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Sample records for del colgajo inguinal

  1. Rescate articular con colgajo anterolateral del muslo

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    F.J. García-Bernal

    2015-06-01

    Full Text Available La preservación del nivel de amputación tanto de la extremidad superior como de la inferior, puede mejorar la función residual y el proceso de rehabilitación protésica de la misma. Ambas van a estar condicionadas por la longitud restante de la extremidad, la presencia o no de articulaciones operativas y la calidad de la cobertura del muñón. Presentamos 2 casos de amputaciones. El primero es un caso agudo de amputación traumática de extremidad superior a la altura del tercio proximal de antebrazo, que asocia avulsión cutánea circular desde el tercio medio del brazo y con articulación de codo conservada. El segundo, es la secuela de una amputación infracondílea de extremidad inferior por osteosarcoma que presenta fístulas cutáneas con drenaje supurativo por osteomielitis en el muñón tibial. En ambos pacientes realizamos cobertura con colgajo anterolateral de muslo anastomosado a la arteria radial en el caso de la extremidad superior, y a la arteria genicular descendente en la extremidad inferior. En los dos casos el postoperatorio transcurrió sin complicaciones, logrando preservar las articulaciones del codo y de la rodilla respectivamente, así como la posterior rehabilitación protésica. Consideramos que el colgajo anterolateral del muslo permite aportar tejido de buena calidad como cobertura del muñón de amputación. Dadas las características del tejido aportado y su volumen, es idóneo tanto para cobertura de defectos agudos como de déficits de almohadillado en casos crónicos.

  2. Aplicaciones clínicas del colgajo en cono

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    W. Calderón

    2014-09-01

    Full Text Available Presentamos nuestra experiencia con el uso de un colgajo previamente descrito, el colgajo denominado en cono por la forma final que obtiene, como la de un barquillo de helado con su bocado. Consta de 2 colgajos acoplados: uno de rotación local y otro un avance en V-Y, ambos fasciocutáneos. Realizamos un análisis retrospectivo de 108 pacientes intervenidos entre 2000 y 2013 por lesiones en diferentes partes del organismo, con edades comprendidas entre los 20 y los 52 años, de los cuales 99 fueron varones, y en los que empleamos este tipo de colgajo. Los defectos cubiertos afectaban a las piernas en el 27% de los casos, tobillos en el 10%, planta del pie en el 9%, al talón en el 8% y a otras localizaciones en el resto de los pacientes. Del total, 80 colgajos tuvieron buena evolución (74%, 11 sufrieron dehiscencia mayor (10,2 %, 13 dehiscencia menor (12% y 4 necrosis (3,7 %. Los resultados confirman que el colgajo en cono es versátil, reproducible, sencillo y seguro de realizar, y permite al cirujano plástico resolver problemas quirúrgicos complejos de forma muy segura y a bajo costo.

  3. Aplicaciones del colgajo frontonasal para la cobertura de defectos nasales

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    M. Pérez

    2015-12-01

    Full Text Available Presentamos una revisión retrospectiva de los pacientes a los cuales se realizó un colgajo frontonasal para la cobertura de defectos nasales intervenidos en la Unidad de Tumores Cutáneos de nuestro Servicio en el periodo comprendido entre enero de 2010 y mayo de 2014. El objetivo es analizar nuestras aplicaciones y resultados además de describir un algoritmo que permita indicar los distintos diseños en función de la localización y el tamaño del defecto a reparar. Empleamos el colgajo frontonasal en 78 pacientes (49 mujeres y 29 varones con un rango de edad de 47 a 92 años (media de 73 años. Creamos un total de 81 defectos, puesto que en 3 casos se resecaron simultáneamente 2 tumoraciones, todos de etiología tumoral (64 carcinomas basocelulares, 16 carcinomas espinocelulares y 1 caso de léntigo maligno melanoma, localizados en el área nasal, con un tamaño mínimo de 12 x 17 mm y máximo de 30 x 35 mm (media de 22 x 25 mm. El periodo de seguimiento fue de entre 2 meses y 4 años (media de 2,5 años. Respecto a las complicaciones observadas, todas ellas menores, hubo 6 casos de necrosis marginal, 8 de dehiscencia parcial de la herida y 1 de cicatrización hipertrófica, tratándose en su mayor parte de varones fumadores. Todos los colgajos sobrevivieron con resultado estético satisfactorio. El colgajo frontonasal permite la cobertura en un sólo tiempo quirúrgico de defectos nasales independientemente de su localización, de hasta 30 x 35 mm en nuestra serie. Se trata de un colgajo seguro y versátil en sus múltiples modificaciones, con unos resultados estéticos satisfactorios. Estas ventajas son de especial importancia en pacientes de edad avanzada como alternativa a técnicas más complejas. Se trata por lo tanto, a nuestro juicio, de una opción a tener en cuenta para la reconstrucción en un único tiempo quirúrgico de defectos nasales.

  4. Aplicaciones del colgajo sural medial en cirugía reconstructiva de cavidad oral y orofaringe

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    Zubillaga, Ignacio; Redondo, Marta; Sánchez, Gregorio

    2017-01-01

    Objetivos: Presentar nuestra serie clínica de colgajos de perforantes basados en la arteria sural medial revisando las indicaciones, las características del colgajo y las complicaciones asociadas. Material y métodos: Análisis retrospectivo de 25 pacientes con defectos de cavidad oral y orofaringe reconstruidos con colgajo sural medial desde 2010 hasta 2013 en el Servicio de Cirugía Oral y Maxilofacial del Hospital Universitario 12 de Octubre de Madrid. Resultados: El rango de edad fue d...

  5. Rescate articular con colgajo anterolateral del muslo

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    F.J. García-Bernal; P. Zayas-Pinedo; J. Regalado-Bilbao; C. Jul-Vázquez; R. Fuentes-Gastañaga

    2015-01-01

    La preservación del nivel de amputación tanto de la extremidad superior como de la inferior, puede mejorar la función residual y el proceso de rehabilitación protésica de la misma. Ambas van a estar condicionadas por la longitud restante de la extremidad, la presencia o no de articulaciones operativas y la calidad de la cobertura del muñón. Presentamos 2 casos de amputaciones. El primero es un caso agudo de amputación traumática de extremidad superior a la altura del tercio proximal de antebr...

  6. Rescate articular con colgajo anterolateral del muslo

    OpenAIRE

    F.J. García-Bernal; P. Zayas-Pinedo; J. Regalado-Bilbao; C. Jul-Vázquez; R. Fuentes-Gastañaga

    2015-01-01

    La preservación del nivel de amputación tanto de la extremidad superior como de la inferior, puede mejorar la función residual y el proceso de rehabilitación protésica de la misma. Ambas van a estar condicionadas por la longitud restante de la extremidad, la presencia o no de articulaciones operativas y la calidad de la cobertura del muñón. Presentamos 2 casos de amputaciones. El primero es un caso agudo de amputación traumática de extremidad superior a la altura del tercio proximal de antebr...

  7. Versatilidad del colgajo en hacha para reconstrucción de lesiones en punta de dedo

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    A. Fernández García

    Full Text Available El colgajo en hacha descrito por Emmet, ha sido recientemente aplicado por Tuncali et al. en amputaciones de punta de dedo. Este sencillo colgajo triangular puede ser utilizado tanto en amputaciones transversas como oblicuas. El objetivo del estudio es presentar nuestra experiencia con este versátil colgajo en la reconstrucción de punta de dedo. Incluimos en el estudio 5 pacientes que completaron un periodo de seguimiento de un año. El nivel de amputación fue considerado de acuerdo con la clasificación de Ishikawa. Los pacientes fueron preguntados por la existencia de intolerancia al frío, hipersensibilidad y dolor. Empleamos diferentes diseños del colgajo en hacha que se aplicaron en pacientes pediátricos y adultos con amputaciones múltiples, lesiones del primer dedo del pie o de la mano, de dedos largos y en reconstrucciones con doble colgajo. La media de tamaño del defecto fue 2,2 x 1,4 cm. En todos los pacientes el colgajo aportó almohadillado protector y resultados estéticos. Se observó rigidez articular en un paciente debido a la combinación con un colgajo de dedo cruzado. El objetivo de toda reconstrucción de punta de dedo es proveer cobertura pulpar suficiente al hueso para evitar inestabilidad y pérdida de sensibilidad como consecuencia de la reconstrucción. El colgajo en hacha es una opción versátil y segura para la reconstrucción de punta de dedo. Los diferentes diseños pueden ser usados conforme a nuestras necesidades.

  8. Drenaje suplementario del sistema venoso superficial en colgajos pediculados Supplementary drainage of superficial venous system in pedicled flaps

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    Fernández García,A.; C. Fernández Pascual; R.A. Moreno Villalba; Ll. Gerrero Navarro

    2012-01-01

    Los colgajos pediculados pueden sufrir edema y congestión debido a que su drenaje a trevés del sistema venoso superfical es imposible y el flujo hacia el sistema profundo a nivel del pedículo es precario. Esta situación suele evolucionar hacia la necrosis parcial o la pérdida total del colgajo en pocas horas. La apertura del sistema venoso superficial permite el drenaje adecuado de los tejidos transferidos y evita estas complicaciones. Este artículo analiza el papel de las anastomosis microqu...

  9. Drenaje suplementario del sistema venoso superficial en colgajos pediculados Supplementary drainage of superficial venous system in pedicled flaps

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    A. Fernández García

    2012-06-01

    Full Text Available Los colgajos pediculados pueden sufrir edema y congestión debido a que su drenaje a trevés del sistema venoso superfical es imposible y el flujo hacia el sistema profundo a nivel del pedículo es precario. Esta situación suele evolucionar hacia la necrosis parcial o la pérdida total del colgajo en pocas horas. La apertura del sistema venoso superficial permite el drenaje adecuado de los tejidos transferidos y evita estas complicaciones. Este artículo analiza el papel de las anastomosis microquirúrgicas en el sistema venoso superficial de los colgajos pediculados. Esta técnica permite comunicar el sistema venoso superfical de los tejidos transferidos con el sistema venoso superficial del territorio que rodea al defecto. Presentamos los resultados obtenidos con esta técnica en colgajos de perforante en hélice, colgajos miocutáneos, colgajos neurocutáneos y colgajos fasciograsos volteados.The pedicled flaps can suffer edema and congestion due to the impossibility of drainage toward the superficial venous system and the precarious flow via the deep system at the level of the pedicle. The evolution of this situation is usually partial necrosis or total loss of the flap in a few hours. The opening of the venous superficial system achieves an appropriate drainage of the transfered tissues and avoids these complications. In this article we analyze the role of the microsurgical anastomosis at the level of the superficial venous system of pedicled flaps. This technique allows to communicate the superficial venous system of the transfered tissues with the superficial venous system of the territory around the defect. We report the results with this method in propeller perforator flaps, miocutaneous flaps, neurocutaneous flaps and adipofascial turn over flaps.

  10. Idoneidad del colgajo anterolateral de muslo para reconstrucción de grandes defectos craneofaciales

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    David González-Ballester

    2014-07-01

    Full Text Available La reconstrucción de grandes defectos en la región craneal y del cuero cabelludo constituyen un reto para el cirujano reconstructivo. Diversos factores pueden influir en la selección de un determinado método quirúrgico, tales como: anatomía del defecto, factores dependientes del paciente, preferencias del cirujano, etc. En condiciones desfavorables, tales como grandes defectos, presencia de infección o cirugías previas, los colgajos microvascularizados se presentan superiores al resto de técnicas reconstructivas en la recuperación de la integridad craneofacial. Presentamos un varón de 57 años de edad con defecto estético importante en región frontal e infección crónica activa de más de 20 años de evolución reconstruido con un colgajo libre microvascularizado de la región antero-lateral del muslo de una forma dual, solucionando con ello el cuadro infeccioso al aportar tejido sano vascularizado; y el defecto estético al añadir volumen, consiguiéndose un excelente resultado final.

  11. Reubicación del ombligo al realizar un colgajo TRAM

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    A. Fuente del Campo

    2014-09-01

    Full Text Available Describimos un método simple para reubicar el ombligo en los casos de plicatura abdominal unilateral consecutiva a la rotación de un colgajo TRAM. El ombligo se desplaza a lo largo de una incisión hecha en la aponeurosis anterior del músculo recto abdominal contralateral. Este procedimiento no debilita la musculatura abdominal contralateral, mantiene el ombligo estable, sin estenosis, y evita la formación de cicatrices hipertróficas a su alrededor. Tras este procedimiento los pacientes conservan una resistencia abdominal normal, pudiendo realizar esfuerzo y ejercicio sin manifestar áreas de debilidad.

  12. Valoración de la selección de los vasos del colgajo DIEP para la reconstrucción mamaria

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    Álvarez García, Rubén

    2015-01-01

    El objetivo principal de este estudio ha sido la utilización de la planificación preoperatoria del colgajo DIEP en reconstrucción mamaria mediante angiotomografía multicorte para conocer la repercusión de diferentes características del vaso perforante seleccionado en la aparición de complicaciones circulatorias del colgajo. Para ello Se llevo a cabo un estudio retrospectivo sobre 61 reconstrucciones mamarias con colgajo DIEP, comparándose las características anatómicas de la perforante elegid...

  13. Complicaciones en el uso del colgajo TRAM pediculado para reconstrucción mamaria por cáncer

    OpenAIRE

    2013-01-01

    Las opciones en reconstrucción mamaria tras tratamiento oncoquirúrgico incluyen el uso de técnicas con implantes, el uso de colgajos autólogos y la combinación de ambos métodos. A nivel internacional, la reconstrucción con tejidos autólogos es el estándar de oro para la reconstrucción mamaria y específicamente, la utilización del colgajo miocutáneo de recto abdominal (colgajo TRAM) pediculado es una de las opciones más empleadas. El presente estudio define con qué frecuencia se presentaron co...

  14. Versatilidad del colgajo en hacha para reconstrucción de lesiones en punta de dedo Versatility of the hatchet flap for reconstruction of fingertip injuries

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    Fernández García,A.; T. Soria Cogollos; R.A. Moreno Villalba; C. Fernández Pascual; S. Alonso Rosa

    2008-01-01

    El colgajo en hacha descrito por Emmet, ha sido recientemente aplicado por Tuncali et al. en amputaciones de punta de dedo. Este sencillo colgajo triangular puede ser utilizado tanto en amputaciones transversas como oblicuas. El objetivo del estudio es presentar nuestra experiencia con este versátil colgajo en la reconstrucción de punta de dedo. Incluimos en el estudio 5 pacientes que completaron un periodo de seguimiento de un año. El nivel de amputación fue considerado de acuerdo con la cla...

  15. Complicaciones en el uso del colgajo TRAM pediculado para reconstrucción mamaria por cáncer

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    J.L. López-Robles

    2013-12-01

    Full Text Available Las opciones en reconstrucción mamaria tras tratamiento oncoquirúrgico incluyen el uso de técnicas con implantes, el uso de colgajos autólogos y la combinación de ambos métodos. A nivel internacional, la reconstrucción con tejidos autólogos es el estándar de oro para la reconstrucción mamaria y específicamente, la utilización del colgajo miocutáneo de recto abdominal (colgajo TRAM pediculado es una de las opciones más empleadas. El presente estudio define con qué frecuencia se presentaron complicaciones tras la cirugía con colgajo TRAM pediculado para reconstrucción mamaria por cáncer en el Servicio de Cirugía Plástica y Reconstructiva del Hospital Central Sur de Alta Especialidad (PEMEX de la Cuidad de México (México, en un periodo de estudio de 7 años. Además, se identifican los factores de riesgo que influyeron sobre la aparición de dichas complicaciones. Diseñamos un estudio descriptivo, observacional y retrospectivo, que incluyó a 71 pacientes, de las cuales el 59.15 % presentaron alguna complicación. La mayoría de dichas complicaciones fueron menores (54.9 % y tan solo 3 pacientes presentaron alguna complicación mayor (4.2 %. La complicación del sitio donante del colgajo más frecuente fue la aparición de hernia abdominal (9.86 %. La complicación más frecuente del colgajo y del sitio receptor fue la necrosis grasa parcial (23.94 %. Las únicas complicaciones sistémicas fueron atelectasia y tromboembolismo pulmonar, con 1 caso de cada. En el análisis bivariado, las pacientes fumadoras tuvieron un 40 % más riesgo de presentar una complicación del colgajo en comparación con las no fumadoras (p=0.041. Las pacientes sometidas a radioterapia tuvieron un incremento del 30 % en las complicaciones totales en comparación con las no radiadas (p=0.021. Al comparar el hecho de recibir quimioterapia o no y la presencia de necrosis grasa, el 32 % de las pacientes tuvo esta complicación en comparación con el 10

  16. Colgajos Pediculados en Defectos de Tejidos Blandos en Niños. [Pedicled flaps for coverage of soft-tissue defects in children].

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    Javier Eduardo Nuñez

    2016-02-01

    Full Text Available Introducción: El objetivo de este trabajo es evaluar los resultados obtenidos con la utilización de colgajos pediculados utilizados para la cobertura de defectos de tejidos blandos en los miembros en niños. Material y Métodos: Se evaluaron retrospectivamente 13 niños que sufrieron traumatismo o quemadura de los miembros con pérdida o retracción severa de tejidos blandos, que requirieron de un colgajo pediculado para la adecuada cobertura del defecto, entre el año 2004 y 2013. La edad de los pacientes promedió 7.9 años. El tiempo entre el trauma inicial y la realización del colgajo promedió 39 días. La cobertura se realizó utilizando colgajo sural en cuatro casos, colgajo en isla vasculo-nervioso (Littler en dos casos, colgajo radial en dos casos, colgajo inguinal en tres casos, colgajo abdominal en un caso y colgajo dorsal ancho en un caso. En todos los casos se realizó la reparación o reconstrucción de las lesiones asociadas en el mismo tiempo quirúrgico. Resultados: El seguimiento de los pacientes promedió 19 meses. En los 13 casos se obtuvo buena cobertura del defecto a cubrir. El tiempo de internación promedió 8.1 días. Hubo una infección, una necrosis superficial y dos pacientes con cicatriz hipertrófica. Dos pacientes necesitaron tenolisis y dos zetaplastias. Todos los colgajos realizados en miembro inferior permitieron la vuelta a la actividad deportiva normal. Conclusión: A pesar del creciente número de colgajos libres descriptos para la reconstrucción de tejidos blandos, los colgajos pediculados permiten obtener una adecuada cobertura en la mayoría de estas lesiones en niños, ya que permiten buena cobertura tanto ósea como de tendones y estructuras vasculo-nerviosas, siendo posible la reconstrucción de las lesiones asociadas por debajo de los mismos sin inconvenientes. Entre las desventajas de la utilización de estos colgajos en adultos se nombran la inmovilización del miembro afectado, con una potencial

  17. Colgajos de las perforantes del pie: problemas y posibles soluciones Foot perforator flaps: problems and possible solutions

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    E. Prousskaia Peregudova

    2010-06-01

    Full Text Available A pesar de diversas publicaciones existentes sobre el colgajo mediano plantar tradicional, los colgajos de las perforantes del pie no están suficientemente estudiados. Es necesario ampliar nuestros conocimientos sobre la anatomía vascular de esta región, los problemas que pueden surgir durante la disección de la zona y las posibles soluciones. Realizamos disección anatómica de 10 pies de cadáver utilizando relleno vascular con látex coloreado. Definimos la secuencia de la disección de las perforantes de la arteria plantar medial. Medimos los puntos de salida de las perforantes dominantes en relación con 3 puntos de referencia, diámetro y longitud de cada perforante. Evaluamos la utilidad de cada colgajo para su uso en reconstrucción local o a distancia en función del diámetro y la longitud de la perforante, grosor del colgajo y morbilidad de la zona donante. Los colgajos de los vasos perforantes del pie son una buena opción para la reconstrucción tanto local como a distancia, con una mínima morbilidad de la zona donante y con un buen resultado funcional gracias a las características del tejido del pie cuando se usa para reconstrucción en mano.Traditional medial plantar flap is widely described in the literature, but foot perforator flap is a relatively new subject which still needs more detailed anatomical investigation. We need to amplify our knowledge about this surgically challenging region, dissection difficulties and possible solutions. We performed anatomical dissection on 10 cadaver feet with dyed latex intravascular injection and then dissected out the perforators arising from the medial plantar artery. We measured the origin of the dominant perforators in relationship to 3 reference points, diameter and length of each perforator. We analyzed the application of flaps based on these perforators as local and free flaps in relation to pedicle length and diameter, flap thickness and donor site morbidity. Foot perforator

  18. Aplicaciones del colgajo sural medial en cirugía reconstructiva de cavidad oral y orofaringe

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    Ignacio Zubillaga

    2017-01-01

    Conclusiones: El colgajo de perforantes de la arteria sural medial es una excelente opción en la reconstrucción de defectos de la cavidad oral y la orofaringe, proporcionándonos una adecuada adaptabilidad a la zona receptora y una mínima morbilidad de la zona donante.

  19. Colgajo sural medial: un nuevo colgajo de perforantes para la reconstrucción del territorio maxilofacial Medial sural flap: a new flap for maxillofacial reconstruction

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    Ignacio Arribas-García

    2012-12-01

    Full Text Available Introducción: La reconstrucción microquirúrgica de defectos mucocutáneos craneofaciales se realiza con técnicas descritas desde hace muchos años y se basan fundamentalmente en el colgajo radial, el anterolateral de muslo y el lateral de brazo, entre otros. Se presenta un nuevo colgajo microvascularizado fasciocutáneo para la reconstrucción de defectos en el territorio de cabeza y cuello, el colgajo de perforantes dependiente de la arteria sural medial. Material y métodos: Se presentan 4 pacientes con carcinoma epidermoide de cavidad oral, donde se realizaron 4 colgajos dependientes de la arteria sural medial para la reconstrucción de sus defectos tras la cirugía ablativa de la lesión tumoral. Resultados: El colgajo sural medial presentó una excelente adaptabilidad y una adecuada viabilidad en todos los casos, con unos buenos resultados funcionales, estéticos y con escasa morbilidad de la zona donante. Conclusión: Se presenta una nueva técnica reconstructiva en defectos de cabeza y cuello.Introduction: Microsurgical reconstruction of craniofacial mucocutaneous defects have been performed for many years using well-known techniques, that are mainly based on flaps from the radial forearm, the anterolateral thigh and lateral arm, among others. We present the medial sural artery perforator flap, a new vascularized fasciocutaneous flap for head and neck reconstruction. Material and methods: We present four patients with oral squamous cell carcinoma. A medial sural artery flap was performed for the oral reconstruction after tumour ablation surgery. Results: The medial sural flap showed excellent adaptability and adequate viability in all cases, with good functional and aesthetic results and low donor site morbidity. Conclusion: We present a new reconstructive technique in head and neck defects.

  20. Descripción anatómico-quirúrgica del colgajo dorsoepigástrico: una opción diferente en reconstrucción mamaria

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    J.L. Haddad Tame

    Full Text Available La importancia de las mamas para el equilibrio biopsico-social de la mujer es evidente. Las secuelas físicas y psíquicas de la mastectomía pueden ser tratadas mediante cirugía de reconstrucción mamaria; la búsqueda de nuevas opciones reconstructivas con menor incidencia de complicaciones y que permitan obtener mejores resultados estéticos, sigue vigente en nuestros días. En un estudio piloto realizado en 3 cadáveres frescos identificamos la anatomía neurovascular del músculo dorsal ancho, que fue constante en los hallazgos, por lo que en una segunda etapa procedimos a realizar reconstrucción mamaría mediante un colgajo dorsoepigástrico conservador de músculo dorsal ancho en 9 pacientes. El diseño del colgajo permite tomar una tira de 5 a 7cms del borde lateral del dorsal ancho, que incluye la rama descendente de la arteria tóracodorsal. La tasa global de complicaciones fue del 0.63 %, por lo que la morbilidad del sitio donante fue menor que la que se presenta con otro tipo de colgajos, y el resultado estético fue muy satisfactorio. Consideramos que el colgajo dorsoepigástrico conservador de músculo dorsal ancho es una excelente opción reconstructiva para las pacientes mastectomizadas, si bien se trata de un estudio piloto y necesitamos ampliar la muestra de pacientes para validar los resultados.

  1. Versatilidad del colgajo zigomático de mejilla en la reconstrucción nasal Versatility of cheek zigomatic flap in nose reconstruction

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    J. De Abullarade

    2012-09-01

    Full Text Available Conocemos bien la gran variedad de técnicas quirúrgicas existentes para la reconstrucción nasal, sin embargo está bien contar con una alternativa que permita restituir los tejidos del defecto con un colgajo zigomático de mejilla, que bien manejado, permite la reconstrucción nasal tridimensional y el camuflaje de las cicatrices. En este trabajo, comprobamos la versatilidad del colgajo zigomático de mejilla para la reconstrucción nasal en defectos postcáncer.It is well known the variety of surgical techniques for nasal reconstruction, but it is good to have an alternative that offers restore tissue defect with zygomatic cheek flap, which well managed, allows reaching the threedimensional nasal reconstruction and subsequent camouflage of the scars. In this study we found the versatility of the cheek zigomatic flap in nasal reconstruction post cancer defects.

  2. Enfoque Fisioterápico del dolor inguinal del montañero

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    Caudevilla Polo, Santos; Rubio Ibarzo, Sara; Lucha López, Orosia; Tricás Moreno, José Miguel; Estébanez De Miguel, Elena; Hidalgo García, César

    2002-01-01

    En este artículo se ha realizado un enfoque fisioterapéutico del dolor inguinal del montañero. El dolor inguinal es un problema frecuente y clínicamente complejo en un gran número de deportes. Existen multitud de causas que pueden generar este dolor, pero en este artículo sólo se muestra lo relacionado con la disfunción de la articulación de la cadera y sus músculos. Los estudios de Kaltenborn-Evjenth, Sohier, Ekman, Butler y Chaitow ofrecen información novedosa para el tratamiento d...

  3. Utilidad del colgajo frontal en la reconstrucción nasal Usefulness of the forehead flap in the nasal reconstruction

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    Julio César Gálvez Chávez

    2009-03-01

    Full Text Available INTRODUCCIÓN. La nariz constituye el centro estético de la cara y cualquier deformidad en ella afecta de modo importante a la armonía facial. Este estudio tuvo como objetivo caracterizar las experiencias en reconstrucción nasal con colgajo frontal en pacientes con defectos anatómicos de la nariz, como consecuencia fundamentalmente de una cirugía oncológica. MÉTODOS. Se realizó un estudio descriptivo, prospectivo, para caracterizar la experiencia de la reconstrucción nasal con colgajo frontal en pacientes con defectos nasales, atendidos en el Hospital «Hermanos Ameijeiras» y en el Instituto Nacional de Oncología y Radiobiología, entre junio de 1999 y mayo de 2007. RESULTADOS. Destacó que el motivo más frecuente de reconstrucción fue la lesión neoplásica, con igual número de pacientes afectados por carcinoma basocelular y epidermoide. El ala nasal fue la zona más afectada y se presentó recidiva tumoral en 5 pacientes. En todos los casos se pudo crear una cubierta externa al defecto y el diseño oblicuo fue el más utilizado. Se reconstruyó la cubierta interna nasal fundamentalmente con injerto de piel total y el soporte nasal, mayormente con injertos cartilaginosos de la concha auricular. Todos los colgajos frontales se mantuvieron vitales después de su desconexión en el segundo tiempo quirúrgico. El cierre directo de la zona donante fue el más utilizado y en algunos casos se logró con la utilización de expansión tisular. Se realizó un tercer tiempo de remodelación en los pacientes que lo necesitaron. Las complicaciones no afectaron al resultado final de la reconstrucción. CONCLUSIONES. Se demostró la utilidad y vigencia del colgajo frontal en la reconstrucción nasal.ABSTRACT INTRODUCTION. The nose is the aesthetic center of the face and any deformity in it significantly affects facial harmony. This study was aimed at characterizing the experiences in nasal reconstruction with forehead flap in patients with

  4. Versatilidad del colgajo en hacha para reconstrucción de lesiones en punta de dedo Versatility of the hatchet flap for reconstruction of fingertip injuries

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2008-09-01

    Full Text Available El colgajo en hacha descrito por Emmet, ha sido recientemente aplicado por Tuncali et al. en amputaciones de punta de dedo. Este sencillo colgajo triangular puede ser utilizado tanto en amputaciones transversas como oblicuas. El objetivo del estudio es presentar nuestra experiencia con este versátil colgajo en la reconstrucción de punta de dedo. Incluimos en el estudio 5 pacientes que completaron un periodo de seguimiento de un año. El nivel de amputación fue considerado de acuerdo con la clasificación de Ishikawa. Los pacientes fueron preguntados por la existencia de intolerancia al frío, hipersensibilidad y dolor. Empleamos diferentes diseños del colgajo en hacha que se aplicaron en pacientes pediátricos y adultos con amputaciones múltiples, lesiones del primer dedo del pie o de la mano, de dedos largos y en reconstrucciones con doble colgajo. La media de tamaño del defecto fue 2,2 x 1,4 cm. En todos los pacientes el colgajo aportó almohadillado protector y resultados estéticos. Se observó rigidez articular en un paciente debido a la combinación con un colgajo de dedo cruzado. El objetivo de toda reconstrucción de punta de dedo es proveer cobertura pulpar suficiente al hueso para evitar inestabilidad y pérdida de sensibilidad como consecuencia de la reconstrucción. El colgajo en hacha es una opción versátil y segura para la reconstrucción de punta de dedo. Los diferentes diseños pueden ser usados conforme a nuestras necesidades.The hatchet flap described by Emmet, has been recently applied by Tuncali et al. in fingertip amputations. This single triangular flap can be used in different types of injuries, as transverse and lateral oblique amputations. The aim of our study was to present the authors´ experience with this versatile flap in fingertip reconstruction. Five patients who have completed their 1-year follow-up period were included in the study. The level of amputation was categorized according Ishikawa

  5. Estudio anatómico vascular y angiosomas del área genital: aplicación en la optimización de la supervivencia de colgajos

    OpenAIRE

    Collado Alcázar, Javier

    2015-01-01

    Existe una escasez de trabajos publicados que detallen profundamente la anatomía vascular del área perineogenital, así como la contribución aproximada de cada vaso a cada territorio cutáneo. Todo ello puede favorecer un diseño incorrecto de los colgajos pediculados en esta zona, dando como resultado un sufrimiento vascular distal en detrimento del resultado de la reconstrucción realizada. Los principales vasos que irrigan el área perineogenital son la arteria pudenda interna, obturatriz y ...

  6. Descripción anatómica de la irrigación del colgajo sural a pedículo distal en piezas cadavéricas

    OpenAIRE

    Quinteros P,Juan Pablo; Sousa R,Jussara; Rapiman G,Andrea; VALDÉS G,FABIO

    2012-01-01

    El colgajo sural fasciomiocutáneo es ampliamente utilizado en la reparación de defectos profundos de tejidos blandos del miembro inferior distal. Este estudio describe su base anatómica mediante la morfometría de las arterias perforantes en una muestra de nuestra población chilena. Material y Método: Se utilizaron 8 miembros inferiores de amputaciones supracondileas. Previa repleción con látex coloreado vía poplítea, se procedió a disecar los miembros inferiores para así obtener un colgajo fa...

  7. Reconstrucción mamaria mediante el colgajo musculocutáneo del dorsal ancho Breast reconstruction with latissimus dorsi musculocutaneous flap

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    C. Colás

    2005-01-01

    Full Text Available En la reconstrucción mamaria intentamos conseguir la mayor simetría posible con la mama contralateral, en el menor número de intervenciones, con la menor secuela posible y con la máxima seguridad. Cuando tenemos mala calidad cutánea en el tórax tenemos que utilizar técnicas que aportan un tejido bien vascularizado, de buena calidad, que conseguimos a cierta distancia en vez de usar los propios tejidos del tórax. En este artículo se revisa el colgajo musculocutáneo del dorsal ancho, la técnica de elevación, variaciones del colgajo, ventajas e inconvenientes del mismo. Se trata de una técnica de gran seguridad, versátil, con pocas secuelas en la zona donante, de tiempo quirúrgico relativamente corto y con buenos resultados estéticos.In breast reconstruction we try to achieve the greatest possible symmetry with the contralateral breast, with the smallest number of interventions, the least possible sequel and the greatest safety. When we find poor cutaneous quality in the thorax we must use techniques that provide a well vascularised tissue of good quality, which we obtain at a certain distance instead of using the thorax tissues themselves. This article reviews the latissimus dorsi musculocutaneous flap, the technique of elevation, variations of the flap, and the advantages and drawbacks involved. This is a very safe and versatile technique, with few sequels in the donor area, with a relatively short surgery time and with good aesthetic results.

  8. Sistematización del colgajo musculocutáneo unipediculado de párpado superior en reconstrucción de párpado inferior, canto interno y externo

    Directory of Open Access Journals (Sweden)

    E. Martínez-Vera

    2015-03-01

    Full Text Available Están publicadas diferentes técnicas para la reconstrucción del párpado inferior y de los cantos interno y externo, algunas de ellas muy ingeniosas, pero a la vez muy complicadas, y sólo accesibles para cirujanos con amplia experiencia. Por lo tanto, simplificar y sistematizar una técnica sería muy útil para obtener un mejor resultado quirúrgico. El objetivo del presente trabajo es la sistematización de un colgajo musculocutáneo unipediculado del párpado superior, de 40 mm de largo y de 7, 10 o 15 mm de ancho, con pedículo en el canto palpebral externo o interno, para reconstruir total o parcialmente el párpado inferior, el canto interno o externo. Esta sistematización consiste en el diseño del colgajo teniendo en cuenta referencias anatómicas de la órbita fáciles de establecer. Para reconstruir la lamela o capa interna del párpado, que corresponde al tarso y conjuntiva, se utiliza un injerto de cartílago auricular o de septo nasal y para la capa externa del párpado, un colgajo musculocutáneo compuesto por piel y músculo orbicular del párpado superior. Con ello, se hace posible una fácil ejecución de la técnica quirúrgica, a la vez que se aprovecha al máximo la versatilidad del colgajo en la reconstrucción palpebral.

  9. Colgajo anterolateral del muslo: anatomía quirúrgica, técnica de disección y aplicaciones clínicas Anterolateral thigh flap: surgical anatomy, dissection technique and clinical applications

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    J. Masià

    2006-12-01

    Full Text Available El colgajo anterolateral de muslo, basado en perforantes de la rama descendente de la arteria circunfleja femoral lateral, es un colgajo idóneo para la reconstrucción de partes blandas de pequeño y mediano tamaño. En el Hospital de la Santa Creu i Sant Pau de Barcelona (España, éste colgajo ha sido ampliamente utilizado desde el año 2000 para defectos de partes blandas sobre todo en reconstrucción de cabeza y cuello y también en la reconstrucción de extremidad inferior. Este artículo trata de revisar los aspectos más importantes del colgajo, su anatomía, las técnicas de disección quirúrgica, desde su diseño sobre el paciente hasta el proceso de elevación del colgajo, las modificaciones que se le pueden realizar para optimizar sus propiedades y sus diversas aplicaciones, sin olvidar un análisis detallado de sus ventajas e inconvenientes.The anterolateral thigh flap, based on the perfora tors of the descending branch of the lateral femoral circumflex artery, is an ideal soft tissue flap. From 2000 year, in Hospital de la Santa Creu i Sant Pau in Barcelona (Spain, this flap have become the wor khorse in soft tissue reconstruction, it is very useful in head and neck reconstruction and lower limb reconstruction. Its versatility, long and large pedicle, and minimal donor site morbidity are the main advantages. In this paper we are going to review the surgical anatomy and, step by step, all the technique for safe harvesting and transfer.

  10. Colgajo de SMAS en la prevención del síndrome de Frey SMAS flap for the prevention of Frey’s syndrome

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    C. Moreno García

    2006-06-01

    Full Text Available Objetivo. El síndrome de Frey puede surgir como complicación tras cirugía de la glándula parótida. Este artículo pretende analizar la prevención de dicho síndrome tras cirugía parotídea cuando se realiza la elevación de un colgajo de sistema músculo aponeurótico superficial (SMAS. Material y Método. Presentamos un estudio retrospectivo con 81 pacientes a los que se realizó cirugía sobre la glándula parótida, en el Servicio de Cirugía Oral y Maxilofacial del Hospital Infanta Cristina de Badajoz desde Octubre de 1997 hasta Febrero de 2005. Resultados. La técnica más comúnmente realizada en nuestro Servicio fue la parotidectomía superficial conservadora (68%. El grupo más numeroso lo formaron aquellos pacientes en los que se realizó colgajo de SMAS y no desarrollaron posteriormente síndrome de Frey con un total de 56 casos (69%. Conclusión. Consideramos adecuada la realización de colgajo de SMAS en cirugía parotídea, para disminuir la frecuencia de aparición del síndrome de Frey.Objective. Frey’s syndrome may occur as a complication following parotid gland surgery. The aim of this article is to analyze the prevention of this syndrome after parotid surgery during which a superficial musculoaponeurotic system (SMAS flap is elevated. Material and Methods. A retrospective study is presented of 81 patients who underwent parotid gland surgery in the department of Oral and Maxillofacial Surgery of the Hospital Infanta Cristina, Badajoz, from October 1997 to February 2005. Results. The most common technique used in our department was the superficial conservative parotidectomy (68%. The most numerous group was made up of patients with SMAS flaps who did not go on to develop Frey’s syndrome, with a total of 56 cases (69%. Conclusion. We consider carrying out a SMAS flap in parotid surgery appropriate for reducing the frequency with which Frey’s syndrome appears.

  11. Radiofrecuencia pulsada para el tratamiento del dolor crónico postherniorrafia inguinal: reporte de caso

    OpenAIRE

    2014-01-01

    Introducción: El dolor crónico postherniorrafia inguinal es una condición clínica caracterizada por dolor frecuentemente neuropático, incapacitante, de difícil control farmacológico, lo cual ha derivado en la búsqueda de diferentes herramientas de tratamiento. Objetivo: Presentamos el caso de un paciente con diagnóstico de dolor crónico postherniorrafia inguinal, refractario al tratamiento farmacológico, a quien se le realizó una radiofrecuencia pulsada con la cual se logró control del dolor ...

  12. Utilización del colgajo de músculo temporal en cirugía reconstructiva maxilofacial: Revisión de 104 casos Use of the temporalis muscle flap in maxillofacial reconstruction surgery: A review of 104 cases

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    I. Zubillaga Rodríguez

    2004-08-01

    Full Text Available Introducción: el colgajo de músculo temporal ha sido empleado en reconstrucción craneofacial desde hace más de 100 años. El primer caso descrito en la literatura fue publicado por Lentz en 1895. Hoy en día el uso de colgajos locales con músculo temporal parece ser desplazado por el uso de colgajos libres microvascularizados en la reconstrucción craneofacial. En nuestra experiencia dichos colgajos locales constituyen una opción segura en muchos de nuestros pacientes. Objetivos: mostrar nuestras indicaciones y resultados en reconstrucción craneofacial con el empleo del colgajo de músculo temporal. Material y método: análisis retrospectivo de nuestra experiencia con el colgajo de músculo temporal en la última década. Resultados: hemos empleado un total de 108 colgajos miofasciales temporales en pacientes adultos con las siguientes indicaciones: reconstrucción de defectos postmaxilectomía (44; cirugía de base de cráneo (25 incluyendo fosa craneal anterior, media y posterior; cavidad oral y orofaringe (23; tras exenteración orbitaria en pacientes oncológicos (6; anquilosis de ATM (6; secuelas faciales postraumáticas (2; reanimación facial (2. Conclusiones: el colgajo de músculo temporal es una de las primeras opciones en cirugía reconstructiva oncológica craneofacial, de la ATM y base de cráneo. La disección traumática del colgajo y la sutura a tensión predisponen la aparición de complicaciones como necrosis o dehiscencia de la sutura.Abstract: Introduction: Temporalis miofascial flap has been used for craniofacial reconstruction since more than 100 years. The first described case in the medical literature was published by Lentz in 1895. The use of pedicled temporalis muscular flaps in cranial or facial reconstruction seems to be shifted nowadays by microvascular free flaps. Nevertheless, in our experience, this miofascial pedicled flap demonstrates to be a safe option for midfacial and lateral cranial base defects

  13. Hernioplastia sin tensión con colgajo autógeno Hernioplasty without tension with autogenous flap

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    Gimel Sosa Martín

    2009-12-01

    Full Text Available INTRODUCCIÓN. La hernia inguinal es una afección frecuente en la población joven, más en el sexo masculino que en el femenino. Su corrección se alcanza solo quirúrgicamente. Los objetivos del presente estudio fueron evaluar los resultados de la hernioplastia sin tensión con colgajo autógeno, así como determinar su utilidad para el tratamiento de hernias inguinales de grados 3, 4 y 5 según la Clasificación de Gilbert (1989 para este particular. MÉTODOS. Se realizó un estudio prospectivo y descriptivo de los pacientes atendidos por hernias inguinales a quienes se practicó una hernioplastia inguinal sin tensión, con colgajo triangular autógeno tomado de la aponeurosis del músculo recto abdominal. Las hernias correspondían a los grados 3, 4 y 5 según Clasificación de Gilbert, y fueron tratadas entre febrero de 2004 y febrero de 2008. RESULTADOS. La muestra estudiada estuvo constituida por 81 pacientes, todos del sexo masculino, de ellos 60 con hernias inguinales indirectas y 21 con hernias directas. La edad promedio fue de 31 años. El 71,60 % (58 pacientes fueron intervenidos quirúrgicamente en régimen de corta estadía, y los 23 restantes lo fueron en régimen de cirugía mayor ambulatoria (28,39 %. Las complicaciones consistieron en hematoma de la herida quirúrgica y orquitis posquirúrgica; no han aparecido reproducciones. El seguimiento de los pacientes se cumplimentó en consultas externas. CONCLUSIONES. La reparación de las hernias inguinales directas e indirectas con un colgajo autógeno es satisfactoria. Las complicaciones encontradas fueron el hematoma de la herida quirúrgica y la orquitis. No se han reportado recidivas de hernias con esta técnica quirúrgica.INTRODUCTION: Inguinal hernia is a frequent affection in young people with more predominance of male then the female one. Its correction is achieved only by surgery. Aims of present study wee to assess results of without tension Hernioplasty using autogenic

  14. Optimización en el uso del colgajo de segunda perforante intercostal de la arteria mamaria interna Optimizing the use of the second intercostal perforator flap of the internal mammary artery

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    D. Sicilia Castro

    2012-06-01

    Full Text Available El colgajo en isla basado en perforantes de la arteria mamaria interna (colgajo IMAP se emplea de manera reciente como técnica reconstructiva en cabeza y cuello. El objetivo de esta revisión es corroborar las posibilidades del arco de rotación de dicho colgajo cuando se realiza una amplia disección de su pedículo vascular. Presentamos 4 pacientes de edades comprendidas entre 46 y 75 años, todos ellos varones, con defectos faríngeos parciales, en los que empleamos un colgajo pediculado basado en la segunda perforante de la arteria mamaria interna para reconstrucción del defecto faríngeo. El tamaño medio del defecto a cubrir fue de 3,2 cm (desviación estándar +/- 1,5 cm en sentido horizontal y 4,5 cm (desviación estándar +/- 2,2 cm en sentido vertical. En todos los casos se disecó un colgajo en isla con un tamaño medio de 6 X 8 cm. La longitud media del pedículo fue de 5,5 cm (desviación estándar +/- 1,51 cm. En todos los casos fue posible sellar el defecto faríngeo sin necesidad de resecar costilla o de incorporar parte de la arteria mamaria interna correspondiente. El colgajo IMAP es un colgajo rápido de realizar que permite la reconstrucción de defectos faríngeos parciales de la región anterior del cuello y hasta la base de la lengua sin necesidad de resección costal o incorporación parcial de los vasos mamarios.The island flap based on perforators of the internal mammary artery (IMAP flap is recently used in reconstruction of head and neck defects. The aim of this review is to verify the possibilities of the arc of rotation of the flap when it's necessary to carry out an extensive dissection of the vascular pedicle. We present reconstruction of partial pharyngeal defects in 4 patients, aged between 46 and 75 years and all men, using a pedicle flap based on the second perforator of the internal mammary artery. The average size of the defect was 3.2 cm (SD +/- 1.5 cm horizontally and 4.5 cm (SD +/- 2.2 cm vertically. In

  15. Reconstrucción total del párpado superior mediante colgajo frontal Whole repair made in the upper eyelid using a frontal flap

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    Yamilé León Rodríguez

    2009-12-01

    Full Text Available Los pacientes que han sido sometidos a resecciones quirúrgicas por cáncer, que han sufrido lesiones por quemaduras de espesor total o traumas avulsivos con pérdida extensa de tejidos que engloban la totalidad del párpado superior, acuden con relativa frecuencia a consulta por presentar la cornea expuesta, y dicha exposición resulta en ulceraciones, cicatriz y ceguera. En estos pacientes se observa una gran insatisfacción por el inconveniente que representa no poder usar una prótesis ocular y algo no menos importante, el gran defecto estético. Se presenta el caso de un paciente del sexo masculino, de 30 años de edad, que sufrió múltiples lesiones por el estallido de un artefacto explosivo, con pérdida total del párpado superior derecho y enucleación ocular. Se le realizó reconstrucción palpebral total mediante el colgajo dermograso frontal y se obtuvieron buenos resultados estéticos.Patients underwent to surgical resections from cancer and whole thickness burn lesions or avulsion traumata with an extent loss of tissues which shape the upper eyelid, came with a relative frequency to consultation due to corneal exposition and this exposition resulting in ulcerations, scar, and blindness. These patients are very unsatisfied because they can not use of an ocular prosthesis, and something less important, the big aesthetic defect. Authors present the case of a male patient aged 30 with multiple lesions from explosion of an explosive artifact with loss of right upper eyelid and ocular enucleation. A total palpebral reconstruction was performed using a frontal dermal fatty flap with good aesthetic results.

  16. Comparación del postoperatorio de dos colgajos en cirugía de terceros molares inferiores Post operative comparison of two flap designs in lower third molar surgery

    OpenAIRE

    G. Laissle Casas del Valle; P. Aparicio Molares; F. Uribe Fenner; D. Alcocer Carvajal

    2009-01-01

    La cirugía de terceros molares constituye en la práctica de la cirugía oral y maxilofacial, una de las intervenciones más realizadas. Las indicaciones son variadas, desde medidas profilácticas hasta grandes lesiones osteolíticas. Algunas de las consecuencias después de dicha intervención son; edema, trismus y dolor postoperatorio. En la técnica quirúrgica, el colgajo cobra gran importancia a la hora de minimizar estas consecuencias. El objetivo del presente estudio es evaluar el postoperatori...

  17. Comparación del postoperatorio de dos colgajos en cirugía de terceros molares inferiores Post operative comparison of two flap designs in lower third molar surgery

    OpenAIRE

    G. Laissle Casas del Valle; P. Aparicio Molares; F. Uribe Fenner; D. Alcocer Carvajal

    2009-01-01

    La cirugía de terceros molares constituye en la práctica de la cirugía oral y maxilofacial, una de las intervenciones más realizadas. Las indicaciones son variadas, desde medidas profilácticas hasta grandes lesiones osteolíticas. Algunas de las consecuencias después de dicha intervención son; edema, trismus y dolor postoperatorio. En la técnica quirúrgica, el colgajo cobra gran importancia a la hora de minimizar estas consecuencias. El objetivo del presente estudio es evaluar el postoperatori...

  18. Comparación del postoperatorio de dos colgajos en cirugía de terceros molares inferiores Post operative comparison of two flap designs in lower third molar surgery

    Directory of Open Access Journals (Sweden)

    G. Laissle Casas del Valle

    2009-06-01

    Full Text Available La cirugía de terceros molares constituye en la práctica de la cirugía oral y maxilofacial, una de las intervenciones más realizadas. Las indicaciones son variadas, desde medidas profilácticas hasta grandes lesiones osteolíticas. Algunas de las consecuencias después de dicha intervención son; edema, trismus y dolor postoperatorio. En la técnica quirúrgica, el colgajo cobra gran importancia a la hora de minimizar estas consecuencias. El objetivo del presente estudio es evaluar el postoperatorio de la cirugía de terceros molares mandibulares incluidos, utilizando un colgajo lineal en un lado y un colgajo triangular en el otro lado del mismo paciente. Se realizó un estudio prospectivo en 15 pacientes de la Facultad de Odontología de la Universidad Mayor. Se tomaron registros fotográficos estandarizados y se midió la apertura bucal máxima pre-quirúrgica de cada paciente. Se registró el edema, la limitación de apertura bucal y el dolor a las 48 horas y a los 7 días, además del tiempo intraoperatorio. Todos los datos fueron analizados estadísticamente. No existen diferencias significativas en el edema, limitación de la apertura ni dolor al utilizar ambos colgajos. Tampoco existe correlación entre el tiempo operatorio y las tres variables estudiadas. El postoperatorio de la cirugía de terceros molares mandibulares incluidos es similar al utilizar un colgajo lineal o un colgajo triangular. El cirujano puede optar por uno o el otro indistintamente, según su preferencia.One of the most common procedures in the field of Oral and Maxillofacial Surgery is third molar surgery. From prophylactic measures to large osteolytic lesions, there are various indications. Some of the consequences of this procedure are; edema, trismus and postoperative pain. Flap design is an important feature of surgical technique that plays a vital role in minimizing these consequences. The objective of this study is a post operative evaluation of included

  19. Cierre de zona donante de colgajo libre radial de antebrazo con colgajo de rotación-avance basado en perforantes cubitales

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    P. Bolado-Gutiérrez

    2013-09-01

    Full Text Available La transferencia libre del colgajo radial de antebrazo se emplea en la práctica clínica habitual en numerosos procedimientos reconstructivos. Sin embargo, también es popular debido a la potencial morbilidad que se genera en la zona donante del colgajo: trastornos vasculares, motores, sensitivos o estéticos. A pesar de haberse realizado numerosas modificaciones tanto en la disección del colgajo como en el cierre del defecto, hasta la actualidad ninguno de los procedimientos empleados ha demostrado paliar completamente estas secuelas. Presentamos nuestra experiencia con la utilización de un colgajo de rotación-avance en V-Y fasciocutáneo basado en los vasos perforantes de la arteria cubital para el tratamiento del defecto resultante de la transferencia libre del colgajo antebraquial radial. Hemos empleado este procedimiento en 7 pacientes con edades comprendidas entre los 30 y los 86 años. Las dimensiones del colgajo radial en el eje longitudinal del antebrazo fueron desde los 4 a los 5,5 cm, con un eje transversal al pedículo vascular desde los 8 a los 10 cm. En todos los casos se conservó la motricidad de antebrazo- muñeca-mano-dedos sin registrarse adherencias a nivel tendinoso. No observamos alteraciones en la fuerza ni en la sensibilidad respecto al preoperatorio en el antebrazo intervenido. Las cicatrices fueron estéticamente aceptables. Concluimos que el colgajo fasciocutáneo de rotación-avance en V-Y basado en perforantes de la arteria cubital aporta numerosas ventajas frente a los injertos cutáneos u otros sustitutos dérmicos, además de ser más barato, con un período de cicatrización más rápido y con un resultado estético superior.

  20. Colgajo de perforante de arteria mamaria interna (IMAP) en paciente con condronecrosis laríngea

    OpenAIRE

    2013-01-01

    La condronecrosis laríngea es una complicación rara y grave que aparece en pacientes sometidos a radioterapia. Presentamos el caso clínico de un paciente con condronecrosis laríngea severa tratada mediante desbridamiento y cobertura con colgajo de perforante de arteria mamaria interna (IMAP). El colgajo se basó en una perforante del segundo espacio intercostal, previa localización con doppler manual. La zona donante se cerró directamente. El colgajo fue viable en un 100%, permitió una adecuad...

  1. Colgajo de perforante de arteria mamaria interna (IMAP en paciente con condronecrosis laríngea

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    A. Lorite-Álvaro

    2013-12-01

    Full Text Available La condronecrosis laríngea es una complicación rara y grave que aparece en pacientes sometidos a radioterapia. Presentamos el caso clínico de un paciente con condronecrosis laríngea severa tratada mediante desbridamiento y cobertura con colgajo de perforante de arteria mamaria interna (IMAP. El colgajo se basó en una perforante del segundo espacio intercostal, previa localización con doppler manual. La zona donante se cerró directamente. El colgajo fue viable en un 100%, permitió una adecuada cobertura del defecto y quedó bien adaptado al mismo. La zona donante cicatrizó sin incidencias. Consideramos que el colgajo de perforante de arteria mamaria interna pediculado permite una solución fiable y adecuada para pacientes con condronecrosis laríngea postradioterapia.

  2. Tratamiento del xantogranuloma palpebral en el adulto mediante colgajos en isla del área zigomática Treatment of adult eyebrow xanthogranuloma with a zygomatic island flap

    Directory of Open Access Journals (Sweden)

    C. León Llerena

    2009-06-01

    Full Text Available El término Xantoma, introducido por Frank Smith en 1869, significa tumor amarillo. El Xantogranuloma en el adulto es una afección cutánea inusual, de localización única, sin afectación visceral y que no remite espontáneamente. La afectación palpebral representa el 25% de los casos y en la mayoría de los casos suele ser un nódulo solitario. Presentamos el caso de un paciente varón de 58 años que acude a nuestro Servicio de Cirugía Plástica por presentar extensas lesiones palpebrales nodulares y bilaterales, de crecimiento lento y coloración amarillenta. Las lesiones fueron diagnosticadas histopatológicamente como xantogranulomas. El defecto palpebral fue reparado mediante un colgajo en isla del área zigomática, descrito por Heywood en 1991, modificado en su diseño original. Nuestro objetivo es describir el Xantogranuloma en el adulto por tratarse de una patología poco frecuente, sus características histológicas y sus posibles diagnósticos diferenciales. Destacamos la utilidad y versatilidad del colgajo zigomático ampliado como una excelente alternativa para la reparación de amplios defectos cutáneos palpebrales inferiores.The term anthoma, meaning yellow tumor, was introduced by Frank Smith in 1869. Xanthogranuloma in adults is an unusual single-site, cutaneous tumor, with no visceral involvement and without spontaneous regress. Palpebral xanthomas account for 25% of all cases, most of which usually involve a solitary nodule. We present a 58-year-old man who was referred to our Plastic Surgery Service with large, yellowish, slow-growing, bilateral palpebral lesions. The histological diagnosis was xanthogranuloma. The palpebral defect was repaired using an island flap from the zygomatic area, described by Heywood in 1991 and modified from the original design. We describe adult xanthogranulomas, which are unusual lesions, and discuss the histological study and differential diagnosis. We also draw atention to the usefulness

  3. Cierre de defecto tóraco-lumbar mediante colgajo de dorsal ancho reverso: a propósito de un caso

    OpenAIRE

    J. Díaz-Ontiveros; R. Moreno-Villalba; F. Santoyo-Gil

    2013-01-01

    Para la reconstrucción de grandes defectos tóracolumbares, ya sean congénitos o adquiridos, se utilizan diversas técnicas quirúrgicas como injertos de piel, colgajos locales, colgajos loco-regionales, colgajos a distancia y colgajos libres, cada una con sus ventajas e inconvenientes dependiendo no solo del defecto a cubrir sino también de la disponibilidad para realizarlos. Presentamos el caso de una mujer de 56 años de edad con patología discal, intervenida quirúrgicamente para artrodesis pó...

  4. Colgajo frontal paramediano de pedículo estrecho para reconstrucción nasal en cáncer de piel

    Directory of Open Access Journals (Sweden)

    Jezabel De Abullarade

    Full Text Available Antecedentes y Objetivos. No se pueden negar los excelentes resultados que el colgajo frontal ofrece en la reconstrucción nasal, por lo que supone una importante herramienta en el arsenal terapéutico del cirujano reconstructivo. El objetivo del presente trabajo es presentar y discutir una modificación de dicho colgajo: el pedículo estrecho del colgajo frontal paramediano, presentando las ventajas que ofrece la modificación del colgajo entre las que destaca el que permite preservar otro potencial colgajo similar para el futuro, en el caso de que éste fuera necesario. Material y método. Analizamos un grupo de pacientes en el que practicamos resección de carcinoma basocelular de piel nasal con limites quirúrgicos negativos por biopsia de congelación, y reconstrucción quirúrgica con elevación de colgajo frontal paramediano con pedículo de 1.5 cm en todos los casos, basado en el hecho de que la arteria supratroclear súperomedial es constante en su borde orbitario .Cerramos el defecto del área donante en la frente mediante sutura directa en todos los casos. Resultados. Operamos con esta técnica a 76 pacientes, 30 mujeres y 46 varones, con una edad media de 59 años. En todos los casos hicimos revisión quirúrgica para autonomización del colgajo, desgrase, cartílago, etc. No hubo necrosis del colgajo en ningún caso. Conclusiones. Comprobamos la utilidad del colgajo frontal de pedículo estrecho y sus ventajas al ser levantado, entre otras, el mantener la integridad del lado contralateral de la frente para otro potencial colgajo frontal paramediano si fuera necesario.

  5. Inguinal hernia

    OpenAIRE

    2008-01-01

    The main risk factors for inguinal hernia are male sex and increasing age. Complications of inguinal hernia include strangulation, intestinal obstruction, and infarction. Recurrence can occur after surgery.

  6. Una complicación inusual del colgajo de Björk en la traqueotomía electiva An unusual complication of Björk flap in elective tracheotomy

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    L. Villalaín Álvarez

    2008-10-01

    Full Text Available Introducción. La traqueotomía temporal electiva se emplea con frecuencia en intervenciones realizadas en el territorio cervicofacial. El colgajo de pared traqueal anterior de base inferior (colgajo de Björk facilita el cambio de cánula en el periodo postoperatorio. Caso clínico. Paciente intervenido de un cáncer oral al que tras haberse cerrado el traqueostoma se le descubrió de forma casual un hilo de sutura en la luz traqueal. Dada la dificultad de su retirada por vía endoscópica y ausencia de sintomatología, se decidió no retirarlo. Discusión. La traqueotomía electiva en oncología cervicofacial asegura la vía aérea, pero presenta también complicaciones. Es muy importante un adecuado manejo del traqueostoma, independientemente de que se elija un cierre primario o secundario del mismo.Introduction. Elective temporary tracheotomy in often performed in head and neck oncologic surgery. An inferiorly hinged tracheal flap (Björk flap provides a secure airway in the inmediate postoperative period. Clinical case. This patient underwent resection of an oral cancer and subsequent tracheotomy. After deccanulation, a piece of suture was found into the trachea as an incidental discovery. There were no symptoms related to it, and it was not possible to remove it from the anterior tracheal wall by means of endoscopy, so it was left in place. Discussion. Elective tracheotomy in head and neck resection for malignancy safeguards the airway, but also has complications. It is very important a careful management of the stoma, without regard if a primary or secundary closure of it is chosen.

  7. Experiencia con el colgajo de Kirschbaum en secuelas de quemaduras cérvico-faciales

    OpenAIRE

    P. Rossell-Perry; P. Paredes-Leandro

    2014-01-01

    Presentamos nuestra experiencia con el colgajo de Kirschbaum (colgajo en charretera) en la corrección de retracciones cicatriciales de la región cervical anterior y del tercio inferior de la cara. Llevamos a cabo un estudio retrospectivo sobre una serie de 63 pacientes con retracciones cicatriciales de la región cervical anterior y del tercio inferior facial, operados por el primer autor entre los años 1996 y 2012 dentro del marco de las campañas quirúrgicas desarrolladas a lo largo del país ...

  8. Variabilidad en el diseño y composición del colgajo de perforante de tibial posterior para la reconstrucción de defectos en la pierna Versatility on design and composition of the tibial posterior perforator flap for reconstruction of leg defects

    Directory of Open Access Journals (Sweden)

    C. Laredo Ortiz

    2011-03-01

    Full Text Available Las pérdidas de sustancia en la pierna y fundamentalmente en su tercio inferior, siguen siendo un reto en Cirugía Reconstructiva puesto que los tejidos de vecindad, dañados por el traumatismo o por el edema concomitante, son inadecuados para cubrir hueso, tendones o material de osteosíntesis expuesto. El colgajo propeller o colgajo en hélice es un método elegante y versátil para la cubrir estas pérdidas de sustancia de la extremidad inferior con tejido locorregional no comprometido vascularmente por el traumatismo y/o lesión causante. A diferencia de los colgajos convencionales de rotación o transposición, es posible el cierre directo de la zona donante, lo que ofrece un resultado estético óptimo. Además, la presencia de perforantes más proximales permite usar pastillas musculares y tendinosas en el mismo colgajo para resolver defectos más complejos, convirtiéndose en algo más que una alternativa a los colgajos libres. Presentamos una serie de 43 pacientes para describir las posibilidades reconstructivas que ofrece el colgajo de perforante de arteria tibial posterior en su forma en hélice, en cuanto a la variabilidad del diseño y a su uso como colgajo compuesto, con el fin de minimizar aun más la morbilidad de la zona donante sin el uso de injertos.Lower extremity defects, specially lower third defects, keep being a true challenge in Reconstructive Surgery, since nearness damaged tissues, due to the traumatism or to the concomitant edema, are not suitable for the coverage of bone, tendons or exposed osteosynthesis material. Propeller flap has become an elegant and mobile method for the coverage of this type of lower extremity defects. It provides us with locorregional tissue with not vascular involvement in the traumatism and/or subsequent injury. Unlike conventional rotation or transposition flaps, direct closure of the donor site is possible, offering an optimum aesthetic result. Moreover, the presence of more proximal

  9. La hernia inguinal estrangulada

    OpenAIRE

    2012-01-01

    Introducción: existen más de 13 técnicas operatorias descritas para el tratamiento de la hernia inguinal estrangulada sin demostrar cuál es mejor. Material y métodos: estudio observacional, longitudinal y prospectivo realizado en el Hospital General del Centro Médico La Raza. Se propone una nueva técnica quirúrgica para tratar la hernia inguinal estrangulada. Se efectuó del 1 diciembre de 2000 al 31 de agosto de 2010. Se operaron en forma consecutiva 43 pacientes adultos con hernia inguinal e...

  10. Colgajo miomucoso de buccinador en la reconstrucción de defectos del área maxilofacial The buccinator myomucosal flap for the reconstruction of defects in the maxillofacial area

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    R. González García

    2005-08-01

    Full Text Available El colgajo miomucoso de buccinador (CMB constituye una alternativa válida para la reconstrucción de defectos intraorales de tamaño moderado. Se caracteriza por su buena plegabilidad, excelente color y textura, además de una mínima morbilidad de la zona donante. En el presente trabajo se describen las particularidades anatómicas de dicho colgajo, así como las diferentes técnicas quirúrgicas que pueden emplearse para su obtención. Su utilización en diferentes defectos de la cavidad oral, ilustra la versatilidad del mismo. Presentamos 4 casos de reconstrucción de defectos del área maxilofacial: dos pacientes con carcinoma epidermoide de suelo de boca, un paciente con melanoma de mucosa y un paciente con fisura palatina. Se obtuvieron resultados óptimos en cuanto a cobertura del defecto postquirúrgico, estética y función. En todos los casos la morbilidad de la zona donante fue mínima. Dadas sus particularidades anatómicas, debe realizarse una cuidadosa técnica de obtención del mismo. La proximidad del CMB a la gran mayoría de los defectos de la cavidad oral y su aceptable espesor, hace del mismo una opción reconstructiva eficaz, sobre todo en aquellos pacientes en los que el tamaño del defecto y/o la existencia de patología asociada desaconsejan el uso de otros colgajos.The buccinator myomucosal flap (BMF constitutes a valid alternative for the reconstruction of moderate defects of the oral cavity. It is characterized by a good pliability, excellent color and texture and minimum donor site morbidity. In this report, the anatomical particularities and the different surgical techniques for BMF are described. Its use in patients with different defects of the oral cavity illustrates its versatility. We present 4 cases of reconstruction of defects of the maxillofacial area: two cases consisting in squamous cell carcinoma of the floor of the mouth, another patient with melanoma of the oral mucosa and one patient with a palatine

  11. Reconstrucción de la extremidad inferior con colgajos de perforantes locales Perforator local flaps in lower limb reconstruction

    OpenAIRE

    T. C. Teo

    2006-01-01

    Las innovaciones técnicas en el diseño y elevación de colgajos y los recientes avances en el conocimiento de la perfusión arterial de los mismos, ha conducido hacia un tipo de reconstrucción más refinada para todas las partes del cuerpo. El concepto de colgajos basados en vasos perforantes ha evolucionado a partir de estos avances. La reconstrucción de la extremidad inferior se ha beneficiado particularmente de este desarrollo de los colgajos de perforantes, tanto pediculados como libres. El ...

  12. Reconstrucción de extremidades inferiores con colgajo sural diferido

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    Victor Huiman Lazo

    2004-07-01

    Full Text Available Objetivo: Evaluar la viabilidad del colgajo sural, en lesiones de extremidades inferiores que comprometen la zona de su pedículo vascular utilizando la técnica quirúrgica de transposición diferida o de retardo. Materiales y Métodos: Se estudiaron 08 pacientes sometidos a cirugía reconstructiva con colgajo sural diferido por lesiones en tercio distal de extremidades inferiores que comprometían la zona de su pedículo vascular, desde junio 2001 a mayo 2003, en el Servicio de Cirugía Plástica del Hospital Nacional Cayetano Heredia. Resultados: El 100% de colgajos estuvo viable al momento de realizar la transposición. Las complicaciones encontradas fueron menores, siendo la más frecuente la necrosis parcial. Conclusiones: La técnica diferida utilizada en el colgajo sural, cuando la lesión compromete la zona de su pedículo vascular, es adecuada para mantener la viabilidad del colgajo.(Rev Med Hered 2004;15:155-158.

  13. Generalidades de colgajos y su importancia en la relación con la reparación del daño corporal

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    Oscar Aymerich Bolaños

    2014-03-01

    Full Text Available El daño corporal es tema de gran discusión en el marco médico legal. Las repercusiones funcionales y estéticas constituyen una secuela de gran importancia para los pacientes. Es mediante técnicas quirúrgicas como los colgajos, que se ha logrado prevenir cicatrices retráctiles y marcas indelebles en el rostro. Siendo estos últimos bloques vascularizados de tejido que se movilizan a partir de un sitio donador y se clasifican según su composición, vascularización y el método de diseño y transferencia. Dichos puntos, se discutirán a continuación.

  14. Descripción anatómico-quirúrgica del colgajo dorsoepigástrico: una opción diferente en reconstrucción mamaria Anatomical and surgical description of a new concept in breast reconstruction: muscle sparing dorsoepigastric flap of latissimus dorsi

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    J.L. Haddad Tame

    2012-03-01

    Full Text Available La importancia de las mamas para el equilibrio biopsico-social de la mujer es evidente. Las secuelas físicas y psíquicas de la mastectomía pueden ser tratadas mediante cirugía de reconstrucción mamaria; la búsqueda de nuevas opciones reconstructivas con menor incidencia de complicaciones y que permitan obtener mejores resultados estéticos, sigue vigente en nuestros días. En un estudio piloto realizado en 3 cadáveres frescos identificamos la anatomía neurovascular del músculo dorsal ancho, que fue constante en los hallazgos, por lo que en una segunda etapa procedimos a realizar reconstrucción mamaría mediante un colgajo dorsoepigástrico conservador de músculo dorsal ancho en 9 pacientes. El diseño del colgajo permite tomar una tira de 5 a 7cms del borde lateral del dorsal ancho, que incluye la rama descendente de la arteria tóracodorsal. La tasa global de complicaciones fue del 0.63 %, por lo que la morbilidad del sitio donante fue menor que la que se presenta con otro tipo de colgajos, y el resultado estético fue muy satisfactorio. Consideramos que el colgajo dorsoepigástrico conservador de músculo dorsal ancho es una excelente opción reconstructiva para las pacientes mastectomizadas, si bien se trata de un estudio piloto y necesitamos ampliar la muestra de pacientes para validar los resultados.Breast importance is evident for women quality of life. The physical and psychological trauma of mastectomy can be treated by breast reconstruction, so it´s important to search for new reconstructive options decreasing complications and improving the cosmetic results. By an anatomical study in 3 fresh cadavers we observed the neurovascular anatomy of the latissimus dorsi and we founded a constant anatomy; then we realized the dorsoepigastric muscle sparing of latissimus dorsi flap taking a strip of 5 to 7cm from lateral edge of the muscle including the descending branch of the thoracodorsal artery in 9 patients meeting inclusion

  15. El colgajo miomucoso de la arteria facial para tratamiento de defectos intraorales. Reporte de 2 Casos.

    OpenAIRE

    Yuri Martínez, Alan; Cleveland, Ohio.

    2014-01-01

    El tratamiento de defectos intraorales puede resultar complicado y mórbido cuando se usan colgajos distantes. En determinados casos el uso del colgajo miomucoso de la arteria facial (CMMAF) puede facilitar el cierre de defectos intraorales de tamaño pequeño y mediano. Presentamos 2 casos manejados con CMMAF para cierre de fistulas oronasal y vestíbulo antero inferior mandibular. La técnica es sencilla y no requiere entrenamiento extensivo ya que la anatomía de la zona es muy familiar para tod...

  16. Experiencia con el colgajo de Kirschbaum en secuelas de quemaduras cérvico-faciales

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    P. Rossell-Perry

    2014-06-01

    Full Text Available Presentamos nuestra experiencia con el colgajo de Kirschbaum (colgajo en charretera en la corrección de retracciones cicatriciales de la región cervical anterior y del tercio inferior de la cara. Llevamos a cabo un estudio retrospectivo sobre una serie de 63 pacientes con retracciones cicatriciales de la región cervical anterior y del tercio inferior facial, operados por el primer autor entre los años 1996 y 2012 dentro del marco de las campañas quirúrgicas desarrolladas a lo largo del país (Perú en las áreas geográficas con mayor necesidad de atención especializada. En todos los casos empleamos el colgajo en charretera tomado de la región lateral del cuello y de la región deltoidea. Evaluamos a los pacientes mediante el examen físico y la documentación fotográfica obtenida en los periodos pre y postoperatorio. Obtuvimos mejoría en diferentes grados de la limitación funcional de la región cervical y facial en todos los casos operados, con viabilidad total del colgajo en 59 casos (93,65 % y parcial en 4 casos (6,34 % . No hubo ningún caso de pérdida total. Las complicaciones recogidas fueron pocas, principalmente hematomas, 6 casos (9,52 % e infección, 2 casos (3,17 % . Las zonas donantes evolucionaron con cicatriz hipertrófica en 22 de los casos (34,92 % . En conclusión, nuestra experiencia con el uso de esta técnica quirúrgica ha demostrado ser de utilidad en el tratamiento de las secuelas de quemadura con retracción cicatricial cervical y facial, por lo que consideramos que el colgajo de Kirschbaum es seguro y tiene pocas complicaciones.

  17. Tratamiento de fracturas abiertas de tibia grado IIIB-IIIC de Gustilo con colgajos libres microvascularizados

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    D. Camporro-Fernández

    2015-09-01

    Full Text Available Los objetivos de este artículo son aportar nuestra experiencia en el tratamiento de las fracturas tibiales tipo IIIBIIIC mediante colgajos libres y presentar nuestro protocolo de actuación ante este tipo de lesiones. El estudio incluye una serie de 49 pacientes en los que se realizaron un total de 51 colgajos libres. El desbridamiento y la estabilización ósea se practicaron el día 1 de la lesión. El número de desbridamientos hasta cobertura fue de 1 a 3 (media 2,1. El tiempo medio desde la lesión a la cobertura definitiva fue de 9,3 días. Hubo supervivencia en 46 colgajos (90,2%, y los 5 fallidos se resolvieron mediante 2 colgajos de piernas cruzadas, un segundo colgajo libre y 2 amputaciones infracondíleas. Obtuvimos consolidación primaria en 23 casos (47% de los pacientes. En el resto realizamos procedimientos ortopédicos secundarios con un 4% de osteomielitis crónicas y un 4% de pseudoatrosis infectadas, una de las cuales requirió amputación secundaria. En total hubo 3 amputaciones, con un 94% de piernas salvadas. El tratamiento de estos pacientes se debe llevar a cabo en un centro hospitalario donde haya estrecha colaboración entre traumatólogos y cirujanos plásticos. A pesar del avance en todas las especialidades implicadas, creemos que la adecuada cobertura con colgajos microvascularizados es clave para obtener la consolidación, sin infección, de estas fracturas.

  18. Colgajo de reposición apical Apically positioned flap

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    L. Pérez-Salcedo

    2011-08-01

    Full Text Available Se describe la técnica del colgajo de reposición apical desde el primer autor, Nabers en 1954, así como las modificaciones realizadas por Ariaudo y Tyrrel en 1957 y Friedman en 1962. También se presenta un caso clínico donde se describen los diferentes pasos de la cirugía de reposición apical. Por último, se hace una revisión evaluando la eficacia del colgajo de reposición apical en el tratamiento de la periodontitis.This paper describes the technique apically positioned flap since the first author Nabers in 1954 and also the modifications performed by Ariaudo and Tyrrell in 1957 and Friedman in 1962. Also a clinical case is presented where it can be observed the different steps of the apically positioned flap in clinical pictures. Afterwards some papers in which the efficacy of the apically positioned flap in the treatment of periodontitis are evaluated and described.

  19. Reconstrucción de antebrazo con colgajo DIEP: caso clínico

    OpenAIRE

    2015-01-01

    Las heridas complejas del antebrazo con fracturas asociadas y pérdida circunferencial de piel, suponen un doble reto reconstructivo. Mostramos el tratamiento de una paciente con lesiones combinadas en el miembro superior tras atrapamiento por rodillos fríos industriales mediante el uso de un colgajo libre de perforante del eje epigástrico inferior profundo (DIEP), tras tratamiento de la fractura articular de la extremidad distal de radio guiado por artroscopia. Conseguimos la estabilización d...

  20. Reconstrucción de antebrazo con colgajo DIEP: caso clínico

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    J. Balaguer-Cambra

    2015-06-01

    Full Text Available Las heridas complejas del antebrazo con fracturas asociadas y pérdida circunferencial de piel, suponen un doble reto reconstructivo. Mostramos el tratamiento de una paciente con lesiones combinadas en el miembro superior tras atrapamiento por rodillos fríos industriales mediante el uso de un colgajo libre de perforante del eje epigástrico inferior profundo (DIEP, tras tratamiento de la fractura articular de la extremidad distal de radio guiado por artroscopia. Conseguimos la estabilización de las fracturas y la cobertura completa del defecto. El colgajo DIEP permite la cobertura de áreas extensas con escasa morbilidad en la zona donante y con un correcto resultado estético.

  1. Colgajo tendinocutáneo vascularizado de dorsalis pedis: caso clínico

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    F. Martínez Martínez

    2013-06-01

    Full Text Available Los grandes accidentes que afectan a la mano suelen cursar con daños en más de un tejido. Son frecuentes las exposiciones óseas, fracturas, lesiones tendinosas y pérdidas de cobertura cutánea, lo que supone un importante problema para la cirugía reconstructiva. Las técnicas quirúrgicas para afrontar estas lesiones múltiples pueden reunirse en tres grupos: A múltiples procedimientos escalonados, B procedimientos únicos parcialmente vascularizados, C procedimientos únicos totalmente vascularizados. Aquellas en las que en un primer tiempo se realiza cobertura cutánea y en un segundo tiempo se procede al injerto tendinoso, acarrean problemas relacionados con rigideces, dificultad en el cálculo de la longitud del injerto tendinoso debido a retracción muscular y adherencias tendinosas. Un colgajo muy utilizado para la reparación de este tipo de lesiones ha sido el del dorsalis pedis; muchos autores rechazan su uso como colgajo debido a varios inconvenientes: anatomía variable de la zona donante, disección tediosa y sobre todo, elevada morbilidad de la zona donante. Sin embargo, puede ser usado como colgajo tendinocutáneo ya que proporciona cuatro tendones vascularizados de adecuada longitud cubiertos por completo de epitenón y unidos de manera holgada a una piel que es muy similar a la del dorso de la mano. Además, el tendón vascularizado reduce el problema de adherencias que ocurre con los colgajos tendinosos simples. Presentamos un caso de traumatismo severo de la mano con afectación completa de los tendones extensores.

  2. Experiencia en reconstrucción auricular en cáncer de piel con colgajo en "quesadilla"

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    C. Gutiérrez Gómez

    Full Text Available La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y no con un simple injerto. Frente a esta dificultad técnica, diseñamos un colgajo ricamente vascularizado que preserva el cartílago no afectado con una buena cubierta y al mismo tiempo respeta la anatomía de la oreja. Para la cobertura del cartílago auricular anterior usamos un colgajo fasciocutáneo posterior que se asemeja a un plato típico de la cocina mexicana que llamamos "quesadilla", donde el cartílago por su color blanco recuerda el queso y el gran colgajo fasciocutaneo recuerda la tortilla que cubre al queso. Este colgajo incluye la piel enrollada del hélix, que en un segundo tiempo retornará a su lugar de origen anatómico mediante una z-plastía asimétrica. Presentamos, de entre una serie de 13 pacientes con carcinoma de pabellón auricular, 2 casos resueltos mediante esta técnica.

  3. Colgajo de avance en V-Y de gastrocnemio medial basado en perforante para cierre de defectos del tercio medio de la pierna V-Y advancement gastrocnemius perforant based flap for closure of defects of the medial third of the leg

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    V. Spröhnle

    2010-06-01

    Full Text Available Los colgajos de avance en V-Y han sido una alternativa popular para el cierre de heridas profundas, pero su movilidad es limitada. Los colgajos basados en perforantes son especialmente útiles cuando se necesita un mayor avance y cobertura. Diseñamos un colgajo de gastrocnemio que utiliza ambas técnicas para cubrir los defectos del tercio medio y superior de la pierna en sus caras lateral y posterolateral. Evaluamos en forma retrospectiva 5 pacientes con heridas en el tercio medio y superior de la pierna, tratados entre enero de 2005 y septiembre de 2007 en un solo centro y por un mismo cirujano. Todos fueron varones, con un promedio de edad de 48 años y la etiología fue traumática en todos los casos. El vaso perforante se evaluó preoperatoriamente por medio de doppler color en todos los casos. Valoramos telefónicamente la satisfacción del paciente en el postoperatorio tardío. En todos los casos, encontramos los vasos perforantes identificados en el preoperatorio; el tiempo operatorio promedio fue de 1.8 horas. No hubo complicaciones; la cobertura fue exitosa en todos los casos y los pacientes se mostraron satisfechos en la encuesta realizada. El tiempo medio de seguimiento postoperatorio fue de 19 meses. En conclusión, creemos que el colgajo de avance en V-Y de gastrocnemio basado en perforante se presenta como una alternativa segura para el cierre de defectos del tercio medial y superior de la pierna, en un sólo tiempo quirúrgico y con buenos resultados estéticos y funcionales a largo plazo.Advancement V-Y flaps have been a popular choice for closure of deep wounds but their mobility is limited. Perforant based flaps are specially useful when greater advancement and bigger coverage are needed. We designed a gastrocnemius based flap that uses both techniques for covering the defects of the medial third of the leg. We follow a retrospective evaluation of 5 patients that had their wounds in the medial and superior third of the leg

  4. Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital

    Directory of Open Access Journals (Sweden)

    I. González-Alaña

    2014-09-01

    Full Text Available Las quemaduras eléctricas producen lesiones profundas, especialmente las debidas a la entrada y salida de la corriente y al arco voltaico, que pueden dejar expuestas estructuras nobles y afectar áreas de flexo-extensión, como la fosa antecubital. Los defectos resultantes pueden cubrirse mediante colgajos libres o pediculados de brazo y antebrazo. Entre las distintas opciones quirúrgicas, el colgajo medial del brazo evita la interrupción de los ejes vasculares mayores y la secuela en la zona donante es discreta. Sin embargo, su uso está poco extendido por considerarse un colgajo de difícil disección debido a la variabilidad anatómica de las arterias colaterales cubitales superior e inferior que lo irrigan. Presentamos la cobertura para un defecto secundario a quemadura eléctrica en la fosa antecubital mediante un colgajo medial del brazo basado en las ramas perforantes de la arteria colateral cubital inferior. Aunque confirmamos en este caso la variabilidad vascular, la disección resultó sencilla y el resultado estético y funcional fue excelente.

  5. Reconstrucción de la extremidad inferior con colgajos de perforantes locales Perforator local flaps in lower limb reconstruction

    Directory of Open Access Journals (Sweden)

    T. C. Teo

    2006-12-01

    Full Text Available Las innovaciones técnicas en el diseño y elevación de colgajos y los recientes avances en el conocimiento de la perfusión arterial de los mismos, ha conducido hacia un tipo de reconstrucción más refinada para todas las partes del cuerpo. El concepto de colgajos basados en vasos perforantes ha evolucionado a partir de estos avances. La reconstrucción de la extremidad inferior se ha beneficiado particularmente de este desarrollo de los colgajos de perforantes, tanto pediculados como libres. El colgajo fasciocutáneo en isla de base distal, basado en una sola perforante, permite la reconstrucción de defectos del tercio inferior de la extremidad inferior, con una técnica de rápida ejecución y con una instrumentación básica. Describimos la anatomía, diseño, ejecución, aplicaciones y ventajas de los colgajos de perforantes locales en la reconstrucción del miembro inferior.Technical innovations in the approach to flap design and dissection and recent advances in unders tanding of the arterial basis of flap perfusion have led to more refined reconstruction in all areas of the body. The concept of perforator vessel based flap has evol ved from this improved knowledge. Lower limb reconstruction has certainly benefited from this development of perforator flaps, both pedi cled and free. The distally based island fasciocutane ous flap, based on a single perforator, has allowed defects on the often awkward distal third of the lower limb to be covered reliably, with a quicker procedure and the simplest of instrtuments. We describe the anatomy, design, technique, appli cations and advantages of perforator local flaps in lower limb reconstruction.

  6. Cierre de defecto tóraco-lumbar mediante colgajo de dorsal ancho reverso: a propósito de un caso

    Directory of Open Access Journals (Sweden)

    J. Díaz-Ontiveros

    2013-09-01

    Full Text Available Para la reconstrucción de grandes defectos tóracolumbares, ya sean congénitos o adquiridos, se utilizan diversas técnicas quirúrgicas como injertos de piel, colgajos locales, colgajos loco-regionales, colgajos a distancia y colgajos libres, cada una con sus ventajas e inconvenientes dependiendo no solo del defecto a cubrir sino también de la disponibilidad para realizarlos. Presentamos el caso de una mujer de 56 años de edad con patología discal, intervenida quirúrgicamente para artrodesis póstero-lateral L1-L5 que requirió varias intervenciones con desbridamiento de la musculatura paravertebral tras infección y hematoma, quedando como secuela de las mismas un defecto de aproximadamente 20 x 5 cm que tras un intento fallido de cicatrización dirigida tuvo que ser reconstruido mediante colgajo de dorsal ancho reverso. Tras 2 años de seguimiento postoperatorio, la paciente presenta una evolución satisfactoria con cierre total del defecto y sin secuelas.

  7. Colgajos en isla tunelizados como alternativa en la reparación de heridas

    Directory of Open Access Journals (Sweden)

    J.L. Ramón-Vera

    2014-03-01

    Full Text Available Los colgajos en isla tunelizados son una variante cuyos resultados estéticos y funcionales pueden ser altamente efectivos y eficientes. Son efectivos, porque permiten lograr la corrección de defectos derivados de la extirpación de lesiones tumorales, de traumas, etc; y son eficientes porque permiten aprovechar de modo racional el área donadora, disminuyendo el efecto iatrogénico sobre ésta y conservando la viabilidad de reserva de tejidos ante posibles recidivas en tumores, úlceras en extremidades, etc. Presentamos una serie de casos en la que exponemos la experiencia con colgajos en isla tunelizados en el Hospital Universitario "Hernando Moncaleano Perdomo", un hospital de referencia de tercer nivel en un área geográfica del sur de Colombia con escasos recursos, graves conflictos y dificultad para el seguimiento postoperatorio de los pacientes. Iniciamos esta experiencia en el 2009 con un caso presentado en esta misma revista y hasta el 2011 hemos recogido 35 casos de pacientes intervenidos por defectos en cara, cuello, axila y extremidades. Hacemos énfasis en la posibilidad de usar este tipo de colgajos como la mejor alternativa para defectos en cara y cuello cuando los recursos asistenciales son limitados, a la vez que hacemos una concisa descripción de las técnicas empleadas y los resultados obtenidos.

  8. Reconstrucción mamaria con colgajos microquirúrgicos de perforantes

    Directory of Open Access Journals (Sweden)

    J. A. Lozano

    Full Text Available La reconstrucción mamaria autógena se realiza frecuentemente con tejido abdominal, ya que se obtiene el mejor resultado estético perdurable en el tiempo, con una nueva mama muy similar en textura, consistencia y ptosis a la contralateral. La secuela a nivel de la zona donante abdominal es el principal problema que plantea este tipo de reconstrucciones. Los colgajos de perforantes se desarrollan como el gran recurso para solventar dicho problema, ya que apenas dañan el músculo y su fascia. El colgajo DIEP (Deep Inferior Epigastric Perforator ha demostrado ser una alternativa reconstructiva destinada a gran cantidad de mujeres, con bajas tasas de complicaciones locales, debido a la falta de sacrificio del músculo recto abdominal, e importante grado de satisfacción por el resultado obtenido. Como inconveniente presenta su mayor dificultad técnica y la necesidad de un equipo quirúrgico que domine la microcirugía vascular. No obstante, el colgajo DIEP se presenta como una técnica quirúrgica con una demanda en importante ascenso.

  9. Una nueva experiencia clínica: Colgajo safeno interno diferido A new clinical experience: the delayed reverse saphenous flap

    Directory of Open Access Journals (Sweden)

    G.A. Wolff I

    2010-12-01

    Full Text Available Los defectos de tejidos blandos de la pierna y el pie cuasados por traumatismos, tumores o infecciones, requieren frecuentemente procedimientos de cobertura mediante el empleo de colgajos. El colgajo safeno interno ha demostrado ser una excelente opción por su versatilidad y su poca morbilidad en el área donante. El diferimiento es un procedimiento útil para reducir las complicaciones vasculares de los colgajos, en pacientes con factores de riesgo añadidos. Su fisiología ha sido estudiada detalladamente, pero aún persisten interrogantes en torno a su uso y al periodo de diferimiento. Presentamos nuestra experiencia clínica con el uso de colgajos diferidos en 2 casos de reconstrucción de pie y tobillo secundarios a traumatismos, en los que se presentó sufrimiento vascular agudo al realizar el colgajo safeno interno reverso. El período de diferimiento varió entre los 7 y los 10 días. Los resultados postoperatorios fueron satisfactorios. Se presentó solo un complicación consistente en necrosis de los bordes de uno de los colgajos (menor del 1%. En conclusión, creemos que el diferimiento de los colgajos regionales es una herramienta útil para reducir la tasa de complicaciones vasculares en los mismos. Nuestra experiencia con el colgajo safeno interno diferido, reportada por primera vez según nuestro conocimiento, confirma la utilidad del procedimiento en este tipo de colgajo, demostrando que aún en condiciones de riesgo vascular esta modificación del colgajo se presenta como una opción alternativa para la reconstrucción exitosa de este tipo de defectos.Complex soft tissue defects of the distal third of the leg and foot represent a challenge in the reconstructive. The internal saphenous flap is a frequently used option for lower leg reconstruction because its versatility and minimal donor site morbidity. The commonly known delay procedure is an alternative. The concept of delay was clearly explained years ago, but still there is

  10. Obliteración de fracturas de seno frontal con colgajos pediculados

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    J. Pefaure

    2014-03-01

    Full Text Available El compromiso del seno frontal con fractura de sus paredes es un tipo de lesión infrecuente, en torno al 5-12% de todas las fracturas faciales. Suele asociarse a lesiones intracraneales, oftalmológicas y a otras fracturas máxilofaciales y cuando conlleva fractura de la pared posterior de seno frontal requiere tratamiento inmediato, siendo necesaria la obliteración del seno frontal debido a la comunicación con meninges y lóbulo frontal, con el riesgo infeccioso que ello representa. Tratamos 18 pacientes con traumatismos craneofaciales y fracturas del seno frontal con compromiso de su pared posterior en el periodo comprendido entre 2007 y 2011; 8 mujeres y 10 varones con edades comprendidas entre los 15 y los 64 años. Todos los casos fueron tratados con reducción y osteosíntesis por vía abierta con distintos abordajes y realizamos en todos colgajos pediculados de vecindad. La vitalidad de los colgajos fue del 100% . Certificamos el posicionamiento correcto mediante tomografía axial computarizada. El tratamiento de las fracturas del seno frontal con compromiso de su pared posterior o del conducto nasofrontal requiere obliteración con tejido vascularizado para evitar comunicaciones con la cavidad nasal.

  11. Reconstrucción Parcial de Pabellón Auricular con Colgajo Retroauricular e Injerto. Presentación de 1 caso

    OpenAIRE

    2012-01-01

    Se presenta el caso de un paciente varón de 33 años quien fuera agredido a través de una mordida en el Pabellón Auricular Izquierdo, cercenándole aproximadamente un tercio del Hélix y Antihélix, siendo sometido a una cirugía en 2 tiempos operatorios, con un Colgajo Retroauricular y colocación de un Injerto de Piel Parcial en la zona dadora de dicho colgajo. Se presenta la técnica quirúrgica y se discuten las diversas formas de reconstrucción.

  12. Colgajo de trapecio extendido en reconstrucción de defectos causados por resección de tumores de cabeza y cuello

    Directory of Open Access Journals (Sweden)

    A.A. Leal Salazar

    Full Text Available Los defectos originados por la resección de tumores en cabeza y cuello pueden ser de difícil resolución. Presentamos un caso clínico en el que se practicó reconstrucción usando el colgajo fasciomusculocutáneo de trapecio extendido basado en la arteria dorsal escapular. Este colgajo puede alcanzar el cuello, la órbita y el vértex del cráneo; por lo tanto, puede ser de utilidad para el tratamiento de grandes defectos en estas áreas.

  13. Colgajo lateral de brazo en reconstrucción de la cavidad oral Lateral arm flap in oral cavity reconstruction

    Directory of Open Access Journals (Sweden)

    A. Dean Ferrer

    2008-08-01

    Full Text Available Introducción. La posibilidad de emplear una piel fácilmente plegable ha permitido reconstruir defectos de la cavidad oral consiguiendo una gran funcionalidad. Aunque el colgajo radial es el colgajo que se utiliza con más frecuencia para reconstruir defectos de superficie de la cavidad oral, el colgajo lateral de brazo puede ser de elección en algunas situaciones. Objetivos. El objetivo del presente trabajo es mostrar las ventajas e inconvenientes y nuestras indicaciones y resultados del colgajo lateral de brazo en reconstrucción de defectos de la cavidad oral. Material y método. Se trata de un estudio prospectivo sobre la utilización del colgajo lateral de brazo en la reconstrucción de defectos de la cavidad oral tras cirugía ablativa. Se ha valorado: la viabilidad del colgajo, la morbilidad del lecho donante, la longitud del pedículo, la selección de vasos receptores, las complicaciones y los resultados funcionales de la zona reconstruida. Resultados. Hemos utilizado el colgajo lateral de brazo en 10 pacientes en reconstrucciones primarias tras cirugía ablativa por carcinoma epidermoide de la cavidad oral. Hubo un caso de necrosis por trombosis venosa. El defecto donante se cerró en 8 casos de modo directo y en 2 con un injerto libre de espesor parcial. La longitud media del pedículo ha sido de 8,75 cm. En 9 casos el resultado funcional de los pacientes ha sido satisfactorio. Conclusiones. El colgajo fasciocutáneo lateral de brazo permite la reconstrucción de la cavidad oral consiguiendo buenos resultados funcionales. Además la morbilidad de la zona donante es mínima y puede realizarse cierre directo del defecto cutáneo del brazo en la mayoría de los casos.Introduction. The availability of easily pliable skin has allowed the functional reconstruction of oral cavity defects. Although the radial forearm free flap is the most frequently used flap for the reconstruction of surface defects of the oral cavity, the lateral arm free

  14. Experiencia en reconstrucción de tercio distal de pierna con colgajo libre de músculo gracilis

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    A. Conejero

    2013-09-01

    Full Text Available En los defectos de cobertura distales de la pierna con exposición ósea o articular, la transferencia de tejidos libres es frecuentemente la única opción viable. Se utilizan en el rescate de extremidades inferiores en riesgo por trauma, infección, ulceración, quemaduras y tumores. El colgajo libre de músculo gracilis está descrito en la literatura como una excelente alternativa. El objetivo de este estudio es describir las características de los pacientes y resultados de la utilización del colgajo libre de músculo gracilis en la reconstrucción del tercio distal de la pierna. Se trata de un estudio retrospectivo, observacional, de revisión de archivo clínico y fotográfico de 7 pacientes operados por los autores entre los años 2007-2010, 4 hombres y 3 mujeres con un promedio de edad de 38,5 años. El defecto de cobertura que motivó la cirugía (de hasta de 20 x 6 cm fue secundario a fractura expuesta (tipo III de Gustilo y a osteomielitis crónica. La cobertura del colgajo se hizo en todos los casos con injerto dermo-epidérmico. No hubo complicaciones menores ni mayores del sitio donante ni del receptor, con resultados funcionales y estéticos satisfactorios. El colgajo libre de músculo gracilis es una muy buena alternativa para la reconstrucción distal de pierna con defectos de cobertura en fracturas expuestas y osteomielitis o en úlceras crónicas. Tras el seguimiento, todos nuestros pacientes lograron una cobertura completa y estable en el tiempo.

  15. Colgajo miocutáneo de trapecio bilateral para reconstrucción de región cervical posterior

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    E. Moretti

    Full Text Available La cirugía reconstructiva para la resolución de defectos en la región cervical posterior y occipital muchas veces puede ser un verdadero desafío para los cirujanos plásticos. El colgajo miocutáneo de trapecio es una de las alternativas más utilizadas. En este artículo describimos una variante técnica del colgajo miocutáneo de trapecio basada en un diseño cutáneo bilateral en V-Y, para reconstruir defectos producidos por dehiscencia de heridas con fístula de líquido cefalorraquídeo en región cervical posterior de 2 pacientes de 52 y 72 años, intervenidos quirúrgicamente por hernia discal cervical. Logramos una cobertura total del defecto en ambos casos, con un exitoso aislamiento biológico proporcionado por la importante superficie y volumen brindados por el tercio medio de ambos músculos trapecios. No hubo sufrimiento de los colgajos ni se manifestaron alteraciones en la funcionalidad de los hombros en ambos casos. El cierre del avance en V-Y se hizo sin tensión. En conclusión, si bien existen distintas opciones para reconstruir la región posterior cervical y occipital, este nuevo diseño de colgajo miocutáneo de trapecio es una herramienta segura, de fácil ejecución, reproducible y que conserva la funcionalidad del hombro.

  16. Reconstrucción en linfedema peneano y escrotal secundario a hernia inguinal bilateral gigante Reconstruction in penile and scrotal lymphedema secondary to billateral giant inguinal hernia

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-12-01

    Full Text Available El linfedema peneano y escrotal tiene consecuencias funcionales, estéticas, sociales y psicológicas significativas para el paciente que lo padece. Es una enfermedad infrecuente en los países desarrollados, aunque relativamente prevalente en los países tropicales. Su causa más común es la filariasis, aunque en nuestra práctica diaria se asocia más frecuentemente a cirugía, radioterapia, procesos inflamatorios y neoplásicos. Presentamos un caso singular de linfedema penoescrotal secundario a cirugía por hernia inguinal gigante bilateral que persistía un año después de la intervención. El tratamiento quirúrgico consistió en la exéresis de toda la piel linfedematosa del escroto involucrada y el uso de colgajos de piel escrotal posterior para la cobertura testicular. En un segundo tiempo quirúrgico se llevó a cabo una extirpación total de la piel del pene y del tejido subcutáneo superficial a la fascia de Buck. Empleamos injertos de piel de grosor parcial para cubrir el pene denudado. El resultado estético postoperatorio fue aceptable y los resultados funcionales y psicológicos son satisfactorios para el paciente 3 años después de la cirugía.Lymphedema of the penis and scrotum has important functional, cosmetic, social, psychological consequences for the affected patient. It is a rare disease in the developed countries, although it is relatively frequent in tropical countries. Globally, the most common cause is filariasis, although in our practice it is most frecuently associated to surgery, radiotherapy, inflammatory and neoplasic diseases. We report one rare case of penoscrotal lymphedema due to billateral giant inguinal hernia reconstrction. The lymphedema was persistent one year after the repair of the billateral hernia. The technique of reconstruction consisted of excision of all involved lymphedematous skin of the scrotum, and use of posterior scrotal flaps for testicular coverage. In a second surgical time, a total

  17. Colgajo lingual excelente alternativa para el cierre de Fístulas Oronasales: reporte de un caso

    OpenAIRE

    Wiegering Cecchi, Guillermo; Servicio de Cirugía Plástica y Quemados del Hospital Nacional Arzobispo Loayza.

    2016-01-01

    Reportamos el caso de una paciente femenina de 24 años, de la ciudad de Cajamarca referida a nosotros, a quien evaluamos, preparamos y operamos quirúrgicamente con un colgajo lingual largo de base anterior, irrigado por la arteria lingual en el servicio de cirugía plástica y quemados del Hospital Nacional Arzobispo Loayza para lograr el cierre, en dos tiempos operatorios (día 0 y luego al día 22) de una gran fistula oronasal que provocaba rinofonía y reflujo nasal de los líquidos y alimentos;...

  18. Inguinal hernia - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000274.htm Inguinal hernia repair - discharge To use the sharing features on ... your child had surgery to repair an inguinal hernia caused by a weakness in the abdominal wall ...

  19. Inguinal hernia (image)

    Science.gov (United States)

    Inguinal hernia is the result of an organ, usually bowel, protruding through a weak point or tear in the thin muscular abdominal wall. Inguinal hernias can restrict blood supply to the bowel herniated ...

  20. Inguinal hernia: medicolegal implications.

    OpenAIRE

    2000-01-01

    Repair of an inguinal hernia is one of the commonest operations undertaken by surgeons but the role of trauma in causing inguinal hernia is not well understood. This paper does not attempt to discuss the cause of inguinal hernia but seeks to analyse the cases which may be accepted by the Courts as being due to trauma.

  1. Analgesia pós-operatória para procedimentos cirúrgicos ortopédicos de quadril e fêmur: comparação entre bloqueio do compartimento do psoas e bloqueio perivascular inguinal Analgesia postoperatoria para procedimientos quirúrgicos ortopédicos de cadera y fémur: comparación entre bloqueo del compartimiento del psoas y bloqueo perivascular inguinal Postoperative analgesia for orthopedic surgeries of the hip and femur: a comparison between psoas compartment and inguinal paravascular blocks

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2006-12-01

    dos cinco nervos do plexo lombar.JUSTIFICATIVA Y OBJETIVOS: Este estudio evaluó la eficacia de la inyección única de bupivacaína a 0,25% en el compartimiento del psoas o perivascular inguinal a través del estimulador de nervios periféricos para analgesia postoperatoria en pacientes sometidos a intervenciones quirúrgicas ortopédicas. MÉTODO: Cien pacientes recibieron bloqueo del plexo lumbar a través del compartimiento del psoas y fueron comparados con 100 pacientes que recibieron bloqueo del plexo lumbar vía perivascular inguinal, identificados por el estimulador de nervios periféricos con la inyección de 40 mL bupivacaína a 0,25% sin epinefrina. La analgesia en los nervios ilioinguinal, genitofemoral, cutáneo femoral lateral, femoral y obturatorio fue evaluada a las 4, 8, 12, 16, 20 y 24 horas después del final de la intervención quirúrgica. La intensidad del dolor también fue medida en el mismo período. La cantidad de opioides administrada en el postoperatorio fue anotada. En cinco pacientes de cada grupo, un estudio radiográfico con contraste no iónico se realizó para medir la dispersión de la solución anestésica. RESULTADOS: Los nervios ilioinguinal, genitofemoral, cutáneo femoral lateral, femoral y obturatorio fueron bloqueados en 92% de los pacientes en el compartimiento del psoas versus 62% en el bloqueo perivascular inguinal. El bloqueo del plexo lumbar redujo la necesidad de opioides y 42% de los pacientes sometidos al bloqueo del compartimiento del psoas y 36% de los pacientes en el bloqueo inguinal no necesitaron analgésico adicional en el postoperatorio. La duración de la analgesia fue de aproximadamente 21 horas con el bloqueo del compartimiento del psoas y 15 horas en el bloqueo perivascular inguinal. CONCLUSIONES: El bloqueo del compartimiento del psoas y perivascular inguinal es una excelente técnica para la analgesia postoperatoria en intervenciones quirúrgicas ortopédicas reduciendo la necesidad de opioides. Ese

  2. Reanimación palpebral con colgajo frontal miofuncional: Caso clínico

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    F. García-García

    2014-06-01

    Full Text Available El párpado es una estructura crítica para la protección y función del globo ocular, y parte primordial en la estética facial. Su reconstrucción está determinada por la extensión de la lesión y el compromiso de las diferentes capas. Siempre se preferirán tejidos loco-regionales debido a su mayor similitud y disposición. Los métodos de reanimación palpebral se pueden dividir en estáticos y dinámicos, considerando a estos últimos como el único medio para restaurar el parpadeo. Presentamos un caso de celulitis orbitaria preseptal con lesión de espesor total del párpado superior y su reconstrucción miofuncional utilizando un colgajo frontal. Este colgajo frontal miocutáneo logró la restauración funcional del párpado comprometido mediante la adición de fibras musculares y permitiendo el fenómeno de reinervación.

  3. Queloide bilateral secundario a otoplastia tratado mediante escisión y colgajos queloideos

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    A. Pérez-Espadero

    2013-08-01

    Full Text Available Los queloides son cicatrices de aspecto tumoral que pueden aparecer hasta varios años después de la herida original, y se extienden más allá de los confines de ésta. La oreja prominente es la deformidad auricular estética más frecuente. La otoplastia para su corrección logra resultados altamente satisfactorios. Sin embargo, no está exenta de complicaciones, entre las que hay que considerar el desarrollo de queloides. Existen muchas técnicas para la extirpación y la posterior cobertura. La técnica del colgajo queloideo consiste en la escisión del queloide preservando una capa delgada de su cubierta cutánea, unida por un pedículo a la piel normal, para reparar el defecto. El colgajo queloideo es una solución sencilla y efectiva para la cobertura de defectos importantes tras la extirpación completa de grandes queloides. Se presenta un caso clínico ilustrativo, secundario a otoplastia, del empleo de dicho procedimiento.

  4. Conservación de la rodilla con colgajo libre plantar en sarcoma de miembro inferior: caso clínico

    Directory of Open Access Journals (Sweden)

    M.T. Sánchez-Medina

    2013-12-01

    Full Text Available La cirugía conservadora del miembro es el objetivo ideal a lograr en el tratamiento del sarcoma de extremidades. La tasa de amputaciones en este tipo de tumores se ha reducido considerablemente. La combinación de cirugía conservadora de miembro y radioterapia proporciona los mismos resultados oncológicos con la ventaja de preservar el miembro y su función. A pesar de esto, todavía existen indicaciones de amputación de extremidades, como cuando se trata de masas que afectan al eje neurovascular principal del miembro, entre otras. En estos casos, puede ser útil el uso de colgajos fileteados para preservar la longitud del miembro o para cubrir estructuras nobles. Presentamos el caso clínico de un paciente con sarcoma fusocelular de alto grado de la rodilla en el que empleamos un colgajo libre plantar fileteado para preservar la articulación.

  5. Efecto protector de la melatonina y del tratamiento tópico con la mezcla eutéctica de lidocaína y prilocaína en un modelo de isquemia reperfusión en el colgajo cutáneo microvascularizado en ratas Protective effect of melatonin and the lidocaine and prilocaine eutectic mixture in an ischemia reperfusion injury model in the microvascular cutaneous flap in rats

    Directory of Open Access Journals (Sweden)

    C. Casado Sánchez

    2012-09-01

    Full Text Available El síndrome de isquemia reperfusión es el conjunto de sucesos desarrollados desde la instauración de la isquemia en un tejido hasta su posterior reperfusión. Se trata de una condición limitante y, hasta la fecha, inevitable, en toda cirugía que implique una revascularización tisular. En un intento por buscar medidas terapéuticas frente al estrés oxidativo desarrollado durante este síndrome en los colgajos microvascularizados, se valoró la acción del antioxidante melatonina y de los anestésicos locales lidocaína y prilocaína en un modelo de isquemia reperfusión en el colgajo epigástrico microvascularizado en ratas. Tanto el indol como los fármacos vasoactivos poseen un efecto protector en el tratamiento del síndrome de isquemia reperfusión, desde un punto de vista bioquímico e histológico, destacando su acción sinérgica manifestada principalmente como un incremento en la neovascularización tisular.Ischemia-reperfusion injury is a set of events developed since the introduction of ischemia in a tissue to subsequent reperfusion. It is a limiting condition and, to date, inevitable in any surgery involving tissue revascularization. In an attempt to find therapeutic measures against oxidative stress developed during this syndrome in microvascular flaps, we evaluated the antioxidant action of melatonin and local anesthetics lidocaine and prilocaine in a model of ischemia reperfusion in the microvascularized epigastric flap in rats. The indole and vasoactive drugs have a protective effect in the treatment of ischemia reperfusion injury, from both a biochemical and histological view, emphasizing their synergistic action mainly manifested as an increase in tissue neovascularization.

  6. Liposucción en Cirugía Reparadora (desengrasamiento de colgajos cutáneos y miocutáneos, exéresis de acúmulos grasos y autotransplante de grasa

    Directory of Open Access Journals (Sweden)

    J.Mª Serra Renom

    2013-12-01

    Full Text Available La liposucción es una técnica quirúrgica de gran utilidad para la remodelación de acúmulos grasos y para el desgrasamiento de los colgajos cutáneos, miocutáneos o musculares. Para el desgrasamiento de los colgajos la realizamos después del año de efectuado el colgajo. También la empleamos en acúmulos grasos, en la reconstrucción mamaria postmastectomía, y acúmulos grasos periféricos en la reducción mamaria. Igualmente en el tratamiento de cicatrices deprimidas con prominencia de tejidos vecinos. En zonas deprimidas la realización del autotransplante de grasa nos ha dado buenos resultados.

  7. Cinco pacientes, once colgajos libres: resultados a largo plazo Five patients, eleven free flaps: long-term results

    Directory of Open Access Journals (Sweden)

    C. Olvera Caballero

    2006-09-01

    Full Text Available Los colgajos libres resuelven problemas complejos. En situaciones en donde existe gran pérdida de tejidos u otros métodos reconstructivos han fracasado se puede lograr restablecer la forma y la función utilizándolos. En este trabajo se presentan cinco pacientes en los que se usaron once colgajos libres (2 por paciente en cuatro casos, tres en otro y sus resultados a largo plazo con un mínimo de seguimiento de 7 años y un máximo de 17 años. Las indicaciones para utilizar más de un colgajo libre en un paciente son: reponer un primer colgajo perdido, por complejidad del problema, por experiencia del cirujano o por deseo expreso del paciente para una reconstrucción similar. En nuestra serie, la complejidad del problema fue la principal indicación de usar este método doble y triple. Cuatro pacientes recibieron los colgajos en los miembros inferiores y uno en la cara. Las etiologías encontradas fueron: secuelas de quemaduras en dos casos, secuelas posttraumáticas en otros dos y secuelas postquirúrgicas y de mielomeningocele en uno. Se utilizaron cuatro colgajos de dorsal ancho, cinco escapulares, uno de peroné y uno de gracilis. El seguimiento a largo plazo nos permite mostrar la gran adaptabilidad de los colgajos libres, su resistencia y su valor como procedimiento reconstructivo de primera opciónFree flaps are useful to solve complex problems. Whenever there is an extensive loss of tissues or when other reconstructive methods have failed, they may provide the means to restore shape and function. This paper deals with five patients in whom eleven free flaps were used (two in four patients and three in one more case to solve complex problems. Furthermore, long-term results are reported, with follow-up ranging from 7 to 17 years Indications to use more than one free flap in a patient are: replacing a first flap that was lost, a highly complex problem, the surgeon’s expertise, or when the patient wish for a similar reconstruction. In

  8. Combinación de colgajos locales y libre microvascularizado para reconstrucción del tercio facial inferior tras traumatismo por arma de fuego Combination of local and free microvascularized flaps for reconstruction of the lower third of the face after gunshot injury

    Directory of Open Access Journals (Sweden)

    Laura Villanueva-Alcojol

    2011-12-01

    Full Text Available El traumatismo por arma de fuego en el territorio maxilofacial constituye uno de los mayores retos a los que se enfrenta el cirujano a la hora de la reconstrucción. La diferencia esencial con otro tipo de traumatismos es la severidad de la lesión y la pérdida de tejidos óseos y blandos. Podemos encontrar en la literatura numerosos artículos sobre reconstrucción facial tras extirpación oncológica; sin embargo, hay pocos documentos que discutan la utilización de colgajos locales y libres microvascularizados para reconstrucción de defectos tras traumatismos de alta energía, y los algoritmos terapéuticos para reconstrucción postraumática. En este trabajo se presenta un caso de reconstrucción del tercio inferior facial tras intento de autolisis y se hace una revisión de los principios de tratamiento de este tipo de pacientes.Gunshot wounds to the maxillofacial region are a challenging problem for the surgeon responsible for reconstruction. The essential difference with respect to other injuries is the severity of the lesion and soft and hard tissue loss. Extensive literature exists on facial reconstruction following tumor extirpation, but there are few reports on the use of local flaps and free tissue transfer for the post-traumatic reconstruction of high-energy defects and therapeutic algorithms for post-traumatic reconstruction. The authors report the case of a patient with reconstruction of the lower third of the face after a suicide attempt and review the principles of treatment of these patients.

  9. Inguinal herniorrhaphy in women

    DEFF Research Database (Denmark)

    Bay-Nielsen, Morten; Kehlet, Henrik

    2006-01-01

    Inguinal hernias in women are relatively rare, and an outcome in this specific subgroup of hernias has not been documented in the literature. An analysis was performed using data from the prospective recording of 3,696 female inguinal hernia repairs in the national Danish hernia database, in the 5...

  10. Reconstrucción de pierna con colgajo venofasciocutáneo de safena menor: Hospital San Juan de Dios de Costa Rica, 2004-2009 Lesser saphenous venofasciocutaneous flap for leg reconstruction: San Juan de Dios Hospital in Costa Rica, 2004-2009

    OpenAIRE

    G. Fonseca Portilla; S. Vargas Naranjo

    2012-01-01

    El colgajo venofascicutáneo de safena se emplea con éxito para la reconstrucción de la pierna en diferentes latitudes con diferentes resultados. El objetivo del presente trabajo es describir la población de pacientes en los que se llevó a cabo cirugía reconstructiva en pierna con este tipo de colgajo, así como la aparición de algunos efectos adversos propios de su utilización (necrosis e infección intrahospitalaria), en el periodo de estudio comprendido entre marzo del 2004 y marzo del 2009 e...

  11. Experiencia en reconstrucción de tercio distal de pierna con colgajo libre de músculo gracilis

    OpenAIRE

    A. Conejero; B. Dagnino; Pereira, N.

    2013-01-01

    En los defectos de cobertura distales de la pierna con exposición ósea o articular, la transferencia de tejidos libres es frecuentemente la única opción viable. Se utilizan en el rescate de extremidades inferiores en riesgo por trauma, infección, ulceración, quemaduras y tumores. El colgajo libre de músculo gracilis está descrito en la literatura como una excelente alternativa. El objetivo de este estudio es describir las características de los pacientes y resultados de la utilización del col...

  12. Colgajo de So en reconstrucción de miembro inferior So muscle flap in lower limb reconstruction

    Directory of Open Access Journals (Sweden)

    Márquez Zevallos

    2008-12-01

    Full Text Available El tratamiento de la extremidad inferior siempre ha sido una dura prueba para el cirujano plástico. La situación anatómica de la tibia, desprovista de protección muscular en su aspecto anterior, la hace altamente vulnerable ante cualquier traumatismo de la extremidad. Toda lesión a este nivel exige un tratamiento óseo y cutáneo adecuados, que deben realizarse primariamente y en forma conjunta. En el presente trabajo describimos 3 casos de pacientes con traumatismos de extremidad inferior, fracturas acompañadas de pérdida de sustancia, en los cuales se practicaron colgajos musculares para reconstruir las partes afectadas. Estos colgajos, en primera instancia se tomaron del músculo sóleo, pero encontramos el inconveniente del grosor exagerado que presentaba la cobertura a pesar de su atrofia posterior y del defecto estético desagradable que quedaba en la zona donante. Por todo ello realizamos una variante: en lugar de tomar la mitad del músculo como indica la técnica convencional, tomamos solo un cuadrante que sobrevivió a expensas de un solo pedículo vascular dominante. El cuadrante restante sirvió para hacer menos notorio el defecto de la zona donante. Los 3 casos tuvieron éxito y los pacientes están muy satisfechos con los resultados estéticos. Presentamos una alternativa quirúrgica innovadora de Colgajo de Sóleo que se puede aplicar satisfactoriamente para la cobertura de defectos de miembro inferior, al cual hemos llamado colgajo de So.Lower limb treatment has always been a headache to the plastic surgeon. Tibial anatomy, doesn´t has frontal muscle protection and it´s vulnerable in any trauma. Every lesion in the lower limb must be treated by traumatologyst and plastic surgeon. In this study we present 3 patients with lower limb trauma, fractures and soft tissue lost, treated with muscle flap to cover affected parts. First, we took the flaps from soleous muscle, but we had problems with flap thickness and with the

  13. Reconstrucción de cuero cabelludo mediante colgajo de galea frontal: a propósito de un caso Scalp reconstruction with galeal frontalis flap: case report

    Directory of Open Access Journals (Sweden)

    J. Balaguer-Cambra

    2006-03-01

    Full Text Available Las grandes pérdidas de sustancia a nivel de cuero cabelludo a menudo presentan dificultad de cobertura debido a la rigidez de los tejidos locales a movilizar, debiendose recurrir a reconstrucción con colgajos locales y expansión tisular, o bien a la transferencia microvascular de tejido libre. El presente trabajo tiene por objeto presentar el tratamiento para la resolución de una pérdida de sustancia de 6 meses de evolución a nivel temporal izquierdo, de 10 x 12 cm. con exposición de hueso temporal, junto con la restitución de la línea de implantación del pelo mediante utilización de colgajo de galea frontal y expansión tisular posterior. El colgajo de galea frontal tiene una vascularización rica y constante procedente del eje supratroclear, y su anatomía y disección ha sido estudiada y ampliamente descrita. En nuestro caso el colgajo de galea frontal ha resultado de utilidad en la reconstrucción de la zona temporal, permitiendo la cobertura de la bóveda craneal y la reconstrucción del cuero cabelludo mediante expansión tisular.Large defects of scalp are difficult for reconstruction because of lacking of local tissues. Most of the times, local flaps, tissue expansion and even free microvascular tissue transfer are indicated. This paper aims the treatment of a 6 months 10x12cm left temporal bone exposure, which was solved with a galea frontalis flap followed by scalp expansion for hair line restitution. The galea frontalis flap has a rich constant vascularization, and it´s anatomy and surgical dissection has been described elsewhere. This flap has been useful in our case for temporal area reconstruction, allowing bone coverage and hairline reconstruction with expansion tissue technique.

  14. Inguinal hernia repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100027.htm Inguinal hernia repair - series—Normal anatomy To use the sharing ... to slide 4 out of 4 Overview A hernia occurs when part of an organ protrudes through ...

  15. Reconstrucción cervical tras resección de neurofibroma solitario gigante con colgajo anterolateral de muslo

    Directory of Open Access Journals (Sweden)

    Mauricio Mendieta-Espinosa

    Full Text Available Los tumores de cabeza y cuello son un grupo heterogéneo; los neurofibromas pueden originarse de cualquier nervio independientemente de su localización, incluyendo nervios periféricos o intracraneales y se dividen en 4 tipos. Los solitarios son tumores confinados, espontáneos y prácticamente sin ninguna manifestación. Anatómicamente, los neurofibromas del cuello son relativamente raros, con un crecimiento lento e indoloro. Presentamos el caso de un paciente varón de 41 años de edad, remitido a nuestra consulta por presentar neurofibroma solitario gigante en la base del lado izquierdo del cuello, de 10 cm de diámetro, con zona central ulcerada y sangrados intermitentes, adherido a planos profundos, de 30 años de evolución y que había sido tratado en 3 ocasiones con resecciones parciales y cubertura con colgajo acromial. Practicamos resección completa de la tumoración y reconstrucción inmediata con colgajo anterolateral de muslo, logrando la mejoría estético-funcional de la zona cervical y sin complicaciones.

  16. Colgajo FAMM para reconstrucción de fístulas de paladar en pacientes con fisura palatina congénita: experiencia y resultados

    Directory of Open Access Journals (Sweden)

    R. López-Sánchez

    2014-09-01

    Full Text Available Las fístulas de paladar suponen una complicación frecuente en la cirugía de los pacientes fisurados. Las opciones de reconstrucción secundaria en fístulas de tamaño moderado-grande son limitadas por la escasez de tejido donante local y las cicatrices de la palatoplastia. Presentamos nuestra experiencia en el tratamiento de fístulas palatinas moderadas-grandes con colgajo músculomucoso basado en la arteria facial (colgajo FAMM: facial artery musculo-mucosal flap y describimos algunos detalles técnicos que hemos incorporado para mejorar su seguridad. Revisamos 8 pacientes, 5 mujeres y 3 varones, con edades comprendidas entre los 5 y los 18 años, nacidos con fisura palatina que desarrollaron fístulas palatinas tras la palatoplastia primaria y que tras evaluación multidisciplinaria fueron sometidos a reconstrucción con colgajo FAMM. Los tamaños de las fístulas oscilaron entre los 0,5 y los 2,3 cm. de diámetro mayor. El seguimiento postoperatorio de los pacientes fue de 1 a 6 años. Obtuvimos cierre completo de las fístulas de paladar en el primer tiempo quirúrgico y sin complicaciones en 5 casos. Los 2 primeros sufrieron necrosis de los bordes distales del colgajo y precisaron revisión quirúrgica y una paciente sufrió necrosis total que requirió una nueva reconstrucción con colgajo FAMM contralateral. No hemos registrado complicaciones de la zona donante en ninguno de los casos. Consideramos que el colgajo FAMM es una excelente opción para la reparación de fístulas palatinas de tamaño moderadogrande secundarias a fisura palatina congénita, ya que permite aportar una gran cantidad de tejido vascularizado con un arco de rotación amplio, lo que posibilita obtener resultados de obturación satisfactorios. La tasa de complicaciones, tras una curva de aprendizaje relativamente breve, es baja.

  17. El reto de las transferencias de colgajos libres en pacientes quemados: ¿cuál es el momento para la cirugía?

    Directory of Open Access Journals (Sweden)

    M.E. Villaverde-Doménech

    Full Text Available La transferencia de colgajos libres es una herramienta fundamental dentro del arsenal reconstructivo para el tratamiento quirúrgico del gran quemado. Durante años ha existido controversia sobre la influencia del momento de la cirugía sobre la tasa de complicaciones, así como el alto riesgo de complicaciones al realizar reconstrucciones con colgajos libres en pacientes quemados. Diseñamos un estudio retrospectivo de las reconstrucciones quirúrgicas mediante colgajos libres realizadas en nuestra Unidad de Quemados del Hospital Universitari y Politecnic La Fe, de Valencia (España en el periodo comprendido entre 2001 y 2013, recogiendo todos los datos relativos al paciente, a la lesión, al procedimiento reconstructivo, a los resultados y relacionando todo ello con el momento en el cual se realizó la cirugía. Para el análisis de los datos y asociaciones entre distintas variables usamos tablas de contingencia y aplicamos el test de independencia de Chi-cuadrado. Exponemos además 2 casos clínicos representativos de la cirugía reconstructiva practicada en pacientes quemados. Recogimos en total datos de 21 procedimientos de reconstrucción mediante colgajo libre en pacientes quemados. En ninguno se realizó reconstrucción primaria inmediata (en los primeros 5 días, mientras que la reconstrucción primaria temprana (entre el día 5 y el 21 se realizó en el 28,57 % de los casos, la primaria intermedia (entre el día 21 y las 6 semanas en el 28,57 %, la secundaria (más de 6 semanas en el 9,5 %, y la cirugía de secuelas en el 33,33 % de los casos. Las tasas de complicaciones mayores y menores fueron respectivamente 19,05 % y 9,5 % . El 50 % de complicaciones mayores ocurrieron en el periodo de reconstrucción primaria temprana, mientras que no registramos ninguna en el periodo primario intermedio. El resto de complicaciones se repartió a partes iguales entre el periodo secundario y la cirugía de secuelas (ambas con el 25 %. No

  18. Inguinal metastases from testicular cancer

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Karas, Vladimir; Sommer, Peter

    2006-01-01

    To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease.......To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease....

  19. Inguinal metastases from testicular cancer

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Karas, Vladimir; Sommer, Peter

    2006-01-01

    To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease.......To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease....

  20. Colgajo de omento para tratamiento de dehiscencia de herida esternal Omental flap for management of sternal wound dehiscence

    Directory of Open Access Journals (Sweden)

    A. Pérez García

    2013-03-01

    Full Text Available La mediastinitis es una de las complicaciones más graves de la cirugía cardíaca. Aparece en el 0,5-5 % de las esternotomías y esta incidencia es mucho mayor en pacientes diabéticos, obesos, inmunodeprimidos, con enfermedad pulmonar obstructiva crónica (EPOC, etc. Presentamos el caso de una paciente diabética, obesa mórbida, que sufre mediastinitis tras doble by-pass coronario. Para la cobertura del defecto se empleó un colgajo de epiplon tunelizado transdiafragmático. El colgajo omental permite cubrir grandes defectos además de que posee capacidad antimicrobiana y favorece la revascularización tisular. Las características de este colgajo hacen que actualmente deba considerarse como primera elección en pacientes con grandes defectos esternales y trastornos de la inmunidad y la cicatrización.Mediastinitis is one of the most serious complications from cardiac surgery. It is reported to occur in 0'5-5 % of sternotomy incisions, and this incidence is much higher in diabetic patients, obese, immunocompromised, COPD, etc. We report a case of a diabetic and morbid obese woman suffering mediastinitis after double coronary bypass surgery. For the reconstruction a transdiaphragmatic tunnelled omental flap was used. The omentum is useful to cover large defects. It has antiinfective properties and promotes revascularization of neighbouring tissues. Omental flap can be a highly effective treatment for patients with large sternal wounds and immune disorders and wound healing disorders.

  1. Estudio de perforantes del tronco tibio-peroneo con aplicaciones quiméricas

    OpenAIRE

    Izquierdo Santiago, Verónica

    2016-01-01

    INTRODUCCIÓN La reconstrucción del miembro inferior ha evolucionado mucho en las últimas décadas. Con la llegada de la microcirugía se han descrito multitud de colgajos de perforante que diversifican las opciones quirúrgicas. Concretamente en el miembro inferior, la utilización de colgajos tipo propeller ha supuesto una disminución de la morbilidad y mejora del resultado estético y funcional. Éste tipo de colgajos permite la movilización de tejidos fasciocutáneos basándonos en su irrigación e...

  2. Direct diverticular inguinal hernia

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kullenberg, K.

    Nineteen patients with direct diverticular inguinal hernia (DDIH) were examined with herniography and surgically explored. A lump medially in the groin and pain were the prominent clinical manifestations in 18 patients. Physical examination indicated the presence of a DDIH in 6 patients. In 16 patients herniography revealed hernial sacs protruding from the supravesical fossa in 5 and from the medial inguinal fossa in 11. At operation a circumscribed defect was found in the transverse fascia laterally and cranially to the pubic tubercle in all patients. In 16 patients peritoneal hernial sacs were demonstrated at surgery while in 3 only lipomas (fatty hernia) were contained within the defect. In our opinion DDIH is a specific variety of inguinal hernia with a fairly typical clinical presentation and radiographic appearance but probably often overlooked at surgery.

  3. Colgajo prefabricado occipital para cobertura de exposición ósea craneal Prefabricated occipital flap to cover craneal bone exposition

    Directory of Open Access Journals (Sweden)

    B. Rivas León

    2010-03-01

    Full Text Available La exposición del cráneo tras un tratamiento quirúrgico oncológico agresivo es un desafió reconstructivo para el cirujano plástico; los defectos pueden variar en dimensiones y complejidad, desde pequeños defectos, que pueden ser cubiertos con injertos dérmicos o colgajos locales, a defectos más extensos que requerirán de un colgajo libre para su cobertura. Presentamos el caso de un varón de 39 años de edad que presentó un defecto biparietal posterior a radioterapia y resección por carcinoma. El defecto fue cubierto con un colgajo prefabricado axial, tomado del área antebraquial e implantado bajo la piel cabelluda occipital, para posteriormente ser llevado al sitio del defecto. El colgajo axial occipital evolucionó satisfactoriamente y logramos cubrir el defecto en su totalidad, sin complicaciones. En conclusión, el colgajo prefabricado occipital aporta suficiente piel cabelluda con patrón vascular axial para cubrir hueso craneal expuesto, cuando no hay una mejor opción cosmética.Cranial bone exposition after an aggressive oncological treatment is a challenge for plastic surgeon; defects can range in size and complexity, from small defects which can be covered only with skin graft or local flaps, to extensive defects that will require a free flap cover. We report a case of a 39 years-old man, who presented soft tissue defect of biparietal area following to radiotherapy and carcinoma resection. This defect was covered by prefabricated axial flap, which was harvest of forearm area and implanted under occipital hair skin and subsequently transported to the defect. The axial occipital flap healed uneventfully with a good outcome; we managed to cover the scalp defect completely without complications. As a conclusion, prefabricated occipital flap provides enough hair skin, with axial vascularity pattern to cover cranial bone exposed, when there is not a better cosmetical option.

  4. Colgajos de pectoral mayor y oblicuo externo para cobertura de expansores y/o prótesis en reconstrucción postmastectomía

    Directory of Open Access Journals (Sweden)

    P. Dávalos-Dávalos

    2015-03-01

    Full Text Available La reconstrucción mamaria inmediata postmastectomía radical modificada o subcutánea devuelve la feminidad a las pacientes al crear una neomama con volumen adecuado, simetría, visión tridimensional, forma anatómica y sensibilidad táctil en el área reconstruida. Para este fin se han descrito múltiples técnicas quirúrgicas, entre las cuales nosotros hemos utilizado los expansores cutáneos y prótesis mamarias texturizadas de forma anatómica, de perfil alto y altura moderada. Describimos nuestra técnica quirúrgica mediante la cual, al realizar la mastectomía, creamos un bolsillo retromuscular amplio, sin tensión, conformado por el músculo pectoral mayor que es desinsertado en su base inferior, y un colgajo con pedículo lateral interno del músculo oblicuo externo, los cuales al suturarse entre sí, cubren, protegen y crean un amplio bolsillo para el expansor o prótesis mamaria. Estos colgajos se cubren a su vez por un colgajo cutáneo-adiposo.

  5. Reconstrucción de cuero cabelludo con colgajo libre de omentum Reconstruction of the scalp with a free flap of omentum

    Directory of Open Access Journals (Sweden)

    C. Navarro Cuellar

    2004-08-01

    Full Text Available Los defectos de cuero cabelludo pueden tener una etiología diversa. Resecciones oncológicas, lesiones postraumáticas e infecciosas pueden dar lugar a diferentes defectos en cuanto a tamaño y extensión. Para su reconstrucción disponemos de múltiples técnicas quirúrgicas como colgajos locales, regionales y expansores titulares. No obstante, para defectos extensos los colgajos libres son la única posibilidad reconstructiva. Presentamos el caso de un paciente con carcinomas epidermoides multicéntricos en cuero cabelludo tratado previamente con radioterapia en el que se realizó una resección amplia del cuero cabelludo y fue reconstruído con un colgajo libre de omentum.Scalp defects may have different etiologies. Oncologic resections, postraumatic lesions and infectious wounds may lead to a great variety of defects in size and extension. In order to accomplish the reconstruction we have different surgical techniques such as local and regional flaps and tissue expanders. Nevertheless, for more extensive defects free flaps are the only reconstructive possibility. We present the case of a patient with multicentric squamous cell carcinomas previously with radiotherapy. He underwent wide resection and was reconstructed with an omentum free flap.

  6. Experiencia en reconstrucción auricular en cáncer de piel con colgajo en "quesadilla" Experience in auricle reconstruction after skin carcinoma with "quesadilla" flap

    OpenAIRE

    C. Gutiérrez Gómez; A. Avila Romay; C. Zepeda Alcántara; A. Cárdenas Mejía

    2008-01-01

    La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y...

  7. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery

  8. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery on

  9. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery on

  10. Colgajo sural reverso en pacientes pediátricos: experiencia de 6 años Reverse sural flap in pediatric patients: 6 years experience

    Directory of Open Access Journals (Sweden)

    S. De la Cruz Reyes

    2012-12-01

    Full Text Available Entre las técnicas reconstructivas de miembros inferiores se encuentra el colgajo neurocutáneo de flujo reverso utilizando el paquete neurovascular sural, técnica conocida pero con escasa experiencia publicada en infantes. El objetivo de este trabajo es presentar y analizar 10 casos clínicos en los que se utilizó el colgajo sural reverso en pacientes de edad pediátrica. Realizamos un estudio retrospectivo, descriptivo y observacional, que incluye a todos los pacientes menores de 16 años a los que se les realizó una reconstrucción con colgajo sural reverso durante el período comprendido entre marzo del 2004 y abril del 2010 en el Centenario Hospital Miguel Hidalgo de Aguascalientes, México. Se incluyeron 10 casos con una mediana de edad de 10 años (rango de 3 a 15 años, 6 masculinos y 4 femeninos. El mecanismo del trauma en 6 de los casos fue por lesión en motocicleta, en 2 paientes atropello por automóvil, 1 caso por lesión en bicicleta y 1 caso con lesión por proyectil de arma de fuego. Las áreas afectadas fueron región dorsal del pie en 5 casos, región calcánea en 4 casos, y una lesión maleolar externa. La mediana del diámetro de las superficies afectadas fue de de 8.8 cm. Tres pacientes presentaron complicaciones postoperatorias menores, 2 epidermólisis distales y 1 dehiscencia parcial del colgajo. No se presentó ninguna complicación grave ni hubo perdidas de colgajos. Los resultados fueron considerados como favorables en el 100 % de los pacientes al término del seguimiento. La técnica de reconstrucción del miembro inferior, específicamente en el caso de lesiones en pie, con colgajo neurocutáneo sural en isla de flujo reverso es, a nuestro juicio, una opción eficaz de tratamiento también para pacientes pediátricos.Among the lower leg reconstructive techniques, the reverse sural neurocutaneous flap is a well known technical option, with little experience reported in infants. Our aim is the pesentation and

  11. Colgajo libre osteocutáneo escapular en el tratamiento diferido de herida por arma de fuego Scapular osteocutaneous free flap in the deferred treatment of firearm wounds

    Directory of Open Access Journals (Sweden)

    D. Durán Moreno

    2008-12-01

    Full Text Available Las heridas por arma de fuego de velocidad alta o intermedia, provocan importantes pérdidas de tejido óseo y blando. El tratamiento diferido de estos casos (tratamiento reconstructivo requiere el aporte de tejido sano de regiones distantes mediante técnicas microquirúrgicas en la mayoría de las ocasiones. Exponemos la utilidad del colgajo osteocutáneo escapular (COE para la reconstrucción de defectos óseos mandibulares laterales con amplio defecto cutáneomucoso. Citamos detalles técnicos de la realización del colgajo ilustrados con la presentación de un caso clínico de un varón de 19 años con herida por arma de fuego en tercio inferior de la región lateral izquierda. Pérdida ósea del cuerpo mandibular y cutánea de la mejilla y región yugal ipsilateral. El tratamiento inicial consistió en traqueotomía, desbridamiento de tejidos desvitalizados, ferulización dentaria, bloqueo intermaxilar, colocación de placa de reconstrucción mandibular y colgajo de avance cervico-facial para cierre del defecto cutáneo. La necrosis del colgajo de avance cervicofacial produjo comunicación orofacial. La retracción cicatricial limitó la apertura oral a 0,8 cm. De forma diferida se procedió a colgajo osteomiocutáneo escapular-paraescapular del brazo izquierdo para reconstrución mandibular y de partes blandas intra y extraorales. Resultados satisfactorios estética y funcionalmente. Complicaciones producidas: fístula salival, desinserción del brazo largo del tríceps, y dehiscencia de herida de zona donante escapular que necesitó intervención para cierre mediante colgajo local.Firearm wounds caused by high-velocity projectiles cause enormous losses of bone and soft tissue. The deferred treatment of these cases (delayed reconstruction in most cases requires the transfer of free tissue from other areas of the body. The use of scapular and parascapular free flaps with scapular bone for the reconstruction of large lateral mandibular

  12. Colgajos de perforantes de las arterias epigástricas inferiores profunda y superficial Deep and superficial inferior epigastric artery perforator flaps

    Directory of Open Access Journals (Sweden)

    A. R. Gagnon

    2006-12-01

    Full Text Available Con el desarrollo de los colgajos miocutáneos de recto abdominal (TRAM, el abdomen inferior ha sido reconocido como la principal área dadora de tejidos autólogos de alta calidad, especialmente útiles en reconstrucción mamaria. Más recientemente la habilidad para obtener componentes adiposocutáneos similares sin sacrificar el músculo recto ha revolucionado el campo de la Cirugía Reconstructiva. El advenimiento de los colgajos de perforantes ha permitido a los cirujanos plásticos lograr los mismos buenos resultados estéticos que con los colgajos miocutáneos tradicionales, pero con un considerable descenso en la morbilidad del área donante. Con los colgajos de perforantes de la arteria epigástrica inferior profunda (DIEP y de la arteria epigástrica inferior superficial (SIEA, los pacientes han incrementado sus opciones de reconstrucción. Este artículo revisa la anatomía quirúrgica de la pared abdominal relativa a los colgajos SIEA y DIEP. Se explican detalladamente los pasos principales para la preparación preoperatoria, la técnica quirúrgica y los cuidados postoperatorios. Se discuten las ventajas y desventajas y se presen- tan los trucos técnicos que pueden ayudar a mejorar el resultado final. Además se ilustran con ayuda de casos clínicos las indicaciones típicas y atípicas.Following the development of the transverse rectus abdominis myocutaneous (TRAM flap, the lower abdomen has been recognized as a prime source of high quality autogenous tissue, especially useful in breast reconstruction. More recently, the ability to harvest a similar adipocutaneous component without sacrifice of the rectus muscle has revolutionized the field of reconstructive surgery. The advent of perforator flaps has allowed plastic surgeons to achieve the same highly esthetic results as with the former myocutaneous flaps while significantly decreasing the donor site morbidity. With the deep inferior epigastric artery perforator (DIEP flap and

  13. Remodelación de los colgajos TRAM libres y DIEP Reshaping in free TRAM and DIEP flaps

    Directory of Open Access Journals (Sweden)

    F. Fidalgo Rodríguez

    2007-03-01

    Full Text Available La reconstrucción mamaria mediante autotrasplante microquirúrgico es la técnica de elección en la mayoría de las pacientes mastectomizadas. Los avances técnicos han permitido el desarrollo del colgajo TRAM libre y posteriormente del Colgajo DIEP como exponentes más representativos del arsenal terapéutico en este campo. Para los cirujanos reconstructores la práctica de estas intervenciones supone un auténtico reto; un reto que ha de convertirse en el quehacer diario de los Servicios de Cirugía Plástica y Reconstructiva, si quieren adaptarse a los tiempos modernos. En nuestro Servicio estas técnicas comienzan a aplicarse en 1999 y desde entonces se han llevado a cabo en 42 casos. Al principio se prestaba mayor atención al desarrollo del proceso microquirúrgico y el cirujano centraba su esfuerzo en la consecución de una sutura óptima que asegurara la supervivencia del colgajo. Una vez conseguido esto, lo demás se consideraba secundario. No obstante nuestra concepción ha cambiado y actualmente centramos el proceso no sólo en lo anterior, sino en la remodelación adecuada del colgajo para dotar a la mama de un aspecto verdaderamente auténtico. En el presente trabajo se exponen una serie de consejos que pueden ser útiles a la hora de concluir la reconstrucción mamaria mediante TRAM libre o DIEP confeccionando una mama de contorno natural, lo más parecida posible a la mama contralateral. Concluimos que en este matiz se encuentra el verdadero éxito de la reconstrucción mamaria.Breast reconstruction through microsurgical autotrasplant is the most common procedure in breast cancer patients. The technical advances have allowed the development of the free TRAM flap (later the DIEP flap, which are the prime examples of the therapeutic material in this field. The implementation of microsurgical techniques has improved the results in breast reconstruction by increasing the survival rate and decreasing the complications. For plastic

  14. Inguinal hernia repair

    OpenAIRE

    1998-01-01

    A hernia usually presents as a painful lump in the groin, often associated with a large strain but it may also be asymptomatic and coincidentally discovered on routine examination. The incidence of hernia increases with age but a large number affected are working men and they can be severely disabled by the condition. Inguinal hernia is a common condition and 763 hernia operations were carried out in Government hospitals in Malta and Gozo during 1997.

  15. Endoscopic inguinal hernia repair

    OpenAIRE

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery only for pain. The operation was performed via a scrotal incision and the wound was left open for secondary healing to increase scarring. Scar tissue was considered optimal reinforcement of the weak ...

  16. Convalescence after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Bay-Nielsen, M; Thomsen, H; Andersen, F Heidemann;

    2004-01-01

    BACKGROUND: Convalescence after inguinal herniorrhaphy is usually 3-4 weeks and is an important outcome parameter of hernia surgery. The aim of this study was to describe in detail the consequences of recommending a short convalescence, including the risk of recurrence. METHODS: This was a multic......BACKGROUND: Convalescence after inguinal herniorrhaphy is usually 3-4 weeks and is an important outcome parameter of hernia surgery. The aim of this study was to describe in detail the consequences of recommending a short convalescence, including the risk of recurrence. METHODS......) was compared with that for comparable patients treated in participating departments but not part of the study group (group 2, n = 1306) and patients in the Danish Hernia Database (group 3, n = 8297). RESULTS: The median time off work was 7 days and the time interval before carrying out the most strenuous...... (approximately 20 per cent). The reoperation rate in group 1 at the median observation time was 0.7 per cent, which was no different to that in group 2 (1.6 per cent) (P = 0.186) or group 3 (1.4 per cent) (P = 0.092). CONCLUSION: Reduced convalescence after inguinal herniorrhaphy may be recommended without...

  17. Colgajo de pectoral mayor basado en perforantes internas inferiores: Doble plano invertido Pectoral muscle flap based on inferior-internal perforators: Inverted dual plane

    OpenAIRE

    V. O. Vassaro; A. H. Ali; D. M. Capponi

    2010-01-01

    El polo inferior de la mama en ocasiones puede estar afectado en su espesor por diferentes causas, como el simple paso del tiempo, resecciones oncológicas, extrusiones protésicas por infección, seromas, fístulas, etc. Describimos en este trabajo una alternativa quirúrgica para brindar una mayor cobertura al cuadrante ínferointerno de la glándula mamaria, utilizando un colgajo de músculo pectoral en su porción distal, basado en la irrigación de sus perforantes internas.Some times, the mammary ...

  18. Colgajo libre córtico-perióstico de la arteria genicular descendente en el tratamiento de la seudoartritis distal de tibia

    OpenAIRE

    2010-01-01

    Presentamos un caso de un varón de 35 años con pseudoartrosis aséptica de tibia distal con escaso defecto óseo, intervenido previamente mediante recambio del material de osteosíntesis e injerto de cresta iliaca, que fracasó. Tras estudio de las diferentes opciones de tratamiento, se le propuso estabilizar el foco mediante enclavado endomedular y aumentar la capacidad osteogénica con un colgajo córtico-perióstico de la arteria genicular descendente, según la técnica de Sakai. Discusión: El man...

  19. Colgajo libre osteocutáneo escapular en el tratamiento diferido de herida por arma de fuego Scapular osteocutaneous free flap in the deferred treatment of firearm wounds

    OpenAIRE

    D. Durán Moreno; A. Cabello Serrano; Marín Fernández, A.B.; C. Bailon Berrio; J.A. Rodríguez Ruiz

    2008-01-01

    Las heridas por arma de fuego de velocidad alta o intermedia, provocan importantes pérdidas de tejido óseo y blando. El tratamiento diferido de estos casos (tratamiento reconstructivo) requiere el aporte de tejido sano de regiones distantes mediante técnicas microquirúrgicas en la mayoría de las ocasiones. Exponemos la utilidad del colgajo osteocutáneo escapular (COE) para la reconstrucción de defectos óseos mandibulares laterales con amplio defecto cutáneomucoso. Citamos detalles técnicos de...

  20. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

    OpenAIRE

    2015-01-01

    Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia. The advantages of day case surgery include greater patient satisfaction and reduced financial costs to the health service. Inguinal nerve b locks may be particularly helpful for patients with cardiovascular or respiratory dis...

  1. Angiotomografía computerizada, colgajos de perforante, cirujano y OsiriX Computed tomography angiography, perforator flaps, surgeon and OsiriX

    Directory of Open Access Journals (Sweden)

    M. Rodríguez-Vegas

    2013-03-01

    Full Text Available Desde la introducción de la transferencia cutánea basada en perforantes, la angiotomografía computerizada ha emergido como una técnica de gran valor en la planificación preoperatoria de los colgajos de perforante. Sin embargo, parece probable que el aprovechamiento de la técnica sea menor del deseable. Evaluamos, a través de la experiencia en 144 pacientes, la utilidad del visor gratuito de imágenes DICOM OsiriX para Mac en la planificación preoperatoria de los colgajos de perforante con tres objetivos: 1 ampliar los conocimientos actuales relacionados con la aplicación de la angiotomografía computerizada en la planificación preoperatoria de los colgajos de perforante, 2 evaluar la aplicación OsiriX en el post-procesamiento de imágenes en la planificación preoperatoria de colgajos de perforante y 3 evaluar el rendimiento obtenible de la angiotomografía considerando que el postprocesamiento es realizado por un cirujano (no especialista en Radiodiagnóstico. La experiencia permite afirmar que el postprocesamiento de las imágenes DICOM por el cirujano con la aplicación Osirix permite habitualmente evaluar de manera adecuada diversas estructuras y parámetros de gran interés en la cirugía de colgajos de perforante: 1 arteria principal, origen de la perforante, 2 diámetro de arteria y vena/s en el hipotético sitio de anastomosis microquirúrgica, 3 recorrido y patrón de ramificación del pedículo del colgajo, 4 disposición de la perforante en la grasa subcutánea (teórico eje de diseño del colgajo, 5 medición del grosor cutáneo en el punto de perforación de la fascia profunda por la rama perforante (teórico grosor de colgajo, 6 medición de la distancia entre el punto de perforación de la fascia profunda por la rama perforante y el origen de la arteria principal (teórica longitud máxima posible de pedículo y 7 medición del diámetro, en el punto de perforación de la fascia profunda, de la perforante. En

  2. Reconstrucción perineal con colgajo fasciocutáneo de glúteo mayor en V-Y: experiencia de 5 años

    Directory of Open Access Journals (Sweden)

    Alberto Blanco-Álvarez

    2016-03-01

    Full Text Available Antecedentes y Objetivos. La cirugía colorrectal y ginecológica precisa a menudo la resección de grandes áreas de tejido en la región perineal. En ocasiones es posible el cierre directo, pero a veces se necesitan técnicas reconstructivas. Una de las más extendidas para la reconstrucción perineal es la utilización de los colgajos fasciocutáneos en V-Y diseñados en la región anatómica del glúteo mayor. Pacientes y Método. Desde 2005 hasta 2011 hemos llevado a cabo reconstrucción del periné con el colgajo fasciocutáneo de avance en V-Y del glúteo mayor basado en sus perforantes en 7 pacientes. El tamaño de los defectos varió desde 50a 400 cm². Resultados. La estancia hospitalaria media fue de 36.8 días. Cuatro pacientes sufrieron complicaciones en la zona operada (57%: 2 necesitaron una segunda intervención por sufrir dehiscencia; 1 tuvo una infección de la herida quirúrgica, y 1 desarrolló una fístula perianal. El paciente de más edad (80 años falleció por complicaciones cardiovasculares durante el postoperatorio. Conclusiones. El colgajo fasciocutáneo de avance en V-Y basado sobre la región glútea, es una técnica segura, de fácil ejecución y mínima morbilidad, para la reconstrucción de pequeños y grandes defectos de la región perineal. Si bien en pacientes tratados previamente con radioterapia es aconsejable pensar en el uso de colgajos a distancia.

  3. Experiencia clínica con el colgajo músculo-cutáneo vertical de trapecio en reconstrucción de cabeza y cuello

    Directory of Open Access Journals (Sweden)

    S. Gallego-Gónima

    2014-03-01

    Full Text Available Presentamos nuestra experiencia clínica con la utilización del colgajo músculo-cutáneo vertical de trapecio para la reconstrucción de defectos en cabeza y cuello a través de la presentación de 10 pacientes con defectos de cobertura en estas áreas tratados entre junio del 2006 y octubre del 2013. Hacemos énfasis en las técnicas quirúrgicas utilizadas, los resultados obtenidos, las complicaciones y la evolución postoperatoria. El colgajo músculo-cutáneo vertical de trapecio es una opción versátil con características anatómicas confiables y que puede realizarse de forma segura para la reconstrucción de defectos de cobertura complejos de cabeza y cuello como primera elección o como alternativa cuando otros procedimientos han fallado y en pacientes en los cuales no es posible realizar una cirugía mayor.

  4. Análisis de controversias en reconstrucción mamaria con colgajo DIEP Analysis of debated uses in mammary reconstruction with DIEP flap

    Directory of Open Access Journals (Sweden)

    C. Casado Sánchez

    2008-12-01

    Full Text Available La reconstrucción mamaria mediante colgajo DIEP (Deep Inferior Epigastric Perforator se encuentra condicionada en muchas ocasiones por características de la paciente o del tratamiento oncológico recibido, de tal forma que diversos grupos de trabajo contraindican este método en caso de existir alguno de esos factores. Nosotros hemos realizado un estudio de los mismos, analizando su impacto sobre la viabilidad del colgajo y su correlación con las complicaciones postoperatorias, para optimizar así su indicación. Los condicionantes analizados son el tabaco, las intervenciones quirúrgicas previas que afecten en alguna medida la pared abdominal, el sobrepeso u obesidad de la paciente, el volumen de la mama contralateral, el tratamiento radioterápico anterior o posterior a la reconstrucción, y finalmente el gasto sanitario que supone. Estas controversias son a su vez las más discutidas en la literatura al respecto. Se valoran los resultados obtenidos tras 55 reconstrucciones mamarias mediante colgajo DIEP entre enero de 2000 y noviembre de 2005, así como los estudios y publicaciones más recientes existentes sobre esta materia. Hemos encontrado una pobre correlación entre los índices de fracaso del colgajo y las controversias estudiadas, determinando así dos contraindicaciones absolutas para que una paciente pudiese beneficiarse de un colgajo DIEP: abdominoplastia previa y radioterapia adyuvante tras reconstrucción inmediata. Los excelentes resultados que se obtienen globalmente, nos llevan a recomendar este colgajo por encima de otras opciones terapéuticas.The use of DIEP (Deep Inferior Epigastric Perforator flap surgery in breast reconstruction is often conditioned by the patient and the oncologic treatment characteristics to such an extent that several working groups advise against this surgical procedure when any of these factors is present. In the study of this interaction, an analysis of its impact on the flap feasibility and its

  5. Efecto protector de la toxina botulínica en colgajos cutáneos The protective effect of botulinum toxin on skin flaps

    Directory of Open Access Journals (Sweden)

    C.X. Astudillo Carrera

    2011-06-01

    Full Text Available Los colgajos cutáneos de patrón vascular randomizado son de gran utilidad en Cirugía Reconstructiva; un aporte vascular adecuado es el factor más importante para la supervivencia de los mismos. Realizamos un estudio experimental levantando un total de 36 colgajos en el dorso de 9 conejos (4 en cada conejo: a 9 controles, b 9 con aplicación de toxina botulínica tipo A transoperatoria a lo largo del colgajo, c 9 con toxina botulínica tipo A aplicada 7 días antes del procedimiento quirúrgico, y, d 9 con aplicación de toxina botulínica tipo A transoperatoria más epinefrina. El análisis de los colgajos se realizó a través de imágenes digitales que se examinaron con el programa ImageJ. Efectuamos el análisis estadístico con la prueba T de Student. La evaluación final de los colgajos se realizó al séptimo día, tiempo en el cual se obtuvo: a una media de área necrótica en los controles del 72.17 ± 3.9% ; b en los que se aplicó toxina botulínica transoperatoria el porcentaje de aérea necrótica fue del 5.09 ± 1.2% p = 0.032; c en aquellos en los que la toxina botulínica se aplicó 7 días antes del procedimiento se reportó necrosis del 24.97 ± 2.7% p = 0.041 y d en los que se aplicó toxina botulínica transoperatoria más epinefrina el porcentaje de necrosis fue del 23.90 ± 3.9% p = 0.045. Concluimos que la toxina botulínica tipo A actúa como protector contra el proceso de sufrimiento-isquemia de los tejidos, debido a su acción vasodilatadora, recomendando su aplicación al inicio del procedimiento quirúrgico.Random-pattern cutaneous flaps are very useful in Reconstructive Surgery; an adequate vascular contribution is an important factor for the survival of the flaps. We designed an experimental study elevating a total of 36 dorsal flaps, divided in 4 groups: a 9 were controls, to which 0.9% physiological solution was applied, b 9 with a transoperatory application of type A botulinum toxin throughout the length of

  6. INGUINAL HERNIA IN FEMALES

    OpenAIRE

    2001-01-01

    9 patients of inguinal hernia in females were diagnosed in a total of 50 patients who presented with congenital groin problems, 8 of these were managed surgically. There were 6 small children, 1 young girl and 2 elderly ladies. All children were managed by herniotomy and herniorrhaphy was done in women. 2 patients under one year presented with irreducible hernia, one of them on exploration was found to be having sliding hernia with incarcerated ovary and tube as contents while other one had i...

  7. Técnica de collage dentario con colgajo mucoperióstico: reporte de caso

    Directory of Open Access Journals (Sweden)

    A. Echevarría Goche

    2014-12-01

    Full Text Available La fractura dental coronaria es la injuria dental traumática más común de los dientes permanentes. El collage dentario es una alternativa restauradora que consiste en pegar fragmentos dentarios con un procedimiento semejante al que se utiliza para unir pedazos sueltos mediante pegamentos convencionales. El presente artículo describe el caso de un paciente con fracturas coronarias en las piezas 11 y 21 que fueron tratadas mediante un collage dentario. El paciente acudió a la consulta con los fragmentos fracturados procediéndose a realizar el tratamiento de conductos de dichas piezas y colocación de postes de fibras de vidrio. Posteriormente se procedió a la unión de los fragmentos previa realización de un colgajo mucoperióstico debido a la invasión del espacio biológico. A la evaluación clínica inmediata y a los tres años de seguimiento fue aceptable tanto funcional como estética.

  8. Cobertura de tobillo con colgajo de hemisóleo de flujo retrógrado: más allá de su indicación clásica

    Directory of Open Access Journals (Sweden)

    J.R. Manzani-Baldi

    2013-09-01

    Full Text Available Planteamos 5 casos clínicos de fractura expuesta de tobillo con pérdida de cobertura cutánea y una revisión de la vascularización del músculo sóleo. Basándonos en conceptos anatomo-hemodinámicos, realizamos la cobertura de dichos defectos con un colgajo muscular de hemisóleo a pedículo distal y flujo retrógrado. El colgajo se llevó más allá de su indicación clásica a partir de la selección de pacientes según puntuación en base a patología previa y edad. En todos los casos la vitalidad del colgajo fue buena y los resultados anatomo-funcionales obtenidos fueron satisfactorios. La recuperación postoperatoria fue de un promedio de 3 semanas, más rápida que la esperada con otros métodos.

  9. Reconstrucción mamaria con colgajos microquirúrgicos de perforantes Breast reconstruction with microsurgical perforator flaps

    Directory of Open Access Journals (Sweden)

    J. A. Lozano

    2005-01-01

    Full Text Available La reconstrucción mamaria autógena se realiza frecuentemente con tejido abdominal, ya que se obtiene el mejor resultado estético perdurable en el tiempo, con una nueva mama muy similar en textura, consistencia y ptosis a la contralateral. La secuela a nivel de la zona donante abdominal es el principal problema que plantea este tipo de reconstrucciones. Los colgajos de perforantes se desarrollan como el gran recurso para solventar dicho problema, ya que apenas dañan el músculo y su fascia. El colgajo DIEP (Deep Inferior Epigastric Perforator ha demostrado ser una alternativa reconstructiva destinada a gran cantidad de mujeres, con bajas tasas de complicaciones locales, debido a la falta de sacrificio del músculo recto abdominal, e importante grado de satisfacción por el resultado obtenido. Como inconveniente presenta su mayor dificultad técnica y la necesidad de un equipo quirúrgico que domine la microcirugía vascular. No obstante, el colgajo DIEP se presenta como una técnica quirúrgica con una demanda en importante ascenso.Autogenous breast reconstruction is frequently carried out with abdominal tissue, since a better and lasting aesthetic result is obtained, providing a new breast that is very similar in texture, consistency and ptosis to the contralateral breast. The main problem presented by this type of reconstruction is the sequel at the level of the donor abdominal area. Perforator flaps are being developed as the main resource for solving this problem, as they hardly damage the muscle and its fascia. The DIEP flap (deep inferior epigastric perforator has proved itself to be an alternative for reconstruction for many women, with low rates of local complications, due to the absence of any sacrifice of the abdominis rectus muscle, and a significant level of satisfaction with the result obtained. One drawback is its greater technical difficulty and the need for a surgical team that is expert in vascular microsurgery. However, the

  10. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

    Directory of Open Access Journals (Sweden)

    Amirthagadeswar

    2015-02-01

    Full Text Available Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia. The advantages of day case surgery include greater patient satisfaction and reduced financial costs to the health service. Inguinal nerve b locks may be particularly helpful for patients with cardiovascular or respiratory disease, for whom there may be advantages in avoiding general anesthesia. The absence of post - operative sedation or drowsiness allows early ambulation and diminishes the requirement for recovery facilities with inguinal nerve block.

  11. Inguinal Herniography in adults

    Energy Technology Data Exchange (ETDEWEB)

    Kim, B. T.; Park, K. J. [57th Evacuation Hospital, Korea Army, Seoul (Korea, Republic of); Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1980-06-15

    Inguinal hernia in children is easily diagnosed in most cases: however, it is sometimes different or impossible to detect by physical examination. The some is true of a contralateral asymptomatic hernia. White have reported that herniography is easy to perform and has a high degree of accuracy and minimal morbidity. The diagnostic accuracy of herniography in detection of patent process vaginalis is 95-98% by white. Rowe found 40% of children over age of of 2 years and adults with a unilateral congenital hernia had an open process vaginalis in contralateral normal site and concluded that 20% of patients with a unilateral hernia will develop a contralateral hernia sometimes during life. It is necessary to check the condition of the normal site before surgery in unilateral hernia by herniogram. But in adults, the hernigraphy was not performed due to some reason. We found that the herniography in adults is also easy ro perform and high degree of accuracy. The results are: 1. Total number of studies are 25 patient of unilateral inguinal hernia. 2. We found 32% of adults male with unilateral hernia had an open process viginalis in contralateral normal site. 3. Slight more abdominal disconfort than children is noted during injection of Hypaque. 4. Prominent lateral recess of Douglaspouch and poor coating of contrast media to peritoneum are different radiologic finding from children.

  12. Estudio preoperatorio de vasos receptores en reconstrucción mamaria con colgajo DIEP Preoperative planning of receiver vessels in breast reconstruction with DIEP flap

    Directory of Open Access Journals (Sweden)

    C. Tejerina Botella

    2011-09-01

    Full Text Available El estudio preoperatorio vascular de cualquier colgajo microquirúrgico es esencial para el buen desarrollo del mismo. En el colgajo DIEP (colgajo de perforante de arteria epigástrica inferior profunda aplicado a la reconstrucción mamaria, se han establecido durante los últimos años diferentes técnicas para la planificación preoperatoria de la anatomía de los vasos perforantes de la arteria epigástrica inferior. Sin embargo, pensamos, que también es muy importante la planificación anatómica preoperatoria de los vasos receptores, que en la mayoría de los casos son la arteria y vena mamarias internas. Estos vasos sufren en ocasiones variaciones anatómicas, llegando incluso a no existir en algunos pacientes. El conocimiento exacto de la localización, permeabilidad y calibre de estos vasos receptores hará que la intervención sea mas rápida y sencilla.An accurate preoperative vascular evaluation of microsurgical flaps is essential for a good procedure. In DIEP (deep inferior epigastric perforator flap, in breast reconstruction, have been described different preoperative techniques to study the anatomy of the deep inferior epigastric perforators. We think that preoperative planning of the receiver vessels, (internal mammary artery and vein, in most of cases is very important too. These vessels have anatomic changes in some patients. To know the exact location, permeability, and calibre of these vessels will help us to have a more easy and quick operation.

  13. Reconstrucción de defectos de la región geniana mediante colgajos y suspensiones musculares Reconstruction of defects in the genian region with flaps and muscle suspension

    Directory of Open Access Journals (Sweden)

    S. Gallana Álvarez

    2007-04-01

    Full Text Available Presentamos tres pacientes con defectos genianos complejos, que fueron reconstruidos mediante tres combinaciones diferentes de colgajos cutáneos y suspensiones dinámicas de músculo temporal. Los defectos comprendían amplias pérdidas de piel y musculatura facial, pudiendo incluir o no la mucosa geniana. En dos de los casos se trataba de una lesión indurada a nivel geniano con histología compatible con dermatofibrosarcoma protuberans, que no habían recibido ningún tratamiento previo. En el otro paciente se trataba de un carcinoma epidermoide, intervenido en dos ocasiones y que había recibido radioterapia. Para la reconstrucción del defecto cutáneo usamos el colgajo libre compuesto radial, un colgajo de rotación cervicofacial y un colgajo de músculo temporal. Todos los pacientes curaron sin complicaciones y los resultados estéticos y funcionales fueron buenos.We present three patients whose genian complex defects were reconstructed with several cutaneous flaps and dynamic suspension of the temporal muscle. Complex genian defects are those that involve major skin and facial muscle loss, which can also include genian mucous or not. Two cases involved a nodular lesion in the genian region with biopsy reports that indicated dermatofibrosarcoma protuberans, without previous treatment; the other patient had an epidermoide carcinoma, which had been operated twice, and she had received radiotherapy. For the cutaneous reconstruction a composite free radial forearm flap, a cervicofacial flap and a temporal muscle flap were used. Primary healing with no complications was achieved in all patients together with good aesthetic and functional results.

  14. Experiencia en reconstrucción auricular en cáncer de piel con colgajo en "quesadilla" Experience in auricle reconstruction after skin carcinoma with "quesadilla" flap

    Directory of Open Access Journals (Sweden)

    C. Gutiérrez Gómez

    2008-06-01

    Full Text Available La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y no con un simple injerto. Frente a esta dificultad técnica, diseñamos un colgajo ricamente vascularizado que preserva el cartílago no afectado con una buena cubierta y al mismo tiempo respeta la anatomía de la oreja. Para la cobertura del cartílago auricular anterior usamos un colgajo fasciocutáneo posterior que se asemeja a un plato típico de la cocina mexicana que llamamos "quesadilla", donde el cartílago por su color blanco recuerda el queso y el gran colgajo fasciocutaneo recuerda la tortilla que cubre al queso. Este colgajo incluye la piel enrollada del hélix, que en un segundo tiempo retornará a su lugar de origen anatómico mediante una z-plastía asimétrica. Presentamos, de entre una serie de 13 pacientes con carcinoma de pabellón auricular, 2 casos resueltos mediante esta técnica.Auricle reconstruction is one of the most difficult techniques because of the sophisticated and delicates forms of the ear. When we need to remove the auricular skin, preserving the cartilage is very important to keep the shape of the auricle. If treating an auricular skin cancer we find an unaffected cartilage, we can use a skin grafting, but in such delicates forms and curves many times it results inappropriate or the lack of pericondrium difficult skin graft integration. When pericondrium is affected, we will need a skin flap to cover de defect. We designed a rich vascularized flap that preserves the unaffected cartilage with an adequate coverage

  15. Colgajo en hélice de perforante interósea posterior: Un nuevo procedimiento reconstructivo Propeller interoseous posterior perforator flap: A new reconstructive procedure

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-03-01

    Full Text Available El colgajo interóseo posterior de pedículo distal se basa en el arco anastomótico dorsal formado por las arterias interóseas anterior y posterior. Cuando dicha arcada está interrumpida, no es posible elevar un colgajo interóseo posterior de pedículo distal. Presentamos un colgajo de perforante interósea posterior diseñado en hélice, disponible en ausencia de la arcada vascular dorsal y útil en la cobertura de tercio distal del antebrazo, carpo y mano. Detallamos la técnica quirúrgica, sus aplicaciones, ventajas e inconvenientes y analizamos el empleo de este tipo de colgajo en diferentes casos. Presentamos el caso de un paciente con exposición de material de osteosíntesis en tercio distal de radio y trombosis de las anastomosis de revascularización tras sufrir aplastamiento severo de su miembro superior izquierdo; el examen con Doppler reveló ausencia de flujo reverso en la arteria interósea posterior. Se practicó un colgajo en hélice de perforante interósea posterior para cubrir el nuevo by-pass y la osteosíntesis. También otro paciente que tras un accidente de automóvil sufrió fracturas cerradas de cúbito y radio en su miembro superior izquierdo. La columna radial del carpo presentaba una severa lesión por aplastamiento. Tras las osteosíntesis, se practicó un colgajo en hélice de perforante interósea posterior para cobertura de la cara dorso-radial del carpo. En los casos clínicos presentados el colgajo en hélice de perforante interósea posterior proporcionó excelente cobertura del carpo y de la mano con escasa morbilidad de la zona donante. El colgajo en hélice de perforante interósea posterior se presenta como una opción versátil y segura para la cobertura del tercio distal de miembro superior, pudiendo ser elevado en ausencia de flujo reverso y sin sacrificio de la arteria interósea posterior.The distally-based posterior interosseous flap is a versatile and useful technique in upper limb

  16. Colgajo libre interóseo posterior para reconstrucción de mano: a propósito de un caso

    Directory of Open Access Journals (Sweden)

    E. Cabrera Sánchez

    Full Text Available La cobertura de la mano es un desafío para el cirujano plástico, debido a las múltiples opciones disponibles. El colgajo interóseo posterior de base distal es una de las opciones más útiles para la reconstrucción de esta clase de defectos. Sin embargo, debido a su inconstante anatomía vascular pueden acontecer problemas en su disección. Las variaciones anatómicas son bien conocidas y son básicamente de dos tipos: la ausencia de anastomosis distal con la arteria interósea anterior o la hipoplasia o aplasia en el tercio distal del antebrazo de la arteria interósea posterior, provocando un porcentaje relativamente alto de necrosis parcial, que puede acarrear un fallo en la cobertura de esta zona. Con objeto de prevenir un resultado desfavorable, hemos usado un colgajo interóseo posterior en forma de transferencia libre para el tratamiento quirúrgico de una mujer que fue remitida a nuestro Servicio con un defecto de 7 x 7 cm de diámetro en el dorso de la mano izquierda.

  17. Colgajo póstero-medial de muslo (adductor: a propósito de un caso Postero-medial thigh flap (adductor flap: case report

    Directory of Open Access Journals (Sweden)

    L. Gómez-Escolar Larrañaga

    2008-12-01

    Full Text Available En pacientes con úlceras masivas o confluentes en la región glútea, puede ser necesaria la amputación de la extremidad inferior y la reconstrucción mediante colgajos totales de muslo para la cobertura del defecto. Esta técnica es muy agresiva y además de las evidentes secuelas físicas que crea puede generar importantes trastornos psíquicos para el paciente. Presentamos el caso de una paciente con una gran úlcera por decúbito en la región isquio-trocantéreosacra en la que se empleó el colgajo Adductor como alternativa a la amputación de la extremidad inferior.Amputation of the lower extremity and total thigh flaps may be necessary for coverage in patients with massive multiple or confluent sores in the buttock region. This is an aggressive technique with important physical and psychological consequences for the patient. The Adductor flap was used as an alternative of the amputation in a patient with a big ischial-trocantericsacral pressure sore.

  18. Reconstrucción perineal con colgajo fasciocutáneo de glúteo mayor en V-Y: experiencia de 5 años

    OpenAIRE

    Alberto Blanco-Álvarez; Pablo Benito-Duque; José-Antonio Alcázar-Montero

    2016-01-01

    Antecedentes y Objetivos. La cirugía colorrectal y ginecológica precisa a menudo la resección de grandes áreas de tejido en la región perineal. En ocasiones es posible el cierre directo, pero a veces se necesitan técnicas reconstructivas. Una de las más extendidas para la reconstrucción perineal es la utilización de los colgajos fasciocutáneos en V-Y diseñados en la región anatómica del glúteo mayor. Pacientes y Método. Desde 2005 hasta 2011 hemos llevado a cabo reconstrucción del periné con ...

  19. Reconstrucción compleja de la cavidad oral mediante dos colgajos simultáneos de peroné y radial Complex reconstruction of the oral cavity by means of the combination of two simultaneous free fibula and radial flaps

    Directory of Open Access Journals (Sweden)

    A. Dean Ferrer

    2004-10-01

    Full Text Available El objetivo del presente trabajo es valorar los resultados funcionales y estéticos de reconstrucciones complejas orofaciales, realizadas mediante la asociación de dos colgajos libres simultáneos de peroné y radial. Se ha realizado este tipo de reconstrucción en tres pacientes con buenos resultados funcionales y estéticos. La reconstrucción con dos colgajos libres está indicada en defectos complejos en los que la reconstrucción con un solo colgajo no obtendría resultados estéticos y funcionales adecuados. Cada colgajo se selecciona por sus características que lo hacen ideal para cada tipo de defecto, óseo y de partes blandas con la finalidad de conseguir un resultado estético y funcional superior al que se obtendría con un solo colgajo.The aim of this paper is to evaluate the functional and aesthetic results of complex orofacial reconstructions by means of the combination of two simultaneous free flaps (fibula osteocutaneous and radial forearm flaps. Three patients who have undergone this kind of reconstruction are presented with good functional and aesthetics results. Reconstruction with two free flaps is indicated in complex defects in which reconstruction with a single flap would not obtain adequate aesthetic and functional results. The choice of each particular flap depends on its specific characteristics that make it ideal for the reconstruction of each particular type of defect, osseous defects and soft tissue defects, with the aim of obtaining a better result than that obtained with the use of a single flap.

  20. Reconstrucción de canto interno y pared lateral nasal con colgajo zigomático de mejilla Reconstructing soft tissue defects at the medial canthus and sidewalls of the nose with cheek zygomatic flap

    Directory of Open Access Journals (Sweden)

    J. de Abullarade

    2009-06-01

    Full Text Available En la reconstrucción del canto interno palpebral y de la pared lateral nasal es importante la continuidad del color, de la textura y del grosor del tejido que vamos a reemplazar. El colgajo zigomático de mejilla es un colgajo de patrón axial que, cuando se diseña adecuadamente, puede seguir los contornos naturales de la cara, como el pliegue nasolabial y el borde del párpado inferior, logrando un reemplazo casi exacto de la calidad de la piel existente y con una reparación realizada en un solo tiempo quirúrgico.In it's important to keep the continuity of colour, texture and thickness of the tissue in a reconstructed nose. The zigomatic cheek flap is an axial pattern flap that, when is properly designed, can follow the natural existing contour lines such as the nasolabial fold and the lower eyelid border. It gets an almost exactly replacement of matching skin quality, in one surgical stage.

  1. Reconstrucción mandibular con el colgajo pediculado osteofascial parietal bicortical: nuestra experiencia en 9 casos

    Directory of Open Access Journals (Sweden)

    Francisco Gálvez-Prieto

    2017-04-01

    Conclusión: El colgajo pediculado osteofascial parietal bicortical aporta a la reconstrucción mandibular un hueso membranoso vascularizado bicortical obtenido de una zona próxima a la receptora. Dicho colgajo puede ser una alternativa a las técnicas microquirúrgicas cuando estas no estén disponibles o no sean aplicables, y a la distracción osteogénica mandibular mediante transporte óseo. Las complicaciones en la zona donante de este colgajo, aun no siendo graves, pueden requerir cirugías de revisión.

  2. Colgajo bilateral de perforantes lumbares para la reconstrucción de un severo defecto tóracolumbar Bilateral lumbar perforator flap in reconstruction of a wide toracolumbar defect

    Directory of Open Access Journals (Sweden)

    P. Benito Duque

    2006-06-01

    Full Text Available En la reconstrucción de los defectos toracolumbares se han empleado numerosas técnicas quirúrgicas. Ocasionalmente se puede utilizar el cierre directo, injertos de piel, colgajos de dorsal ancho volteado y lumbosacro transverso, colgajos de transposición o de rotación tipo random, pero están limitados cuando los tejidos circundantes están radiados o presentan cicatrices por cirugías previas. Igualmente, la extensión del defecto puede hacerlos inviables. Los colgajos de perforantes están especialmente indicados en pacientes con deambulación conservada, haciendo posible el aporte de una gran superficie de piel y tejido subcutáneo bien vascularizado, basado en los vasos perforantes y evitando así el sacrificio de vasos principales o músculos. Presentamos el caso de una paciente con un defecto en la espalda de 17 cm. De diámetro secundario a la resección de un tumor espinocelular con exposición de cuerpos vertebrales, tratado mediante la transposición de dos colgajos basados en las arterias perforantes lumbares asociados a un colgajo de rotación de dorsal ancho miocutáneo.Thoracolumbar defects have been treated by a variety of surgical methods. Primary closure, skin grafting, reverse latissimus dorsi musculocutaneous flap, transverse lumbosacral back flap, local randomly designed rotation, or transposition flaps may be indicated in occasional cases, but there is limited indication for their use in some cases with a wide lesion or when the surrounding tissues have been compromised by previous surgery or irradiation. Perforator flaps are specially indicated for ambulatory patients, in which large amounts of well-vascularized skin and subcutaneous tissue are transfered easily based on one perforator vessel without sacrificing main vessels or muscles. The authors present a patient with a 17 cm wide defect in the midback region and exposed bone after excision of a squamous cell carcinoma, treated by two perforator flaps based on

  3. [Inguinal and femoral hernia repair].

    Science.gov (United States)

    Geissler, B; Anthuber, M

    2011-05-01

    With an incidence of 200,000 new cases per year in Germany, inguinal hernia has a significant socioeconomic impact. The 2009 guidelines from the European Hernia Society established treatment recommendations. Hernia repair is based on reinforcing the posterior wall of the inguinal canal by suture or mesh repair by an anterior or posterior approach. Lightweight mesh reduces recurrence rates and is the treatment of choice even in primary hernias. Laparoscopic hernia repair is associated with specific risks but is superior in postoperative pain and earlier return to work.

  4. El colgajo fasciocutáneo dorsal ulnar en quemaduras eléctricas de la mano: un colgajo constante, rápido y seguro

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    Trinidad Delgado-Ruiz

    2016-03-01

    Full Text Available Antecedentes y Objetivos. La extremidad superior es el área más frecuentemente afectada en las quemaduras eléctricas de alto voltaje, con una alta tasa de amputaciones, síndromes compartimentales y defectos de partes blandas que precisan cobertura. La literatura en cuanto a la cirugía reconstructiva de la mano con quemaduras eléctricas es escasa, pero es fundamental en la fase aguda establecer un plan quirúrgico y una cobertura estable de estos frecuentes defectos en mano y muñeca. Pacientes y Método. Empleamos el colgajo fasciocutáneo dorsal ulnar en 3 pacientes con defectos cutáneos en muñeca secundarios a quemaduras eléctricas de alto voltaje, durante la fase aguda de estas lesiones. Resultados. Obtuvimos en todos los casos una cobertura estable y de alta calidad y sin registrar complicaciones relacionadas con el colgajo o con la zona donante. Conclusiones. Debido a la constancia de su pedículo, la rapidez y seguridad de su disección y la preservación de ambos ejes arteriales, el colgajo fasciocutáneo dorsal ulnar es una herramienta de primer uso en la cobertura de los defectos de la mano y de la muñeca tras quemaduras eléctricas de alto voltaje.

  5. Aplicación de los colgajos fasciocutáneos vulvoperineales en cirugía pediátrica: a propósito de un caso Application of vulvoperineal fasciocutaneous flaps in pediatric surgery: case report

    OpenAIRE

    2008-01-01

    La incidencia de agenesia de vagina es de 1/4000- 10000 recién nacidas vivas. La causa más frecuente es el síndrome de Mayer-Rokitansky-Küster-Hauser. Presentamos un caso de reconstrucción vaginal con colgajos fasciocutáneos vulvoperineales de Málaga en una paciente pediátrica afecta de este síndrome, describiendo los pasos del procedimiento y las bases anatómicas en las que se fundamenta. Esta técnica permite la creación de una neovagina sensible, con una cobertura de excelente calidad, con ...

  6. Developments in inguinal hernia repair

    NARCIS (Netherlands)

    Voorbrood, C.E.H.

    2016-01-01

    Performing inguinal hernia surgery in a high volume clinic allows for gaining expertise and achieving considerable experience and knowledge. This results in the recognition of benefits of tailored treatment, selection of patients, and structured aftercare rendering improvement of patients' outcome a

  7. Developments in inguinal hernia repair

    NARCIS (Netherlands)

    Voorbrood, C E H

    2016-01-01

    Performing inguinal hernia surgery in a high volume clinic allows for gaining expertise and achieving considerable experience and knowledge. This results in the recognition of benefits of tailored treatment, selection of patients, and structured aftercare rendering improvement of patients´ outcome a

  8. Colgajo en hacha de tensor de fascia lata para úlceras por presión trocantereas Hatchet-Shaped fascia lata tensor flap for the treatment of trochanteric pressure sores

    Directory of Open Access Journals (Sweden)

    W. Calderón

    2010-12-01

    Full Text Available Las úlceras trocantéreas por presión representan un problema importante a nivel extra e intrahospitalario. Existen múltiples opciones terapéuticas, ya sean colgajos randomizados, musculocutáneos, fasciocutáneos o libres. Presentamos la técnica quirúrgica del colgajo en hacha de tensor de fascia lata para el tratamiento de esta patología. Consiste en el diseño de un colgajo en V con irrigación por su base superior, que contacta con la úlcera por uno de sus extremos, simulando la forma de un hacha. Resecamos la úlcera hasta obtener un lecho vital, resecando además el hueso prominente dicho hasta un plano en que se visualice tejido sano. Levantamos y rotamos el colgajo cubriendo el defecto. Finalmente se realiza el cierre primario en VY sin tensión. La zona donante permite un cierre primario sin tensión. Mantenemos drenajes durante 10 días. Este colgajo permite obtener una buena cobertura para úlceras trocantéreas por decúbito con un adecuado resultado cosmético. Recogemos una casuística de 17 úlceras tratadas mediante el colgajo descrito; como complicaciones se presentaron 3 seromas, resueltos con sistema de cierre con presión negativa externa e interna; 2 casos de dehiscencia de sutura y 2 hematomas resueltos en pabellón de cirugía. Creemos pertinente conocer este colgajo que debe estar siempre presente dentro de las posibilidades terapéuticas para pacientes con úlceras trocantereas por decúbito.The trochanteric pressure sore it´s an important intra and extrahospitalary problem. There are different therapeutic options for this pathology, for example random, musculocutaneous, fasciocutaneous or free flaps. We present the hatchet-shaped fascia lata tensor flap to treat this kind of lesions. We design a V flap with irrigation in the superior base, having one of the extreme in contact with the sore. The shape of the flap is a hatchet. It´s important to get a vital bed resecting affected tissues and prominent bone; then

  9. Colgajo fasciocutáneo sural inverso para cobertura de defectos de partes blandas en pierna, tobillo y pie. [Reverse­ fasciocutaneous­ sural­ flap­ for­ soft-tissue­ coverage­ in­ the­ leg,­ ankle­ and­ foot­

    Directory of Open Access Journals (Sweden)

    Santiago Iglesias

    2014-12-01

    Full Text Available In­tro­duc­ción: el objetivo de este trabajo es evaluar los resultados obtenidos con la utilización del colgajo fasciocutáneo sural de base distal para la reconstrucción de defectos de partes blandas alrededor de la tibia distal, el tobillo y el pie. Materiales­ y ­Métodos: se evaluaron, en forma retrospectiva, 20 colgajos pediculados fasciocutáneos surales inversos realizados entre 2007 y 2013. La edad promedio de los pacientes era de 42 años (rango 6-79; 14 hombres y 5 mujeres. Las causas de los defectos fueron: postraumáticas (17 casos, un caso bilateral y secundarias a resecciones oncológicas (2 casos. La muestra incluyó tres pacientes diabéticos, una mujer obesa y ocho pacientes tabaquistas. En 10 casos, las heridas presentaban exposición tendinosa y, en 10 casos, exposición ósea. El diámetro promedio de los defectos fue de 8,9 x 5,75 cm. Resultados: el seguimiento promedio fue de 16 meses. Se logró una exitosa cobertura completa del defecto en los 20 casos. el tiempo promedio de internación fue de 3.15 días. Tres colgajos presentaron necrosis parcial superficial, en un caso el colgajo sufrió necrosis en su tercio distal y, en un paciente, se decidió amputar la extremidad por persistencia de la osteomielitis. Conclusiones: Pese a que se han descrito múltiples opciones de cobertura en defectos de tejidos blandos alrededor de la tibia distal, el tobillo y el pie, el colgajo sural inverso es, en la actualidad, uno de los procedimientos más frecuentes para cubrir estos defectos. Se evaluaron 20 colgajos surales inversos y se logró la cobertura completa de los defectos de tejidos blandos, tanto en defectos postraumáticos como en los resultantes de resecciones oncológicas

  10. Colgajo lingual para cierre de fístula oronasal: aportación a la técnica Lingual Flap for Closure of Oronasal Fistula: Contribution to the technique

    Directory of Open Access Journals (Sweden)

    Carlos Licéaga-Escalera

    2012-03-01

    Full Text Available La fístula oronasal es la complicación más común posterior a una palatoplastía y frecuentemente requiere de una reparación secundaria. Se ha desarrollado una gran cantidad de técnicas quirúrgicas para su manejo, siendo una de las más populares el colgajo lingual. A pesar de la excelente vascularidad de la lengua, para asegurar la viabilidad del colgajo, éste debe ser manejado con extremo cuidado durante el procedimiento. Con este propósito sugerimos el uso de una platina acrílica en forma de herradura que aporta estabilidad e inmoviliza la lengua durante la cirugía, lo que facilita el procedimiento y ayuda a evitar errores durante el diseño y el levantamiento del colgajo.The oronasal fistula is the most common complication after a palatoplasty and it frequently needs a secondary repair. A great number of surgical techniques have been developed for the management of this condition. The lingual flap is one of the most popular treatments. In spite of the excellent vascularity of the tongue, it must be handled carefully during the procedure to assure the viability of the flap. For this reason we suggest the use of an acrylic slide in the shape of horse-shoe that improves the stability and immobilises the tongue during the surgery. This makes the procedure easier and helps to avoid mistakes during the design and the raising of the flap.

  11. Reconstrucción de rodilla con doble colgajo de gemelo Knee reconstruction with double gemelar muscular flap

    Directory of Open Access Journals (Sweden)

    C. Márquez Zevallos

    2011-06-01

    Full Text Available Los traumatismos de miembros inferior representan un reto importante para el cirujano plástico en cuanto a su reconstrucción cuando no se dispone de técnicas microquirúrgicas. En el presente trabajo se presentan 2 casos de reconstrucción de rodilla con doble colgajo muscular de gemelo, en los que se demuestra que se pueden utilizar simultáneamente los dos gemelos sin dejar ninguna secuela estética importante ni funcional en la deambulación de los pacientes. Hasta donde podemos conocer, no existe en la literatura nacional ni internacional un reporte de casos con esta aplicación, ya que siempre se ha empelado un solo músculo precisamente por el temor a alterar la función de flexo-extensión del pie.Lower limb traumatism has always been a problem for plastic surgeon when in the moment of the surgical reconstruction we have not microsurgical techniques. In this paper, we present 2 cases of knee reconstruction using a double gemelar muscular flap, showing how is possible the simultaneous use of the two muscles without aesthetic or functional sequels. As we know, there is no national or international report of cases with this muscular reconstruction; it has been usual to use only one muscle, in order to avoid problems in the flexo-extension movements of the foot.

  12. Cirugía reconstructiva con colgajos libres en el tratamiento de los carcinomas de cabeza y cuello factores pronósticos clínicos y biológicos relacionados con la aparición de complicaciones /

    OpenAIRE

    López Fernández, Susana

    2013-01-01

    INTRODUCCIÓN: El objetivo del presente estudio es averiguar si existe una relación significativa entre el riesgo de aparición de complicaciones perioperatorias y el antecedente de radioterapia previa en los pacientes con tumores de cabeza y cuello reconstruidos con colgajos libres. Nuestro objetivo secundario es estudiar la capacidad pronóstica de los niveles de expresión del transforming growth factor-β (TGF-β) a nivel de la mucosa del lecho quirúrgico en relación a la aparición de complicac...

  13. The Danish Inguinal Hernia database

    DEFF Research Database (Denmark)

    Friis-Andersen, Hans; Bisgaard, Thue

    2016-01-01

    of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. DESCRIPTIVE DATA: According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous...... access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles...... the medical management of the database. RESULTS: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). CONCLUSION: The Danish Inguinal Hernia...

  14. Reconstrucción mamaria con el colgajo musculocutáneo recto abdominal transverso (TRAM Breast reconstruction with the transverse rectus abdominis musculocutaneous (TRAM flap

    Directory of Open Access Journals (Sweden)

    J. A. Lozano

    2005-01-01

    Full Text Available El colgajo musculocutáneo de recto abdominal transverso ha sido la técnica quirúrgica más utilizada en reconstrucción mamaria autógena. Proporciona una nueva mama con volumen adecuado, ptosis, aspecto natural y no requiere la implantación de prótesis, obteniéndose una buena simetría con la mama contralateral, que perdura en el tiempo. El inconveniente de esta técnica es la morbilidad de la pared abdominal. Este colgajo sacrifica el músculo y la vaina anterior del recto que puede tener consecuencias como hernias y eventraciones. Para minimizar este problema se desarrolló el colgajo de recto abdominal microquirúrgico, que sólo sacrifica una porción muscular, disminuyendo significativamente el número de secuelas. Como inconveniente presenta la dificultad de la técnica quirúrgica, requiriendo dominio de la microcirugía vasculonerviosa. En conclusión, se puede devolver a la mujer mastectomizada una nueva mama de forma completamente autógena, con volumen, forma y textura similares al lado sano que ayude, en definitiva, a recuperar la autoestima perdida.The transverse rectus abdominis musculocutaneous (TRAM flap has been the most employed technique in autogenous breast reconstruction. It provides a new breast of adequate volume, ptosis and natural appearance, and does not require the implantation of prosthesis; a good symmetry with the contralateral breast is obtained, which lasts over time. The drawback of this technique is the morbidity of the abdominal wall. This flap sacrifices the muscle and the anterior rectus sheath which can result in consequences such as hernias and eventrations. To minimise this problem the microsurgical TRAM flap was developed, which only sacrifices a portion of muscle, significantly reducing the number of sequels. A drawback is the difficulty of the surgical technique, which requires mastery of vascular-nervous microsurgery. In conclusion, a new breast can be returned to the mastectomised woman in a

  15. An inguinal hernia of a third kind?

    Science.gov (United States)

    Lloyd, D M; Karmand, K J; Norwood, M G A

    2009-02-01

    Inguinal hernias are classified anatomically into indirect and direct types. We illustrate two cases of an inguinal hernia where the defect was demonstrated to lie between the deep ring and the inferior epigastric vessels, therefore, not fitting the standard criteria for either direct or indirect inguinal hernias. Taking this into account, we propose that the hernia which we describe should either be considered as a completely new type of inguinal hernia or, alternatively, all of the currently accepted classifications should be changed or adapted to incorporate it.

  16. [Complications of inguinal hernia repair].

    Science.gov (United States)

    Forte, A; D'Urso, A; Gallinaro, L S; Lo Storto, G; Bosco, M R; Vietri, F; Beltrami, V

    2002-03-01

    It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases. No important intraoperative complications were observed; the patients restarting work varied from 3 to 15 days after the discharging in relation to patient anxiety, onset of complications and to the type of work. The complications observed were: urine retention (1.6%), superficial haematoma (1.3%), superficial infection (1%), wound suppuration (0.5%), serous effusion (0.7%), postsurgery pain (2.1%), scrotal edema (1.7%), persistent inguinal neuralgia (0.6), local hypoesthesia (4.3%), ischemical orchitis (0.1%), recurrence (0.2%). In conclusion Authors assert that "tension free" repair allows optimal results both for the surgery point (easiness of the technique, repeatability, less invasivity, scanty incident of recurrences, low frequency of postoperative complications) and in economic terms, allowing an early mobilization of the patients. A further improvement would be obtained with more care in surgical and patient management, with more excellent results.

  17. Colgajo libre osteoseptocutáneo de peroné en la reconstrucción primaria de la radionecrosis masiva mandibular Fibular osteoseptocutaneous free flap in the primary reconstruction after massive radionecrosis of the mandible

    Directory of Open Access Journals (Sweden)

    P. Infante Cossío

    2004-06-01

    Full Text Available Resumen: Una de las complicaciones más serias del uso de la radioterapia en el tratamiento del carcinoma epidermoide de la cavidad oral, es la osteorradionecrosis. En este trabajo, presentamos cuatro pacientes afectos de osteorradionecrosis masiva de la mandíbula que habían fracasado inicialmente con medidas conservadoras y que fueron tratados con resección radical y reconstrucción primaria con un colgajo libre osteoseptocutáneo de peroné. El defecto mandibular tras la resección ósea midió una media de 10 cm e incluyó mucosa intraoral, piel o ambos. En dos casos de reconstrucción, se empleó el colgajo libre de peroné con doble paleta para reconstruir defectos extensos intra y extraorales. Se realizaron osteotomías en el peroné vascularizado en todos los casos para recrear el contorno mandibular. Todos los colgajos sobrevivieron completamente. Tres pacientes curaron primariamente con buenos resultados estéticos y funcionales. Una paciente falleció en el primer mes tras la operación por una pancreatitis aguda y fallo renal. En un paciente se han insertado implantes osteointegrados. En nuestra experiencia, el colgajo libre osteoseptocutáneo de peroné puede ser una opción ideal para la reconstrucción en un solo tiempo de defectos complejos mandibulares compuestos en pacientes afectos de osteorradionecrosis masiva.Abstract: Osteoradionecrosis is one of the most serious complications after radiation therapy of squamous carcinoma of the oral cavity. In this article, we report four cases of massive osteoradionecrosis of the mandible, all of whom had failed initial conservative management and treated with radical resection and primary reconstructed with fibular osteoseptocutaneous free flap. Mandible defects after radical resection were around 10 cm long and included intraoral mucosa, skin or both. A doubled-paddle peroneal tissue transfer was used in two cases for reconstruction of an extensive extra- or intraoral defects. The

  18. El colgajo submental en reconstrucción de defectos orofaciales

    Directory of Open Access Journals (Sweden)

    Kora Sagüillo

    2015-10-01

    Conclusiones: El colgajo submental constituye una alternativa válida para la reconstrucción de defectos orofaciales, especialmente en aquellos pacientes que por edad o estado general deteriorado requieren tratamientos poco agresivos y con tiempos quirúrgicos reducidos. Requiere descartar la presencia de enfermedad metastásica ganglionar cervical previamente a su realización. Su empleo es controvertido para la reparación de defectos tras resección de tumores con alta linfofilia.

  19. Inguinal lymph node metastasis of colon cancer

    Directory of Open Access Journals (Sweden)

    Sloane McGraw

    2011-01-01

    Full Text Available We present a case of adenocarcinoma of colon with unusual metastasis to inguinal lymph nodes. Our patient is a young male with bilateral inguinal lymphadenopathy, bone pains, and jaundice who presented as carcinoma of unknown primary. He was diagnosed as widely metastatic adenocarcinoma of colon for which he received chemotherapy and has had a good response to the treatment.

  20. Inguinal Hernia Management: Focus on Pain

    NARCIS (Netherlands)

    A.R. Wijsmuller

    2010-01-01

    textabstractIn the Netherlands approximately 31,000 inguinal hernias are corrected yearly, making it one of the most frequently performed operations in surgery. The majority of inguinal hernia repairs is conducted in male patients older than 50 years. Since recurrence rates have been reduced to a fe

  1. Periappendicular Abscess Presenting within an Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Norman Loberant

    2015-01-01

    Full Text Available The presence of the appendix within an inguinal hernia is a rare finding. We present the case of an elderly woman who developed appendicitis within an inguinal hernia, complicated by a supervening periappendicular abscess. She was successfully treated with a combination of antibiotics and percutaneous drainage.

  2. Periappendicular Abscess Presenting within an Inguinal Hernia

    Science.gov (United States)

    Loberant, Norman; Bickel, Amitai

    2015-01-01

    The presence of the appendix within an inguinal hernia is a rare finding. We present the case of an elderly woman who developed appendicitis within an inguinal hernia, complicated by a supervening periappendicular abscess. She was successfully treated with a combination of antibiotics and percutaneous drainage. PMID:26605128

  3. Colgajo bilateral de perforantes lumbares para reconstrucción glútea tras infiltración por modelantes

    Directory of Open Access Journals (Sweden)

    J. Gordillo-Hernández

    2014-09-01

    Full Text Available La inyección de sustancias modelantes es un procedimiento usado desde el siglo XIX para mejorar el contorno corporal con fines estéticos. Durante la última década ha aumentado la demanda de técnicas quirúrgicas para la reconstrucción de los defectos originados tras la resección de unidades anatómicas afectadas por infiltración de estas sustancias modelantes, haciendo que en ocasiones tengamos que recurrir al empleo de expansores cutáneos, injertos, colgajos locales, colgajos regionales e incluso, a colgajos libres. Describimos el proceso de reconstrucción glútea en caso de infiltración de sustancias modelantes en el que tuvimos que emplear un colgajo de perforantes lumbares debido a su fiabilidad, a que preserva la musculatura, a su versatilidad de diseño sin comprometer otras posibles alternativas reconstructivas y por su baja morbilidad. Analizamos también la anatomía, diseño, técnica quirúrgica e indicaciones específicas de estos colgajos de perforantes de la región glútea.

  4. Colgajo comisural palmar: su utilidad en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. [Commissural­ palmar­ flap:­ use­ in­ Dupuytren’s­ disease­ involving­ adjacent­ fingers

    Directory of Open Access Journals (Sweden)

    Sebastián E. Valbuena

    2015-01-01

    Full Text Available In­tro­duc­ción: El diseño de las incisiones en la enfermedad de Dupuytren es probablemente el detalle técnico más importante en el tratamiento quirúrgico. El objetivo de este trabajo es realizar una valoración retrospectiva de la utilidad del colgajo comisural palmar en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. Materiales­ y­ Métodos:­ Entre abril de 2009 y diciembre de 2012, los autores operaron a 32 pacientes con enfermedad de Dupuytren. Se incluyeron 12 pacientes con compromiso de, al menos, 2 dedos contiguos y el diseño de un colgajo comisural palmar. Se evaluaron entre los días 3-5, 15-21, 45-60 y a los 6 meses posoperatorios. Al final del seguimiento, se constataron las recidivas, la satisfacción y el puntaje QuickDASH. Resultados: Se realizaron 13 colgajos comisurales palmares en 12 pacientes, 6 manos derechas y 6 izquierdas. Los rayos contiguos afectados fueron el 4° y 5° dedos (8 casos, el 3°, 4° y 5° dedos (3 casos, y el 3° y 4° dedos (un caso. La distancia promedio del colgajo comisural palmar comisura-vértice fue de 2,23 cm (rango 1,2-4,3 y la transversal, de 2,42 cm (rango 1,6-3,8. Siempre se pudo realizar la resección de las cuerdas patológicas y la fasciectomía parcial sin complicaciones intraoperatorias. Hubo una necrosis distal parcial, tratada con técnica de palma abierta. Conclusiones: El colgajo comisural palmar es de fácil disección y seguro a causa de su múltiple vascularización, permite una correcta visualización de las estructuras vasculonerviosas digitales y las bandas patológicas, útil en afección de dedos contiguos.

  5. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  6. Convalescence after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette Astrup; Rosenberg, Jacob; Bisgaard, Thue

    2016-01-01

    BACKGROUND: Duration of convalescence after inguinal hernia repair is of major socio-economic interest and an often reported outcome measure. The primary aim was to perform a critical analysis of duration of convalescence from work and activity and secondary to identify risk factors for unexpected...... prolonged convalescence after laparoscopic inguinal hernia repair. METHODS: A qualitative systematic review was conducted. PubMed, Embase and the Cochrane database were searched for trials reporting convalescence after laparoscopic inguinal hernia repair in the period from January 1990 to January 2016...... factors for prolonged convalescence extending more than a few days after laparoscopic inguinal hernia repair. CONCLUSIONS: Patients should be recommended a duration of 1-2 days of convalescence after laparoscopic inguinal hernia repair. Short and non-restrictive recommendations may reduce duration...

  7. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  8. El colgajo muscular de hemitríceps sural para la cobertura de grandes defectos en la pierna: Experiencia de 9 años The sural hemitriceps muscular flap for reconstruction of large tissue defects of the leg: A 9 year experience

    Directory of Open Access Journals (Sweden)

    R. Graciano Balcón

    2009-09-01

    Full Text Available En el Instituto Nacional de Ortopedia y Traumatología de Montevideo, Uruguay, utilizamos el colgajo muscular de hemitríceps sural para reconstruir defectos de cobertura en traumatismos graves de pierna que asientan en el tercio medio y en la unión del tercio medio con el distal. El colgajo de hemitríceps sural permite cubrir exposiciones óseas más extensas que el colgajo de hemisóleo en forma aislada, con un menor tiempo quirúrgico y sin afectar a la potencia en la flexión plantar. Presentamos una serie de 13 casos clínicos de fracturas expuestas con importantes defectos de cobertura cutánea de la pierna, tratados con colgajos de hemitríceps durante el período marzo de 1999 a julio de 2008. El seguimiento promedio fue de 15 meses.The sural hemitriceps muscular flap is used in the National Institute of Orthopedics and Traumatology in Montevideo to reconstruct soft-tissue defects after severe lower extremity trauma on the middle third and the union of the middle and inferior third of the leg. The hemitriceps sural flap can successfully cover more extensive osseous exposure than the hemisoleus flap alone, with less surgical time and without affecting plantar flexion strength. A series of 13 cases is presented of leg open fractures with important cutaneous soft-tissue defect treated with hemitriceps flaps, operated on the period from march 1999 to july 2008. Average follow-up time was 15 months.

  9. Rehabilitación implantosoportada en el colgajo libre de peroné Implant-supported rehabilitation using the fibula free flap

    Directory of Open Access Journals (Sweden)

    C. Navarro Cuéllar

    2006-10-01

    Full Text Available El colgajo de peroné ha demostrado ser el más versatil para la reconstrucción oromandibular, gracias a la gran longitud ósea que podemos utilizar y a la posibilidad de incorporar una amplia paleta cutánea para cobertura de tejidos blandos intraorales. El uso de implantes dentales osteointegrados proporciona un importante método terapéutico para la rehabilitación oral de estos pacientes. Los implantes osteointegrados proporcionan la forma más rígida de estabilización protésica para soportar las fuerzas masticatorias. Estos implantes pueden ser insertados de forma inmediata o diferida. A la hora de utilizar el colgajo libre de peroné realizamos la implantología de forma diferida a los 6-12 meses debido a la gran cantidad de material de osteosíntesis necesaria para la fijación del colgajo. Cuatro o seis meses después, cuando el proceso de osteointegración ha ocurrido, los implantes son cargados con una rehabilitación dental. Analizamos 12 casos de reconstrucción mandibular con colgajo libre de peroné y su rehabilitación estética y funcional con implantes osteointegrados y un seguimiento mínimo de 2 años. Se han colocado un total de 56 implantes, presentando todos ellos excepto uno, una correcta osteointegración. Todos estos pacientes han recuperado la función masticatoria, y mejorado de forma considerable la competencia labial, la continencia salival, la pronunciación y la armonía facial.Free fibula flap has proved to be one of the most versatile for oromandibular reconstruction due to the available length of bone and the possibility of incorporating a long skin paddle to cover intraoral soft tissues. The use of osseointegrated dental implants is an important technique for the oral rehabilitation of these patients. Osseointegrated implants provide the most rigid prosthetic stabilization available to withstand masticatory forces.These implants can be placed immediately or in a second time procedure.In our case

  10. Herniorrafia inguinal: Técnica por sobrecapas de Fascia Transversalis

    Directory of Open Access Journals (Sweden)

    José Miguel Goderich Lalán

    1997-08-01

    Full Text Available Se realizó un estudio descriptivo, prospectivo, observacional y longitudinal para evaluar los resultados obtenidos con la aplicación de una técnica de reparación herniaria inguinal (original del autor por sobrecapas de fascia transversalis, en la que se afronta una primera capa de ésta en sutura continua, desde la proyección del tubérculo púbico hasta obliterar el anillo inguinal profundo, después de lo cual se crea una segunda capa al afrontar el arco aponeurótico del transverso a la cintilla iliopubiana. Luego de un seguimiento superior a los 10 años, se comprobó que de 1 475 pacientes sólo hubo recidivas en 1,2 %; éstas fueron más frecuentes en los hombres, en las hernias del tipo indirecto y en los pacientes con más de 45 años. El mayor número de recidivas ocurrió entre el primer y tercer año de operado. Se recomienda introducir esta nueva técnica en la práctica quirúrgica, y cumplir las indicaciones y el proceder señalado por el autorA descriptive, prospective, observational, and longitudinal study was performed to evaluate the results obtained with the application of a technique for the repair of inguinal hernia (the author's original technique by overlayers of fascia transversalis, in which the first layer is copped with the use of continuos suture from the projection of the pubic tubercle until the obliteration of the deep inguinal rign, creating a second layer when copping the aponeurotic arch of the transverse to the iliopubic eminence. After a follow-up longer than 10 years, it was proved that out of 1 475 patients, only 1,2 % presented with recurrences. Relapses were more frequent in males, in indirect hernias and in patients over 45 years of age. The greatest number of recurrences occurred between the first and the third year after the operation. It is recommended to introduce this new technique within the surgical practice and to comply with the indications for the procedure made by the author

  11. La hernia inguinal en la era laparoscópica.

    OpenAIRE

    WEBER SÁNCHEZ, Alejandro; VAZQUEZ, José A.; MANSILLA DORIA, Percy; CUETO GARCÍA, Jorge

    2013-01-01

    Objetivo: Describir los resultados de 327 reparaciones via laparoscópica de hernias inguinales. Material y métodos: Estudio descriptivo de 327 reparaciones vía laparoscópica de hernias inguinales practicadas en 257 pacientes, realizadas entre 1992 y 1996 en el Servicio de Cirugia del American British Cowdray Medical Center, en México Distrito Federal. Resultados: El sexo fue predominantemente masculino (77.4 %); las edades oscilaron entre 9 y 89 años. En 85 pacientes se trató de hernia inguin...

  12. The Danish Inguinal Hernia Database

    Directory of Open Access Journals (Sweden)

    Friis-Andersen H

    2016-10-01

    Full Text Available Hans Friis-Andersen1,2, Thue Bisgaard2,3 1Surgical Department, Horsens Regional Hospital, Horsens, Denmark; 2Steering Committee, Danish Hernia Database, 3Surgical Gastroenterological Department 235, Copenhagen University Hospital, Hvidovre, Denmark Aim of database: To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Study population: Patients ≥18 years operated for groin hernia. Main variables: Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. Descriptive data: According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time. All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. Results: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015. A total of 49 peer-reviewed national and international publications have been published from the database (June 2015. Conclusion: The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair. Keywords: nation-wide, recurrence, chronic pain, femoral hernia, surgery, quality improvement

  13. The Danish Inguinal Hernia database

    Science.gov (United States)

    Friis-Andersen, Hans; Bisgaard, Thue

    2016-01-01

    Aim of database To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Study population Patients ≥18 years operated for groin hernia. Main variables Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. Descriptive data According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. Results The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). Conclusion The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair. PMID:27822094

  14. Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1 com ropivacaína e a analgesia subaracnóidea com morfina Analgesia pós-operatoria en cirugía ortopédica: estudio comparativo entre el bloqueo del plexo lombar por vía perivascular inguinal (3 en 1 con ropivacaína y la analgesia subaracnóidea con morfina Postoperative analgesia following orthopedic surgery: a study comparing perivascular lumbar plexus inguinal block with ropivacaine (3 in 1 and spinal anesthesia with morphine

    Directory of Open Access Journals (Sweden)

    Neuber Martins Fonseca

    2003-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo lombar pelo acesso perivascular inguinal, chamado de bloqueio 3 em 1, tem sido utilizado para analgesia pós-operatória. O objetivo deste estudo foi comparar a analgesia pós-operatória do bloqueio 3 em 1 a da morfina subaracnóidea em pacientes submetidos a cirurgias ortopédicas em membro inferior (MI. MÉTODO: Foram estudados 40 pacientes escalados para cirurgia ortopédica de MI, de ambos os sexos, estado físico ASA I e II, com idades entre 15 e 75 anos, distribuídos em 2 grupos (M e BPL. Foi realizada anestesia subaracnóidea em todos os pacientes, em L3-L4 ou L4-L5, com 20 mg de bupivacaína isobárica a 0,5%. No grupo M (n = 20 foi associado 50 µg de morfina ao anestésico local. No grupo BPL (n = 20 foi realizado o bloqueio 3 em 1 ao término da cirurgia, utilizando 200 mg de ropivacaína a 0,5%. Avaliou-se a analgesia e a intensidade da dor às 4, 8, 12, 14, 16, 20 e 24 horas após o término da cirurgia, o nível do bloqueio subaracnóideo, o tempo cirúrgico e as complicações. RESULTADOS: A duração da analgesia no grupo BPL foi de 13,1 ± 2,47, enquanto no grupo M todos os pacientes referiam dor e ausência de bloqueio motor no primeiro instante avaliado (4 horas. Houve falha do bloqueio de um dos 3 nervos em 3 pacientes. A incidência de náusea e prurido foi significativamente maior no grupo M. Quanto à retenção urinária, não houve diferença significante entre os grupos. Não houve depressão respiratória, hipotensão arterial ou bradicardia. A analgesia pós-operatória foi mais efetiva no grupo BPL, comparada ao grupo M às 4, 8, 12,14 e 16 horas. Às 20 e 24 horas não houve diferença significante entre os grupos. CONCLUSÕES: A analgesia pós-operatória proporcionada pelo bloqueio 3 em 1 apresentou efeitos colaterais inferiores à morfina subaracnóidea com tempo de analgesia semelhante.JUSTIFICATIVA Y OBJETIVOS: El bloqueo del plexo lumbar por el acceso

  15. Colgajo de trapecio extendido en reconstrucción de defectos causados por resección de tumores de cabeza y cuello Extended trapezius fasciomyocutaneous flap for reconstruction after head and neck tumoral resection

    Directory of Open Access Journals (Sweden)

    A.A. Leal Salazar

    2011-12-01

    Full Text Available Los defectos originados por la resección de tumores en cabeza y cuello pueden ser de difícil resolución. Presentamos un caso clínico en el que se practicó reconstrucción usando el colgajo fasciomusculocutáneo de trapecio extendido basado en la arteria dorsal escapular. Este colgajo puede alcanzar el cuello, la órbita y el vértex del cráneo; por lo tanto, puede ser de utilidad para el tratamiento de grandes defectos en estas áreas.Head and neck defects caused by tumoral resection could be a difficult task for a plastic surgeon. We present a clinical case of reconstruction using an extended trapezius myocutaneous flap based on dorsal scapular artery, in the occipital region. This flap can reach the neck, the orbit and the vertex of the head so it may be useful for treating large defects in these areas.

  16. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  17. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  18. Faloplastia mediante colgajo libre microquirúrgio antebraquial radial con doble tunelización: A propósito de un caso Microsurgical penile reconstruction with a radial forearm free-flap and double tubularization: Case report

    Directory of Open Access Journals (Sweden)

    M. Martín Díaz

    2011-06-01

    Full Text Available La reconstrucción del pene sigue siendo uno de los mayores retos de la Cirugía Plástica debido a la complejidad inherente que conlleva el conseguir tanto la forma anatómica como la función urológica del pene. El objetivo ideal del cirujano al realizar una faloplastia incluye la construcción, en una sola etapa, de un pene estéticamente aceptable y con sensibilidad erógena y táctil, que permita al paciente orinar de pie y mantener relaciones sexuales. La multitud existente de colgajos que pueden ser utilizados para la reconstrucción del pene sólo demuestra que ninguna de estas técnicas se considera ideal. Sin embargo, el colgajo radial es el que se utiliza más frecuentemente y es considerado universalmente como la técnica estándar. Las desventajas relativas de la misma son el número más elevado de fístulas que aparecen inicialmente, la cicatriz residual en el antebrazo y las complicaciones urológicas potenciales a largo plazo. Presentamos una reconstrucción de pene realizada mediante un colgajo libre radial antebraquial con un nuevo diseño geométrico bidimensional que permite la creación tridimensional de un neofalo con excelentes resultados estéticos.Reconstruction of penile defects remains one of the greatest challenges in Plastic Surgery because of the inherent complexity of restoring both the anatomical form and the urologic function of the penis. The surgeon's ideal goals in performing a phalloplasty include the construction, in one-stage procedure, of an aesthetic penis with erogenous and tactile sensation, which enables the patient to void while standing and to have sexual intercourse. The multitude of flaps used for phalloplasty only demonstrates that none of these techniques is considered ideal. Still, the radial forearm flap is the most frequently used one and universally considered as the standard technique. The relative disadvantages of this technique are the rather high number of initial fistulas, the residual

  19. Cirugía mínimamente invasiva de la hernia inguinal Minimally invasive surgery of the inguinal hernia

    Directory of Open Access Journals (Sweden)

    J. M. Olea

    2005-01-01

    Full Text Available El abordaje mínimamente invasivo de la hernia inguinal presenta ventajas respecto a los abordajes convencionales anteriores en las hernias inguinales bilaterales y recurrentes, si bien los resultados iniciales fueron malos, se sumaron nuevos problemas derivados del abordaje laparoscópico. El objetivo de este artículo es describir la técnica quirúrgica y analizar los resultados preliminares de nuestra serie de 600 hernioplastias totalmente extraperitoneales realizadas en la Clínica Universitaria de Navarra. La complicación intraoperatoria más frecuente (25,7% fue la apertura accidental del peritoneo. No hubo complicaciones intrabdominales asociadas. En el seguimiento hubo 9 (1,5% recidivas y 13 reintervenciones. Once (1,8% pacientes desarrollaron dolor neuropático transitorio en el territorio del fémoro-cutáneo. En nuestra experiencia el abordaje totalmente extraperitoneal es una técnica especialmente indicada en hernias recidivadas y bilaterales. Las ventajas presentes en cuanto a dolor y disconfort postoperatorio, recuperación de la actividad física y laboral, y los buenos resultados en cuanto a recidivas y dolor neuropático nos animan a indicarla no sólo en las hernias inguinales recidivadas o bilaterales sino en las primarias.The minimally invasive approach to the inguinal hernia shows advantages with respect to previous conventional approaches in bilateral and recurrent inguinal hernias; while the initial results were bad, new problems were added deriving from the laparoscopic approach. The aim of this article is to describe the surgical technique and analyse the preliminary results of our series of 600 totally extra-peritoneal hernioplasties, performed at the University Clinic of Navarra. The most frequent complication (25.7% was the accidental rupture of the peritonea. There were no associated intra-abdominal complications. In the follow-up there were 9 relapses (1.5% and 13 reinterventions. Eleven (1.8% of the patients

  20. Reconstrucción mamaria con colgajo recto abdominal: reporte de primeros 15 casos

    Directory of Open Access Journals (Sweden)

    Gustavo Chavarría-León

    2002-03-01

    Full Text Available Las opciones terapéuticas y reconstructivas disponibles hoy en día para las mujeres con cáncer mamario son numerosas. De los métodos disponibles para la reconstrucción mamaria autóloga el colgajo recto abdominal ha sido el más popular. Es un colgajo que incluye la piel, el tejido graso y el músculo recto abdominal, este conjunto es llevado con su irrigación de la arteria epigástrica superior hasta el defecto de la mastectomía, en el tórax. El colgajo recto abdominal (TRAM ha sido calificado por algunos líderes en el campo de la Cirugía Plástica como el procedimiento más ingenioso realizado en esta especialidad. Entre abril de 1999 y diciembre 2000 realizamos 15 reconstrucciones mamarias utilizando el TRAM. La reconstrucción fue unilateral en catorce casos y bilateral en un caso. En trece pacientes se utilizó un pedículo contralateral y en dos el pedículo fue ipsilateral. Como complicaciones tuvimos dos hernias abdominales, una necrosis grasa parcial y un hematoma, todas fueron resueltas satisfactoriamente. La reconstrucción inmediata ofrece ventajas sobre la reconstrucción retardada . En nuestro país podemos realizar tanto la reconstrucción retardada como inmediata y en los equipos de trabajo (oncólogos, cirujanos generales, cirujanos plásticos, psiquiatras, etc se debe fomentar la reconstrucción inmediata.

  1. Pain characteristics after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Strandfelt, Pernille; Rosenberg, Jacob;

    2011-01-01

    Previous studies have shown different pain characteristics in different types of laparoscopic operations, but pain pattern has not been studied in detail after laparoscopic inguinal hernia repair. To optimise preoperative patient information and postoperative analgesic treatment the present study...

  2. Giant right groin lipoma mimicking inguinal hernia

    Directory of Open Access Journals (Sweden)

    Igor Gerych

    2015-01-01

    Conclusion: Lipoma in the groin may be treated as inguinal hernia. Thus, for the accurate verification of correct diagnosis, it is necessary to perform a follow-up examination involving computer tomography (CT and nuclear magnetic resonance imaging (NMRI.

  3. Planned inguinal herniorrhaphy but no hernia sac?

    DEFF Research Database (Denmark)

    Jensen, P; Bay-Nielsen, M; Kehlet, H

    2004-01-01

    Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention.......Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention....

  4. Chronic pain after inguinal hernia repair

    OpenAIRE

    2008-01-01

    : BACKGROUND: Chronic post herniorrhaphy groin pain is defined as pain lasting > 6 months after surgery, which is one of the most important complication occurring after inguinal hernia repair, occurs with greater frequency than previously thought. Chronic groin pain is one of the most significant complications following inguinal hernia repair, and majority of chronic pain has been attributed to ilioinguinal nerve entrapment. Various other factors are involved in development of...

  5. Chronic Pain after Inguinal Hernia Repair

    OpenAIRE

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of ...

  6. Retroperitoneal liposarcoma presenting a indirect inguinal hernia.

    Directory of Open Access Journals (Sweden)

    Noguchi H

    2001-02-01

    Full Text Available A 60-year-old man was admitted to our hospital with a right inguinal swelling that had been growing in size without any pain for 7 months. We diagnosed the growth as a right inguinal hernia and operated on him. The growth, however, was found to be a tumor it situated along the spermatic cord and testicular vessels. We diagnosed it as a lipoma. The tumor was resected near part of the internal inguinal ring. Histopathological diagnosis showed well-differentiated liposarcoma of the sclerosing type. Postoperative computed tomography (CT revealed a large residual tumor in the retroperitoneum. We believed that the tumor was a retroperitoneal liposarcoma and that it developed in the inguinal region. The residue of the liposarcoma was resected onto the right inguinal tract. A periodic follow up has been performed and no evidence of recurrence or metastasis has been seen in the 4 years and 9 months since the second surgery. No adjuvant therapy was performed. Inguinal liposarcomas are relatively rare and in most cases these tumors are thought to originate in the spermatic cord. The origin of the tumor is believed to be the retroperitoneum.

  7. Reconstrucción de partes blandas de la planta del pie: Retrospective analysis of 12 patients

    OpenAIRE

    2010-01-01

    Se presenta una casuística de 12 pacientes que requirieron reconstrucción de la planta del pie en el Hospital de la Universidad Católica entre los años 2005 y 2008. La etiología principal fueron lesiones tumorales en 7 casos; las técnicas de reconstrucción fueron: injerto de piel (1 paciente), colgajos locales (8 pacientes) y colgajos libres (3 pacientes). Hubo complicaciones en 5 pacientes, uno de los cuales requirió una nueva cirugía reconstructiva. La recuperación funcional fue adecuada en...

  8. Planificación preoperatoria de los colgajos de perforantes Preoperative planning on perforator flaps

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    J Masià

    2006-12-01

    Full Text Available La valoración preoperatoria precisa de la anatomía vascular es altamente valiosa para conseguir la mejor planificación quirúrgica y poder realizar colgajos de perforantes de una forma más rápida y segura. La localización de la mejor perforante y la valoración de su trayecto hasta el vaso origen es esencial para definir la perforante ideal para nuestro colgajo. Por tanto, después de estudiar el tipo de defecto a reconstruir, el punto clave será el encontrar una perforante con un flujo sanguíneo adecuado, una localización apropiada y una disección sencilla.An accurate preoperative evaluation of the vascular anatomy is extremely valuable in improving the surgical strategy in perforator flaps and performing safer and faster procedures. The placement of the best perforators and the assessment of their course to the source vessel is essential to define the ideal perforator for our chosen flap. Therefore, after assessing the quality and the dimensions of the soft tissue requirements, the key step in the surgical planning is to find a perforator with a good blood supply, a suitable location inside our flap and an easy dissection route.

  9. Irreducible Inguinal Hernias in the Paediatric Age Group | Ezomike ...

    African Journals Online (AJOL)

    Irreducible Inguinal Hernias in the Paediatric Age Group. ... Nigerian Journal of Medicine ... Irreducibility is an ever present risk in untreated inguinal hernias and its management remains an important part of pediatric surgery practice. When a ...

  10. Giant recurrent retroperitoneal liposarcoma presenting as a recurrent inguinal hernia

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    Ajay H. Bhandarwar

    2011-11-01

    Full Text Available Retroperitoneal liposarcoma presenting as an inguinal hernia is a rare entity. We present the first case of Giant recurrent liposarcoma presenting as a recurrent inguinal hernia in a 40-year-old male. Physical examination showed an irreducible lump in the right inguinal region and a scar in the right lumbar and right inguinal region. Computed tomography (CT scan of abdomen revealed it to be a retro peritoneal mass extending into the right inguinal region along and involving the cord structures. Wide local excision of the tumour with right orchidectomy and inguinal hernioplasty was performed. Histo-pathology confirmed it to be a liposarcoma. Patient received postoperative radio therapy. Follow up of two years has shown him to be disease free. Retroperitoneal liposarcoma can grow along cord structures into the inguinal canal and mimic an irreducible indirect inguinal hernia.

  11. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  12. Lidocaine Patch (5%) in Treatment of Persistent Inguinal Postherniorrhaphy Pain

    DEFF Research Database (Denmark)

    Bischoff, Joakim M; Petersen, Marian; Uçeyler, Nurcan;

    2013-01-01

    Evidence-based pharmacological treatment options for patients with persistent inguinal postherniorrhaphy pain are lacking.......Evidence-based pharmacological treatment options for patients with persistent inguinal postherniorrhaphy pain are lacking....

  13. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  14. Hernioplastia inguinal de Rutkow y Robbins, sin recurrencias Rutkow y Robbins' inguinal hernioplasty without recurrences

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    Bárbaro de Armas Pérez

    2008-06-01

    Full Text Available INTRODUCCIÓN. La universalización del uso de las bioprótesis y sus actuales pioneros Lichtenstein, Gilbert, Rutkow y Robbins, están logrando vencer lo que hasta hoy ha sido el fantasma de la cirugía herniaria: las recurrencias. Las técnicas a base de tapón de malla ya tienen más de 20 años de evaluación y son ampliamente aceptadas por la mayoría de los cirujanos. MÉTODOS. Se estudiaron 34 pacientes afectos de hernia inguinal a los cuales se les realizó hernioplastia de Rutkow y Robbins entre enero del 2001 y diciembre del 2004. Con el objetivo de determinar la efectividad de dicha técnica, se analizaron las variables: edad, sexo, lado y variedad de hernia, tiempo de hospitalización y anestesia, material protésico utilizado, complicaciones posoperatorias y recurrencias. RESULTADOS. La muestra estuvo constituida mayormente por hombres, con un promedio de edad de 56 años. Predominaron las hernias del lado derecho, de los tipos 2 y 3 según la clasificación de Gilbert modificada por Rutkow y Robbins, de etiología primaria en el 82,35 % de los casos. El 79,41 % de los pacientes se operó de forma ambulatoria, mayormente con anestesia espinal y el material protésico más empleado fue el polipropileno. El índice de complicaciones fue del 14,74 % y hasta la fecha no han existido recurrencias. CONCLUSIONES. Los resultados obtenidos con la técnica de Rutkow y Robbins son alentadores, con baja morbilidad y sin recurrencias.INTRODUCTION. The universalization of the use of bioprostheses and its pioneers Lichtenstein, Gilbert, Rutkow and Robbins are being able to overcome what has been the ghost of hernial surgery: recurrences. The techniques based on mesh plug have been evaluated for more than 20 years and are widely accepted by most of the surgeons. METHODS. 334 patients with inguinal hernia that had undergone Rutkow y Robbins' hernioplasty from January 2001 to December 2004 were studied. The following variables were analyzed in order

  15. Amyad's hernia while reparing the bilateral inguinal hernia

    OpenAIRE

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  16. Amyad's hernia while reparing the bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Arif Aslaner

    2015-01-01

    Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  17. Amyad's hernia while reparing the bilateral inguinal hernia

    OpenAIRE

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  18. Bases anatómicas vasculares de los colgajos perforantes cutáneos Vascular anatomical basis of perforator skin flaps

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    S. Morris

    2006-12-01

    Full Text Available En las ultimas dos décadas, el uso de colgajos perforantes musculocutaneos se ha incrementado a medida que los microcirujanos se han familiarizado con la técnica y estos colgajos se han convertido en una parte de la evolución de la Microcirugía. Como se basan en perforantes musculocutaneas o septocutaneas individuales, el microcirujano reconstructivodebe tener la información anatómica detallada para planificar la transferencia de colgajos perforantes. El fin de este trabajo es la revisión de las diversas técnicas angiográficas disponibles para estudiar la anatomía vascular del cuerpo humano y presentar nuestra técnica habitual de inyección vascular. Exhibiremos ejemplos ilustrativos utilizando la técnica de la inyección de gelatina de oxido de plomo para visualizar la anatomía relevante de los sitios donantes de colgajos perforantes. La técnica de la inyección de gelatina de óxido descrita por Salmon y Rees y Taylor, puede ser utilizada para inyecciones arteriales o venosas, pero la hemos utilizado primariamente para inyección arterial. Los pasos para la inyección se describen detalladamente en el trabajo. En los pasados 5 años hemos disecado un total de 21 cadáveres frescos tras estudios de inyección arterial de gelatina de oxido de plomo. Se han revisado un total de 7000 radiografías. Presentamos los resultados de la búsqueda anatómica en las áreas de cabeza, cuello, miembros superiores, torso y miembros inferiores. La técnica de la inyección de gelatina de oxido de plomo es simple y económica a su vez; la técnica de análisis computarizado es barata y las técnicas de análisis informático son directas y proveen excelente visualización de la arquitectura de la piel humana. Los delicados detalles identificados utilizando esta técnica de inyección proveen información útil a los cirujanos para planificar transferencias de piel, músculo, hueso y nervio, y por tanto favorecen nuestra comprensión de la anatom

  19. Diagnosis of an Inguinal Hernia after a Blunt Inguinal Trauma with an Intestinal Perforation

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    Farès Moustafa

    2014-01-01

    Full Text Available Introduction. Inguinal hernias are very common in men. A clinical exam can do the diagnosis easily. But bowel perforation inside an inguinal hernia caused by a directly blunt trauma is rare and can have important consequences. Up to now, there have been a few case reports that described blunt injury to the inguinal area causing traumatic perforation of the bowel in the inguinal hernia. Case Report. We present a case of a 45-year-old Eastern European man with a small perforation of ileal bowels and a peritonitis after direct blunt trauma to the inguinal hernia region, with no inguinal hernia known by the patient, and show how the diagnosis can be difficult. Conclusion. This case shows that external forces, that may seem too trivial to cause intraperitoneal injury, can cause significant injury when applied to a patient with a hernia and shows how a careful examination, with the help of an abdominal CT scan, is important even if the patient do not seem to have an inguinal hernia.

  20. Rare Presentation of Inguinal Hernia in a Female Infant

    Directory of Open Access Journals (Sweden)

    B. Alami

    2015-06-01

    Full Text Available We report a case of a 1 month female presented with a 4 cm irreducible left inguinal mass, Birth history was unremarkable. Ultrasonography of the left inguinal region showed the ovary with peripheral follicles and the uterus that passed through the left inguinal canal. There were no abdominal abnormalities.

  1. Colgajo de piel en isla con pedículo fasciocutáneo para cuello: caso clínico Island skin flap with fasciocutaneous pedicle for neck reconstruction: case report

    Directory of Open Access Journals (Sweden)

    J.L. Ramón Vera

    2009-06-01

    Full Text Available Los defectos por falta de piel o las secuelas de quemaduras a nivel del cuello presentan gran dificultad de cobertura debido a la escasez de tejidos locales útiles para corregirlos, ya que debemos dar una solución a las graves alteraciones funcionales y estéticas que producen, con un mínimo de secuelas. Presentamos un caso clínico con graves secuelas de quemaduras en cuello que producían retracción importante y que fue resuelto con un colgajo de piel en isla con pedículo fasciosubcutáneo tomado de región subclavicular. Este colgajo presenta irrigación cutánea por medio de arterias cutáneas directas provenientes de la arteria mamaria interna y brinda la oportunidad de solucionar alteraciones a nivel del cuello con gran facilidad para su realización y con mínimas secuelas en la zona donante.Cutaneous defects or burn sequels at the neck level present difficult of covering, due to the poor local tissues, although we should give a solution to the serious functional and aesthetic alterations with minimal sequels. We present a clinical case with burn sequels of the neck that produced important retraction and that was solved whit an island fasciocutaneous pedicle flap from subclavicular region. This flap has skin irrigation supported by the cutaneous arteries coming from the internal mammary artery and gives us the opportunity to solve these alterations at the neck level in an easy way and with minimal sequels in the donor area.

  2. Colgajo submental para reconstrucción de defectos oncológicos en cabeza y cuello Submental flap to reconstruct oncologic head and neck defects

    Directory of Open Access Journals (Sweden)

    J. Brunsó Casellas

    2009-08-01

    Full Text Available El colgajo submental es un procedimiento eficaz para la reconstrucción en el territorio maxilofacial. Caracterizado por su delgadez, versatilidad, excelente color y textura y mínima morbilidad en la zona donante, su utilización en lesiones malignas es controvertida, por el riesgo de trasladar enfermedad metastásica cervical a la zona receptora. Material y métodos: Se presentan 3 casos clínicos en los que se ha aplicado en pacientes afectos de un carcinoma epidermoide de cabeza y cuello. Describimos las particularidades anatómicas, y se realiza una revisión de la técnica quirúrgica. Resultados: Fueron óptimos en cuanto a cobertura del defecto, estética y función salvo por una necrosis parcial en uno de ellos. En todos los casos la morbilidad en la zona donante fue mínima. Conclusiones: El colgajo submental es una opción a considerar incluso en pacientes oncológicos sobre todo en los que, por edad avanzada o presentar patología asociada no están indicados procedimientos más agresivos.The submental flap is an effective option for the reconstruction in the maxillofacial territory. Characterized by its thinness, versatility, excellent colour and texture and minimum morbidity in the donor zone, its use in malignant injuries is controverted by the risk of transferring cervical metastasic disease to the receiving zone. Material and methods: we present 3 clinical cases in which it has been used in patients affected by an squamous cell carcinoma of head and neck. In addition, the anatomical particularities are described, and a revision of the surgical technique is made. Results: They were optimal in relation to covering of the defect, aesthetics and function except for a partial necrosis in one of them. In all the cases the morbidity in the donor zone was minimum. Conclusions: The submental flap is an option to consider in oncologic patients, mainly in those whom by advanced age or by the existence of comorbidity advice against the use

  3. Síndrome de Dolor Inguinal Crónico (SDIC)

    OpenAIRE

    2009-01-01

    El Síndrome de Dolor Inguinal Crónico (SDIC) ha sido un hallazgo frecuente en el Centro de Cirugía Mayor Ambulatoria de las Hernias del CRS Cordillera. Presentamos un estudio observacional descriptivo del SDIC, basado en la información contenida en las fichas clínicas en un período de 7 años. Se estudiaron los síntomas, el examen físico de la región inguinal, de la columna vertebral, de la inervación de la zona y de la articulación coxofemoral. El cuadro clínico afectó a 150 pacientes, 87 var...

  4. Pain related sexual dysfunction after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Møhl, Bo; Bay-Nielsen, Morten

    2006-01-01

    To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation......, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18-40 years undergoing inguinal herniorrhaphy between October...... 2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224...

  5. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    a learning curve of about 50-100 cases and decreases chronic pain, but slightly increases the risk of serious complications compared with open mesh repairs. Therefore, a simpler kind of operation is needed. The ONSTEP technique is a possible solution to this problem. The objective of the present randomised......INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  6. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...... of long-term complications such as persisting pain and impairment of sexual function. The Onstep approach is a newer type of groin hernia repair with promising preliminary results in terms of very few cases of chronic pain and recurrences. This protocol describes a randomised clinical trial the objective...... of which is to evaluate chronic pain and sexual dysfunction after inguinal hernia repair using the Lichtenstein repair compared with the Onstep approach....

  7. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... a learning curve of about 50-100 cases and decreases chronic pain, but slightly increases the risk of serious complications compared with open mesh repairs. Therefore, a simpler kind of operation is needed. The ONSTEP technique is a possible solution to this problem. The objective of the present randomised...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  8. Management of persistent postsurgical inguinal pain

    DEFF Research Database (Denmark)

    Werner, Mads U

    2014-01-01

    PURPOSE: Severe persistent pain is a major postsurgical complication affecting 2-4 % of patients following inguinal hernia repair and may cause critical physical and socioeconomic disability. This review introduces relevant criteria and analyses the current evidence base underlying recommended...... management strategies. RESULTS: Development of persistent postsurgical pain (PPP) following inguinal hernia repair cannot automatically be considered to follow a simple trajectory from acute to chronic pain. Surgical management comprising neurectomy with or without meshectomy was described in 25 studies...... patients with severe PPP following inguinal hernia repair. The evidence base for other management methods is still fragile, although promising results appear in the neuromodulation studies. CONCLUSIONS: There is a need for improved study designs and, launching of large multicenter collaborative studies...

  9. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...... of which is to evaluate chronic pain and sexual dysfunction after inguinal hernia repair using the Lichtenstein repair compared with the Onstep approach....... of long-term complications such as persisting pain and impairment of sexual function. The Onstep approach is a newer type of groin hernia repair with promising preliminary results in terms of very few cases of chronic pain and recurrences. This protocol describes a randomised clinical trial the objective...

  10. Tratamiento de lesión cervical no cariosa y recesión gingival a través de colgajo posicionado coronalmente

    Directory of Open Access Journals (Sweden)

    I.A. Juárez Membreño

    Full Text Available El caso que se desarrolla a continuación, tiene por objetivo mostrar el resultado clínico de un paciente con biotipo gingival grueso, que fue sometido a cirugía periodontal, utilizando la técnica de colgajo posicionado coronalmente (CPC en el tratamiento de una lesión cervical no cariosa y recesión gingival individual en el sector anterosuperior. Un clínico no debe olvidar que cada caso es diferente, por tanto, es necesario evaluar las dimensiones y espesor del tejido periodontal, el tipo y tamaño de la recesión gingival, especialmente cuando se encuentra presente una lesión cervical no cariosa. En vista de los resultados, consideramos que el CPC, en biotipos gingivales gruesos, es efectivo para proporcionar una reducción significativa de la recesión individual en el sector anterosuperior y el tratamiento de lesión cervical no cariosa a corto plazo.

  11. Reconstrucción mamaria con colgajo recto abdominal: reporte de primeros 15 casos

    Directory of Open Access Journals (Sweden)

    Gustavo Chavarría-León

    2002-03-01

    Full Text Available Las opciones terapéuticas y reconstructivas disponibles hoy en día para las mujeres con cáncer mamario son numerosas. De los métodos disponibles para la reconstrucción mamaria autóloga el colgajo recto abdominal ha sido el más popular. Es un colgajo que incluye la piel, el tejido graso y el músculo recto abdominal, este conjunto es llevado con su irrigación de la arteria epigástrica superior hasta el defecto de la mastectomía, en el tórax. El colgajo recto abdominal (TRAM ha sido calificado por algunos líderes en el campo de la Cirugía Plástica como el procedimiento más ingenioso realizado en esta especialidad. Entre abril de 1999 y diciembre 2000 realizamos 15 reconstrucciones mamarias utilizando el TRAM. La reconstrucción fue unilateral en catorce casos y bilateral en un caso. En trece pacientes se utilizó un pedículo contralateral y en dos el pedículo fue ipsilateral. Como complicaciones tuvimos dos hernias abdominales, una necrosis grasa parcial y un hematoma, todas fueron resueltas satisfactoriamente. La reconstrucción inmediata ofrece ventajas sobre la reconstrucción retardada . En nuestro país podemos realizar tanto la reconstrucción retardada como inmediata y en los equipos de trabajo (oncólogos, cirujanos generales, cirujanos plásticos, psiquiatras, etc se debe fomentar la reconstrucción inmediata.Today, the therapeutic and reconstructive options for mastectomized women are numerous. Of the different methods for autologous breast reconstruction, the transversus rectus abdominis muscle "TRAM" flap has been the most popular. The flap includes skin, subcutancous tissue and the rectus abdominis muscle. This flap irrigated by the superior epigastric artery is taken lo the mastectomy defect in the thorax.. From April 1999 to December 2000 we performed 15 breast reconstructions using the rectus abdominis flap. The reconstruction was unilateral in fourteen cases and bilateral in one. In thirteen patients we utilized a

  12. Cirugía mínimamente invasiva de la hernia inguinal

    OpenAIRE

    Olea, J.; Diaz-Caballero, A. (A.); Vicens, C. (C.); Cuadrado, A.; Valenti, V; Pastor, C.

    2005-01-01

    El abordaje mínimamente invasivo de la hernia inguinal presenta ventajas respecto a los abordajes convencionales anteriores en las hernias inguinales bilaterales y recurrentes, si bien los resultados iniciales fueron malos, se sumaron nuevos problemas derivados del abordaje laparoscópico. El objetivo de este artículo es describir la técnica quirúrgica y analizar los resultados preliminares de nuestra serie de 600 hernioplastias totalmente extraperitoneales realizada...

  13. INGUINAL HERNIOPLASTY IN ELDERLY PATIENTS UNDER LOCAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-05-01

    Full Text Available OBJECTIVE: To evaluate the feasibility and safety of inguinal hernioplasty under local anesthesia in elderly patients with significant comorbidity. METHODS: A prospective study of 68 patients requiring inguinal mesh hernioplasty for inguinal hernia was carried. One group comprising 34 patients under 60 years of age underwent inguinal mesh hernioplasty while the other group comprising 34 patients over 60 years of age. The comorbid conditions and complications were compared between both groups. RESULTS: Inguinal mesh hernioplasty in elderly patients is more likely associated with comorbid conditions than younger patients in terms of hypertension, chronic obstructive pulmonary disease, cardiovascular diseases, benign prostatic hyperplasia etc. CONCLUSION: Elective inguinal mesh hernioplasty under local anesthesia has good results in elderly patients with significant comorbidities. Inguinal mesh hernioplasty under local anesthesia is safe and results in good success rate in elderly patients with significant comorbidities

  14. Direct inguinal hernias and anterior surgical approach are risk factors for female inguinal hernia recurrences.

    Science.gov (United States)

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian; Bisgaard, Thue; Rosenberg, Jacob

    2014-01-01

    The purpose of this study was to establish the risk of recurrence after direct and indirect inguinal hernia operation in a large-scale female population and to establish the relationship between the type of hernia at the primary and recurrent procedure. Using data from the Danish Hernia Database (DHDB), a cohort was generated: all females operated on electively for a primary inguinal hernia by either Lichtenstein’s technique or laparoscopy from 1998 to 2012. Within this prospectively collected cohort, the hernia type at the primary procedure (direct inguinal hernia (DIH), indirect inguinal hernia (IIH), combination hernia), the hernia type at the recurrent procedure (DIH, IIH, combination hernia, femoral hernia), anesthesia type, and time from primary procedure to reoperation were registered. A total of 5,893 females with primary elective inguinal hernia operation on in the study period (61 % IIH, 37 % DIH, 2 % combined hernias) were included with a median follow-up time of 72 months (range 0 to 169). A total of 305 operations for suspected recurrences were registered (61 % inguinal recurrences, 38 % femoral recurrences, 1 % no hernias), which corresponded to an overall reoperation rate of 5.2 %. All femoral recurrences occurred after a previous open anterior operation. The crude reoperation rate after primary DIH operation was 11.0 %, 3.0 % after primary IIH operation and 0.007 % after combined hernia operation (p hernia recurrences exclusively existed after anterior open primary operation.

  15. The Onstep Method for Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Andresen, Kristoffer

    2016-01-01

    Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique...

  16. Herniographic appearance of the lateral inguinal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kesek, P.

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do.

  17. New Clinical Concepts in Inguinal Hernia

    NARCIS (Netherlands)

    R.N. Veen, van (Ruben Nico)

    2008-01-01

    textabstractHernia surgery is one of the earliest forms of surgery and currently the most frequently performed operation in general surgery. Relatively modest improvements of clinical outcomes or savings of resource use in inguinal hernia repair would already have a signifi cant medical and economic

  18. Inguinal Hernia Surgery: a patient centered approach

    NARCIS (Netherlands)

    H.R. Langeveld-Benders (Hester)

    2014-01-01

    markdownabstract__Abstract__ The introduction of surgical mesh to create a tension free repair in inguinal hernia surgery in the 1990s, was quickly implemented worldwide, because recurrence rates dropped dramatically. Debate on the best surgical approach for this tension-free mesh repair is ongoing

  19. Pain characteristics after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Strandfelt, Pernille; Rosenberg, Jacob;

    2011-01-01

    Previous studies have shown different pain characteristics in different types of laparoscopic operations, but pain pattern has not been studied in detail after laparoscopic inguinal hernia repair. To optimise preoperative patient information and postoperative analgesic treatment the present study...... investigated postoperative pain in terms of time course, pain intensity and individual pain components during the first 4 days after transabdominal preperitoneal hernia repair (TAPP)....

  20. Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair.

    Science.gov (United States)

    Putnis, Soni; Wong, April; Berney, Christophe

    2011-12-01

    During totally extraperitoneal (TEP) endoscopic repair of inguinal hernias, it is possible to see the internal opening of the femoral canal. The aim of our study was to determine the incidence of synchronous femoral hernias found in patients undergoing TEP endoscopic inguinal hernia repair. This was a retrospective review of prospectively collected data on 362 consecutive patients who underwent 484 TEP endoscopic inguinal hernia repairs during a 5-year period, May 2005 to May 2010. During surgery, both inguinal and femoral canal orifices were routinely inspected. The presence of unilateral or bilateral inguinal and femoral hernias was recorded and repaired accordingly. There were a total of 362 patients. More males (343, 95%) underwent a TEP hernia repair than females (19, 5%). There were more cases of unilateral (240/362, 66%) than bilateral (122/362, 34%) inguinal hernias. A total of 18 cases of synchronous femoral hernias were found during operation. There was a higher incidence of femoral hernia in females (7/19, 37%) compared to males (11/343, 3%) (P hernias were clinically detectable preoperatively. Females undergoing elective inguinal hernia repair are more likely to have a synchronous femoral hernia than males. We suggest that all women presenting with an inguinal hernia also have a formal assessment of the femoral canal. TEP endoscopic inguinal hernia repair is an ideal approach as both inguinal and femoral orifices can be assessed and hernias repaired simultaneously during surgery.

  1. Tratamiento local de metástasis cutánea facial de cáncer de colon mediante colgajo submentoniano Local management of colon carcinoma metasasis in the face with a submental flap

    Directory of Open Access Journals (Sweden)

    A. Acosta Arencibia

    2010-12-01

    Full Text Available Las metástasis cutáneas de los tumores del aparato digestivo son lesiones infrecuentes que aparecen en pacientes con estadíos avanzados de la enfermedad, frecuentemente ya intervenidos del tumor primario. Son lesiones que aparecen de novo, de características variables y crecimiento rápido; suelen localizarse en tronco o extremidades inferiores y se diagnostican precozmente, lo que hace fácil su extirpación y el cierre directo del defecto. Presentamos el caso de un paciente con cáncer de colon en estadío avanzado con lesión metastásica facial de 6 cm de diámetro en mejilla derecha. Esta lesión ulcerada y maloliente, precisaba curas diarias y empeoraba la calidad de vida del paciente. Se procedió a su extirpación y para cobertura realizamos un colgajo submentoniano ipsilateral con excelente resultado. Este colgajo proporciona un tejido muy parecido al del defecto, creando mínimas secuelas de la zona donante que queda oculta en el área de sombra submandibular, por lo que representa una alternativa terapéutica ideal en defectos faciales de tamaño medio.Cutaneous metastasis of the digestive tract are infrequent lesions appearing in patients with advanced disease. Most of these patients have been already operated of their primary tumour. Lesions are variable in aspect, arising de novo and evolving with rapid growth. They usually lie in the trunk or lower extremities thus facilitating an early diagnosis and management with simple extirpation and direct closure. A case-report of a patient with advanced colonic cancer is here presented. At admission he presented a cutaneous matastasic lesion in the right cheek; it was a 6 cm ulcerated, bad -smelling lesion which needed daily dressings affecting patient's normal life. The lesion was removed using successfully a submental flap as coverage. The submental flap provides a very similar tissue to facial defects, leaving no donor area sequelae which is in addition well hidden, being

  2. Empalamiento inguinal. Presentación de dos casos clínicos

    OpenAIRE

    Carlos Baeza-Herrera; Ulises Darío Medellín-Sierra; Salomón T. Domínguez-Pérez; José Luis Atzín-Fuentes; Luis Manuel García-Cabello

    2008-01-01

    Introducción: Las lesiones traumáticas del canal inguinal en niños son relativamente raras, y las ocasionadas por mecanismos como el empalamiento lo son aún más. El propósito al presentar nuestra experiencia es mostrar el curso clínico observado. Casos clínicos: Fueron estudiados dos menores de 13 y 7 años de edad que sufrieron caída y en quienes en la exploración física se encontró encajamiento de palo de escoba y varilla metálica, respectivamente, en canal inguinal. La operación mostró ause...

  3. Defective anterior wall of inguinal canal and its role in the pathophysiology of direct inguinal hernias

    Directory of Open Access Journals (Sweden)

    Abdolvahabi SA

    2002-06-01

    Full Text Available Regrding pathophysiology of direct inguinal hernias the following are pointed our:1-Absence of contribution of fascia of transverses abdominis muscle along with fascia transversalis in making posterior wall of the inguinal canal causing defect point in Hesselbachs triangle.2- Defects in protectin mechanisms of the inguinal canal such as: I shutter like effect of the arch of internal oblique and transverses abdominis muscles. ii Sphincter like effect of fascia of oblique muscle (anterior wall of canl.During several years of observation and practice in the field of surgical repair of hernias, a new phenomenon was observed regarding the etiology of direct hernias.Evaluation of superficial ring and Ant. Wall of inguinal canal in 25 patients showed that the ant. Wall was not perfect and the defect was seen as a spectrum of moderate defect to complete absence of the wall. This phenomenon may be a newly observed mechanism in pathology of direct inguinal hernia that might help the operative repair. Taking this into account, i.e. repair of this defect, might help the classic herniorrhaphy techniques

  4. Ureteral inguinal hernia: an uncommon trap for general surgeons

    Science.gov (United States)

    Yahya, Zarif; Al-habbal, Yahya; Hassen, Sayed

    2017-01-01

    Inguinal hernias involving the ureter, a retroperitoneal structure, is an uncommon phenomenon. It can occur with or without obstructive uropathy, the latter posing a trap for the unassuming general surgeon performing a routine inguinal hernia repair. Ureteral inguinal hernia should be included as a differential when a clinical inguinal hernia is diagnosed concurrently with unexplained hydronephrosis, renal failure or urinary tract infection particularly in a male. The present case describes a patient with a known ureteroinguinal hernia who proceeded to having a planned hernia repair and ureteric protection. The case is a reminder that when faced with an unexpected finding such an indirect sliding inguinal hernia, extreme care should be taken to ensure that no structures are inadvertently damaged and that a rare possibility is the entrapment of the ureter in the inguinal canal. PMID:28275027

  5. Sliding inguinal hernia is a risk factor for recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Bisgaard, Thue; Rosenberg, Jacob

    2015-01-01

    PURPOSE: A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder. Thus, repair of a sliding inguinal hernia may have higher risk of complications and recurrence compared with non-sliding inguinal hernia. The aim...... of this study was to investigate the incidence and reoperation rates following sliding inguinal hernia repair. METHODS: This study was based on data from the Danish Hernia Database covering the period between January 1, 1998 and February 22, 2012. Data were collected prospectively and nationwide. RESULTS......: In total, 70,091 primary hernia repairs were included for analysis. The occurrence of sliding inguinal hernias of the total group of included hernia repairs was 9.4 % among males and 2.9 % among females (p inguinal hernias had a higher cumulated reoperation rate...

  6. Left-sided omental torsion with inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    Yasumitsu Hirano; Kaeko Oyama; Hiroshi Nozawa; Takuo Hara; Koichi Nakada; Masahiro Hada; Takeshi Takagi; Makoto Hirano

    2006-01-01

    We report a case of surgically proved left-sided torsion of the greater omentum that caused secondary by untreated inguinal hernia. Case A 36-year-old man presented to our hospital with abdominal pain. He had been diagnosed with a left inguinal hernia, but he had not received any treatments. Contrast-enhanced computed tomography (CT) of the abdomen showed a large fat density mass below the Sigmoid colon and left inguinal hernia with incarcerated fat. Exploratory laparotomy revealed torsion of the greater omentum with small bloody ascites. The greater omentum was twisted into one and a half circles and entered into a left inguinal hernia. An omentectomy with a repair of left inguinal hernia was performed. A resected omentum was submitted for pathological examination, which showed hemorrhagic infarction. Omental torsion is a rare cause of acute abdominal pain but should be included in the differential diagnoses of acute abdomen, especially in patients with untreated inguinal hernia.

  7. Noninvasive Inguinal Approach for Cryptorchidectomy in Thirty-eight Stallions

    Science.gov (United States)

    Arighi, Mimi; Horney, J. Donald; Bosu, William T. K.

    1988-01-01

    We describe the results of the noninvasive inguinal approach in 38 cases of cryptorchidism. Whether the retained testis was intra-abdominal or in the inguinal canal, this technique was found to be an easy, reliable method of locating abdominal and inguinal testes through a normal body opening. No postoperative complications were recorded in this series of cases and the postoperative rest period was minimal. PMID:17423023

  8. Surgical approach for recurrent inguinal hernias

    DEFF Research Database (Denmark)

    Öberg, S; Andresen, K; Rosenberg, J

    2016-01-01

    Purpose: Guidelines recommend that the reoperation of a recurrent inguinal hernia should be by the opposite approach (anterior–posterior) than the primary repair. However, the level of evidence supporting the guidelines is partially low. The purpose of this study was to compare re-reoperation rates...... between repairs performed according to the guidelines with the ones performed against it. Methods: This cohort study was based on the Danish Hernia Database, including 4344 patients with two inguinal hernia repairs in the same groin. Four groups were compared as follows: Lichtenstein–Lichtenstein vs......-reoperation for Lichtenstein–Lichtenstein was only seen if the primary hernia was medial. Conclusions: A primary Lichtenstein repair of a primary medial hernia should be reoperated with a laparoscopic repair. A primary Lichtenstein repair of a primary lateral hernia can be reoperated with either a Lichtenstein...

  9. Complicated childhood inguinal hernias in UITH, Ilorin

    Directory of Open Access Journals (Sweden)

    Kayode T Bamigbola

    2012-01-01

    Full Text Available Background: Complicated inguinal hernias pose a threat to the life of the child as well as increase the morbidity associated with management of an otherwise straightforward condition. The aim of this study was to determine the presentation, treatment and management outcome of complicated inguinal hernias in children. Materials and Methods: A retrospective study of all children 15 years and less managed for complicated inguinal hernia between 2002 and 2010. Data obtained included demographic characteristics, presentation, operative findings and outcome. Results: Complicated hernia rate was 13.9%.There were 41 children, 38 boys (92.7% and 3 girls. Ages ranged between 4 days and 15 years (Median = 90days. Most were infants (48.8%, n = 20 and neonates accounted for 19.5% (n = 8. Median duration of symptoms prior to presentation was 18 h (range = 2-96 h. Seven patients had been scheduled for elective surgery. Hernia was right sided in 68.3% (n = 28. Symptoms included vomiting (68.3%, abdominal distension (34.1% and constipation (4.9%; one patient presented with seizures. In 19 (46.3% patients hernia was reducible while 22(53.7% had emergency surgery. Associated anomalies included undescended testis (12.2%, umbilical hernia (14.6%. Intestinal resection rate was 7.3% and testicular gangrene occurred in 14.6%. Mean duration of surgery was 60.3 ± 26.7 min. Wound infection occurred in six patients (14.6%. Overall complication rate was 24.4%, 30% in infants. The mortality rate was 2.4% (n = 1. Conclusions: Morbidity associated with complicated inguinal hernia is high in neonates and infants. Delayed presentation is common in our setting. Educating the parents as well as primary care physicians on the need for early presentation is necessary.

  10. Chronic Pain after Inguinal Hernia Repair.

    Science.gov (United States)

    Manangi, Mallikarjuna; Shivashankar, Santhosh; Vijayakumar, Abhishek

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P = 0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P = 0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

  11. Adductor longus tendon rupture mistaken for incarcerated inguinal hernia.

    Science.gov (United States)

    Aerts, Bas R J; Plaisier, Peter W; Jakma, Tijs S C

    2014-03-01

    An incarcerated inguinal hernia is a common diagnosis, since the risk of an inguinal hernia incarcerating or strangulating is around 0.3-3%. An acute rupture of the adductor longus tendon is rarely seen and mostly affects (semi-) professional sportsmen. We present a case of a patient with an assumed incarcerated inguinal hernia which turned out to be a proximal adductor longus tendon rupture. If patients without a history of inguinal hernia present themselves with acute groin pain after suddenly exorotating the upper leg, a rupture of the adductor longus tendon should be considered. Both surgical and non-surgical treatment can be performed.

  12. Direct inguinal hernias and anterior surgical approach are risk factors for female inguinal hernia recurrences

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian

    2014-01-01

    ), indirect inguinal hernia (IIH), combination hernia), the hernia type at the recurrent procedure (DIH, IIH, combination hernia, femoral hernia), anesthesia type, and time from primary procedure to reoperation were registered. RESULTS: A total of 5,893 females with primary elective inguinal hernia operation...... on in the study period (61 % IIH, 37 % DIH, 2 % combined hernias) were included with a median follow-up time of 72 months (range 0 to 169). A total of 305 operations for suspected recurrences were registered (61 % inguinal recurrences, 38 % femoral recurrences, 1 % no hernias), which corresponded to an overall...... reoperation rate of 5.2 %. All femoral recurrences occurred after a previous open anterior operation. The crude reoperation rate after primary DIH operation was 11.0 %, 3.0 % after primary IIH operation and 0.007 % after combined hernia operation (p 

  13. Anal Canal Cancer: Management of Inguinal Nodes and Benefit of Prophylactic Inguinal Irradiation (CORS-03 Study)

    Energy Technology Data Exchange (ETDEWEB)

    Ortholan, Cecile, E-mail: c.ortholan@wanadoo.fr [Antoine Lacassagne Cancer Center, Nice (France); Princess Grace Hospital (Monaco); Resbeut, Michel [French Red Cross, Toulon (France); Paoli Calmettes Institut, Marseille (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France); Hannoun-Levi, Jean-Michel [Antoine Lacassagne Cancer Center, Nice (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France); Teissier, Eric [Azurean Cancer Center, Mougins (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France); Gerard, Jean-Pierre [Antoine Lacassagne Cancer Center, Nice (France); Ronchin, Philippe [Azurean Cancer Center, Mougins (France); Zaccariotto, Audrey [Timone Academic Hospital, Marseille (France); Minsat, Mathieu [Paoli Calmettes Institut, Marseille (France); Benezery, Karen; Francois, Eric [Antoine Lacassagne Cancer Center, Nice (France); Salem, Naji [Paoli Calmettes Institut, Marseille (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France); Ellis, Steve [Catalan Oncology Center, Perpignan (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France); Azria, David [Val d' Aurelle Cancer Center, Montpellier (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France); Champetier, Cedric; Gross, Emmanuel [Timone Academic Hospital, Marseille (France); Cowen, Didier [Timone Academic Hospital, Marseille (France); Cercle des Oncologues Radiotherapeutes du Sud (CORS), Mougins (France)

    2012-04-01

    Purpose: To evaluate the benefit of prophylactic inguinal irradiation (PII) in anal canal squamous cell carcinoma (ASCC). Methods and Materials: This retrospective study analyzed the outcome of 208 patients presenting with ASCC treated between 2000 and 2004 in four cancer centers of the south of France. Results: The population study included 35 T1, 86 T2, 59 T3, 20 T4, and 8 T stage unknown patients. Twenty-seven patients presented with macroscopic inguinal node involvement. Of the 181 patients with uninvolved nodes at presentation, 75 received a PII to a total dose of 45-50 Gy (PII group) and 106 did not receive PII (no PII group). Compared with the no PII group, patients in the PII group were younger (60% vs. 41% of patients age <68 years, p = 0.01) and had larger tumor (T3-4 = 46% vs. 27% p = 0.01). The other characteristics were well balanced between the two groups. Median follow-up was 61 months. Fourteen patients in the no PII group vs. 1 patient in the PII group developed inguinal recurrence. The 5-year cumulative rate of inguinal recurrence (CRIR) was 2% and 16% in PII and no PII group respectively (p = 0.006). In the no PII group, the 5-year CRIR was 12% and 30% for T1-T2 and T3-T4 respectively (p = 0.02). Overall survival, disease-specific survival, and disease-free survival were similar between the two groups. In the PII group, no Grade >2 toxicity of the lower extremity was observed. Conclusion: PII with a dose of 45 Gy is safe and highly efficient to prevent inguinal recurrence and should be recommended for all T3-4 tumors. For early-stage tumors, PII should also be discussed, because the 5-year inguinal recurrence risk remains substantial when omitting PII (about 10%).

  14. Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias.

    Science.gov (United States)

    Hoshino, M; Sugito, K; Kawashima, H; Goto, S; Kaneda, H; Furuya, T; Hosoda, T; Masuko, T; Ohashi, K; Inoue, M; Ikeda, T; Tomita, R; Koshinaga, T

    2014-06-01

    Previously, we established a pre-operative risk scoring system to predict contralateral inguinal hernia in children with unilateral inguinal hernias. The current study aimed to verify the usefulness of our pre-operative scoring system. This was a prospective study of patients undergoing unilateral inguinal hernia repair from 2006 to 2009 at a single institution. Gender, age at initial operation, birth weight, initial operation side, and the pre-operative risk score were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of our pre-operative risk scoring system. The follow-up period was 36 months. We used forward multiple logistic regression analysis to predict contralateral hernia. Of the 372 patients who underwent unilateral hernia repair, 357 (96.0 %) were completely followed-up for 36 months, and 23 patients (6.4 %) developed a contralateral hernia. Left-sided hernia (OR = 5.5, 95 %, CI = 1.3-24.3, p = 0.023) was associated with an increased risk of contralateral hernia. The following covariates were not associated with contralateral hernia development: gender (p = 0.702), age (p = 0.215), and birth weight (p = 0.301). The pre-operative risk score (cut-off point = 4.5) of the patients with a contralateral hernia was significantly higher, compared with the patients without a contralateral hernia using the area under the receiver operating characteristic curve (p = 0.024). Using multivariate analysis, we confirmed usefulness of our pre-operative scoring system and initial side of the inguinal hernia, together, for the prediction of contralateral inguinal hernia in children.

  15. Herniorrafia inguinal em potro neonato Repair of congenital inguinal hernia in a newborn foal

    Directory of Open Access Journals (Sweden)

    Marcelo Weinstein Teixeira

    1998-03-01

    Full Text Available As hérnias inguinais congênitas em potros não são um achado raro na casuística hospitalar. A maioria dos casos são conduzidos clinicamente, por se tratar de hérnias indiretas. As hérnias inguinais congênitas diretas, irredutíveis, em potros são uma urgência cirúrgica e se não tratadas imediatamente causam 100% de óbito. Um potro da raça Quarto-de-milha, com 36 horas de vida, apresentando volume parcialmente redutível na região inguinal esquerda, desconforto abdominal contínuo e congestão de mucosas aparentes, foi admitido no hospital veterinário. O animal foi imediatamente encaminhado à cirurgia, onde a herniorrafia com ressecção de alça intestinal, por acesso inguinal foi realizada. A recuperação pós-operatória foi satisfatória e o animal apresenta desenvolvimento físico normal para a raça.Equine congenital inguinal hernias are a common finding in clinical practice. Since most cases are indirect hernias, these usually are treated clinically. Inguinal hernias in newborn foals represent a surgical emergency, that, if not treated result in 100% mortality. A quarter-horse mth 36 hours of life with a volume on the left inguinal region, continous signs of abdominal pain and mucosal congestion was admitted at the hospital. The animal was imediately sent to surgery, where a hernioraphy by inguinal acces with ressection of an intestinal loop was realized. Post-surgical evolution was satifactory and the animal today presents normal physical growth for the breed standarts.

  16. Reconstrucción de cuero cabelludo con colgajo libre de omentum Reconstruction of the scalp with a free flap of omentum

    OpenAIRE

    Navarro Cuellar, C.; F. Riba García; B. Guerra Martínez; R. Pujol Romanya; H. Herencia Nieto; C. Navvarro Vila

    2004-01-01

    Los defectos de cuero cabelludo pueden tener una etiología diversa. Resecciones oncológicas, lesiones postraumáticas e infecciosas pueden dar lugar a diferentes defectos en cuanto a tamaño y extensión. Para su reconstrucción disponemos de múltiples técnicas quirúrgicas como colgajos locales, regionales y expansores titulares. No obstante, para defectos extensos los colgajos libres son la única posibilidad reconstructiva. Presentamos el caso de un paciente con carcinomas epidermoides multicént...

  17. Colgajo libre radial de doble paleta cutánea para reconstrucción de lengua y suelo de boca Double pad radial free flap to reconstruct touque and floor of the mouth

    Directory of Open Access Journals (Sweden)

    M. Acosta Feria

    2006-10-01

    Full Text Available Introducción. La cirugía reconstructiva tras la exéresis de tumores malignos que afectan a la lengua y al suelo de boca, continúa siendo uno de los grandes retos de la cirugía oral y maxilofacial. La mayor recuperación del habla y de la deglución, van a ser los objetivos finales de toda la reconstrucción de la cavidad oral. Presentamos un nuevo diseño del colgajo libre radial para la cirugía reconstructiva del carcinoma lengua y suelo de boca. Material y método. Nuestra serie consta de tres pacientes diagnosticados de carcinoma epidermoide de lengua y suelo de boca. Tras la cirugía oncológica ablativa, se reconstruyó el defecto oral con un colgajo libre radial de doble paleta cutánea con zona intermedia desepidermizada microvascularizado. Resultados. La movilidad de la lengua de nuestros pacientes fue suficiente y adecuada, consiguiéndose una buena calidad de vida. No hubo pérdida de la comida u otros fluidos a través del tracto respiratorio. Conclusiones. Con el colgajo radial de doble paleta cutánea microvascularizado, se consigue una buena recuperación funcional tanto en el habla como en la deglución en los pacientes, por lo que creemos que debería estandarizarse su uso en la cirugía reconstructiva oral tras la exéresis de tumores malignos de lengua y suelo de boca.Introduction: The firearm injuries are not very common in our country, and the experience in its management is limited. In this review we show the experience of our Service in this wounds and review the literature to systematize the initial management of the firearm injuries in maxillofacial region. Material and Methods: We present six patients treated in our Service in 2002. We study the demographics characteristic, aetiology, lesions patterns and treatment. Results: Five male and a female were treated of firearm lesions during this period, with a mean age of 38 years (range 13-74. Most frequent aetiology was the aggression. Only one patient required

  18. Orejas valgas: estabilización mediante colgajo dermo-graso-pericóndrico retroauricular Prominent ears: stabilization with a retroauricular dermal-fat-perichondrium flap

    Directory of Open Access Journals (Sweden)

    J. Amorrortu

    2013-03-01

    Full Text Available El tratamiento quirúrgico para la corrección de las orejas prominentes o valgas se basa en crear una distancia de entre 17-21 mm entre el hélix y la mastoides, así como recrear unos pliegues auriculares anteriores bien definidos. Desde finales de 1800 hasta la actualidad se han descrito muchas técnicas para corregir las orejas despegadas, prominentes o valgas, cada una de ellas con sus propias características. En el presente trabajo describimos una técnica para estabilizar el resultado quirúrgico cuando se corrige esta entidad y evitar su recidiva. Se trata de un procedimiento de fijación mastoidea de la oreja mediante un colgajo dermo-graso-pericóndrico de sencillo diseño, útil, seguro y fácilmente reproducible. Hemos empleado esta técnica durante más de 15 años y creemos que ha resistido la prueba del tiempo.The treatment for the correction of prominent or valgus ears, is to create a normal distance (17-21 mm between the mastoid and the helix and a normal appearance of the anterior auricular folds. From late 1800 to the present, many surgical techniques for correcting prominent or valgus ears have been described, each one with its own characteristics. We describe a technique to stabilize the result and prevent recurrence. This technique stabilizes the correction of the ear fixing it to the mastoid fascia using a dermalfat-perichondrium flap of simple design, useful, safe and easily reproducible. We have used it over 15 years, and that makes us believe that has stood the test of time.

  19. Análisis de perforantes de la epigástrica inferior profunda con Angio TC 3D, Eco Doppler color y Doppler simple de ultrasonidos en colgajo DIEP: resultados preliminares Analysis of deep inferior epigastric perforating vessels with 3D CT angiography, color Doppler ultrasonography and Doppler in diep flaps: preliminary results

    Directory of Open Access Journals (Sweden)

    J. Castro García

    2008-09-01

    Full Text Available Nuestro objetivo es la validación de la Angio TC tridimensional como herramienta de planificación de los colgajos DIEP, comparándolo con el Doppler de ultrasonidos (US y eco Doppler color. Entre enero de 2006 y marzo de 2007 se realiza en 11 pacientes (13 DIEP un estudio comparativo prospectivo entre el Doppler de US, eco Doppler color y Angio TC con reconstrucción tridimensional, utilizando como dato de referencia los hallazgos intraoperatorios. En dicho proceso se localiza la mejor perforante que pueda servir como pedículo al colgajo DIEP en función de su localización, calibre, trayecto y relaciones anatómicas con respecto al músculo. La Angio TC con reconstrucción tridimensional, demuestra una especificidad del 100% (IC 95% 75.3-100 lo que le convierte en una prueba con un alto valor predictivo positivo y una excelente herramienta en la planificación de los colgajos de perforantes. El eco Doppler color determinó, que tan sólo en un 46,1% (IC 95% 19,2-74,9 de los pacientes, la perforante seleccionada por la prueba de forma preoperatoria, coincidía con la perforante elegida en quirófano. Con el Doppler de US, en un 30,8 % (IC 95% 9,1-61,4 de los colgajos estudiados, coincidía la mejor perforante escogida de forma preoperatoria, con los hallazgos obtenidos tras la disección del colgajo. En el presente estudio, la Angio TC tridimensional se ha mostrado como una técnica con una gran especificidad que proporciona valiosa información, sólo comparable con la disección anatómica y por delante de pruebas como el Doppler de ultrasonidos y el eco Doppler color.The aim of this report, is to validate the Angio-CT technique with three-dimentional reconstruction as a preoperative planning tool, after comparison with Doppler ultrasound and color- Duplex. Between january 2006 and march 2007, we studied 11 consecutive patients (13 DIEP in whom a prospective comparative followed up was performed comparing, the findings observed using

  20. Are there any predictive factors of metachronous inguinal hernias in children with unilateral inguinal hernia?

    Science.gov (United States)

    Jallouli, M; Yaich, S; Dhaou, M B; Yengui, H; Trigui, D; Damak, J; Mhiri, R

    2009-12-01

    This study was done to identify risk factors for metachronous manifestation of contralateral inguinal hernia in children with unilateral inguinal hernia. This is a retrospective study of 565 patients with inguinal hernia during a nine-year period at a single institution. Age, sex, and side of the hernia at presentation were recorded. The incidence of metachronous inguinal hernia and its risk factors were analyzed. Of 565 children, 62 (11%) were presented with synchronous bilateral hernias. Of the remaining 503, a metachronous contralateral hernia developed in 22 (4.4%). The age at hernia repair of the patients with contralateral manifestation (18 ± 3.67 months; mean ± SD), was significantly younger than observed in the control patients (34 ± 1.34 months; p = 0.000). There was no significant difference between the groups in other factors such as the age at hernia presentation, the initial side of the hernia, birth weight. and the percentage of patients who had experienced incarceration. We believe that the incidence is still too low to recommend routine contralateral exploration. Therefore, infants younger than 18 months appear to be a higher-risk subpopulation and should receive closer follow-up over this time period.

  1. Endoscopic totally extraperitoneal repair of bilateral inguinal hernias

    NARCIS (Netherlands)

    M.T.T. Knock (M. T T); W.F. Weidema (Wibo); L.P. Stassen (Laurents); R.U. Boelhouwer (Roelof Ubbo); C.J. van Steensel (C.)

    1999-01-01

    textabstractBackground: Recurrence rates associated with bilateral inguinal hernia repair with a giant prosthesis (Stoppa procedure) are low. Endoscopic totally extraperitoneal bilateral inguinal hernia repair with a giant prosthesis combines the low recurrence rate of the Stoppa repair and the adva

  2. Hospital costs associated with laparoscopic and open inguinal herniorrhaphy.

    Science.gov (United States)

    Spencer Netto, Fernando; Quereshy, Fayez; Camilotti, Bruna G; Pitzul, Kristen; Kwong, Josephine; Jackson, Timothy; Penner, Todd; Okrainec, Allan

    2014-01-01

    The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy. A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operating room (OR) and total hospital costs. Two hundred eleven patients underwent elective unilateral inguinal herniorrhaphy (117 open and 94 laparoscopic), and 33 patients underwent elective bilateral inguinal herniorrhaphy (9 open and 24 laparoscopic). OR and total hospital costs for open unilateral inguinal hernia repair were significantly lower than for the laparoscopic approach (median total cost, $3207.15 vs $3723.66; P costs for repair of elective bilateral inguinal hernias were similar between the open and laparoscopic approaches (median total cost, $4574.02 vs $4662.89; P = .827). In the setting of a Canadian academic hospital, when considering the repair of an elective unilateral inguinal hernia, the OR and total hospital costs of open surgery were significantly lower than for the laparoscopic techniques. There was no statistical difference between OR and total hospital costs when comparing open surgery and laparoscopic techniques for the repair of bilateral inguinal hernias. Given the perioperative benefits of laparoscopy, further studies incorporating hernia-specific outcomes are necessary to determine the cost-effectiveness of each approach and to define the optimal treatment strategy.

  3. Retroperitoneal hematoma after manual reduction of indirect inguinal hernia.

    Science.gov (United States)

    Xu, Xiequn; Hong, Tao; Li, Binglu; Liu, Wei; Zheng, Chaoji; He, Xiaodong

    2013-07-01

    This report presents the case of a 59-year-old man with sudden severe pain in the right lower abdomen after manually reducing the right indirect inguinal hernia who had bilateral indirect inguinal hernia for 5 years. A subsequent contrast computed tomography scan with contrast of the abdomen and pelvis revealed a significant extensive retroperitoneal hematoma at the abdomen and pelvis of the right side. There was contrast leaked out, which was suspected from inferior epigastric artery. He underwent successful laparotomy. The bleeding ruptured inferior epigastric artery at the interior side of the deep inguinal ring was found, the deep inguinal ring was avulsed, ligature of the inferior epigastric artery and removal of the retroperitoneal hematoma were done, and the patient was discharged from hospital on the seventh postoperative day. This is the first report in the literature on retroperitoneal hematoma caused by manual reduction of indirect inguinal hernia.

  4. A CLINICAL STUDY ON SLIDING INGUINAL HERNIAS

    Directory of Open Access Journals (Sweden)

    Sobha Rani

    2015-09-01

    Full Text Available INTRODUCTION: A sliding hernia is a type of hernia in which posterior wall of the sac is not only formed by the parietal peritoneum, but also by sigmoid colon with its mesentery on its left side; caecum on right side and often with portion of bladder in both sides. During surgery care is taken not t o separate the content from the sac as the posterior wall of the sac is formed by the sliding component itself and attempts to dissect it from wall results in vascular injury to the structure and end in ischemic insult of the sliding component. Thus slidin g hernia is important for the special surgical technique and care during intraoperative period which decreases the morbidity. AIMS AND OBJECTIVE S : To study the incidence of sliding hernia in S.V.R.R.G. General Hospital Tirupati . To know the presentation, o rgan involved in the sliding, post - operative complications in the management of sliding hernias. METHODOLOGY : STUDY DESIGN: Prospective Clinical Study , STUDY AREA: Sri Venka teswara Medical College Tirupat i . SOURCE OF DATA: This study is an observational study in which 600 patients with hernia were studied and 40 patients with sliding component during intra operative period were studied in a period of 12 months. S AMPLE SIZE: 40 patients fulfilling the inclusion criteria . METHOD OF COLLECTION OF DATA: Detai led history taking , Complete clinical examination , Appropriate Investigations Blood & Urine Examination, USG , Surgery is performed & Operative findings were recorded. INCLUSION CRITERIA: Patients more than 13 years, with inguinal hernia giving written inform ed consent. EXCLUSION C RITERIA: Patients less than 13 yrs. Patients with comorbid conditions like heart diseases, liver and renal diseases. SOFTWARE: Statistical software mainly SPSS 11.0 and Systat 8.00 was used for the analysis of the data and Microsoft word and excel have been used to generate graphs tables etc. CONCLUSION: In the observational study done on 40 ca ses of

  5. Breast cancer with inguinal node recurrence

    Directory of Open Access Journals (Sweden)

    Shikha Goyal

    2015-03-01

    Full Text Available Surgery and irradiation for breast cancer may interfere with conventional pathways of spread, leading to bizarre patterns of dissemination through lymphatics or through hematogenous route. Lymphoscintigraphic studies may help identify nodal involvement. Other possible reasons could be occurrence of primary breast cancer in accessory breast tissue retained in the vulva following involution of milk line. We describe a case of triple negative breast cancer, who developed contralateral breast cancer during treatment. Three years later, she developed isolated inguinal nodal metastases, which responded to local radiotherapy and chemotherapy. However, the patient relapsed after 2 years and could not be salvaged thereafter.

  6. Inguinal Lymph Node Anthracosis: A Case Report

    Science.gov (United States)

    Soto, Carlos Alberto

    2016-01-01

    Summary: Anthracosis is defined as black, dense pigments in tissues, usually carbon deposits. We, as surgeons, have to make decisions during surgery to the best of our knowledge and based on what the literature provides us. We present the case of a 30-year-old female patient who underwent abdominoplasty. During surgery, bilateral inguinal pigmented and enlarged lymph nodes were seen. Biopsy of the nodes was done to rule out any malignancy. The results showed tattoo pigments on all lymph nodes. We present this case as tattoo pigment migration, which has been rarely described. PMID:27536493

  7. Histiocitoma fibroso maligno de orofaringe: Resección y reconstrucción con colgajo fasciocutáneo radial Malignant oropharyngeal fibrous histiocytoma: Resection and radial reconstruction with fasciocutaneous flap

    Directory of Open Access Journals (Sweden)

    L. García Monleón

    2008-04-01

    Full Text Available El histiocitoma fibroso maligno se reconoce como el sarcoma de tejidos blandos más frecuente de la edad adulta, aunque su localización en faringe no es usual habiéndose recogido en la literatura científica tan solo 6 casos en esta localización. Presentamos el caso de un paciente con un histiocitoma fibroso maligno en orofaringe de gran tamaño, al que se le realizó una resección con amplios márgenes y la reconstrucción del defecto con un colgajo fasciocutáneo radial. Discutiremos a raíz del caso la epidemiología, manifestaciones clínicas, incidencia de metástasis, histopatología, factores pronósticos y tratamiento de este tipo de tumores.Malignant fibrous histiocytoma is recognized as the most common soft-tissue sarcoma in adults, although its location in the pharynx is unusual. Only 6 cases of the pharynx have been reported in the scientific literature. We report the case of a patient with a large malignant fibrous histiocytoma in the oropharynx. The tumor was resected with generous margins and the defect was reconstructed with a radial fasciocutaneous flap. The epidemiology, clinical manifestations, incidence of metastases, histopathology, prognostic factors and treatment of malignant fibrous histiocytoma are discussed in relation to this case.

  8. Herniorrafía inguinal: Técnica por sobrecapas de Fascia Transversalis

    Directory of Open Access Journals (Sweden)

    José Miguel Goderich Lalán

    1998-04-01

    Full Text Available Se realizó un estudio descriptivo, prospectivo, observacional y longitudinal para evaluar los resultados obtenidos con la aplicación de una técnica de reparación herniaria inguinal (original del autor por sobrecapas de fascia transversalis, en la que se afronta una primera capa de ésta en sutura continua, desde la proyección del tubérculo púbico hasta obliterar el anillo inguinal profundo, después de lo cual se crea una segunda capa al afrontar el arco aponeurótico del transverso a la cintilla iliopubiana. Luego de un seguimiento superior a los 10 años, se comprobó que de 1 475 pacientes sólo hubo recidivas en 1,2 %; éstas fueron más frecuentes en los hombres, en las hernias del tipo indirecto y en los pacientes con más de 45 años. El mayor número de recidivas ocurrió entre el primer y tercer año de operado. Se recomienda introducir esta nueva técnica en la práctica quirúrgica, y cumplir las indicaciones y el proceder señalado por el autorA descriptive, prospective, observational, and longitudinal study was performed to evaluate the results obtained with the application of a technique for the repair of inguinal hernia (the author's original technique by overlayers of fascia transversalis, in which the first layer is copped with the use of continuos suture from the projection of the pubic tubercle until the obliteration of the deep inguinal rign, creating a second layer when copping the aponeurotic arch of the transverse to the iliopubic eminence. After a follow-up longer than 10 years, it was proved that out of 1 475 patients, only 1,2 % presented with recurrences. Relapses were more frequent in males, in indirect hernias and in patients over 45 years of age. The greatest number of recurrences occurred between the first and the third year after the operation. It is recommended to introduce this new technique within the surgical practice and to comply with the indications for the procedure made by the author

  9. Colgajo miocutáneo de glúteo mayor en isla con cierre V en Y para la cobertura de úlceras isquiáticas Island miocutaneous gluteus maximus flap for coverage of ischiatic ulcers

    Directory of Open Access Journals (Sweden)

    S. Llanos Olmedo

    2006-03-01

    Full Text Available Las úlceras en la región isquiáticas ocurren por la permanencia en posición de sentado durante períodos prolongados. Son las úlceras con la mayor recidiva y presencia de lechos ulcerosos múltiples y sinuosos. Esto ocasiona hospitalización prolongada, aseos quirúrgicos repetidos, antibioterapia múltiple y retraso de la rehabilitación. La cobertura se puede realizar con colgajos miocutáneos de glúteo mayor, bíceps femoris, gracilis, tensor de fascia lata, semimembranoso y semitendinoso, entre otros. El colgajo miocutáneo de glúteo mayor realizado para la cobertura de úlceras isquiáticas, es actualizado en este trabajo y se incorpora como variante la utilización de una isla cutánea irrigada por perforantes, que avanza al lecho con cierre V en Y sin tensión. Nuestro objetivo es demostrar que el colgajo de glúteo mayor sería de primera elección en la cobertura de úlceras isquiáticas. Proponemos como variante quirúrgica la liberación completa del músculo, proveyendo un amplio eje de rotación, y una isla de piel sobre él, produciendo un cierre sin tensión. Todo esto reduciría la morbilidad y recidiva. Se realizaron 13 colgajos miocutáneos de glúteo mayor de avance y rotación con cierre V en Y para la cobertura de úlceras isquiáticas de presión grado III y IV. Las patologías asociadas fueron tetraplejia y paraplejia por lesión medular y paraplejia espástica familiar. El seguimiento fue de 6 meses hasta 7 años. Hasta la fecha no se ha documentado morbilidad ni recidiva. En nuestra experiencia el colgajo miocutáneo de glúteo mayor seria de elección para cierre de úlceras isquiáticas por su volumen de relleno e importante irrigación. El cierre sin tensión estaría dado por la liberación completa del músculo produciendo un amplio eje de rotación, y por una isla de piel que se transporta sobre élThe ischiatic ulcers develop as a consecuense of long sitting position. This kind of ulcers relapse in a great

  10. La hernia inguinal en la era laparoscópica

    Directory of Open Access Journals (Sweden)

    Alejandro Weber Sánchez

    1999-01-01

    Full Text Available Objetivo: Describir los resultados de 327 reparaciones via laparoscópica de hernias inguinales. Materiales y métodos: Estudio descriptivo de 327 reparaciones vía laparoscópica de hernias inguinales practicadas en 257 pacientes, realizadas entre 1992 y 1996 en el Servicio de Cirugia del American British Cowdray Medical Center, en México Distrito Federal. Resultados: El sexo fue predominantemente masculino (77.4 %; las edades oscilaron entre 9 y 89 años. En 85 pacientes se trató de hernia inguinal bilateral y de ellas se trataron en 35 casos según la técnica de Stoppa. Tres de los casos se desarrollaron como cirugía de urgencia por el compromiso intestinal concomitante. Las complicaciones representaron el 8.8 % y se resolvieron espontáneamente; constituidas por meralgia parestésica, retención urinaria, hematomas inguino escrotales. Las recidivas constituyeron el 1.2 %. Conclusiones: Los autores establecen el manejo de las hernias bajo una propuesta de clasificación laparoscópica de los defectos herniarios basada en la de Nyhus. ( Rev Med Hered 1999; 10:7-13.

  11. CHRONIC PAIN AFTER INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-09-01

    Full Text Available : BACKGROUND: Chronic post herniorrhaphy groin pain is defined as pain lasting > 6 months after surgery, which is one of the most important complication occurring after inguinal hernia repair, occurs with greater frequency than previously thought. Chronic groin pain is one of the most significant complications following inguinal hernia repair, and majority of chronic pain has been attributed to ilioinguinal nerve entrapment. Various other factors are involved in development of chronic pain. MATERIAL AND METHODS: Patients undergoing elective inguinal hernioplasty in Victoria hospital from November2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for follow up at end of six months. A detailed preoperative, intraoperative and post-operative details of cases were recorded according to proforma. The postoperative pain and pain at two, seven days and at end of six months were recorded on a VAS scale. RESULTS: Chronic pain at six month follow up was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7 % of patients with preoperative pain developed chronic pain. Patients with significant preoperative pain had higher chances of developing chronic pain (p<.0001. Preemptive analgesia failed to show statistical significance in development of chronic pain (p=0.079. Nerve injury were present in 22 of cases it was found that nerve injury significantly affected development of chronic pain (p=0.001.Post-operative infiltration of local anesthesia was practiced in 16.3 % of cases and it was found that local infiltration at incision site significantly reduced incidence of chronic pain (p=0.001.Postoperative complications in the form of hematoma, seroma or infection was present in 8.5 % of cases. It was found that post-operative complication not only increased early post-operative pain

  12. [Is the presence of an asymptomatic inguinal hernia enough to justify repair?].

    Science.gov (United States)

    Metzger, Jürg

    2015-11-11

    The risk of strangulation in case of a inguinal hernia is low. Patients with a symptomatic inguinal hernia should undergo an operation. Morbidity and mortality in inguinal hernia surgery are very rare. There is also non-conservative treatment of inguinal hernias. Trusses should no longer be recommended. Watchful waiting is an option for men with minimally symptomatic or asymptomatic inguinal hernias. But patients must be informed that there is a high risk of becoming symptomatic.

  13. A DEMOGRAPHIC, CLINICAL AND SURGICAL STUDY OF OBSTRUCTED INGUINAL HERNIA

    Directory of Open Access Journals (Sweden)

    Mohammed Imran Khaleel

    2016-11-01

    Full Text Available BACKGROUND An obstructed inguinal hernia means the inguinal hernia is associated with intestinal obstruction due to occlusion of lumen of bowel. A distinguishing feature of strangulated hernia is the bowel's blood supply is not compromised. Intestinal obstruction is absent in case of omentocele, Richter's hernia and Littre's hernia. In this study, a sincere effort has been made to study and understand an obstructed inguinal hernia. This study is intended to help the practicing surgeon to understand the complications and to take necessary actions. MATERIALS AND METHODS  Eighty cases of obstructed inguinal hernia were studied between June 2009 to September 2011.  This study has been conducted from the patients of Deccan College of Medical Sciences admitted during the above period.  Out of 80 cases for follow up after discharge, 25 cases were reviewed. RESULTS  The incidence of obstruction in inguinal hernia is 7.9% in this study.  Obstructed inguinal hernia is more common in age group 20-50 yrs. of age.  It is 80 times more common in males. Male-to-female ratio is 79:1.  There is right-sided preponderance. Obstruction occurs in ratio of 3:1 on right and left sides. CONCLUSION A study of common surgical emergency- obstructed inguinal hernia was presented. Anatomy, pathophysiology, aetiological factors, clinical features and complications were noted.

  14. Study of a new method for inguinal hernia repair

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    Noori M.

    2007-11-01

    Full Text Available Background: Inguinal hernia accounts for about 80% of all hernias and are the most common surgical procedure done in infants. There are different methods for repairing of inguinal hernia such as tissue repair; rate of recurrence by this method is 1-3%. The purpose of this study was to introduce new method for this surgery and assessing recurrence and complications.Methods: This was a semi clinical trial. 174 patients were considered after five years. (During 1998-2002. In this method after removing of hernia's sac, the floor of inguinal canal was torn in two layers continuously. One of them was torn from cooper ligament to fascia transversalis and the other one was torn from inguinal ligament to conjoint tendon and finally the fascia of external muscle was torn on spermatic cord. The patients were assessed by a questionnaire composed of two sections; one about the site of inguinal hernia and age of patients and the other was composed of questions about complication and recurrence of surgery. Data was compared to other conventional tissue repair using Z test. Results: The mean age of patients were 28-48 years, 164(94% were males and 10(5/7% were females, 59(34% of patients had left inguinal hernia (56 male and 3 female, 92(52% had right inguinal hernia (88 male and 4 female and 23(13% had bilateral inguinal hernia (20 male and 3 female. Two patients (1/1% had recurrence two years after surgery and no complication were seen after 5 years. Conclusions: There were no significant difference between methods of surgery (1/1% recurrence and other conventional tissue repair methods (1-3% recurrence. More long evaluation is required to recommend this fast and simple method for routine repair of inguinal hernias.

  15. The Shouldice technique for the treatment of inguinal hernia

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    Chan Chin

    2006-01-01

    Full Text Available The Shouldice repair has been refined over several decades and is the gold standard for the prosthesis-free treatment of inguinal hernias. A recurrence rate around 1% has been consistently demonstrated over the years. The objective of this paper is to outline and highlight the key principles, including the dedicated pre-operative preparation, the use of local anesthesia, a complete inguinal dissection and the eponymous four-layered reconstruction. A knowledge and understanding of inguinal hernia anatomy and the patho-physiology of recurrence are vital to achieving a long-term success and patient satisfaction for a pure tissue repair.

  16. Nueva técnica para corrección del pezón invertido sin cicatriz evidente

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    E. Moretti

    2015-06-01

    Full Text Available Presentamos una vía de abordaje diferente para la resolución del pezón invertido sin cicatriz aparente. Este procedimiento corta los conductos galactóforos e interpone dos colgajos dérmicos triangulares en la base del pezón con el objeto de evitar la recidiva del proceso. El aspecto más innovador de la presente publicación es el abordaje quirúrgico, que realizamos medianter una incisión inconspicua en la base del pezón que con el tiempo se torna imperceptible.

  17. Colgajo libre interóseo posterior para reconstrucción de mano: a propósito de un caso Posterior interosseous free flap for hand reconstruction: case report

    Directory of Open Access Journals (Sweden)

    E. Cabrera Sánchez

    2008-06-01

    Full Text Available La cobertura de la mano es un desafío para el cirujano plástico, debido a las múltiples opciones disponibles. El colgajo interóseo posterior de base distal es una de las opciones más útiles para la reconstrucción de esta clase de defectos. Sin embargo, debido a su inconstante anatomía vascular pueden acontecer problemas en su disección. Las variaciones anatómicas son bien conocidas y son básicamente de dos tipos: la ausencia de anastomosis distal con la arteria interósea anterior o la hipoplasia o aplasia en el tercio distal del antebrazo de la arteria interósea posterior, provocando un porcentaje relativamente alto de necrosis parcial, que puede acarrear un fallo en la cobertura de esta zona. Con objeto de prevenir un resultado desfavorable, hemos usado un colgajo interóseo posterior en forma de transferencia libre para el tratamiento quirúrgico de una mujer que fue remitida a nuestro Servicio con un defecto de 7 x 7 cm de diámetro en el dorso de la mano izquierda.Hand coverage is a challenge for plastic surgeons, because there are many therapeutic options available. The distally based posterior interosseous artery flap is one of the most useful elections for reconstruction of this defect. However, we can find problems in dissecting the flap due to an inconstant vascular anatomy. Anatomical variants are well known and they can be of two types: the absence of the distal anastomosis with the anterior interosseous artery and the hypoplasia or aplasia of the middle third of fhe posterior interosseous artery, with a relatively high rate of partial flap loss which may result in coverage failure. In order to prevent an unsuccessful flap harvest, we have used an interosseous free flap for a woman with a 7 x 7 cm defect in the dorsum of her left hand.

  18. Paravesical gossypiboma following inguinal herniorrhaphy: Laparoscopic retrieval

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    Chao-Chun Huang

    2015-01-01

    Full Text Available Retained surgical sponge (gossypiboma following an inguinal herniorrhaphy is a rare condition and may cause medicolegal problems. Differential diagnosis for the lesion should be made meticulously. We report a case of a 45-year-old man who had a herniorrhaphy about 8 years previously. He presented one episode of painless gross hematuria. Laboratory and imaging studies excluded any significant lesion in the urological organs. Abdominal CT scan demonstrated a heterogeneous neoplasm of 4 cm in size in the left paravesical area that was retrieved laparoscopically. Abdominal CT and clinical suspicion are helpful for diagnosis. Laparoscopy may be used to confirm the diagnosis and to remove the retained surgical gauze, and considered as an alternative therapy for some selected patients.

  19. Inguinal hernia repair: anaesthesia, pain and convalescence

    DEFF Research Database (Denmark)

    Callesen, Torben

    2003-01-01

    Elective surgical repair of an inguinal or femoral hernia is one of the most common surgical procedures. The treatment, however, presents several challenges regarding anaesthesia for the procedure, the postoperative analgesic therapy and convalescence, as well as planning of the procedure. Local......, general, and regional anaesthesia are all used for hernia repair, but to different degrees, primarily depending on traditions and whether the institution has specific interest in hernia surgery. Thus, the use of local anaesthesia varies from a few percent in Sweden, 18% in Denmark and up to almost 100......% in specialised institutions, dedicated to hernia surgery. The feasibility of local anaesthesia is high, as judged by the rate of conversion to general anaesthesia (

  20. Radiologic investigation after laparoscopic inguinal hernia repair

    Energy Technology Data Exchange (ETDEWEB)

    Larmark, Martin; Ekberg, Olle [Department of Diagnostic Radiology, Malmoe University Hospital, 205 02, Malmoe (Sweden); Montgomery, Agneta [Department of Surgery, Malmoe University Hospital, 205 02, Malmoe (Sweden)

    2003-12-01

    Laparoscopic instead of open surgical repair of inguinal hernias is becoming more frequent. Radiologists may expect different postoperative findings depending on the technique used. We studied how radiology had been used postoperatively and what findings were encountered after laparoscopic herniorraphy. Postoperative radiologic examinations related to hernia repair of all consecutive patients that had had laparoscopic herniorraphy in Malmoe University hospital between 1992 and 1998 were retrospectively evaluated. A total of 538 groins were included, 3.9% (n=21) of these were postoperatively examined with ultrasound (n=10), herniography (n=7), plain abdominal films (n=2), CT (n=1), or fistulography (n=1). Significant findings were found in five groins, namely, one sinus tract, two hematomas, one small bowel obstruction, and one recurrence of hernia. Four insignificant seromas were found. The characteristics of the findings and pitfalls are described. Symptoms resulting in radiologic examination are rare after laparoscopic herniorraphy. The radiologist must be familiar with the spectrum of such findings. (orig.)

  1. Inguinal hernia repair: toward Asian guidelines.

    Science.gov (United States)

    Lomanto, Davide; Cheah, Wei-Keat; Faylona, Jose Macario; Huang, Ching Shui; Lohsiriwat, Darin; Maleachi, Andy; Yang, George Pei Cheung; Li, Michael Ka-Wai; Tumtavitikul, Sathien; Sharma, Anil; Hartung, Rolf Ulrich; Choi, Young Bai; Sutedja, Barlian

    2015-02-01

    Groin hernias are very common, and surgical treatment is usually recommended. In fact, hernia repair is the most common surgical procedure performed worldwide. In countries such as the USA, China, and India, there may easily be over 1 million repairs every year. The need for this surgery has become an important socioeconomic problem and may affect health-care providers, especially in aging societies. Surgical repair using mesh is recommended and widely employed in Western countries, but in many developing countries, tissue-to-tissue repair is still the preferred surgical procedure due to economic constraints. For these reason, the development and implementation of guidelines, consensus, or recommendations may aim to clarify issues related to best practices in inguinal hernia repair in Asia. A group of Asian experts in hernia repair gathered together to debate inguinal hernia treatments in Asia in an attempt to reach some consensus or develop recommendations on best practices in the region. The need for recommendations or guidelines was unanimously confirmed to help overcome the discrepancy in clinical practice between countries; the experts decided to focus mainly on the technical aspects of open repair, which is the most common surgery for hernia in our region. After the identification of 12 main topics for discussion (indication, age, and sex; symptomatic and asymptomatic hernia: type of hernia; type of treatment; hospital admission; preoperative care; anesthesia; surgical technique; perioperative care; postoperative care; early complications; and long-term complications), a search of the literature was carried out according to the five levels of the Oxford Classification of Evidence and the four grades of recommendation.

  2. Recurrence and complications of pediatric inguinal hernia repair ...

    African Journals Online (AJOL)

    complications of inguinal hernia repair in pediatric patients who underwent ... were complications such as pain, wound infection, and fever. Results. In this study ... incidence of recurrence within 1 year after the surgery .... Treatment strategy of.

  3. A very nervous inguinal floor: report of a case.

    Science.gov (United States)

    Kulacoglu, H; Sen, T; Ozyaylali, I; Elhan, A

    2013-01-01

    Chronic pain after inguinal hernia repair with prosthetic meshes is recorded in some patients. Although the exact etiology of the pain is not fully understood, it can be related to the trauma to the regional nerves. It is possible to involve these nerves by injuring, suturing, stapling, tacking or compressing them during the operation. Therefore, a delicate surgical approach to the inguinal floor with correct identification of three nerves is necessary for patient comfort at early and late postoperative period. We herein report a surgical view of an inguinal floor which are very rich of neural structures in a patient undergo an elective inguinal hernia repair. The number of the main nerve bundles was excessive, and they were thicker than generally met. This kind of anatomic variations may create a difficulty for repair with prosthetic material. The identification of the nerve structures was hard at first sight and the correct identification was only made by consulting the surgical picture with a senior anatomist.

  4. Outcome of laparoscopic inguinal hernia repair in a South African ...

    African Journals Online (AJOL)

    Outcome of laparoscopic inguinal hernia repair in a South African private practice setting. ... South African Journal of Surgery ... hernia recurrence, chronic pain and technique preference if they had previously undergone an open repair.

  5. Acceptable nationwide outcome after paediatric inguinal hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, H; Oehlenschlager, J;

    2014-01-01

    PURPOSE: The primary objective was to describe 30-day outcomes after primary inguinal paediatric hernia repair. METHODS: Prospectively collected data from the National Patient Registry covering a 2-year study period 1 January 2005 to 31 December 2006 were collected. Unexpected outcomes were defined...... was not associated with the inguinal hernia repair. The usual technique was a simple sutured plasty (96.5 %). Emergency repair was performed in 54 patients (2.2 %) mainly in children between 0 and 2 years (79.6 %). During the 1 year follow-up, reoperation for recurrent inguinal hernia was performed in 8 children...... after elective repair (recurrence rate 0.3 %). Paediatric repairs were for most parts performed in surgical public hospitals, and most departments performed less than 10 inguinal hernia repairs within the 2 years study period. CONCLUSION: These nationwide results are acceptable with low numbers...

  6. Post operative pain control in inguinal hernia repair: comparison of ...

    African Journals Online (AJOL)

    Post operative pain control in inguinal hernia repair: comparison of tramadol versus ... Log in or Register to get access to full text downloads. ... postoperative pain control effects and cost effectiveness of Tramadol versus Bupivaaine in wound ...

  7. Acute Osteomyelitis of the Symphysis Pubis after Inguinal Hernia Surgery

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    Recep Tekin

    2015-01-01

    Full Text Available Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition.

  8. Comparison of elective inguinal node irradiation techniques in anal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  9. REAPPRAISAL OF DARNING METHOD OF INGUINAL HERNIA REPAIR

    OpenAIRE

    2014-01-01

    OBJECTIVE: To evaluate the darning method of inguinal hernia repair with polypropylene. MATERIAL AND METHODS: 125 Patient of unilateral or bilaterally inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by standard procedure using no-1 polypropylene. Patients were operated under spinal, general anesthesia or local anesthesia. Patients were followed up at one week, four weeks and six months after operation for wound hea...

  10. Tumescent local anesthetic technique for inguinal hernia repairs

    OpenAIRE

    2014-01-01

    Purpose We evaluated the adequacy and feasibility of a tumescent solution containing lidocaine and bupivacaine for inguinal hernia repairs. Methods The medical records of 146 consecutive inguinal hernia patients with 157 hernia repairs using the tumescent local anesthesia technique performed by a single surgeon between September 2009 and December 2013 were retrospectively reviewed. Results The mean operation time (±standard deviation) and hospital stay were 64.5 ± 17.6 minutes and 2.7 ± 1.5 d...

  11. RESULTS OF INGUINAL HERNIA REPAIRS PERFORMED UNDER LOCAL ANESTHSEIA

    OpenAIRE

    2001-01-01

    Aim: The aim of this study was to investigate the results of inguinal hernia repairs performed under local anesthesia with respect to operation duration, hospitalization period, postoperative complications, need for analgesics, and duration for recovery to normal life style. Material and Methods: Patients admitted to our hospital between January 1998 to January 2001 with diagnose of inguinal hernia were involved in this study. Of these patients whose with cardiovasculary and respiratory prob...

  12. Transmission block to simplify combined pelvic and inguinal radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kalnicki, S.; Zide, A.; Maleki, N.; DeWyngaert, J.K.; Lipsztein, R.; Dalton, J.F.; Bloomer, W.D.

    1987-08-01

    A homogeneous dose distribution of radiation to inguinal lymph nodes and deep pelvic structures can be achieved with use of a transmission block over the central portion of a large anterior pelvic-inguinal portal, together with a smaller posterior field. This relatively simple technique permits individualization of isodose distributions and eliminates the problems of matching abutting portals. Reproducibility of daily setup and optimization of machine utilization are both improved.

  13. Transmission block to simplify combined pelvic and inguinal radiation therapy.

    Science.gov (United States)

    Kalnicki, S; Zide, A; Maleki, N; DeWyngaert, J K; Lipsztein, R; Dalton, J F; Bloomer, W D

    1987-08-01

    A homogeneous dose distribution of radiation to inguinal lymph nodes and deep pelvic structures can be achieved with use of a transmission block over the central portion of a large anterior pelvic-inguinal portal, together with a smaller posterior field. This relatively simple technique permits individualization of isodose distributions and eliminates the problems of matching abutting portals. Reproducibility of daily setup and optimization of machine utilization are both improved.

  14. Pain and functional impairment 6 years after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Bay-Nielsen, Morten; Kehlet, Henrik

    2006-01-01

    To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation...... and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors.......To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation......, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18-40 years undergoing inguinal herniorrhaphy between October...

  15. Implante con el sistema de reparación herniaria inguinal de prolene (Prolene hernia system

    Directory of Open Access Journals (Sweden)

    José Goderich Lalán

    2002-04-01

    Full Text Available Se realizó un estudio clinicodescriptivo y prospectivo del seguimiento de 21 pacientes a los que se les realizó implante sistema de reparación herniaria inguinal de prolene en hernias inguinales, reproducidas entre el 15 de octubre de 1998 y el 31 de marzo de 1999, con el objetivo de evaluar sus resultados. En todos los casos se utilizó el método de cirugía de corta estadía, anestesia local y sedación o espinal y antibioticoterapia profiláctica. En el seguimiento a muy corto plazo no se reportan recidivas y ninguna complicación posoperatoria. Más de la mitad de los pacientes había recibido más de 2 operaciones. La media de edad fue 49 años y el sexo predominante el masculino. La técnica que se utilizó para implante fue la recomendada por los fabricantesA clinical descriptive and prospective study of the follow-up of 21 patients who received implant of the Prolene inguinal hernia repair system in inguinal hernias reproduced between October l5th, 1998, and March 31st, 1999, was conducted aimed at evaluating the results. The short-stay surgery method, local anesthesia and sedation, or spinal anesthesia and prophylactic antibiotic therapy were used in all cases. No relapses or postoperative complications were reported in a very short-term follow-up. More than half of the patients had undergone more than 2 operations. Average age was 49 and there was a predominance of males. The technique used for the implant was the one recommended by the manufacturers

  16. [Spinal anesthesia versus general anesthesia in the surgical treatment of inguinal hernia. Cost-effectiveness analysis].

    Science.gov (United States)

    Fernández-Ordóñez, M; Tenías, J M; Picazo-Yeste, J

    2014-05-01

    To compare the costs related to the clinical effectiveness of general anesthesia versus spinal anesthesia in inguinal hernioplasty ambulatory surgery. An observational, retrospective cohort study measurement and analysis of cost-effectiveness, in the ambulatory surgery unit of a general hospital. All patients over 18 years of age diagnosed with primary inguinal hernia and scheduled for unilateral hernioplasty between January 2010 and December 2011 were included. Duration of anesthetic induction, length of stay in both the operating room, and in the post-anesthesia care unit, the anesthetic effectiveness (the incidence of adverse effects and the patient's comfort level), and variable economic costs associated with the use of drugs, as well as the use of human resources, were compared. The final analysis included 218 patients, 87.2% male, with a mean age of 53 years (range: 18-85 years). Of these, 139 (63.76%) received subarachnoid anesthesia and 79,(36.2%) general anesthesia. The length of time a patient remained in the post-anesthesia care unit was 337.6±160.2min in the subarachnoid anesthesia group, and 210.0±97.5min for the general anesthesia group (P<.001). Costs of drugs for general anesthesia were higher than that for subarachnoid anesthesia (86.2±8.3 vs. 18.7±7.2). The total cost difference between the 2 techniques was €115.8 more for subarachnoid anesthesia (P<.001). Both techniques showed similar effectiveness. The overall costs for subarachnoid anesthesia were greater than for the general. The cost-effectiveness of general anesthesia is better for outpatient inguinal hernia repair surgery. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  17. Technique of Rutkow and Robbins (plug and patch to the reparation of inguinals hernias.

    Directory of Open Access Journals (Sweden)

    Ángel S. Luque

    2009-12-01

    Full Text Available Objetivo: Caracterizar la reparación de las hernias inguinales según la técnica de Rutkow y Robbins (tapón y parche con malla de polipropileno. Material y Métodos: Se realizó un estudio descriptivo donde se evaluaron 102 pacientes de la Consulta de Cirugía General, del Hospital Dr. Manuel Noriega Trigo, San Francisco, Venezuela con diagnóstico de hernia inguinal primaria, en el lapso de enero 2002 a 30 de septiembre 2005. Se practicaron 124 hernioplastias porque 11 pacientes presentaban hernias bilaterales. Se valoró sexo, edad, tipo de hernia, tiempo quirúrgico, dolor postoperatorio, período de estancia hospitalaria, reincorporación al trabajo habitual y complicaciones. Resultados: Del total de pacientes, 91 (89.2% eran del sexo masculino y 11 (10.8% del femenino. El promedio de edad fue 42.7±18.29, con un rango que oscilaba entre 12 y 82 años, el grupo etario más frecuente fue de 21 a 30 años (23.5%. En el sexo masculino predominó la hernia inguinal indirecta con 47 casos de los cuales 25.5% eran derechas y 20.6% izquierdas, en el sexo femenino prevaleció la hernia directa con 4 casos (3.9%. El tiempo quirúrgico tuvo un promedio de 32.18±6.42 minutos. El dolor postoperatorio se informó como molestia (33.3% o leve (39.2% en la mayoría de los casos, moderado en 8.8% y en ningún caso se supo de dolor severo. La estancia hospitalaria fue 23.41±3.8 horas, con cifras entre 3 y 40 horas; el reintegro al trabajo promedió 21.56±6.5 días (entre 10 y 40. Las complicaciones post-operatorias se presentaron en 6.9% de los pacientes: infección de la herida, 1%; hematoma, 1%; seromas, 2%; 1% neuralgia inguinal, 1%; y retención urinaria, 2%. Conclusión: Técnica rápida de ejecutar, poca morbilidad postoperatoria, corta estancia, pronto reintegro laboral y escasas complicaciones, por lo que demostró ser segura para la reparación de las hernias inguinales.

  18. Systemic inflammatory responses during laparoscopic and open inguinal hernia repair: a randomised prospective study

    DEFF Research Database (Denmark)

    Jess, P; Schultz, Karen; Bendtzen, K

    2000-01-01

    To see if the inflammatory responses during and after laparoscopic and open inguinal hernia repairs differed.......To see if the inflammatory responses during and after laparoscopic and open inguinal hernia repairs differed....

  19. Inguinal hernia recurrence: Classification and approach

    Directory of Open Access Journals (Sweden)

    Campanelli Giampiero

    2006-01-01

    Full Text Available The authors reviewed the records of 2,468 operations of groin hernia in 2,350 patients, including 277 recurrent hernias updated to January 2005. The data obtained - evaluating technique, results and complications - were used to propose a simple anatomo-clinical classification into three types which could be used to plan the surgical strategy:Type R1: first recurrence ′high,′ oblique external, reducible hernia with small (< 2 cm defect in non-obese patients, after pure tissue or mesh repairType R2: first recurrence ′low,′ direct, reducible hernia with small (< 2 cm defect in non-obese patients, after pure tissue or mesh repairType R3: all the other recurrences - including femoral recurrences; recurrent groin hernia with big defect (inguinal eventration; multirecurrent hernias; nonreducible, linked with a controlateral primitive or recurrent hernia; and situations compromised from aggravating factors (for example obesity or anyway not easily included in R1 or R2, after pure tissue or mesh repair.

  20. Herniorrafia inguinal: anestesia local ou regional? Inguinal herniorrhaphy: local or regional anesthesia?

    Directory of Open Access Journals (Sweden)

    Kelston Paulo Felice de Sales

    2000-05-01

    Full Text Available A herniorrafia inguinal é um dos procedimentos cirúrgicos mais realizados no mundo. Devido a isso tem-se procurado otimizar o procedimento, diminuindo custos, tempo de internamento e complicações decorrentes do ato operatório e da anestesia. Neste trabalho, fizemos uma análise comparativa entre anestesia regional e anestesia local na herniorrafia de 32 pacientes divididos em dois grupos. No grupo 1, foi utilizada anestesia regional e, no grupo 2, anestesia local. Em relação ao desconforto transoperatório, o método de anestesia regional se mostrou mais efetivo. Já em relação a incidência de complicações pós-operatórias e diminuição do tempo de internamento, a anestesia local se mostrou mais eficiente.Inguinal herniorrhaphy is one of the most frequent surgical procedures around the world. Therefore its optimization has been tried to reduce expenses, hospitalization time and complications resulting from surgical and anesthetic procedures. This experiment compared regional and local anesthesia in herniorrhaphy of 32 patients divided into two groups. Regional anesthesia was applied to group one patients and local anesthesia was applied to group two patients. Regional anesthesia showed to be more effective in terms of trans-surgical discomfort while local anesthesia showed to be more efficient in reducing post-surgical complications and hospitalization time.

  1. Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital

    OpenAIRE

    2016-01-01

    Background Local anesthesia (LA) has been reported to be the best choice for elective open inguinal hernia repair because it is cost efficient, with less post-operative pain and enables more rapid recovery. However, the role of LA in emergency inguinal hernia repair is still controversial. The aim of this study is to investigate the safety and effectiveness of LA in emergency inguinal hernia repair. Methods All patients underwent emergency inguinal hernia repair in our hospital between Januar...

  2. Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma

    Directory of Open Access Journals (Sweden)

    Muhammed Beşir Öztürk

    2014-01-01

    Full Text Available Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity.

  3. [Azoospermia and a history of inguinal hernia repair in adult].

    Science.gov (United States)

    Khodari, M; Ouzzane, A; Marcelli, F; Yakoubi, R; Mitchell, V; Zerbib, P; Rigot, J-M

    2015-10-01

    Inguinal hernia repair is one of the most performed surgeries in the world. It is recognized that any surgery of the pelvic floor may represent a risk factor of male infertility. Retrospective study of patients with azoospermia and a history of adult inguinal hernia repair surgery and referred to our center between January 1990 and January 2011 for infertility. Among 69 azoospermia patients with history of adult inguinal hernia repair surgery, 60 patients underwent surgical extraction of sperm that was successful in 75% (45/60). Positive extraction rate decreases in the subgroup of patients with risk factors for infertility (61.4%) as well as in the group with bilateral inguinal hernia (67.9%). There was no statistically significant difference in the positive rate of sperm retrieval according to surgical technique or according to the use of polypropylene mesh (P>0.05). The obstruction of the vas deferens due to an inguinal hernia repair was a potential iatrogenic cause of male infertility that was rare and underestimated. The influence of using a polypropylene mesh was not clearly demonstrated. The management of these patients is based on prevention in order to identify patients with risk factors of infertility in order to propose a presurgery cryopreservation of sperm. 5. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Inguinal hernias associated with a single strenuous event.

    Science.gov (United States)

    Williamson, J S; Jones, H G; Radwan, R R; Rasheed, A

    2016-10-01

    There is debate regarding the role of physical activity and, in particular, a single strenuous event (SSE) in the development of inguinal hernia. This study aims to identify the incidence and associated features of hernias perceived to be due to a single strenuous event and to compare their features with published guidelines. All consecutive patients surgically treated for primary inguinal hernia at a single NHS trust between April 2010 and April 2011 were identified and contacted to participate in a questionnaire. Clinical details from operative records and case notes were compared with patients' responses to identify features of their presentation attributable to a single strenuous event according to previously published guidelines. Three hundred and thirty five eligible patients were contacted with a response rate of 292 (87 %). 41/292 (14 %) of patients reported an SSE associated with the onset of their hernia. Only 2 of 41 (5 %) patients reporting a hernia associated with SSE met published criteria for association of the hernia with SSE, and this represented less than 1 % of all patients treated for inguinal hernia at a single centre in a 1-year period. The relationship between physical activity and development of inguinal hernia is under debate; however, we find that inguinal hernia that can be attributed to SSE is a rare event, despite the fact that many patients present with acute symptoms. Updated guidelines for the assessment of 'cause' in industrial claims for the association of hernia with workplace activity are required.

  5. Unusual initial presentation of herpes simplex virus as inguinal lymphadenopathy.

    Science.gov (United States)

    Fleming, Sarah A; Strickler, John G

    2015-01-01

    Genital herpes simplex virus (HSV) infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy.

  6. Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Sarah A. Fleming

    2015-01-01

    Full Text Available Genital herpes simplex virus (HSV infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy.

  7. Dermatofibrosarcoma protuberans en el dorso del pie: a propósito de un caso

    OpenAIRE

    2015-01-01

    El dermatofibrosarcoma protuberans es un tumor de partes blandas poco frecuente, de etiología desconocida y crecimiento lento. Con una incidencia de metástasis inferior al 5%, presenta una tasa de recidivas superiores al 30%. Presentamos el caso de un dermatofibrosarcoma protuberans en el dorso del pie que requirió una amplia resección del tumor y la posterior cobertura mediante colgajo pediculado libre anterolateral de muslo. El paciente se encuentra tras 4 años libre de enfermed...

  8. Imaging findings of angiomyxolipoma of the spermatic cord mimicking inguinal hernia

    NARCIS (Netherlands)

    Cho, H.S.; Woo, J.Y.; Hong, H.S.; Yang, I.; Lee, Y.; Jung, A.Y.; Yang, D.H.; Kim, J.W.

    2013-01-01

    We report the case in a 72-year-old man who presented with a right inguinal mass and with a one month history that was initially interpreted as an inguinal hernia. Ultrasonography (US) and computed tomography (CT) demonstrated a right inguinal mass, including myxoid and fat component, extending from

  9. Aneurisma da veia femoral simulando uma hérnia inguinal Femoral vein aneurysm simulating an inguinal hernia

    Directory of Open Access Journals (Sweden)

    Victor Assad Buffara-Jr

    2009-12-01

    Full Text Available INTRODUÇÃO: Somente seis casos de aneurismas da veia femoral simulando hérnia inguinal foram descritos na literatura. RELATO DO CASO: Um caso de aneurisma da veia femoral comum direita que simulava uma hérnia inguinal é descrito em jovem de 19 anos de idade com uma massa dolorosa de consistência mole na região inguinal direita de seis meses de duração. Durante a consulta médica, o paciente morreu durante em episódio de convulsão generalizada. Na necropsia, tromboembolismo pulmonar maciço e um aneurisma da veia femoral comum de 8x8x7 cm com trombos foram diagnosticados.BACKGROUND: Only six cases of femoral vein aneurysm are related on medical literature. CASE REPORT: A case of a right common femoral vein aneurysm simulating an inguinal hernia in a 19 year-old male. He had a soft and painful mass in the right inguinal area of six months of duration. At medical consultation, the patient died during a generalized convulsive episode. At necropsy, massive pulmonary thromboembolism and an 8x8x7 cm common femoral vein aneurysm with thrombus were recognized.

  10. An animal model to train Lichtenstein inguinal hernia repair

    DEFF Research Database (Denmark)

    Rosenberg, J; Presch, I; Pommergaard, H C

    2013-01-01

    PURPOSE: Inguinal hernia repair is a common surgical procedure, and the majority of operations worldwide are performed ad modum Lichtenstein (open tension-free mesh repair). Until now, no suitable surgical training model has been available for this procedure. We propose an experimental surgical...... training model for Lichtenstein's procedure on the male and female pig. METHODS: In the pig, an incision is made 1 cm cranially to the inguinal sulcus where a string of subcutaneous lymph nodes is located and extends toward the pubic tubercle. The spermatic cord is located in a narrow sulcus in the pig...... pigs, and a total of 55 surgeons have been educated to perform Lichtenstein's hernia repair in these animals. CONCLUSIONS: This new experimental surgical model for training Lichtenstein's hernia repair mimics the human inguinal anatomy enough to make it suitable as a training model. The operation...

  11. REAPPRAISAL OF DARNING METHOD OF INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Pawan

    2014-05-01

    Full Text Available OBJECTIVE: To evaluate the darning method of inguinal hernia repair with polypropylene. MATERIAL AND METHODS: 125 Patient of unilateral or bilaterally inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by standard procedure using no-1 polypropylene. Patients were operated under spinal, general anesthesia or local anesthesia. Patients were followed up at one week, four weeks and six months after operation for wound healing and complications. RESULTS: Out of 125 patients, ranging in age from 18 to 85 Years, 90 patients (72% were given spinal anesthesia, 28 Patients, (22.4% were operated under general anesthesia, 7 patients under local anesthesia. Patients were discharged from the hospital after 4 days. 20 Patients were above 50 yr. who were operated under spinal anesthesia were catheterized to prevent urinary retentions. Recurrence rate was 1.6% CONCLUSION: Darning methods of inguinal hernia repair with polypropylene is a safe and cheaper method of hernia repair

  12. Experiencia en hernioplastía inguinal con anestesia local.

    OpenAIRE

    Aliaga Chávez, Noél

    2013-01-01

    Objetivo: Evaluar la utilidad de la cirugía ambulatoria con anestesia local en pacientes con patología herniaria inguinal. Material y métodos: Se realizó un estudio descriptivo tipo serie de casos, entre abril de 1996 y marzo de 1999, en el Servicio de Cirugía de la Clínica Fiori. Se intervinieron 1,167 pacientes por patología de pared abdominal, de las cuales 432 correspondieron a pacientes intervenidos por patología herniaria inguinal, de ellos 372 fueron operados con anestesia local, los c...

  13. Laparoscopic surgery for inguinal hernia: Current status and controversies

    Directory of Open Access Journals (Sweden)

    Bhandarkar Deepraj

    2006-01-01

    Full Text Available Repair of inguinal hernia is one of the commonest operations performed by surgeons around the world. The treatment of this common problem has seen an evolution from the pure tissue repairs to the prosthetic repairs and in the recent past to laparoscopic repair. The fact that so many hernia repairs are practiced is a testimony to the fact that probably none is distinctly superior to the other. This review assesses the current status of surgery for repair of inguinal hernia and examines the various controversial issues surrounding the subject.

  14. INTRAOPERATIVE PNEUMOTHORAX COMPLICATING TOTALLY EXTRAPERITONEAL INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Charulatha

    2015-07-01

    Full Text Available Laparoscopic inguinal hernia repair compared with open procedure is associated with reduced recurrence rate and earlier return to work. [1,2] Though insufflation of carbon dioxide is limited to preperitoneal space, higher insufflation pressures and longer operative times have been associated with pneumothorax and pneumomediastinum even during totally extra peritoneal patchplasty (TEP . [3] We present a patient who developed pneumothorax due to inadvertent peritoneal tear during hernial sac dissection that resolved with conservative management in the postoperative period. This case report highlights the importance of peritoneal tear closure before proceeding with the rest of the procedure during extra peritoneal inguinal hernia repair.

  15. Toxic shock syndrome following inguinal hernia repair: a rare condition

    Directory of Open Access Journals (Sweden)

    Rohit Prasad Yadav

    2014-01-01

    Full Text Available A 25-year-old man developed fulminant multisystem failure 28 hours after elective repair of an inguinal hernia. Toxic shock syndrome (TSS was diagnosed. The patient recovered fully with supportive care in ICU, antibiotics, and IV human immunoglobin . To the best of our knowledge, only one case of TSS following inguinal hernia repair have ever been previously published. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 57-59 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9689

  16. Direct and Recurrent Inguinal Hernias are Associated with Ventral Hernia Repair

    DEFF Research Database (Denmark)

    Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten

    2013-01-01

    A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the pr......A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim...... of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery....

  17. Reduction en masse of inguinal hernia: MDCT findings of two cases.

    Science.gov (United States)

    Hoshiai, S; Mori, K; Shiigai, M; Uchikawa, Y; Watanebe, A; Shiotani, S; Atake, S; Minami, M

    2015-12-01

    Reduction en masse of inguinal hernia is an extremely rare complication arising from manual reduction of a hernia. The hernial content remaining in the hernia sac returns above the inguinal canal but remains in the abdominal wall. Accurate preoperative diagnosis of reduction en masse of inguinal hernia is challenging because the hernia appears to be reduced upon physical examination. We experienced two cases of reduction en masse. In both cases, multidetector row computed tomography revealed a closed loop obstruction near the inguinal fossa. In addition, we observed a continuous tract of the hernia sac to the inguinal canal and prominent peritoneal thickening suggestive of the hernia sac.

  18. Hérnia inguinal na infância Inguinal hernia in childhood

    Directory of Open Access Journals (Sweden)

    Ennio Gabriel

    2001-12-01

    Full Text Available A persistência do conduto peritoniovaginal (CPV pode se manifestar como hérnia inguinal indireta, hidrocele comunicante, cisto do cordão ou pela combinação de duas ou até três destas formas. A hérnia é muito comum na infância, seu número vem crescendo com a sobrevida cada vez maior de prematuros de baixo peso, e deve ser operada sem demora devido ao risco de encarceramento. Já o cisto e a hidrocele só serão operados após uma certa espera pela sua cura espontânea. São resumidos o quadro clínico e o diagnóstico de cada uma das três formas de apresentação. A irredutibilidade, seja o simples encarceramento ou o estrangulamento, é analisada, lembrando aspectos característicos da criança, como por exemplo o risco que corre o testículo. A técnica operatória na criança é centralizada na ligadura do conduto peritoniovaginal. A conduta a tomar em situações especiais, como o encontro de uma Síndrome de Testículos Feminizantes é descrita, assim como as variantes técnicas a serem empregadas nos casos mais difíceis. Os casos em que a operação não pode ser limitada à simples ligadura do saco são lembrados. A conduta terapêutica na hérnia irredutível é descrita. O problema de explorar ou não a região inguinal oposta, dada a freqüência com que a persistência do CPV é bilateral, é analisado, mostrando os parâmetros que podem nortear a conduta em cada caso, inclusive o uso da videolaparoscopia. Finalmente, são revistas as complicações peculiares à cirurgia da hérnia na criança, lembrando que a recidiva é muito menos freqüente que no adulto.The patent processus vaginalis can appear as an indirect inguinal hernia, a hydrocele, a spermatic cord cyst or by the combination of two or three of these forms. Hernia is very common during childhood and its rate is increasing along with the ever growing survival of low weight premature child. Hernia must be operated without delay because of the incarceration risk

  19. Hérnia inguinal na infância Inguinal hernia in childhood

    OpenAIRE

    Ennio Gabriel

    2001-01-01

    A persistência do conduto peritoniovaginal (CPV) pode se manifestar como hérnia inguinal indireta, hidrocele comunicante, cisto do cordão ou pela combinação de duas ou até três destas formas. A hérnia é muito comum na infância, seu número vem crescendo com a sobrevida cada vez maior de prematuros de baixo peso, e deve ser operada sem demora devido ao risco de encarceramento. Já o cisto e a hidrocele só serão operados após uma certa espera pela sua cura espontânea. São resumidos o quadro clíni...

  20. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Linderoth, G; Kehlet, H; Aasvang, E K;

    2011-01-01

    About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim...... of the study was to describe and classify patients with severe persistent pain after laparoscopic herniorrhaphy....

  1. Two Ports Laparoscopic Inguinal Hernia Repair in Children

    Directory of Open Access Journals (Sweden)

    Medhat M. Ibrahim

    2015-01-01

    Full Text Available Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7% cases were suffering unilateral hernia and 20 (22.2% patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%. The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.

  2. Postural stability after inguinal herniorrhaphy under local infiltration anaesthesia

    DEFF Research Database (Denmark)

    Persson, F; Kristensen, Billy Bjarne; Lund, Claus;

    2001-01-01

    patients listed for elective inguinal herniorrhaphy. INTERVENTIONS: Preoperative and intraoperative infiltration anaesthesia by bupivacaine 2.5 mg/ml (median dose 41 ml, range 30-84 ml), and sedation with midazolam intraoperatively (median dose 3 mg, range 0-10 mg). Lichtenstein tension-free technique...

  3. Nerve-identifying inguinal hernia repair : A surgical anatomical study

    NARCIS (Netherlands)

    Wijsmuller, A. R.; Lange, J. F. M.; Kleinrensink, G. J.; van Geldere, D.; Simons, M. P.; Huygen, F. J. P. M.; Jeekel, J.; Lange, J. F.

    2007-01-01

    Background: Pain syndromes of somatic and neuropathic origin are considered to be the main causes of chronic pain after open inguinal hernia repair. Nerve-identification during open hernia repair is suggested to be associated with less postoperative chronic pain. The aim of this study was to define

  4. Incidence of inguinal hernia in children with congenital cerebral palsy

    DEFF Research Database (Denmark)

    Reimers, J I; Latocha, J E

    1990-01-01

    The incidence of inguinal hernia among 247 children with cerebral palsy was ascertained. During the first year of life, 20 of the 153 boys developed hernia, as did one of the 94 girls. Among boys with birthweights of 1000 to 2000g the incidence was 31 per cent, which is twice the rate for normal...

  5. Current status of laparoscopic inguinal hernia repair in Denmark

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Bay-Nielsen, M

    2008-01-01

    BACKGROUND: Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume for lapar......BACKGROUND: Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume...... for laparoscopic inguinal hernia repair, it is important to know the typical indications for surgery, re-operation rates, details of surgical technique, and status of surgical training on a national level in order to rationalize interventions to improve outcome. METHODS: Data from the National Hernia Database...... for the last 8 years regarding laparoscopic inguinal hernia repair were used in combination with questionnaire data obtained from all surgical units in Denmark. The questionnaire included issues such as the number of operating surgeons in the department, number of residents training in the laparoscopic...

  6. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Linderoth, G; Kehlet, H; Aasvang, E K

    2011-01-01

    About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim...... of the study was to describe and classify patients with severe persistent pain after laparoscopic herniorrhaphy....

  7. Ultrasound-guided nerve block for inguinal hernia repair

    DEFF Research Database (Denmark)

    Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth;

    2012-01-01

    Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

  8. Sonographic findings of inguinal herniation of the ovary

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung; Lee, Sun Wha [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2003-09-01

    To describe the sonographic findings of inguinal herniation of the ovary. Forty-five girls aged 1-12 (mean, 4.7) months with a groin mass underwent sonographic examination, and in seven of the 45, inguinal herniation of the ovary was detected, and confirmed at surgery. Gray-scale and color Doppler sonographic examinations were performed to evaluated the size, echo pattern, and blood flow of the mass. Sonography of the pelvis and contralateral groin was also performed. In all seven cases, sonography revealed an oval-shaped complex mass 15-25 mm in maximal diameter and composed of heterogeneous hypoechoic portions and one to seven small internal cysts, each 2-9 mm in diameter. Blood flow was observed in all cases, though was subtly decreased in one. In two there was associated herniation of the salpinx, and in two others, incarceration. In four, contralateral inguinal hernia was present. Sonographic findings of an oval-shaped heterogeneous hypoechoic mass with internal small cysts, present in the groin, indicate inguinal herniation of the ovary.

  9. Postural stability after inguinal herniorrhaphy under local infiltration anaesthesia

    DEFF Research Database (Denmark)

    Persson, F; Kristensen, Billy Bjarne; Lund, Claus

    2001-01-01

    patients listed for elective inguinal herniorrhaphy. INTERVENTIONS: Preoperative and intraoperative infiltration anaesthesia by bupivacaine 2.5 mg/ml (median dose 41 ml, range 30-84 ml), and sedation with midazolam intraoperatively (median dose 3 mg, range 0-10 mg). Lichtenstein tension-free technique...

  10. The Burnia: Laparoscopic Sutureless Inguinal Hernia Repair in Girls.

    Science.gov (United States)

    Novotny, Nathan M; Puentes, Maria C; Leopold, Rodrigo; Ortega, Mabel; Godoy-Lenz, Jorge

    2017-04-01

    Laparoscopic inguinal hernia repair in children is in evolution. Multiple methods of passing the suture around the peritoneum at the level of the internal inguinal ring exist. Cauterization of the peritoneum at the internal ring is thought to increase scarring and decrease recurrence. We have employed a sutureless, cautery only, laparoscopic single port repair of inguinal hernias and patent processus vaginalis (PPV) in girls. After institutional ethical review was obtained, a retrospective review of sutureless laparoscopic inguinal hernia repairs in girls by 4 surgeons at separate institutions was performed. Patient demographics, intraoperative findings, and postoperative outcomes were recorded and analyzed. The technique involves an umbilical 30° camera and either a separate 3 mm stab incision in the midclavicular line or a 3 mm Maryland grasper placed next to the camera, and the distal most portion of the hernia sac is grasped and pulled into the abdomen and cauterized obliterating the sac. Eighty inguinal hernias were repaired using this technique in 67 girls between July 2009 and September 2015. The ages and weights ranged from 1 month to 16 years and from 2 to 69 kg, respectively. There was one conversion to open approach because an incarcerated ovary was too close to the ring. A single umbilical incision was utilized in 85%. Fifty-seven percent patients had hernias on the right whereas 42% had hernias on the left. Of the patients with presumed unilateral hernias, 22 patients were found to have PPV and were treated through the same incisions, 17/22 were found during a contralateral hernia surgery and 5/22 were found incidentally during appendectomy. Average operative time for unilateral and bilateral hernias was 22 minutes (5-38 minutes) and 31 minutes (11-65 minutes), respectively. No patient required a hospital stay because of the hernia repair. At an average of 25 months follow-up (1.6-75 months), there were no recurrences. The only complication was

  11. Cierre de una fístula oroantral usando cemento óseo y un colgajo de mucosa yugal Closure of an oroantral fistula using bone cement and a jugal mucosa flap

    Directory of Open Access Journals (Sweden)

    Beatriz Ágreda Moreno

    2012-03-01

    Full Text Available Una fístula oroantral es una solución de continuidad patológica entre el seno maxilar y la cavidad oral, producida frecuentemente tras una extracción dentaria, en la mayoría de los casos, del primer o segundo molar. El síntoma más común que provoca es una sinusitis aguda, que evolucionará a la cronicidad si la fístula permanece. El diagnóstico se realiza mediante endoscopia transalveolar, ortopantografía o tomografía computarizada dental. Su cierre quirúrgico es necesario cuando la fístula tiene más de 3 mm, o no sella por sí misma en 3 semanas. Existen, para ello, varias técnicas, usando distintos materiales y colgajos, cuyo fin es ocluir, tanto el defecto óseo, como el mucoso, para solucionar así a la vez la fístula y el problema sinusal.The oroantral fistula is a solution of pathological continuity between the maxillary sinus and the oral cavity, frequently produced after a teeth extraction in most of cases of the first or second molars. The commonest symptom provoked is an acute sinusitis evolving to chronicity if the fistula remains. The diagnosis is made by transalveolar, orthopantography or dental computerized tomography. Its surgical closure is necessary when the fistula has more than 3 mm or not seal by itself in three weeks. For it, there are some techniques using different materials and flaps where its objective is to occlude the bone defect as well as the mucous one thus solving the fistula and the sinus problem.

  12. Inguinodynia in patients submitted to conventional inguinal hernioplasty.

    Science.gov (United States)

    Dias, Bruno Garcia; Santos, Marcelo Protásio Dos; Chaves, Ana Barbara DE Jesus; Willis, Mariana; Gomes, Marcio Couto; Andrade, Fernandes Tavares; Melo, Valdinaldo Aragão DE; Santos, Paulo Vicente Dos

    2017-01-01

    to evaluate the incidence of chronic pain and its impact on the quality of life of patients submitted to inguinal hernioplasty using the Lichtenstein technique. this was a descriptive, cross-sectional study of patients operated under spinal anesthesia from February 2013 to February 2015 and who had already completed six postoperative months. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. out of 158 patients submitted to the procedure, we identified 7.6% as having inguinodynia. Of these, there was an impact on the quality of life in 25%. the incidence of inguinodynia after hernioplasty with repercussion in quality of life was similar to the one of found in the world literature. avaliar a incidência de dor crônica e o seu impacto na qualidade de vida de pacientes submetidos à hernioplastia inguinal pela técnica de Lichtenstein. trata-se de estudo transversal descritivo, de pacientes operados de hérnia inguinal pela técnica de Lichtenstein sob anestesia raquidiana, no período de fevereiro de 2013 a fevereiro de 2015, e que já haviam completado seis meses de pós-operatório. Os pacientes foram questionados sobre a presença de dor inguinal crônica e, caso confirmada, convidados a uma consulta na qual foi feita análise da qualidade da dor e seu impacto na qualidade de vida. do total de 158 pacientes submetidos ao procedimento, 7,6% foram identificados como portadores de inguinodinia. Destes, houve impacto na qualidade de vida em 25%. observou-se incidência de inguinodinia pós-hernioplastia com repercussão na qualidade de vida semelhante à literatura mundial.

  13. Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Serdar Karaca

    2013-10-01

    Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

  14. Manual de disección de colgajos del miembro inferior / Manual surgical dissection of autonomy: lower limb flaps

    OpenAIRE

    Molina Traslaviña, Jaime

    2012-01-01

    La práctica en el laboratorio de anatomía es una herramienta importante en la formación de los residentes de las especialidades quirúrgicas en especial de cirugía plástica, estas prácticas dan mayor confianza, destreza y familiaridad al residente para el momento de enfrentarse a un procedimiento quirúrgico in vivo. Este manual de disecciones de anatomía quirúrgica pretende motivar y facilitar la utilización de este recurso tan importante, además de ser una herramienta de consul...

  15. Inguinal hernia repair: anaesthesia, pain and convalescence.

    Science.gov (United States)

    Callesen, Torben

    2003-08-01

    Elective surgical repair of an inguinal or femoral hernia is one of the most common surgical procedures. The treatment, however, presents several challenges regarding anaesthesia for the procedure, the postoperative analgesic therapy and convalescence, as well as planning of the procedure. Local, general, and regional anaesthesia are all used for hernia repair, but to different degrees, primarily depending on traditions and whether the institution has specific interest in hernia surgery. Thus, the use of local anaesthesia varies from a few percent in Sweden, 18% in Denmark and up to almost 100% in specialised institutions, dedicated to hernia surgery. The feasibility of local anaesthesia is high, as judged by the rate of conversion to general anaesthesia (thirds have moderate or severe pain during activity, while one third still have moderate or severe pain after one week, and approximately 10% after 4 weeks. Pain after laparoscopic surgery is less pronounced than after open surgery, while different open repair techniques do not exhibit significant differences. Postoperative pain is best treated with a combination of local analgesia and peripherally acting agents (paracetamol, NSAID or their combination), while opioids should be avoided due to side effects, primarily nausea and sedation. Moderate or severe pain one year postoperatively is seen in 5-12% of patients. There seem to be no difference between different surgical or anaesthetic techniques, but the following factors have been related to a higher rate of chronic pain: previous or subsequent hernia surgery on the same side, young age, pain before surgery, high pain scores in the immediate postoperative period, and postoperative complications and prolonged convalescence. Patients should be informed about the risk of chronic pain, particularly if the hernia is asymptomatic. The duration of convalescence after hernia repair varies considerably, primarily due to variation in recommendations. No documentation is

  16. Planificación preoperatoria de los colgajos de perforantes de la arteria epigàstrica inferior profunda (DIEP) mediante el estudio con el TAC de multidetectores

    OpenAIRE

    Masià Ayala, J. Jaume

    2009-01-01

    Tesis Doctoral realizada como compendio de publicaciones, basada en 6 trabajos: 1 capitulo de un libro publicado en USA (Perforator Flaps: Anatomy, Techniques. QMP 2006), 4 articulos publicados en las revistas de cirugía plástica con mayor factor de impacto (J Plast Reconstr Aesthetic Surg, Cir Plas Iberolatinoam, Ann Plast Surg, Plast Reconstr Surg) y 1 articulo publicado en una revista de radiología (Am J Roentgenol). Por su versatilidad, menor morbilidad y óptimos resultados, los colgajos ...

  17. Rehabilitación implantosoportada en el colgajo libre de peroné Implant-supported rehabilitation using the fibula free flap

    OpenAIRE

    C. Navarro Cuéllar; S. Ochandiano Caicoya; F. Riba Garcia; F.J. Lopez de Atalaya; J. Acero Sanz; M. Cuesta Gil; C. Navarro Vila

    2006-01-01

    El colgajo de peroné ha demostrado ser el más versatil para la reconstrucción oromandibular, gracias a la gran longitud ósea que podemos utilizar y a la posibilidad de incorporar una amplia paleta cutánea para cobertura de tejidos blandos intraorales. El uso de implantes dentales osteointegrados proporciona un importante método terapéutico para la rehabilitación oral de estos pacientes. Los implantes osteointegrados proporcionan la forma más rígida de estabilización protésica para soportar la...

  18. Anatomía arterial de los colgajos musculares de extensor carpi radialis longus y extensor carpi radialis brevis para su uso en transferencia muscular funcional libre Arterial anatomy of the extensor carpi radialis longus and extensor carpi radialis brevis muscle flaps related to its use in free functioning muscle transfer

    Directory of Open Access Journals (Sweden)

    A. Rodríguez Lorenzo

    2008-09-01

    Full Text Available El objetivo de este trabajo es documentar el aporte arterial y el patrón vascular intramuscular de los músculos Extensor Carpi Radialis Longus (ECRL y Extensor Carpi Radialis Brevis (ECRB para analizar su utilización como colgajos libres en transferencia muscular funcional para reanimación facial. Realizamos un estudio anatómico en 29 brazos humanos en fresco. Las técnicas de inyección utilizadas fueron la modificada de oxido de plomo y gelatina en 11 cadáveres y la de inyección pulsátil de látex color en 18. Disecamos los músculos ECRL y ECRB y sus pedículos, los fotodocumentamos y radiografiamos valorando los resultados en función del patrón vascular intramuscular, relaciones anatómicas, calibres y longitud de pedículos. Encontramos dos patrones vasculares diferentes en las 29 disecciones siguiendo la clasificación de Mathes y Nahai de la anatomía vascular de los músculos (en función del número de pedículos vasculares y su dominancia: Tipo I( 37,9% ECRL y 20,7% ECRB y Tipo II(62,1% del ECRL y 79,3% del ECRB. El pedículo principal del ECRL (de diámetro medio 1,73 mm y longitud de pedículo media de 32,32 mm es en el 100% de los casos rama de la arteria recurrente radial y el pedículo principal del ECRB (de diámetro medio 1,11 mm y longitud de pedículo media de 27,77 mm es rama de la arteria radial en el 68,9% de los casos y de la arteria recurrente radial en el 31,1% de los casos. Concluimos que El ECRL y ECRB presentan dos tipos de patrones vasculares: tipo I y tipo II, siendo más frecuente en nuestro trabajo el tipo II, que hacen que ambos puedan ser transferidos como colgajos libres por su pedículo principal. Ambos músculos presentan un tamaño, contorno, contenido fascial importante para el anclaje de suturas y una longitud de pedículo y calibre vascular adecuados para su transferencia microvascular libre en reanimación facial. De los dos, el más realizable como colgajo libre es el ECRB ya que la relaci

  19. Obliteración de fracturas de seno frontal con colgajos pediculados

    OpenAIRE

    J. Pefaure; M. Mackfarlane; G. Bustos-Martínez; C. Angrigiani

    2014-01-01

    El compromiso del seno frontal con fractura de sus paredes es un tipo de lesión infrecuente, en torno al 5-12% de todas las fracturas faciales. Suele asociarse a lesiones intracraneales, oftalmológicas y a otras fracturas máxilofaciales y cuando conlleva fractura de la pared posterior de seno frontal requiere tratamiento inmediato, siendo necesaria la obliteración del seno frontal debido a la comunicación con meninges y lóbulo frontal, con el riesgo infeccioso que ello representa. Tratamos 18...

  20. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era.

    Science.gov (United States)

    Esposito, Ciro; Escolino, Maria; Turrà, Francesco; Roberti, Agnese; Cerulo, Mariapina; Farina, Alessandra; Caiazzo, Simona; Cortese, Giuseppe; Servillo, Giuseppe; Settimi, Alessandro

    2016-08-01

    The surgical repair of inguinal hernia and hydrocele is one of the most common operations performed in pediatric surgery practice. This article reviews current concepts in the management of inguinal hernia and hydrocele based on the recent literature and the authors׳ experience. We describe the principles of clinical assessment and anesthetic management of children undergoing repair of inguinal hernia, underlining the differences between an inguinal approach and minimally invasive surgery (MIS). Other points discussed include the current management of particular aspects of these pathologies such as bilateral hernias; contralateral patency of the peritoneal processus vaginalis; hernias in premature infants; direct, femoral, and other rare hernias; and the management of incarcerated or recurrent hernias. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and hydrocele, emphasizing that the current use of MIS in pediatric patients has completely changed the management of pediatric inguinal hernias. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Surgical management of chronic pain after inguinal hernia repair

    DEFF Research Database (Denmark)

    Aasvang, E; Kehlet, H

    2005-01-01

    BACKGROUND: Chronic pain after inguinal hernia repair is an adverse outcome that affects about 12 per cent of patients. Principles of treatment have not been defined. This review examines neurectomy and mesh or staple removal as possible treatments. METHOD: A literature search was carried out using...... the Medline and Ovid databases. Keywords were 'pain; chronic', 'herniorrhaphy; inguinal', 'neurectomy' and similar words. Article references were cross-checked for additional references. Articles were reviewed for data on surgical treatment of chronic pain after hernia repair. RESULTS: Neurectomy...... of the ilioinguinal, iliohypogastric, genitofemoral or lateral femoral cutaneous nerve was described in 14 papers. Overall, a favourable outcome was reported. However, the methodological quality was poor in all studies in respect of preoperative diagnostic criteria and treatment, intraoperative success in identifying...

  2. Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Bischoff, Joakim Mutahi; Linderoth, Gitte; Aasvang, Eske Kvanner

    2012-01-01

    regarding dysejaculation and pain during sexual activity were mailed 3 months to 12 years after surgery, and 1,172 patients were included for analysis. RESULTS: The response rate was 68.7% (n = 805). Dysejaculation occurring after laparoscopic repair was present in 25 patients (3.1%). Pain from the groin......BACKGROUND: Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual...... activity after laparoscopic inguinal herniorrhaphy on a nationwide basis. METHODS: The study population comprised all men aged 18-50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires...

  3. Quiste subaracnoideo y displasia del ala mayor del esfenoides en neurofibromatosis

    Directory of Open Access Journals (Sweden)

    J. Cortés-Arreguín

    Full Text Available Los quistes subaracnoideos representan menos del 1% de los tumores de ocupación intracraneal. Hay pocas publicaciones acerca de quistes subaracnoideos del lóbulo temporal con remodelación de la cavidad orbitaria, pero no existen en relación al tratamiento reconstructivo de la cavidad orbitaria en esta patología. Presentamos el caso clínico de un varón de 44 años de edad con diagnóstico de neurofibromatosis tipo 1, aumento progresivo de volumen del ojo y párpado izquierdos de 40 años de evolución y dolor retro-ocular intermitente desde hacía 10 años, al que se le diagnostica un quiste subaracnoideo del lóbulo temporal que invade la cavidad orbitaria con displasia del ala mayor del esfenoides. Realizamos drenaje y cistocisternostomía del quiste subaracnoideo, con reconstrucción de paredes orbitarias con malla de titanio y cobertura con un colgajo de pericráneo así como elevación y reposicionamiento del globo ocular mediante cantopexias, seguida de una osteotomía de la órbita para reducir el volumen de la misma.

  4. Pediatric inguinal hernia repair-a critical appraisal

    DEFF Research Database (Denmark)

    Rosenberg, J.

    2008-01-01

    Inguinal hernia repair in infants and babies is a routine operation, but many issues have not been addressed scientifically. Thus, it is not known, e.g., if all children with a hernia should be operated on, what is the best timing of surgery, or if the operation should be performed with an open...... approach or laparoscopically. The review is a critical discussion of these and other issues in pediatric herniorrhaphy pointing out the need for further research Udgivelsesdato: 2008/4...

  5. Prehospital Emergency Inguinal Clamp Controls Hemorrhage in Cadaver Model

    Science.gov (United States)

    2013-07-01

    the CRoC preassembled for quick use. The clamp compresses the casualty’s tissues and is unat- tached to things like a litter. When screwed down, it is...for use on the battlefield to control difficult bleeds in the inguinal area. Study Design The study design was a sequence of experiments of clamp...temperature 4 hours before testing. The torso was rotated onto a wood block to intubate the aorta through a left thoracotomy incision. The thoracic aorta

  6. COMPARATIVE STUDY OF LICHTENSTEIN VERSUS DESARDA REPAIR FOR INGUINAL HERNIA

    Directory of Open Access Journals (Sweden)

    Sowmya

    2015-12-01

    Full Text Available BACKGROUND Inguinal hernia repair is the most frequently performed operation in any general surgical unit. The Bassini’s, Shouldice and other tissue-based techniques are still being acceptable for primary inguinal hernia repair. Desarda’s technique is originally a tissue based hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal. The aim of the present study was to compare Lichtenstein hernia repair and Desarda herniorrhaphy. METHODS A total of 40 patients with primary unilateral inguinal hernia were subjected either to Desarda herniorrhaphy or Lichtenstein hernioplasty. The patients were followed in terms of recurrence rate, post-operative complications, convalescence, chronic pain and cost effectiveness. RESULTS During the followup all patients had either mild or moderate pain, but the pain intensity was more in Lichtenstein repair compared to Desarda repair in the immediate postoperative period. In Lichenstein repair patients had chronic groin pain even at the end of one year, but none of the patients in Desarda repair had chronic groin pain. Complications such as seroma and wound infection were less in Desarda repair. Time taken to resume normal activities was significantly less in case of Desarda herniorrhaphy; however, there was no recurrence observed in both the groups during the followup period. Average cost incurred for Desarda repair was significantly less than Lichtenstein repair. CONCLUSION Lichtenstein method of hernia repair is simple and safe. But the mesh prosthesis has its drawbacks. Desarda hernia repair is based on physiological principles and the results are good with less convalescence period and fewer recurrences and no chronic groin pain. It is more cost effective.

  7. Inguinal hernioraphy under local anesthesia in the elderly patients

    OpenAIRE

    2012-01-01

    Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years) and theyounger. Anesthesia methods, additional anesthesia r...

  8. Direct and recurrent inguinal hernias are associated with ventral hernia repair: a database study.

    Science.gov (United States)

    Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten; Jorgensen, Lars N

    2013-02-01

    A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery. In the nationwide Danish Hernia Database, a cohort of 92,457 patients operated on for inguinal hernias was recorded from January 1998 until June 2010. Eight-hundred forty-three (0.91 %) of these patients underwent a ventral hernia operation between January 2007 and June 2010. A multivariate logistic regression analysis was applied to assess an association between inguinal and ventral hernia repair. Direct (Odds Ratio [OR] = 1.28 [95 % CI, 1.08-1.51]) and recurrent (OR = 1.76, [95 % CI, 1.39-2.23]) inguinal hernias were significantly associated with ventral hernia repair after adjustment for age, gender, and surgical approach (open or laparoscopic). Patients with direct and recurrent inguinal herniation are more prone to ventral hernia repair than patients with indirect inguinal herniation. This is the first study to show that herniogenesis is associated with type of inguinal hernia.

  9. Liposarcoma of the Spermatic Cord Masquerading as an Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    William Londeree

    2014-01-01

    Full Text Available This is a case of a 70-year-old male who presented with a mass in his right testicle. He was treated with antibiotics for epididymitis while undergoing serial ultrasounds for one year due to testicular swelling and pain. His fourth ultrasound revealed a mild hydrocele with a large paratesticular mass of undescribed size, superior to the right testicle, thought to be an inguinal hernia. Preoperative CT scan demonstrated a large fat-containing inguinal hernia extending into the scrotal sac. An inguinal hernia repair was complicated by fatty tissue surrounding the testicle requiring a right orchiectomy. Pathology review of the tissue demonstrated well-differentiated liposarcoma with a small focus of dedifferentiation grade 2 tumor. Tumor was identified at the inked margins indicating an incomplete resection. It was decided that no further surgical intervention was needed and the patient would undergo surveillance for local tumor recurrence. Six-month follow-up MRI scan was negative for any recurrence of disease. A liposarcoma presenting as a paratesticular mass with spermatic cord involvement is rare, and imaging studies may fail to distinguish a liposarcoma from normal adipose tissue.

  10. An inguinal hernia sac tumor of extrahepatic cholangiocarcinoma origin

    Directory of Open Access Journals (Sweden)

    Yamazaki Hidehiro

    2006-03-01

    Full Text Available Abstract Background Metastatic hernia sac tumor from biliary malignancy is extremely rare with only one such case previously reported. We herein report an additional case of extrahepatic cholangiocarcinoma presenting as a hernia sac tumor. Case presentation A 78-year-old man presented with an irreducible right inguinal hernia associated with a firm tumor, 2.0 cm in diameter. A computed tomography scan demonstrated a soft tissue density mass with heterogeneous enhancement within the right inguinal canal. The patient underwent a hernia repair and the hernia sac tumor was resected. Histological examination of the tumor revealed a metastatic adenocarcinoma suggesting the tumor was of pancreato-biliary origin. Further investigation using imaging studies disclosed a primary tumor in the upper bile duct. The patient died of the disease nine months after the resection. Conclusion Hernia sac tumors should be considered when an irreducible, growing mass appears within an inguinal hernia. Computed tomography may be useful for the early detection of hernia sac tumors from undiagnosed intra-abdominal malignancies.

  11. Transabdominal preperitoneal laparoscopic approach for incarcerated inguinal hernia repair

    Science.gov (United States)

    Yang, Shuo; Zhang, Guangyong; Jin, Cuihong; Cao, Jinxin; Zhu, Yilin; Shen, Yingmo; Wang, Minggang

    2016-01-01

    Abstract To investigate the efficacy, key technical points, and complication management of the transabdominal preperitoneal (TAPP) approach for incarcerated inguinal hernia repair. Seventy-three patients with incarcerated inguinal hernias underwent TAPP surgery in our department between Jan 2010 and Dec 2015. A retrospective review was performed by analyzing the perioperative data from these patients. The operation was successfully completed in all 73 patients. Operation time was 54.0 ± 18.8 minutes (range, 35–100 minutes). Length of stay was 3.9 ± 1.1 days (range, 3–9 days). There was 1 case of incisional infection, 32 cases of seroma, and 3 cases of postoperative pain during follow-up. All patients recovered after the appropriate treatment. No recurrence or fistula was observed. The TAPP approach represents a safe and effective technique for incarcerated inguinal hernia repair because of its potential in assessment of hernia content and decreasing incisional infection rate. However, it requires experienced surgeons to ensure safety with special attention paid to the key technical points as well as complication management. PMID:28033260

  12. Inguinal lymph node metastases from germ cell testicular tumors.

    Science.gov (United States)

    Klein, F A; Whitmore, W F; Sogani, P C; Batata, M; Fisher, H; Herr, H W

    1984-03-01

    Between 1948 and 1982, 22 patients were seen with metastasis to the inguinal nodes from testicular germ cell tumors: 8 had a history of unilateral or bilateral orchiopexy with or without herniorrhaphy, 4 had nonsurgically corrected or uncorrected cryptorchidism, 9 had a history of herniorrhaphy, hydrocelectomy or transscrotal orchiectomy and 1 had no history of scrotal, iliac or inguinal surgery, or of tunica vaginalis or scrotal wall involvement by tumor. The histological type was pure seminoma in 5 patients, embryonal carcinoma in 7 and mixed tumor in 10. Treatment was individualized for tumor type and mode of presentation, and varied during the years according to the modalities available. At the time of this report 8 of 22 patients (36 per cent) are alive without evidence of disease from 2 to 29.5 years, 3 (16 per cent) have died without evidence of disease 10 to 17 years after treatment, 10 (45 per cent) have died of metastases 10 months to 6 years after treatment and 1 has been lost to followup. The over-all incidence of groin metastases from testicular carcinoma is low, even with a history of scrotal or inguinal surgery.

  13. Inguinal hernioraphy under local anesthesia in the elderly patients

    Directory of Open Access Journals (Sweden)

    Nurettin Kahramansoy

    2012-12-01

    Full Text Available Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years and theyounger. Anesthesia methods, additional anesthesia requirementand complications were compared.Results: Of totally 177 patients, 30.5% were elderly.Operation type, anesthesia method and score of operationalrisk differed between groups. The percentage of comorbidity (55.6% in the elderly was significantly high (p<0.001. Among elderly, the frequency of co morbidity wasslightly higher in patients who had local anesthesia comparedto spinal and general anesthesia. Patients in youngand middle ages preferred to be operated less under localanesthesia (34.1% compared to elderly (70.4%. Therewas one case (2.6% converted to general anesthesiaas an additional anesthesia in the elderly group. Postoperativecomplications were slight more frequent in elderly.These cases were five in number (31.3% and were operatedunder spinal or general anesthesia (p=0.002.Conclusions: The frequency of co morbidity and riskscore of operation (ASA category rise in the elderly.However, inguinal hernioraphy can be performed underlocal anesthesia without complication and conversion togeneral anesthesia.Key words: Inguinal hernia; aged; comorbidity; local anesthesia

  14. Differentiation of a Femoral Hernia from an Inguinal Hernia on Isotropic Multidetector-Row CT (MDCT): the Benefit of Inguinal Ligament Coronal-Oblique Images

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ju Hyun; Jang, Kyung Mi; Kim, Min Jeong; Ko, Ji Young; Koh, Sung Hye; Yie, Mi Yeon; Min, Kwang Seon; Kim, In Gyu [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Choi, Dong Il; Park, Yul Ri [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-04-15

    This study was designed to evaluate the diagnostic value of the use of inguinal ligament coronal-oblique CT images in the differentiation of femoral hernias from inguinal hernias. A total of 32 patients (with 11 femoral hernias and 21 inguinal hernias) underwent CT imaging. All of the examinations were performed with a 16- multidetector row CT (MDCT) scanner with contrast enhancement, and transverse sections, coronal sections and coronal-oblique CT images were reformed along an imaginary inguinal ligament plane. Two independent observers retrospectively evaluated the CT scans. Image analysis was first performed with only transverse and coronal images. A second analysis was then performed with transverse, coronal and coronal- oblique images. The mean angle difference between coronal and coronal-oblique CT images was 8.0 degrees (range, 0-22 degrees). A radiologist correctly diagnosed the presence of a femoral hernia in nine (82%) of 11 patients and a radiology fellow correctly diagnosed the presence of a femoral hernia in seven (64%) of 11 patients in the first session. Both of the reviewers made the correct diagnosis in all patients in the second session. For inguinal hernias, both reviewers correctly diagnosed all patients during both sessions. The coronal-oblique CT images were the most valuable images for the evaluation of the relationship between hernias of the neck and inguinal ligament. Inguinal ligament coronal-oblique CT images can provide additional diagnostic value in the evaluation of groin hernias.

  15. Tratamento videolaparoscópico da hérnia inguinal em meninos = Laparoscopic treatment of inguinal hernia in boys

    Directory of Open Access Journals (Sweden)

    Faria, Adyr Eduardo Virmond

    2008-01-01

    Conclusões: a técnica videolaparoscópica mostrou-se efetiva, segura e com baixa incidência de complicações no tratamento cirúrgico da hérnia inguinal em meninos. Acredita-se que o tratamento videolaparoscópico das hérnias inguinais em meninos seja um método alternativo válido em relação à cirurgia tradicional

  16. Diagnóstico de masa inguinal, más allá de la hernia inguinal

    Directory of Open Access Journals (Sweden)

    María Trigás Ferrin

    2012-12-01

    Full Text Available Caso clínico de mujer de 86 años con masa inguinal izquierda como hallazgo incidental en la exploración física y diagnóstico final de quiste de canal de nuck, una rara entidad en adultos y que obliga a revisar el diagnóstico diferencial de las masas inguinales

  17. Cono extendido, nueva variante técnica en la cirugía de la hernia inguinal Extended cone a new technical variant in the inguinal hernia surgery

    Directory of Open Access Journals (Sweden)

    Hiram Rodríguez Blanco

    2011-06-01

    Full Text Available INTRODUCCIÓN. El tratamiento de la hernia inguinal continúa siendo un tema controvertido y no existe un punto común de acción en cuanto a la modalidad terapéutica que se emplea. Con el desarrollo de las técnicas protésicas la controversia continúa a pesar de las demostradas ventajas de estas. El objetivo de este estudio fue evaluar los primeros casos intervenidos quirúrgicamente mediante la técnica del cono extendido, una modificación de las técnicas clásicas de Liechtenstein y Rutkow. MÉTODOS. Se realizó un estudio prospectivo lineal en 45 pacientes operados mediante una técnica protésica denominada cono extendido. Los pacientes fueron operados en un período de 2 años en la Clínica Multiperfil de Luanda (Angola y para clasificarlos se utilizó la clasificación de Gilbert modificada. RESULTADOS. Hubo un predominio del sexo masculino. La localización más frecuente fue la región inguinal derecha. Predominaron los pacientes clasificados de grado III según la clasificación de Gilbert. Hubo 6 complicaciones menores y hasta el momento no han ocurrido recidivas. CONCLUSIONES. La técnica del cono extendido es una opción más para el tratamiento de los pacientes que presenten hernias inguinales de grado III y VI de la clasificación de Gilbert.INTRODUCTION. The treatment of the inguinal hernia remains being a controversial subject and there is not a common point of action as regards the therapeutic modality used. With the development of the prosthetic techniques the controversy remains despite their demonstrated advantages. The objective of present study was to assess the first cases operated on with the extended cone technique a modification of the classic Liechtenstein's and Rutkow's techniques. METHODS. A linear and prospective study was conducted in 45 patients operated on by a prosthetic technique called extended cone. The patients were operated on in a period of two years in the Multiprofile Clinic of Luanda (Angola and

  18. Exodoncia atraumática e implante post exodoncia sin colgajo combinado con injerto gingival libre

    OpenAIRE

    García Linares, Sixto; Yon Guerrero, Helen

    2010-01-01

    Presentamos un caso donde se describe la técnica de exodoncia atraumática, colocación de un implante post exodoncia y cierre por primera intención mediante un injerto gingival libre. El uso de implantes post exodoncia necesita varias condiciones para poder realizarse, entre ellas: paredes óseas conservadas, hueso alveolar más allá del ápice mayor a 4 mm. , margen gingival conservado, ausencia de fístula, etc. El injerto gingival libre permite una cicatrización por primera intención n...

  19. Exodoncia atraumática e implante post exodoncia sin colgajo combinado con injerto gingival libre

    OpenAIRE

    García Linares, Sixto; Yon Guerrero, Helen

    2010-01-01

    Presentamos un caso donde se describe la técnica de exodoncia atraumática, colocación de un implante post exodoncia y cierre por primera intención mediante un injerto gingival libre. El uso de implantes post exodoncia necesita varias condiciones para poder realizarse, entre ellas: paredes óseas conservadas, hueso alveolar más allá del ápice mayor a 4 mm. , margen gingival conservado, ausencia de fístula, etc. El injerto gingival libre permite una cicatrización por primera intención n...

  20. A STUDY OF POSTOPERATIVE COMPLICATIONS FOLLOWING OPEN MESH INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Abdul Kalam

    2016-09-01

    Full Text Available BACKGROUND Inguinal hernia is the most common type of hernia. Inguinal region consists of deep inguinal ring, inguinal canal and superficial inguinal ring, which make the region weak and susceptible to hernia. 65% of inguinal hernias are indirect hernias and 35% direct hernias. Hernioplasty is the strengthening of posterior wall of inguinal canal. It can be done either with the help of mesh repair or darning. Hernioplasty is indicated in recurrent hernia cases, inguinal hernia with weak abdominal muscle tone where mesh plasty is preferred and inguinal hernia with good muscle tone where darning can be done. In mesh repair, posterior wall (Lichtenstein repair of inguinal canal is strengthened by a Prolene or Marlex mesh. Over time, fibroblasts and capillaries grow over the mesh converting it into a thick sheath strengthening the posterior wall. Complications which can be encountered postsurgery are pain, bleeding, urinary retention, scrotal swelling, abdominal distension, seroma and wound infections, chronic pain, keloid and testicular atrophy. MATERIALS AND METHODS  The study was conducted in the Department of General Surgery, Travancore Medical College, Kollam.  The study was done from January 2015 to January 2016.  One hundred cases were identified and were chosen for the study. INCLUSION CRITERIA 1. Inguinal hernia cases treated by open mesh repair. EXCLUSION CRITERIA 1. Other types of inguinal hernia repair. RESULTS All the cases studied belonged to male sex. In our study, age group twenty to forty years amounted to sixty one cases followed by age group forty to sixty years, which amounted to twenty eight cases. Age group zero to twenty years amounted to six cases and age group more than sixty years amounted to five cases. In the study group, seventy two cases were indirect inguinal hernias and twenty eight cases were direct inguinal hernias. Based on the complications encountered, pain at the site was the commonest complaint, which

  1. Randomized clinical trial of total extraperitoneal inguinal hernioplasty vs lichtenstein repair: A long-term follow-up study

    NARCIS (Netherlands)

    H.H. Eker (Hasan); H.R. Langeveld-Benders (Hester); P.J. Klitsie (Pieter); M. van 't Riet (Martijne); L.P. Stassen (Laurents); W.F. Weidema (Wibo); E.W. Steyerberg (Ewout); J.F. Lange (Johan); H.J. Bonjer (Jaap); J. Jeekel (Hans)

    2012-01-01

    textabstractHypothesis: Mesh repair is generally preferred for surgical correction of inguinal hernia, although the merits of endoscopic techniques over open surgery are still debated. Herein, minimally invasive total extraperitoneal inguinal hernioplasty (TEP) was compared with Lichtenstein repair

  2. Cobertura con colgajo escrotal en desforramiento peneano. A propósito de dos casos

    OpenAIRE

    2008-01-01

    Restablecer la cobertura cutánea en lesiones de urgencia es un desafío para el cirujano, más aún si se trata del pene, ya sea por desforramiento accidental o secundario a procesos sépticos de la región perineal. Se presentan 2 casos. El primero por lesión accidental en un menor de 9 años, quien pierde la totalidad de la piel peneana. El segundo caso en un paciente de 65 años, diabético e hipertenso que presentó un episodio de fasceítis necrotizante. En ambos casos se realiza una cobertura cut...

  3. Reanimación palpebral con colgajo frontal miofuncional: Caso clínico

    OpenAIRE

    F. García-García; A. Cárdenas-Mejía

    2014-01-01

    El párpado es una estructura crítica para la protección y función del globo ocular, y parte primordial en la estética facial. Su reconstrucción está determinada por la extensión de la lesión y el compromiso de las diferentes capas. Siempre se preferirán tejidos loco-regionales debido a su mayor similitud y disposición. Los métodos de reanimación palpebral se pueden dividir en estáticos y dinámicos, considerando a estos últimos como el único medio para restaurar el parpadeo. Presentamos un cas...

  4. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia.

    LENUS (Irish Health Repository)

    O'Reilly, Elma A

    2012-05-01

    Laparoscopic inguinal hernia repair (LIHR), using a transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) technique, is an alternative to conventional open inguinal hernia repair (OIHR). A consensus on outcomes of LIHR when compared with OIHR for primary, unilateral, inguinal hernia has not been reached.

  5. Indirect Inguinal Hernia Containing the Uterus, Both Ovaries, and Fallopian Tubes in an Infant: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong; Cho, Bum Sung; Han, Gi Seok; Lee, Seung Young; Kang, Min Ho [Dept. of Radiology, Chungbuk National University Hospital, Jeonju (Korea, Republic of)

    2012-08-15

    In female infants, an inguinal hernia containing an ovary with or without Fallopian tubes is not uncommon. However, an inguinal hernia containing the entire uterus and both ovaries is extremely rare. Herein, we report on a case of an inguinal hernia containing the uterus, both ovaries, and both Fallopian tubes, diagnosed by ultrasonography. We discuss the case and review the relevant literature.

  6. Hypogonadism and man’s infertility at patients with indirect inguinal hernia after hernioplasty

    Directory of Open Access Journals (Sweden)

    I. S. Sobennikov

    2014-11-01

    Full Text Available The article estimates hydrologic status and fertility prognosis of 35 year-old reproductive age men with unilateral inguinal hernioplasty in past history from the system syndrome-based approach perspective to the etiology and pathogenesis of indirect inguinal hernia and hypogonadism.

  7. Hypogonadism and man’s infertility at patients with indirect inguinal hernia after hernioplasty

    Directory of Open Access Journals (Sweden)

    I. S. Sobennikov

    2012-01-01

    Full Text Available The article estimates hydrologic status and fertility prognosis of 35 year-old reproductive age men with unilateral inguinal hernioplasty in past history from the system syndrome-based approach perspective to the etiology and pathogenesis of indirect inguinal hernia and hypogonadism.

  8. Patient-Related Risk Factors for Recurrence After Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pommergaard, Hans-Christian; Bisgaard, Thue

    2015-01-01

    Background. Several factors influence the risk of recurrence after inguinal hernia surgery; however, a systematic review and meta-analysis of patient-related risk factors for recurrence after inguinal hernia surgery has not been performed earlier. Methods. MEDLINE, Embase, and Cochrane databases ...

  9. Surgical physiology of inguinal hernia repair - a study of 200 cases

    Science.gov (United States)

    Desarda, Mohan P

    2003-01-01

    Background Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured as a result of current techniques of operation, though factors that are said to prevent hernia formation are not restored. Therefore, the surgical physiology of inguinal canal needs to be reconsidered. Methods A retrospective study is describer of 200 patients operated on for inguinal hernia under local anaesthesia by the author's technique of inguinal hernia repair. Results The posterior wall of the inguinal canal was weak and without dynamic movement in all patients. Strong aponeurotic extensions were absent in the posterior wall. The muscle arch movement was lost or diminished in all patients. The movement of the muscle arch improved after it was sutured to the upper border of a strip of the external oblique aponeurosis (EOA). The newly formed posterior wall was kept physiologically dynamic by the additional muscle strength provided by external oblique muscle to the weakened muscles of the muscle arch. Conclusions A physiologically dynamic and strong posterior inguinal wall, and the shielding and compression action of the muscles and aponeuroses around the inguinal canal are important factors that prevent hernia formation or hernia recurrence after repair. In addition, the squeezing and plugging action of the cremasteric muscle and binding effect of the strong cremasteric fascia, also play an important role in the prevention of hernia. PMID:12697071

  10. Emergency repair of inguinal hernia in the premature infant is associated with high direct medical costs

    NARCIS (Netherlands)

    J. Verhelst (Joost); B. de Goede (Barry); B.J.H. van Kempen (Bob); H.R. Langeveld-Benders (Hester); M.J. Poley (Marten); G. Kazemier (Geert); J. Jeekel (Hans); R.M.H. Wijnen (René); J.F. Lange (Johan)

    2015-01-01

    textabstractPurpose: Inguinal hernia repair is frequently performed in premature infants. Evidence on optimal management and timing of repair, as well as related medical costs is still lacking. The objective of this study was to determine the direct medical costs of inguinal hernia, distinguishing b

  11. Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair

    DEFF Research Database (Denmark)

    Vad, Marie Vestergaard; Frost, Poul; Bay-Nielsen, Morten;

    2012-01-01

    We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair.......We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair....

  12. Chronic pain after TEP inguinal hernia repair, does MRI reveal a cause?

    NARCIS (Netherlands)

    Burgmans, J. P J; Voorbrood, C. E H; Van Dalen, T.; Boxhoorn, R. N.; Clevers, G. J.; Sanders, F. B M; Naafs, D. B J; Simmermacher, R. K J

    2016-01-01

    Purpose: Persistent pain is a known side effect after TEP inguinal repair disabling 2–5 % of patients. A standardized diagnostic work-up so far is not available. MRI is a diagnostic tool in the work-up of inguinal hernias. In the present study the yield of MRI in evaluating chronic pain after TEP he

  13. Surgical physiology of inguinal hernia repair - a study of 200 cases

    Directory of Open Access Journals (Sweden)

    Desarda Mohan P

    2003-04-01

    Full Text Available Abstract Background Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured as a result of current techniques of operation, though factors that are said to prevent hernia formation are not restored. Therefore, the surgical physiology of inguinal canal needs to be reconsidered. Methods A retrospective study is describer of 200 patients operated on for inguinal hernia under local anaesthesia by the author's technique of inguinal hernia repair. Results The posterior wall of the inguinal canal was weak and without dynamic movement in all patients. Strong aponeurotic extensions were absent in the posterior wall. The muscle arch movement was lost or diminished in all patients. The movement of the muscle arch improved after it was sutured to the upper border of a strip of the external oblique aponeurosis (EOA. The newly formed posterior wall was kept physiologically dynamic by the additional muscle strength provided by external oblique muscle to the weakened muscles of the muscle arch. Conclusions A physiologically dynamic and strong posterior inguinal wall, and the shielding and compression action of the muscles and aponeuroses around the inguinal canal are important factors that prevent hernia formation or hernia recurrence after repair. In addition, the squeezing and plugging action of the cremasteric muscle and binding effect of the strong cremasteric fascia, also play an important role in the prevention of hernia.

  14. Imaging Findings of Angiomyxolipoma of the Spermatic Cord Mimicking Inguinal Hernia

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyun Suk; Woo, Ji Young; Hong, Hye-Suk; Yang, Ik; Lee, Yul; Jung, Ah Young [Department of Radiology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 150-950 (Korea, Republic of); Yang, Dae Hyun; Kim, Ji Won [Department of General Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 150-950 (Korea, Republic of); Kim, Jeong Won [Department of Pathology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul 150-950 (Korea, Republic of)

    2013-07-01

    We report the case in a 72-year-old man who presented with a right inguinal mass and with a one month history that was initially interpreted as an inguinal hernia. Ultrasonography (US) and computed tomography (CT) demonstrated a right inguinal mass, including myxoid and fat component, extending from the right spermatic cord to the right inguinal subcutaneous layer. Mass excision was performed, and the diagnosis turned out to be angiomyxolipoma. Angiomyxolipoma is a rare tumor and the preoperative diagnosis of this disease is very difficult. However, angiomyxolipoma of the spermatic cord should be considered in the differential diagnosis in patients with an irreducible inguinal mass. Imaging diagnosis, such as US and CT may help to make a preoperative diagnosis.

  15. Outpatient repair for inguinal hernia in elderly patients: still a challenge?

    Science.gov (United States)

    Palumbo, Piergaspare; Amatucci, Chiara; Perotti, Bruno; Zullino, Antonio; Dezzi, Claudia; Illuminati, Giulio; Vietri, Francesco

    2014-01-01

    Elective inguinal hernia repair as a day case is a safe and suitable procedure, with well-recognized feasibility. The increasing number of elderly patients requiring inguinal hernia repair leads clinicians to admit a growing number of outpatients. The aim of the current study was to analyze the outcomes (feasibility and safety) of day case treatment in elderly patients. Eighty patients >80 years of age and 80 patients ≤55 years of age underwent elective inguinal hernia repairs under local anesthesia. There were no mortalities or major complications in the elderly undergoing inguinal herniorraphies as outpatients, and only one unanticipated admission occurred in the younger age group. Elective inguinal hernia repair in the elderly has a good outcome, and age alone should not be a drawback to day case treatment. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

    Science.gov (United States)

    Kawaguchi, Tsutomu; Itoh, Tadao; Yoshii, Kazuhiro; Otsuji, Eigo

    2015-01-01

    Introduction Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. Presentation of case Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination was diagnosed as right inguinal hernia and potential of left inguinal hernia using computed tomography. He underwent laparoscopic bilateral hernia repair, and intraoperative findings revealed right external supravesical hernia and left internal inguinal hernia. Discussion Laparoscopic hernia repair may make it possible to avoid overlooking of internal hernia such as supravesical hernia. Moreover it was possible to cover the hernia orifice and dissected layer of the dorsal site of urine bladder using bilateral approach in the current case. Conclusion In conclusions, laparoscopic hernia repair might be a surgical option for supravesical hernia. PMID:26263448

  17. Pubic inguinal pain syndrome: the so-called sports hernia.

    Science.gov (United States)

    Cavalli, Marta; Bombini, Grazia; Campanelli, Giampiero

    2014-03-01

    The "sportsman's hernia" commonly presents as a painful groin in those sports that involve kicking and twisting movements while running, particularly in rugby, football, soccer, and ice hockey players. Moreover, sportsman's hernia can be encountered even in normally physically active people. The pain experienced is recognized at the common point of origin of the rectus abdominis muscle and the adductor longus tendon on the pubic bone and the insertion of the inguinal ligament on the pubic bone. It is accepted that this chronic pain caused by abdominal wall weakness or injury occurs without a palpable hernia. We proposed the new name "pubic inguinal pain syndrome." In the period between January 2006 and November 2013 all patients afferent in our ambulatory clinic for chronic groin pain without a clinically evident hernia were assessed with medical history, physical examination, dynamic ultrasound, and pelvic and lumbar MRI. All patients were proposed for a conservative treatment and then, if it was not effective, for a surgical treatment. Our etiopathogenetic theory is based on three factors: (1) the compression of the three nerves of the inguinal region, (2) the imbalance in strength of adductor and abdominal wall muscles caused by the hypertrophy and stiffness of the insertion of rectus muscle and adductor longus muscle, and (3) the partial weakness of the posterior wall. Our surgical procedure includes the release of all three nerves of the region, the correction of the imbalance in strength with the partial tenotomy of the rectus and adductor longus muscles, and the repair of the partial weakness of the posterior wall with a lightweight mesh. This treatment reported excellent results with complete relief of symptoms after resumption of physical activity in all cases.

  18. Single benign metastasising leiomyoma of an inguinal lymph node.

    Science.gov (United States)

    Laban, Kamil G; Tobon-Morales, Roberto E; Hodge, Janice A L; Schreuder, Henk W R

    2016-08-10

    Benign metastasising leiomyoma (BML) is a rare benign disease associated with uterine leiomyoma and history of uterine surgery. It most frequently occurs in premenopausal woman, with a pulmonary localisation, and consisting of multiple nodules. We present an uncommon case of a 69-year-old woman with a single BML of an inguinal lymph node. CT scans of thorax and abdomen excluded other metastasis localisation. The patient was cured with surgical excision of the mass. Lymph node involvement has been reported incidentally in BML literature. Lymphangitic spread can be considered a possible mechanism of BML metastasis.

  19. A case of endometriosis presenting as an inguinal hernia.

    Science.gov (United States)

    Husain, Fahd; Siddiqui, Zain Ahmed; Siddiqui, Midhat

    2015-03-11

    Endometriosis is a common clinical presentation for gynaecologists. Occasionally it can present to general surgeons as a swelling in the groin or abdominal wall. This condition should be included in the differential diagnosis in female patients. A 32-year-old woman with a 2-year history of a painful persistent lump in her right groin was referred to the general surgeons by her general practitioner. She was referred with a diagnosis of a suspected inguinal hernia. MRI excluded a hernia and exploration of the groin and subsequent histology confirmed the lesion to be an endometrial deposit.

  20. Inguinal hernia incarceration as a form of intestinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Mellyssande Faccin

    Full Text Available We report the case of a 41 year-old male who came to the emergency room with a complaint of abdominal pain, and was diagnosed to have an acute obstructive abdomen due to a right inguinal hernia incarceration. During surgery, an intestinal granulomatous inflammation was observed adhered to the hernial sac.The histopathologic study confirmed the diagnosis of tuberculosis. We present a review of the different clinical forms of intestinal tuberculosis and the difficulties encounted in the differential diagnosis of such, emphasizing the uncommon presentation described in our patient.

  1. Colgajo de nuca para reconstrucción de lesiones en cuero cabelludo Retalho de nuca para reconstrução de lesões de couro cabeludo Nape flap for scalp lessions reconstruction

    Directory of Open Access Journals (Sweden)

    L.F. Dos Santos

    2010-09-01

    Full Text Available Un total de 16 pacientes de sexo masculino y edades comprendidas entre los 20 y los 35 años de edad, fueron sometidos a Cirugía Reconstructiva con colgajo pediculado de nuca, entre los años 2000 y 2003 en el Servicio de Cirugía Plástica del hospital Agamenon Magalháes de Recife, Pernambuco (Brasil, para tratamiento de lesiones inflamatorias crónicas de origen micótico en cuero cabelludo y en 1 caso, por lesión secundaria a quemadura eléctrica con necrosis de cuero cabelludo y exposición ósea, todas ellas en la región occipital. El tiempo de hospitalización osciló entre los 3 a 4 días. Se identificaron 3 casos de necrosis de punta del colgajo en la región retroauricular, de tamaño entre 0,5 a 1 cm, que cicatrizaron por segunda intención. No hubo ningún caso de de infección o necrosis del pedículo. La técnica que proponemos presentó ventajas para la corrección quirúrgica de este tipo de lesiones en un solo tiempo quirúrgico y el cierre directo de la lesión con un buen resultado cosmético. Como desventajas, identificamos 3 casos de incremento del área alopécica y, en algunos casos, cicatrización hipertrófica que sin embargo, en opinión de los pacientes, no comprometió su calidad de vida.Dezesseis pacientes do sexo masculino com idade entre 20 e 35 anos foram submetidos a Cirurgia Reconstrutiva com retalho pediculado de nuca, entre 2000 e 2003, no Serviço de Cirurgia Plástica do Hospital Agamenon Magalhães, Recife, Pernambuco, Brasil, para tratamento de lesões inflamatórias crônicas de origem micótica e um caso de lesão secundária a queimadura elétrica com necrose de couro cabeludo e exposição óssea, todos em região occipital. O tempo de internamento variou entre 3 e 4 dias. Foram identificados três casos de necrose de ponta de retalho, em região retroauricular, medindo entre 0,5 cm e 1 cm, que cicatrizaram por segunda intenção. Não houve qualquer caso de infecção ou necrose pedicular. A t

  2. Cierre de fístula oroantral con injerto óseo y con rotación y avance de colgajo palatino

    OpenAIRE

    Godoy R,Emilio; Godoy S,Alejandro; Godoy S,Paula

    2011-01-01

    La fístula oroantral se presenta entre otras causas como resultado de la extracción de un molar en relación al maxilar Como consecuencia el paciente presenta episodios de sinusitis de evolución tórpida y refractaria a tratamiento médico, siendo la reparación quirúrgica su mejor solución, existiendo distintas técnicas. El objetivo de este caso es mostrar la experiencia de un paciente operado mediante la utilización de un colgajo de rotación y avance palatino e injerto de hueso autólogo. Se tra...

  3. Reconstrucción de la subunidad estética de la ceja con un colgajo temporal en isla de cuero cabelludo

    Directory of Open Access Journals (Sweden)

    J. Gaona Silva

    Full Text Available La reconstrucción de las cejas juega un papel importante en la Cirugía Reconstructiva facial, debido a que la ausencia o deformidad de las mismas altera la expresión y las características de la cara, ejerciendo una influencia poderosa en la apariencia de la región periorbitaria, así como en el aspecto y en la autoestima de los pacientes. Describimos una técnica quirúrgica basada en el empleo de un colgajo temporal en isla de cuero cabelludo para la reconstrucción de la subunidad estética de la ceja y presentamos 3 casos de pacientes con defectos alopécicos de las cejas reconstruidos mediante dicha técnica.

  4. Surgical approach for recurrent inguinal hernias: a Nationwide Cohort Study.

    Science.gov (United States)

    Öberg, S; Andresen, K; Rosenberg, J

    2016-12-01

    Guidelines recommend that the reoperation of a recurrent inguinal hernia should be by the opposite approach (anterior-posterior) than the primary repair. However, the level of evidence supporting the guidelines is partially low. The purpose of this study was to compare re-reoperation rates between repairs performed according to the guidelines with the ones performed against it. This cohort study was based on the Danish Hernia Database, including 4344 patients with two inguinal hernia repairs in the same groin. Four groups were compared as follows: Lichtenstein-Lichtenstein vs. Lichtenstein-Laparoscopy, and Laparoscopy-Laparoscopy vs. Laparoscopy-Lichtenstein. The outcome was re-reoperation rates, which were compared by crude rates, cumulated rates, and hazard ratios. There was no difference in the re-reoperation rates when the primary repair was laparoscopic, regardless of the type of reoperation. However, Lichtenstein-Lichtenstein had a significantly higher re-reoperation rate compared with Lichtenstein-Laparoscopy (crude rate 8.7 vs. 3.1 %, p value hernia was medial. A primary Lichtenstein repair of a primary medial hernia should be reoperated with a laparoscopic repair. A primary Lichtenstein repair of a primary lateral hernia can be reoperated with either a Lichtenstein or a laparoscopic repair according to surgeon's choice. For a primary laparoscopic operation, the method of repair of a recurrent hernia did not affect the re-reoperation rate.

  5. Predictors for length of hospital stay after inguinal hernia surgery

    Science.gov (United States)

    Aldoescu, S; Patrascu, T; Brezean, I

    2015-01-01

    Aim: identifying the variables that can help in quantifying/ predicting duration of hospital stay after inguinal hernia surgery. Method: 257 patients who were diagnosed with inguinal hernia underwent surgery between January 2013 and October 2014 and were prospectively registered and statistically analyzed by using linear regression with the aim of emphasizing, calculating and validating the predictors for duration of hospital stay. Results: out of 257 patients, 50,7% underwent laparoscopic surgery (TAPP and TEP) and 49,7% had an anterior approach by using the technique described by Lichtenstein in most of the cases. From the variables registered in the study (age, recurrence, emergency surgery, ASA [American Society of Anesthesiologists] risk classification, surgery duration, local and general complications) only the age and presence/absence of complications were statistically associated with the modification of the duration of hospital stay in this pathology. Conclusions: the duration of hospital stay can be evaluated preoperatory by using a mathematical model, which takes into consideration factors that depend on the patient or the procedure, with results that can have a significant impact on planning the local resources. PMID:26351540

  6. A Giant Retroperitoneal Abscess Mimicking Incarcerated Inguinal Hernia

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    Naciye Sinem Gezer

    2015-06-01

    Full Text Available An 82-year-old man was admitted to the emergency room with an acute left-sided groin pain and scrotal swelling. He has suffered from a groin hernia for two years. Abdominal x-ray demonstrated air-fluid levels in the left upper quadrant suggesting an intestinal obstruction (Figure 1. Abdominal computed tomography (CT scan was obtained with an initial diagnosis of an incarcerated inguinal hernia. However, it showed multiple perirenal abscesses and a giant-sized retroperitoneal abscess extending from the retroperitoneal space into the scrotum through the inguinal canal (Figure 2 and 3. Retroperitoneal abscesses are most frequently seen in the 3rd to 6th decades of life (1. Gram-negative bacteria, most commonly E. coli, are the cause of infection which usually develops secondary to pyelonephritis, urinary stasis or immune suppression. The onset of clinical manifestations of the infection, including flank, abdomen and groin pain, chills, fever, tachycardia, weakness and anorexia are often insidious (2,3. Laboratory findings include leukocytosis, increased serum creatinine levels and pyuria. The literature emphasizes the possibility of diagnostic delay and postponed treatment of retroperitoneal abscess due to the fact that its prodrome phase may be long.

  7. Preliminary experience with laparoscopic repair of associated inguinal and umbilical hernias in children.

    Science.gov (United States)

    Bertozzi, M; Magrini, E; Appignani, A

    2015-08-01

    The authors report their preliminary experience in laparoscopic repair of associated inguinal and umbilical hernias in children. Twenty-six patients affected by the association of inguinal and umbilical hernia with an umbilical defect larger than 5 mm underwent a laparoscopic procedure. A 5-mm trocar was placed through the umbilical defect for the optic. To fix the trocar to avoid loss of carboperitoneum, we fashioned and tightened a purse-string non-absorbable suture with a sliding knot around the defect. In this manner, we ensured the trocar, fixing it and avoiding any loss of CO2, proceeding safely to the laparoscopic IH repair, by means of two additional 3 mm operative trocars. At the end of the inguinal herniorrhaphy, the previously fashioned purse-string suture was tightened to repair the umbilical defect. The mean operative time for the repair of associated inguinal and umbilical hernias was 30.1 ± 7.4 min in cases of unilateral inguinal hernia and 39.5 ± 10.6 for bilateral inguinal hernia. Follow-up ranged from 8 to 32 months. Neither intra- nor post-operative complications nor recurrences were seen. This small sample suggests that this simple method is safe, effective and might be useful for pediatric surgeons performing laparoscopic repair for inguinal hernia in presence of an associated UH with a statistically significant decrease of operative time.

  8. Left Amyand’s hernia: An unexpected finding during inguinal hernia surgery

    Science.gov (United States)

    Al Maksoud, Ahmed M.; Ahmed, Ahmed Salah

    2015-01-01

    Introduction Amyand’s hernia is a rare finding of the appendix inside an inguinal hernia sac with classically estimated incidence of 1%. Most cases are found intra-operatively during right-sided inguinal hernia repair. Presentation of case We are reporting a very rare case of left-sided Amyand’s hernia. An 81 year-old man with long standing left inguinal hernia was referred to our surgical assessment unit with tender irreducible left inguinal hernia. He was vitally stable with no clinical signs of intestinal obstruction. A diagnosis of irreducible left inguinal hernia without obstruction was made. Exploration of the hernia sac revealed the presence of non-inflamed appendix, caecum and terminal ileum. The contents were reduced and a mesh repair was performed with satisfactorily outcome. Discussion The surgical management of Amyand’s hernia involves appendectomy of inflamed appendix through the inguinal incision together with hernia repair. Prophylactic appendectomy is not recommended by most authors except in young patients. Conclusion There are less than 20 cases reported in the literature describing left-sided Amyand’s hernia. Awareness of such very unusual condition may help surgeons to be prepared for appropriate management of a very usual procedure as inguinal hernia repair. PMID:26196311

  9. Dolor y costos hospitalarios en la reparación de la hernia inguinal primaria: Lichtenstein frente a Desarda Pain and hospital costs in primary inguinal hernia repair: Lichtensten versus Desarda

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    Pedro López Rodríguez

    2010-09-01

    Full Text Available INTRODUCCIÓN. La hernia inguinal tiene una alta incidencia en la población y representa un problema de salud por sus importantes implicaciones sociales y laborales. El objetivo de este trabajo fue comparar los resultados del tratamiento de la hernia inguinal mediante dos técnicas quirúrgicas distintas: una protésica (técnica de Lichtenstein y otra anatómica (técnica de Desarda, haciendo hincapié en la valoración del dolor posoperatorio y los costos hospitalarios de dichos procedimientos, además de otros factores. MÉTODOS. Se realizó un estudio prospectivo aleatorizado de 625 pacientes intervenidos quirúrgicamente entre enero de 2003 y enero del 2009 en el Hospital General Docente «Dr. Enrique Cabrera» (La Habana. Fueron también estudiadas otras variables, como edad, localización y tipo de hernia, duración de la intervención y complicaciones. RESULTADOS. El tiempo quirúrgico fue menor en la hernioplastia de Lichtenstein y hubo un comportamiento similar en cuanto al dolor posoperatorio entre el primero y tercer día, y en la hernioplastia fue superior al quinto día. Se encontró diferencia estadísticamente significativa en cuanto al costo hospitalario, que fue superior con la técnica protésica. CONCLUSIONES. Con la técnica de Desarda se obtienen los mismos resultados satisfactorios en las hernias no recidivadas que con la técnica de Lichtenstein, y el costo hospitalario es menor.INTRODUCTION. The inguinal hernia has a high incidence in population and represents a health problem due to its significant social and working implications. The objective of present paper was to compare the results of inguinal hernia treatment using two different techniques: a prosthetic one (Lichtenstein technique and other of anatomical type (Desarda's technique emphasizing on evaluation of postoperative pain and the hospital costs due to such procedures in addition to other factors. METHODS. A randomized and prospective study was conducted in

  10. Adenocarcinoma arising at a colostomy site with inguinal lymph node metastasis: report of a case.

    Science.gov (United States)

    Iwamoto, Masayoshi; Kawada, Kenji; Hida, Koya; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-02-01

    Inguinal lymph node metastasis from adenocarcinoma arising at a colostomy site is extremely rare, and the significance of surgical resection for metastatic inguinal lymph nodes has not been established. An 82-year-old woman who had undergone abdominoperineal resection 27 years earlier was admitted to our hospital complaining of bleeding from a colostomy. Physical examination revealed that a tumor at the colostomy site directly invaded into the peristomal skin, and that a left inguinal lymph node was firm and swollen. Positron emission tomography/computed tomography scan demonstrated accumulation of (18)F-fluorodeoxy glucose into both the colostomy tumor and the left swollen inguinal lymph node, while there was no evidence of metastasis to liver or lungs. She underwent open left hemicolectomy with wide local resection of the colostomy, and dissection of left inguinal lymph nodes. Histological diagnosis was a moderately differentiated adenocarcinoma that directly invaded into the surrounding skin and metastasized to the left inguinal lymph node. The patient has been followed up for >5 years without any sign of recurrence. In general, inguinal lymph node metastasis from colorectal cancers is regarded as a systemic disease with a poor prognosis, and so systemic chemotherapy and radiotherapy, but not surgical lymph node dissection, are recommended. Considering the lymphatic drainage route in the present case, inguinal lymph node metastasis does not represent a systemic disease but rather a sentinel nodal metastasis from adenocarcinoma at a colostomy site. Surgical dissection of metastatic inguinal lymph nodes should be considered to enable a favorable prognosis in the absence of distant metastasis to other organs.

  11. The Inguinal Herniation of the Ovary in the Newborn: Ultrasound and Color Doppler Ultrasound Findings

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    Omer Kaya

    2014-01-01

    Full Text Available Inguinal hernias in the newborn age group are seldom encountered. In the affected female patient, the ovaries, fallopian tubes, and the intestines may settle in the hernia sac. The early diagnosis of torsion in cases in which the ovary is herniated into the inguinal canal is of utmost importance in order to give surgery the chance of reduction and correction. In this paper, a case of an ovarian herniation into the inguinal canal without the presence of torsion is being presented, and the place of US and CDUS in the differential diagnosis of the situation is being discussed.

  12. Leiomyoma mimicking an incarcerated inguinal hernia: A rare complication of laparoscopic hysterectomy

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    Carlos Apestegui

    2011-01-01

    Full Text Available A 52-year-old, obese, female patient was referred for a right inguinal mass, which appeared seven months after a laparoscopic hysterectomy, which was performed because of myomatosis. Despite several examinations, including ultrasound, computed tomography (CT-Scan, positron emission tomography (PET-CT, and ultrasound-guided biopsy, the diagnosis remained unclear until surgical exploration, which disclosed a well-encapsulated solid tumour corresponding to a fibrotic leiomyoma. Spilling of leiomyoma cells is a rare and unusual complication of laparoscopic surgery. Tumour development in the inguinal canal after laparoscopic gynaecological surgery should be kept in mind in the differential diagnosis of inguinal hernia and other uncommon pathologies.

  13. Testicular atrophy secondary to a large long standing incarcerated inguinal hernia

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    Nikolaos S Salemis

    2011-09-01

    Full Text Available Testicular atrophy is a rare but distressing complication of inguinal hernia repair. Apart from the postsurgical etiology, ischemic orchitis and subsequent testicular atrophy may occur secondary to compression of the testicular vessels by chronically incarcerated hernias. We present a rare case of testicular atrophy secondary to a large long standing incarcerated inguinal hernia of 2-decade duration in a 79-year-old man. Testicular atrophy should be always considered in long standing incarcerated inguinal hernias and patients should be adequately informed of this possibility during the preoperative work-up. Preoperative scrotal ultrasonography can be used to determine testicular status in this specific group of patients.

  14. Perforated Sigmoid Colon Cancer within an Irreducible Inguinal Hernia: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kai Hsiung; Yu, Chih Yung; Kao, Chien Chang; Tsai, Shih Hung; Huang, Guo Shu; Chang, Wei Chou [Tri-Service General Hospital, Taipei (China)

    2010-04-15

    A perforated sigmoid colon cancer within an inguinal hernia is extremely rare. This unexpected finding is usually discovered during surgery and causes an unavoidable septic evolution. Here, we describe the case of an 84-year-old man who presented with fever, abdominal distension, and a painful, enlarged, left scrotum. A CT showed a left, incarcerated, inguinal hernia containing a perforated sigmoid adenocarcinoma (which was confirmed by histopathology). The possibility of an irreducible inguinal hernia in association with perforated sigmoid colon cancer should be considered in the array of diagnoses. A pre-operative CT scan would be helpful in facilitating an accurate diagnosis.

  15. Persistent Mullerian duct syndrome presenting as an inguinal hernia : A case report

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    Amit Dangi

    2016-10-01

    Full Text Available A brief report of persistent mullerian duct syndrome (PMDS with 46XY karyotype which is one of the rarest variety of disorders of sexual differentiation (DSD accounting only 5% cases of all is being presented. A 21 years old male with left inguinal hernia and absent right testis presented in surgical outdoor and was operated. On exploration female genital organs like uterus and fallopian tubes along with contralateral testis were present in left inguinal canal as a content of sliding left inguinal hernia.

  16. The Anterior Preperitoneal Approach for Repair of Complex Inguinal Hernias

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    Safa Onel

    2014-08-01

    Results: A total of 40 patients (Male:32, Female:8 underwent hernia repair with our technique during the study period. The mean age was (+/-SD 44+/-6.8 years. Four patients had giant direct hernia,12 patients had giant inguino-scrotal hernia, 14 patients had recurrent and 10 patients had femoral hernia. 4 patients were underwent emergent surgery due to incarceration. The mean operation time was (+/-SD 61+/-11 min. There was no recurrence with the mean follow-up time of 7+/-2.2 years. Cnclusion: Our surgical technique allows to repair all types of inguinal hernia with one piece of prolene mesh by covering all potential defects. [Cukurova Med J 2014; 39(4.000: 822-828

  17. Hérnia inguinal na infância

    OpenAIRE

    Gabriel,Ennio

    2001-01-01

    A persistência do conduto peritoniovaginal (CPV) pode se manifestar como hérnia inguinal indireta, hidrocele comunicante, cisto do cordão ou pela combinação de duas ou até três destas formas. A hérnia é muito comum na infância, seu número vem crescendo com a sobrevida cada vez maior de prematuros de baixo peso, e deve ser operada sem demora devido ao risco de encarceramento. Já o cisto e a hidrocele só serão operados após uma certa espera pela sua cura espontânea. São resumidos o quadro clíni...

  18. Stone ingestion causing obstructed inguinal hernia with perforation

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    Paiboon Sookpotarom

    2014-01-01

    Full Text Available We report a rare case of obstructed right inguinal hernia caused by ingested stones. A 2 year-old boy from Northern Thailand was transferred to our hospital with low-grade fever, vomiting, and acute painful swelling at his right hemiscrotum for one day. The physical examination revealed marked enlargement with inflammation in his right hemiscrotum. The radiological findings showed huge number of stones in the right hemiscrotum. At surgery, the content of hernia sac was ascending colon, which was full of hard masses. With the help of additional lower transverse abdominal incision, the obstructed segment was successfully reduced and revealed a perforation. Most of the stones were removed through the perforation. The colonic wound was primarily repaired and both incisions were primarily closed. Although he developed post-operative wound infection, the boy had uneventfully recovered. The psychological exploration in this "stone pica" revealed no other psychological disorders.

  19. Estudio comparativo entre el uso de N – 2 butilcianoacrilato modificado y Vicryl 4 – 0 para el cierre de colgajos en cirugía de terceros molares Inferiores retenidos

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    José Ignacio Serrano

    2014-12-01

    , quinto y octavo día postquirúrgico. Resultados: Los resultados arrojados por el estudio demuestran una gran efectividad en la disminución del dolor postquirúrgico y en la reducción de la dehiscencia de los colgajos al utilizar técnicas adhesivas de sutura a base de cianoacrilatos (Glubran2.

  20. FIELD BLOCK FOR INGUINAL HERNIA REPAIR- A CLINICAL STUDY

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    Shivakumar

    2013-01-01

    Full Text Available ABSTRACT: BACKGROUND AND OBJECTIVES: Present clinical study was conducted to evaluate advantages of field block for inguinal her nia repair, with respect to duration and quality of analgesia, haemodynamic stability, and s peed of recovery by using 1% lidocaine with adrenaline. METHODS: Study was conducted on 50 patients posted for elective ingu inal hernia repair. Field block was instituted with 1% lidocaine with adrenaline with mean volume of 35.48 ml to block ilioinguinal, iliohypogastric, genital b ranch of genitofemoral nerve with subcutaneous infiltration. Patients were observed f or duration and quality of analgesia. Haemodynamic stability with PR, systolic and diasto lic BP. Post anaesthesia recovery was assessed by using “criteria for fast track eligibil ity for ambulatory anaesthesia” after the surgery. Duration of analgesia was assessed with su bjective complaint of pain (duration of onset of analgesia till the subjective complaint of pain. RESULTS: In the present study, the quality of analgesia was excellent in 72% of cases, good in 16 %, fair in 8% and poor in 4%. The mean duration of analgesia was 201.02 min (160 min to 28 0 min. All patients were haemodynamically stable throughout the surgery. Usi ng fast tract eligibility criteria for recovery all the patient had a score of 12 at 0 min and all o f them had score of > 12 at 15 min and 30 min and were ready to be shifted toward from the OR byp assing the post anaesthesia recovery room. CONCLUSION: Thus field block for inguinal hernia repair is a saf e technique, that provides excellent quality and prolonged analgesia, w ith rapid recovery and minimal to nil complications.

  1. Needlescopic Surgery Versus Single-port Laparoscopy for Inguinal Hernia

    Science.gov (United States)

    Hollinsky, Christian

    2015-01-01

    Background and Objectives: In recent years, 2 modifications of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair—needlescopic (nTAPP) surgery and single-port (sTAPP) surgery—have greatly improved patient outcomes over traditional approaches. For a comparison of these 2 modifications, we sought to investigate and compare the extent of surgical trauma and postoperative consequences for the abdominal wall in these two procedures. Methods: In a retrospective study, 50 nTAPP and 35 sTAPP procedures occurring at a community hospital from November 1, 2009, through July 31, 2012 were reviewed. Intraoperative data, including length of the umbilical skin incision and operative time, were recorded. A follow-up evaluation included investigation of hernia recurrence, postoperative pain, abdominal wall mobility, cosmetic satisfaction, and period of sick leave. Results: The mean umbilical skin incision was 13 ± 4 mm in nTAPP vs 27 ± 3 mm in sTAPP (P < .001). The nTAPP procedure required less operating time than the sTAPP procedure (54.8 ± 16.9 minutes vs 85.9 ± 19.7 minutes; P < .001). The mean immediate postoperative pain score on the visual analog scale was 2.7 ± 2.1 in the nTAPP group and 4.4 ± 1.9 in the sTAPP group (P = .016). In addition, patients who underwent nTAPP had a shorter period of sick leave (11.2 ± 8.4 days vs 24.1 ± 20.1 days; P = .02). At the follow-up evaluation after approximately 30 months, abdominal wall mobility and cosmetic satisfaction were equally positive, with no hernia recurrence. Conclusion: In patients with uncomplicated inguinal hernia, the nTAPP procedure, with less surgical trauma and operating time, has distinct advantages in reduction of immediate postoperative pain and sick leave time. PMID:26229421

  2. A Rare Case Report of Inguinal Hernia with Persistent Mullerian Duct and Klinefelter Syndrome

    Science.gov (United States)

    Om, Prabha; Shridatt, Sharma Ankit; Patni, Ankur; Verma, Naveen

    2016-01-01

    Inguinal hernia in male is a common problem but having female reproductive organs in hernial sac is rare. It occur because of failure of mullerian duct to regress in a male fetus during embryonic development, result in a syndrome known as Persistent Mullerian Duct Syndrome (PMDS), which is a rare entity of male pseudohermaphroditism. We hereby present a case of 21-year-old male patient reported with complains of cryptorchidism and inguinal hernia. Generally diagnosis of PMDS was established during investigation like ultrasonography, MRI for localization of undescended testis and during surgical exploration for inguinal hernia or cryptorchidism. Our patient was operated by bilateral inguinal incision; hernial sac contained adult size uterus fallopian tube and upper 2/3rd of vagina. On karyotyping it was found that he was a case of klinefelter syndrome also. Association of PMDS with klinefelter syndrome is very rare. PMID:27504355

  3. Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy

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    Hala Saad Abdel-Ghaffar

    2017-01-01

    Conclusion: Wound instillation of bupivacaine/ketamine is a simple, noninvasive, and effective technique that could be a safe alternative to CK for postoperative analgesia in children undergoing inguinal hernia repair.

  4. Multicystic mesothelioma of the liver with secondary involvement of peritoneum and inguinal region.

    Science.gov (United States)

    Di Blasi, Arturo; Boscaino, Amedeo; De Dominicis, Gianfranco; Marsilia, Giuseppina Marino; D'Antonio, Antonio; Nappi, Oscar

    2004-01-01

    A case of multicystic mesothelioma of the liver with secondary involvement of the pelvic peritoneum and the inguinal region is presented. The case is of interest because of its unusual location and peculiar biological behavior.

  5. Left Inguinal Adenopathy Two Years after Cytoreductive Surgery: A Rare Sign of Recurrence

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    Aibek E. Mirrakhimov

    2013-01-01

    Full Text Available Ovarian cancer is the second most common gynecological cancer in the Western world. Despite a good response to treatment, most patients with ovarian cancer will relapse. The abdominal, pelvic, and retroperitoneal cavities represent the most common sites of ovarian cancer recurrence, with inguinal lymph node involvement rarely reported. Herein we report the case of a 48-year-old Caucasian female who underwent successful surgical and chemotherapy treatment for ovarian epithelial cancer. Two years later, the patient was found to have painless left inguinal adenopathy, which was subsequently found to be metastatic ovarian cancer. CA-125 levels were elevated despite the lack of any foci of metabolically active tissue on imaging. Inguinal lymph node involvement is a rare sign of ovarian cancer. Despite that, it is essential to consider ovarian cancer in the differential diagnosis for inguinal lymphadenopathy in a female patient.

  6. Short-term outcome after Onstep versus Lichtenstein technique for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, K; Burcharth, J; Fonnes, S;

    2015-01-01

    Because of the high number of patients with chronic pain following inguinal hernia repair, a new, simple and safe method of repair is needed. Onstep is a new type of inguinal hernia repair that might be able to reduce postoperative acute and chronic pain. The aim of this study was to investigate...... patients, > 18 years, with a primary inguinal hernia. Experimental treatment in this study was the Onstep technique, which was compared with the Lichtenstein repair. Primary outcome was postoperative pain during the first 10 days following surgery. Secondary outcomes included duration of surgery, period...... between the groups regarding early postoperative pain or minor postoperative complications. Four patients had a recurrence within the first 10 days of follow-up, one patient in the Lichtenstein group and three patients in the Onstep group, p = 0.30. The Onstep technique for inguinal hernia repair was safe...

  7. Pain during sexual activity before and after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Rosenberg, Jacob

    2015-01-01

    BACKGROUND: Sexual life may be impaired by pain during sexual activity in patients with inguinal hernia. On the other hand, inguinal hernia repair has also been reported to cause sexual dysfunction in terms of pain during sexual activity and ejaculation. The primary aim of this study...... was to estimate the prevalence of pain during sexual activity before and after laparoscopic inguinal hernia repair, and the secondary, to describe pain location, frequency of pain during sexual activity, and to which degree sexual life was affected by the pain. Furthermore, to examine whether preoperative pain...... during sexual activity was a risk factor for postoperative pain during sexual activity. METHODS: A prospective questionnaire study before and 6 months after hernia repair was conducted. Men (age 18-85 years) undergoing laparoscopic inguinal hernia repair were included. RESULTS: In total, 160 men were...

  8. The totally extraperitoneal method versus Lichtenstein's technique for inguinal hernia repair

    DEFF Research Database (Denmark)

    Koning, G G; Wetterslev, J; van Laarhoven, C J H M

    2013-01-01

    Lichtenstein's technique is considered the reference technique for inguinal hernia repair. Recent trials suggest that the totally extraperitoneal (TEP) technique may lead to reduced proportions of chronic pain. A systematic review evaluating the benefits and harms of the TEP compared...

  9. A RARE CASE OF INDIRECT INGUINAL HERNIA WITH OVARY AS CONTENT

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    Kakkireni

    2015-10-01

    Full Text Available This is a case of a 26 year old female who presented with swelling in the left groin associated with dragging pain in the left iliac fossa. She was investigated and diagnosed as left indirect inguinal hernia. Hernioplasty was planned and intraoperatively ovary along with fimbria was identified as content. An inguinal ovary may occur if the gubernaculum fails to attach to the uterus in fetal life or if the canal of Nuck remains open after birth

  10. Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

    OpenAIRE

    2015-01-01

    Introduction: Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. Presentation of case: Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination ...

  11. Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair Using 3-dimensional Mesh Without Mesh Fixation.

    Science.gov (United States)

    Aliyazicioglu, Tolga; Yalti, Tunc; Kabaoglu, Burcak

    2017-08-01

    Approximately one fifth of patients suffer from inguinal pain after laparoscopic total extraperitoneal (TEP) inguinal hernia repair. There is existing literature suggesting that the staples used to fix the mesh can cause postoperative inguinal pain. In this study, we describe our experience with laparoscopic TEP inguinal hernia surgery using 3-dimensional mesh without mesh fixation, in our institution. A total of 300 patients who had undergone laparoscopic TEP inguinal hernia repair with 3-dimensional mesh in VKV American Hospital, Istanbul from November 2006 to November 2015 were studied retrospectively. Using the hospital's electronic archive, we studied patients' selected parameters, which are demographic features (age, sex), body mass index, hernia locations and types, duration of operations, preoperative and postoperative complications, duration of hospital stays, cost of surgery, need for analgesics, time elapsed until returning to daily activities and work. A total of 300 patients underwent laparoscopic TEP hernia repair of 437 inguinal hernias from November 2006 to November 2015. Of the 185 patients, 140 were symptomatic. Mean duration of follow-up was 48 months (range, 6 to 104 mo). The mean duration of surgery was 55 minutes for bilateral hernia repair, and 38 minutes for unilateral hernia repair. The mean duration of hospital stay was 0.9 day. There was no conversion to open surgery. In none of the cases the mesh was fixated with either staples or fibrin glue. Six patients (2%) developed seroma that were treated conservatively. One patient had inguinal hernia recurrence. One patient had preperitoneal hematoma. One patient operated due to indirect right-sided hernia developed right-sided hydrocele. One patient had wound dehiscence at the umbilical port entry site. Chronic pain developed postoperatively in 1 patient. Ileus developed in 1 patient. Laparoscopic TEP inguinal repair with 3-dimensional mesh without mesh fixation can be performed as safe as

  12. Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia

    OpenAIRE

    Joseph Thomas; Natarajan Kumaresan; Sumanth Channapatna Suresh; Basant Mahadevappa

    2009-01-01

    Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera.  Case reports and series have been published with various organs and rare organs being part of the hernia.  Urinary bladder is a known content of sliding hernias.  This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.

  13. Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia.

    Science.gov (United States)

    Mahadevappa, Basant; Suresh, Sumanth Channapatna; Natarajan, K; Thomas, Joseph

    2009-01-01

    Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera. Case reports and series have been published with various organs and rare organs being part of the hernia. Urinary bladder is a known content of sliding hernias. This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.

  14. Dedifferentiated retroperitoneal liposarcoma presenting as right inguinal hernia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Myung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of); Choi, Moon Hyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-01-15

    Retroperitoneal liposarcomas usually present as painless, slow-growing abdominal masses. When masses grow large enough to compress surrounding structures, symptoms may occur. Retroperitoneal liposarcoma clinically manifesting as inguinal hernia is a very rare entity; only 11 cases have been reported. Herein, we present radiographic features of a 37-year-old male with a painless palpable mass in the right groin that was identified as dedifferentiated retroperitoneal liposarcoma herniated through the right inguinal canal.

  15. MYXOID LIPOSARCOMA OF THE SPERMATIC CORD MIMICKING LEFT INGUINAL HERNIA: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sanjay

    2015-11-01

    Full Text Available Myxoid liposarcoma of the spermatic cord is a rare condition. Preoperative diagnosis is difficult since the clinical findings are very similar to that of inguinal hernia. We report a rare case of myxoid liposarcoma of spermatic cord in a 55-year-old male, who was clinically diagnosed with left inguinal hernia. Surgical excision specimen showed globular lump, which measures 13x12x6cm and cut surface show myxoid gelatinous areas. Microscopic examination showed features of myxoid liposarcoma

  16. Pain and sensory dysfunction 6 to 12 months after inguinal herniotomy

    DEFF Research Database (Denmark)

    Mikkelsen, Trine; Werner, Mads U; Lassen, Birgit;

    2004-01-01

    Inguinal hernia repair is associated with a 5%-30% incidence of chronic pain, but the pathogenesis remains unknown. We therefore evaluated pain and sensory dysfunction by quantitative sensory testing 6-12 mo after open hemiorrhaphy. Before sensory testing, all patients (n = 72) completed a short...... inguinal hemiotomy but has a low specificity for chronic postherniotomy pain. Factors other than nerve damage may be involved in the development of chronic posthemiotomy pain....

  17. Tailored Approach in Inguinal Hernia Repair – Decision Tree Based on the Guidelines

    OpenAIRE

    2014-01-01

    The endoscopic procedures TEP and TAPP and the open techniques Lichtenstein, Plug and Patch, and PHS currently represent the gold standard in inguinal hernia repair recommended in the guidelines of the European Hernia Society, the International Endohernia Society, and the European Association of Endoscopic Surgery. Eighty-two percent of experienced hernia surgeons use the “tailored approach,” the differentiated use of the several inguinal hernia repair techniques depending on the findings of ...

  18. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    OpenAIRE

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias...

  19. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

    OpenAIRE

    2015-01-01

    Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar res...

  20. Preperitoneal Surgery Using a Self-Adhesive Mesh for Inguinal Hernia Repair

    OpenAIRE

    2014-01-01

    Background and Objectives: Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh. Methods: This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from Ap...

  1. A Contralateral Complication of Extra-peritoneal Laparoscopic Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Jacob S

    2010-03-01

    Full Text Available A 63 year old female underwent an uncomplicated total extraperitoneal repair of a right direct inguinal hernia. One week later she presented with a strangulated left femoral hernia. We believe the dissection of the extraperitoneal space caused bleeding which tracked down through the femoral canal resulting in a femoral hernia. To date there are no reports of such a complication following total extraperitoneal inguinal hernia repair in the literature.

  2. Surgical risk factors for recurrence in inguinal hernia repair – a review of the literature

    Directory of Open Access Journals (Sweden)

    Niebuhr Henning

    2017-04-01

    Full Text Available Despite all the progress made in inguinal hernia surgery driven by the development of meshes and laparoendoscopic operative techniques, the proportion of recurrent inguinal hernias is still from 12% to 13%. Recurrences can present very soon after primary inguinal hernia repair generally because of technical failure. However, they can also develop much later after the primary operation probably due to patient-specific factors. Supported by evidence-based data, this review presents the surgical risk factors for recurrent inguinal hernia after the primary operation. The following factors are implicated here: choice of operative technique and mesh, mesh fixation technique, mesh size, management of medial and lateral hernia sac, sliding hernia, lipoma in the inguinal canal, operating time, type of anesthesia, participation in a register database, femoral hernia, postoperative complications, as well as the center and surgeon volume. If these surgical risk factors are taken into account when performing primary inguinal hernia repair, a good outcome can be expected for the patient. Therefore, they should definitely be observed.

  3. [Round ligament cyst simulating incarcerated inguinal hernia. Report of a case].

    Science.gov (United States)

    Vargas-Ávila, Arcenio Luis; Gómez-Montoya, Luis Ernesto; Guidos-Gil, José César; Ávila-Rivera, José Luis; Huerta-García de León, Óscar; Medina-Tirado, Manuel Alejandro

    Round ligament cysts are rare lesions, often diagnosed as irreducible inguinal hernias. Most patients are in the third to fourth decade of life, but they can occur in younger patients. They are usually clinically asymptomatic or tend to produce subtle symptoms such as pain, discomfort, or a feeling of heaviness, and swelling. Cysts should not be resized with the Valsalva manoeuvre. Ultrasound is the diagnostic method of choice. The definitive diagnosis is made during surgery, and confirmed by pathological examination. To present a case of round ligament cyst, initially diagnosed as an incarcerated inguinal hernia, and a review of the literature. A 19 year-old female, who was admitted to the emergency department due to her current condition of 5 days of onset. She had an increased volume in right inguinal region that increased with physical exertion, throbbing pain, and nausea without vomiting. A right inguinal mass of approximately of 6cm in diameter was found, which was painful on mid-superficial palpation, reaching a pre-surgical diagnosis of incarcerated right inguinal hernia with an indication of surgical intervention. Round ligament cysts are a rare pathology, often confused with incarcerated inguinal hernias. Although ultrasound is the study of choice, the final diagnosis is usually made during surgery and confirmed by histopathology. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  4. Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report

    Directory of Open Access Journals (Sweden)

    Hipkins Gabrielle

    2010-06-01

    Full Text Available Abstract We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers. To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

  5. Comparison of Treatment Outcomes of Surgical Repair in Inguinal Hernia with Classic versus Preperitoneal Methods on Reduction of Postoperative Complications

    OpenAIRE

    Hormoz Mahmoudvand; Shahab Forutani; Sedigheh Nadri

    2017-01-01

    Background. This study aims to evaluate and compare the results of inguinal herniorrhaphy with mesh in classic and preperitoneal method. Methods. Our study community includes 150 candidate patients for inguinal herniorrhaphy with mesh. Totally, 150 candidate patients for inguinal herniorrhaphy were randomly divided into two groups: (1) classic group in which the floor of the canal was repaired and the mesh was located on the floor of the canal and (2) preperitoneal group in which the mesh was...

  6. Injerto de tejido conectivo subpediculado y colgajo de avance coronal para el tratamiento de una recesión gingival en paciente con tratamiento de ortodoncia: Presentación de un caso Connective tissue graft and coronally advanced flap for treatment of a gingival recession in a patient with orthodontics treatment: a case report

    Directory of Open Access Journals (Sweden)

    A. Díaz Caballero

    2009-08-01

    Full Text Available A menudo es notable la presencia de recesiones gingivales en pacientes con tratamiento ortodóncico, debido a que el movimiento ocasionado por la aparatología, afecta directamente el periodonto. Las recesiones gingivales constituyen una preocupación tanto estética como funcional para el paciente. Estas pocas veces resultan en la pérdida de los dientes; sin embargo, se asocian, por lo general con afecciones tales como; sensibilidad dental e irritación del tejido marginal, causada por la incapacidad del paciente para remover la placa. Existen diversas técnicas para contrarrestar estos defectos, entre las que encontramos: el injerto de tejido conectivo subepitelial, injerto de matriz dérmica acelular, injerto gingival libre y la regeneración tisular guiada. Se presenta un caso de un paciente con retracción del margen gingival a nivel del incisivo central inferior derecho y ausencia de encía adherida asociada al tratamiento ortodóncico, describiéndose la técnica quirúrgica utilizando tejido conectivo subepitelial del paladar combinado con un colgajo de avance coronal, obteniéndose excelentes resultados estéticos y una buena cobertura radicular.It is often marked the presence of gingival recession in patients with orthodontic treatment, because the movement caused by the apparatus, directly affects the periodontium. Gingival recessions are a concern aesthetic and functional for the patient. These rarely result in tooth loss, but are associated, usually with conditions such as: tooth sensitivity and irritation of the marginal tissue, caused by the inability of the patient to remove the plaque. There are various techniques to decrease these defects, among which are: the subepithelial connective tissue graft, acellular dermal matrix graft, free gingival graft and guided tissue regeneration. It is reported a case of a patient with retraction of the gingival margin at the lower right central incisor and the absence of adherent gums

  7. Satisfacción en pacientes con reconstrucción mamaria con colgajo D.I.E.P. Patient’s satisfaction after diep flap reconstruction

    Directory of Open Access Journals (Sweden)

    E. Cabrera Sánchez

    2006-09-01

    Full Text Available La reconstrucción mamaria tras mastectomía se realiza primordialmente para proporcionar calidad de vida a la paciente. Este estudio se desarrolló para valorar la satisfacción y calidad de vida de las pacientes reconstruidas mediante colgajo D.I.E.P. (Deep Inferior Epigastric Perforator y evaluar el resultado estético de la reconstrucción. Treinta y tres pacientes, de 51 reconstrucciones mamarias con colgajo DIEP realizadas entre enero de 2000 y noviembre de 2004 fueron preguntadas acerca de aspectos generales relativos a la cirugía, imagen corporal y sensación subjetiva. El resultado de imagen corporal fue evaluado por dos observadores externos, un cirujano plástico y una enfermera, además de por la propia paciente. Para valorar la reconstrucción mamaria, se utilizó una escala de 4 puntos. La satisfacción general de nuestro estudio fue más elevada que la observada en estudios precedentes. Hemos conseguido una valoración alta en simetría, dentro de los parámetros objetivos y en integridad corporal entre los subjetivos. Hemos encontrado una correlación alta entre las respuestas de los observadores comparada con las respuestas de las propias pacientes. Por último, hemos visto una fuerte correlación entre integridad corporal y satisfacción generalBreast reconstructions after breast cancer surgery are primarily performed to improve patient’s quality of life. This study investigates patient’s satisfaction and quality of life with breast reconstruction after deep inferior epigastric perforator (D.I.E.P. flap surgery and to evaluate the aesthetic result of the breast reconstruction. Thirty-three patiens, from fifty-one DIEP breast reconstruction made between january 2000 and december 2004 were answered about three questionnaires concerning to general aspect, body image, and subjective sensation. The body image outcome was also evaluated by one plastic surgeon and a nurse. The panel evaluated breast reconstruction on 4 subescales

  8. Efficacy and safety of transdermal diclofenac patch versus intramuscular diclofenac injections in postoperative patients of inguinal hernia

    National Research Council Canada - National Science Library

    Pranjit Narzaree; Mahavir S. Griwan; Janardhan Singh

    2016-01-01

    Background: The aim of this study was to compare the efficacy and safety of diclofenac transdermal patch with intramuscular diclofenac injections in postoperative patients of inguinal hernia. Methods...

  9. Novel use of cap-assisted enteroscopy for detection of colorectal tumor in a patient with incarcerated inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    Victoria; PY; Tan; Ivan; WC; Wong; Yuk; Tong; Lee

    2014-01-01

    Multiple reports have documented unsuspected ingui-nal hernias which result in difficulties during the colo-noscopic examinations of patients. In most cases, the colonoscopy can be delayed until a surgical consult has further evaluated the inguinal hernia. This case report documents a patient who required a colonoscopy but surgical intervention for the detected inguinal hernia was not appropriate due to his co-morbid medical con-ditions. With the use of the combination of an entero-scope fitted with a cap and fluoroscopy, the inguinal hernia was able to be negotiated and the diagnosis of a cecal carcinoma was able to be confirmed.

  10. Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report.

    Science.gov (United States)

    Ueda, Junji; Yoshida, Hiroshi; Makino, Hiroshi; Maruyama, Hiroshi; Yokoyama, Tadashi; Hirakata, Atsushi; Akagi, Ichiro; Watanabe, Manabu; Uchida, Eiichi; Uchida, Eiji

    2016-01-01

    The uterus, ovary, and fallopian tube are rarely present in an inguinal hernia. We report on an operation to treat just such a rare condition for a right inguinal hernia. An 87-year-old Japanese woman was admitted with swelling in the right inguinal region and a purulent discharge from the vagina. Vital signs were stable, but the mobile mass was irreducible. Computed tomography of the abdomen indicated uterine tissue in a right inguinal hernia. We diagnosed an inguinal hernia with an incarcerated uterus and performed surgery on that basis. An incision approximately 6 cm long was made in the skin above the swollen area to open the inguinal sac, disclosing a tumor enveloped by a hernial sac. Opening the hernial sac revealed the prolapsed uterus, the fallopian tube, and the right ovary. Because no ischemic change was noted, the incarcerated uterus was returned to the abdominal cavity, and the hernial opening was closed with the onlay mesh technique. The posterior wall of the inguinal canal was found to have prolapsed laterally to the inferior epigastric artery, resulting in an external inguinal hernia. This case demonstrates that careful attention must be paid to inguinal hernias in female patients because the uterus, ovary, and fallopian tube may be involved.

  11. Estudio clínico controlado aleatorizado para evaluación del Emdogain como terapia adjunta en el tratamiento de recesiones gingivales/Randomized controlled clinical trial for evaluation of Emdogain in adjunctive therapy in gingival recession treatment

    OpenAIRE

    Esquivel Muñoz, Joel Benito; Universidad Autónoma de Nicaragua; Chadid Núñez, Giovanna; Pontificia Universidad Javeriana; Pereira Ebratt, Ramón; Pontificia Universidad Javeriana; Serrano, Juan Jaime; Pontificia Universidad Javeriana

    2005-01-01

    ANTECEDENTES: publicaciones previas han demostrado que las proteínas derivada de la matriz del esmalte tienen la habilidad de mejorar los parámetros . OBJETIVO:comparar clínicamente los resultados obtenidos con relación a profundidad de la bolsa, nivel de inserción clínica al aplicar el Emdogain, más injerto de tejido conjuntivo (ITC)con colgajo posicionado coronal (CPC), con ITC con CPC como tratamiento único, en recesiones ginigivales tipo I y II de Miller para verificar si con el Emdogain ...

  12. Cirugía de la hernia inguinal en la tercera edad: ambulatoria y con hospitalización corta Inguinal hernia surgery in third age patients: ambulatory and with a short hospitalization

    Directory of Open Access Journals (Sweden)

    Pablo Gonzalo Pol Herrera

    2011-03-01

    Full Text Available INTRODUCCIÓN. La cirugía de la enfermedad herniaria de la pared abdominal, y en especial de la hernia inguinofemoral, ha sufrido un incremento pero en realidad su prevalencia se desconoce. El objetivo de este estudio fue valorar el resultado del tratamiento quirúrgico de la hernia de la región inguinofemoral en los pacientes de la tercera edad atendidos en el Hospital General Docente «Dr. Enrique Cabrera». MÉTODOS. Se realizó un estudio en 1 093 pacientes de la tercera edad operados de hernia inguinofemoral entre enero de 1999 y diciembre del 2008, en el Hospital General Docente «Dr. Enrique Cabrera». En todos los casos se ofreció al paciente la alternativa de ser operado de forma ambulatoria o con corta estadía. También se incluyeron los pacientes operados de urgencia. De entre los pacientes operados de forma electiva se excluyeron los que padecían enfermedades asociadas, cardiopulmonares o tromboembólicas de tipo ASA-III (clasificación de la American Society of Anesthesiologists. RESULTADOS. La mayor incidencia de la hernia inguinal se encontró en las edades de 60-69 años (59,3 %. La hernia inguinal derecha, indirecta, apareció con mayor frecuencia. La técnica quirúrgica anatómica de Desarda fue la más aplicada en la hernia inguinal, y la técnica protésica de Lichtenstein, con el 32 %, le siguió en frecuencia. Hubo un total de 20 recidivas (1,8 %. Se aplicó anestesia local en el 75,4 % de los pacientes, de forma ambulatoria en el 76,4 %. El total de complicaciones fue de 78 (7,1 %. CONCLUSIONES. El tratamiento quirúrgico de las hernias inguinofemorales, de forma ambulatoria o con corta hospitalización, es un procedimiento adecuado en pacientes de la tercera edad, ya que aumenta la comodidad de los pacientes, disminuye el riesgo de infección hospitalaria, reduce las listas de espera y los costos hospitalarios.INTRODUCTION. The surgery of hernial disease of abdominal wall and especially of the inguinofemoral hernia

  13. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Directory of Open Access Journals (Sweden)

    Reza Firoozabadi

    2015-09-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  14. Single site and conventional totally extraperitoneal techniques for uncomplicated inguinal hernia repair: A comparative study

    Directory of Open Access Journals (Sweden)

    Felipe Araujo

    2014-01-01

    Full Text Available Objective: To demonstrate the feasibility of endoscopic extraperitoneal single site (EESS inguinal hernia repair and compare it outcomes with the conventional totally extraperitoneal (TEP technique. Background : TEP inguinal hernia repair is a widely accepted alternative to conventional open technique with several perioperative advantages. Transumbilical laparoendoscopic singlesite surgery (LESS is an emerging approach and has been reported for a number of surgical procedures with superior aesthetic results but other advantages need to be proven. Patients and Methods : Thirty-eight uncomplicated inguinal hernias were repaired by EESS approach between January 2010 and January 2011. All procedures were performed through a 25 cm infraumbilical incision using the Alexis wound retractor attached to a surgical glove and three trocars. Body mass index, age, operative time, blood loss, complications, conversion rate, analgesia requirement, hospital stay, return to normal activities and patient satisfaction with aesthetic results were analysed and compared with the last 38 matched-pair group of patients who underwent a conventional TEP inguinal hernia repair by the same surgeon. Results: All procedures were performed successfully with no conversion. In both unilateral and bilateral EESS inguinal repairs, the mean operative time was longer than conventional TEP (55± 20 vs. 40± 15 min, P = 0.049 and 70± 15 vs. 55± 10 min, P = 0.014. Aesthetic result was superior in the EESS group (2.88± 0.43 vs. 2.79± 0.51, P = 0.042. There was no difference between the two approaches regarding blood loss, complications, hospital stay, time until returns to normal activities and analgesic requirement. Conclusion: EESS inguinal hernia repair is safe and effective, with superior cosmetic results in the treatment of uncomplicated inguinal hernias. Other advantages of this new technique still need to be proven.

  15. Internal inguinal ring closure by laparoscopy using homologous pericardium grafts in horses

    Directory of Open Access Journals (Sweden)

    Julio David Spagnolo

    2016-02-01

    Full Text Available ABSTRACT: The occlusion of inguinal ring is the treatment to avoid the inguinal hernia in horses. The aim of this study is evaluate the efficacy of homologous pericardium grafts for internal inguinal ring closure in horses, comparing mechanical or manual laparoscopic suture. Cross over study, using six healthy intact male Mangalarga breed horses aged between 3 and 12 years. Horses were operated under general anesthesia in 25º Trendelenburg position. Five laparoscopic portals were employed. Pericardium grafts measuring 4x5cm were anchored covering the left and right internal inguinal rings using either manual intracorporeal suture or laparoscopic stapler. Horses were followed-up during 11 weeks when were submitted to a laparoscopic control. Surgical time, trans and postoperative complications and effectiveness of internal inguinal closure were evaluated and statistically analyzed. The level of significance was set at 5% P<0.05. The procedures were realized without complications and the mean time required for manual and mechanical suture procedures differed significantly (67.8±15.3 and 14.1±2.1 min respectively; P<0.05. All manually sutured grafts remained in place and partial suture dehiscence with incomplete occlusion of the internal inguinal ring was observed in two stapled grafts. Non-severe complications were observed trans or postoperatively. One synechiae and three omental adhesions were observed by laparoscopic control on day 77, but without clinical relevance in the evaluated period. The use of homologous pericardium grafts was effectiveness to internal inguinal ring closure by laparoscopy. Mechanical suture was faster to perform than manual, but provided less satisfactory results concerning safety of graft fixation.

  16. Tumor borderline do ovário localizado no canal inguinal: relato de caso A borderline ovarian tumor in inguinal canal: case report

    Directory of Open Access Journals (Sweden)

    Vinícius Basso Preti

    2010-06-01

    Full Text Available Os sintomas do tumor ovariano são inespecíficos e uma forma rara de apresentação é como conteúdo de uma hérnia inguinal. Relatamos o caso de uma paciente de 82 anos, com diagnóstico de câncer de mama e lesão anexial hipoecoica à ecografia. A mesma foi submetida à cirurgia conservadora da mama e à laparotomia, com achado de lesão ovariana sólido-cística no interior do canal inguinal à direita. A análise por congelação foi negativa para malignidade, e o exame anatomopatológico mostrou tratar-se de tumor ovariano borderline.The symptoms of ovarian tumor are not specific and a rare presentation of the tumor is as the content of an inguinal hernia. We reported a case of an 82-year-old woman, diagnosed with breast cancer and with a concomitant hypoecoic adnexal mass at the ecographic exam. The patient was treated with conservative breast surgery and laparotomy. A cystic-solid ovarian lesion was found inside the right inguinal canal. Frozen-section examination was negative for malignancy, and the anatomopathological analysis revealed a borderline ovarian tumor.

  17. Quantitative and qualitative analysis of collagen types in the fascia transversalis of inguinal hernia patients A fascia transversalis na etiopatogenia da hérnia inguinal

    Directory of Open Access Journals (Sweden)

    Alberto Luiz Monteiro Meyer

    2007-09-01

    Full Text Available BACKGROUND: Inguinal hernia is the second most common surgical case in our field. The anatomical factors alone are not enough to explain the inguinal hernia. Studies show changes in the proportion and quantity of collagen fibers in the developing of inguinal hernia. The greater production of collagen type III compared to the type I could justify the thinning of the fascia transversalis and its weakness. AIM: To determine the quantitative and qualitative changes of collagen in the fascia transversalis in inguinal hernia patients and compare them to findings from corpses without inguinal hernia. METHOD: Prospective case-control study based on the biopsy of fascia transversalis of 27 patients and 24 corpses. The technique used was hematoxylin-eosin and picrosirius colorimetry. RESULTS: The medium percent area of collagen (types I + III and collagen type I, in both groups, show no statistic difference. The quantity of collagen type III was greater in the patients. Patients classified with Nyhus IIIa presented greater quantity of collagen type III. CONCLUSION: There is no significant difference in the quantity of collagen in the fascia transversalis of patients compared to the controls. An increase in the quantity of collagen type III was found in patients with inguinal hernia and a greater quantity in those patients classified with Nyhus IIIa.RACIONAL: A hérnia inguinal é a segunda afecção cirúrgica mais comum em nosso meio. Os fatores anatômicos, isoladamente, não são suficientes para explicar a ocorrência das hérnias inguinais. Estudos apontam alterações na proporção e quantidade de fibras colágenas no desenvolvimento da hérnia inguinal. A maior produção de colágeno tipo III em relação ao tipo I poderia justificar o adelgaçamento da fascia transversalis e sua fraqueza. OBJETIVO: Determinar as alterações quantitativas e qualitativas de colágeno na fascia transversalis de doentes com hérnia inguinal e compará-las com

  18. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Takeshi Matsutani

    2016-01-01

    Full Text Available Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP inguinal hernia repair using a memory-ring patch (Polysoft™ mesh. Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia, and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132 for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

  19. PROSPECTIVE STUDY ON DARNING AND LICHTENSTEIN MESH HERNIOPLASTY (LMH IN INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Affin

    2016-01-01

    Full Text Available INTRODUCTION Prospective study on Darning and Lichtenstein Mesh Hernioplasty in Inguinal Hernia Repair is a study of 61 cases of inguinal hernias which were treated by either open Inguinal hernia mesh repair (Lichtenstein or darning repair. The study was conducted with an objective to compare the effectiveness of these procedures and complications if any. 61 cases of inguinal hernia admitted in Yenepoya Medical College Hospital, Mangalore were selected on the basis of the non-probability (prospective sampling method. All patients with uncomplicated direct and indirect hernias treated by darning or mesh repair were included. After preoperative preparation they were randomly chosen for darning or mesh repair. The age/sex incidence, mode of presentation, precipitating factors, surgical treatment and postoperative complications were all evaluated and compared with standard published literature. The total number of postoperative complications was reported in 13.9% patients, complications was high after Mesh repair when compared to Darning. Seroma was the most common complication followed by funiculitis and wound infection. There was one recurrence each noted till date in the two groups under study. Darn repair is equally effective and much less costly treatment for inguinal hernia than mesh repair which had more risk of infection.

  20. Genome-wide linkage analysis of inguinal hernia in pigs using affected sib pairs

    Directory of Open Access Journals (Sweden)

    Taubert Helge

    2006-05-01

    Full Text Available Abstract Background Inguinal and scrotal hernias are of great concern to pig producers, and lead to poor animal welfare and severe economic loss. Selection against these conditions is highly preferable, but at this time no gene, Quantitative Trait Loci (QTL, or mode of inheritance has been identified in pigs or in any other species. Therefore, a complete genome scan was performed in order to identify genomic regions affecting inguinal and scrotal hernias in pigs. Records from seedstock breeding farms were collected. No clinical examinations were executed on the pigs and there was therefore no distinction between inguinal and scrotal hernias. The genome scan utilised affected sib pairs (ASP, and the data was analysed using both an ASP test based on Non-parametric Linkage (NPL analysis, and a Transmission Disequilibrium Test (TDT. Results Significant QTLs (p Conclusion For the first time in any species, a genome scan has revealed suggestive QTLs for inguinal and scrotal hernias. While this study permitted the detection of chromosomal regions only, it is interesting to note that several promising candidate genes, including INSL3, MIS, and CGRP, are located within the highly significant QTL regions. Further studies are required in order to narrow down the suggestive QTL regions, investigate the candidate genes, and to confirm the suggestive QTLs in other populations. The haplotype associated with inguinal and scrotal hernias may help in achieving selection against the disorder.

  1. Transumbilical endoscopic technique for complete closure of inguinal hernias in female pediatric patients

    Science.gov (United States)

    Zhou, Xuewu; Qi, Xi; Jiang, Bing; Sha, Yongliang; Song, Daiqiang

    2017-01-01

    Laparoscopic percutaneous extraperitoneal closure of inguinal hernia with variable devices as an effective technique in minimal-access surgery for pediatric inguinal hernias in children was investigated in the present study. A Veress needle was inserted into the abdomen. Trocars, laparoscope and needle holder were placed through the umbilical incision. Under laparoscopic monitoring, a round needle was introduced into the peritoneal cavity through the anterior abdominal wall. The end of the suture inside the peritoneal cavity was left outside the peritoneal cavity in favor of ligation. The needle was passed through the peritoneum to place an extraperitoneal purse-string suture around the internal inguinal ring, counterclockwise on the left and clockwise on the right. The needle was then passed back into the peritoneal cavity and out through the abdominal wall, and the needle ends of the stitch were cut. The ends of the suture were tied. We described a technique used for transumbilical endoscopic closure of pediatric inguinal hernias in girls. This technique is simple and can be performed quickly. The cosmetic result is excellent because the two umbilical incisions are only 5-mm long, which make it possible to perform surgery without a visible scar. We performed this procedure in over 96 patients and have had no recurrences. Thus, this method may become the laparoscopic repair of choice for females with inguinal hernias. PMID:28123465

  2. [The value of diagnostic ultrasound for detecting occult inguinal hernia in patients with groin pain].

    Science.gov (United States)

    Lorenzini, Cesare; Sofia, Lorenzo; Pergolizzi, Francesca Pia; Trovato, Massimo

    2008-01-01

    The value of diagnostic ultrasound for detecting occult inguinal hernia in The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing occult hernia in patients with recurrent inguinal pain and a negative clinical examination. Over a period of three years, a total of 51 patients were referred for ultrasound examination with clinically suspected occult inguinal hernia. Patients with positive US scans were offered surgery, while those with negative US findings were offered further imaging or other diagnostic tests. The ultrasound examination of the inguinal region was conducted using a 5-10 MHz linear probe. The scan was performed with the patient in the supine and erect positions, in a relaxed state, as well as during coughing and during a Valsalva manoeuvre. Overall, ultrasound diagnosed 20 inguinal hernias and all 20 patients with positive scans underwent surgery. Surgery confirmed the ultrasound diagnosis in 19 patients, only 1/20 having no hernia at operation (100% ultrasound sensitivity and 96.9% specificity). Patients undergoing surgery showed complete symptom resolution at a three-month follow-up. This study confirms that ultrasound is capable of accurately diagnosing groin hernia and this may justify its use in patients with chronic groin pain due to a suspected occult hernia.

  3. Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

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    Yuri N. Shiryajev

    2013-01-01

    Full Text Available An epiploic appendage of the sigmoid colon is considered to be an unusual type of inguinal hernia content. The strangulation of a sigmoid colon appendage into a right inguinal hernia is exclusively rare. We present a case of an 81-year-old female patient with severe cardiovascular comorbidities who was urgently admitted after an episode of strangulation and subsequent spontaneous reduction of a right inguinal hernia. The condition of the patient was stable, and an urgent operation was not indicated for three days after admission. However, we had to operate because the hernia strangulation recurred. In the hernia sac, a free fatty body (a separated and saponified epiploic appendage of the colon and a strangulated epiploic appendage of dolichosigmoid, with signs of necrosis, were found. Removal of the free fatty body and necrotic epiploic appendage and subsequent anterior-wall inguinal hernioplasty were successfully performed. In the world literature, this case may be the first report of a sigmoid epiploic appendage strangulation in a right inguinal hernia that is well documented by photography.

  4. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    Science.gov (United States)

    Nomura, Tsutomu; Matsuda, Akihisa; Takao, Yoshimune

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain. PMID:27635414

  5. Estado gingival y profundidad al sondeado de bolsas como signo de cicatrización y complicaciones post quirúrgicas en colgajos a grosor completo, usando o no colutorios

    OpenAIRE

    Donayre Gonzáles, Fernando; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,; Chávez Reategui, Beatriz del Carmen; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,

    2014-01-01

    El presente estudio compara el estado gingival y la profundidad al sondeado como signosprincipales de la cicatrización y complicaciones post quirúrgicas en pacientes tratadosquirúrgicamente mediante colgajos a grosor completo que usaron y no usaron colutorios oralesantes y después de cirugías periodontales. Se tomaron 34 pacientes de ambos sexos, de los cuales17 realizaron enjuagatorios orales con clorhexidina, antes y después de la cirugía periodontaly los otros 17 solamente realizaron cepil...

  6. Estado gingival y profundidad al sondeado de bolsas como signo de cicatrización y complicaciones post quirúrgicas en colgajos a grosor completo, usando o no colutorios

    OpenAIRE

    Donayre Gonzáles, Fernando; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,; Chávez Reategui, Beatriz del Carmen; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,

    2014-01-01

    El presente estudio compara el estado gingival y la profundidad al sondeado como signosprincipales de la cicatrización y complicaciones post quirúrgicas en pacientes tratadosquirúrgicamente mediante colgajos a grosor completo que usaron y no usaron colutorios oralesantes y después de cirugías periodontales. Se tomaron 34 pacientes de ambos sexos, de los cuales17 realizaron enjuagatorios orales con clorhexidina, antes y después de la cirugía periodontaly los otros 17 solamente realizaron cepil...

  7. Amyand's hernia masquerading inguinal abscess complicated with appendico-cutaeneous fistula in an infant with Hirschsprung's disease

    Directory of Open Access Journals (Sweden)

    Ruzaimie Noor

    2017-06-01

    Full Text Available A normal or diseased vermiform appendix located inside the inguinal hernia is called Amyand's hernia (AH. The incidence of appendicitis in Amyand's hernia is rare. The appendicitis per se is uncommon disease in infancy. We reported an extremely rare case of undiagnosed right Amyand's hernia mimicking inguinal abscess complicated with appendico-cutaneous fistula in total colonic Hirschsprung's Disease.

  8. A Low-Cost Teaching Model of Inguinal Canal: A Useful Method to Teach Surgical Concepts in Hernia Repair

    Science.gov (United States)

    Ansaloni, Luca; Catena, Fausto; Coccolini, Frederico; Ceresoli, Marco; Pinna, Antonio Daniele

    2014-01-01

    Objectives: Inguinal canal anatomy and hernia repair is difficult for medical students and surgical residents to comprehend. Methods: Using low-cost material, a 3-dimensional inexpensive model of the inguinal canal was created to allow students to learn anatomical details and landmarks and to perform their own simulated hernia repair. In order to…

  9. Torsion of an Undescended Testis in the Inguinal Canal Diagnosed with Doppler Ultrasound: A Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yu Mi; Kim, Jee Eun [Gachon University of Medicine and Science, Gil Medical Center, Incheon (Korea, Republic of)

    2010-12-15

    We report here on two cases of testicular torsion in the inguinal canal, and there have been only rare published reports on this condition. Doppler ultrasound was used for making the diagnosis in the present two cases, which were initially considered to be inguinal hernia

  10. Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) for Inguinal Hernia : The First 1,000 Patients

    NARCIS (Netherlands)

    Lange, J.F.M.; Lange, M. M.; Voropai, D. A.; van Tilburg, M. W. A.; Pierie, J. P. E. N.; Ploeg, R. J.; Akkersdijk, W. L.

    After the introduction of mesh in inguinal hernia repair, the focus to improve surgical technique has changed from recurrence to chronic postoperative inguinal pain. At present, the most common surgical techniques are the Lichtenstein hernioplasty and total extraperitoneal procedure. Both techniques

  11. Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) for Inguinal Hernia : The First 1,000 Patients

    NARCIS (Netherlands)

    Lange, J.F.M.; Lange, M. M.; Voropai, D. A.; van Tilburg, M. W. A.; Pierie, J. P. E. N.; Ploeg, R. J.; Akkersdijk, W. L.

    2014-01-01

    After the introduction of mesh in inguinal hernia repair, the focus to improve surgical technique has changed from recurrence to chronic postoperative inguinal pain. At present, the most common surgical techniques are the Lichtenstein hernioplasty and total extraperitoneal procedure. Both techniques

  12. Lack of association between inguinal hernia and abdominal aortic aneurysm in a population-based male cohort

    DEFF Research Database (Denmark)

    Henriksen, N A; Sorensen, L T; Jørgensen, Lars Nannestad

    2013-01-01

    Previous studies have reported a higher prevalence of inguinal hernia in patients with abdominal aortic aneurysm (AAA). The aim of this study was to explore the association between inguinal hernia and AAA in a large population-based cohort of men who had screening for AAA....

  13. Direct radionuclide cystography imaging in colovesical fistula due to inguinal hernia operation complication.

    Science.gov (United States)

    Tamam, Muge; Yavuz, Hatice Sümeyye; Hacimahmutoğlu, Serafettin; Mülazimoğlu, Mehmet; Kacar, Tulay; Ozpacaci, Tevfik

    2009-09-01

    Colovesical fistula is an abnormal connection between the enteric and urinary systems, usually sigmoid colon, caused by various conditions. One cause of colovesical fistula is iatrogenic injury, such as induced by inguinal hernia surgery. We present a case of colovesical fistula. A 57-year-old male was admitted to a local hospital with complaints of dysuria and pneumaturia. He had a past history of total extraperitoneal laparoscopic inguinal hernia repair operation 7 years previously for bilateral inguinal hernia. The case was assessed with radiologic and scintigraphic techniques. Radiologic techniques (plain abdominal radiography, intravenous pyelogram, ultrasound examination, double-contrast barium enema, CT, MRI) were inadequate to determine the colovesical fistula. The colovesical fistula was visualized with direct radionuclide voiding cystography as an alternative scintigraphic method.

  14. Does nerve identification during open inguinal herniorrhaphy reduce the risk of nerve damage and persistent pain?

    DEFF Research Database (Denmark)

    Bischoff, J M; Aasvang, E K; Kehlet, H

    2012-01-01

    PURPOSE: Nerve identification during open inguinal hernia herniorrhaphy has been suggested as one of the factors that may reduce the risk of development of persistent postherniorrhaphy pain. In this prospective study, we evaluated whether intraoperative inguinal nerve identification influenced...... the risk of development of persistent postherniorrhaphy pain, sensory dysfunction in the groin and functional ability score after open hernia repair. METHODS: A total of 244 men with a primary inguinal hernia underwent open Lichtenstein repair in a high-volume hernia surgery centre, where information.......0 %) had substantial pain-related functional impairment at 6 months follow-up. There was no difference in risk of development of substantial pain-related functional impairment in patients with identification compared with non-identification of the iliohypogastric nerve (P = 1.0), the ilioinguinal nerve (P...

  15. Inguinal Hernia Containing Uterus, Fallopian Tube, and Ovary in a Premature Newborn

    Science.gov (United States)

    Karadeniz Cerit, Kıvılcım; Ergelen, Rabia; Colak, Emel; Dagli, Tolga E.

    2015-01-01

    A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence. PMID:26351609

  16. Inguinal hernia containing uterus and uterine adnexa in female infants: report of two cases.

    Science.gov (United States)

    Ming, Yung-Ching; Luo, Chih-Cheng; Chao, Hsun-Chin; Chu, Shih-Ming

    2011-04-01

    We herein report two female cases, aged 1 and 1.5 months, of inguinal sliding hernias containing the uterus, fallopian tube, and ovary. The diagnosis of inguinal hernia with uterus and uterine adnexa was highly suspected preoperatively by ultrasonography and was confirmed during surgical correction. Freeing the attachment of fallopian tube and uterus from the sac and with reduction of the uterus, ovary, and fallopian tube back to the peritoneal cavity, high ligation of the hernia sac was performed in these cases. In conclusion, the hernia sac containing fallopian tube, ovary, and uterus in the female is very rare. We present our experience of treatment with these rare cases and suggest that sonography be performed routinely in female infants with an inguinal hernia containing a palpable movable mass.

  17. Do blind ending vas deferens and testicular vessels on inguinal exploration always indicate a vanishing testis?

    Directory of Open Access Journals (Sweden)

    Mete Kaya

    2014-07-01

    Full Text Available In nonpalpable testis cases, laparoscopically blind-ending vas deferens and testicular vessels prior to entering the internal ring is sufficient to diagnose a “vanishing” testis, which requires no further exploration. Laparoscopic identification of cord structures entering the internal ring is required the exploration of the inguinal canal to find a testis or to rule out a “vanishing” testis".However, the need for further investigation in cases that identified the blindending cord structures on inguinal canal is questioned. Herein, we present a case of the scrotal nubbin along with blind ending cord structures during inguinal exploration.

  18. Is there a Place for Prebiotics in the Management of Neonatal Inguinal Hernia? A Preliminary Study

    Science.gov (United States)

    Dhaou, Mahdi Ben; Zouari, Mohamed; Ammar, Saloua; Bouraoui, Amira; Gassara, Imene; Feki, Ines; Zitouni, , Hayet; Jallouli, Mohamed; Masmoudi, Jawaher; Gargouri, Abdellatif; Mhiri, Riadh

    2017-01-01

    The objective of this study was to assess the place of prebiotics in the management of neonatal inguinal hernia. Boys with a diagnosis of unilateral non-complicated inguinal hernia, aged less than 40 days, were prospectively followed from January 2012 to December 2014. Clinical and psychiatric data and outcomes were collected before and after prebiotics (Primalac AC) administration. Ninety-eight patients were included. There were 75 inguinal hernias and 23 inguino-scrotal hernias. Before prebiotics administration 72.2% of infants had abdominal distention and 98% had colic. After prebiotics, abdominal distention and colic regressed in 85.2% and 73.2% of patients, respectively. Hernias disappeared clinically in 66.3% of cases. The factors associated with the disappearance of hernias were the type of the hernia (pinguinal hernia. They decrease colic and abdominal distention, which seems helpful to prevent strangulation and probably get spontaneous resolution of small hernias. PMID:28083493

  19. Awake caudal anesthesia for inguinal hernia operations: successful use in low birth weight neonates.

    Science.gov (United States)

    Geze, S; Imamoğlu, M; Cekic, B

    2011-09-01

    Neonates with inguinal hernia face a relatively high risk of incarcerated hernia and bowel obstruction and this therefore requires surgical treatment. Complications following general anesthesia even for minor surgery are more common in low birth weight neonates than in term neonates. Caudal epidural anesthesia without adjunct general anesthesia has been recommended for neonates to reduce the risk of postoperative complications. The successful application of awake caudal anesthesia with levobupivacaine for inguinal hernia repair in 15 low birth weight neonates is reported. Single dose caudal epidural anesthesia was administered for inguinal hernia surgery to avoid complications associated with general anesthesia. Caudal block was performed with 2.5 mg/kg body weight (BW) levobupivacaine. Caudal anesthesia can be recommended as an effective technique for avoiding postoperative anesthetic complications in low birth weight neonates.

  20. Recurrence patterns of direct and indirect inguinal hernias in a nationwide population in Denmark

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian;

    2014-01-01

    hernia [DIH]), we found an overall reoperation rate of 3.8%. More primary IIHs were operated by Lichtenstein's technique than primary DIH (90.7% vs 85.4%, respectively; P hernias, and 3.9% were for femoral hernias. DIHs resulted more often......BACKGROUND: Detailed knowledge on risk of reoperation after direct and indirect inguinal hernia (IIH) repair could be useful in preoperative counseling as well as in the planning of postoperative follow-up. This knowledge is not available in the literature. METHODS: Using data from the Danish...... Hernia Database, we included all male patients operated on for an elective, primary inguinal hernia from 1998 to 2012. Within this prospectively collected cohort, the type of inguinal hernia at primary and recurrent procedures was registered. Furthermore, time from primary procedure to reoperation...

  1. Outcomes of pediatric inguinal hernia repair with or without opening the external oblique muscle fascia

    Directory of Open Access Journals (Sweden)

    Masoud Nazem

    2015-01-01

    Full Text Available Background: Considering that complications and outcome of each method of pediatric inguinal hernia repair are one of the determinants for pediatric surgeons for selection of the appropriate surgical technique, we compared the early and late complications of two inguinal repair techniques, with and without opening the external oblique muscle fascia. Materials and Methods: In this double-blind clinical trial study, boy children aged 1-month to 6 years with diagnosed inguinal hernia were included and randomly allocated into two groups for undergoing two types of hernia repair techniques, with and without opening the external oblique muscle fascia. Surgical complications such as fever, scrotal edema and hematoma, and wound infections classified as early complication and recurrence, testis atrophy and sensory impairment of inguinal area classified as late complications. The rates of mentioned early and late complications were compared in the two interventional groups. Results: In this study, 66 patients were selected and allocated to the two interventional groups. The prevalence of early and late complications in two studied groups were not different significantly in two interventional groups (P > 0.05. Operation time was significantly shorter in inguinal repair techniques without opening the external oblique muscle fascia than the other studied technique (P = 0.001. Conclusion: The findings of our study indicated that though early and late complications of the two repair methods were similar, but the time of procedure was shorter in herniotomy without opening the external oblique muscle, which considered the superiority of this method than inguinal hernia repair with opening the external oblique muscle.

  2. Outcomes of pediatric inguinal hernia repair with or without opening the external oblique muscle fascia

    Science.gov (United States)

    Nazem, Masoud; Dastgerdi, Mohamad Masoud Heydari; Sirousfard, Motaherh

    2015-01-01

    Background: Considering that complications and outcome of each method of pediatric inguinal hernia repair are one of the determinants for pediatric surgeons for selection of the appropriate surgical technique, we compared the early and late complications of two inguinal repair techniques, with and without opening the external oblique muscle fascia. Materials and Methods: In this double-blind clinical trial study, boy children aged 1-month to 6 years with diagnosed inguinal hernia were included and randomly allocated into two groups for undergoing two types of hernia repair techniques, with and without opening the external oblique muscle fascia. Surgical complications such as fever, scrotal edema and hematoma, and wound infections classified as early complication and recurrence, testis atrophy and sensory impairment of inguinal area classified as late complications. The rates of mentioned early and late complications were compared in the two interventional groups. Results: In this study, 66 patients were selected and allocated to the two interventional groups. The prevalence of early and late complications in two studied groups were not different significantly in two interventional groups (P > 0.05). Operation time was significantly shorter in inguinal repair techniques without opening the external oblique muscle fascia than the other studied technique (P = 0.001). Conclusion: The findings of our study indicated that though early and late complications of the two repair methods were similar, but the time of procedure was shorter in herniotomy without opening the external oblique muscle, which considered the superiority of this method than inguinal hernia repair with opening the external oblique muscle. PMID:26958052

  3. Unusual metachronous isolated inguinal lymph node metastasis from adenocarcinoma of the sigmoid colon

    Directory of Open Access Journals (Sweden)

    Parodo Giuseppina

    2011-10-01

    Full Text Available Abstract This study aimed to describe an unusual case of metachronous isolated inguinal lymph nodes metastasis from sigmoid carcinoma. A 62-year-old man was referred to our department because of an obstructing sigmoid carcinoma. Colonoscopy showed the obstructing lesion at 30 cm from the anal verge and abdominal CT revealed a sigmoid lesion infiltrating the left lateral abdominal wall. The patient underwent a colonic resection extended to the abdominal wall. Histology showed an adenocarcinoma of the colon infiltrating the abdominal wall with iuxtacolic nodal involvement. Thirty three months after surgery abdominal CT and PET scan revealed a metastatic left inguinal lymph node involvement. The metastatic lymph node was found strictly adherent to the left iliac-femoral artery and encompassing the origin of the left inferior epigastric artery. Histology showed a metachronous nodal metastasis from colonic adenocarcinoma. Despite metastastic involvement of inguinal lymph node from rectal cancer is a rare but well known clinical entity, to the best of our knowledge, this is the first report of inguinal metastasis from a carcinoma of the left colon. Literature review shows only three other similar reported cases: two cases of inguinal metastasis secondary to adenocarcinoma of the cecum and one case of axillary metastasis from left colonic carcinoma. A metastatic pathway through superficial abdominal wall lymphatic vessels could be possible through the route along the left inferior epigastric artery. The solitary inguinal nodal involvement from rectal carcinoma could have a more favorable prognosis. In the case of nodal metastasis to the body surface lymph nodes from colonic carcinoma, following the small number of such cases reported in the literature, no definitive conclusions can be drawn.

  4. Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia

    Directory of Open Access Journals (Sweden)

    Joseph Thomas

    2009-01-01

    Full Text Available Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera.  Case reports and series have been published with various organs and rare organs being part of the hernia.  Urinary bladder is a known content of sliding hernias.  This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.

  5. TUBERCULAR SUPPURATIVE VASITI S PRESENTED AS AN INGUINAL MASS : A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kavimozhy

    2015-07-01

    Full Text Available We report a case of suppurative vasitis that presented as an inguinal mass in a n elderly man. Infectious vasitis, while rarely reported in the literature, is thought to be caused by Escherichia coli, mycobacteria causing tuberculosis, and other rare urogenital pathogens such as Haemophilus influenza. We report a case of tuberculous vasitis occurring as a primary infectious suppurative vasitis is rare and presenting as an inguinal mass is unusual. Only, very few cases were reported in literature with such presentation.

  6. A Child with Lung Hypoplasia, Congenital Heart Disease, Hemifacial Microsomia, and Inguinal Hernia: Ipsilateral Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Chengming Fan

    2015-01-01

    Full Text Available A 3-year-old Chinese boy was diagnosed with ipsilateral congenital malformations: right lung hypoplasia, dextroversion of heart, atrial septal defect, hepatic vein drainage directly into the right atrium, facial asymmetry, right microtia and congenital deafness, and indirect inguinal hernia. He underwent indirect inguinal hernia repair at the age of 2. Although without any facial plastic surgery performed, he underwent a repair of atrial septal defect and recovered uneventfully. At 6-month follow-up, the patient was free from any symptom of dyspnea; his heart function returned to the first grade.

  7. Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy

    Directory of Open Access Journals (Sweden)

    Jennings Jason

    2010-01-01

    Full Text Available Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP approach using Polypropylene Mesh (Mesh and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.

  8. Acute inguinal pain associated with iliopectineal bursitis in four professional soccer players.

    Science.gov (United States)

    Brunot, S; Dubeau, S; Laumonier, H; Creusé, A; Delmeule, T; Reboul, G; Das Neves, D; Bouin, H

    2013-01-01

    Four professional soccer players were investigated for acute or subacute pain in the inguinal region. Clinical tests were negative for an inguinal hernia or adductor tendinitis. Resisted hip flexion caused pain. MRI in these four patients showed the onset of iliopectineal bursitis, with signal abnormalities predominantly at the periphery of the psoas tendon in contact with the iliopectineal eminence. Ultrasound-guided steroid injection allowed the two players injected to continue their sporting activity. The two other players were treated by 3 and 7 days rest and oral anti-inflammatory treatment. Copyright © 2012 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  9. An Uncommon Case of Adolescent Ovarian Teratoma Incarcerated in Inguinal Hernia.

    Science.gov (United States)

    Pensabene, Marco; Girgenti, Vincenza; Cimador, Marcello; Li Voti, Giuseppe; Rodolico, Vito; Siracusa, Fortunato

    2016-01-01

    Mature cystic teratoma is the most frequent benign ovarian neoplastic lesion in adolescents and is generally composed of fully differentiated tissue arising from multipotential three germinal layers. It accounts for approximately 50% of benign ovarian tumors in childhood. Rarely, a bilateral, synchronous, or metachronous presentation can be observed, supporting a conservative approach as the first surgical approach. We report a case of an ovarian mature cystic incarcerated in indirect inguinal hernia in a 15-year-old girl undergoing ovary-sparing surgery. To our knowledge this is the first case of such lesion incarcerated in an inguinal hernia reported in literature.

  10. An Uncommon Case of Adolescent Ovarian Teratoma Incarcerated in Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Marco Pensabene

    2016-01-01

    Full Text Available Mature cystic teratoma is the most frequent benign ovarian neoplastic lesion in adolescents and is generally composed of fully differentiated tissue arising from multipotential three germinal layers. It accounts for approximately 50% of benign ovarian tumors in childhood. Rarely, a bilateral, synchronous, or metachronous presentation can be observed, supporting a conservative approach as the first surgical approach. We report a case of an ovarian mature cystic incarcerated in indirect inguinal hernia in a 15-year-old girl undergoing ovary-sparing surgery. To our knowledge this is the first case of such lesion incarcerated in an inguinal hernia reported in literature.

  11. Aspectos médico-legais da cirurgia para hérnia inguinal

    Directory of Open Access Journals (Sweden)

    José Guilherme Minossi

    Full Text Available Professional responsibility is an inherent factor to the medical activity. Therefore, the adoption of a healthy conduct based on good relationship between the physician and the patient, as well as the understanding of this professional of the several aspects involved in the inguinal hernia repairs, are considered the better means to protect himself against possible litigations with its patients. This issue provides a complete evaluation of medical and legal problems related to the inguinal hernia surgery, and discusses the care that surgeon must exercise during preoperative, intraoperative and postoperative periods. That authors also comment about medical error and its conception from the point of the new Civil Code.

  12. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males

    DEFF Research Database (Denmark)

    Bay-Nielsen, M; Nilsson, E; Nordin, P;

    2004-01-01

    males operated on for an indirect inguinal hernia with a Lichtenstein mesh repair, Shouldice or Marcy (annulorrhaphy) repair. METHODS: This was a postal questionnaire study carried out within the Danish and Swedish Hernia Database Collaboration. Some 2612 patients responded (response rate 80.9 per cent...... it as worse after than before surgery, and 56.6 per cent stated that it interfered with social activities. CONCLUSION: Chronic pain is common after primary inguinal hernia repair in young males, but there is no difference in the pain associated with open mesh and non-mesh repair....

  13. A Child with Lung Hypoplasia, Congenital Heart Disease, Hemifacial Microsomia, and Inguinal Hernia: Ipsilateral Congenital Malformations

    Science.gov (United States)

    Fan, Chengming; Huang, Can; Liu, Jijia; Yang, Jinfu

    2015-01-01

    A 3-year-old Chinese boy was diagnosed with ipsilateral congenital malformations: right lung hypoplasia, dextroversion of heart, atrial septal defect, hepatic vein drainage directly into the right atrium, facial asymmetry, right microtia and congenital deafness, and indirect inguinal hernia. He underwent indirect inguinal hernia repair at the age of 2. Although without any facial plastic surgery performed, he underwent a repair of atrial septal defect and recovered uneventfully. At 6-month follow-up, the patient was free from any symptom of dyspnea; his heart function returned to the first grade. PMID:26294998

  14. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

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    Coturel A

    2015-11-01

    Full Text Available Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar results regarding recurrence. It has no specific complications of spinal anesthesia. Performed a randomized missing on costs, pain and quality of life postoperatively prospective analysis

  15. NiTiNol Hernia Device Stability in Inguinal Hernioplasty Without Fixation

    OpenAIRE

    Brown, Roderick B.

    2011-01-01

    Background and Objective: To determine whether the NiTiNol frame of a novel hernia repair device utilizing polypropylene mesh for inguinal hernioplasty remains stable and intransient without fixation after a minimum of 6 months. Methods: Twenty patients had 27 inguinal hernias repaired using a novel hernia repair device that has a NiTiNol frame without any fixation. Initial single-view, postoperative X-rays were compared with a second X-ray obtained at least 6 months later. The NiTiNol frame,...

  16. TORSION OF OVARY IN MRKH SYNDROME PRESENTING AS IRREDUCIBLE SLIDING INGUINAL HERNIA

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    Sneha

    2015-09-01

    Full Text Available Inguinal hernias may have very unusual sac content. The Fallopian tube and ovary are found in 15% to 20% of the sliding hernias in females. Mayer - Rokitansky - Kuster - Hauser (MRKH syndrome, is one of the associated genital anomalies with an incidence of 1:4500 female births. We report a rare case of sliding inguinal herniation of ovary with torsion & fallopian tube in a 20 year old woman with MRKH syndrome type I. Preservation of ovarian function by repositioning the gonad followed by herniorrhaphy was done.

  17. Corrección de cicatrices postraqueostomía mediante doble colgajo adipofascial opuesto Double opposite adipofascial flap for the correction of post-tracheostomy scars

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    S. Llanos

    2012-12-01

    Full Text Available La traqueostomía es un procedimiento frecuentemente para asegurar una vía aérea permeable en casos de intubación prolongada, trauma facial severo y neoplasias de cabeza y cuello. Tras la extubación, el defecto se deja cerrar por segunda intención con el resultado de una cicatriz defectuosa, de pobre resultado estético y con frecuentes alteraciones funcionales asociadas, como por ejemplo disfagia. Se han descrito muchas técnicas para la corrección de estas cicatrices, sin embargo, algunas no corrigen los defectos funcionales y otras requieren una gran disección y movilización de los tejidos. Proponemos una técnica basada en dos colgajos adipofasciales de base opuesta y dependientes de circulación random realizada en 7 pacientes con cicatriz defectuosa postraqueostomía con buenos resultados estéticos y funcionales.Tracheostomy is a frequently used procedure to secure a viable airway in cases such as prolonged intubation, facial trauma and head and neck cancer. After decannulation, the defect is left to heal by secondary intention resulting in a poor aesthetic and functional outcome. Many techniques have been described to correct this defects, however they don´t correct functional defect and some of them require large and complex dissections and manipulation of subdermal tissues. In order to correct these defects we present a technique using a doble opposite adipofascial flap based on random irrigation. This technique has been used in 7 patients with good aesthetical and functional results.

  18. Preperitoneal sutureless mesh repair of inguinal hernia by open inguinal approach using inferior epigastric vessel complex as landmark: A tertiary care centre experience

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    Inderjit Chawla

    2014-01-01

    Full Text Available Introduction: The study is a clinical trial done on patients with inguinal hernia, who were treated by open preperitoneal sutureless mesh repair, using inferior epigastric vessel complex as landmark. Aim: To study the postoperative complications and recurrence rates associated with the open preperitoneal sutureless mesh repair. Materials and Methods: Total 100 patients of inguinal hernia were recruited in this clinical trial from January 2009 to December 2012. Those with bilateral inguinal hernia or recurrent hernias were excluded from the study. Results: The average time taken to complete the surgery was 42.2 minutes and the average hospital stay was 2.5 days. Post-surgery, at a median follow-up period of 2 years, only 2 patients had seroma formation. Visual analog scale pain scores of 4 and 6 were seen in 60% and 40% cases, respectively. No recurrences were encountered post-surgery in any of the case till the last follow-up. Conclusion: This procedure was found to have fewer complications and was less time-consuming as compared to the other conventional open hernia repairs.

  19. Short convalescence after inguinal herniorrhaphy with standardised recommendations: duration and reasons for delayed return to work

    DEFF Research Database (Denmark)

    Callesen, T; Klarskov, B; Bech, K;

    1999-01-01

    inguinal herniorrhaphy under local anaesthesia. One day convalescence for light/moderate and three weeks for strenuous physical activity was recommended. MAIN OUTCOME MEASURE: Duration of absence from work or main recreational activity. RESULTS: Overall median absence (including the day of operation) was 6...

  20. Electrosurgical operation of vulvar carcinoma with postoperative irradiation of inguinal lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Kucera, H.; Weghaupt, K.

    1988-02-01

    The results of treatment in the department of 607 patients with invasive squamous cell carcinoma of the vulva between 1952 and 1980 is described and analyzed. The absolute 5-year cure rate in these patients was 60.3%. Particular attention was given to lymph node status (TNM system) in the analysis of the last 141 patients treated. The absolute 5-year survival rate was 67% for the N0-N1 patients and 43% for the N2-N3 patients. Patients were treated uniformly by means of electrosurgical operation and postactinic irradiation of the inguinal lymph nodes. Operative lymphadenectomy was performed only in 5% of cases when the diameter of inguinal lymph nodes was greater than 2 cm. This simple surgical technique, in combination with irradiation of inguinal lymph nodes, gives excellent results and avoids the complications associated with inguinofemoral lymphadenectomy. Owing to its combination of electrosurgical operation of the vulva and irradiation of the inguinal regions as a standard procedure, the treatment involves extremely low strain on the patient and is almost free of complications. This seems to be particularly important as the results of our treatment are not less satisfactory than those of more aggressive procedures.

  1. Laparoscopic inguinal hernia repair in children: The early learning curve of the trainer and trainees

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    Manoharan S

    2006-01-01

    Full Text Available Aims: To report our experience with laparoscopic inguinal hernia repair in children. Materials and Methods: A total of 45 children, who underwent laparoscopic inguinal hernia repair between November 2003 and June 2005 were included in the study. Data were obtained by retrospective review of the case notes. Results: A total of 63 laparoscopic inguinal hernia repairs (18 right, 9 left and 18 bilateral were performed on 45 children (29 boys and 16 girls. Age of the children ranged from 4 weeks to 4 years. The operative time ranged from 30 to 70 minutes for unilateral repair and 38 to 95 minutes for bilateral repair (median for unilateral was 48 minutes and for bilateral 55 minutes. This time decreased with surgeon experience, though not reflecting directly due to the fact that the training registrars performed part of the procedures in the last 23 patients. There were no intraoperative complications. The follow up period ranged from 3 to 15 months. One child developed umbilical port site infection, which was treated with appropriate antibiotics. Conclusions: Laparoscopic inguinal hernia repair in children is safe, with minimal complications. With experience operative time decreases.

  2. TIPP and Lichtenstein modalities for inguinal hernia repair: a cost minimisation analysis alongside a randomised trial

    NARCIS (Netherlands)

    Koning, G.G.; Adang, E.M.M.; Stalmeier, P.F.M.; Keus, F.; Vriens, P.W.H.E.; Laarhoven, C.J.H.M. van

    2013-01-01

    The transinguinal preperitoneal (TIPP) technique using a soft mesh with a memory ring was developed recently for inguinal hernia repair. To compare TIPP with the Lichtenstein method, a randomised trial was conducted (ISRCTN93798494). The aim of this study was to perform an economic evaluation of the

  3. TIPP and Lichtenstein modalities for inguinal hernia repair : a cost minimisation analysis alongside a randomised trial

    NARCIS (Netherlands)

    Koning, G. G.; Adang, E. M. M.; Stalmeier, P. F. M.; Keus, F.; Vriens, P. W. H. E.; van Laarhoven, C. J. H. M.

    2013-01-01

    The transinguinal preperitoneal (TIPP) technique using a soft mesh with a memory ring was developed recently for inguinal hernia repair. To compare TIPP with the Lichtenstein method, a randomised trial was conducted (ISRCTN93798494). The aim of this study was to perform an economic evaluation of the

  4. Sexual dysfunction after inguinal hernia repair with the Onstep versus Lichtenstein technique

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Fonnes, Siv

    2017-01-01

    BACKGROUND: Sequelae after inguinal hernia repair include pain-related impairment of sexual function. Pain during intercourse can originate from the scar, scrotum, penis, or during ejaculation. The aim of this study was to investigate if the Onstep technique resulted in better results than...

  5. Left inguinal lymphadenopathy as the solitary metastatic presentation of primitive neuroectodermal tumor of unknown origin

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    Tamojit Chaudhuri

    2013-01-01

    Full Text Available Primitive neuroectodermal tumor (PNET/ewing′s sarcoma is a rare neural crest tumor of central nervous system, thoracopulmonary regions, pelvis, and lower extremities. Visceral involvement by PNET is a rare phenomenon, with kidney being the most commonly involved organ. We report a 35-year-old Asian female presenting with left inguinal swelling, with computed tomography scan evidence of conglomerate lymph nodal mass in the left external iliac and inguinal region. A clinico-radiological diagnosis of lymphoproliferative disorder was made. She subsequently underwent excision biopsy. Histopathology of the biopsy specimen revealed completely effaced lymph nodal architecture, which was replaced by a tumor composed of nests of small, round, blue cells. On immunohistochemistry, the tumor cells were positive for CD99 and negative for CD3, CD20, leucocyte common antigen, epithelial membrane antigen, cytokeratin, desmin, vimentin, synaptophysin, and chromogranin A. Extensive search regarding any possible different site of involvement by the tumor was negative. The clinical presentation and histological, cytological, and immunohistochemical pattern, lead to the diagnosis of metastatic PNET of the left external iliac and inguinal lymph node with unknown primary origin. To the best of our knowledge, it is the first ever reported case of inguinal lymphadenopathy as the solitary metastatic presentation of PNET of unknown origin.

  6. The Onstep Method for Inguinal Hernia Repair: Operative Technique and Technical Tips

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    Jacob Rosenberg

    2016-01-01

    Full Text Available Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique together with tips and tricks to make it easy and without complications.

  7. Preferred mesh-based inguinal hernia repair in a teaching setting: results of a randomized study.

    NARCIS (Netherlands)

    Nienhuijs, S.W.; Kortmann, B.B.M.; Boerma, M.; Strobbe, L.J.; Rosman, C.

    2004-01-01

    HYPOTHESIS: Surgeons' preferences for any of 3 methods of inguinal hernia repair are comparable in terms of operating time, incision length, perceived difficulty, and surgeon's satisfaction. DESIGN: Randomized patient-blinded study. SETTING: Teaching hospital. PATIENTS: A total of 334 patients rando

  8. Left Amyand’s hernia: An unexpected finding during inguinal hernia surgery

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    Ahmed M. Al Maksoud

    2015-01-01

    Conclusion: There are less than 20 cases reported in the literature describing left-sided Amyand’s hernia. Awareness of such very unusual condition may help surgeons to be prepared for appropriate management of a very usual procedure as inguinal hernia repair.

  9. An international consensus algorithm for management of chronic postoperative inguinal pain

    NARCIS (Netherlands)

    Lange, Johan; Kaufmann, R.; Wijsmuller, A. R.; Pierie, J. P. E. N.; Ploeg, R. J.; Chen, D. C.; Amid, P. K.

    2015-01-01

    Purpose Tension-free mesh repair of inguinal hernia has led to uniformly low recurrence rates. Morbidity associated with this operation is mainly related to chronic pain. No consensus guidelines exist for the management of this condition. The goal of this study is to design an expert-based algorithm

  10. External Genital Abnormalities and Inguinal Hernia among Males of Children Nurseries, North West of Iran

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    Hossein Haratipour

    2016-02-01

    Full Text Available Background Abnormalities of external genitalia in male children nurseries and inguinal hernia are the most common congenital disorders in children. We aimed to determine prevalence rate of inguinal hernia and other genital among children nurseries, in Shahrood-Iran. Materials and Methods In this descriptive cross-sectional study, we examined 920 children nurseries boys. Physical examination of children was performed in presence of a parent in a warm room in supine and upright position with and without Valsalva maneuver. A written consent was obtained from parents before examination. Past medical history and history of surgery on inguinal and genital area was taken. Examination was performed 2 interns who were trained about genital system examination.   Results A total of 920 children nurseries boys aged 3 to 6 years were examined which were detected in 88 children and prevalence rate of these abnormalities were 9.6%. The prevalence of abnormalities in the children under study were as follows: Inguinal hernia (5.1%, cryptorchidism (2.1%, Hydrocele (1.5%, hypospadias (0.4%, Varicocele (0.1%, micropenis (0.4%. Conclusion Regarding to relatively high prevalence rate of these abnormalities and low level of people knowledge, seem screening systems for diagnosis and appropriate treatment of these abnormalities to be necessary.

  11. Strangulated bowel obstruction resulting from mesh plug migration after open inguinal hernioplasty:case report

    Institute of Scientific and Technical Information of China (English)

    LIANG Xiao; CAI Xiu-jun; YU Hong; WANG Yi-fan

    2008-01-01

    @@ The use of mesh plug in hernioplasty was introduced by Shulman et al 1 in 1990 as a"rolled plug"fixed with two stitches to close the internal inguinal ring.Robbins and Rutkow 2 described their mesh plug technique in 1993.

  12. Proposed technique for inguinal hernia repair with self-gripping mesh: avoiding fixation to undesired structures.

    Science.gov (United States)

    Porrero, J L; Cano-Valderrama, O; Castillo, M J; Alonso, M T

    2015-10-01

    Self-gripping meshes have been developed to avoid fixing sutures during inguinal hernia repair. Operative time is shorter when using a self-gripping mesh than with conventional Lichtenstein repair. However, these meshes can be difficult to handle because they fix to undesired structures. The aim of this report is to describe a new technique to avoid this problem. Inguinal hernia dissection is made as usual. Once dissection is finished, a Parietex ProGrip(®) (Covidien, Dublin, Ireland) flat sheet mesh is cut depending on the size needed. A small split is made between the lower and medium third of the mesh to mark where the split for the spermatic cord will be. Using this mark, the upper third of the mesh is folded over the medium third, hiding the microgrips that make this a self-gripping mesh. In this way, only the lower third of the mesh has the microgrips exposed and the mesh can be fixed to the pubic bone and inguinal ligament without fixation to undesired structures. Once the lower third of the mesh is fixed, the split for the spermatic cord is completed and the upper part of the mesh is passed below the spermatic cord. Then, the mesh is unfolded to expose the microgrips again and the medium and upper third of the mesh are descended to its final position. This proposed technique for inguinal hernia repair with self-gripping mesh makes the surgery easier, avoiding mesh fixation to undesired structures.

  13. Tailored approach in inguinal hernia repair – Decision tree based on the guidelines

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2014-06-01

    Full Text Available The endoscopic procedures TEP and TAPP and the open techniques Lichtenstein, Plug and Patch and PHS currently represent the gold standard in inguinal hernia repair recommended in the guidelines of the European Hernia Society, the International Endohernia Society and the European Association of Endoscopic Surgery. 82 % of experienced hernia surgeons use the tailored approach, the differentiated use of the several inguinal hernia repair techniques depending on the findings of the patient, trying to minimize the risks. The following differential therapeutic situations must be distinguished in inguinal hernia repair: unilateral in men, unilateral in women, bilateral, scrotal, after previous pelvic and lower abdominal surgery, no general anaesthesia possible, recurrence and emergency surgery. Evidence-based guidelines and consensus conferences of experts give recommendations for the best approach in the individual situation of a patient. This review tries to summarized the recommendations of the various guidelines and to transfer them into a practical dicision tree for the daily work of surgeons performing inguinal hernia repair.

  14. Sampson’s Artery Hemorrhage after Inguinal Hernia Repair: Second Case Reported

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    Joseph Adjei Boachie

    2016-01-01

    Full Text Available Sampson artery is normally obliterated in postembryonic development. In rare cases it can remain patent and complicate a routine outpatient herniorrhaphy when severed. This is the second reported case in the available English literature of hemoperitoneum due to bleeding from a patent Sampson’s artery following an open inguinal hernia repair.

  15. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia

    Science.gov (United States)

    Jorgenson, Eric; Makki, Nadja; Shen, Ling; Chen, David C.; Tian, Chao; Eckalbar, Walter L.; Hinds, David; Ahituv, Nadav; Avins, Andrew

    2015-01-01

    Inguinal hernia repair is one of the most commonly performed operations in the world, yet little is known about the genetic mechanisms that predispose individuals to develop inguinal hernias. We perform a genome-wide association analysis of surgically confirmed inguinal hernias in 72,805 subjects (5,295 cases and 67,510 controls) and confirm top associations in an independent cohort of 92,444 subjects with self-reported hernia repair surgeries (9,701 cases and 82,743 controls). We identify four novel inguinal hernia susceptibility loci in the regions of EFEMP1, WT1, EBF2 and ADAMTS6. Moreover, we observe expression of all four genes in mouse connective tissue and network analyses show an important role for two of these genes (EFEMP1 and WT1) in connective tissue maintenance/homoeostasis. Our findings provide insight into the aetiology of hernia development and highlight genetic pathways for studies of hernia development and its treatment. PMID:26686553

  16. Nursing and psychological treatment during tension-free inguinal hernia repair under local nerve blocked anesthesia

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li-hui

    2007-01-01

    Tension-free inguinal hernia repair under local nerve blocked anesthesia ia an up-to-date technology and is different from the traditional approach.The aim of this study isto evaluate the nursing and psychological treatment during operation under local nerve blocked anesthesia.

  17. Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia

    DEFF Research Database (Denmark)

    Henriksen, N A; Thorup, J; Jorgensen, L N

    2012-01-01

    Small femoral hernias may be difficult to diagnose by physical examination and are sometimes identified unexpectedly by laparoscopy. The aim of this study was to examine the incidence of unsuspected femoral hernia discovered during laparoscopic inguinal hernia repair in two well-defined patient...

  18. REPAIR OF ADULT INGUINAL HERNIA WITH CONTINUOUS SUTURES OF EXTERNAL OBLIQUE APONEUROSIS

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    Sunilkumar Sing

    2016-04-01

    Full Text Available OBJECTIVE To study the repair of adult inguinal hernia with continuous sutures of external oblique aponeurosis with respect to its acceptability, effectiveness, outcome and the satisfaction of patients. METHODOLOGY The observational study was conducted from August 2008 to September 2010 in Surgery Unit IIA of the Department of General Surgery, Regional Institute of Medical Sciences, Hospital, Imphal. Adult patients with inguinal hernia (18-75 years were admitted and treated with continuous sutures of external oblique aponeurosis as originally described by Desarda in 2001. RESULTS There were 54 patients - 51 males (94.44% and 3 females (5.6%. Age of the patient’s ranges from 18-75 years (Mean age of 53.9 years. Out of the 54 patients, 32 patients (59.3% were having indirect inguinal hernia, 19 patients (35.2% with direct inguinal hernia and 3 patients (5.6% had combined direct and indirect inguinal hernias. Right sided hernia was seen in 37 patients (68.5% and left sided hernia in 17 patients (31.5%; 47 patients (87.03% were operated under Spinal Anaesthesia (SA and 7 patients (12.96% under epidural anaesthesia. Adhesions were found in 5 cases (9.26%, four patients (7.41% had transient wound oedema, 3 patients (5.6% had pus collection followed by drainage, 3 (5.6% patients had wound haematoma, which subsided by itself and 2 (3.70% had seroma formation which required regular dressing. During the follow-up period, no hernia recurrence was encountered. Majority of the patients had mild-to-moderate post-operative pain, which was easily managed with analgesics. The hospital stay was short, thus allowing the patients a quicker return to activity. Majority of the patients (40, i.e. 74.07% were discharged on the 3rd post-operative day. Majority of the patients were satisfied with the operation. CONCLUSION Repair of adult inguinal hernia with continuous sutures of external oblique aponeurosis is safe and effective in terms of postoperative pain, return

  19. Epithelioid malignant mesothelioma of tunica vaginalis with deciduoid features: An unusual malignancy clinically masquerading an inguinal hernia

    Directory of Open Access Journals (Sweden)

    Sharique Ahmed

    2012-01-01

    Full Text Available Paratesticular/scrotal and inguinal canal mass lesions in elderly patients may pose a diagnostic challenge to both the surgeon as well as the pathologist. In most cases, these represent hernial sacs with their contents, and true neoplasms like lipomas, rhabdomyosarcomas, and fibrous pseudotumors are infrequent. Malignant mesotheliomas arising from the tunica layers are rare cause of inguinal and paratesticular tumors. Herein, we report a case of an elderly patient who presented with an inguinal hernia which pathologically had features of deciduoid malignant mesothelioma.

  20. Long-term follow-up after mesh removal and selective neurectomy for persistent inguinal postherniorrhaphy pain

    DEFF Research Database (Denmark)

    Bischoff, J M; Enghuus, Casper Nørskov; Werner, M U;

    2013-01-01

    PURPOSE: Persistent inguinal pain, influencing daily activities, is seen in about 5 % of patients following inguinal herniorrhaphy. Surgical treatment of patients with persistent postherniorrhaphy pain has been associated with pain relief and improvement in functional status. However, the detailed...... long-term outcome effects remain to be clarified. The aim of this study was to determine the long-term effects of mesh removal and selective neurectomy in patients with persistent postherniorrhaphy pain after previous open repair. METHODS: The study consecutively included 54 inguinal postherniorrhaphy...

  1. The initial experience of introducing the Onstep technique for inguinal hernia repair in a general surgical department

    DEFF Research Database (Denmark)

    Andresen, K; Burcharth, J; Rosenberg, J

    2015-01-01

    BACKGROUND AND AIMS: A new technique for the repair of inguinal hernia, called Onstep, has been described. This technique places the mesh in the preperitoneal space medially and between the internal and external oblique muscles laterally. The Onstep technique has not yet been described outside...... repair. Inguinal Pain Questionnaire results: 95.5% reported no pain or pain that was easily ignored. CONCLUSIONS: It seems from this study that the Onstep technique is a safe method for inguinal hernia repair regarding perioperative and postoperative complications. The postoperative pain seems...

  2. [Hernia surgery in urology: part 1: inguinal, femoral and umbilical hernias - fundamentals of clinical diagnostics and treatment].

    Science.gov (United States)

    Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

    2013-05-01

    Hernias are a common occurrence with correspondingly huge clinical and economic impacts on the healthcare system. The most common forms of hernia which need to be diagnosed and treated in routine urological work are inguinal and umbilical hernias. With the objective of reconstructing and stabilizing the inguinal canal there are the possibilities of open and minimally invasive surgery and both methods can be performed with suture or mesh repair. Indications for surgery of umbilical hernias are infrequent although this is possible with little effort under local anesthesia. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostics and therapy of inguinal, femoral and umbilical hernias.

  3. Hernias inguinales bilaterales operadas con anestesia local mediante hernioplastia de Lichtenstein Bilateral inguinal hernias operated on with local anesthesia by Lichtenstein hernioplasty

    Directory of Open Access Journals (Sweden)

    Bárbaro Agustín Armas Pérez

    2009-03-01

    Full Text Available INTRODUCCIÓN. La hernioplastia inguinal bilateral libre de tensión de Lichtenstein es una posibilidad real de tratamiento en pacientes con hernia inguinal bilateral. Este método es en esencia menos costoso para el paciente, la institución y la economía en general, y permite una reincorporación rápida a la sociedad, por lo cual en el presente estudio se presentaron los resultados de este protocolo de tratamiento, con la finalidad de evaluar su efectividad. MÉTODOS. Se realizó un estudio descriptivo transversal con los primeros 38 pacientes operados con la técnica de Lichtenstein mediante anestesia local (técnica combinada de Braun y de Shleider. Los pacientes fueron operados de forma ambulatoria entre enero de 2001 y diciembre del 2007. Se dio el alta en la tarde, si la operación fue en la mañana; y al amanecer del día siguiente, si se operó en la tarde, con el objetivo de evitar la equimosis declive con la movilización precoz. RESULTADOS. Cuatro de los pacientes presentaban hernias recurrentes. El material protésico más empleado fue el polipropileno (86,9 %. Las complicaciones alcanzaron el 9,1 % (referidas no a los 38 pacientes, sino a las 76 hernioplastias; y después de un seguimiento que osciló entre 1 y 36 meses, se presentó un rechazo al material protésico (1,3 % y una recidiva (1,3 %. CONCLUSIONES. Se concluyó que este procedimiento es aplicable a las hernias bilaterales, ya que el estrés, los costos institucionales y las molestias del paciente se reducen, con lo cual demuestra su eficacia.INTRODUCTION. Lichtenstein's tension free bilateral inguinal hernioplasty is a real possibility for treating patients with bilateral inguinal hernia. This method is essentially less expensive for the patient, the institution and the economy in general, and it allows a fast reincorporation to society. Therefore, the results of this treatment protocol were included in the present study aimed at evaluating its effectiveness. METHODS

  4. Cure of inguinal hernias with large preperitoneal prosthesis: Experience of 2,312 cases

    Directory of Open Access Journals (Sweden)

    Alexandre J

    2006-01-01

    Full Text Available It is clear that the recurrence rates after nonprosthetic methods for the repair of inguinal hernias, like McVay, Bassini or Shouldice techniques, are high (6-10%. Since 20 years, we are convinced, in the GREPA-EHS group, about the advantages of the use of a prosthetic mesh in majority of patients for repairs of primary or recurrent inguinal hernias and incisional hernias. We describe our typical technique for the cure of all inguinal hernias. We place a large supple mesh, by open inguinal route, posterior to the transversalis fascia and anterior to the peritoneum. We have made a double modification in the initial technique of Rives - the use of a very large unsplit prosthesis (15 x 17 cm and the parietalization of the spermatic cord helped by a wide opening of the Fruchaud′s orifice by diversion of the epigastric vessels. The positioning of the mesh is about the same as in the TEP technique but with the advantages of reduction in the vital laparoscopic risks and reinforcement of the wall by a short tension-free McVay technique. For this prospective study, we repaired 2,312 consecutive hernias in 1,828 patients, 284 of which were recurrent. We present our results in terms of quality of repairs, recurrence rates (0.4%, morbidity rate (8%, and mortality rate (0.8%. This technique involves the placement by an open incisional route of a large preperitoneal sheet of mesh for initial treatment of all inguinal hernias - including scrotal, giant or femoral - to ensure a definitive solid muscular wall, even for recurrent hernias.

  5. Incidental non-inguinals hernias in totally extra-peritoneal hernia repair.

    Science.gov (United States)

    Old, O J; Kulkarni, S R; Hardy, T J; Slim, F J; Emerson, L G; Bulbulia, R A; Whyman, M R; Poskitt, K R

    2015-03-01

    Totally extra-peritoneal (TEP) inguinal hernia repair allows identification and repair of incidental non-inguinal groin hernias. We assessed the prevalence of incidental hernias during TEP inguinal hernia repair and identified the risk factors for incidental hernias. Consecutive patients undergoing TEP repair from May 2005 to November 2012 were the study cohort. Inspection for ipsilateral femoral, obturator and rarer varieties of hernia was undertaken during TEP repair. Patient characteristics and operative findings were recorded on a prospectively collected database. A total of 1,532 TEP repairs were undertaken in 1,196 patients. Ninety-three patients were excluded due to incomplete data, leaving 1,103 patients and 1,404 hernias for analyses (1,380 male; 802 unilateral and 301 bilateral repairs; median age, 59 years). Among the 37 incidental hernias identified (2.6% of cases), the most common type of incidental hernia was femoral (n=32, 2.3%) followed by obturator (n=2, 0.1%). Increasing age was associated with an increased risk of incidental hernia, with a significant linear trend (p60 years of age was 4.0% vs 1.4% for those aged hernias were found in 29.2% of females vs 2.2% of males, (phernia in those with a recurrent inguinal hernia was 3.0% vs 2.6% for primary repair (p=0.79). Incidental hernias during TEP inguinal hernia repair were found in 2.6% of cases and, though infrequent, could cause complications if left untreated. The risk of incidental hernia increased with age and was significantly higher in patients aged >60 years and in females.

  6. Occult hernias detected by laparoscopic totally extra-peritoneal inguinal hernia repair: a prospective study.

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    Dulucq, J-L; Wintringer, P; Mahajna, A

    2011-08-01

    One distinct advantage of laparoscopic inguinal hernia repair is the opportunity for clear visualization of the direct, indirect, femoral, obturator and other groin spaces. The aim of this study was to examine/assess the potential of the laparoscopic totally extraperitoneal (TEP) inguinal hernia repair method in detecting unexpected additional hernias. Patients who underwent an elective inguinal hernia repair, in the department of abdominal surgery at the institute of laparoscopic surgery (ILS, Bordeaux, France) between September 2003 and July 2005 were enrolled prospectively in the study. The patients' demographic data, operative, postoperative course and outpatient follow-up were studied. A total of 337 laparoscopic inguinal hernia repairs were performed in 263 patients. Of these, 189 patients had unilateral hernia (109 right and 80 left) and 74 patients had bilateral hernias. Indirect hernias were the most common, followed by direct and then femoral hernias. There were 218 male patients and 45 female patients with a mean age of 60 ± 15 years. There were 44 unexpected hernias: 6 spegilian hernias, 19 obturator hernias and another 19 femoral hernias. Two patients were converted to transabdominal preperitoneal (TAPP) due to surgical difficulties. There were no major intraoperative complications in all patients except for three cases of bleeding arising from the inferior epigastric artery. Only one patient had postoperative bleeding and was re-operated on several hours after the hernia repair. No recurrence occurred in the present series. The laparoscopic inguinal hernia repair approach allows viewing of the entire myopectineal orifice, facilitating repair of any unexpected hernias and thereby reducing the chance of recurrence.

  7. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.

    Science.gov (United States)

    Waite, Kimberly E; Herman, Mark A; Doyle, Patrick J

    2016-09-01

    Despite growing popularity and potential advantages of robotics in general surgery, there is very little published data regarding robotic inguinal hernia repair. This study examines a single surgeon's early experience with robotic TAPP inguinal hernia repair compared with laparoscopic TAPP repair in terms of feasibility and cost. We performed a retrospective review of 63 consecutive patients (24 laparoscopic and 39 robotic) who underwent inguinal hernia repair between December 2012-December 2014 at a single institution by a single surgeon. Data examined included gender, age, BMI, operative times, recovery room times, pain scale ratings, and cost. Patient groups were the same in terms of age and BMI. The mean operative time (77.5 vs 60.7 min, p = 0.001) and room time (109.3 vs 93.0 min, p = 0.001) were significantly longer for the robotic vs the laparoscopic patients. Recovery room time (109.1 vs 133.5 min, p = 0.026) and average pain scores in recovery (2.5 vs 3.8, p = 0.02) were significantly less for the robotic group. The average direct cost of the laparoscopic group was $3216 compared with $3479 for the robotic group. The average contribution margin for the laparoscopic group was $2396 compared with $2489 for the robotic group. Robotic TAPP inguinal hernia repair had longer operative times, but patients spent less time in recovery and noted less pain than patients who underwent laparoscopic TAPP inguinal hernia repair. The direct cost and contribution margin are nearly equivalent. These results should allow the continued investigation of this technique without concern over excess cost.

  8. EXPERIENCE OF INGUINAL HERNIA REPAIR IN 230 PATIENTS BY LICHTENSTEIN TECHNIQUE

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    Mahesh

    2016-01-01

    Full Text Available BACKGROUND The main aim of the surgeon is to lower the recurrence rate while dealing the defect in inguinal canal. Lichtenstein technique has opened a new era in such repairs. In our study we have evaluated 230 patients who have undergone mesh repair in inguinal hernias by Lichtenstein technique. MATERIAL AND METHODS The study was done prospectively from September 2013 to August 2015. Surgery related complications, operative time, hospital stay and return to routine activities were recorded. All the patients with age more than 15 years were included in this study; however patients with medical diseases like diabetes mellitus and chronic obstructive pulmonary disease were not included. Also patients with complications of hernia having features of obstruction or strangulation were also excluded from this study. RESULTS Out of 230 patients, 223 patients (96.95% were male and 07 patients (3.04% were female. Indirect inguinal hernia was present in 122 patients (53.04%, direct inguinal hernia in 93 (40.43% and pantaloon hernia in 15 patients (6.5%. The incidence of unilateral hernia was 75.21% whereas bilateral hernia was observed only in 24.78% patients. Postoperative seroma and haematoma was observed in 3 and 1 patient respectively which were drained successfully. None of our patients encountered postoperative neuralgia, wound infection or recurrence till date. CONCLUSION Lichtenstein technique of inguinal hernia repair in adults is still considered as the method of choice by many surgeons around the world in lieu of its simplicity in performing the procedure, minimum postoperative complications, early recovery with return to normal activities, less hospital stay and very low recurrence rate.

  9. A 5-year review of darning technique of inguinal hernia repair

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    Olalekan O Olasehinde

    2015-01-01

    Full Text Available Context: The Darning technique of inguinal hernia repair is a tissue-based technique with documented low recurrence rate in some parts of the world. Though practiced in our setting, little is documented on its outcome. Aims: The aim was to review the outcome of Darning technique of inguinal hernia repair in our setting. Study Design: A descriptive retrospective study. Patients and Methods: Clinical records of all patients who had inguinal hernia repair using the Darning technique between January 2007 and December 2011 in our institution were obtained. Details of sociodemographic data, intraoperative findings and postoperative complications were reviewed. Statistical Analysis Used: simple frequencies, proportions and cross-tabulations. Results: A total of 132 patients whose ages ranged from 15 to 84 years (mean = 49.4 years with a male: female ratio of 12:1 were studied. Majority of the hernias were right sided (68.9%, mostly indirect (81.8%. The procedures were for emergencies in 17 (12.9% cases whereas the rest (87.1% were done electively. Most procedures, 110 (83.3% were performed under local anesthesia. Surgical site infection was the most common complication occurring in six patients (4.5%, while four patients (3% had chronic groin pain. At a mean follow-up period of 15 months there were two recurrences (1.5% both occurring in patients with bilateral hernias (P = 0.001. Conclusions: The Darning technique of inguinal hernia repair is a safe and effective method for inguinal hernia repair in our setting.

  10. The diagnosis and classification of inguinal and femoral hernia on multisection spiral CT

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    Cherian, P.T. [Good hope Hospital, Rectory road, Sutton Coldfield (United Kingdom)], E-mail: tomcherian@hotmail.co.uk; Parnell, A.P. [Good hope Hospital, Rectory road, Sutton Coldfield (United Kingdom)

    2008-02-15

    Aim: To assess the contribution of high-quality multiplanar reconstructions of the groin from multisection computed tomography (CT) to the accurate diagnosis of inguinal and femoral hernias. Materials and Methods: Twenty-eight patients who had undergone both a contrast-enhanced CT and a herniorrhaphy were identified from hospital records. Seventeen were excluded, as the images did not include the groin area. The remaining 11 images were re evaluated on a workstation without knowledge of the surgical findings and the hernias were identified and classified using the axial data and coronal and sagittal reconstructions. Anatomical structures and radiological details that hindered or aided this classification were recorded. Results: Hernias were identified in nine out of the 11 patients. Of the seven inguinal hernias, six were identified with the correct side recorded in each case. Of the four patients with surgical data that distinguished direct from indirect inguinal hernias, the correct diagnosis was provided in all cases using CT. Of the four patients with a femoral hernia CT was used to correctly classify three. Among the three available planes, the axial was particularly poor for the identification of the inguinal ligament compared with the other planes. In contrast, the coronal views were very useful in the evaluation of femoral hernias. Conclusions: The high-resolution coronal and sagittal images available from multisection CT now permit the accurate diagnosis of groin hernias. Using simple anatomical criteria, direct and indirect inguinal hernias and femoral hernias can be reliably distinguished, abolishing the need for surrogate markers, which was hitherto necessary.

  11. Exploring a Third Confirmed Case of Hemoperitoneum following Open Inguinal Hernia Repair Caused by Sampson Artery Hemorrhage

    Science.gov (United States)

    Hebert, Jordan; Jagtiani, Manoj; Schmelzer, David; Wolodiger, Fred

    2017-01-01

    Hemoperitoneum is a rare complication of open inguinal hernia repair. This is the third reported case of this complication attributed to the same bleeding source: Sampson's artery. Sampson's artery courses along the round ligament of the uterus in the inguinal canal of females, originating from the arcade formed between the uterine and ovarian arteries. Usually obliterated in postembryonic development, this artery can persist in some adult female patients. Disruption of Sampson's artery can lead to hemoperitoneum following ligation of the uterine round ligament during open inguinal hernia repair in females. This case report describes a third confirmed case of hemoperitoneum complicating an open inguinal hernia repair. We review all three reported cases to date and discuss the recurring signs, symptoms, epidemiologic factors, and diagnostic findings associated. Our review suggests that females of childbearing age, particularly those in the peripartum period, are most at risk of developing this rare complication. PMID:28487804

  12. Exploring a Third Confirmed Case of Hemoperitoneum following Open Inguinal Hernia Repair Caused by Sampson Artery Hemorrhage

    Directory of Open Access Journals (Sweden)

    Jordan Hebert

    2017-01-01

    Full Text Available Hemoperitoneum is a rare complication of open inguinal hernia repair. This is the third reported case of this complication attributed to the same bleeding source: Sampson’s artery. Sampson’s artery courses along the round ligament of the uterus in the inguinal canal of females, originating from the arcade formed between the uterine and ovarian arteries. Usually obliterated in postembryonic development, this artery can persist in some adult female patients. Disruption of Sampson’s artery can lead to hemoperitoneum following ligation of the uterine round ligament during open inguinal hernia repair in females. This case report describes a third confirmed case of hemoperitoneum complicating an open inguinal hernia repair. We review all three reported cases to date and discuss the recurring signs, symptoms, epidemiologic factors, and diagnostic findings associated. Our review suggests that females of childbearing age, particularly those in the peripartum period, are most at risk of developing this rare complication.

  13. Transverse testicular ectopia with scrotal hypospadias but without inguinal hernia – Case report of a rare association

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    Pradeep Kajal

    2017-01-01

    Full Text Available Transverse testicular ectopia is an extremely rare anomaly, in which both the testis migrate towards the same hemiscrotum through the same inguinal canal. It is usually associated with other abnormalities such as persistent Mullerian duct syndrome, true hermaphroditism, inguinal hernia, pseudohermaphroditism, and scrotal anomalies; the association with inguinal hernia being the commonest. We, here, report a case of transverse testicular ectopia in a 12 years old boy having the ectopic testis in contralateral hemiscrotum without any inguinal hernia but having scrotal hypospadias with severe chordee. The diagnosis was made on clinical examination and confirmed on ultrasonography. Trans-septal orchiopexy was done for ectopic testis and hypospadias and chordee were managed by staged repair.

  14. Simulation and study of the behaviour of the transversalis fascia in protecting against the genesis of inguinal hernias.

    Science.gov (United States)

    Fortuny, G; Rodríguez-Navarro, J; Susín, A; López-Cano, M

    2009-10-16

    Simulating the muscular system has many applications in biomechanics, biomedicine and the study of movement in general. We are interested in studying the genesis of a very common pathology: human inguinal hernia. We study the effects that some biomechanical parameters have on the dynamic simulation of the region, and their involvement in the genesis of inguinal hernias. We use the finite element method (FEM) and current models for the muscular contraction to determine the deformed fascia transversalis for the estimation of the maximum strain. We analysed the effect of muscular tissue density, Young's modulus, Poisson's coefficient and calcium concentration in the genesis of human inguinal hernia. The results are the estimated maximum strain in our simulations, has a close correlation with experimental data and the accepted commonly models by the medical community. Our model is the first study of the effect of various biological parameters with repercussions on the genesis of the inguinal hernias.

  15. [Recurrence of bladder cancer in remnant urethra and inguinal lymph node metastasis nine years after total cystectomy: a case report].

    Science.gov (United States)

    Obata, Jun; Kikuchi, Eiji; Kaneko, Gou; Miyajima, Akira; Kameyama, Kaori; Jinzaki, Masahiro; Oya, Mototsugu

    2011-01-01

    A 68-year-old man underwent total cystectomy, urethrectomy preserving fossa navicularis, and an Indiana pouch urinary diversion in 1997. The histopathology was UC, G3, pT4 (prostate). Nine years after the operation, he had multiple metastases to the inguinal and paraaortic lymph nodes (LNs), and he complained of erosion around the glans. Histological diagnosis of the glans revealed recurrent UC to the urethra of the glans. We considered the possibility that the inguinal LN metastasis was due to lymphatic spread from a remnant urethral recurrence. Thus, a partial penectomy and inguinal LN dissection were undertaken. Systemic chemotherapy was administered. Remnant urethral recurrence after urethrectomy preserving the fossa navicularis and inguinal LN metastasis are rare.

  16. Evaluation of Anesthesia Profile in Pediatric Patients after Inguinal Hernia Repair with Caudal Block or Local Wound Infiltration

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    Aleksandra Gavrilovska-Brzanov

    2016-02-01

    CONCLUSIONS: Between children undergoing inguinal hernia repair, local wound infiltration insures safety and satisfactory analgesia for surgery. Compared to caudal block it is not overwhelming. Caudal block provides longer analgesia, however complications are rather common.

  17. Knowledge, Attitude and Practices of General Surgeons Regarding Pediatric Inguinal Hernia at Liaquat University Hospital Jamshoro Sindh

    OpenAIRE

    Pushpa Goswami; Samreen Memon; Nand Lal Kella

    2014-01-01

    Inguinal hernia is a most common surgical condition worldwide during infancy. In spite of significant improvements in pediatric surgery it still carries mortality and morbidity due to delay between diagnosis and surgical intervention. A delay in the treatment of inguinal hernia may lead to incarceration and strangulation. In developing countries like us the risk of incarceration and complications is much higher due to delay in seeking treatment due to lack of awareness among parents, general ...

  18. Knowledge, Attitude and Practices of General Surgeons Regarding Pediatric Inguinal Hernia at Liaquat University Hospital Jamshoro Sindh

    OpenAIRE

    Pushpa Goswami; Samreen Memon; Nand Lal Kella

    2014-01-01

    Inguinal hernia is a most common surgical condition worldwide during infancy. In spite of significant improvements in pediatric surgery it still carries mortality and morbidity due to delay between diagnosis and surgical intervention. A delay in the treatment of inguinal hernia may lead to incarceration and strangulation. In developing countries like us the risk of incarceration and complications is much higher due to delay in seeking treatment due to lack of awareness among parents, general ...

  19. Comparison between general and spinal anesthesia in inguinal hernia repair in Clinical University Hospital "St. Naum Ohridski" - Skopje

    OpenAIRE

    2015-01-01

    Most often recommended treatment for inguinal hernia diagnosed patients is surgery. Generally, the surgical treatment includes several components: opening the subcutaneous fat by incision of the abdominal wall, mobilization of cord structures, dissection of weakened tissue and closure of inguinal canal with application of sterile synthetic mesh patch used to repair and decrease the tension in the weakened area of the abdominal wall after mobilization of hernia. Usually, the patient is given g...

  20. Application of spinal and anesthezia for inguinal hernia repair compared patient satisfaction at the Clinical Center in Stip

    OpenAIRE

    2012-01-01

    Inguinal hernia is the most common surgical procedure. The choice of anesthetic techniques ranging from local infiltration through regional or subarachnoidal block and general endotracheal. This selection can be performed based on the complexity of the procedure and its length, the preferences of the surgeon and anesthesiologist, the patient's wishes, coexisting morbidity or any combination of these. In this article we made a comparison and use of two anesthetic techniques for inguinal hernia...