Laparoscopic-assisted Hartmann's reversal with the Dexterity Pneumo Sleeve.

Several laparoscopic techniques of Hartmann reversal have been published. An alternative laparoscopic-assisted procedure, essentially aseptic, which uses the minilaparotomy for colostomy mobilization to apply the Dexterity Pneumo Sleeve device is described. This technique combines the advantages of the minimally-invasive approach with the direct access of the surgeon's hand to the patient's abdomen.

[Problems inherent in the diagnosis and treatment of common bile duct calculi during video-laparoscopic cholecystectomy. Report on 700 cases, February 1991 to December 1997]. / Problematiche inerenti alla diagnosi e al trattamento della calcolosi della via biliare principale in corso di videolaparocolecistectomia. Revisione di un'esperienza di 700 casi dal febbraio 1991 al dicembre 1997.

Conditions of predictivity seem to make treatment of common bile duct (CBD) stones during VLC more safe and adequate. IV cholangiography (or, nowadays, MRI and echoendoscopy) drive to a selective use of ERCP and cholangiography, help to reduce the incidence of residual lithiasis and give a "topographical map" of the CBD that can be useful, during VLC, in the search of the hilum structures, especially when the anatomical situation is not clear.