Introduction: The familial adenomatous polyposis of the colon (FAP) is a rare hereditary disease, transmitted as an autosomal dominant trait due to the mutation of the APC gene. The purpose of the study is to assess, even according to the data of our experience, the possibility of clinical application of the results of the new genetic research, linking the problem to prevention and/or treatment. Some operative remarks conclude the study.

Introduction: The improved living and environmental conditions have resulted in an increase in life expectancy with greater observation of breast cancer in elderly. The present study, through a retrospective analysis of our series, compares the results of treatment in two similar groups of patients under 75 (65-75) and over 75 (76-85) years of age, evaluating the efficacy and complications of locoregional and general therapy in relationship to biological age, associated diseases, and also the influence on the results of the cultural level and lifestyle.

Objective: To demonstrate the characteristic of high-voltage electrically head injury patients presenting underlying calvarial osteomyelitis. Methods: Retrospectively report of patients high-voltage electrically head injured with calvarial osteomyelitis from January 1st 2011 to December 31st 2013. The demographic variable namely age, sex, place of accident, present of calvarial osteomyelitis, Glasgow coma scale, surgical treatment type, grading of burn injury and total body surface area of burn (TBSA).

Surgical management of portal hypertension has changed according to time, evolving from just complete shunts to selective shunts and to liver transplantation. The outcomes also greatly improved owing to better understanding of portal hemodynamics and disease nature. Introduction of selective shunts showed promising results just to be challenged by poor outcome with development of “pancreatic siphon” which then studies in detail. This intra-pancreatic and peri-pancreatic collateral veins which connected portal and splenic veins formed basis of systemic loss of portal flow and thus ending up in failure of selectivity. Pancreatic siphon was found to be associated with increased rates of hepatic encephalopathy post selective shunting along with increased rates of hepatic failure. In addition to this pancreatic siphon led to metabolic sequel like new onset of diabetes, ischemic or compressive pancreatic ductopathy and intrapancreaic cholangiopathy. Although the shunting procedures are not that commonly done, pancreatic siphon has moved out of the limelight. It was just an attempt of recapping the existence of an unfamiliar entity forming delicate balance in the portal circulation.

This is a case report of an open depressed and compound elevated skull fracture that located in the area where superior sagittal sinus lies beneath. This is a very rare variant of skull fractures. This patient was admitted to our Department of Neurosurgery Hasan Sadikin Hospital, Bandung Indonesia. He is a 14 years old male with a motor vehicle accident and diagnosed with compound elevated and depressed skull fracture. A CT Scan demonstrated an Epidural hematoma with suggested cerebral prolapse. The initial GCS was 15 with slight hemiparesis and the patient underwent an emergency surgery. The elevated skull compound was fixated by a titanium mesh but we left the prolapse untouched, then the procedure followed by duraplasty using a pericranial flap. After 7 days of post-op treatment, he was discharged without any neurological deficit. With proper emergency surgery, and by preserving the prolapsed brain tissue with the fixation on the elevated skull fracture to prevent further injury may give good results on this patient.

Introduction: The diseases most frequently found in the elderly are E.I. (inguinal hernia)* and BPH. (Prostatic hypertrophy non-neoplastic)*. The latter causes an effect on the abdominal wall to the increase in abdominal pressure from cervical-urethral obstruction, leading to the onset of the inguinal hernia pathology due to abdominal pressure which is higher, the greater as the residual bladder urine. The purpose of the study is to provide information on the surgical strategy and on timing in the presence of the simultaneous two diseases.

Background: The increasing demand for robotics in general surgery has prompted academic institutions to train general surgery residents toward the acquisition of basic robotic skills. Our current robotic training curriculum begins in the PGY-3 year and is based on the use of surgical simulators in a risk-free environment, in which each resident must show proficiency prior to advancing to training on an animate model as PGY-4. Our unpublished data on the curriculum indicates that PGY-3s required additional remediation training on the robotic simulator, suggesting room for improvement in our teaching paradigm [8]. Because of resident duty hour restrictions, we could not provide remediation by simply increasing the number of training sessions. We therefore decided to investigate an alternative strategy of shifting the training to an earlier time point in general surgical residency during PGY-1 and PGY-2 years. To explore the feasibility of a new curriculum, we undertook a pilot study to investigate the willingness of residents in their PGY-1 and PGY-2 years to begin robotic training on the robotic simulator, the dV-Trainer (dV-T). We also wanted to see if even minimal early exposure to the dV-T would help overcome residents’ initial diffidence in using the daVinci Surgical System (DaVss).

Introduction: Although mesh techniques are used with increasing frequency, they are correlated to major long-term complications such as chronic inguinal pain (8.6%) and recurrence (1.6-8.6%). It is due to a non-development of an ideal mesh, which simultaneously ensures inguinal wall strength and a lower inflammatory foreign body reaction, which also seems to be correlated to the use of a non absorbable mesh.

Purpose: Anastomotic leak following colorectal resection surgery is associated with short and long-term negative patient outcomes, prolonged hospitalization, and increased healthcare costs. Various patient related and surgical factors are known to contribute to the development of postoperative anastomotic leaks. This study systematically reviewed the literature to assess the incidence of post-operative leak and identify patient factors associated with the development of leaks.

Background: Fistula in ano is a common disease seen in the surgical outpatient department. Many procedures are advocated for the treatment of fistula in ano. However, none of the procedures is considered the gold standard. Aim of this study was to evaluate our procedure in the managing high perianal fistula.

Background: The impact of systemic inflammatory response on carcinogenesis and tumor progression has recently gained much attention. Biochemical markers such as albumin, pre-albumin and C-reactive protein (CRP) are currently used to predict prognosis in several cancer types, and the usefulness of these biomarkers in gastric cancer has become an emerging topic of research. The present study aims to assess the correlation between tumor stage and the levels of pre-albumin, albumin and CRP in patients who underwent surgery for gastric cancer.

Purpose: Anastomotic leak following colorectal resection surgery is associated with high rates of morbidity, infection, and escalated healthcare expenditures. One method to prevent leaks includes early detection through intra-operative testing. This study employed systematic review of the literature to estimate the rate of intra-operative anastomotic leaks in colorectal resection surgery.

In 2001 a woman underwent a cholecystectomy in Strasbourg, France. What was new? The surgical team who performed the operation was 14,000 km away, in New York [1]. It was the first case of remote robotic surgery. The operation had no complications and the patient had a decent postoperative follow-up. This epoch-making event was dedicated to Charles Lindbergh, the pioneering American aviator who flew across the Atlantic in 1927.

Aim: To investigate the level of vessel ligation in splenic flexure cancer (SFC) in term of oncology outcome and overall survival. Methods: From 2005 until 2012 records reviewed. 43 patients diagnosed with SFC enrolled and analyzed. Patients categorized based on the level of vessel ligation. Left branch of middle colic (LMA) and left colic artery division (LCA) compared to ligation of LCA and marginal of middle colic artery (MMC).