Anatomical Bases for Aesthetic Costal Surgery: Assessing the Thoracoabdominal Limits.

Background: Knowing the anatomy of the ribs is crucial for understanding various rib procedures. The present study is aimed at describing radiological measurements and ratios of 83 Latin American patients undergoing thoracoabdominal computed tomography (CT). Methods: A total of 83 thoracoabdominal computed tomography scans of women aged 18-35 conducted at a medical center in Lima, Peru, were reviewed from January 2022 to January 2023. The resulting measurements and ratios were used to calculate frequency distributions. All data were stored in a Microsoft Excel database and analyzed using statistical analysis software SPSS version 28. Results: Ratios and measures of the tenth, eleventh, and twelfth ribs are shown in the different tables, and costal characteristics with an adequate statistical significance are defined. Conclusions: Using radiological measurements and rib ratios, we were able to find key anatomical relationships with an adequate level of significance, which could help establish objective results in rib procedures.

Forgotten double-J stent: Experience of a tertiary care center.

INTRODUCTION: We share our experience of managing 15 cases of forgotten double-J (DJ) stent in our tertiary care center. METHODS: This is a retrospective analysis of cases with forgotten DJ stent for a period of 2 years spanning from January 2017 to January 2019. The details included sex, age, literacy, socioeconomic status, stenting indication, duration of indwelling stent, presenting complaints, type of encrustations, various treatments given, intraoperative complications, and their management and eventual outcome. RESULTS: The male-to-female ratio was 2:1, and the mean age was 39.5 years (17-65). The mean indwelling time was 31.7 months. The majority of patients had an education score of 1 out of 7 and belonged to lower socioeconomic class according to the modified Kuppuswamy scale. The most common presentation was irritative voiding symptom. The complicated and heavily encrusted stents were managed by combination of endourological procedures, and procedures were staged whenever deemed necessary. Majority of the stents were removed with simple retrograde cystoscopic removal. There was no mortality in our study. CONCLUSIONS: A forgotten DJ stent affects population having low education score and belonging to the lower end of the socioeconomic class. Endourological procedures are quite successful in managing a forgotten DJ stent, provided the treatment options are selected judiciously and meticulously. We also suggest some protocols to be followed in our study in order to prevent a forgotten DJ stent.

Aesthetic subunits of the trunk: Anatomy and behavior of skin and adipose tissue in each unit for better outcomes in liposuction.

BACKGROUND: Liposuction and abdominal contouring is one of the most common procedures performed by plastic surgeons worldwide. Surprisingly, there has been few attempts at dividing the abdomen into subunits to delineate and aid in this endeavour. We have evolved a system of abdominal aesthetic subunits which has enabled us to achieve high quality results. MATERIALS AND METHODS: A system of 8 subunits of the abdomen was evolved after analysing 1000 cases: Upper midline, upper rectus, lower rectus, pubic, Lateral abdomen, Lumbar Posterior midline and Bra Roll. RESULTS: The system was used in 2000 cases with good results. The system enabled the performance of tailored liposuction in each area, with greater accuracy, better results and fewer complications. CONCLUSION: Our success with this classification validates its use, and makes liposuction more scientific and effective.

Laparoscopic heminephrectomy in horseshoe kidneys: A single center experience.

INTRODUCTION: Laparoscopic approach in horseshoe kidney (HSK) is a challenge because of the aberrant vessels, the renal isthmus and the renal ectopia are all unique features of this anomaly encountered during the surgery. We report our single center experience with this technique in managing three patients with HSK. METHODS: A total of 15 cases (9 males and 6 females) were operated between June 2011 and December 2016 for various indications. Of these four patients were managed laparoscopically, two patients with HSK had non-functioning renal moiety underwent transperitoneal heminephrectomy. The third patient with a mass in right moiety with thin fibrous isthmus was successfully managed with laparoscopic heminephrectomy. Fourth patient with pelvi-ureteric junction obstruction with multiple renal calculi was managed with pyeloplasty and complete clearance of all calyceal the stones. RESULT: Mean operating time was 140 ± 1.8 (100-180) min, and estimated blood loss was 131 ± 12.6 (30-320) ml. The mean hospital stay was 2.3 ± 1.4 (1-5) days. There were no major intra- and post-operative complications except minimal postoperative discomfort. CONCLUSION: Laparoscopic nephrectomy is technically feasible, safe, and reliable for benign and malignant diseases in a HK with mainly three factors posing challenges during the surgery are the abnormal vasculature, division of the isthmus, and lower location of the kidney.

Spectrum of features in pterygium syndrome.

Pterygium syndrome is a complex and rare congenital deformity that consists of contractures involving multiple flexural surfaces and associated craniofacial anomalies. It often has associated conditions, including anomalies of the cardiovascular, respiratory, gastrointestinal and genitourinary systems. It may present in different forms, including multiple pterygium syndrome of Escobar, lethal multiple pterygium syndrome, popliteal pterygium syndrome, lethal popliteal syndrome (Bartsocas-Papas syndrome) and arthrogryposis multiplex congenita. The clinical presentation, multidisciplinary management and the long-term outcome in three patients with this condition are presented.