Pair Of Forceps Research Articles

A Survey on the Diversity of Field Insect Pests of Okro (Abelmoschus Esculentus) within the Six Adp Zones in Akwaibom State

A survey was conducted to determine the diversity and abundance of insect pests associated with okra (Abelmoschus esculentus) across the six Agricultural Development Programme (ADP) zones in Akwa Ibom state namely; Uyo, Abak, Eket, Ikot ekpene, Etinan and Oron using multi – stage random sampling technique, swoop nets for flying insects, aspirators for collecting tiny insects, pair of forceps and hand picking for larvae and slow moving insects. A total of 634 insects were collected across the six zones and identified into 4 orders, 13 families and 15 species. The dominant order by specie was Hemiptera having (6/40%) followed by Lepidoptera (4/26.67%), Coleoptera (3/20%) and the least was Orthoptera having (2/13.33%) while dominant order by individuals was Coleoptera having 279/44.01%), followed by Hemiptera (244 /38.49%), Lepidoptera (68/10.73%) and the least was Orthoptera (43/6.78%). Dominant insect specie across the six zones was Flea beetle (Podagrica sp.) with total population of 185 followed by Aphids (Aphis gossypii - 98) and the least was Cabbage looper (Trichoplusia ni – 7). Diversity index result showed that Eket zone had the highest no. of individuals (122) with the least no. of species (12) and least Shannon index value (H_ 2.11) followed by Oron zone with 112 individuals, no. species (13) and shannon index ( H_2.31). Uyo zone had the least no. of individuals (93), no. species (13) and Shannon index (H_2.21) while Ikot ekpene zone had the highest Shannon index value (H_2.34) and highest no. of species (14) with no. of individual (101). This study reveals that there is high diversity and abundance of insect species attacking okra in Akwa Ibom State hence drastic control measures is imperative for successful and profitable production of Okra.

Description of the Life Cycle Stages of the Parasitic Cymothoid, Cymothoa indica Schioedte and Meinert, 1884, and Its Prevalence in Commercial Fishes from Chilika Lagoon, India.

To study the morphology of all the life stages and the life cycle of the parasitic isopod Cymothoa indicaSchioedte and Meinert, 1884, and its prevalence in different commercial fishes in the Chilika Lagoon, India. From April 2021 to December 2022, different life stages of the said parasites were collected from five different fish species from four localities of the Chilika Lagoon. The parasites were carefully removed from the host with a pair of forceps and then identified following standard literature and description. The morphology of all life stages, life cycle, and prevalence of the isopod C. indica were carried out as per the standard protocol. A total of 1252 host fishes were analysed. The total prevalence was 44.5%. The host with the highest prevalence of C. indica was Glossogobius giuris, with 58.79% of the hosts parasitized by at least one parasite individual. Followed by the host Datnoides polota (50.98%), Johnius dussumieri (46.25%), Etroplus suratensis (28.45%) and the least prevalence was in Lates calcarifer (14.70%). The description of the life stages is based on the observation of 523 females, 116 males, 46 Juveniles, and 50 embryonic stages of the said parasites. The description of all the life stages and life cycles certainly helps to identify this species with clarity and ease in understanding the species' biology. In future, this study may be helpful in the effective management towards the improvement of aquaculture productivity.

Hand Forceps for Delivery of Floating Fetal Head at Cesarean Section: A Randomized Pilot Study [ID: 1375984

INTRODUCTION: On occasion, obstetricians encounter difficulty delivering the floating fetal head at cesarean section; additional techniques may need to be employed beyond the traditional one-handed delivery technique. We propose a modified two-handed manual delivery method or “hand forceps,” with surgeon’s both hands shaped like a pair of forceps, as an alternative technique for fetal head delivery. The purpose of this study is to compare the efficacy and safety of two-handed technique by comparing with the traditional one-handed technique. METHODS: We conducted a randomized pilot study of women undergoing cesarean section (NCT04159857, ClinicalTrials.gov). Inclusion criteria included a singleton in cephalic presentation, at gestational age of 37 weeks or greater, with planned low transverse uterine incision, cervical dilation of 6 cm or lower and station less than −3. Patients were randomized to either the one-handed or two-handed delivery group. The primary outcome was “U-D interval,” defined as the time from entry of the hands into the uterus to the delivery of the fetal head. The secondary outcome was incidence of hysterotomy extension. Neonatal safety data were also collected. RESULTS: A total of 40 patients participated in the study; 16 randomized to the one-handed group, 19 randomized to the two-handed group, and 5 patients excluded because of protocol deviation. U-D interval (mean±SD) was significantly shorter in the two-handed group (6.0±7.4 seconds) than in the one-handed group (14.3±9.9 seconds), P<.001. There was no significant difference in incidence of hysterotomy extension, maternal and neonatal outcomes between the two groups. CONCLUSION: The two-handed method for fetal head delivery has a significantly decreased U-D interval compared to the one-handed method, without increasing the incidence of hysterotomy extension. A large-scale multicenter randomized controlled study is needed to further determine whether the “hand forceps” can be considered a safe alternative technique for delivery of the floating fetal head in cesarean sections.

Medical Students' Clinical Skills Compared to Educational Standards at Universities of Medical Sciences: A Self-assessment Study

Background: Physicians, as the leading decision-makers of the health system, are affected by various clinical statuses. Objectives: This study aimed to compare the clinical skills of medical students as future physicians with the educational standards of Zahedan University of Medical Sciences in 2020 - 2021. Methods: This study was performed on 107 medical students (53 stagers and 54 interns). After obtaining students' consent and recording their demographic and academic information, clinical skills were assessed using the Clinical Medical Skills Questionnaire. The obtained data were analyzed using SPSS software Ver. 20. Results: The least trained skills in the surgical department were suprapubic puncture and thoracotomy with a needle in compressive pneumothorax. In the pediatric ward, no clinical skill training was in good condition, and only practical measures to monitor growth and development were adequately trained. In the internal ward, the least training skill was related to lumbar puncture and aspiration of knee joint fluid. In the gynecology ward, abortion evacuation with pairs of forceps in cases of life-threatening bleeding and postpartum hemorrhage were considered the least instructed clinical skills. Finally, in the emergency ward, nasal bleeding catheter, suprapubic sampling, and cricothyrotomy were the least instructed clinical skill. Conclusions: The results showed a low number of encounters of medical students with the minimum expected clinical skills in the investigated medical school, indicating the poor quality of clinical training. The medical programs should be modified so that learners can be equipped with “the must learn” clinical skills.

Effect of Heparin on the Formation and the Healing of Kissing Gastric Ulcers in Rats

The incidence of gastric ulcers remains at a fairly high level: it is diagnosed annually in 7‐14% of the adult population. Despite the decrease in morbidity and the development of diagnostic methods as well as effective treatment, the number of complications such as bleeding and perforation is increasing. One of the significant pathological factors leading to the gastric injury is disturbances in blood flow through mucosal microvessels (providing oxygen and nutrients). In this regard, it becomes relevant to study drugs that affect the rheological properties of blood and microcirculation.This study aimed to investigate the effect of heparin on the formation and the healing of the experimentally induced gastric ulcers in rat. Adult male Sprague‐Dawley rats weighing 230‐250 g were used after 24 h preliminary fasting. Gastric ulcers were produced by luminal application of 60% acetic acid to an area clamped with a pair of forceps (kissing ulcer model developed by S. Okabe) in anesthetized rats. Day 4 after the application (Day 0) was chosen as the time point for the ulcer formation, and Day 7 was chosen as the time point for incomplete ulcer healing. Heparin was injected at a dose of 1000 U/kg (s.c., once a day). While studying the effect on the ulcer formation, heparin was injected daily from Day 0 to Day 3. While studying the effect on the ulcer healing, heparin was injected daily from Day 4 to Day 6. Control rats were injected with saline. The blood hemoglobin levels were evaluated before the acid application surgery and in the end of experiments.The heparin injection before the ulcer formation resulted in a decrease of the ulcer area. The average area of kissing ulcers in heparin‐treated group was significantly smaller than that in the control group (p <0.05). The ulcer healing was significantly accelerated in the heparin‐treated group in comparison to the control group (p < 0.05). Blood hemoglobin levels were decreased in both heparin‐treated and control groups without significant differences between the groups.The results suggest that heparin therapy has the potential to accelerate gastric ulcer healing and prevent their formation.

Investigating the role of Ca2+/calmodulin-dependent protein kinase II in the survival of retinal ganglion cells.

Investigating the role of Ca2+/calmodulin-dependent protein kinase II in the survival of retinal ganglion cells.

Outbreak of Arcanobacterium haemolyticum in chronic wounds in The Netherlands

Aging and comorbidities such as diabetes and vascular problems contribute to the increasing occurrence of chronic wounds. From the beginning of 2016, a marked increase in Arcanobacterium haemolyticum (ARH) in chronic wound cultures was noted among patients visiting a wound expertise centre in The Netherlands. To report the outbreak investigation of ARH cultured from chronic wounds and describe the implemented infection prevention measures. In total, 50 ARH isolates were sent to a reference laboratory for molecular typing. Samples for bacterial culture and ARH polymerase chain reaction were taken from care workers, the environment and items used for wound care. Infection prevention measures were implemented in a bundled approach, involving education, better aseptic wound care conditions and hygienic precautions. Before and after the implementation of infection prevention measures, two screening rounds of ARH testing were performed among all patients receiving home care. ARH isolates from wound care patients were found to be identical by core genome multi-locus sequence typing. No definite outbreak source could be determined by culture. However, three pairs of forceps, used by two nurses on multiple patients, were found to be ARH positive by polymerase chain reaction. In the two screening rounds before and after the implementation of infection prevention measures, the proportion of ARH-positive patients decreased significantly from 20% (20/99) to 3% (3/104). Subsequently, no new cases occurred. This first ARH outbreak was likely caused by re-using contaminated instruments. Through the implementation of improved infection prevention measures and re-education of all employees involved, the outbreak was controlled. With the current trend of care transition, infection control must be a major concern.

Tubal Pregnancy with Acute Bleeding Treated by Laparoscopic Surgery: Tips and Case Presentation

Laparoscopic surgery is the standard surgical approach for ectopic pregnancy. However, some surgeons prefer laparotomy for patients with acute bleeding. We evaluated four cases of tubal pregnancy with massive hemoperitoneum (>800 ml) and performed laparoscopic surgery. The patient age ranged from 20 to 37 years, and the gestational age ranged from 5 to 8 weeks. All cases were hemodynamically unstable. Two cases had hemoperitoneum of >2000 mL, which was caused by the rupture of the left isthmus tube. In three cases, surgery could be started within approximately 30 min, and in one case, the start time extended owing to difficulty in anesthesia introduction. Moreover, in three cases, the target lesion was reached within 7 min, and the lesion was excised in approximately 20 min from the start of insufflation, and in one case with a lesion exceeding 7 cm, the time extended. All patients were safely treated via laparoscopic surgery. To initiate surgery without deterioration of the hemodynamic condition, blood transfusion can be started simultaneously with preparation for laparoscopic surgery. Lifting the lesion with a pair of forceps can help immediately stop bleeding, even if it is difficult to secure the visual field owing to massive bleeding. When there is difficulty in anesthesia or a large pregnancy lesion, care should be taken to avoid an increase in the amount of bleeding associated with extension of the perioperative period.

Use of a chalazion clamp for intraoral biopsies: a technical note.

Oral biopsies are common diagnostic and therapeutic procedures in oral and maxillofacial surgical (OMFS) outpatient departments. The chalazion clamp is similar to a pair of forceps. One extension has a flat, solid, oval plate, the other, a ring-like structure that is used to clamp and retract soft tissues. We highlight the benefits of using this simple, widely-available tool during oral biopsies. We find that the clamp increases effectiveness and efficiency for the clinician and assistant. We recommend its use in daily OMFS practice.

A Century of Change towards Prevention and Minimal Intervention in Cariology

Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature—coupled with limited diagnostic tools and therapeutic treatment options—meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession’s move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession’s greatest challenge is moving this evidence into practice.

Permeability of the porcine iris stroma

Current literature has not considered or provided any data on the permeability of the iris stroma. In this study, we aimed to determine the hydraulic permeability of porcine irides from the isolated stroma. Fifteen enucleated porcine eyes were acquired from the local abattoir. The iris pigment epithelium was scraped off using a pair of forceps and the dilator muscles were pinched off using a pair of colibri toothed forceps. We designed an experimental setup, based on Darcy's law, and consisting of a custom 3D-printed pressure column using acrylonitrile butadiene styrene (ABS) plastic. PBS solution was passed through the iris stroma in a 180° arc shape, with a column height of approximately 204 mm (2000 Pa). Measurements of iris stromal thickness were conducted using optical coherence tomography (OCT). To measure flow rate, we measured the mass (volume) of PBS solution using a mass balance in approximately 1 min. Histology was performed using hematoxylin and eosin (H&E) and anti-smooth muscle antibody (anti-α-SMA) for validation. The permeability experiments demonstrated that the iris stroma is a biphasic tissue that allows fluid flow. Our image processing results determined the area of flow to be 7.55 mm2 and the tissue thickness to be between 180 and 430 μm. The hydraulic permeability of the porcine stroma, calculated using Darcy's law, was 5.13 ± 2.39 × 10−5 mm2/Pa•s. Histological and immunochemical studies confirmed that the tissues used for this permeability study were solely iris stroma. Additionally, anti-α-SMA staining revealed staining specific for stromal blood vessels, with the notable absence of dilator and sphincter muscle staining. Our study combined experimental microscopic data with the theory of biphasic materials to investigate the hydraulic permeability of the iris stroma. This work will serve as a basis on which to validate future biomechanical studies of human irides with which may ultimately aid disease diagnosis and inform the design of novel treatments.

Femtosecond laser-assisted removal of an intracorneal chestnut, a case report

BackgroundTo report a case of femtosecond laser-assisted removal of an intracorneal chestnut.Case presentationA chestnut was obliquely protruding to the stroma of cornea and it was localized at the paracentral region on the left eye of a 32-year-old man. The best-corrected visual acuity (BCVA, in decimal values) was 0.6 in the injured eye. The white ulcers with feathery edges or satellite infiltrates were not observed in the lesion, and the anterior chamber was deep and quiet. Anterior segment optical coherence tomography (AS-OCT) demonstrated that the original entry path of the foreign body had been sealed, spanning a thickness of approximate 152 μm. In view of location of the intraocular chestnut at the paracentral region, femtosecond laser was applied according to the procedures of IntraLase Enabled Keratoplasty (IEK) to create an anterior lamellar flap rapidly and precisely. The lamellar flap was easily separated with a flap lifter, and the chestnut was removed entirely using a pair of forceps. In 3 days after surgery, the patient complained of mild pain and blurred vision. These symptoms were relieved after treatment with the eyedrops. At three-month follow-up, the corneal wound was healed well, and the BCVA was greatly improved to 1.2 in the left eye. A dot-like haze was observed corresponding to the scar at the site of foreign body removal. No surgical induction of corneal astigmatism was found in the corneal topography.ConclusionsWithout induction of a visually significant scar and corneal astigmatism, the IEK procedure of femtosecond laser is of particular interest as it provides a unique method for removal of intracorneal foreign bodies impinging on the visual axis.

Near-infrared laser thermal conjunctivoplasty

Conjunctivochalasis is a common cause of tear dysfunction due to the conjunctiva becoming loose and wrinkly with age. The current solutions to this disease include either surgical excision in the operating room, or thermoreduction of the loose tissue with hot wire in the clinic. We developed a near-infrared laser thermal conjunctivoplasty system. The system utilizes a 1460-nm programmable laser diode system as the light source. At this wavelength, a water absorption peak exists and the blood absorption is minimal, so the heating of redundant conjunctiva is even and there is no bleeding. A miniaturized handheld probe delivers the laser light and reshapes the laser into a 10 × 1 mm2 line on the working plane. A foot pedal is used to deliver a preset number of calibrated laser pulses. A fold of loose conjunctiva is grasped by a pair of forceps. The NIR laser light is delivered through an optical fiber and a laser line is aimed exactly on the conjunctival fold by a cylindrical lens. Ex vivo experiments using porcine eye was performed to investigate the induced shrinkage of conjunctiva and decide the optimal laser parameters. It was found that up to 45% of conjunctiva shrinkage could be achieved.

Intestinal schistosomiasis among some inhabitants of Bassa Local Government Area of Plateau State, Central Nigeria

Human schistomiasis is endemic and still remains a public health problem in Nigeria. Most reported cases of the disease have focused mainly on the urinary form with the intestinal form less reported.. Thus 600 fresh stool samples from consenting individuals in Bassa Local Government Area of Plateau State an endermic foci of schistosomiasis were collected and fixed in 10% formol-saline solution and processed using the Kato-katz technique. Prevalence of infection between ages and gender were tested using Chi-square (x^2) while one-way analysis of variance (ANOVA) was used in analyzing data relating to occupation. Association between infection and occupation was assessed by the independent student t-test. Freshwater snails were sampled using a scoop net and pair of forceps. Infection was significantly higher in younger than older individuals (P

Agrobacterium-mediated transformation of a Eucalyptus camaldulensis × E. tereticornis hybrid using peeled nodal-stem segments with yeast HAL2 for improving salt tolerance

Genetic improvements of Eucalyptus require both breeding and gene transformation to generate desirable traits for forest industry. Because most of the current Eucalyptus transformation methods rely on juvenile seedling tissues as explants, the resulting transgenics are subjected to phenotypic segregation through the use of segregated seedlings. This is unsuitable for transformation of selected Eucalyptus breeding lines, especially the interspecific hybrids. Here, we developed an Agrobacterium-mediated transformation method using peeled nodal-stem explants from in vitro-propagated plantlets of a Eucalyptus hybrid. The explant was prepared by peeling off epidermal layers around the axillary buds using a pair of forceps, before co-cultivation with Agrobacterium tumefaciens. Transgenic shoots generated from the axillary buds were then obtained through kanamycin selection. The transformation efficiency was at most 24% as confirmed by PCR and GUS assay. Transformation of a E. camaldulensis × E. tereticornis F1 hybrid clone using yeast HAL2 showed that, out of 35, 11 transgenic plantlets had an increase in salt tolerance and grew and developed roots, though at a slow rate, on the medium supplemented with NaCl up to 300 mM concentration. This work demonstrates the efficiency of this transformation method for further genetic improvement of Eucalyptus clones selected through hybridization and breeding.

A Survey on Tick Infestation in Domestic Birds Sold at Gwagwalada Market, Abuja, FCT, Nigeria.

Ticks transmit a greater variety of pathogenic micro-organisms than any other arthropod vector group, and are among the most important vectors of diseases affecting animals. A survey on the prevalence of tick species infesting domestic birds sold in Gwagwalada main market, Abuja between April and July, 2015. A total of 450 birds were examined by feather separation with fingers and a pair of forceps to expose the skin of the birds for presence of the ticks. An overall prevalence of 25.6% was observed. Out of the 150 domestic fowls examined 62(53.9%) were infested, 44(29.3%) of the 150 Guinea fowl and 9(6.0%) of the 150 Pigeons were infested. Of all the ticks identified, 93(51.4%) were from the Domestic Fowls and 77(42.5%) from the Guinea fowl and 11(6.0%) from Pigeon. Thirty (32.3%) of the ticks from the Domestic fowls were Argas persicus, 25(26.9%) Argas walkerae, 20 (21.5%) Ornithodorus moubata and 18(19.4%) Ornithodorus savignyi. Similarly, 34(44.2%) of the ticks from Guinea fowl were A. walkerae, 20(28.2%) O. moubataand 23(32.4%) O. savignyi. Five (45.5%) of the ticks from Pigeon were A. persicus, 4 (36.4%) were A. walkerae, 2 (18.2%) were O. moubata and no O. savignyi. Observation on the location of tick from the hosts body showed highest prevalence was found under the wings (55.2%) and lowest on the head & neck (5.00%). The result of this research revealed that Gwagwalada market poultry section is endemic of tick infestation. Chemical control with acaricides and improved management and sanitation of the poultry cages in the market should be enforced.

A feasibility of single-incision laparoscopic percutaneous extraperitoneal closure for treatment of incarcerated inguinal hernia in children: our preliminary outcome and review of the literature.

The purpose of this study is to examine the feasibility of single-incision laparoscopic percutaneous extraperitoneal closure (LPEC) for incarcerated inguinal hernia (IIH) repair. 6 single-incision LPEC procedures were performed for IIH repair and 60 procedures were performed for reducible inguinal hernia (RIH) in the same period of time in one hospital. The laparoscope and one pair of grasping forceps were placed through the same umbilical incision. In IIH repair, the herniated organ was gently pulled using the grasping forceps with external manual pressure. If it was difficult to reduce the herniated organ with one pair of forceps, another pair of forceps were inserted through a multi-channel port without extending the umbilical incidion. Using the LPEC needle, the hernia orifice was closed extraperitoneally. We performed a retrospective analysis to compare the outcomes of single-incision LPEC for IIH repair or reducible inguinal hernia. All procedures were completed by single-incision without open conversion. A multi-channel port with another pair of forceps was needed in three cases. The operation time and the length of stay were significantly longer with IIH repair than with RIH repair. There were no major complications and there was no evidence of early recurrence in any patient. In conclusion, single-incision LPEC with a multi-channel port is feasible and safe for IIH repair.

A method for assessing chemically-induced paralysis in headless mosquito larvae

There is a growing interest in studies of mosquito physiology and toxicology due to the heightened need for controlling this group of human disease vectors. In the process of testing a group of polar compounds on mosquito muscles, a novel headless larva bioassay was developed. The heads were removed from fourth instar Aedes aegypti larvae, which permitted access of pharmacological agents to the hemocoel while maintaining larval viability. The method allowed effective quantification of the paralytic actions of water soluble compounds that could not ordinarily penetrate the mosquito larva integument and was more easily performed than injection when studying small, soft-bodied aquatic organisms.The summary of the method is:•Heads of A. aegypti larvae were detached with two pairs of forceps, and the larvae remained responsive for at least 5h.•The responsiveness of the larvae was assessed by using a microscope to observe movement after the larvae were probed with an insect pin.•Drug effects were quantified using either a binary paralysis determination (paralyzed vs. not paralyzed), or by counting movement units after probing.

Laparoscopic Bowel-lifting Technique

Although surgeons have tried to reduce the number of ports in order to achieve better cosmesis and less postoperative pain, it may lead to increased risk for complications. Herein, we introduce a technique, "laparoscopic bowel-lifting (LBL) technique," which helps to reduce ports without additional trocars. The mesocolon is pierced near the line of transaction using the pair of dissecting forceps. A 1-0 Vicryl suture is introduced into the abdominal cavity using a grasping needle and passed through the mesocolon. The colon is retracted using the suture and fixed to the abdominal wall using a pair of forceps. Thereafter, traction is placed on the main nutrient artery. Mobilization of the rectum is performed after moving the traction to the cranial side by using a grasping needle. As the rectal tube was pulled toward the cranial side, it is possible to identify the mesorectum with a good visual field. We performed this procedure in 100 consecutive patients with rectal cancer who underwent curative laparoscopic low anterior resection (Lap-LAR) between November 2001 and March 2010. The median duration of follow-up after Lap-LAR was 53.2 months. The tumor was located in the middle rectum in 75 patients and in the lower rectum in 25 patients. The stage grouping on the basis of the TNM classification was as follows: stage 0, 6; stage I, 46; stage II, 18; and stage III, 30. The number of trocars used in the LBL group was 3 or 4. No LBL cases used 5 trocars. No operative complications were attributable to this technique. The overall rates of anastomotic leakage and morbidity were 10.0% and 33.0%, respectively. The 5-year relapse-free and 5-year overall survival rates were stage 0, 100/100; stage I, 93.3/96.8; stage II, 81.5/88.5; and stage III, 74.5/75.7. LBL technique is feasible for performing Lap-LAR. This method reduces the number of ports and might help to introduce a single-incisional surgery.

Gastric perforation in neonate: A rare complication of birth trauma

Abstract We report the case of a neonate, born at 36 + 5 weeks of gestation, with shoulder dystocia requiring a pair of forceps. The Apgar score was 3/7 at 1 and 5 min requiring resuscitation. He was transferred at 21 h of life (H21) in intensive care unit for an acute abdomen and an oedematous ecchymotic left testis. Biochemical investigation showed severe renal and hepatic failure and disseminated intravascular coagulation. X-Ray examination showed a large pneumoperitoneum with left scrotal pneumatocele. Surgery exploration disclosed hematoma of the 2 adrenal gland, part of the liver and 2 gastric perforations of the anterior part of the large gastric tuberosity, which were sutured; the inguino-scrotal hernia was repaired. In this case report, we discuss the different etiology of neonatal gastric perforation. The two major particularities were the early presentation in life and the suspected mechanism of perforation. Indeed, most of the non idiopathic etiology of neonatal gastric perforation were eliminated and the major birth trauma was the mechanism the most suitable to explain the gastric perforation, possibly by a mechanism of barotrauma. In a context of difficult extraction, an acute abdomen or a scrotal hernia should lead to X-Ray examination; a pneumoperitoneum should lead to surgical examination looking for a gastric perforation.