Assuntos
Cálculos Biliares/complicações , Derivação Gástrica/efeitos adversos , Obstrução da Saída Gástrica/etiologia , Obesidade/cirurgia , Complicações Pós-Operatórias/etiologia , Anastomose em-Y de Roux/efeitos adversos , Feminino , Obstrução da Saída Gástrica/diagnóstico , Obstrução da Saída Gástrica/cirurgia , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgiaRESUMO
Laparoscopic Loop colostomy has been described in the literature as a safe and useful minimally invasive technique. It is indicated in patients with large perineal wounds requiring fecal diversion, obstructing lesions of the distal colon or rectum. The purpose of this article is to describe a modified version of this procedure which was used by 1 surgeon in our institution on a series of 5 patients. In this method, an esophageal retractor and Penrose drain are used to tent up and exteriorize the desired segment of colon to be used for the colostomy site. Results were that all 5 were completed laparoscopically and there were no complications. In conclusion, this variation in the technique has been useful in our institution and others may find it worthwhile to consider.
Assuntos
Doenças do Colo/cirurgia , Colostomia/métodos , Laparoscopia/métodos , Adulto , Colostomia/instrumentação , Drenagem/instrumentação , Humanos , Laparoscopia/instrumentação , Pessoa de Meia-Idade , Instrumentos CirúrgicosRESUMO
BACKGROUND: Hibernoma is a rare benign tumor arising from remnants of fetal brown adipose tissue. This tumor was first described by Merkel in 1906. The brown fat is a specialized form of fat found in the hibernating and nonhibernating animals such as rats, cats, monkeys, rabbits, and humans. CASE PRESENTATION: A 27-year-old man presented with a painless, enlarging, anterior abdominal wall mass, which, upon core-needle biopsy, was found to be hibernoma. This was evaluated with abdominal computed tomography, which showed a heterogeneous mass that contained fat. At operation, the entire mass measuring 30x25x6 cm lying below the external oblique muscle was excised with a cuff of normal tissue. CONCLUSION: Hibernoma is a rare, slow-growing benign soft tissue tumor composed of brown fat that is successfully treated by complete excision while preserving all related vital structures. Unlike lipoma, hibernoma is well vascularized and therefore good hemostasis must be achieved at surgery to prevent postoperative bleeding or hematoma. No case of recurrence has been previously reported.
