Ethical and legal aspects concerning robotic surgery in Brazil.

Robotic surgery is a technological milestone that directly impacts the provision of healthcare services. Procedures that utilize robotics are continuously being developed. In this context, it is important to analyze the distribution of ethical and civil liability among doctors, hospitals, and suppliers of surgical equipment in cases of alleged medical errors or adverse events that may harm patients.

TITANIUM CLIPS FOR CLOSURE OF THE PERITONEAL FLAP DURING LAPAROSCOPIC INGUINAL HERNIA REPAIR.

Background: The laparoscopic approach for inguinal hernia repair has been widely used since its introduction in the 1990s. As a step in the procedure, the surgeon must access the preperitoneal space through an incision in the peritoneum, creating an adequate dissection for mesh placement. At the end of the procedure, the peritoneal flap must be closed to avoid adhesions.

Gastrointestinal emergency care during the COVID-19 pandemic: rapid communication.

Objective: Social distancing during the COVID-19 pandemic has been associated with a decrease in the search for medical care. High-risk patients have avoided hospital environments fearing infection. We hypothesize that there was also a decrease in the search for medical care related to gastrointestinal emergencies.

Preoperative Level of Leptin Can Be a Predictor of Glycemic Control for Patients with Diabetes Undergoing Bariatric Surgery.

Introduction: Bariatric surgery is a first-line treatment for patients with obesity and diabetes. It is uncertain whether leptin has an influence on glycemia in the postoperative period.

Methods: A cohort study of thirty-eight individuals with obesity and diabetes who underwent laparoscopic Roux-en-Y gastric bypass was undertaken.

Elastic Fibers Density: a New Parameter of Improvement of NAFLD in Bariatric Surgery Patients.

Purpose: Obesity is a major risk factor for nonalcoholic fatty liver disease (NAFLD), affecting 25% of the worldwide population. Weight loss through bariatric surgery can improve much of the liver steatosis, inflammation, and fibrosis. However, it is not known whether there is reversal of the elastic fiber deposition process, triggered by hepatic damage and related to worse prognosis.

Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass?

Introduction: Transient tissue elastography (TTE) may estimate the degree of hepatic fibrosis in patients with obesity, but the method has restrictions that are mainly related to patients' BMI.

Purpose: To compare the results of the evaluation of hepatic fibrosis by biochemical methods and TTE with those determined by liver biopsy in patients after RYGB.

Methods: This was a cross-sectional study involving patient data, TTE, and liver biopsy 1 year after RYGB.

Collagen I and III in women with diastasis recti.

Objectives: Interest in elucidating the etiology of hernias has encouraged countless studies of musculoaponeurotic structures in individuals with and without hernias. Studies of hernia patients have firmly demonstrated a correlation between hernias and collagen alterations in their fascia. Diastasis recti is an increased width of the abdominal midline that is exclusively composed of interlacing aponeurotic expansions of the anterolateral abdominal muscles.

LINEA ALBA COLLAGEN ASSESSMENT IN MORBIDLY OBESE PATIENTS.

Background: The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy.

Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers.

Methods: Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group).

Laparoscopic splenectomy for isolated splenic sarcoidosis.

Introduction: Sarcoidosis is an inflammatory disease with an unknown etiology. The pulmonary interstitium is mainly involved, with noncaseating granulomas and lymphadenopathy. It is a multisystemic disease, and the differential diagnosis should include infectious, neoplastic, and autoimmune diseases to prevent inappropriate treatment and unnecessary surgery.

[Can videolaparoscopic access be used as routine in splenectomies?].

Background: Laparoscopic splenectomy is an alternative for the treatment of patients undergoing elective splenectomy. One of its main indications is in hematologic diseases non-responsive to pharmacological treatment. Videolaparoscopy presents advantages to patients when compared to laparotomy: less post-operative pain, recovery of the functions of the gastrointestinal tract, better cosmetic results and shorter hospitalization.

Melanoma metastasis to the spleen: Laparoscopic approach.

We report a case of minimally invasive surgery in the management of metastasis to the spleen. A 67-year-old male patient with possible splenic soft tissue melanoma metastasis was referred to our hospital. He had a history of an excised soft tissue melanoma from his back eight months earlier, and the control abdominal computer tomography (CT) scan revealed a hypodense spleen lesion.

Monopolar electrosurgery on the extrahepatic bile ducts during laparoscopic cholecystectomy: an experimental controlled trial.

Introduction: The purpose of this study is to investigate the occurrence of thermal injury in the extrahepatic bile ducts when monopolar electrosurgery is used to perform dieresis of the cystic duct and cystic vessels in laparoscopic cholecystectomy.

Methods: Female pigs (n=40) of the Large White breed were separated into 2 groups of 20 animals. In the experimental groups, dieresis of the cystic duct and cystic vessels was performed with monopolar electrosurgery using a hook-like dissector using a power setting of 20 W, whereas in the control group this procedure was performed with a pair of Metzenbaum scissors disconnected from any kind of thermal energy source.

Fibroplasia after polypropylene mesh implantation for abdominal wall hernia repair in rats.

Purpose: This study assessed the collagen deposition and correlated it with local inflammatory responses to evaluate the length of time required for fibroplasia when polypropylene meshes are used to repair incisional abdominal wall hernias in rats.

Methods: Thirty-six male Wistar rats underwent longitudinal resection of a peritoneal and musculoaponeurotic tissue segment (3x2 cm) of the abdominal wall followed by defect reconstruction with polypropylene mesh bridging over aponeurosis. The animals were divided into 6 groups according to the time points for the analysis of fibroplasia: 1, 2, 3, 7, 21 and 30 days post-implantation.