Parahiatal hernias are uncommon diaphragmatic hernias and not familiar to the general surgeons. Laparoscopic treatment of parahiatal hernia is feasible and safe in the majority cases. Surgeons should be aware of this disease when performing paraoesophageal hernia repair, as it may occur with or without previous diaphragmatic surgery.

A supravesical hernia is a rare abdominal wall hernia that is defined by the protrusion of abdominal viscera through the supravesical fossa, between the remnants of urachus and foetal umbilical arteries. It mainly concerns males and is usually presented as an internal hernia. The majority of patients refer to healthcare facilities with symptoms and signs of bowel obstruction.

In this study, we analysed 1499 patients undergoing low anterior resection for rectal cancer, proving that intraoperative indocyanine green imaging has a positive significance in reducing the incidence of anastomotic leakage after rectal cancer resection, secondary surgery and post-operative complications. The importance of this report is providing further evidence supporting the intraoperative use of indocyanine green imaging technique in rectal cancer surgery.

Neoadjuvant therapy is associated with significantly lower rates of post-operative pancreatic fistula after pancreatoduodenectomy but not after distal pancreatectomy. Further studies are required to determine whether neoadjuvant therapy should be added to post-operative pancreatic fistula risk calculators.

Cystic lesions of the pancreas (PCLs) may be inflammatory or proliferative and making an accurate and timely pre-operative diagnosis remains a significant clinical challenge. This narrative review examines the current diagnostic benchmarks and identifies novel diagnostic techniques that warrant further consideration, a number of which are beginning to be included in routine clinical practice when these PCLs are being investigated. We have highlighted the need for a comprehensive and standardised algorithm for the diagnosis and management of PCLs and we are confident that this can be achieved with the presently available and emerging technologies.

A summary of published population-based data on pancreatic cancer from Australia, highlighting areas of knowledge as well as issues that need to be addressed in the future.

Mean monthly trauma admissions for March/April by year: We aimed to evaluate the impact of societal restrictions and lockdown on trauma admissions during the coronavirus pandemic. There was a decreased number of minor trauma admissions; however the number of major traumas and in-hospital interventions required was unchanged. There was a decrease in trauma admissions from road traffic collisions and falls, but the number of admissions due to assault and self-harm was unchanged.

This study compares 663 patients undergoing closed reduction of paediatric forearm fractures in the emergency department under sedation to those performed in the operating theatre under general anaesthetic. We found comparable results between the two groups in regards to both re-intervention rates and adverse events.

Telemedicine is an innovative way to overcome geographical and infrastructural barriers in health systems, particularly in rural and remote settings. During the COVID-19 pandemic, telemedicine has become a necessary avenue for provision of safe patient care. This study demonstrates that rapid implementation of telehealth for orthopaedic fracture clinics does not seem to increase complication rates. Our experience can be used to implement a rapid telehealth plan if a similar scenario occurs in the future and to support increased uptake of telehealth for patients with geographical barriers to access to healthcare.

This study analyses the trends in inguinal hernia repairs (IHRs) rates in Australia over a 15-year period. Population data revealed decreasing IHR rates per 100 000 population, with an increase in laparoscopic surgery and a subsequent decline in open IHRs.

The aim of this study was to investigate the effect of immunosuppression on wound complications after hernia repair with synthetic mesh. Our results do not show an association between immunosuppression and mesh infection or surgical site infection, but suggest that immunosuppression and mesh infection increase the odds for hernia recurrence.

A retrospective analysis of all emergency general surgery patient admitted to Auckland City Hospital during the COVID-19 New Zealand lockdown.

(a) Computed tomography scans for patients with a non-surgical diagnosis. (b) Patients with a non-surgical diagnosis discharged <12 h.

Initial and repeat cholecystectomy over time. Number of first and second cholecystectomies annually. Rate of second cholecystectomy as a percentage of all cholecystectomies, demonstrating an increasing annual trend.

Research about the long-term outcomes of oesophagogastric devascularization and splenectomy (OGDS) to treat portal hypertension is scarce. The aim of this study was to evaluate the safety and the long-term treatment efficacy of OGDS, especially in elderly patients. OGDS remains safe and effective to treat portal hypertension secondary to liver cirrhosis and it can be performed successfully in elderly patients and achieve a curative effect that is not inferior to young patients.

This retrospective study of patients with pyogenic liver abscess demonstrates continued preference for percutaneous drainage techniques over surgical drainage. The mortality rate attributable to pyogenic liver abscess was low; however, the risk of complications appeared to concentrate in patients who did not undergo abscess drainage.

This study determined the incidence of unsuspected choledocholithiasis in a population deemed to be low risk undergoing laparoscopic cholecystectomy with routine intra-operative cholangiography. In addition to this, the management of these patients was reported along with predictive factors for an abnormal intra-operative cholangiogram were determined. Risk factors independently associated with unsuspected choledocholithiasis included patients over the age of 55 years of age (odds ratio 2.93, P = 0.038) and a large cystic duct size (odds ratio 3.13, P < 0.001) on multivariable analysis.

Due to the lack of understanding of definite aetiology and the rarity of idiopathic megacolon in adults, preoperative examination and diagnosis must be comprehensive. Laparoscopic-assisted colectomy with Duhamel procedure is a safe and effective technique for idiopathic megacolon in adults. The scope of colon resection and the anastomosis pattern should be individually selected.

This experimental study aims to investigate the effect of platelet-rich plasma gel on colon anastomosis in rats treated with hyperthermic intra-peritoneal chemotherapy (HIPEC) using 5-fluorouracil. The HIPEC procedure significantly reduces anastomotic bursting pressure through its negative effects on anastomotic healing. This paper suggests that the negative effect of HIPEC on anastomotic healing can be reversed by the application of platelet-rich plasma gel.

An example of quantitative measurement of visceral fat areas (light blue) and subcutaneous fat areas (dark blue) on L4/L5 vertebrae level on axial slice of computed tomography scan.

Recent changes to the Australian Medicare Benefits Scheme funding for rhinoplasty on November 2018 have included a Nasal Obstruction Symptom Evaluation (NOSE) Scale threshold of >45 as a criteria for surgical intervention. The NOSE Scale is a patient-reported outcome measure of nasal obstruction which is well validated for use in rhinoplasty and septorhinoplasty patients. Up until now, however, there has been minimal normative data for the NOSE Scale in the general population and no normative data from the general Australian population published in the literature. This article provides that context, presenting the first normative NOSE Scale data for the general Australian population.

Tracheostomy-tube change protocols are implemented primarily due to concern regarding infections. However, currently no evidence-based guidelines exist to justify these protocols. In this prospective cohort study, no statistically significant difference in colonisation in patients undergoing tube changes more than every 4 weeks to those less than every 4 weeks was found. The timing of tracheostomy-tube changes may not affect colonisation and infection rates.

The aim of this study was to determine the surgeon-modifiable factors which impact the rates of post-operative complications following parotidectomy for benign pathology. Focused tumour dissection, nerve integrity monitoring and dermofat grafting are surgeon-modifiable variables associated with lower rates of post-operative complications following parotidectomy for benign pathology. However, the benefit of these operative techniques relies on their appropriate utilization by performing surgeons.

This study reviews the management of a rare skin tumour (pleomorphic dermal sarcoma) at a tertiary cancer centre.

Tendinous mallet finger deformity can be treated by reconstructing extensor tendon insertion, and it is realized by suturing the transferred portion of flexor digitorum profundus tendon with the ruptured extensor tendon via the constructed bone tunnel.

Necrotising fasciitis continues to present a unique diagnostic challenge to clinicians across multiple specialties. A high index of suspicion for necrotising fasciitis, especially in high-risk patients, urgent surgical review and aggressive debridement may reduce mortality.

Our research demonstrates a high rate of immediate breast reconstruction following mastectomy that includes a wide range of autologous and alloplastic reconstructions within a diverse patient population. Our study represents a unique opportunity to identify barriers and facilitate patient choice reconstruction rates, particularly in tertiary services with a strong multicultural and multi-linguistic population.

This retrospective study determined the rate of breast reconstruction in women who had mastectomy as treatment for breast cancer at public hospitals in South Western Sydney Local Health District – a culturally diverse health district in New South Wales, Australia – and compared the rate of reconstruction in the culturally and linguistically diverse (CALD) and non-CALD populations. The study found a low breast reconstruction rate in public hospitals in South Western Sydney Local Health District. The reconstruction rate did not differ between CALD or English-speaking patients, or between patients from diverse socio-economic backgrounds.

In this paper, we reviewed the three-dimensional interplay between tumour and surgical specimen dimensions in patients undergoing oncoplastic breast surgery compared to simple wide local excision. The relationship between tumour and specimen medio-lateral, supero-inferior and antero-posterior dimensions were explored in both groups. Despite larger tumour dimensions, oncoplastic surgery is not inferior to wide local excision in providing clear surgical margins.

Incarcerated groin hernia management often required emergency surgery. Hernioscopy is a safe alternative to repair hernia and explore intra-abdominal cavity. Alexis Laparoscope System is a useful device to perform hernioscopy.

We describe a step by step technique for repair of a small umbilical hernia laparoscopically that aims to provide an excellent technical and cosmetic result without a significant increase in operative time or cost. Patients report good quality of life post-operatively and appear satisfied with the cosmetic result.