Transumbilical single-incision laparoscopically assisted ventriculoperitoneal shunting: a minimal invasive technique.

OBJECTIVE: Hydrocephalus is not rare in the child. Ventriculoperitoneal shunt (VPS) is still the gold standard in treating non-obstructive hydrocephalus in children. Several approaches have been described and in modern surgery, in which lesser invasive techniques are predominant. This study aims at presenting a minimally invasive technique for the placement of the abdominal part of the catheter. METHODS: We describe a minimally invasive approach for the placement of the abdominal part of the catheter using a single-incision laparoscopic technique (SILS). Furthermore, considerations about complications, follow-up, and advantages and disadvantages of the above mentioned technique will be discussed. RESULT: These surgeries were performed successfully without any conversion. The operation time was 60 min, and the abdominal procedure was 11 min. The patient had the oral fluid intake 12 h later with the average hospitalization of 3 days after the surgery. During a 2-month follow-up, favorable cosmetic results were obtained with no relevant complications occurred. CONCLUSION: Single-incision laparoscopically assisted VPS is feasible and safe in the treatment of hydrocephalus with less invasive and better cosmetic results from the preliminary experience.

Laminarin enhances the activity of natural killer cells in immunosuppressed mice.

The aim of the study was to investigate the effects of laminarin on natural killer (NK) cell cytotoxicity of immunosuppressive mice and its mechanism. Cyclophosphamide (cy) was used to make an immunosuppressive model of mice. The mice of two groups were given interventions by gavage with laminarin 500 mg/kg and 1000 mg/kg every day for 10 days. MACS was adopted to isolate spleen NK cells, and cytotoxicity of NK cells and IL-12, IFN-γ level in serum were detected in vivo. Cytotoxicity of NK92-MI cells, activating receptors (NKp30, NKp44, NKp46 and NKG2D) and perforin and granzyme B expression were detected in vitro. Compared to the normal control group, the cytotoxicity of NK cells, IL-12 and IFN-γ level in serum in the cy model group were all reduced significantly (p < 0.01). Compared to the cy model group, laminarin increased the cytotoxicity of NK cells, IL-12 and IFN-γ levels in serum significantly (p < 0.05). In vitro, laminarin increased the cytotoxicity, NKp30 and NKG2D, perforin and granzyme B expressions of NK92-MI cells (p < 0.01). This research showed that laminarin can promote NK cell cytotoxicity in immunosuppressive mice by increasing the levels of IL-12 and IFN-γ in serum and expressions of NKp30 and NKG2D, perforin and granzyme B.

Transumbilical single-incision laparoscopic-assisted technique for removal of ileocecal foreign body.

The aim of this paper is to present the case of a 40-year-old man who accidentally ingested a piece of metal. The patient complained of having intermittent right lower quadrant abdominal pain for 2 days. An abdominal X-ray was performed, and a piece of metal was found in the right lower quadrant of the abdomen. There was no gas in the abdominal cavity. Surgical treatment was therefore needed. Single-incision laparoscopic surgery (SILS) was attempted with conventional laparoscopic instruments. The foreign body was identified around the ileocecal region, an enterostomy was made and the foreign body was successfully removed. Subsequently, the incised ileocecal was wall sutured. The time for this surgery was 1 h with little bleeding. The patient made a quick recovery with a good cosmetic outcome. Based on this case, the use of SILS-assisted technique in the removal of an ileocecal foreign body proves to be safe and feasible.

Single-incision laparoscopic-assisted ileal resection for adult intussusception.

Adult intussusception is rare and laparotomy is required in most of the cases due to the potential pathologic underlying reasons. Although it is technically challenging, single-incision laparoscopic surgery can work as an alternative to laparotomy. Here we report the case of a 45-year-old man with intermittent right lower quadrant abdominal pain for 1 month. Abdominal enhanced computed tomography (CT) scan was performed and ileo-ileal intussusception was found, with lipoma as a likely leading point. Ileal resection was performed using the single-incision laparoscopic-assisted technique. Multiple trocars in the umbilical incision technique and conventional instruments were used. After identification of the ileo-ileal intussusception, the involved small bowel was extracted from the umbilical incision, and resection and anastomosis were performed extracoporeally. The operation time was 65 min and the post-operative hospital stay was 2 days. The patient recovered uneventfully, with better cosmetic results.