A case report of the first laparoscopic radical nephrectomy done at the Clinic of Urology, Clinical Centre of Serbia.

Laparoscopic interventions are at the very beginning of its evolution in the Clinic of Urology. The first steps have been made primarily to cope with problem of varicocele. We continued to gain laparoscopic experience by switching to solving some demanding intervention, primarily kidney cyst. The only logical next step lead to laparoscopic renal surgery. So, after a few successful primary simple nephrectomy, the next step was to perform a laparoscopic radical nephrectomy. Today, at the Clinic of Urology, Clinical Center of Serbia we successfully perform much more demanding interventions, such as extraperitoneal laparoscopic radical prostatectomy. In this paper we present our experience with the first laparoscopic radical nephrectomy, which was done at the Clinic of Urology, Clinical Center of Serbia.

Diagnostic and therapeutic protocol in the treatment of hypo functional kidney.

Laparoscopic nephrectomy is indicated in the treatment of many benign conditions of the kidneys. Hydronephrosis caused by obstruction of the ureter, either internal, or external, is one of the main indications for laparoscopic reconstruction. If an obstruction is prolonged, consequently, it leads to chronic inflammatory process accompanied by persistent and recurrent pain with fever, which eventually become resistant to therapy. If not operated sufficiently fast to resolve the causes, as a consequence it leads to hypofunction and ultimately afunction of affected kidney. In such a situation, the only therapeutic option is surgical treatment. By analyzing the case, we will try to illustrate the diagnostic algorithm and therapeutic treatment modality.

Pyramidal lobe of the human thyroid gland: an anatomical study with clinical implications.

The presence, position, extent, relationships to neighboring structures and size of the human pyramidal lobe were investigated in 58 human post-mortem specimens in order to determine the variability of this structure. The pyramidal lobe is found in 55.2% of cases as a single conical extension of the thyroid gland. It was present more often in male (53.1%) than in female (46.9%) specimens and located slightly more often on the left side of the midsagittal plane (53.1%). According to the origin and location of its base, we defined five types of pyramidal lobe, with the left-sided types (Types III and IV) being predominant. The pyramidal lobe was 22.6 mm long, 11.2 mm wide and 3.6 mm thick (mean values). The means of all measured parameters were higher in female than in male specimens (pyramidal lobe was 2.3 mm longer, 1.6 mm wider and 0.4 mm thicker in female specimens) but these differences were not significant. In addition, we found that the size of the pyramidal lobe was dependent on the presence of a fibrous or muscular band that may represent a fibrous remnant of the thyroglossal duct or the levator glandulae thyroideae muscle. The pyramidal lobe was four times longer and its base was two and a half times wider and three times thicker when it was associated with this band. We believe that our data can be used to perform safer and more effective partial thyroidectomy in order to preserve thyroid function after surgical treatment.

Unilateral fibrous contracture in augmentation mammoplasty.

Of 77 augmentation mammoplasties performed using the inframammary approach from 1977 to 1982, only 4 patients (5.1%) developed spherical fibrous capsular contracture (SFCC). In each case, contracture was unilateral. Although the etiology of SFCC is unclear, in these 4 patients casual factors include mammary aplasia (which necessitated inserting too large an implant into too small a space) hematoma formation and evacuation, inevitable violation of the fascia to treat mastopathia, and inability to move the implant after secondary insertion.

Complications after silicone injection therapy in aesthetic plastic surgery.

Silicone injection therapy plays a significant, but limited, role in soft tissue augmentation. It is confined only to a tissue defect, folds, and deep wrinkles of the face. It is important to use only a small amount of injectable silicone (1-2 ml) in one area of the face at a time. Massage is applied over the injected area for 5-6 minutes. The following side effects and complications are observed: diminished volume, descending of silicone fluid due to the gravity, and silicone granuloma formation. Liquid silicone should be available, for the time being, only to surgeons for experimental purposes, because of the danger of complications and abuse. In this experimental study, the author applied 1,677 silicone injections (only in the face).