Cystoscopic stent removal using a guidewire loop.

Stent removal is a simple procedure performed with a rigid cystoscope and a stent removal forceps. In the rare event when the stent removal forceps does not work or breaks down, a guidewire loop can be used to remove the stent.

Hydrocele with a surprise: Malignant mesothelioma of the tunica vaginalis - Case report and review of literature.

Hydrocele is a very common condition that is simple to evaluate and treat. Management of hydrocele is usually delegated to the junior members of the surgical team. Sometimes this simple condition can spring huge surprises. A 20-year-old man presented with acute onset large, painless fluctuant left hemi-scrotal swelling. Scrotal ultrasonography showed thickened tunica vaginalis. A diagnosis of left hydrocele was made and repair by excision of sac was planned. During the procedure, the sac was found studded with red nodular growths; histopathology reported malignant mesothelioma of tunica vaginalis. Metastatic evaluation showed extensive retroperitoneal lymph nodal involvement. Despite receiving adjuvant chemotherapy with radiotherapy patient died due to extensive metastasis within 16 months. This case is presented for rarity of diagnosis, young age of presentation, absence of etiological factor and rapidly progressive clinical course.

A double J stent misplaced in the inferior vena cava during Boari flap repair.

A 30-year-old lady underwent a Boari flap repair for post-hysterectomy mid-ureteric stricture. The upper end of the double J stent inserted during the procedure was misplaced in the supra-renal inferior venal cava. Cystoscopic stent removal could be performed uneventfully, while the stricture was managed by endoureterotomy.

Laparoscopy-assisted continuous ambulatory peritoneal dialysis catheter placement using Amplatz dilators: a new technique with results.

OBJECTIVE: To describe a new modified technique of laparoscopic placement of continuous ambulatory peritoneal dialysis (CAPD) catheters and assess the early results. METHODS: CAPD catheter implantation was performed in 100 consecutive patients. The technique used laparoscopically guided, extraperitoneal tunneling of the CAPD catheter using Amplatz dilators. The extraperitoneal tunneling helped to maintain the catheter's orientation toward the deep pelvis. Omentopexy was performed on patients with long omentum. Wherever indicated, adhesiolysis was performed to eliminate compartmentalization that could affect the completeness of dialyzate drainage. The average duration of surgery, hospital stay, morbidity, mortality, and catheter survival were assessed. RESULTS: The average operative time was 40 ± 7 minutes, and hospital stay was 3 ± 1 days. There were no conversions from laparoscopy to conventional catheter insertion methods. Exit site or tunnel infections, hemorrhagic complications, abdominal wall hernias, or catheter cuff extrusions were not detected. No patient had either catheter migration or displacement. Peroperative mortality did not occur in this series of patients. Catheter survival was 97% at 6 months. CONCLUSION: The laparoscopic method described in this report is compliant with consensus guidelines for the best demonstrated practices in peritoneal access placement. Laparoscopy permits direct visualization of all procedure steps in a safe, efficient, and reproducible manner. The use of Amplatz dilators helps in better orientation of the catheter reducing the risk of catheter tip migration.