Laparoscopic colon resection and intracorporeal hand-sewn anastomosis.

The application of laparoscopic surgical techniques to colonic surgery is restricted to selected cases and to rather few surgical centers. On the one hand, the disadvantages of the open approach involves the sizable laparotomy incision for mobilization of the viscera, especially if the colonic flexures are to be mobilized. On the other hand, in the minimally invasive approach the extent of dissection requires additional skills and a well honed endoscopic surgical team is needed especially if laparoscopic reconstruction of the large colon is to be accomplished. The teamwork is more critical for colon procedures than for laparoscopic gallbladder surgery.

[Microsurgical, neuroprotective plaque isolation in plastic penile induration]. / Mikrochirurgische, neuroprotektive Plaqueisolation bei Induratio penis plastica.

Conservative therapy of Peyronie's disease has not given very encouraging results. This means operative treatment strategies are the only effective therapy form that appears to be successful. Another treatment form, which often leads to a non-acceptable shorting of the penis, is the technique used in the Schröder-Essed and Nesbit procedures. Removal of the plaque, followed by a tissue transplant to cover the excision area, enables a correction of the deviation and maintenance of the original length of the penis. Because of the periodically described, possibly fatal results of postoperative perception disorders of the glans penis, preparation of the dorsal neurovascular bundle is performed under microsurgical conditions. Because of the certainty with which optical identification of nerves and vessels is achieved, it is possible to keep the nerves protected and to have atraumatic isolation of the plaque. After the first encouraging surgical results, we present the operative procedure under microsurgical conditions.