Supradentate Transmucosal Hemorrhoidopexy (Original Technical Variant).

Symptomatic hemorhoidal disease is a serious issue affecting the quality of life. The multiplicity of current interventional procedures reflects the failure of covering all pathological aspects, thus justifying the quest for other operative solutions. Any new operative procedure is challenged by the need for broad applicability and less invasive attributes and should fit inside the frame of reasonable costs, fair efficacy, low morbidity and recurrence rate based on a procedural technique that is simple enough, reproducible and easy-tolearn. Aiming to achieve these goals we conceived a procedural variant of hemohrhoidopexy fit for outpatient surgery, a technique that does not require sophisticated/costly medical equipment or disposables and is less invasive. The operative indication concerned 2nd, 3rd and 4th grade hemorrhoids. The surgical indication was represented by 2nd, 3rd and 4th grade hemorrhoids. The needed anesthesia is regional (caudal spinal anesthesia), which qualifies this procedure for private medical services. Prolapse reduction is followed by transmucosal suturing using two rows of slowly absorbable half-step staggered en-X stitches placed just above the dentate line. Preliminary results are encouraging both as therapeutic success rate and legerity of postoperative consequences. This hemorrhoidopexy is a simple and broadly applicable technique, causing mild pain, low morbidity and good efficacy, preferable to other techniques used to treat 3rd grade and selected 4th grade hemorrhoids.

Bilateral Axillary Accessory Breast Tissue Revealed by Pregnancy.

We illustrate a rare case of a 28 year-old woman with bilateral axillary masses, which were uncovered during her first pregnancy only and grew progresively in size ever since. On local examination, there were two 5/3/5 cm masses with benign clinical characteristics, developed apparently on the axillary extension of the mammary gland. During lactation, a milk-like liquid was evacuated through a brownish, rudimentary, nipple located in the center of each axillary masses. One year after parturition, the MRI showed bilateral axillary breast tissue appearance, separated from the eutopic mammary gland, but having similar signal intensity. Due to aesthetic reasons and the additional risk for subsequent malignant or benign breast disease, the ectopic breast tissues were completely surgically removed. The histology report showed normal glandular breast tissue.