Initial 30 cholecystectomy procedures performed with the Senhance digital laparoscopy system.

PURPOSE: The Senhance digital laparoscopy system (SDLS) is a novel platform developed for digitization in endoscopic surgery. This retrospective study aimed to evaluate the short-term outcome in the initial 30 consecutive patients. METHODS: SDLS cholecystectomies were performed in 30 consecutive patients (13 male, 17 female) by a single surgeon from September 2020 to March 2022. The patients' median age (range) was 77.5 (27-82) years, and median body mass index was 23.3 (19-38) kg/m2 . Four trocars were used, three of which were docked to manipulator arms of the SDLS. Surgical procedures performed with the SDLS were almost the same as those by conventional surgery. RESULTS: Median docking time, cockpit time, and operation time in minutes were 4 (3-13), 34 (13-81), and 69 (47-201), respectively. Operation time after the sixth case tended to shorten compared with that for the initial five cases. Three cases (10%) were converted to conventional laparoscopic surgery due to severe cholecystitis, but none required conversion to open surgery. Postoperative complications of Clavien-Dindo grade ≥II were not observed. CONCLUSION: This retrospective study showed that cholecystectomy using the SDLS appeared to be safe and feasible in limited cases without severe inflammation.

An extremely rare case of neuromuscular and vascular hamartoma of the appendix.

BACKGROUND: Neuromuscular and vascular hamartoma is a rare lesion of the small intestine, with only 26 cases reported since its initial description in 1982. No occurrence of hamartoma in the appendix has been reported until now. CASE PRESENTATION: A 60-year-old man had been suffering from longstanding right lower quadrant pain. Abdominal computed tomography showed a slight swelling of the appendix as the possible cause of his pain. Laparoscopic appendectomy with partial resection of the cecum was performed for diagnostic and therapeutic purposes. An 18 × 10-mm lesion located on the tip of the appendix was found in the resected specimen. Pathological examination showed that the lesion was covered with normal mucosa and consisted of adipose tissue, smooth muscle fibers, small vessels, and neural fibers. These findings were consistent with neuromuscular and vascular hamartoma of the appendix. CONCLUSION: This is the first report of neuromuscular and vascular hamartoma arising from the appendix.

[A case report of complete response to RPMI regimen for multiple lymph node metastases following rectal cancer surgery].

A 78-year old man underwent low anterior resection for Stage IIIb rectal cancer(Ra). After surgery, he underwent the Roswell Park Memorial Institute(RPMI)regimen for 6 months followed by oral UFT for 8 months. Since liver metastasis(S6)recurred 2 years and 2 months after surgery, he underwent S6 subsegmentectomy. Four years and 4 months later, he developed multiple lymph node metastases(the Virchow, paraaortic, and intrapelvic lymph nodes), for which FOLFIRI therapy was started, but converted to the RPMI regimen because of strong gastrointestinal side effects. After 3 courses of this regimen, tumor markers returned to normal, and imaging studies showed that the metastases had disappeared. This was interpreted as a complete response(CR). The patient has maintained the complete response for 1 year and 4 months since the start of the RPMI regimen.