Irish journal of medical science
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Transanal minimally invasive surgery (TAMIS) has gained worldwide acceptance as a means of local excision of early rectal cancers and benign rectal lesions. However, it is technically challenging due to the limitations of rigid laparoscopic instruments in the narrow rectal lumen. ⋯ Robotic TAMIS represents an exciting new development that may be more versatile than traditional TAMIS. In this review, we describe the first case of robotic TAMIS performed in our country and a review of current literature on the technique.
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Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition characterised by autoimmune destruction of the pancreatic beta cell. It is associated with macrovascular and microvascular complications. Tight glycaemic control has been shown to ameliorate the long-term complications of T1DM, but this benefit has to be balanced with the risk and fear of hypoglycaemia. ⋯ More recently, continuous glucose monitoring (CGM) systems, which measure interstitial glucose, have become available. CGM systems remove or significantly reduce the need for blood glucose testing and have been shown in real world and clinical trial settings to improve glycaemic control, reduce frequency of hypoglycaemia, improve recognition of hypoglycaemia and improve quality of life. The question now is whether CGM should replace capillary blood glucose measurements and be offered to all patients with T1DM.
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Acute cholecystitis (AC) is a common emergency condition with severity ranging from mild to severe. Gallstones and critical illnesses are the common predisposing factors. Mild AC is primarily managed with medical therapy and early cholecystectomy. ⋯ There are different approaches to PC. The technical aspects, success, and complications of PC as well as management of cholecystostomy catheter after the patient recovers from the acute episode should be thoroughly understood by the interventional radiologist. We present an extensive up-to-date review of the essential aspects of PC including indications, contraindications, techniques, and outcomes, including complications and success rates.