Evaluation of the Appropriate LigaSure™ Device to Transect the Appendix-A Comparison between 5 mm and 10 mm Laparoscopic Devices in an Ex Vivo Trial.

Background and Objectives: A topic of greatinterest in the surgical field comprises cost and time reduction operative techniques with high efficiency rates. Thus, the aim of this paper is to evaluate whether a transection of the appendix using only a laparoscopic LigaSure™ device is feasible and, if so, which size of the laparoscopic device is optimal. Materials and Methods: Appendectomy specimens were sealed and cut using LigaSureTM V (5 mm) and LigaSure AtlasTM (10 mm) devices ex vivo. Analysis criteria included handling, resistance to bursting pressure of the appendicular stump (adequacy), eligibility, durability and airtightness. Results: Twenty sealed areas were measured. While the 5 mm instrument was not able to transect the appendix in one attempt in any of the cases, the 10 mm device could be applied successfully without any handling difficulties. The adequacy of the sealed area was rated as complete and dry in all 10 cases using the 10 mm device and as oozing in 8 of the cases using the 5 mm device. There was no leakage in terms of air and liquid tightness using the 10 mm device, in contrast to six sealed segments with air and liquid leakage when using the 5 mm device. The resistance to bursting pressure was on average 285 mmHg and 60.5 mmHg with the 10 mm and 5 mm devices, respectively. The durability and eligibility of the 10 mm device were rated as very sufficient in 9 of 10 cases (1 perforation) in contrast to the 5 mm device, where the sealing in 9 of 10 cases was not sufficient (9 perforations). Conclusions: Using the 10 mm laparoscopic LigaSure™ device for the transection of the appendix seems to be feasible, safe and resistant to 300 mmHg bursting pressure. The 5 mm LigaSure™ instrument is inadequate to seal the appendix in humans.

Comparative Spectrographic Analysis of the Newborns' Cry in the Presence of Tight Intrapartum Nuchal Cord vs. Normal using the Neonat App. Preliminary Results.

Background and objectives: The objective of this study was to contribute to the evaluation of the newborn (NB) cry as a means of communication and diagnosis. Materials and Methods: The study implied the recording of the spontaneous cry of 101 NBs with no intrapartum events (control sample), and of 72 NBs with nuchal cord (study sample) from the "Bega" University Clinic of Obstetrics-Gynecology and Neonatology of Timisoara, Romania. The sound analysis was based upon: Imagistic highlighting methods, descriptive statistics, and data mining techniques. Results: The differences between the cry of NBs with no intrapartum events and that of NBs affected by nuchal cord are statistically significant regarding the volume unit meter (VUM) (p = 0.0021) and the peak point meter (PPM) (p = 0.041). Conclusions: While clinically there are no differences between the two groups, the cry recorded from the study group (nuchal cord group) shows distinctive characteristics compared to the cry recorded from the control group (eventless intrapartum NBs group).

Mesenchymal hamartoma of the left liver lobe in an 18-month-old female patient.

Mesenchymal hamartoma of the liver (MHL) is a benign and rare hepatic lesion, with an uncertain etiology and a potential for developing into an undifferentiated distant embryonal sarcoma after an incomplete resection. It mainly presents as progressive abdominal distension with normal blood works. Most cases are diagnosed in the first two years of life, with a higher frequency in boys and on the right liver. We report the case of a mesenchymal hamartoma of the left liver in an 18-month-old girl, with a rough evolution and a literature review. There were performed an abdominal computed tomography (CT) scan and resection of the lesion. The macroscopic and histological examination described a 16.5×17.9×10.5 cm multicystic mass as a MHL lesion. MHLs may have a malignant potential and in the clinical presence of a "neoplastic" syndrome there requires a good diagnosis and drastic surgical treatment.