under 5.5, the median durations of postoperative oral intake and postoperative survival were 58 and 85.5 days, respectively. For the 4 patients in the group with PaP scores of ≥ 5.5, the corresponding values were 3 and 25.5 days, respectively. For the 10 patients in the group with PNI of <40, the median durations of postoperative oral intake and postoperative survival were 38.5 and 51.5 days, respectively. For the 2 patients in the group with PNI of ≥ 40, the corresponding values were 88 and 183.5 days, respectively. Conclusion: Colostomy performed on patients for MBO due to end-stage gynecological cancer contributed to improved quality of life. The data suggests that the PaP score and PNI may facilitate the prediction of postoperative outcomes.