Two unusual cases: vulvar lipoma - description of the largest case in literature. Developing myoma with the longest pedicle.

The authors present two cases of benign tumors one located on the outer surface of the vulva, and the second extending beyond the vagina. The first, originating from the right pudendal lip, a lipoma measuring 23 cm in greatest diameter, weighing 6.6 kg, and the second a pedunculated, uterine smooth muscle myoma with a pedicle of 6.5 cm, maximum diameter 18 cm, weight 700 grams, which caused significant metroptosis. Operative procedures in each case were free of complications.

[Laparoscopic resection of the pancreatic head. Feasibility and perioperative results]. / Laparoskopische Pankreaskopfresektion. Machbarkeit und perioperative Ergebnisse.

BACKGROUND: Whereas pancreatic tail resection is routinely and safely performed in several institutions, laparoscopic resection of the pancreatic head is only performed by a handful of surgeons worldwide, none of them in Germany. PATIENTS AND METHODS: We review our experience with 9 laparoscopic pancreatic head resections (lap-PPPD) performed between March and September 2010. The operations were performed using a hybrid approach with complete laparoscopic pylorus-preserving pancreatic head resection and successive reconstruction via a small retrieval incision. Perioperative outcome was compared to 605 open pancreatic head resections (1997-2010). RESULTS: In the group lap-PPPD 3 out of 9 conversions had to be performed due to oncologic reasons. There were no significant differences in perioperative outcome when comparing open-PPPD to lap-PPPD. CONCLUSION: Laparoscopic pancreatic head resection with hybrid open reconstruction combines the potential advantages of laparoscopic resection with the safety of an open pancreatic anastomosis. Even at the beginning of the learning curve the procedure can be performed with no concessions to safety or duration of the operation.