We aim to offer a description of the surgical technique and to review the current state retroperitoneal robot-assisted partial nephrectomy (rRAPN).

Partial nephrectomy is the standard treatment for localized kidney tumours. rRAPN is especially useful for kidney tumours of posterior location. It offers advantages such as direct access to the renal artery and no need for bowel mobilization. The disadvantages are the small working space and the less familiar anatomical landmarks. It is a reproducible technique that achieves similar oncological and functional results to the more traditional transperitoneal route (tRAPN). High-quality randomized studies are needed to ascertain the role of new technologies as modern high-flow insufflation systems, intracavitary ultrasound, 3D planning, and augmented reality (AR), in the performance of this operation. rRAPN is especially useful for kidney tumours of posterior location. Robotic surgeons ideally should become familiar with both approaches, transperitoneal or retroperitoneal.

Partial nephrectomy is the standard treatment for localized kidney tumours. rRAPN is especially useful for kidney tumours of posterior location. It offers advantages such as direct access to the renal artery and no need for bowel mobilization. The disadvantages are the small working space and the less familiar anatomical landmarks. It is a reproducible technique that achieves similar oncological and functional results to the more traditional transperitoneal route (tRAPN). High-quality randomized studies are needed to ascertain the role of new technologies as modern high-flow insufflation systems, intracavitary ultrasound, 3D planning, and augmented reality (AR), in the performance of this operation. rRAPN is especially useful for kidney tumours of posterior location. Robotic surgeons ideally should become familiar with both approaches, transperitoneal or retroperitoneal.The global presence of antibiotics in the environment has created concerns about the emergence of antibiotic resistance bacteria and potential hazard to humans and the ecosystem. This work aims to study the removal of levofloxacin, a new generation fluoroquinolone antibiotic from aqueous solutions by enzyme mediated oxidation process and optimization of the conditions thereof by response surface methodology (RSM) using Box-Behnken design (BBD). For this study, experiments were conducted to analyze the effect of independent variables namely, pH, temperature, mediator concentration and antibiotic concentration on the degradation percentage of levofloxacin antibiotic using laccase enzyme derived from Trametes versicolor. The residual levofloxacin concentration was determined using high performance liquid chromatography (HPLC). On applying the quadratic regression analysis, among the main parameters, it was found that the percentage degradation was significantly affected by all the four variables. The predicted v89% degradation in synthetic wastewater at the optimized conditions. The biodegradation studies were conducted using only 2 units of laccase. Thus, the expensive commercial laccase can be effectively replaced by crude laccase isolated from indigenous macrofungi such as P. eryngii, P. florida and P. sajor caju as a cost effective alternative to degrade levofloxacin present in contaminated wastewater using as low as 2 units of enzyme for a 72 h treatment period.

Intussusception is an uncommon cause of intestinal obstruction in adults. The etiology of this disease differs from the children. Thus, its management depends on the possible etiology and is different from pediatric cases.

We aimed to study the clinico-histopathological spectrum ofthe tumors and tumor-like lesions in the intussusception in adults.

A retrospective review of the adult (> 18years) intussusception cases was performed. The clinical data and follow-up were obtained. The histopathology was reviewed along with the special stains and immunohistochemistry for ascertaining a histopathological diagnosis.

Fifteen cases of adult intussusception were identified from 107 resected specimens of adult intestinal obstruction. The mean age was 44.5years with a male/female ratio of 1.11. A definitive pathology could be ascertained in 80% of the cases (n = 12/15). Eight cases had benign non-neoplastic etiology (53.3%) (33.3% tumor-like lesions) while seven cases (46.7%) had neoplastic etiology (20% benigtussusceptions were associated with neoplasia whereas 90% of the enteric intussusceptions occurred due to benign non-neoplastic causes. CONCLUSIONS Non-neoplastic causes are predominant in the enteric intussusceptions while neoplastic causes are more commonly associated with colonic or enterocolic intussusceptions. The post-operative histopathological examination concludes on the adequacy of the index surgery or the provision of further management if required.In this study, we numerically investigated the mechanical responses and trajectories of frictional granular particles under oscillatory shear in the reversible phase where particle trajectories form closed loops below the yielding point. When the friction coefficient is small, the storage modulus exhibits softening, and the loss modulus remains finite in the quasi-static limit. As the friction coefficient increases, the softening and residual loss modulus are suppressed. Metabolism inhibitor The storage and loss moduli satisfy scaling laws if they are plotted as functions of the areas of the loop trajectories divided by the strain amplitude and diameter of grains, at least for small values of the areas.

Abdominal myomectomy can be a challenging procedure, with elevated intraoperative blood loss and post-operative complications such as the need for blood transfusion and hemostasis with sometimes hysterectomy. Previous studies suggested that preemptive uterine artery embolization (PUAE) might reduce intraoperative blood loss.

We reviewed all cases of abdominal myomectomy in our institution between January 2016 and June 2018. Out of 119 cases, 16 patients had PUAE and 103 did not. The objective of our study was to determine whereas PUAE reduced blood loss and post-operative complication rate.

In our study, there was no difference between the two groups in regard to average blood loss (128 vs 192 mL, OR 1,00 [0.99;1,01], p = 0,73), difference between pre- and post-operative hemoglobin level (- 1,15 g/dL vs - 1,32 g/dL, OR 0,91 [0.47;1,73], p = 0,79), and post-operative complications (need for transfusion, surgical revision, post-operative embolization, hysterectomy).

Our findings could not conclude that PUAE is effective in reducing intraoperative blood loss during abdominal myomectomy, but it should still be considered an option for patients with large or multiple myomas, with a specific situation or previously operated, who wish to preserve their uterus.