Operative treatment of athletic pubalgia in competitive athletes: a retrospective study.

BACKGROUND: Athletic pubalgia is an obscure sport injury, presenting mainly with groin pain during twisting movements. The present 15 year study reports outcomes, intraoperative findings and complications of the endoscopic surgical treatment in competitive athletes. METHODS: All competitive athletes, from 2004 to 2018, suffering from athletic pubalgia, treated with laparoscopic Total Extra-Peritoneal technique, at the Department of General, Laparoscopic, Oncologic and Robotic Surgery of the Athens Medical Center were included in this retrospective cohort. Postoperative pain, complications, return to previous training routine and patients' satisfaction were evaluated. RESULTS: A total of 130 patients (115; 88.5% males and 15; 11.5% females) with a mean age of 26.7±7.5 years were evaluated. Preoperatively, mean numeric scale pain was found to be 7.7±1.7. Three days postoperatively, the mean numeric pain scale was 3.4±1.5, showing 55.8% decrease. The mean time for return to sports activity was found to be 6.27±3.02 weeks. Regarding complications, six patients (4.6%) had slight numbness at the groin area during the first 6 postoperative months and one patient (0.8%) suffered from a postoperative hematoma. No recurrence was observed. At the final follow-up (mean 76.58±46.5 months), a total of 97 (74.7%) patients were very satisfied, 31 (23.8%) satisfied and two (1.5%) not satisfied with the outcome. CONCLUSIONS: Laparoscopic operative treatment in competitive athletes suffering from athletic pubalgia seems to offer rapid recovery, rapid return to sports, as well as very low complications rate and no recurrence.

Robotic resection of a giant retroperitoneal leiomyosarcoma: A case report.

The management of abdominal leiomyosarcoma is challenging. Surgical excision is considered the only effective treatment; however, this is associated with considerable morbidity. Robotic surgery has emerged during the past decades and has enhanced the general surgery armamentarium, allowing surgeons to carry out demanding operations in a safe manner. The surgical resection of retroperitoneal leiomyosarcoma (RPLM) can be associated with significant morbidity, which is primarily due to the origin or the close proximity of the tumor with important vascular structures, including the inferior vena cava and tributaries, the duodenum and the ureter. The present case describes the first case of robotic resection of RPLM in a high-volume robotic center. In the present case, a large RPLM was safely removed with respect to oncological principles with the use of the Da Vinci platform.

Robot-Assisted Removal of a Broken Scalpel Blade following Discectomy.

The risk of a broken scalpel blade during discectomy is considered extremely rare, while no guidelines exist regarding this complication. We report a case of a robotic broken blade removal following lumbar discectomy. A 52-year-old female was subjected to L4-L5 discectomy. During the annulus resection, the scalpel blade broke and was retained within the disc space. The broken blade migrated towards the abdominal cavity and viscera. Emergency CT angiography scan revealed that the main vessels were intact, while the broken surgical knife was located anterior to the lumbar spine at the L4/L5 level, to the left of the aorta and superiorly of the left common iliac artery. At that point, robot-assisted laparoscopy was performed. The broken instrument was located and carefully removed. It seems more proper that such foreign bodies should be removed, while robotic surgery may play a significant role in cases that the foreign body is near major vessels.