Laparoendoscopic single-site surgery, minilaparoscopy and natural orifice transluminal endoscopic surgery in urology.

This article reviews the development of laparo-endoscopic single-site surgery (LESS), minilaparoscopy (MiniLap), and natural orifice transluminal endoscopic surgery (NOTES) with a particular focus on the applications in urologic surgery. We also provide the reader with a focused summary of the relevant nomenclature, history, and comparative outcomes. A literature search was conducted on LESS, MiniLap, needlescopy, microlaparoscopy and NOTES procedures in urology which is current through January 2013. The most relevant contemporary publications were selected and the pertinent findings were reviewed. Over the last few decades, we note that many innovative surgeons have performed a myriad of urologic procedures using LESS, MiniLap and NOTES techniques. These techniques are beginning to garner interest throughout the world; however, the enthusiasm for said techniques, while high, has not yet been met with high level scientific data clearly demonstrating the advantages of these approaches over conventional laparoscopy. In this review, we outline the history and clinical implementation of these techniques while also reviewing the comparative data where it exists. We attempt to provide the reader with a balanced overview of these techniques, their origins and lay the groundwork for future research and development.

Xylometazoline hydrochloride 0.1 per cent versus physiological saline in nasal surgical aftercare: a randomised, single-blinded, comparative clinical trial.

OBJECTIVES: A variety of topical preparations are used for symptomatic relief following nasal surgery. The aim of this study was to compare the effect of two commonly used products on patient symptom scores following nasal surgery. DESIGN: Randomised, single-blinded, comparative clinical trial. SETTING: A single, secondary otorhinolaryngology centre. PARTICIPANTS: One hundred and twenty patients undergoing septoplasty or functional endoscopic sinus surgery as an isolated procedure between November 2003 and January 2006. Patients undergoing additional nasal procedures were excluded, as were those requiring additional post-operative medications other than standardised analgesia. METHODS: Following nasal surgery, patients were randomised to receive either xylometazoline hydrochloride 0.1 per cent nasal spray or a sterile physiological saline aerosol. MAIN OUTCOME MEASURES: Visual analogue scale symptom scores for nasal obstruction, rhinorrhoea, pain, loss of sense of smell and bleeding were assessed at day 10 post-operatively. RESULTS: Post-operative symptom scores were compared between treatment groups. Overall, median pain scores were significantly higher in the xylometazoline group (p = 0.03, chi-square test). When analysed by procedure, median pain scores were significantly higher in septoplasty patients using xylometazoline (p = 0.019, chi-square test). CONCLUSION: There is no evidence to support the use of xylometazoline hydrochloride 0.1 per cent nasal spray over aerosolised physiological saline alone, following nasal surgery. Furthermore, there may be more pain associated with the post-operative use of xylometazoline.

Masson's pseudotumour of the ethmoid sinus - a case report.

OBJECTIVE: We report a case of Masson's pseudotumour or intravascular papillary endothelial hyperplasia presenting in the ethmoid sinus. CASE REPORT: We present a diagnostically challenging case of Masson's pseudotumour of the ethmoid sinus presenting with persistent epistaxis and a review of the available literature. CONCLUSION: Intravascular papillary endothelial hyperplasia is a benign, reactive lesion first described by the French pathologist Pierre Masson in 1923. It can lead to diagnostic uncertainty due to its close resemblance clinically, radiologically and histopathologically to angiosarcoma.