Regional air transportation of ovarian tissue for cryopreservation in a prepubertal female with cancer.

Ovarian tissue cryopreservation is the only fertility preservation (FP) option available to prepubescent females receiving gonadotoxic therapy, but it has limited availability. A 6-year-old female was diagnosed with high-risk rhabdomyosarcoma, and the planned treatment carried an 80% risk of ovarian failure. Her parents desired FP, but the nearest center was 500 miles away. The patient underwent oophorectomy at the cancer center with air transport of the tissue to the oncofertility center, where it was successfully cryopreserved. Formation of networks between full-service and limited oncofertility centers in a hub-and-spoke model would increase access to FP services, particularly in children.

Laparoscopic versus open inguinal hernia repair: Expeditionary Medical Facility Kuwait experience.

BACKGROUND: Inguinal hernia is a common surgical problem in the active duty population. The decision to perform a hernia repair in the traditional open manner versus a laparoscopic approach is somewhat controversial. Furthermore, the type of repair performed has not been analyzed in a systematic manner within an operational setting. METHODS: We retrospectively reviewed all inguinal hernia repairs performed at Expeditionary Medical Facility Kuwait (EMFK) over an 18-month period, from April 2007 through October 2008. Operative times and time to return to duty were compared between active duty personnel undergoing open mesh repair and laparoscopic extraperitoneal inguinal hernia repair. RESULTS: One hundred seventy-six consecutive patients who underwent inguinal hernia repair by six different surgeons were analyzed. One hundred and four patients had an open repair and 72 patients underwent laparoscopic repair. The mean operative time was significantly longer in the laparoscopic group (20.2 minutes, p < 0.001). The mean time to return to duty was significantly shorter in the laparoscopic group (2.3 days, p = 0.008). CONCLUSIONS: Laparoscopic inguinal hernia repair is associated with longer operative times but shorter recovery periods. The laparoscopic approach may be a viable option for patients in the expeditionary setting.