The 5mm wide angle optics allows having a very good operative view equivalent to a usual 10mm optic used in laparoscopic surgery. Narrower optics could be developed in the future. The length of this procedure is slightly longer than the usual technique due to the transgastric removal and the gastric closure. In our these experience, the after effects are very simple without early or late abdominal wall and gastric complications in the followup. The patients resumed normal activity quickly. The esthetic result is perfect with minute skin incisions. The risk of gastric complications is very low in the context of a nonpathological gastric wall but will be the object of a more accurate assessment. There are some difficulties with the gall bladder removal in cholecystitis and very large gall stones (larger than 3cm).
It could be overcome by carrying out endoscopic control of the removal with or without a specific cover. This endoscopic control could also be interesting in the presence of a hiatus hernia, an oesophagitis, and so forth. 5. Conclusion Our procedure (laparoscopic cholecystectomy using micro instruments and a 5mm optic in a transgastric gall bladder removal) allows abdominal wall trauma reduction and to resume as soon as possible normal physical activity without risk of incisional hernia. The cystic pediclar dissection is a usual and standardized procedure. The hand sewn gastrostomy is safer than N.O.T.E.S. and endoscopic clipping. It could open the way to other transgastric abdominal organ removals.
Pueraria tuberosa DC (Family: Fabaceae) is a reputed medicinal herb of Indian traditional system of medicines distributed throughout tropical parts of the India.[1] In India it has several vernacular names like in Bengali: shimia, batraji, Gujarati: vidarikand; Hindi: bilaikand; Kannada: gumadi gida; Malayalam: mutukku; Marathi: badra; Tamil and Telugu: dari gummadi.[2] Traditionally, the P. tuberosa tubers (PTT) are used as tonic, anti-rheumatic, diuretic, galactogogue, vital energy and immune booster.[1,3] PTT was reported to contain puerarin, daidzein, puerarone, coumestan, tuberosin, pterocarpintuberosin, puetuberosanol and hydroxytuberosone.[4] The isoflavone, puerarin [Figure 1], one of the most active constituent of PTT, revealed wide range of pharmacological activities including hypoglycemic,[5] anti-cancer,[6] cardioprotective,[7] neuroprotective,[8] anti-allergic,[9] and anti-arrhythmic[10] activity. Figure 1 Chemical structure of puerarin The quantitative determination of bioactive metabolites in the extracts and formulations is essential for quality control Batimastat and dose determination of herbal medicines.