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  1. Article: Lemmel's syndrome: Case report of a not feasible endoscopic management.

    Sergi, William / Libia, Annarita / Stasi, Elisa / Depalma, Norma / D'Ugo, Stefano / Spampinato, Marcello

    International journal of surgery case reports

    2024  Volume 117, Page(s) 109522

    Abstract: Introduction: Lemmel's syndrome is a rare disease presenting with obstructive jaundice, secondary to common bile duct compression by duodenal diverticulum.: Presentation of case: A 79-year-old female was admitted to our emergency department with ... ...

    Abstract Introduction: Lemmel's syndrome is a rare disease presenting with obstructive jaundice, secondary to common bile duct compression by duodenal diverticulum.
    Presentation of case: A 79-year-old female was admitted to our emergency department with cholangitis and obstructive jaundice, due to choledocal compression by two periampullary diverticula, with major papilla opening near the biggest one (periampullary diverticulum type III). Endoscopic retrograde cholangiopancreatography didn't succeed sphincterotomy, therefore laparoscopic rendez-vous was performed.
    Discussion: This case is an example of an unusual cause of obstructive jaundice, which should be mentioned along with choledocolithiasis and biliary or ampullary neoplasms, in order to avoid delay in diagnosis and management.
    Conclusion: The commonest treatment of Lemmel's syndrome reported in literature is ERCP with sphincterotomy, but when endoscopic management fails, interventional radiology and surgery should also be considered.
    Language English
    Publishing date 2024-03-11
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2024.109522
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  2. Article: Laparoscopic treatment of symptomatic Dunbar syndrome: a case report.

    Sergi, William / Depalma, Norma / D'Ugo, Stefano / Botrugno, Ivan / Manoochehri, Farshad / Spampinato, Marcello

    International journal of surgery case reports

    2022  Volume 93, Page(s) 106925

    Abstract: Introduction and aim of the study: Dunbar syndrome is a rare disorder due to the external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting with a significative reduction in patients' ...

    Abstract Introduction and aim of the study: Dunbar syndrome is a rare disorder due to the external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting with a significative reduction in patients' quality of life. Laparoscopy has proven to be a safe procedure. The aim of this study is to present a case of Dunbar syndrome undergoing laparoscopic surgery.
    Case presentation: A 40-year-old male patient presented at Emergency Room with upper abdominal pain and dyspepsia, related to food intake. A selective arteriography of the celiac trunk revealed stenosis due to compression of the celiac artery.
    Clinical discussion: Laparoscopic decompression of the celiac trunk by the median arcuate ligament was performed. Postoperative course was uneventful and the patient was discharged on the 5th postoperative day.
    Conclusion: Minimally invasive surgical division of the arcuate ligament is feasible and safe and it can restore patients' quality of life.
    Language English
    Publishing date 2022-03-09
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2022.106925
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  3. Article ; Online: Feasibility of a tailored ERAS programme in octogenarian patients undergoing minimally invasive surgery for colorectal cancer.

    Depalma, N / Cassini, D / Grieco, M / Barbieri, V / Altamura, A / Manoochehri, F / Viola, M / Baldazzi, G

    Aging clinical and experimental research

    2019  Volume 32, Issue 2, Page(s) 265–273

    Abstract: Background: The enhanced recovery after surgery (ERAS) is nowadays a widely accepted multimodal programme of care in colorectal surgery, but still there is some reluctance in its application to very elderly patients.: Aim: The aim of this study is to ...

    Abstract Background: The enhanced recovery after surgery (ERAS) is nowadays a widely accepted multimodal programme of care in colorectal surgery, but still there is some reluctance in its application to very elderly patients.
    Aim: The aim of this study is to investigate short-term outcomes of laparoscopic resection for colorectal cancer in octogenarian patients within the ERAS programme.
    Methods: Data on 162 consecutive patients aged ≥ 80 years receiving elective minimally invasive colorectal resections within ERAS programme were collected in a multicentre, retrospective database in the period 2008-2017 in Italy. Univariate and multivariate analyses were performed to assess possible risk factors for poor clinical outcomes.
    Results: The postoperative minor morbidity rate (Clavien-Dindo 1 and 2) was 25.9%. The incidence of postoperative major morbidity rate (severe medical and surgical complications defined as Clavien-Dindo 3 and 4) accounted 6.1% and only 1.8% had an anastomotic leakage. Reoperation rate was 5.5%, perioperative 30-day mortality was 1.8%, and 30-day readmission rate was 6.8%. On average, patients were released after 6 days. A univariate analysis showed that possible risk factors for severe medical complications were: low preoperative albumin level, high Charlson Age Comorbidity Index Score and number of days in the intensive care unit (ICU); risk factors for severe surgical complications were: low preoperative albumin level; risk factors for late hospital discharge were: multivisceral resections, number of days in ICU and body mass index (BMI) > 25 kg/m
    Discussion: The minimal invasive nature of the laparoscopic approach together with a multimodal analgesia therapy, the early resumption to oral diet and mobilisation could minimize the surgical stress and play an essential role in order to reduce medical morbidity in high-risk patients.
    Conclusion: Colorectal surgery within ERAS programme in octogenarians is a safe and flexible treatment in high-volume centres.
    MeSH term(s) Aged, 80 and over ; Colorectal Neoplasms/surgery ; Digestive System Surgical Procedures/adverse effects ; Elective Surgical Procedures/adverse effects ; Enhanced Recovery After Surgery ; Feasibility Studies ; Female ; Humans ; Italy ; Length of Stay ; Male ; Minimally Invasive Surgical Procedures/adverse effects ; Postoperative Complications/etiology ; Postoperative Period ; Reoperation ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2019-04-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2104785-6
    ISSN 1720-8319 ; 1594-0667
    ISSN (online) 1720-8319
    ISSN 1594-0667
    DOI 10.1007/s40520-019-01195-6
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  4. Article: NIR ICG-Enhanced Fluorescence: A Quantitative Evaluation of Bowel Microperfusion and Its Relation to Central Perfusion in Colorectal Surgery.

    Depalma, Norma / D'Ugo, Stefano / Manoochehri, Farshad / Libia, Annarita / Sergi, William / Marchese, Tiziana R L / Forciniti, Stefania / Del Mercato, Loretta L / Piscitelli, Prisco / Garritano, Stefano / Castellana, Fabio / Zupo, Roberta / Spampinato, Marcello Giuseppe

    Cancers

    2023  Volume 15, Issue 23

    Abstract: Background: To date, no standardized protocols nor a quantitative assessment of the near-infrared fluorescence angiography with indocyanine green (NIR-ICG) are available. The aim of this study was to evaluate the timing of fluorescence as a reproducible ...

    Abstract Background: To date, no standardized protocols nor a quantitative assessment of the near-infrared fluorescence angiography with indocyanine green (NIR-ICG) are available. The aim of this study was to evaluate the timing of fluorescence as a reproducible parameter and its efficacy in predicting anastomotic leakage (AL) in colorectal surgery.
    Methods: A consecutive cohort of 108 patients undergoing minimally invasive elective procedures for colorectal cancer was prospectively enrolled. The difference between macro and microperfusion (ΔT) was obtained by calculating the timing of fluorescence at the level of iliac artery division and colonic wall, respectively.
    Results: Subjects with a ΔT ≥ 15.5± 0.5 s had a higher tendency to develop an AL (
    Conclusions: The analysis of the timing of fluorescence provides a quantitative, easy evaluation of tissue perfusion. A ΔT/HR interaction ≥832 may be used as a real-time parameter to guide surgical decision making in colorectal surgery.
    Language English
    Publishing date 2023-11-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15235528
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  5. Article: Symptomatic acinar cell cystadenoma of the pancreas.

    Sergi, William / D'Ugo, Stefano / Libia, Annarita / Depalma, Norma / Marchese, Tiziana / Garritano, Stefano / Vadrucci, Stefania / Stasi, Elisa / Botrugno, Ivan / Manoochehri, Farshad / Spampinato, Marcello

    Journal of surgical case reports

    2023  Volume 2023, Issue 6, Page(s) rjad360

    Abstract: Acinar cystic transformation (ACT), also known as 'acinar cell cystadenoma', is an uncommon cystic neoplasm of pancreas with unknown malignant potential. This case regards a woman with symptomatic pancreatic head ACT, revealed with pathological exam of ... ...

    Abstract Acinar cystic transformation (ACT), also known as 'acinar cell cystadenoma', is an uncommon cystic neoplasm of pancreas with unknown malignant potential. This case regards a woman with symptomatic pancreatic head ACT, revealed with pathological exam of specimen after pancreaticoduodenectomy. A 57-years-old patient presented mild hyperbilirubinemia and recurrent cholangitis; she underwent to ERCP, EUS and MRI, and these exams revealed a large cyst of the pancreatic head that caused biliary compression. The discussion of the case by the multidisciplinary group indicated surgical resection. Pancreatic ACT is so rare, and its preoperative diagnosis is difficult. The symptoms of the patients and the features of the cyst are the criteria to choose a surgical resection.
    Language English
    Publishing date 2023-06-27
    Publishing country England
    Document type Case Reports
    ZDB-ID 2580919-2
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjad360
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  6. Article: Robotic-assisted distal pancreatectomy with splenectomy in a paediatric patient for solid pseudopapillary tumour.

    Sergi, William / Depalma, Norma / Marchese, Tiziana / Manoochehri, Farshad / D'Ugo, Stefano / Garritano, Stefano / Botrugno, Ivan / Chiappini, Ambra / Libia, Annarita / Atzeni, Carlo Olla / Stasi, Elisa / Spampinato, Marcello G

    Journal of surgical case reports

    2023  Volume 2023, Issue 3, Page(s) rjad145

    Abstract: Solid pseudopapillary tumour is a rare low-grade malignant potential carcinoma of the pancreas that typically occurs in females in their third decade. It most commonly occurs in the tail of the pancreas, although any site can be affected. Surgical ... ...

    Abstract Solid pseudopapillary tumour is a rare low-grade malignant potential carcinoma of the pancreas that typically occurs in females in their third decade. It most commonly occurs in the tail of the pancreas, although any site can be affected. Surgical resection is the standard treatment and offers an excellent prognosis. We report a case of a 17-year-old female with an acute onset abdominal pain and a radiological diagnosis of a cystic lesion in the distal pancreas. A robotic-assisted distal pancreatectomy with splenectomy was performed. Robotic-assisted surgery is an emerging technique for the treatment of pancreatic neoplasms. This approach can be considered for younger patients, thanks to the potential advantages of the robotic Da Vinci Xi System.
    Language English
    Publishing date 2023-03-28
    Publishing country England
    Document type Case Reports
    ZDB-ID 2580919-2
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjad145
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  7. Article ; Online: Laparoscopic lavage and drainage for Hinchey III diverticulitis: review of technical aspects.

    Gregori, Matteo / Cassini, Diletta / Depalma, Norma / Miccini, Michelangelo / Manoochehri, Farshad / Baldazzi, Gianandrea A

    Updates in surgery

    2018  Volume 71, Issue 2, Page(s) 237–246

    Abstract: The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by ... ...

    Abstract The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by some authors as a safe and effective alternative to single- or multi-stage resective surgery. However, among all the different studies on LLD, there is no uniformity in terms of surgical technique adopted and data show significant differences in postoperative outcomes. Aim of this review was to analyze the differences and similarities among the authors in terms of application, surgical technique and outcomes of LLD in Hinchey 3 patients. A bibliographical research was performed by referring to PubMed and Cochrane. "Purulent peritonitis", "Hinchey 3 diverticulitis", "acute diverticulitis", "colonic perforation" and "complicated diverticulitis" were used as key words. Twenty-eight papers were selected, excluding meta-analysis, reviews and case reports with a very small number of patients. The aim of this review was to establish how LLD should be done, suggesting important technical tricks. We found agreement in terms of indications, preoperative management, ports' positioning, antibiotics, enteral feeding and drain management. On the contrast, different statements regarding indications, adhesiolysis and management of colonic hole and failure of laparoscopic lavage are reported. A widespread diffusion of LLD and standardization of its technique are impossible because of data heterogeneity and selection bias in the limited RCTs. It is necessary to wait for long terms results from randomized clinical trials (RCTs) in progress to establish the efficacy and safety of this technique. More importantly, an increased number of highly skilled and dedicated colorectal laparoscopic surgeons are required to standardized the procedure.
    MeSH term(s) Acute Disease ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/surgery ; Drainage/methods ; Humans ; Laparoscopy/methods ; Peritonitis/complications ; Peritonitis/surgery ; Sigmoid Diseases/surgery ; Therapeutic Irrigation/methods
    Language English
    Publishing date 2018-08-10
    Publishing country Italy
    Document type Journal Article ; Systematic Review
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-018-0576-7
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  8. Article ; Online: Robotic pelvic dissection as surgical treatment of complicated diverticulitis in elective settings: a comparative study with fully laparoscopic procedure.

    Cassini, Diletta / Depalma, Norma / Grieco, Michele / Cirocchi, Roberto / Manoochehri, Farshad / Baldazzi, Gianandrea

    Surgical endoscopy

    2018  Volume 33, Issue 8, Page(s) 2583–2590

    Abstract: Background: Recently, minimally invasive treatment of complicated sigmoid diverticulitis is becoming a valid alternative to standard procedures. Robotic approach may be useful to allow more precise dissection in arduous pelvic dissection as in ... ...

    Abstract Background: Recently, minimally invasive treatment of complicated sigmoid diverticulitis is becoming a valid alternative to standard procedures. Robotic approach may be useful to allow more precise dissection in arduous pelvic dissection as in complicated diverticulitis. The aim of this study is to investigate effectiveness, potential benefits and short-term outcomes of robotic-assisted laparoscopic surgical resection, compared with fully laparoscopic resection in complicated diverticulitis.
    Methods: Between January 2009 and December 2017, 156 consecutive patients with history of complicated diverticular disease were referred to our Department of General, Mininvasive and Robotic Surgery. All patients underwent elective colonic resections performed by the same colorectal surgeon and followed a perioperative ERAS program. Demographic and clinical features, surgical data, postoperative data, 30-day morbidity and mortality, VAS for surgeon's compliance were evaluated.
    Results: One hundred and fifty-six consecutive patients underwent elective colonic resection: 92 fully laparoscopic (FL) colorectal resections and 64 procedures with robotic hybrid approach (RHA). Conversion rate was none in the RHA group versus 6.5% in the FL group, because of poor vision due to bowel distension, inflammatory pseudotumor and peritoneal adhesions. No 30-day mortality was observed. Mean operative time was 167.5 ± 54.4 min (80-420) in the FL group and 172.5 ± 55.64 min (110-325) in the RHA group (p 0.079), mean intraoperative blood loss was 144.6 ± 40.6 ml (40-200) with the FL technique and 138.4 ± 28.3 ml (20-185) with the RHA (p 0.295). Mean hospital stay for FL was 5 ± 4.1 days (range 3-45) and 5 ± 2.7 days (range 3-20) for RHA (p 0.974). Overall postoperative morbidity rate was 21.6% in the FL group and 12.3% in the RHA (p 0.067). Major postoperative morbidity (Clavien-Dindo 3 and 4) represented 13% and 4.6%, respectively (p 0.091). VAS for surgeon's compliance revealed a better performance in the robotic arm (p 0.059).
    Conclusions: This preliminary study highlights the potential benefits of robotic-assisted laparoscopy in colorectal resections for complicated diverticular disease in terms of surgical efficacy, postoperative morbidity and better surgeon's compliance.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Colon/surgery ; Diverticulitis/surgery ; Diverticulum, Colon/surgery ; Elective Surgical Procedures/methods ; Female ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Postoperative Complications/epidemiology ; Robotic Surgical Procedures/adverse effects
    Language English
    Publishing date 2018-11-07
    Publishing country Germany
    Document type Comparative Study ; Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-018-6553-x
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  9. Article ; Online: The MIS-COVID-AGICT Study: Trend of Minimally Invasive Surgery for Gastrointestinal Cancer Treatment During the First Waves of the COVID-19 Pandemic in Italy. Subgroup Analysis from the COVID-AGICT Study: COVID-19 and Advanced Gastrointestinal Cancer Surgical Treatment.

    Giuliani, Giuseppe / Coletta, Diego / Guerra, Francesco / Esposito, Sofia / Esposito, Alessandro / De Pastena, Matteo / Rega, Daniela / Delrio, Paolo / La Raja, Carlotta / Spinelli, Antonino / Massaron, Simonetta / De Nardi, Paola / Kauffmann, Emanuele Federico / Boggi, Ugo / Deidda, Simona / Zorcolo, Luigi / Marano, Alessandra / Borghi, Felice / Piccoli, Micaela /
    Depalma, Norma / D'Ugo, Stefano / Spampinato, Marcello / Cozzani, Federico / Del Rio, Paolo / Marcellinaro, Rosa / Carlini, Massimo / De Rosa, Raffaele / Scabini, Stefano / Maiello, Fabio / Polastri, Roberto / Turri, Giulia / Pedrazzani, Corrado / Zese, Monica / Parini, Dario / Coratti, Andrea

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2023  Volume 33, Issue 6, Page(s) 579–585

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Humans ; COVID-19 ; Gastrointestinal Neoplasms/surgery ; Minimally Invasive Surgical Procedures/methods ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome
    Language English
    Publishing date 2023-05-02
    Publishing country United States
    Document type Clinical Study ; Journal Article
    ZDB-ID 1381909-4
    ISSN 1557-9034 ; 1092-6429
    ISSN (online) 1557-9034
    ISSN 1092-6429
    DOI 10.1089/lap.2023.0058
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  10. Article ; Online: The role of mirror neurons in processing vocal emotions: evidence from psychophysiological data.

    Ramachandra, Vijayachandra / Depalma, Nina / Lisiewski, Sara

    The International journal of neuroscience

    2009  Volume 119, Issue 5, Page(s) 681–690

    Abstract: Recent evidence suggests that the mirror neuron system may serve as a common neural substrate for processing motor, linguistic, emotional, and other higher-level cognitive information. The current study employed psychophysiological methods to elucidate ... ...

    Abstract Recent evidence suggests that the mirror neuron system may serve as a common neural substrate for processing motor, linguistic, emotional, and other higher-level cognitive information. The current study employed psychophysiological methods to elucidate the role of this system in processing vocal emotions. Skin conductance and heart rate were measured for 25 undergraduate students while they were both listening to emotional vocalizations and also thinking (internal production) about them. The results revealed changes in skin conductance response and heart rate during both "listening" and "thinking" conditions. This suggests an active role of the mirror neuron system in processing vocal emotions.
    MeSH term(s) Adult ; Auditory Perception/physiology ; Cognition/physiology ; Electrodes ; Emotions ; Female ; Galvanic Skin Response ; Heart Rate ; Humans ; Male ; Neurons/physiology ; Pattern Recognition, Physiological/physiology ; Young Adult
    Language English
    Publishing date 2009
    Publishing country England
    Document type Journal Article
    ZDB-ID 3061-2
    ISSN 1563-5279 ; 1543-5245 ; 0020-7454
    ISSN (online) 1563-5279 ; 1543-5245
    ISSN 0020-7454
    DOI 10.1080/00207450802572188
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