Laparoscopic gastric sleeve (LGS) resection in super-obese patients (BMI > 50 kg/m
) is a challenging procedure. We have developed a unique approach and technique for LGS with no buttress stapling ...and without oversewing. After 102 operations there have been no leaks and late complications.
The bilayer patch device (Ethicon, Prolen Hernia System®) for inguinal hernia
repair has a connector that acts as a ‚plug‘ in the internal inguinal ring. The position of this ‚plug‘ component
may be ...responsible for higher incidence of chronic pain and intestinal damage. We assumed
that changing the position of the connector of a bilayer patch device (PHS®) and placing it medially
in Hesselbach triangle would contribute to lower incidence of chronic pain and would not result in
intestinal damage, with good clinical outcome following indirect inguinal hernioplasty. This retrospective
study included 73 patients with 76 indirect inguinal hernias, who underwent the procedure of
modifying the position of the bilayer patch device in the 2005-2015 period. The mean age of the patients
was 57 years. Three patients had early postoperative complications (3.95%), two of which had
postoperative seroma and one had postoperative pain. Three patients (3.95%) had late postoperative
complications. One patient (1.32%) had chronic pain. There was one recurrence (1.32%) and one patient
(1.32%) needed the mesh removed due to discomfort. The ‘plug free’ position of the connector of
a bilayer patch device in patients with indirect inguinal hernioplasty is a safe procedure with low rate
of chronic pain, no intestinal damage, and standard low recurrence.
Hepatocellular carcinoma (HCC) is the most frequent type of liver malignancy. As a carcinogen,
aflatoxin B1 (AFB1) causes HCC by inducing deoxyribonucleic acid adducts that lead to genetic
changes in ...liver cells and may be the cause of HCC in up to 30% of cases. The incidence of HCC has been
on the rise and is an issue in the countries of the Western Balkans.
This paper presents a case of a 37-year-old woman who was diagnosed with HCC, without
hepatitis B, hepatitis C, or liver cirrhosis. The patient consumed milk and dairy products in quantities of
over two liters per day over the course of 20 years, which indicates the impact of aflatoxin in milk on
HCC. A positive signal for the presence of AFB1 was detected by ELISA (enzyme-linked immunosorbent
assay) in-house using immunoperoxidase screening test.
As carcinogenic difuranocoumarin derivative, aflatoxin B1 is the most likely cause of malignant
transformation of hepatocytes, which resulted in hepatocellular carcinoma in this patient.
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