Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Apr 2018
Case ReportsBowel obstruction caused by broad ligament hernia sucessfully repaired by laparoscopy.
Internal hernais are rare bowel obstructions. We present a case of small bowel obstruction in a 37-year-old woman caused by internal herniation through a defect in broad ligament, which was managed by laparoscopic surgery.
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Ann R Coll Surg Engl · Apr 2018
Observational StudyHartmann's procedure, reversal and rate of stoma-free survival.
Background Hartmann's procedure is a commonly performed operation for complicated left colon diverticulitis or malignancy. The timing for reversal of Hartmann's is not well defined as it is technically challenging and carries a high complication rate. Methods This study is a retrospective audit of all patients who underwent Hartmann's procedure between 2008 and 2014. ⋯ Conclusions Hartmann's procedure is reversed less frequently than thought and consented for. Only 46% of Hartmann's procedures were stoma free at the end of the audit period. The anastomotic complication rate of 1% is also low for reversal of Hartmann's procedure in this study.
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Ann R Coll Surg Engl · Apr 2018
Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux - results and challenges.
Introduction Gastro-oesophageal reflux disease (GORD) is a common, chronic debilitating condition. Surgical management traditionally involves fundoplication. Magnetic sphincter augmentation (MSA) is a new definitive treatment. ⋯ Conclusions MSA is highly effective in the treatment of uncomplicated GORD, with durable results and an excellent safety profile. This laparoscopic, minimally invasive procedure provides a good alternative for patients where surgical anatomy is unaltered. Our experience demonstrates that innovative technology can be incorporated into NHS practice with an acceptable business plan and compliance with NICE recommendations.