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L'objectif de cet article est de décrire de manière exhaustive la technique du lambeau péritonéal prélevé par voie cœlioscopique dans la chirurgie d'affirmation de genre homme-à-femme (HtF), en particulier dans les cas de défauts de profondeur vaginale post-vaginoplastie par lambeau pénien inversé. Nos résultats à court terme révèlent que la vaginoplastie par lambeau péritonéal, adaptée de la procédure de Davydov, montre un potentiel significatif pour l'amélioration des résultats fonctionnels et esthétiques, y compris la création d'un néo-vagin autolubrifiant. Cependant, la complexité de la procédure nécessite une expertise chirurgicale avancée et des soins postopératoires adaptés. La sélection des patientes joue également un rôle essentiel, car toutes les patientes ne sont pas des candidates idéales pour cette procédure. Malgré ses promesses, l'adoption généralisée de la technique du lambeau péritonéal dans la chirurgie d'affirmation du genre HtF est entravée par plusieurs défis, notamment la nécessité d'une formation chirurgicale spécialisée et les complications postopératoires potentielles. Ainsi, cette technique doit être considérée comme une alternative ou un complément aux méthodes traditionnelles, en fonction des facteurs propres aux patientes. Des recherches plus approfondies et des essais cliniques plus étendus sont nécessaires pour bien comprendre son potentiel et ses limites afin d'améliorer l'arsenal des options chirurgicales efficaces pour la chirurgie d'affirmation de genre HtF.œ The aim of this article is to provide a comprehensive description of the peritoneal flap technique in male-to-female (MtF) gender affirmation surgery, particularly in cases of insufficient depth after penile inversion vaginoplasty. Our short-term results reveal that the peritoneal flap vaginoplasty, adapted from the Davydov procedure, has shown significant potential for improving functional and aesthetic outcomes, including the creation of a self-lubricating neovagina. However, the complexity of the procedure requires advanced surgical expertise and appropriate postoperative care. Patient selection also plays an essential role as not all patients are ideal candidates for this procedure. Despite its promises, the widespread adoption of the peritoneal flap technique in male-to-female (MtF) gender affirmation surgery is hindered by several challenges, including the need for specialized training and potential postoperative complications. Thus, this technique should be considered as an alternative or complement to traditional methods, depending on individual patient factors. Further research and extensive clinical trials are needed to better understand its potential and limitations in order to enhance the arsenal of effective surgical options for MtF gender affirmation surgery. [ABSTRACT FROM AUTHOR]

Abstract: Coelioscopy is a surgical technique in which small incisions are made into the coelomic cavity through which specific instrumentation is inserted to evaluate the internal structures within. For this reason, coelioscopy must be considered a less-invasive surgical method than traditional abdominal surgery. This study was aimed at evaluating and adapting the general coelioscopic principles of the technique to teleosts (10 European eels [Anguilla anguilla]). All the examined fish were anaesthetized with tricaine methanesulfonate solution. The coelioscopic procedures were performed with a rigid, 30° offset, 1.9-mm diameter endoscope connected to a portable video system. The results confirm that coelioscopy represents an imaging technique with high sensitivity in evaluating the coelomic organs in European eels. [Copyright &y& Elsevier]

Abstract: We report two cases of robot-assisted coelioscopic proximal tubal reanastomosis after proximal tubal ligature. Patients were aged 43 and 34 years respectively and had previously undergone proximal tubal ligation by coagulation section at 37 years of age for the first patient, and by Filshie clip at 24 years for the second one. Both had regular menstrual cycles and their ovarian reserve was good. Their partners were presenting with normal sperm criteria. Proximal tubal reanastomosis was carried out in September 2010 by robotic coelioscopy with five extramucous vicryl 5-0 stitches on each tube and positive blue testing. Total durations of the interventions were 200 and 220minutes respectively. Postoperative outcomes were simple and patients had spontaneous pregnancy at 4 and 2.5 months respectively. Both pregnancies show normal progress currently. This is a contribution to literature data meant to determine the role of robotics in proximal tubal reanastomosis. [Copyright &y& Elsevier]

Abstract: The term minimally invasive surgery refers to procedures performed using endoscopic guidance to enter a part of the body (e.g., laparoscopy, thoracoscopy, arthroscopy, rhinoscopy, gastroscopy). Endoscope-assisted procedures generally use a rigid endoscope to improve visualization and/or access or permit completion of the procedure extracorporeally to access internal body structures through small openings compared with traditional “open” incision techniques. Endoscope-assisted procedures currently performed in exotics include, but are not limited to, exploratory laparoscopy/coelioscopy/thoracoscopy, procurement of thoracic and abdominal organ biopsies, intestinal foreign body removal, cystotomy, and reproductive sterilization. [Copyright &y& Elsevier]

Abstract: Introduction: The aim of this study was to determine the epidemiological, clinical and therapeutic features, and the outcome of peritoneal tuberculosis in an endemic area of tuberculosis on the basis of our experience. Methods: All cases of peritoneal tuberculosis confirmed by histologic examination and hospitalized in the department of gastroenterology of Hedi-Chaker hospital between January 1987 and December 2006 were analyzed retrospectively. Results: Forty-two cases (mean age 38 years) were included in this study. Clinical presentation was dominated by ascites (100%), fever (76.2%) and abdominal pain (73.8%). The average delay for consultation after the first symptom was 3.6 months. The ascites was exudative in 100% of cases with lymphocytic predominance in 96.6%. The tuberculous skin test was above 10mm in 39.1% of cases. All of our patients had a peritoneal exploration. A nodular aspect of the peritoneal cavity was found in 40 patients (95.2%). Adhesions were noted in 25 patients. Therapeutic protocols varied among years. The outcome was favorable in all patients. Conclusion: Diagnosing peritoneal tuberculosis is a challenge for clinicians. Coelioscopy with peritoneal biopsies still remains the method of choice to establish a definite diagnosis of peritoneal tuberculosis. [Copyright &y& Elsevier]

Objective: To investigate the effects of coeliosurgery by catecholamine assays and the use of urapidil in the management of phaeochromocytoma.Study design: Prospective cohort study.Patients: Nine consecutive patients from April 1997 to April 2001.Methods: Urapidil (250 mg·j–1) was administered by continuous intravenous infusion three days before surgery and continued throughout anaesthesia. Plasma catecholamine concentrations were measured before surgery, after induction of anaesthesia, during insufflation, after adrenalectomy and in the recovery room. Haemodynamic disorders were treated by nicardipine ± esmolol bolus doses.Results: Creation of pneumoperitoneum and adrenal gland manipulations resulted in significant catecholamine releases associated with hypertension in five and eight patients respectively. Preventive urapidil use enabled easy control of blood pressure variations by additive antihypertensive drugs.Conclusion: Perioperative α1 blockade by urapidil enables an effective and easy control of acute peroperative haemodynamic changes. [Copyright &y& Elsevier]

Abstract: Massive obesity is an important risk factor in gynaecologic surgery. The traumatic effect of traditional laparotomy on the parietal wall is responsible for important perioperative morbidity. We describe the first reported case of an obese woman (Body Mass Index=55 kg/m2) with stage IIA neuroendocrine carcinoma of the cervix treated by laparoscopy after radiochemotherapy. After a complete response to radiochemotherapy, the patient underwent laparoscopic hysterectomy and bilateral salpingo-oophorectomy. The laparoscopic procedure was performed with a low-pressure pneumoperitoneum. She was discharged at day 2. No major complication was observed. Surgical and anesthesiological laparoscopic management in obese women are discussed. [Copyright &y& Elsevier]

Summary Colorectal surgeons often participate in the multidisciplinary management of young females with endometriosis. Complications of endometriosis as well as its management often result in infertility since they can involve all pelvic organs including the procreative organs: uterus, ovaries and fallopian tubes. Complete excision of all endometriotic lesions should not be performed at the expense of irreversible destruction of the procreative organs; definitive infertility should not be the price to pay in order to obtain an improvement of the painful symptoms caused by endometriosis. Surgery for ovarian endometriomas should be specifically adapted to the patient's desire for future conception and to her preoperative ovarian reserve. Two main techniques are used to treat ovarian endometriomas: ovarian cystectomy excises the wall of the cyst while ablation consists of destruction of the internal surface of the cyst. The use of mono polar or biolar coagulation for cyst ablation is strongly contra-indicated. Ablation using laser or plasma energy has resulted in comparable rates of post-operative pregnancy to those obtained by ovarian cystectomy. Patients who wish to delay their attempt to conceive for some period of time, should be placed on long-term oral contraception with prevention of menstruation to reduce the risk of recurrent endometriosis. When surgery for colorectal endometriosis is necessary, the laparoscopic approach increases the chances of spontaneous conception compared to laparotomy. Surgery for deep-seated endometriosis has been accompanied by a high rate of spontaneous conception and successful pregnancy and does not seem to decrease the chances for conception by in vitro fertilization. [ABSTRACT FROM AUTHOR]