To describe the spectrum of robotic surgical techniques used for removal of synthetic midurethral slings (MUS) in different mesh-related complications and to report perioperative and functional outcomes in a tertiary referral setting. Robotic MUS removal has recently emerged as an alternative approach; however, data regarding its indications, technical aspects and outcomes remain limited. We analyzed a prospectively maintained database of all female patients who underwent robotic MUS removal at a single tertiary referral center between August 2022 and July 2025. Indications for surgery included pain, mesh exposure, or patient request for complete removal. Depending on the indication and shared decision-making process, either complete removal of all remaining mesh components or partial removal of the extruded segment was planned. Patients with preoperative stress urinary incontinence (SUI) were offered concomitant robotic autologous fascial sling placement, whereas those without preoperative SUI underwent pubourethral ligament plication. Outcomes assessed included postoperative complications (Clavien–Dindo classification), pain evaluated using a visual analog scale (VAS), continence outcomes, Patient Global Impression of Improvement (PGI-I), and need for reintervention. Seventy patients were included. The planned extent of mesh excision was achieved in all patients; complete removal of all remaining mesh components was performed in 74 cases and partial removal in 6 cases. Median operative time was 160 min, and median length of hospital stay was 3 days (range 0–21). Major complications (Clavien–Dindo ≥ III) occurred in 6 patients (8.6
There is a knowledge gap on the epidemiology of inflammatory bowel disease in Africa. To begin to address this issue, we formed a case reporting network of practitioners with an interest in inflammatory bowel disease across sub-Saharan Africa. Here, we report a series of 175 cases from 12 countries over 2 years.
Tahiri, Mohamed MD; Goh, Khean-Lee MD, MWGO; Abbas, Zaigham MD; Epstein, David MD; Min-Hu, Chen MD; Mulder, Chris J.J. MD; Puri, Amarender Singh MD; Schultz, Michael MD, PhD; LeMair, Anton MD; Melberg, Jim Author Information
Introduction: Improving handwashing with soap (HWWS) among children in humanitarian emergencies has the potential to reduce the transmission of several important infectious diseases. However, there is limited evidence on which approaches are effective in increasing HWWS among children in humanitarian settings. One recent innovation – the “Surprise Soap” intervention – was shown to be successful in a small-scale efficacy trial in a humanitarian setting in Iraq. This intervention includes soap with embedded toys delivered through a short household session comprising a glitter game, instruction of how and when to wash hands, and HWWS practice. Whilst promising, this approach has not been evaluated at programmatic scale in a complex humanitarian setting. Methods: We conducted a cluster-randomised controlled equivalence trial of the Surprise Soap intervention in IDP camps in Kahda district, Somalia. Proportionate stratified random sampling was employed to recruit 200 households, with at least one child aged 5-12, across the camps. Eligible households were randomly allocated to receive the Surprise Soap intervention (n=100) or an active comparator handwashing intervention in which plain soap was delivered in a short household session comprising standard health-based messaging and instruction of how and when to wash hands (n=100). The primary outcome was the proportion of pre-specified occasions when HWWS was practiced by children aged 5-12 years, measured at baseline, 4-weeks, 12 weeks, and 16 weeks post invention delivery. Results: HWWS increased in both groups (by 48 percentage points in the intervention group and 51 percentage points in the control group, at the 4-wee follow up), however, there was no evidence of a difference in HWWS between the groups at the 4-week (adjusted RR (aRR)=1.0, 95% CI 0.9–1.1), 12-week (aRR=1.1, 95% CI 0.9–1.3), or 16-week (aRR=1.0, 95% CI 0.9–1.2) follow-up. Conclusions: In a complex humanitarian setting, where soap availability and past exposure to handwashing promotion was low, it appears that well-designed targeted handwashing interventions can increase child HWWS and potentially reduce disease risk, but the Surprise Soap intervention offers no marginal benefit that would justify the additional costs.
PURPOSE:The primary objective of this study was to compare the re-rupture rate, clinical results, and functional outcomes six months after the surgical repair of an acute Achilles tendon rupture between three different techniques (open repair, percutaneous repair with the Tenolig®, and minimally invasive repair).METHODS:A prospective, comparative, multicenter, non-randomized study was performed and included 111 patients who had an acute ruptured Achilles tendon: 74 underwent an open repair, 22 underwent a percutaneous repair using the Tenolig® and 15 had a minimally invasive repair. At six months follow-up we analyzed the number of re-ruptures, phlebitis, infections, complex regional pain syndrome, clinical outcomes (muscle atrophy, ankle dorsal flexion), functional scores (ATRS, VISA-A, EFAS, SF-12), and return to running.RESULTS:There were more re-ruptures (p=0.0001) after repair with the Tenolig® (27%) than with open repairs (1.3%) and minimally invasive repairs (0%). The rate of other complications was not different. No clinical differences were found between the three groups. Only some functional scores EFAS Total (p=0.006), and VISA-A (p=0.015) were worse in the Tenolig® group. All the other results were similar between the three groups.CONCLUSION:Despite heterogeneous studies in literature, the results of this comparative and prospective study between three surgical techniques of Achilles tendon repair confirmed that Tenolig® repair increased the rate of early re-rupture compared to open or minimally invasive techniques.
