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Abstract Background: The COVID-19 pandemic has significantly affected healthcare service systems and personnel worldwide. Important decisions have been made such as surgical activity changes, recommendations to cancel elective surgery, and shifting surgeons to other medical activities. However, following the collection of new data and acceptance that this pandemic would last for at least a few years, firstly elective cases and then laparoscopic operations were started again. While it was reported that the COVID-19 virus was detected in the abdominal cavity in studies published in the form of series of a few cases, there is no clear information about the virulence of this detected virus yet. In guidelines published as recommendations by surgical associations, it is stated that it could be performed by taking the necessary precautions, but open surgery needs to be preferred in positive cases. We aimed in this study to show minimally invasive surgery is safe with all the precautions made preoperatively for both patients and surgical crew. Material and Method: We retrospectively examined the laparoscopic cases included between August 2020 and December 2020 at the General Surgery Clinic of the Hitit University Erol Olçok Research and Training Hospital from the hospital’s information system. We collected the ages of the found cases, their preoperative COVID diagnostic tests, and their COVID polyclinic visitation data in their postoperative follow-up. We also examined whether or not the surgical team involved in the surgeries of these patients was diagnosed with COVID-19 within 2 weeks following these surgeries. Results: A total of 124 laparoscopic cases were included at our clinic between August 2020 and December 2020. Most of these cases (68.5%) were laparoscopic cholecystectomy cases. A total of 124 laparoscopic cases were included at our clinic between August 2020 and December 2020. Most of these cases (68.5%) were laparoscopic cholecystectomy cases. The surgical team comprised the surgical nurse and operating room personnel under the leadership of the surgeon. Based on verbal questioning, it was determined that no person from the team involved in these surgeries was infected with SARS-CoV-2. Conclusion: In our study, as a result of our application of all these recommendations in the literature, we did not encounter any contamination in the 124 laparoscopic surgery cases we examined. In conclusion, we think that laparoscopic surgery may be performed safely with taking the necessary precautions during the COVID-19 pandemic period.

Background and Aim: To derive lessons from the data of patients who were followed for various periods with the misdiagnosis of liver hemangioma and eventually found to have a malignancy.Material and Methods: The records of 23 patients treated between 2003 and 2018 were analyzed retrospectively.Results: Twelve patients were men and 11 were women; median (range) age was 55 (35–80). The principal diagnostic modality for the initial diagnosis was ultrasonography (n:8), magnetic resonance imaging (MRI) (n:13), and computed tomography (CT) (n:2). At our institution, MRI was performed in 16 patients; the diagnosis was made with the available MRI and CT studies in five and two patients, respectively. In other words, the ultrasonography interpretations were not confirmed on MRI; in others, the MRI or CT examinations were of low quality or they had not been interpreted properly. Fifteen patients underwent surgery; the other patients received chemotherapy (n:6) or chemoembolization (n:2). The misdiagnosis caused a median (range) 10 (0–96) months delay in treatment. The final diagnoses were hepatocellular carcinoma in 12 patients, cholangiocarcinoma in four patients, metastatic mesenchymal tumor, metastasis of colon cancer, metastatic neuroendocrine carcinoma, sarcomatoid hepatocellular carcinoma, angiosarcoma, thoracic wall tumor, and metastatic tumor of unknown primary in one patient each.Conclusions: High-quality MRI with proper interpretation and judicious follow up are vital for the accurate differential diagnosis of liver lesions.

In this study, it was aimed to reveal whether playing video games had a positive effect on laparoscopic surgical skills. A retrospective analysis was performed on the data of the patients, who underwent laparoscopic cholecystectomy between 01.08.2016 and 01.02.2021. Patients were divided into two groups as patients, who underwent laparoscopic cholecystectomy performed by surgeons who did not play video games (Group I), and patients, who underwent laparoscopic cholecystectomy performed by surgeons who played video games (Group II). The groups were compared in terms of demographic data, ASA scores, duration of surgery, length of stay in the hospital and intraoperative complications. In the study, 449 patients were included in Group I, and 595 patients were included in Group II, after the exclusion criteria were applied. It was observed that there was no significant difference between the two groups in terms of demographic data, ASA scores and intraoperative complications. The mean duration of surgeries performed by surgeons who did not play video games (Group I) was 49.39 ± 18.05 minutes, and the mean duration of surgeries performed by surgeons who played video games (Group II) were found to be 46.74 ± 17.50 minutes, with statistically significance (p= 0.01). Playing video game regularly has a positive effect in terms of ability and speed of laparoscopy. Besides, it is considered to be encouraging in terms of advanced laparoscopic surgical interventions. [Med-Science 2021; 10(3.000): 959-62]

OBJECTIVES: To determine the serum and tissue levels of markers of impaired oxidative metabolism and correlate these levels with the histopathology and Alvarado score of acute appendicitis patients. METHOD: Sixty-five acute appendicitis patients (mean age, 31.4±12.06 years; male/female, 30/35) and 30 healthy control subjects were studied. The Alvarado score was recorded. Serum samples were obtained before surgery and 12 hours postoperatively to examine the total antioxidant status, total oxidant status, paraoxonase, stimulated paraoxonase, arylesterase, catalase, myeloperoxidase, ceruloplasmin, oxidative stress markers (advanced oxidized protein products and total thiol level) and ischemia-modified albumin. Surgical specimens were also evaluated. RESULTS: The diagnoses were acute appendicitis (n = 37), perforated appendicitis (n = 8), phlegmonous appendicitis (n = 12), perforated+phlegmonous appendicitis (n = 4), or no appendicitis (n = 4). The Alvarado score of the acute appendicitis group was significantly lower than that of the perforated+phlegmonous appendicitis group (p = 0.004). The serum total antioxidant status, total thiol level, advanced oxidized protein products, total oxidant status, catalase, arylesterase, and ischemia-modified albumin levels were significantly different between the acute appendicitis and control groups. There was no correlation between the pathological extent of acute appendicitis and the tissue levels of the markers; additionally, there was no correlation between the tissue and serum levels of any of the parameters. CONCLUSIONS: The imbalance of oxidant/antioxidant systems plays a role in the pathogenesis acute appendicitis. The Alvarado score can successfully predict the presence and extent of acute appendicitis.