[Abdominal surgery: what's new in 2023]. / Chirurgie viscérale: ce qui a changé en 2023.

In 2023, robotic surgery has witnessed an expansion in the number of surgical procedures and in the number of platforms on the market. We illustrate the phenomenon, by exploring parietal, œso-gastric and liver robotic surgery. Surgical innovation aligns with advancements in oncology. Immunotherapy now enables "watch and wait" strategies for patients with colorectal cancer, and decreases recurrence rate and improves survival after liver surgery for hepatocellular carcinoma and œso-gastric surgery. The multidisciplinary field of obesity management has seen the development of new medications, diversifying the treatment options, while surgery continues to deliver the best weight-loss outcomes.

En 2023, la chirurgie robotique a poursuivi son expansion avec une augmentation du nombre d'interventions et la mise sur le marché de nouvelles plateformes. Ce phénomène est illustré dans cet article par la description des chirurgies robotique pariétale, œsogastrique et hépatique. L'innovation en chirurgie accompagne aussi celle de l'oncologie. L'immunothérapie permet maintenant une stratégie « watch and wait ¼ chez les patients avec un cancer colorectal, diminue le risque de récidive et améliore la survie après chirurgie hépatique pour un carcinome hépatocellulaire et chirurgie œsogastrique. Le domaine multidisciplinaire de la prise en charge de l'obésité a aussi vu l'arrivée de nouveaux traitements médicamenteux, qui viennent diversifier les options thérapeutiques, où la chirurgie continue d'apporter les meilleurs résultats en termes de perte de poids.

Wandering Spleen Volvulus: A Case Report and Literature Review of This Diagnostic Challenge.

BACKGROUND Wandering spleen is a rare condition in which the spleen lacks the usual peritoneal attachments, resulting in increased intra-abdominal mobility. Complications can occur due to the torsion of the splenic vascular pedicle, resulting in symptoms ranging from an incidental finding to an acute abdomen as a result of an ischemic necrosis of the spleen. CASE REPORT We present the case of a 25-year-old female patient who presented with a recurring abdominal pain associated with serum lipase and C-reactive protein elevation. The computed tomography scan revealed torsion of the splenic pedicle and hypoperfusion of the spleen. A surgical exploration was performed and a wandering spleen was diagnosed perioperatively. It was characterized by the lack of peritoneal ligaments, thus resulting in a splenic volvulus. A splenectomy was carried out due to the definite ischemic necrosis of the spleen. CONCLUSIONS The diagnosis of this rare condition can be very challenging since it can be presented with a vast variety of symptoms, mimicking other abdominal pathologies. The intermittent nature of an ultimate splenic torsion can add to the diagnostic challenge. Medical literature concerning the wandering spleen and knowledge about this pathology originates mainly from individual case reports. Despite the evolving diagnostic modalities available, this rare and ambiguous disorder remains misdiagnosed, and a high index of suspicion is needed for the appropriate diagnosis to be established.