Single-incision laparoscopic appendectomy (SILA) has recently emerged as a promising alternative for the management of acute appendicitis. This study aimed to compare the surgical outcomes of the SILA with those of three laparoscopic appendectomies (TLA) procedures using the existing equipment, the 10-mm laparoscope, and the surgical-glove port method. Between February 2021 and February 2022, this single-center retrospective study examined 68 patients who underwent laparoscopic appendectomy by a single surgeon. The study excluded patients with severe appendicitis, grade IV-V, following the American Association for the Surgery of Trauma classification. Clinical outcomes were analyzed, including operation time, hospital stay, postoperative pain, and postoperative morbidity. There were no statistically significant differences between SILA and TLA patients, respectively, in operation time (37.5 minutes vs. 35 minutes, p = 0.261) and the median duration of hospitalization (three days vs. three days, p = 0.929). There was no difference in the mean visual analog scale score between the two groups on the first day (p = 0.852), second day (p = 0.540), and the day of discharge from the hospital (p = 0.686), as well as return to diet (two days vs. two days, p = 0.053). Two (10%) cases of short-term complications in the SILA group and one (2.1%) case in the TLA group were noted. SILA performed through a handmade surgical-glove port is a safe and viable therapy option for mild-to-moderate appendicitis. When the hospital lacks a specialized laparoscopic single-incision surgical system, this technique should be used on patients.

Madelung disease is a rare condition of unknown etiology, characterized by large masses of subcutaneous fat in the upper body bilaterally. It rarely affects the lower extremities and genital region. Here, we report a patient with Donhouser's type III Madelung's disease. A 47-year-old male patient presented with a giant fatty scrotal tumor that caused deformation of the scrotum and penis, made it difficult to perform daily activities, and hindered sexual activity. The adipose tumor was completely removed using a midline scrotal incision. The scrotum was reconstructed with bilateral anterior and posterior scrotal skin flaps. The excess skin was cut into a wedge shape between the anterior and posterior scrotal regions. At 3 months postoperatively, the scrotum was normal in shape and size, and the patient was able to perform personal activities and normal sexual activity. The surgical options, lipectomy results, and experiences drawn from the clinical cases have been discussed. Giant scrotal lipomas are very rare in Madelung's disease. Lipectomy and scrotal reconstruction are required. Wedge-shaped scrotal skin excision in the midsection on each side of the scrotum removes excess skin, which could restore the shape and function of the penis and scrotum.

Introduction and importance: A simple kidney cyst is the most common type of renal cyst. These cysts are usually asymptomatic and detected incidentally upon radiological exams of the abdomen. Currently, there are many methods of treating renal cysts, in which retroperitoneoscopy to remove the cyst is a safe and more effective method. However, the simple renal cyst with renal pelvis stones will raise a question in the approach. Case presentation: In this report, we present two cases, admitted to the hospital with abdominal pain and diagnosed with a simple renal cyst with renal calculis. The two patients underwent retroperitoneal laparoscopic treatment of renal cyst and renal calculi in one surgery. Clinical discussion: We want to discuss and share our experience in surgically treating these exceptional cases. Conclusion: In two cases, we chose the retroperitoneoscopic technique to remove the renal cyst and the renal stone, which resulted in good treatment results. This is an effective and safe alternative for the simultaneous treatment of renal cysts and ipsilateral renal calculi in carefully selected patients. Highlights:

Objectives: This study aimed to evaluate the safety and efficacy of digital flexible ureteroscopy in the management of lower pole stones and to assess patients' postoperative quality of life. Methods: A longitudinal, single-center, nonrandomized cohort study was conducted on patients with renal calculi eligible for flexible ureteroscopy. The study population comprised 44 patients diagnosed with treatment of lower pole stones who underwent treatment at Bach Mai Hospital between January 2023 and October 2024. Surgical outcomes, including surgery duration, stone-free rate, duration of hospitalization, surgical complications, and quality of life, were evaluated and monitored during the follow-up period. Results: The mean age of the patients was 51.4 years, and the mean stone size was 13.7 mm. Immediately postoperative stone-free rates were 79.5 %, 77.3 % at 1-month and 68.2 % at 3-month. The mean operative time was 73.4 minutes, the lithotripsy duration was 55.7 minutes, and the average hospital stay was 5.7 days. Only 1 minor complication (2.3%) was recorded. The quality-of-life scores significantly improved over time (p < 0.001), with most patients reporting no disruption to daily activities after 1 month. Conclusions: Single-use digital flexible ureteroscopy is a safe and effective modality for managing lower pole renal stones, offering high stone-free rates, low complication rates, and significant improvements in patient quality of life. Further large-scale, controlled studies are needed to confirm these findings and evaluate long-term outcomes.