In vivo tissue engineering of musculoskeletal tissues.

Tissue engineering of musculoskeletal tissues often involves the in vitro manipulation and culture of progenitor cells, growth factors and biomaterial scaffolds. Though in vitro tissue engineering has greatly increased our understanding of cellular behavior and cell-material interactions, this methodology is often unable to recreate tissue with the hierarchical organization and vascularization found within native tissues. Accordingly, investigators have focused on alternative in vivo tissue engineering strategies, whereby the traditional triad (cells, growth factors, scaffolds) or a combination thereof are directly implanted at the damaged tissue site or within ectopic sites capable of supporting neo-tissue formation. In vivo tissue engineering may offer a preferential route for regeneration of musculoskeletal and other tissues with distinct advantages over in vitro methods based on the specific location of endogenous cultivation, recruitment of autologous cells, and patient-specific regenerated tissues.

Single-incision laparoscopic surgery for right hemicolectomy.

HYPOTHESIS: Single-incision laparoscopic surgery (SILS) allows surgeons to perform laparoscopic procedures through a single umbilical incision, minimizing surgical trauma. DESIGN: We describe herein our methods of SILS right hemicolectomy using a recent case as an example. SETTING: SILS appendectomy and cholecystectomy have been performed by our surgical team for longer than 1 year among more than 80 patients. Patient  SILS right hemicolectomy was performed in a 38-year-old woman with a history of B-cell lymphoma and ileocecal mass. INTERVENTIONS: The operation was performed using a SILS port and an extracorporeal stapled anastomosis. MAIN OUTCOME MEASURES: Length of stay and postoperative pain and complications. RESULTS: SILS right hemicolectomy took 175 minutes to perform. The patient was discharged on postoperative day 6; a chest infection after surgery had prolonged the length of stay. CONCLUSIONS: SILS is an attractive method to further minimize surgical trauma and can be applied in more complex cases, such as colectomy. Large trials are needed to determine the benefits of this new technique.