ObjectiveTo evaluate totally laparoscopic Meckel's diverticulectomy in comparison with laparoscopic-assisted or open diverticulectomy.MethodsThe clinical data of 58 cases of Meckel's diverticulum admitted between January 2006 and January 2011 were analyzed.Cases were divided into three groups according to different period of time. As a result,totally laparoscopic surgery was performed in 13 cases,laparoscopic-assisted resection in 25 cases and open diverticulectomy in 20 cases. Totally laparoscopic group was compared with the other two groups in operation time,flatus defecation time,the incidence of postoperative complications and postoperative hospital stay.ResultsThe mean length of incision was ( 1.6 ± 0.4 ) cm,the mean operation time was ( 41 ± 5 ) min,flatus defecation time was (21.2 ±3.7) h,and the postoperative hospital stay was (6.3 ± 1.2) d in totally laparoscopic group.While that was (2.5 ± 1.2 ) m,( 38 ± 2 ) cm,( 23.6 ± 4.2 ) h,( 6.5 ± 2.3 ) d,respectively in laparoscopicassisted group,and the mean length of incision was (5.0 ± 2.2 ) cm,the mean operation time was (51 ± 6 )min,flatus defecation time was (32.3 ± 6.7) h,the postoperative hospital stay was (8.4 ± 3.8) d in open surgery group.Compared with conventional laparotomy,laparoscopic techniques enjoy advantages of minimal invasion,shorter operative time,fewer complications,shorter recovery period and earlier gastrointestinal recovery(P ＜ 0.05). There were nosignificant differences in operative time, recovery period and complications between totally laparoscopic group and laparoscopic-assisted group.ConclusionsTotally laparoscopic Meckel's diverticulectomy is safe,effective and miniinvasive in experienced hands.

Objective To investigate the imaging features of papillary tumor of the pineal region(PTPR).Methods The ima-ging data of 10 patients with PTPR confirmed by operation and pathology were analyzed retrospectively.Results All lesions were located in the posterior commissure area of the posterior inferior wall of the third ventricle.All lesions were heterogeneously hyper-intensity on T1WI and hyperintensity on T2WI.Multiple small cysts or microcapsules signal intensity were observed within the tumor.Of all 10 lesions,there were 9 lesions with high signal intensity within or at the edge of the lesion on T1WI.All lesions showed restricted diffusion.All 10 cases showed uneven and obvious enhancement patterns.Midbrain tectum was compressed and moved backward in 5 cases,moved downward in 2 cases,moved forward and downward in 1 case,and was not clearly displayed in other 2 cases.One case was disseminated and 1 case was hyperperfusion.There were all 10 cases with obstructive hydrocephalus and equal or slightly high density on CT imaging,and 4 cases with calcification.Conclusion Imaging characteristics of PTPR included the lesions centered on the posterior commissure,compressed tectum with backward and downward,multiple small cysts or micro-capsules components within the tumor,hyperintensity on T1WI,and uneven and obvious enhancement patterns.

Objective:To explore the feasibility, efficacy and limitation of robot-assisted laparoscopic surgery in the treatment of adrenal tumors in children.Methods:The clinical data of 5 children with adrenal tumors treated with robot-assisted laparoscopic surgery in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from October 2020 to March 2021 were retrospectively analyzed. All patients were males aged between 2 years and 4 months to 13 years and 1 month (median: 7 years and 7 months). One case had left adrenal adenomas and 4 cases had right adrenal adenomas.The maximum diameter of tumors was 3.0-6.0 cm (median: 4.8 cm).Results:Robot-assisted laparoscopic adrenalectomy was performed successfully on all 5 patients.The ope-ration time was 215-325 min (median: 275 min). The intraoperative bleeding was 10-50 mL (median: 28 mL). The indwelling time of the drainage tube after surgery was 3-5 days (median: 4 days). The postoperative hospital stay was 9-13 days (median: 11 days). The hospitalization cost was 51 268-58 157 yuan (median: 53 485 yuan). No complications occurred during or after the operation.Postoperative pathological tests suggested adrenal cortex adenocarcinoma in 1 case, pheochromocytoma in 1 case, gangliocytoma in 2 cases, and ganglioneuroblastoma in 1 case.Conclusions:Robot-assisted laparoscopic surgery is safe and feasible in children with adrenal tumors, but there are some limitations.This approach needs to be verified by further clinical research.