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Mesenteric cysts are rare intra-abdominal masses which can occur at any point in the gastrointestinal tract from the duodenum to the rectum. These cysts may remain asymptomatic or may present with an abdominal mass, abdominal pain, or fever. Management may be conservative, percutaneous, or surgical excision. Here we present a case of a spontaneously infected mesenteric cyst in a male in his early 70s who was undergoing surveillance of the cystic mass yearly following its incidental finding on CT 4 years prior., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Objective: Hemodialysis patients usually receive an arteriovenous fistula (AVF) in the arm as vascular access conduit to allow dialysis 2-3 times a week. This AVF introduces the high flow necessary for dialysis, but over time the ever-present supraphysiological flow is the leading cause of complications. This study aims to develop an implantable device able to non-invasively remove the high flow outside dialysis sessions., Methods: The developed prototype features a magnetic ring allowing external coupling and torque transmission to non-invasively control an AVF valve. Mock-up devices were implanted into arm and sheep cadavers to test sizes and locations. The transmission torque, output force, and valve closure are measured for different representative skin thicknesses., Results: The prototype was placed successfully into arm and sheep cadavers. In the prototype, a maximum output force of 78.9 ± 4.2 N, 46.7 ± 1.9 N, 25.6 ± 0.7 N, 13.5 ± 0.6 N and 6.3 ± 0.4 N could be achieved non-invasively through skin thicknesses of 1-5 mm respectively. The fistula was fully collapsible in every measurement through skin thickness up to the required 4 mm., Conclusion: The prototype satisfies the design requirements. It is fully implantable and allows closure and control of an AVF through non-invasive torque transmission. In vivo studies are pivotal in assessing functionality and understanding systemic effects., Significance: A method is introduced to transfer large amounts of energy to a medical implant for actuation of a mechanical valve trough a closed surface. This system allows non-invasive control of an AVF to reduce complications related to the permanent high flow in conventional AVFs.

Veress needles (VN) are commonly used in establishing pneumoperitoneum in laparoscopic surgery. Previously, a VN with a new safety mechanism 'VeressPLUS' needle (VN+) was developed to reduce the amount of overshoot., Methods: Eighteen participants (novices, intermediates, and experts) performed in total of 248 insertions in a systematic way on Thiel-embalmed bodies with wide and small bore versions of the conventional VN (VNc) and the VN+. Insertion depth was measured by recording the graduations on the needle under direct laparoscopic vision., Results: Participants graded the bodies and the procedures as lifelike. Overall, a significant reduction ( P <0.001) in average insertion depth was found for the VN+ compared to the VNc of 26.0 SD16 mm versus 46.2 SD15 mm. The insertion depth difference in the novice group was higher compared to the intermediates and experts ( P <0.001). The average insertion depth for both needle types was less ( P <0.001) for female participants compared to male., Conclusion: This study indicated that the VN+ significantly reduced the insertion depth in all tested conditions. Whether the difference between female and male performance can be linked to differences in muscle control or arm mass should be further investigated. Useful technical information was gathered from this study to further improve the VN+., Competing Interests: Roelf R. Postema, Jenny Dankelman, Christian Camenzuli, Jean Calleja-Agius, Sem Hardon, Frank-Willem Jansen, and Tim Horeman-Franse have no conflicts of interest or financial ties to disclose, David Cefai has a patent pending on the VN+., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)