BACKGROUND Giant inguinoscrotal hernias are huge inguinal hernias that extend below the midpoint of the inner thigh in the standing posture.Giant inguinoscrotal hernias are rare in developed countries because of their...BACKGROUND Giant inguinoscrotal hernias are huge inguinal hernias that extend below the midpoint of the inner thigh in the standing posture.Giant inguinoscrotal hernias are rare in developed countries because of their better medical resources and early treatment.However,they can develop in patients who refuse surgery or ignore their condition.Intervention is inevitable because strangulation and organ perforation can occur,leading to peritonitis and sepsis.Common surgical approaches include open abdominal and inguinal approaches or a combination of both.CASE SUMMARY We present the case of a 73-year-old man who visited our emergency department with a huge mass in his left scrotum and septic complications.Abdominal computed tomography revealed a large left inguinoscrotal hernia that contained small bowel loops and the colon.Emergency surgical intervention was performed immediately because intestinal strangulation was highly suspected.The operative repair was performed using a combination of mini-exploratory laparotomy and the inguinal approach.The incarcerated organs,which included the ileum and sigmoid colon,had relatively good intestinal perfusion without perforation or ischemic changes.They were successfully reduced into the abdomen,and bowel resection was not necessary.A tension-free prosthetic mesh was used for the hernia repair.Two weeks after the initial surgery,and with adequate antimicrobial therapy,the patient recovered and was discharged from our hospital.No evidence of hernia relapse was noted during the outpatient follow-up examination 3 mo after surgery.CONCLUSION Emergency surgery involving combined mini-exploratory laparotomy and the inguinal approach should be performed for serious incarcerated giant inguinoscrotal hernias.展开更多
In this study titled"A comparison of visual discomfort experienced by surgeons in wireless versus conventional endoscopy in laparoscopic surgery",Xu et al.present a novel fifth-generation transmission wirele...In this study titled"A comparison of visual discomfort experienced by surgeons in wireless versus conventional endoscopy in laparoscopic surgery",Xu et al.present a novel fifth-generation transmission wireless endoscopic system.They evaluated the visual discomfort in a small cohort of single-institution surgeons(n=20)and compared its degree between conventional and wireless endoscopic laparoscopic surgeries(laparoscopic radical prostatectomy and laparoscopic radical cystectomy).Subjective questionnaires and objective physiologicalindicators were used to assess this outcome.They found no difference in visual discomfort between these technologies.展开更多
Urologists can prioritize patient care and enhance the quality of care delivery by adopting a patient-centered approach that accounts for the interplay between physical,mental,and social factors concerning pa-tient he...Urologists can prioritize patient care and enhance the quality of care delivery by adopting a patient-centered approach that accounts for the interplay between physical,mental,and social factors concerning pa-tient health outcomes.To enhance the ability to collect and analyze health-related quality of life(HRQoL)data,urologists should pri-oritize patient-reported outcomes as the primary measure of success while fostering a culture of multidisciplinary collaboration.Such data are essen-tial for understanding treatment efficacy and making informed decisions about interventions that could optimize quality improvement initiatives.By prioritizing HRQoL metrics and embracing multidisciplinary alliances to address different patient person dimensions(physical,psychologi-cal,social,and spiritual),urologists can make strides toward global standards of urological practice while delivering optimal patient care.展开更多
Iatrogenic ureteral injuries and strictures are relatively common complication of pelvic surgery and radiation treatment.Left untreated they are associated with severe shortand long-term complications such as urinoma,...Iatrogenic ureteral injuries and strictures are relatively common complication of pelvic surgery and radiation treatment.Left untreated they are associated with severe shortand long-term complications such as urinoma,septic state,renal failure,and loss of a renal unit.Treatment depends on timing of diagnosis,as well as extent of injury,and ranges from simple endoscopic management to complex surgical reconstruction under usage of pedicled grafts.While recent advances in ureteral tissue engineering are promising the topic is still underreported.Historically a domain of open surgery,laparoscopic and robotic-assisted approaches have proven their feasibility in small case series,and are increasingly being utilized as means of reconstructive surgery.This review aims to give an outline of incidence and treatment of ureteral injuries and strictures in light of the latest advances.展开更多
文摘BACKGROUND Giant inguinoscrotal hernias are huge inguinal hernias that extend below the midpoint of the inner thigh in the standing posture.Giant inguinoscrotal hernias are rare in developed countries because of their better medical resources and early treatment.However,they can develop in patients who refuse surgery or ignore their condition.Intervention is inevitable because strangulation and organ perforation can occur,leading to peritonitis and sepsis.Common surgical approaches include open abdominal and inguinal approaches or a combination of both.CASE SUMMARY We present the case of a 73-year-old man who visited our emergency department with a huge mass in his left scrotum and septic complications.Abdominal computed tomography revealed a large left inguinoscrotal hernia that contained small bowel loops and the colon.Emergency surgical intervention was performed immediately because intestinal strangulation was highly suspected.The operative repair was performed using a combination of mini-exploratory laparotomy and the inguinal approach.The incarcerated organs,which included the ileum and sigmoid colon,had relatively good intestinal perfusion without perforation or ischemic changes.They were successfully reduced into the abdomen,and bowel resection was not necessary.A tension-free prosthetic mesh was used for the hernia repair.Two weeks after the initial surgery,and with adequate antimicrobial therapy,the patient recovered and was discharged from our hospital.No evidence of hernia relapse was noted during the outpatient follow-up examination 3 mo after surgery.CONCLUSION Emergency surgery involving combined mini-exploratory laparotomy and the inguinal approach should be performed for serious incarcerated giant inguinoscrotal hernias.
基金funding from The Fulbright ProgramNational Institutes of Health“All of Us”Research program+1 种基金Amalia Lacroze de Fortabat FellowshipMonica Mourier de Archibald Endowment.
文摘In this study titled"A comparison of visual discomfort experienced by surgeons in wireless versus conventional endoscopy in laparoscopic surgery",Xu et al.present a novel fifth-generation transmission wireless endoscopic system.They evaluated the visual discomfort in a small cohort of single-institution surgeons(n=20)and compared its degree between conventional and wireless endoscopic laparoscopic surgeries(laparoscopic radical prostatectomy and laparoscopic radical cystectomy).Subjective questionnaires and objective physiologicalindicators were used to assess this outcome.They found no difference in visual discomfort between these technologies.
文摘Urologists can prioritize patient care and enhance the quality of care delivery by adopting a patient-centered approach that accounts for the interplay between physical,mental,and social factors concerning pa-tient health outcomes.To enhance the ability to collect and analyze health-related quality of life(HRQoL)data,urologists should pri-oritize patient-reported outcomes as the primary measure of success while fostering a culture of multidisciplinary collaboration.Such data are essen-tial for understanding treatment efficacy and making informed decisions about interventions that could optimize quality improvement initiatives.By prioritizing HRQoL metrics and embracing multidisciplinary alliances to address different patient person dimensions(physical,psychologi-cal,social,and spiritual),urologists can make strides toward global standards of urological practice while delivering optimal patient care.
文摘Iatrogenic ureteral injuries and strictures are relatively common complication of pelvic surgery and radiation treatment.Left untreated they are associated with severe shortand long-term complications such as urinoma,septic state,renal failure,and loss of a renal unit.Treatment depends on timing of diagnosis,as well as extent of injury,and ranges from simple endoscopic management to complex surgical reconstruction under usage of pedicled grafts.While recent advances in ureteral tissue engineering are promising the topic is still underreported.Historically a domain of open surgery,laparoscopic and robotic-assisted approaches have proven their feasibility in small case series,and are increasingly being utilized as means of reconstructive surgery.This review aims to give an outline of incidence and treatment of ureteral injuries and strictures in light of the latest advances.
