Hand-assisted laparoscopic adrenalectomy: An alternative minimal invasive surgical technique for the adrenal gland

Background: Presently the surgical approach to the adrenal gland is in a state of flux. While the traditional approach to the adrenal gland has been the open transabdominal technique, more recently laparoscopic approaches, particularly via the transabdominal route, have increasingly been utilized. However, laparoscopic intervention for the adrenal gland can be problematic in certain circumstances, particularly for large adrenal masses and in instances of adrenal malignancies. Methods: In this report we describe the use of hand-assisted laparoscopic adrenalectomy as an alternative minimal invasive surgical approach to the adrenal gland. Hand-assisted laparoscopic adrenalectomy using the HandPort system (Smith & Nephew, Sydney, Australia) was undertaken in three patients requiring adrenalectomy for mass lesions including one patient with Conn's syndrome. Results: In all three cases, surgery proceeded promptly and uneventfully. In the present paper, the details of the technique of hand-assisted adrenalectomy are described. This is the first report in the world literature of this new technique for the adrenal gland. Conclusions: Hand-assisted laparoscopic adrenalectomy is an easily performed technique, which can be completed within a short operative time span and which has the advantage of providing intraoperative tactile localization for the adrenal gland. It may be particularly applicable for large adrenal tumours, yet only involves the performance of a small abdominal incision. Postoperative recovery is comparable with that reported for the laparoscopic-only technique. Hand-assisted adrenalectomy is a new technique which has great potential and which warrants further evaluation.

The spectrum of minimal defining sets of some Steiner systems

For a design D, define spec(D) = {\M\ \ M is a minimal defining set of D} to be the spectrum of minimal defining sets of D. In this note we give bounds on the size of an element in spec(D) when D is a Steiner system. We also show that the spectrum of minimal defining sets of the Steiner triple system given by the points and lines of PG(3,2) equals {16,17,18,19,20,21,22}, and point out some open questions concerning the Steiner triple systems associated with PG(n, 2) in general. (C) 2002 Elsevier Science B.V. All rights reserved.

Link invariants associated with gauge equivalent solutions of the Yang-Baxter equation: The one-parameter family of minimal typical representations of Uq[gl(2|1)]

In this paper we investigate the construction of state models for link invariants using representations of the braid group obtained from various gauge choices for a solution of the trigonometric Yang-Baxter equation. Our results show that it is possible to obtain invariants of regular isotopy (as defined by Kauffman) which may not be ambient isotopic. We illustrate our results with explicit computations using solutions of the trigonometric Yang-Baxter equation associated with the one-parameter family of minimal typical representations of the quantum superalgebra U-q,[gl(2/1)]. We have implemented MATHEMATICA code to evaluate the invariants for all prime knots up to 10 crossings.