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  1. Article ; Online: Reply to correspondence by Smart and Watson.

    Ratto, C

    Techniques in coloproctology

    2018  Volume 22, Issue 3, Page(s) 249–250

    Language English
    Publishing date 2018
    Publishing country Italy
    Document type Letter ; Comment
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-018-1763-8
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    Zs.A 5842: Show issues Location:
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  2. Article ; Online: Comment on: Perianal block with ropivacaine as a supplement to anaesthesia in proctological surgery: double-blind randomized placebo-controlled trial (PERCEPT).

    Parello, A / Ratto, C

    The British journal of surgery

    2020  Volume 107, Issue 9, Page(s) e351

    MeSH term(s) Anesthetics, Local ; Double-Blind Method ; Humans ; Nerve Block ; Ropivacaine
    Chemical Substances Anesthetics, Local ; Ropivacaine (7IO5LYA57N)
    Language English
    Publishing date 2020-06-07
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1002/bjs.11745
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    Uk I Zs.66: Show issues Location:
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  3. Article ; Online: Mystifications in Methods Produce Fake Results!

    Ratto, Carlo

    Surgical innovation

    2018  Volume 25, Issue 5, Page(s) 540–541

    Language English
    Publishing date 2018-07-26
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2182571-3
    ISSN 1553-3514 ; 1553-3506
    ISSN (online) 1553-3514
    ISSN 1553-3506
    DOI 10.1177/1553350618788946
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    Zs.A 4269: Show issues Location:
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  4. Article ; Online: Technical modifications for cost optimization in robot-assisted ventral mesh rectopexy: an initial experience.

    Marra, A A / Campennì, P / De Simone, V / Parello, A / Litta, F / Ratto, C

    Techniques in coloproctology

    2023  Volume 27, Issue 7, Page(s) 551–557

    Abstract: Background: Robot-assisted ventral mesh rectopexy is considered a valid option in the treatment of rectal prolapse. However, it involves higher costs than the laparoscopic approach. The aim of this study is to determine if less expensive robotic surgery ...

    Abstract Background: Robot-assisted ventral mesh rectopexy is considered a valid option in the treatment of rectal prolapse. However, it involves higher costs than the laparoscopic approach. The aim of this study is to determine if less expensive robotic surgery for rectal prolapse can be safely performed.
    Methods: This study was conducted on consecutive patients who underwent robot-assisted ventral mesh rectopexy at Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, from 7 November 2020 to 22 November 2021. The cost of hospitalization, surgical procedure, robotic materials, and operating room resources in patients undergoing robot-assisted ventral mesh rectopexy with the da Vinci Xi Surgical Systems was analyzed before and after technical modifications, including the reduction of robotic arms and instruments, and the execution of a double minimal peritoneal incision at the pouch of Douglas and sacral promontory (instead of the traditional inverted J incision).
    Results: Twenty-two robot-assisted ventral mesh rectopexies were performed [21 females, 95.5%, median age 62.0 (54.8-70.0) years]. After an initial experience performing traditional robot-assisted ventral mesh rectopexy in four patients, we adopted technical modifications in other cases. No major complication or conversion to open surgery occurred. In total, mean cost of hospitalization, surgical procedure, robotic materials, and operating room resources was €6995.5 ± 1058.0, €5912.7 ± 877.0, €2797.6 ± 545.6, and €2608.3 ± 351.5, respectively. Technical modifications allowed a significant reduction in the overall cost of hospitalization (€6604.5 ± 589.5 versus €8755.0 ± 906.4, p = 0.001), number of robotic instruments (3.1 ± 0.2 versus 4.0 ± 0.8 units, p = 0.026), and operating room time (201 ± 26 versus 253 ± 16 min, p = 0.003).
    Conclusions: Considering our preliminary results, robot-assisted ventral mesh rectopexy with appropriate technical modifications can be cost-effective and safe.
    MeSH term(s) Female ; Humans ; Middle Aged ; Rectal Prolapse/surgery ; Robotics ; Laparoscopy/methods ; Surgical Mesh ; Treatment Outcome ; Robotic Surgical Procedures/methods
    Language English
    Publishing date 2023-02-18
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-023-02756-8
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    Zs.A 5842: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: THD Doppler procedure for hemorrhoids: the surgical technique.

    Ratto, C

    Techniques in coloproctology

    2013  Volume 18, Issue 3, Page(s) 291–298

    Abstract: Transanal hemorrhoidal dearterialization (THD) is an effective treatment for hemorrhoidal disease. The ligation of hemorrhoidal arteries (called "dearterialization") can provide a significant reduction of the arterial overflow to the hemorrhoidal piles. ... ...

    Abstract Transanal hemorrhoidal dearterialization (THD) is an effective treatment for hemorrhoidal disease. The ligation of hemorrhoidal arteries (called "dearterialization") can provide a significant reduction of the arterial overflow to the hemorrhoidal piles. Plication of the redundant rectal mucosa/submucosa (called "mucopexy") can provide a repositioning of prolapsing tissue to the anatomical site. In this paper, the surgical technique and perioperative patient management are illustrated. Following adequate clinical assessment, patients undergo THD under general or spinal anesthesia, in either the lithotomy or the prone position. In all patients, distal Doppler-guided dearterialization is performed, providing the selective ligation of hemorrhoidal arteries identified by Doppler. In patients with hemorrhoidal/muco-hemorrhoidal prolapse, the mucopexy is performed with a continuous suture including the redundant and prolapsing mucosa and submucosa. The description of the surgical procedure is complemented by an accompanying video (see supplementary material). In long-term follow-up, there is resolution of symptoms in the vast majority of patients. The most common complication is transient tenesmus, which sometimes can result in rectal discomfort or pain. Rectal bleeding occurs in a very limited number of patients. Neither fecal incontinence nor chronic pain should occur. Anorectal physiology parameters should be unaltered, and anal sphincters should not be injured by following this procedure. When accurately performed and for the correct indications, THD is a safe procedure and one of the most effective treatments for hemorrhoidal disease.
    MeSH term(s) Anal Canal/blood supply ; Anal Canal/diagnostic imaging ; Anal Canal/surgery ; Hemorrhoidectomy/methods ; Hemorrhoids/diagnostic imaging ; Hemorrhoids/surgery ; Humans ; Ligation/methods ; Patient Positioning ; Proctoscopes ; Rectum/blood supply ; Rectum/diagnostic imaging ; Rectum/surgery ; Ultrasonography, Doppler ; Ultrasonography, Interventional
    Language English
    Publishing date 2013-09-12
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-013-1062-3
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  6. Article ; Online: Rare recurrence of malignant mesothelioma spreading to the perineum.

    Marra, Angelo Alessandro / Di Giorgio, Andrea / Ratto, Carlo

    BMJ case reports

    2023  Volume 16, Issue 2

    Abstract: Malignant mesothelioma is a rare aggressive tumour of the mesothelium with a propensity to spread locally and, rarely, to distant organs. The latest advances in its diagnosis and treatment have led to an increase in unusual disease presentations. ... ...

    Abstract Malignant mesothelioma is a rare aggressive tumour of the mesothelium with a propensity to spread locally and, rarely, to distant organs. The latest advances in its diagnosis and treatment have led to an increase in unusual disease presentations. Although a direct invasion of the perineum has been previously described in a men, a malignant mesothelioma spreading to the perianal region was never reported in a women. We presented a rare case of malignant mesothelioma recurrence spreading from the peritoneal cavity to the perineum through the rectovaginal space.
    MeSH term(s) Male ; Humans ; Female ; Mesothelioma, Malignant ; Mesothelioma/diagnosis ; Mesothelioma/therapy ; Mesothelioma/pathology ; Perineum/pathology ; Peritoneal Neoplasms/diagnosis ; Peritoneal Neoplasms/surgery ; Peritoneal Neoplasms/pathology ; Combined Modality Therapy
    Language English
    Publishing date 2023-02-14
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2022-252441
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  7. Article ; Online: Hemorrhoids and the recurrent attempts to destroy them.

    Ratto, Carlo

    Techniques in coloproctology

    2017  Volume 21, Issue 1, Page(s) 69–71

    MeSH term(s) Hemorrhoids ; Humans ; Recurrence
    Language English
    Publishing date 2017-01
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-016-1569-5
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  8. Article ; Online: The role of extracellular vesicles as biomarkers in colorectal cancer.

    Lucchetti, D / Litta, F / Ratto, C / Sgambato, A

    Techniques in coloproctology

    2018  Volume 22, Issue 12, Page(s) 989–990

    MeSH term(s) Biomarkers ; Colonic Neoplasms ; Colorectal Neoplasms ; Extracellular Vesicles ; Humans
    Chemical Substances Biomarkers
    Language English
    Publishing date 2018-11-16
    Publishing country Italy
    Document type Letter ; Comment
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-018-1880-4
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    Zs.A 5842: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  9. Article ; Online: Doppler-guided ligation of hemorrhoidal arteries with mucopexy: A technique for the future.

    Ratto, C / de Parades, V

    Journal of visceral surgery

    2015  Volume 152, Issue 2 Suppl, Page(s) S15–21

    Abstract: Purpose: The transanal hemorrhoidal de-arterialization (THD) procedure is an effective treatment of hemorrhoidal disease. The ligation of hemorrhoidal arteries ("de-arterialization") can provide a significant reduction of arterial blood flow to the ... ...

    Abstract Purpose: The transanal hemorrhoidal de-arterialization (THD) procedure is an effective treatment of hemorrhoidal disease. The ligation of hemorrhoidal arteries ("de-arterialization") can provide a significant reduction of arterial blood flow to the hemorrhoidal tissues. Plication of redundant rectal mucosa/submucosa ("mucopexy") can reposition prolapsing tissue to its original anatomical site. In this paper the surgical technique using a specific device (THD(®) Doppler) and peri-operative patient management are illustrated.
    Methods: After appropriate clinical assessment, patients undergo the THD procedure under general or spinal anesthesia, in either the dorsal lithotomy or prone jackknife position. A specifically designed device is used. In all patients, THD is performed, consisting of selective ligation of hemorrhoidal arteries identified by Doppler and marked with a mucosal stitch overlying the artery. In patients with hemorrhoidal or mucosal prolapse, a mucopexy is also performed using continuous suture(s) that include the redundant prolapsing mucosa and submucosa.
    Results: In long-term follow-up, THD results in resolution of symptoms in the majority of patients. The most common complication is transient but sometimes-painful tenesmus. Rectal bleeding occurs in only a very limited number of patients. There is little or no risk of fecal incontinence or chronic pain. Ano-rectal manometry and endo-anal ultrasound show no evidence of injury to physiologic sphincteric function.
    Conclusions: THD is a safe procedure and is, at present, one of the most effective treatments of hemorrhoidal disease.
    MeSH term(s) Hemorrhoids/diagnostic imaging ; Hemorrhoids/surgery ; Humans ; Ligation/methods ; Ligation/trends ; Rectum/blood supply ; Rectum/diagnostic imaging ; Rectum/surgery ; Transanal Endoscopic Microsurgery/methods ; Transanal Endoscopic Microsurgery/trends ; Treatment Outcome ; Ultrasonography, Doppler/trends ; Ultrasonography, Interventional/trends
    Language English
    Publishing date 2015-04
    Publishing country France
    Document type Journal Article ; Review
    ISSN 1878-7886
    ISSN (online) 1878-7886
    DOI 10.1016/j.jviscsurg.2014.08.003
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  10. Article: Would Surgeons Like to Be Submitted to Anal Fistulotomy? An International Web-Based Survey.

    Ratto, Carlo / Marra, Angelo Alessandro / Parello, Angelo / De Simone, Veronica / Campennì, Paola / Litta, Francesco

    Journal of clinical medicine

    2023  Volume 12, Issue 3

    Abstract: Traditional fistulotomy is the most performed surgical procedure in anal fistula surgery. We conducted an international online survey to explore colorectal surgeons' opinions and preferences on fistulotomy. Considering the healing and continence ... ...

    Abstract Traditional fistulotomy is the most performed surgical procedure in anal fistula surgery. We conducted an international online survey to explore colorectal surgeons' opinions and preferences on fistulotomy. Considering the healing and continence impairment rates reported in the literature, surgeons were invited to answer as a hypothetic patient susceptible to being submitted to fistulotomy for low and high anal fistula. A total of 767 surgeons completed the survey from 72 countries. The majority of respondents were consultants, having treated more than 20 anal fistulas in the last year. Most of them declared that anal fistula would be able to negatively affect quality of life and would be worried/anxious about it. Taking into account all aspects, 87.5% and 37.8% of respondents would agree to be treated with a fistulotomy in case of a low and high fistula, respectively, with an acceptance rate that varied worldwide. At multivariate analysis, factors correlated to the acceptance of anal fistulotomy were male gender (
    Language English
    Publishing date 2023-01-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12030825
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