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The authors describe a case of giant appendiceal mucocele, secondary to a mucinous neoplasm of the appendix, diagnosed during laparotomy for acute abdomen. By a review of the literature they stress the rarity of this lesion, the particular onset in their case as acute complication of appendiceal neoplasm with rupture of the intestinal wall, the difficulties of diagnosis and management in emergency.

Introduction: The Authors describe our preliminary experience with the cholecistectomy with the S.I.L.S. (Single Incision Laparoscopic Surgery), with a multilumen trocar and dedicated laparoscopic instruments., Materials and Methods: Five operations of laparoscopic cholecistectomy with S.I.L.S. technique (3 men and 2 women), of age between 26 and 52 years are reported., Results: In one case was applied an additional 5 mm trocar in the right ipocondrium; in two cases a transparietal suture to suspend the gallbladder was used. Operative time was 98 minutes for the first operation, and 45-65 minutes for the following. The operators have been some difficulties to moving the instruments because both the operating instruments and laparoscope are introduced through the same incision and on the same axis, the operator and assistant often impede the movements of each other. Any post-operative complications was registered. All the patients was very satisfied with post-operative pain and aesthetic results., Conclusions: The S.I.L.S. is a new technique already used in general surgery, urology and ginecology with good results; this surgey is probably destinated to improve his tecnique and instruments, but certainly it going to offer a further push of the mini-invasive "philosophy".