[Open laparoscopic approach--an alterative to the Veress needle. Experiences after 1,000 laparoscopies]. / Der offene laparoskopische Zugang--Alternative zu der Veress-Nadel. Erfahrungen nach 1000 Laparoskopien.

A mini-laparotomy as described by Hasson was used in a modified way in 1000 laparoscopic procedures. In comparison with the insertion of a Veress needle we find the open approach to be a safer and quicker way of obtaining pneumoperitoneum.

[Results of a prospective study of laparoscopic appendectomy]. / Ergebnisse einer prospektiven Studie zur laparoskopischen Appendektomie.

Laparoscopic appendicectomy for acute appendicitis is being increasingly criticized, because of the possible complications, the technical effort required and the high costs. The results of the present prospective study performed between May 1992 and March 1994 on 222 appendectomies (110 conventional and 112 laparoscopic) are intended to serve as a tentative guide. The use of endoscopic stapling and cutting devices, as well as the observance of exclusion criteria make laparoscopic appendicectomy a safe operation. It can be employed routinely and shows certain advantages for the patient e.g. fewer disturbances of wound healing and shorter postoperative hospitalization. Although laparoscopic appendicectomy has brought us valuable experience, it is by no means the method of choice and for the time being, it is unlikely to replace conventional appendicectomy.

[Uses and risks of drainage following elective colon resection. A prospective, randomized and controlled clinical study]. / Nutzen und Risiken einer Drainage nach elektiven Colonresektionen. Eine prospektive, randomisierte und kontrollierte klinische Studie.

The results of a controlled randomized and prospective clinical study including 113 patients from March 1987 until August 1988 showed that prophylactic drainage in elective resection for cancer of the colon was not necessary. 60 patients received a drain, 53 patients were not drained. The drain turned out to be ineffective even concerning its expected function of draining intraabdominal fluid: its diagnostic and therapeutic value failed in clinical practice. The rate of surgical complications--i.e. anastomotic leakage, impaired wound healing and relaparotomy--was significantly higher in the drained group. In elective colon resection the use of a drain as a routine procedure cannot be recommended.

[Incidence of accessory adrenal cortex tissue of the inguinal region in the child--results of a prospective study]. / Häufigkeit akzessorischen Nebennierenrindengewebes in der Inguinalregion beim Kind--Ergebnisse einer prospektiven Untersuchung.

Aberrant adrenal cortical tissue is often found in close contact to the urogenital system. In a prospective study covering 150 operations for inguinal hernia, and 110 operations for undescended testes, we looked for aberrant adrenal cortical tissue. In 5.2% of the inguinal hernias and 10.9% of the undescended testes, aberrant adrenal cortical tissue was found. The frequency was higher than reported in the literature. The aberrant adrenal cortical tissue is of clinical importance only in the very rare cases of development of malignant tumours in this tissue.

[Proctomucosectomy and colo-anal anastomosis in rectovaginal fistula following the use of suppositories containing ergotamine]. / Proktomucosektomie und coloanale Anastomose bei recto-vaginaler Fistel nach Anwendung ergotaminhaltiger Suppositorien.

We observed a rectovaginal fistula in 2 patients who had applied ergotamine suppositories against migraine headaches. The local effect of ergotamine on the rectum mucosa as well as the higher systemic concentration after rectal application seem to promote the development of a rectovaginal fistula. Different methods for the surgical fistula repair are discussed, depending on location and diameter of the fistula. In our patients we have carried out the abdomino-transanal resection of the rectum with sutured colo-anal anastomosis.