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Introduction: Obesity is currently the most common multifactorial disease affecting almost all social strata of the population. Conservative therapy of obesity usually succeeds in reducing excess weight by an average of 10-15%. After surgical treatment of severe obesity (bariatric surgery), the average decrease in excess weight is several times greater and, in most cases, has a long-term positive effect on the overall clinical condition of the patients., Methods: Sleeve gastrectomy (SG) is the most used bariatric method of treating severe obesity today. The principle of SG is a vertical resection of a major portion of the gastric greater curvature. After the resection, the residual stomach has the shape of a sleeve with a remaining volume of about 120-150 ml. The effect of the method is both restrictive and hormonal, because after SG, the plasma level of active ghrelin decreases in the long term, among other things., Conclusion: Obesity is considered one of the most serious global health problems today. In 2018 a total of 696,191 bariatric procedures were performed worldwide. Sleeve gastrectomy was originally used in high-risk severely obese patients as the first stage of a duodenal switch (DS) or gastric bypass. Since 2003, this method has been used independently because for most of the patients, SG had a sufficient effect on weight reduction and improvement of comorbidities, and that is why since 2015, SG has become the most frequently used bariatric method.

Introduction: The Czech Republic belongs to countries in which colorectal cancer significantly contributes to the overall oncological burden. Radical removal of tumor-affected tissues plays a key role in the multimodal therapy of rectal cancer. In the first decade of the third millennium the mini-invasive approach in rectal cancer surgery gradually expanded to include robotic-assisted surgeries. The aim of this paper is to present the results of a non-randomized study with prospectively collected data from robotically assisted rectal cancer surgeries., Methods: 204 patients with rectal cancer (.

Introduction: The aim of this study was to evaluate a group of bariatric patients operated at the Military University Hospital in Prague during the last 10 years (20112020), in whom laparoscopic sleeve gastrectomy was performed., Methods: Retrospective survey of the internal operation database. The search used the following combination of keywords: “sleeve“, “LSG“ and the diagnosis “E6*“. A total of 279 operated patients were enrolled. We evaluated the sex, age at the time of surgery, complications, need for drainage, weight, BMI, presence of type two diabetes mellitus and any effect of the surgery on its improvement, length of hospital stay, follow-up duration and % excess weight loss., Results: A total of 279 patients, including 195 women and 84 men, underwent laparoscopic sleeve gastrectomy in the period of 10 years. The mean age was 44.46 years. The average operating time was 111 minutes. The mean BMI of the patients before surgery was 42.24 and the weight was 123.4 kg. The mean BMI one year after the surgery corresponded to a decrease of approximately 10 and the mean weight of 93.8 kg. Rather severe acute postoperative complications occurred in 2.87% patients. An improvement or complete cure of type two diabetes mellitus was observed in 57.8% patients., Conclusion: Currently, laparoscopic sleeve gastrectomy is the most common bariatric operation at the Military University Hospital in Prague. This study demonstrates a satisfactory effect of bariatric surgery in terms of long-term significant weight loss and an improvement or even cure of associated diseases such as type two diabetes mellitus, arterial hypertension and others.

The trend of minimally invasive surgery expands even into the most technically demanding areas, including HPB surgery. Faster recovery and elimination of surgical site infections achieved with a minimally invasive approach provides, in addition to a better quality of life, the possibility of starting adjuvant treatment earlier. However, evidence of non-inferiority of short-term and oncological results compared to open surgery is required. In minimally invasive distal pancreatectomy, there is sufficient evidence to suggest that it as the method of choice for benign tumors and low-grade malignancies. For pancreatic cancer, the long-term results so far appear to be equivalent, although this still needs to be confirmed by ongoing randomized controlled trials (RCT). Enucleation of accessible lesions is also a suitable procedure for the minimally invasive approach. In contrast, in pancreaticoduodenectomy, available evidence does not demonstrate a clear benefit of the minimally invasive approach. Safety concerns still remain, and not even formal training has been successful in eliminating the consequences of the long learning curve for perioperative outcomes. Robotic approach appears to be more promising than laparoscopy for pancreaticoduodenectomy. Key words: pancreaticoduodenectomy distal pancreatectomy minimally invasive - laparoscopic robotic.

Introduction: Although several techniques of laparoscopic left pancreatectomy have already been developed through experiments on animals and human patients, there is still insufficient information about their pathophysiological mechanisms, especially the impact on surgical stress., Method: In a group of 10 pigs, open left pancreatectomy was performed, and the other group of 10 pigs underwent laparoscopic left pancreatectomy. Postoperative stress was compared by determining serum levels of leukocytes, interleukin 1, 6 and CRP from peripheral venous blood collection. The blood was collected prior to incision, 1 and 2 hours after incision, 24 hours after the beginning of the procedure, and on the 7th postoperative day., Results: No statistically significant difference was found between open and laparoscopic left pancreatectomy in the measured values of leukocytes, IL-1 and 6 and CRP.Key words: laparoscopy - left pancreatectomy surgical stress response interleukin 1 interleukin 6.