A new approach for sutureless 20-G vitrectomy

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Dikran G Hovaghimian

2015-01-01

The new approach of 20-G sutureless vitrectomy utilizing N-butyl-2-cyanoacrylate is a safe and effective technique for the surgical treatment of a variety of vitreoretinal pathologies. Conversion to this technique is very simple. A very short learning curve is required, with no need for new expensive instrumentation. It combines all the advantages of 20-G vitrectomy, adding to it the sutureless advantage of the technique.

Management of giant paraesophageal hernia.

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Awais, O; Luketich, J D

2009-04-01

Management of giant paraesophageal hernia remains one of the most difficult challenges faced by surgeons treating complex benign esophageal disorders. These large hernias are acquired disorders; therefore, they invariably present in elderly patients. The dilemma that surgeons faced in the open surgical era was the risk of open surgery in this elderly, sick patient population versus the life threatening catastrophic complications, nearly 30% in some series, observed with medical management. During the 1990s, it was clearly recognized that laparoscopic surgery led to decreased morbidity with a quicker recovery. This has lead to a 6-fold increase in the surgical management of giant paraesophageal hernias over the last decade compared to a period of five decades of open surgery; however, this has not necessarily translated into better outcomes. One of the major issues with giant paraesophageal hernias is recognizing short esophagus and performing a lengthening procedure, if needed. Open series which report liberal use of Collis gastroplasty leading to a tension-free intraabdominal fundoplication have shown the best anatomic and clinical outcomes. As we duplicate the open experience laparoscopically, the principle of identifying a shortened esophagus and constructing a neo-esophagus must be honored for the success of the operation. The benefits of laparoscopy are obvious but should not come at the cost of a lesser operation. This review will illustrate that laparoscopic repair of giant paraesophageal hernia at experienced centers can be performed safely with similar outcomes to open series when the fundamental principles of the operation are maintained.

Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa.

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Wang, Y T; Meheš, M M; Naseem, H-R; Ibrahim, M; Butt, M A; Ahmed, N; Wahab Bin Adam, M A; Issah, A-W; Mohammed, I; Goldstein, S D; Cartwright, K; Abdullah, F

2014-08-01

Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians. A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures. Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20). Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.

Preperitoneal approach to parastomal hernia with coexistent large incisional hernia.

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Egun, A; Hill, J; MacLennan, I; Pearson, R. C

2002-03-01

OBJECTIVE: To assess the outcome of preperitoneal mesh repair of complex incisional herniae incorporating a stoma and large parastomal hernia. METHODS: From 1994 to 1998, symptomatic patients who had repair of combined incisional hernia and parastomal hernia were reviewed. Body mass index, co-morbidity, length of hospital stay, patient satisfaction and outcomes were recorded. RESULTS: Ten patients (seven females and three males), mean age 62 (range 48-80) years underwent primary repair. All had significant comorbidities (ASA grade 3) and mean body mass index was 31.1 (range 20-49). Median hospital stay was 15 (range 8-150) days. Complications were of varying clinical significance (seroma, superficial infection, major respiratory tract infection and stomal necrosis). There were no recurrences after a mean follow up of 54 (range 22-69) months. CONCLUSION: The combination of a parastomal hernia and generalised wound dehiscence is an uncommon but difficult problem. The application of the principles of low-tension mesh repair can provide a satisfactory outcome and low recurrence rate. This must be tempered by recognition of the potential for significant major postoperative complication.

[Plug-technique for umbilical hernia repair in the adult].

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Brancato, G; Privitera, A; Gandolfo, L; Donati, M; Caglià, P

2002-02-01

Umbilical hernia represents 6% of all abdominal wall hernias in the adult. Surgical repair should always be carried out due to possible occurrence of complications. Aim of this paper is to evaluate the efficacy of the plug-technique. From October 1995 to April 2000, the authors performed 21 operations for acquired umbilical hernia with a defect smaller than 4 cm. Local anesthesia was used and a light intravenous sedation added in particularly anxious patients. The repair was achieved by insertion of a polypropylene dart plug sutured to the margins of the hernial defect. All patients were up and about straightaway and were discharged within 24 hours of surgery. Postoperative pain was mild and required hospital analgesia in only 19% of cases and domiciliary analgesia in 24%. During a follow-up ranging from 6 to 60 months (mean 30), only one recurrence has been recorded. This tension-free technique allows immediate rehabilitation, with few complications and a low recurrence rate.

Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatch?†.

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Belluschi, Igor; Moriggia, Stefano; Giacomini, Andrea; Del Forno, Benedetto; Di Sanzo, Stefania; Blasio, Andrea; Scafuri, Antonio; Alfieri, Ottavio

2017-06-01

The aim of this study is to compare the theoretical incidence of patient-prosthesis mismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matching. Between May 2012 and March 2016, 65 patients with severe symptomatic aortic stenosis underwent a sutureless aortic valve replacement with the Perceval bioprosthesis in 2 centres. Moreover, 177 aortic valve replacements with conventional sutured bioprosthesis were performed between August 2003 and September 2015. Perceval and sutured patients were 1:1 exactly matched for sex and body surface area (BSA), resulting in 62 couples (sutureless: BSA 1.77 ± 0.16 m 2 , female 62.9% vs sutured: BSA 1.77 ± 0.15 m 2 , female 62.9%). After matching, the indexed effective orifice area was 1.50 ± 0.18 cm 2 /m 2 and 0.81 ± 0.19 cm 2 /m 2 in the sutureless and the sutured group, respectively ( P  < 0.001). No PPM occurred in patients who received a Perceval bioprosthesis ( n  = 62). In the sutured group ( n  = 62), 38 patients (61.3%) developed a PPM, which was moderate in 41.9% ( n  = 26) and severe in 19.4% ( n  = 12) ( P  < 0.001). The indexed effective orifice area of the sutureless group was significantly larger than in the sutured one. The incidence of PPM with the conventional sutured biprosthesis was 61.3%, while it decreases to 0% in the sutureless group. No PPM was reported in the sutureless valve group. Therefore, the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reduce the risk of a PPM. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Aortic valve replacement with sutureless prosthesis: better than root enlargement to avoid patient-prosthesis mismatch?

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Beckmann, Erik; Martens, Andreas; Alhadi, Firas; Hoeffler, Klaus; Umminger, Julia; Kaufeld, Tim; Sarikouch, Samir; Koigeldiev, Nurbol; Cebotari, Serghei; Schmitto, Jan Dieter; Haverich, Axel; Shrestha, Malakh

2016-06-01

Aortic valve replacement in patients with a small aortic annulus may result in patient-prosthesis mismatch (PPM). Aortic root enlargement (ARE) can reduce PPM, but leads to extended cardiac ischaemia times. Sutureless valves have the potential to prevent PPM while reducing cardiac ischaemia times. Between January 2007 and December 2011, a total of 128 patients with a small aortic annulus underwent surgery for aortic valve stenosis at our centre. Thirty-six (17% male, n = 6) patients received conventional valve replacement with ARE and 92 (16% male, n = 18) subjects received sutureless valve implantation (Sorin Perceval). We conducted a comparative, retrospective study with follow-up. The sutureless group showed a significantly higher age (79 years) than the ARE patients (62 years, P body surface area was 0.91 ± 0.2 cm(2)/m(2) in ARE patients and 0.83 ± 0.14 cm(2)/m(2) in sutureless patients (P = 0.040). The rate of patients with severe PPM was 6% (n = 2) in ARE patients and 11% (n = 8%) in sutureless patients (not significant, n.s.). The 30-day mortality rates were 2% (n = 2) in sutureless patients and 6% (n = 2) in ARE patients (n.s.). The 1- and 5-year survival rates of the sutureless group were 92 and 54% years, respectively, whereas the 1- and 5-year survival rates of the ARE group were 76% (n.s.). Although the sutureless valve patients received significantly more concomitant procedures, all operation-associated times were significantly shorter. Despite sutureless valve patients being older, the 30-day mortality and survival rates were comparable in the two groups. Since the indexed EOA was only slightly lower and the incidence of severe PPM was not significantly higher in the sutureless valve patients, we conclude that sutureless valve implantation is an alternative to conventional ARE to treat a small aortic annulus and avoid PPM, especially in geriatric patients who benefit from the quick implantation process. © The Author 2016. Published by Oxford

Evaluation of outcome of totally extra peritoneal laparoscopic inguinal hernia repair with lichtenstein open repair

International Nuclear Information System (INIS)

Ahmed, I.; Dian, A.; Azam, U.F.; Khan, M.

2015-01-01

The objective of this study was to evaluate outcome of total extraperitoneal laparoscopic inguinal hernia repair with Lichtenstein open repair in terms of postoperative pain. Study Design: Quasi experimental study. Place and Duration of Study: Surgical unit l Rawalpindi and Allied hospitals from January to June 2012. Patients and Methods: Sixty patients, with unilateral, primary, inguinal hernia were alternately allocated to undergo either total extraperitoneal (TEP) laparoscopic repair of inguinal hernia or Lichtenstein tension free, mesh repair of inguinal hernia. Pain scores at 12, 24, and 48 hours and at 7 days of follow up were noted using a visual analogue scale. Total number of intravenous injections of Diclofenac Sodium requested by the patient for pain relief was also noted. Results: At 12 hours after surgery, the mean pain scores in the TEP group were 3.1 ± 1.8 and in the Lichtenstein group they were 4.2 ± 2.1 (p 0.031). At 24 hours after surgery, the scores were 2.3 ± 1.5 and 3.1 ± 1.9 for the TEP and Lichtenstein groups, respectively (p = 0.026). At 48 hours after surgery, the mean pain scores in the TEP group were 1.5 ± 1.1 while in the Lichtenstein group they were 2.0 ± 1.6 (p = 0.041). At 7 days after surgery, the scores were 0.3 ± 0.5 in the TEP group and 0.4 ± 0.8 in the Lichtenstein group (0.137). The mean number of injection of Diclofenac Sodium required by the TEP and Lichtenstein groups was 3.1 ± 1.6 and 5.8 ± 2.2, respectively (p = 0.011). Conclusion: Less postoperative pain and requirement for analgesics were reported by patients who underwent total extraperitoneal laparoscopic repair of inguinal hernia as compared to those who underwent inguinal hernia repair by Lichtenstein tension free mesh hernioplasty. (author)

Congenital pleuroperitoneal hernia presenting as gastrothorax in five cavalier King Charles spaniel dogs.

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Rossanese, M; Pivetta, M; Pereira, N; Burrow, R

2018-04-30

Five cavalier King Charles spaniels were examined for acute onset of respiratory distress. Thoracic radiographs demonstrated diaphragmatic hernia and tension gastrothorax, visible as a distended stomach occupying the left caudal thoracic cavity. Exploratory midline coeliotomy confirmed congenital pleuroperitoneal diaphragmatic hernia with herniation and dilatation of the stomach. The hernia configuration was consistent in all cases, with a defect affecting the left diaphragmatic crus. Congenital pleuroperitoneal diaphragmatic hernia is a rare condition caused by a defect in the dorsolateral diaphragm. Defects of the left crus of the diaphragm could result in the herniation of the stomach into the thoracic cavity with possible subsequent tension gastrothorax. Cavalier King Charles spaniels may have a predisposition to this condition. Tension gastrothorax is an acute life-threatening consequence of gastric herniation through a diaphragmatic defect that must be promptly recognised and surgically treated. © 2018 British Small Animal Veterinary Association.

Paediatric sutureless circumcision-an alternative to the standard technique.

LENUS (Irish Health Repository)

2012-01-31

INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

POSTOPERATIVE URINARY RETENTION AND EARLY REPOSITION OF TENSION-FREE VAGINAL TAPE

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Marijan Lužnik

2003-12-01

Full Text Available Background. The purpose of this article is to show a possible method of treatment of postoperative urinary retention after an initial tension-free vaginal tape.Methods. From December 1999 to May 2003 we performed one hundred TVT procedures at our department, among them five women had postoperative urinary retention evaluated with catheterization. Revision and reposition of tension-free vaginal tape were performed if retention of urine was over 100 ml.Results. Urinary retention after an initial tension-free vaginal tape was successfully treated by early reposition of tension-free vaginal tape. This resulted in immediate residualfree voiding and continence, which remained unchanged at 6 week and 3 month follow-up.Conclusions. Postoperative urinary retention may be treated by reposition instead of dissection or elongation of the tension-free vaginal tape.

A Meta-Analysis Examining Differences in Short-Term Outcomes Between Sutureless and Conventional Aortic Valve Prostheses.

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Hurley, Eoghan T; O'Sullivan, Katie E; Segurado, Ricardo; Hurley, John P

2015-01-01

Sutureless aortic valve prostheses are anchored by radial force in a mechanism similar to that of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is associated with an increased permanent pacemaker (PPM) requirement in a significant proportion of patients. We undertook a meta-analysis to examine the incidence of PPM insertion associated with sutureless compared with conventional surgical aortic valve replacement. A systematic review was conducted in accordance with the Prisma guidelines. All searches were performed on August 10, 2014. Studies between 2007 and 2014 were included in the search. A total of 832 patients were included in the sutureless group and 3,740 in the conventional group. Aortic cross-clamp (39.8 vs 62.4 minutes; P < 0.001) and cardiopulmonary bypass (64.9 vs 86.7 minutes; P = 0.002) times were shorter in the sutureless group. Permanent pacemaker implantation rate was higher in the sutureless cohort (9.1% vs 2.4%; P = 0.025). Sutureless aortic valve prostheses are associated with significantly shorter cardiopulmonary bypass and aortic cross-clamp times and a higher incidence of PPM insertion than conventional. Further investigation of the prognostic significance is required.

[Tension gastrothorax as a cause of death by obstructive shock - case report].

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García-Regalado, Juan F; Navarro-Rojas, Mariana M

2014-07-01

Tension gastrothorax is caused by the herniation of the stomach into the thorax due to a congenital defect of the diaphragm; the Bochdaleck diaphragmatic hernia (HDB) is the most frequent type. Tension gastrothorax should be considered as a differential diagnosis in patients with obstructive shock and tension pneumothorax. A previously healthy 10 month-old male infant, who presented increased respiratory distress, increased volume of the left hemithorax, absence of breath sounds, ipsilateral hyper-resonance, 76% saturation, cold skin and capillary filling > 5 seconds, followed by a cardio-respiratory arrest. Due to clinical suspicion of pneumothorax, needle decompression was performed reversing cardiac arrest, but with persistent hemodynamic and respiratory instability; chest radiograph suggested diaphragmatic hernia. He underwent surgery confirming the presence of a diaphragmatic hernia of 5 cm. The evolution of this case shows the difficulty differentiating a tension gastrothorax from tension pneumothorax in patients admitted to the emergency room who are in serious condition; therefore, a high index of suspicion is needed for its identification.

Patient goals after tension free vaginal tape operation

DEFF Research Database (Denmark)

Glavind, Karin; Bjørk, Jonna; Kousgaard, Sabrina Just

INTRODUCTION: This prospective study investigates sexual function in women after a tension-free vaginal tape (TVT) operation and compares short-term and long-term effects. METHODS: Sixty-three women had a TVT operation performed at Aalborg University Hospital, Department of Gynecology and Obstetr......INTRODUCTION: This prospective study investigates sexual function in women after a tension-free vaginal tape (TVT) operation and compares short-term and long-term effects. METHODS: Sixty-three women had a TVT operation performed at Aalborg University Hospital, Department of Gynecology...

Aortic Root Enlargement or Sutureless Valve Implantation?

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Nikolaos G. Baikoussis

2016-11-01

Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

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Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

2016-01-01

-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated......A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh...

The effects of combined elastic- and free-weight tension vs. free-weight tension on one-repetition maximum strength in the bench press.

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Bellar, David M; Muller, Matthew D; Barkley, Jacob E; Kim, Chul-Ho; Ida, Keisuke; Ryan, Edward J; Bliss, Mathew V; Glickman, Ellen L

2011-02-01

The present study investigated the effects of training combining elastic tension, free weights, and the bench press. Eleven college-aged men (untrained) in the bench press participated in the 13-week study. The participants were first given instructions and then practiced the bench press, followed by a one-repetition maximum (1RM) test of baseline strength. Subjects were then trained in the bench press for 3 weeks to allow for the beginning of neural adaptation. After another 1RM test, participants were assigned to 1 of 2 conditions for the next 3 weeks of training: 85% Free-Weight Tension, 15% Elastic Tension (BAND), or 100% Free-Weight Tension (STAND). After 3 weeks of training and a third 1RM max test, participants switched treatments, under which they completed the final 3 weeks of training and the fourth 1RM test. Analysis via analysis of covariance revealed a significant (p ≤ 0.05) main effect for time and interaction effect for Treatment (BAND vs. STAND). Subsequent analysis via paired-samples t-test revealed the BAND condition was significantly better (p = 0.05) at producing raw gains in 1RM strength. (BAND 9.95 ± 3.7 kg vs. STAND 7.56 ± 2.8 kg). These results suggest that the addition of elastic tension to the bench press may be an effective method of increasing strength.

Laparoscopic Hernia Repair in Infancy and Childhood; Evaluation of ...

African Journals Online (AJOL)

Materials & Methods: A prospective randomized controlled study was carried out in the ... Group B was subjected to laparoscopic hernia repair of inguinal hernia by ... Inclusion criteria included; bilateral inguinal hernia, recurrent hernia, hernia in ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.

The management of sportsman's groin hernia in professional and amateur soccer players: a revised concept.

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Kopelman, D; Kaplan, U; Hatoum, O A; Abaya, N; Karni, D; Berber, A; Sharon, P; Peskin, B

2016-02-01

Chronic groin pain appears in athletes with a diverse etiology. In a select few, it can be defined as a sportsman's hernia, that may be related, among other pathologies, to weakness of the posterior inguinal wall and may successfully respond to surgery. Surgical repair of the sportsman's hernia is associated with good functional outcomes, if the diagnosis is based on meticulous examination and follows a simple selection flowchart. Prospective case cohort study. The study assessed patients recruited from 2006 until the present assessed by a dedicated team with clinical and radiographic features of a sportsman's hernia who had failed a specified period of conservative therapies. Surgery was performed using a tension-free mesh open inguinal hernia repair. Of 246 male patients with chronic groin pain, 51 underwent surgery (mean age 20.7 years, range 14-36 years) with 58 inguinal procedures performed. Of the operated group, seven underwent bilateral surgery with a direct hernia found in 9/58 operated sides (15.5%), an indirect hernial sac in 8/58 (14%) and a direct and indirect hernia being found in 3/58 (5%) of operated sides. There was no post-operative morbidity (median follow-up 36.1 months; range 1-74 months), with two failures (3.45 % of operated sides). All other patients were asymptomatic, returned to full sports activity within 4.3 weeks (range 3-8 weeks) after surgery, and required no analgesics or further treatment. Selective surgical hernia repair, based on meticulous anamnesis and physical examination is effective in the management of chronic groin pain in athletes.

Rare Abdominal Wall Malformation: Case Report of Umbilical Cord Hernia

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Andro Gliha

2018-02-01

Full Text Available The umbilical cord hernia is the rarest form of abdominal wall malformations, anatomically completely different from gastroschisis and omphalocele. It occurs due to the permanent physiological evisceration of abdominal organs into umbilical celom and persistence of a patent umbilical ring. The umbilical cord hernia is often mistaken for omphalocele and called “small omphalocele”. Here we present a case of a female newborn with umbilical cord hernia treated in our Hospital. After preoperative examinations surgery was done on the second day of life. The abdominal wall was closed without tension. The aim of this article is to present the importance of the proper diagnose of these three entities and to stimulate academic community for the answer, is this umbilical cord hernia or small omphalocele.

Rare Abdominal Wall Malformation: Case Report of Umbilical Cord Hernia.

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Gliha, Andro; Car, Andrija; Višnjić, Stjepan; Zupancic, Bozidar; Kondza, Karmen; Petracic, Ivan

The umbilical cord hernia is the rarest form of abdominal wall malformations, anatomically completely different from gastroschisis and omphalocele. It occurs due to the permanent physiological evisceration of abdominal organs into umbilical celom and persistence of a patent umbilical ring. The umbilical cord hernia is often mistaken for omphalocele and called "small omphalocele". Here we present a case of a female newborn with umbilical cord hernia treated in our Hospital. After preoperative examinations surgery was done on the second day of life. The abdominal wall was closed without tension. The aim of this article is to present the importance of the proper diagnose of these three entities and to stimulate academic community for the answer, is this umbilical cord hernia or small omphalocele.

The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

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Gerritsen Pieter G

2009-09-01

Full Text Available Abstract Background Anterior open treatment of the inguinal hernia with a tension free mesh has reduced the incidence of recurrence and direct postoperative pain. The Lichtenstein procedure rules nowadays as reference technique for hernia treatment. Not recurrences but chronic pain is the main postoperative complication in inguinal hernia repair after Lichtenstein's technique. Preliminary experiences with a soft mesh placed in the preperitoneal space showed good results and less chronic pain. Methods The TULIP is a double-blind randomised controlled trial in which 300 patients will be randomly allocated to anterior inguinal hernia repair according to Lichtenstein or the transinguinal preperitoneal technique with soft mesh. All unilateral primary inguinal hernia patients eligible for operation who meet inclusion criteria will be invited to participate in this trial. The primary endpoint will be direct postoperative- and chronic pain. Secondary endpoints are operation time, postoperative complications, hospital stay, costs, return to daily activities (e.g. work and recurrence. Both groups will be evaluated. Success rate of hernia repair and complications will be measured as safeguard for quality. To demonstrate that inguinal hernia repair according to the transinguinal preperitoneal (TIPP technique reduces postoperative pain to Discussion The TULIP trial is aimed to show a reduction in postoperative chronic pain after anterior hernia repair according to the transinguinal preperitoneal (TIPP technique, compared to Lichtenstein. In our hypothesis the TIPP technique reduces chronic pain compared to Lichtenstein. Trial registration ISRCTN 93798494

Surgical treatment for giant incisional hernia

DEFF Research Database (Denmark)

Eriksson, A; Rosenberg, J; Bisgaard, T

2014-01-01

INTRODUCTION: Repair for giant incisional hernias is a challenge due to unacceptable high morbidity and recurrence rates. Several surgical techniques are available, but all are poorly documented. This systematic review was undertaken to evaluate the existing literature on repair for giant...... % with a wide range between studies of 4-100 %. The mortality ranged from 0 to 5 % (median 0 %) and recurrence rate ranged from 0 to 53 % (median 5 %). Study follow-up ranged from 15 to 97 months (median 36 months). Mesh repair should always be used for patients undergoing repair for a giant hernia......, and the sublay position may have advantages over onlay positioning. To avoid tension, it may be advisable to use a mesh in combination with a component separation technique. Inlay positioning of the mesh and repair without a mesh should be avoided. CONCLUSIONS: Evidence to optimise repair for giant hernias...

Influence of hiatal hernia on lower esophageal sphincter function.

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Pettersson, G B; Bombeck, C T; Nyhus, L M

1981-01-01

Sliding hiatal hernia has long term been implicated as a cause of lower esophageal sphincter (LES) incompetence and gastroesophageal reflux. The physics of LES function in hiatal hernia were investigated in in vitro and in vivo experiments. In vitro models of sliding hernias were constructed from excised canine gastroesophageal specimens. A "sphincter" was simulated with a rubber band around the gastroesophageal junction. It was found that placement of a ligature "hernia ring" on the stomach increased the opening pressure of the model sphincter. Addition of a tissue "hernia sac" sutured to the esophagus above the sphincter further increased the opening pressure, the protective effect being related to the pressure transmitted from the stomach to the hernia sac. There was no fluid leakage from the hernia sac between the hernia ring and the stomach. In anesthetized dogs (in vivo model) gastric and esophageal pressures were measured during gastric infusion while the LES gas way to reflux. A ligature tied loosely around the stomach to simulate a "hernia ring" and a sliding hernia without a hernia sac increased both the opening and the closing pressures of the LES by 36 +/- 18% and 35 +/- 20% (mean +/- SD), respectively. The opening pressure was increased by a decrease in gastric wall tension at the gastroesophageal junction, which was caused by the decreased radius of the herniated portion of the stomach. Pressure transmitted from the stomach to the hernia sac added to the LES pressure, and thereby further increased the opening pressure of the sphincter. The results explain how gastroesophageal reflux may be prevented in patients with hiatal hernia. It was recognized that the hernia sac may protect the sphincter, provided that it inserts into the esophagus above the LES. PMID:7469555

Outcome of Treatment of Anterior Vaginal Wall Prolapse and Stress Urinary Incontinence with Transobturator Tension-Free Vaginal Mesh (Prolift and Concomitant Tension-Free Vaginal Tape-Obturator

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Sameh Azazy

2008-12-01

Full Text Available Objective. It is to assess the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift and concomitant tension-free vaginal tape-obturator (TVT-O system as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI. Patients and Methods. Between December 2006 and July 2007, 20 patients with anterior genital prolapse and voiding dysfunction were treated with the transobturator tension-free vaginal mesh (Prolift and concomitant tension-free vaginal tape-obturator (TVT-O. Sixteen patients had stress urinary incontinence and 4 patients were considered at risk for development of de novo stress incontinence after the prolapse is repaired. All patients underwent a complete urodynamic assessment. All the patients underwent pelvic examination 4–6 weeks after the operation, and anatomical and functional outcomes were recorded. Results. Twenty cystocoeles were repaired: 6 grade II, 12 grade III, and 2 grade IV. There were no vessel or bladder injuries. Eighteen patients had optimal anatomic results and 2 patients had persistent asymptomatic stage I prolapse. Conclusion. These preliminary results suggest that Prolift system offers a safe and effective treatment for female anterior vaginal wall prolapse. However, a long-term followup is necessary in order to support the good result maintenance.

A comparison of conventional surgery, transcatheter aortic valve replacement, and sutureless valves in "real-world" patients with aortic stenosis and intermediate- to high-risk profile.

Science.gov (United States)

Muneretto, Claudio; Alfieri, Ottavio; Cesana, Bruno Mario; Bisleri, Gianluigi; De Bonis, Michele; Di Bartolomeo, Roberto; Savini, Carlo; Folesani, Gianluca; Di Bacco, Lorenzo; Rambaldini, Manfredo; Maureira, Juan Pablo; Laborde, Francois; Tespili, Maurizio; Repossini, Alberto; Folliguet, Thierry

2015-12-01

We sought to investigate the clinical outcomes of patients with isolated severe aortic stenosis and an intermediate- to high-risk profile treated by means of conventional surgery (surgical aortic valve replacement), sutureless valve implantation, or transcatheter aortic valve replacement in a multicenter evaluation. Among 991 consecutive patients with isolated severe aortic stenosis and an intermediate- to high-risk profile (Society of Thoracic Surgeons score >4 and logistic European System for Cardiac Operative Risk Evaluation I >10), a propensity score analysis was performed on the basis of the therapeutic strategy: surgical aortic valve replacement (n = 204), sutureless valve implantation (n = 204), and transcatheter aortic valve replacement (n = 204). Primary end points were 30-day mortality and overall survival at 24-month follow-up; the secondary end point was survival free from a composite end point of major adverse cardiac events (defined as cardiac-related mortality, myocardial infarction, cerebrovascular accidents, and major hemorrhagic events) and periprosthetic regurgitation greater than 2. Thirty-day mortality was significantly higher in the transcatheter aortic valve replacement group (surgical aortic valve replacement = 3.4% vs sutureless = 5.8% vs transcatheter aortic valve replacement = 9.8%; P = .005). The incidence of postprocedural was 3.9% in asurgical aortic valve replacement vs 9.8% in sutureless vs 14.7% in transcatheter aortic valve replacement (Prisk factor for overall mortality hazard ratio (hazard ratio, 2.5; confidence interval, 1.1-4.2; P = .018). The use of transcatheter aortic valve replacement in patients with an intermediate- to high-risk profile was associated with a significantly higher incidence of perioperative complications and decreased survival at short- and mid-term when compared with conventional surgery and sutureless valve implantation. Copyright © 2015 The American Association for Thoracic Surgery. Published by

Sutureless choledochoduodenostomy with an intraluminal degradable stent in dog model

Institute of Scientific and Technical Information of China (English)

ZHU Ling-hua; LIANG Xiao; LIN Hui; WANG Yi-fan; ZHU Yi-ping; CAI Xiu-jun

2011-01-01

Background It is difficult and time-consuming for carrying out conventional hand-sewn bilioenteric anastomosis, especially for small bile duct anastomosis and laparoscopic procedure. In order to simplify it, we have developed a novel procedure of sutureless bilioenteric anastomosis with an intraluminal degradable stent. This study aimed to evaluate the feasibility and safety of this technique with cholangioduodenostomy in dog model.Methods A patent intraluminal degradable stent tube for sutureless choledochoduodenostomy in dog model was made with polylactic acid in diameter of 3 mm or 4 mm. Thirty-eight dogs were randomly divided into to a stent group (SG, n=20) and a control group (CG, n=18). Dogs in the SG underwent sutureless choledochoduodenostomy with intraluminal stent, while the CG underwent conventional choledochoduodenostomy (single layer discontinuous anastomosis with absorbable suture). Dogs of each group were divided into 4 subgroups according to time of death (1,3,6, and 12 months postoperatively) to evaluate the healing of anastomosis. Operation time, intraoperative tolerance pressure of anastomosis, rate of postoperative bile leakage, bursting pressure of anastomosis were compared between the two groups. Anastomosis tissue was observed afterwards by pathology evaluation, hydroxyproline content, serum bilirubin, liver enzyme level and magnetic resonance cholangio-pancreatography (MRCP) to assess the stricture.Results All procedures were completed successfully. The surgical time of the SG was significantly less than the CG (SG: (19.2±4.3) minutes, vs. CG: (29.2±7.1) minutes, P=0.000). One bile leakage was occurred in either group. No significant difference of intraoperative tolerance pressure of anastomosis, rate of bile leakage and postoperative bursting pressure of anastomosis, anastomotic stricture, hydroxyproline content, serum bilirubin and liver enzyme level was found between the two groups. MRCP showed no anastomosis stricture and obstruction

Results of repeated antireflux operations on hiatal hernias

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Khubolov A.M.

2016-06-01

Full Text Available The research goal: to carry out the retrospective analysis of results of repeated antireflux interventions at the recurrent hernias of an esophageal opening of a diaphragm (HEOD. Material and methods. Results of surgical treatment of 38 patients with recurrence of HEOD in various terms after operation are studied. Results. At the most part of patients at repeated operations anatomic prerequisites to formation of recurrence of HEOD — migration of a fundoplication cuff, insolvency, an excessive tension of tissues when forming the gastric coupling, violation of technology of imposing of a cuff come to light. In this regard, proceeding from these references and the analysis of own research, it has been considered that plasticity of local tissues at recurrent HEOD, is insufficient for reliable elimination of a gastroesopha-geal reflux. Conclusion. The analysis of the results of antireflux surgical treatment of HEOD with a reflux-esophageal phenomenon has shown high efficiency of no tension plasticity, with use of a synthetic artificial limb. The fundoplication technique in antireflux surgery with no tension plasticity may be used as an operation of choice at recurrent hernias of an esophageal opening of a diaphragm.

Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

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Kawaji T

2016-01-01

Full Text Available Takahiro Kawaji,1,2 Tomoki Sato,2 Hidenobu Tanihara11Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, 2Sato Eye & Internal Medicine Clinic, Kumamoto, JapanPurpose: To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL by using our developed simple technique.Methods: We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed.Results: The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%, cystoid macular edema in two eyes (4.2%, and iris capture of the IOL in two eyes (4.2%. No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period.Conclusion: The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe.Keywords: intraocular lenses, ophthalmologic surgical procedures, intrascleral fixation, sutureless fixation

Keratometric alterations following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy.

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Citirik, Mehmet; Batman, Cosar; Bicer, Tolga; Zilelioglu, Orhan

2009-09-01

To assess the alterations in keratometric astigmatism following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy. Sixteen consecutive patients were enrolled into the study. Conventional vitrectomy was applied to eight of the cases and 25-gauge transconjunctival sutureless vitrectomy was performed in eight patients. Keratometry was performed before and after the surgery. In the 25-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were not observed in the corneal curvature in any post-operative follow-up measurement (p > 0.05); whereas in the conventional pars plana vitrectomy group, statistically significant changes were observed in the first postoperative day (p = 0.01) and first postoperative month (p = 0.03). We noted that these changes returned to baseline in three months (p = 0.26). Both 25-gauge transconjunctival sutureless and conventional pars plana vitrectomy are effective surgical modalities for selected diseases of the posterior segment. Surgical procedures are critical for the visual rehabilitation of the patients. The post-operative corneal astigmatism of the vitrectomised eyes can be accurately determined at least two months post-operatively.

Glue versus suture for mesh fixation in inguinal hernia repair.

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Chandrasekar, Shruthi; Jeyakumar, S; Ganapathy, Tharun

2018-03-22

Inguinal hernia is one of the most common surgical problem presenting to the surgical OPD. Surgery is the mainstay of treatment for inguinal hernia today. Surgery for inguinal hernia has undergone a great evolution over a period of several centuries. Lichenstein's tension free hernioplasty is the one of the first surgeries taught to a surgical resident. The main aim of surgeries in this era is to give the best possible results with the least possible pain, scar and time. This has given rise to so many modifications to the classical Lichenstein's procedure and also to laparoscopic hernioplasty. Pain after inguinal hernia surgery is found to be debilitating and altering the quality of life in several patients, which has been attributed to the traumatic fixation of the mesh with sutures. This has paved way to the development of various atraumatic methods of fixation, tissue glue is one such development. Hence this study, to compare traumatic and atraumatic methods of mesh fixation in inguinal hernia repair. The aim of this study was to compare suture fixation versus tissue glue fixation of the mesh in inguinal hernia repair. Primary objective was to compare the immediate and chronic post-operative pain. Secondary objective was to compare the time taken for the procedure by the two methods in use and also to compare the presence of any complications. and methodology: This study was done in the General Surgery department of XXX hospital, medical college and research centre, kattangulathur after Ethics committee clearance. It is a single blinded study. The study was done on 51 patients consenting for the study and meeting the inclusion criterias from the period of March 2016 to August 2017 out of which 26 were selected for glue mesh fixation and 25 for suture mesh fixation according to simple randomization. The suture group patients underwent classical Lichenstein's tension free hernioplasty and the glue group underwent Lichenstein's hernioplasty with glue where dots of

Preliminary report of a sutureless onlay technique for incisional hernia repair using fibrin glue alone for mesh fixation.

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Stoikes, Nathaniel; Webb, David; Powell, Ben; Voeller, Guy

2013-11-01

The Rives repair for ventral/incisional (V/I) hernias involves sublay mesh placement requiring retrorectus dissection and transfascial stitches. Chevrel described a repair by onlaying mesh after a unique primary fascial closure. Although Chevrel fixated mesh to the anterior fascia with sutures, he used fibrin glue for fascial closure reinforcement. We describe an onlay technique with mesh fixated to the anterior fascia solely with fibrin glue without suture fixation. From January 2010 to January 2012, 50 patients underwent a V/I hernia onlay technique with fibrin glue mesh fixation. Records were reviewed for technical details, demographics, mesh characteristics, and postoperative outcomes. Primary fascial closure with interrupted permanent suture was done with or without myofascial advancement flaps. Onlay polypropylene mesh was placed providing 8 cm of overlap. Fibrin glue was applied over the prosthesis and subcutaneous drains were placed. Mean age was 62.4 years. Mean body mass index was 30.1 kg/m(2). Average mesh size was 14.5 cm × 19.1 cm. Mean operative time was 144.4 minutes (range, 38 to 316 minutes). Mean discharge was postoperative Day 2.9 (range, 0 to 15 days). Morbidity included eight seromas, one hematoma, and three wound infections. Seventeen patients required components separation. Mean follow-up was 19.5 months with no recurrences. This is the first series describing fibrin glue alone for mesh fixation for V/I hernia repair. It allows for immediate prosthesis fixation to the anterior fascia. Early results are promising. Potential advantages include less operative time, less technical difficulty, and less long-term pain. A prospective trial is needed to evaluate this approach.

Sutureless human sclera donor patch graft for Ahmed glaucoma valve.

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Zeppa, Lucio; Romano, Mario R; Capasso, Luigi; Tortori, Achille; Majorana, Mara A; Costagliola, Ciro

2010-01-01

To report the safety and effectiveness of a sutureless human sclera donor patch graft covering the subconjunctival portion of glaucoma drainage implant tube to prevent its erosion throughout the overlying conjunctiva. This was a prospective pilot study. Fifteen eyes of 15 consecutive patients not responsive to medical and to not-implant surgical glaucoma treatment underwent Ahmed glaucoma valve (AGV) implant surgery with sutureless human sclera donor patch graft. The surgical procedure included AVG implant placed 8 mm behind the corneal limbus and fixed to the sclera with two 9-0 black nylon sutures. The tube was passed through the scleral tunnel, parallel to the corneal limbus, and shortened at the desired length. The anterior part of the tube was covered with human donor scleral graft and kept in place with fibrin glue (Tissue Coll) under the conjunctiva. Examinations were scheduled at baseline and then at 1 week and 1, 3, 6, and 12 months after surgery. At 12-month follow-up, the best-corrected visual acuity did not significantly improve from baseline 0.78+/-1.2 logMAR, whereas mean intraocular pressure significantly decreased from preoperative values of 29.8 (SD 8.4) mmHg. In all cases, the scleral patch was found in place at each check during the follow-up period. No conjunctival erosion over the AGV tube nor sign of endophthalmitis was recorded at any time during the follow-up period. AVG implant surgery with sutureless human sclera donor patch graft represents an effective and relatively safe surgical procedure for complicated glaucomas, avoiding conjunctival erosions over the AGV tube.

Fixation free femoral hernia repair with a 3D dynamic responsive implant. A case series report.

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Amato, G; Romano, G; Agrusa, A; Gordini, L; Gulotta, E; Erdas, E; Calò, P G

2018-04-23

To date, no gold standard for the surgical treatment of femoral hernia exists. Pure tissue repair as well as mesh/plug implantation, open or laparoscopic, are the most performed methods. Nevertheless, all these techniques need sutures or mesh fixation. This implies the risk of damaging sensitive structures of the femoral area, along with complications related to tissue tear and postoperative discomfort consequent to poor quality mesh incorporation. The present retrospective multicenter case series highlights the results of femoral hernia repair procedures performed with a 3D dynamic responsive implant in a cohort of 32 patients during a mean follow up of 27 months. Aiming to simplify the surgical procedure and reduce complications, a 3D dynamic responsive implant was delivered for femoral hernia repair, in a patient cohort. After returning the hernia sack to the abdominal cavity, the implant was simply delivered into the hernia defect where it remained, thanks to its inherent centrifugal expansion, obliterating the hernia opening without need of fixation. Postoperative pain assessment was determined using the VAS score system. The use of the 3D prosthetic device allowed for easier and faster surgical repair in a fixation free fashion. None of the typical fixation related complications occurred in the examined patients. Postoperative pain assessment with VAS score showed a very low level of pain, allowing the return of patients to normal activities in extremely reduced times. In the late postoperative period, no discomfort or chronic pain was reported. Femoral hernia repair with the 3D dynamic revealed a quick and safe placement procedure. The reduced pain intensity, as well as the absence of adverse events consequent to sutures or mesh fixation, seems to be a significant benefit of the motile compliance of the device. Furthermore, this 3D prosthesis has already proven to induce an enhanced probiotic response showing ingrowth in the implant of the typical tissue

Sympathetic ophthalmia after 23-gauge transconjunctival sutureless vitrectomy

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Masatoshi Haruta

2010-11-01

Full Text Available Masatoshi Haruta1, Hirokazu Mukuno2, Kazuaki Nishijima3, Hitoshi Takagi4, Mihori Kita51Department of Ophthalmology, Kurume University School of Medicine, Kurume, Fukuoka, Japan; 2Department of Ophthalmology, Konan Hospital, Kobe, Hyogo, Japan; 3Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan; 4Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; 5Department of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, JapanPurpose: We report a case of a sympathetic ophthalmia that occurred after 23-gauge transconjunctival sutureless vitrectomy for a retinal detachment.Case report: A 41-year-old Japanese woman underwent combined phacoemulsification with intraocular lens implantation and 23-gauge transconjunctival sutureless vitrectomy for a rhegmatogenous retinal detachment in the right eye. Endolaser photocoagulation and silicone oil tamponade were used to manage inferior retinal holes. Four weeks after the surgery, she returned with a 5-day history of reduced vision and metamorphopsia in her left eye. Slit-lamp examination showed a shallow anterior chamber in the right eye and moderate anterior uveitis bilaterally. Silicone oil bubbles and pigment dispersion were observed in the subconjunctival space adjacent to the right eye’s superonasal sclerotomy site. Fundus examination showed multifocal serous retinal detachments in both eyes. A diagnosis of sympathetic ophthalmia was made and the patient was treated with intensive topical and systemic steroids. The subretinal fluid cleared in both eyes following treatment. Twelve months after the onset of inflammation, the patient’s condition was stable on a combination of oral cyclosporine and topical steroids. Sunset glow retinal changes remain, but there has been no evidence of recurrent inflammation.Conclusion: Sympathetic ophthalmia can develop after 23-gauge

Sutureless implantation of the perceval s aortic valve prosthesis through right anterior minithoracotomy.

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Gilmanov, Daniyar; Miceli, Antonio; Bevilacqua, Stefano; Farneti, Pierandrea; Solinas, Marco; Ferrarini, Matteo; Glauber, Mattia

2013-12-01

Many new, less invasive strategies are proposed for aortic valve operation in elderly patients. Rapid deployment sutureless aortic valve prosthesis has been recently introduced. We analyzed our experience with a sutureless valve implanted through a minimally invasive approach. A retrospective observational study with prospectively registered data was conducted on 137 patients undergoing aortic valve replacement through a right anterior minithoracotomy. Between April 2011 and January 2013, 137 consecutive patients underwent aortic valve replacement with a recently introduced, rapid deployment, sutureless pericardial valve in minithoracotomy access (47 men; mean age, 76.6 ± 7.1 years). There were 35 obese patients with a body mass index of more than 30 kg/m(2). Mean logistic EuroSCORE I was 10.0; 74 (54%) patients were in New York Heart Association functional class III and IV. In all, 19 (13.9%), 45 (32.8%), and 73 (53.3%) patients received 21-, 23-, and 25-mm valve prostheses, respectively. The mean aortic cross-clamp and cardiopulmonary bypass times were 59.3 ± 19 min and 92.3 ± 27 min, respectively. No operative mortality occurred. Median stay in the intensive care unit was 1 day, with assisted ventilation necessary for a median of 6 hours. Three cases of postoperative ischemic stroke were observed (1 patient with a previous history of an ischemic cerebral event). Median hospital length of stay was 6 days. A sutureless valve for minimally invasive aortic valve replacement is a feasible, effective, and safe tool. Ultimately amplifying indications for less invasive aortic valve replacement in a high surgical risk subset of patients, it can become a valid alternative for transcatheter aortic valve implantation. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

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Cihad Tatar

2016-08-01

Full Text Available Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of noncomplicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3, and the other consisting of patients not undergoing bowel resection (Group 4. Results: In Group 1, it was observed that eight (7.14% of the patients had wound infections, while two (1.78% had hematomas, four (3.57% had seromas, and one (0.89% had relapse. In Group 2, one (2.56% of the patients had a wound infection, while three (7.69% had hematomas, one (2.56% had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection

Amyad's hernia while reparing the bilateral inguinal hernia

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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. 

Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center.

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Tarchi, P; Cosola, D; Germani, P; Troian, M; De Manzini, N

2014-06-01

Lichtenstein tension-free mesh repair is the most frequently performed procedure for inguinal hernioplasty. In the past surgery aimed to control recurrences. Nowadays it is important to avoid postoperative chronic pain and thus several studies have examined the potential role of meshes in causing postoperative pain. The purpose of this study was to retrospectively assess the early and long-term results after Lichtenstein tension-free repair using a self-adhesive mesh (Parietex ProgripTM - Covidien, Germany) in a single center. The study enrolled 211 patients, 199 males (94.3%) and 12 females (5.7%), mean age 62 years (28-90 years), between January 2008 and December 2011. Of these, 206 had primary inguinal hernias while 5 were recurrences following previous tension repair. Ten different general surgeons, including residents, performed Lichtenstein hernia repair using a 12 x 8-cm Parietex ProgripTM mesh. In 88.1% of patients no additional fixation was used, while in 11.9% a single 2-0 polypropylene stitch was placed on the pubic bone. A 1-10 visual analog scale (VAS) was used to assess postoperative pain, evaluating it at 1 week, 1 month and 12, 24 and 36 months. Local paresthesia was assessed at same intervals. Any pain sensation lasting longer than 3 months postoperatively, or requiring injection of analgesics was defined as chronic pain. Mean operating time was 64.1 minutes (SD ± 21.14). There were no intraoperative complications. Early postoperative complications included hematoma-seroma (5.7% cases), superficial wound infection (1%), urinary retention (0.5%), and scrotal swelling (1%). The main follow-up period was 3 years, although patients operated between 2009 and 2011 underwent a shorter follow-up. At one-year follow-up, 17 patients reported groin discomfort, but did not require analgesics. Three patients reported moderate pain, requiring occasional use of oral analgesics, and 2 of these described a discontinuous pain mainly during movement. One patient

Amyad's hernia while reparing the bilateral inguinal hernia

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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. 

Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures.

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Hanedan, Muhammet Onur; Yuruk, Mehmet Ali; Parlar, Ali Ihsan; Ziyrek, Ugur; Arslan, Ali Kemal; Sayar, Ufuk; Mataraci, Ilker

2018-02-01

In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34-93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32). Baseline patient characteristics were similar except for worse New York Heart Association functional status and the prevalence of diabetes mellitus in group 1. In group 1, the operative, cross-clamp, and cardiopulmonary bypass times were shorter (all P =0.001), postoperative drainage amounts were lower ( P =0.009), hospital stays were shorter ( P =0.004), and less red blood cell transfusion was needed ( P =0.037). Echocardiograms before patients' discharge from the hospital showed lower peak and mean aortic gradients in group 1 (mean transvalvular gradient, 8.4 ± 2.8 vs 12.2 ± 5.2 mmHg; P =0.012). We found that elderly, high-risk patients who underwent multiple cardiac surgical procedures and sutureless AVR had better hemodynamic outcomes and shorter ischemic times than did patients who underwent conventional AVR.

Tension pneumothorax due to perforated colon.

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Abdullah, Muhammad; Stonelake, Paul

2016-05-31

A very rare case of traumatic diaphragmatic hernia is reported in a 65-year-old woman who presented 46 years after her initial thoracoabdominal injury with tension faecopneumothorax caused by a perforated colon in the chest cavity. She presented in a critical condition with severe respiratory distress, sepsis and acute kidney injury. She had a long-standing history of bronchial asthma with respiratory complications and had experienced progressive shortness of breath for the past year. A recent CT scan had excluded the presence of a diaphragmatic hernia but showed a significantly raised left hemidiaphragm. On admission, chest X-rays showed a significantly raised left hemidiaphragm and mediastinal shift, but the possibility of a diaphragmatic hernia with strangulated bowel in the chest was not suspected until the patient was reviewed by the surgical and intensive care unit consultants the next morning and a repeat CT performed. She had a successful outcome after her emergency operation. 2016 BMJ Publishing Group Ltd.

Outcomes of using a sutureless bovine pericardial patch graft for Ahmed glaucoma valve implantation.

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Quaranta, Luciano; Riva, Ivano; Floriani, Irene C

2013-01-01

To evaluate the long-term outcomes of a surgical technique using a sutureless bovine pericardial patch graft for the implantation of an Ahmed glaucoma valve (AGV). 
 This was a pilot study on patients with primary open-angle glaucoma refractory to repeated surgical filtering procedures. All patients underwent AGV implant technique using a sutureless bovine pericardial patch graft. The pericardial membrane was cut using an ordinary corneal trephine with a diameter of 9.0 or 10.0 mm. The anterior part of the tube was covered with the graft and kept in place with fibrin glue. Subsequently, the cap was stitched all around the tube and the dissected conjunctiva was laid over it. Intraocular pressure (IOP) and complications were evaluated 1 week and 1, 3, 6, 12, and 24 months after surgery.
 The procedure was used to treat 20 eyes of 20 consecutive patients (12 men and 8 women: mean age [SD] 64.8 [7.8] years). Mean IOP was 28.1 mm Hg (SD 4.9) at baseline and decreased to 14.9 mm Hg (SD 1.5) 24 months after surgery (pendophthalmitis were recorded.
 The results suggest that the sutureless technique using a bovine pericardial graft patch is a safe and rapid procedure for AGV implantation.

Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation.

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Scharioth, Gabor B; Prasad, Som; Georgalas, Ilias; Tataru, Calin; Pavlidis, Mitrofanis

2010-02-01

To report the intermediate multicenter results of a technique of sutureless intrascleral fixation of a standard 3-piece posterior chamber intraocular lens (PC IOL) in the ciliary sulcus. Four European ophthalmology centers. A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PC IOL was retrospectively evaluated. The technique uses standardized maneuvers to fixate the PC IOL without need for special haptic architecture or preparation or haptic suturing. All patients having IOL implantation by the technique were evaluated for preoperative status (visual acuity, refractive error, preexisting ocular conditions, optical biometry), postoperative status, complications, and need for further surgery. The study evaluated 63 consecutive patients from 4 institutions (4 surgeons). The median follow-up was 7 months. Two dislocated PC IOLs (3.6%) were decentered; the other 61 IOLs (96.8%) were stable and well centered. There were no cases of recurrent dislocation, endophthalmitis, retinal detachment, or glaucoma. Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases. Copyright 2010 ASCRS and ESCRS. All rights reserved.

Clinical and hemodynamic outcomes of Perceval S sutureless bioprostheses implanted through a mini-approach in the aortic position

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A. N. Molchanov

2017-11-01

Full Text Available Aim. Aortic valve disease is one of three most common cardiovascular problems. Aortic stenosis is responsible for 70% of valve disease. Aortic valve replacement is the most effective treatment for aortic stenosis nowadays. A traditional suture technique of aortic valve replacement is associated with a high risk of complications. Most of these complications occur due to ischemic aortic cross-clamp time and comorbidities. Perceval S sutureless aortic valves to be implanted in selected patients are supposed to meet the challenge. The study was aimed at assessing Perceval S sutureless aortic valve hemodynamic and clinical parameters, its intraoperative advantages and postoperative complication rates.Methods. A prospective cohort study of Perceval S sutureless aortic valve implanted via J-sternotomy (n = 22 and median sternotomy (n = 10 was conducted. Early and medium postoperative clinical and functional outcomes were obtained and evaluated.Results. A decrease in the transaortic gradient was observed in early (peak gradient 21.6±4.2 (p = 0.1, mean gradient 11.3±2.8 (p = 0.58 and medium (peak gradient 15.8±5.5 (p = 0.342, mean gradient 8.8±1.9 (p = 0.54 follow-up. The myocardial mass index tended to be reduced throughout the entire follow-up (p = 0.01. There were no prosthesis dysfunctions or biodegradation. No patient died in the postoperative period. Survival at 36 months of follow-up was 93.75%.Conclusion. Perceval S xenopericardial sutureless aortic bioprostheses adequately resolve hemodynamic problems and improve left ventricle functional parameters in early and median follow-up. They may be recommended for elderly patients. Sutureless aortic valve implantation is technically feasible through J-sternotomy and contributes to an eventless follow-up.Received 17 February 2017. Revised 16 August 2017. Accepted 28 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

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Stina Öberg

2016-01-01

Full Text Available A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh for slender patients. The aim of this study was to illustrate an easy procedure that alleviates/removes the pain. A male patient had persistent pain six months after the Onstep operation and therefore had a ring removal operation. The procedure is presented as a video and a protocol. At the eleven-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated in a video.

The outcome of A. Double mesh intraperitoneal repair for complex ventral hernia: A retrospective cohort study.

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Afifi, Raafat Y; Hamood, Mokhtar; Hassan, Maged

2018-05-01

Complex ventral hernia is a challenging surgical entity, commonly attended with huge defect, loss of domain and possible soft tissue infection. It is difficult to repair, especially with multiple recurrences. Numerous methods of repair have been described with no evidence-based data available to prefer one method over the other. The purpose of this study is to determine the long-term outcome of the proposed new modification of intraperitoneal mesh repair procedure in complex ventral hernia. This is a single-center retrospective analysis utilizing the prospectively-maintained dataset in our institution during the study period between January 2003 and June 2017. Patients who fit the inclusion criteria of having a complex ventral hernia, whether de-novo or recurrent and were subjected to A. Double Mesh Intraperitoneal Repair (ADMIR) procedure were included in the study. Patients were followed up till recurrence or lost to follow through a period ranging from 6 to 174 months (mean: 142.96 ± SE: 11.91). Forty-nine cases were included in this study (38 females and 11 males) with a female to male ratio of 3.5:1. The age range was from 28 to 81 years (mean 49 ± 12.4). BMI range from 25 to 42 (mean 33.6 ± 5.42). The ratio between the hernia sac volume and abdominal cavity volume was more than 20% in 12 patients (24.5%), who were subjected to preoperative progressive pneumoperitoneum (PPP) for an average period of two weeks. Hernias were recurrent in 28 cases (57%) and associated comorbidities were observed in 29 patients (63%). Postoperative complications occurred in 19 patients (38.7%), among them only 2 patients developed recurrence (4%) after a mean follow up period of 142 months. Five patients were lost to follow and were included in the Kaplan and Meier survival analysis. ADMIR procedure is successful for the repair of complex ventral hernias as it is applicable to all sites of ventral hernias. The mesh is tension free hidden within the abdomen allowing

Free energies of stable and metastable pores in lipid membranes under tension.

Science.gov (United States)

den Otter, Wouter K

2009-11-28

The free energy profile of pore formation in a lipid membrane, covering the entire range from a density fluctuation in an intact bilayer to a large tension-stabilized pore, has been calculated by molecular dynamics simulations with a coarse-grained lipid model. Several fixed elongations are used to obtain the Helmholtz free energy as a function of pore size for thermodynamically stable, metastable, and unstable pores, and the system-size dependence of these elongations is discussed. A link to the Gibbs free energy at constant tension, commonly known as the Litster model, is established by a Legendre transformation. The change of genus upon pore formation is exploited to estimate the saddle-splay modulus or Gaussian curvature modulus of the membrane leaflets. Details are provided of the simulation approach, which combines the potential of mean constraint force method with a reaction coordinate based on the local lipid density.

Atypical right diaphragmatic hernia (hernia of Morgagni, spigelian hernia and epigastric hernia in a patient with Williams syndrome: a case report

Directory of Open Access Journals (Sweden)

Rashid Farhan

2009-01-01

Full Text Available Abstract Introduction Williams syndrome is rare genetic disorder resulting in neurodevelopmental problems. Hernias of the foramen of Morgagni are rare diaphragmatic hernias and they mostly present on the right side, in the anterior mediastinum. They are usually asymptomatic and are difficult to diagnose, especially in patients with learning disabilities. Case presentation This 49-year-old woman with Williams syndrome, cognitive impairment and aortic stenosis presented to physicians with right-sided chest pain. She had previously undergone repair of her right spigelian and epigastric hernia. Her abdominal examination was unremarkable. Chest X-ray suggested right-sided diaphragmatic hernia and pleural effusion for which she received treatment. The computed tomography scan showed a diaphragmatic hernia with some collapse/consolidation of the adjacent lung. Furthermore, the patient had aortic stenosis and was high risk for anaesthesia (ASA grade 3. She underwent successful laparoscopic repair of her congenital diaphragmatic hernia leading to a quick and uneventful postoperative recovery. Conclusion These multiple hernias suggest that patients with Williams syndrome may have some connective tissue disorder which makes them prone to develop hernias especially associated with those parts of the body which may have intracavity pressure variations like the abdomen. Diaphragmatic hernia may be the cause of chest pain in these patients. A computed tomography scan helps in early diagnosis, and laparoscopic repair helps in prevention of further complications, and leads to quick recovery especially in patients with learning disabilities. In the presence of significant comorbidities, a less invasive operative procedure with quick recovery becomes advisable.

Incarcerated Pediatric Hernias.

Science.gov (United States)

Abdulhai, Sophia A; Glenn, Ian C; Ponsky, Todd A

2017-02-01

Indirect inguinal hernias are the most commonly incarcerated hernias in children, with a higher incidence in low birth weight and premature infants. Contralateral groin exploration to evaluate for a patent processus vaginalis or subclinical hernia is controversial, given that most never progress to clinical hernias. Most indirect inguinal hernias can be reduced nonoperatively. It is recommended to repair them in a timely fashion, even in premature infants. Laparoscopic repair of incarcerated inguinal hernia repair is considered a safe and effective alternative to conventional open herniorrhaphy. Other incarcerated pediatric hernias are extremely rare and may be managed effectively with laparoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

Science.gov (United States)

Pavlidis, Mitrofanis; de Ortueta, Diego; Scharioth, Gabor B

2011-05-01

To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus. A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus. Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis. Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction. Copyright 2011, SLACK Incorporated.

Diagnosis of Groin Pain Associated With Sports Hernia Using Dynamic Ultrasound and Physical Examination: A Case Report.

Science.gov (United States)

Yang, Dong Chan; Nam, Ki Yeun; Kwon, Bum Sun; Park, Jin Woo; Ryu, Ki Hyung; Lee, Ho Jun; Sim, Gyu Jeong

2015-12-01

Groin pain in athletes is a complex diagnostic and therapeutic challenge. Sports hernia is one of the common causes of groin pain. We report a case of sports hernia, initially presented as groin pain and aggravated by sports activity. A 19-year-old soccer player visited the outpatient department of general surgery and was referred to the rehabilitation center due to no abnormalities detected in the abdomen and pelvis by computed tomography. An incipient direct bulge of the posterior inguinal wall was detected with dynamic ultrasound when abdominal tension was induced by raising both legs during a full inhalation. Surgery was performed and preoperatively both groins showed the presence of inguinal hernia. Diagnosing sports hernia is very challenging. Through careful history documentation and physical examination followed by dynamic ultrasonography, we identified his posterior inguinal wall deficiency for early management.

Lichtenstein Mesh Repair (LMR) v/s Modified Bassini's Repair (MBR) + Lichtenstein Mesh Repair of Direct Inguinal Hernias in Rural Population - A Comparative Study.

Science.gov (United States)

Patil, Santosh M; Gurujala, Avinash; Kumar, Ashok; Kumar, Kuthadi Sravan; Mithun, Gorre

2016-02-01

Lichtenstein's tension free mesh hernioplasty is the commonly done open technique for inguinal hernias. As our hospital is in rural area, majority of patients are labourers, open hernias are commonly done. The present study was done by comparing Lichtenstein Mesh Repair (LMR) v/s Modified Bassini's repair (MBR) + Lichtenstein mesh repair (LMR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate. A comparative randomized study was conducted on patients reporting to MNR hospital, sangareddy with direct inguinal hernias. A total of fifty consecutive patients were included in this study of which, 25 patients were operated by LMR and 25 patients were operated by MBR+LMR and followed up for a period of two years. The outcomes of the both techniques were compared. Study involved 25 each of Lichtenstein's mesh repair (LMR) and modified bassini's repair (MBR) + LMR, over a period of 2 years. The duration of surgery for lichtenstein mesh repair is around 34.56 min compared to LMR+MBR, which is 47.56 min which was statistically significant (p-value is MBR group in POD 1, but not statistically significant (p-value is 0.0949) and from POD 7 the pain was almost similar in both groups. The recurrence rate is 2% for LMR and 0% for MBR+LMR. LMR+MBR was comparatively better than only LMR in all direct inguinal hernias because of low recurrence rate (0%) and low postoperative complications, which showed in our present study.

Strangulated spigelian hernia

International Nuclear Information System (INIS)

Amin, F.M.; Sultan, T.

2004-01-01

Spigelian hernia is a rare ventral hernia. Strangulation is Spigelian hernia is common but still seen very rarely in clinical practice. We report a case of strangulated Spigelian hernia in an elderly women which was managed satisfactory and the patient discharged on ninth post operative day. (author)

Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

Directory of Open Access Journals (Sweden)

Pavlidis Theodoros

2011-09-01

Full Text Available Abstract Introduction A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. Case presentations We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%. A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis, presenting as an incarcerated right groin hernia, and underwent simultaneous appendectomy and Bassini suture hernia repair. Two patients, Caucasian men aged 36 and 43 years old, had normal appendices in their sacs, which clinically appeared as non-incarcerated right groin hernias. Both underwent a plug-mesh hernia repair without appendectomy. The fourth patient, a 25-year-old Caucasian man with a large but not inflamed appendix in his sac, had a plug-mesh hernia repair with appendectomy. Conclusion A hernia surgeon may encounter unexpected intraoperative findings, such as Amyand's hernia. It is important to be prepared and apply the appropriate treatment.

A late presenting congenital diaphragmatic hernia misdiagnosed as spontaneous pneumothorax

Directory of Open Access Journals (Sweden)

Chitra Sanjeev Juwarkar

2010-01-01

Full Text Available Congenital diaphragmatic hernia (CDH is described as (1 failure of diaphragmatic closure at development, (2 presence of herniated abdominal contents into chest and (3 pulmonary hypoplasia. Usually, pleural space is drained urgently when there is respiratory distress and radiological appearance of mediastinal shift. We present a case of a 5-month-old baby, diagnosed as tension pneumothorax and treated with chest drain insertion. CDH was the intraoperative diagnosis.

Adult abdominal hernias.

LENUS (Irish Health Repository)

Murphy, Kevin P

2014-06-01

Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

Reparación protésica de hernias inguinales con técnica de Lichtenstein

Directory of Open Access Journals (Sweden)

Ernesto Simón Enríquez Weinmann

2003-03-01

Full Text Available Se presentan los resultados de un estudio prospectivo que trata de la colocación de prótesis por vía anterior en la reparación de hernias inguinales con la utilización de variantes técnicas propuestas por Lichtenstein. Se incluye un total de 150 pacientes, a los que se les realizó operación, desde septiembre de 1996 hasta febrero de 2001; en 100 de éstos se practicó la técnica de reforzamiento protésico inicialmente descrita por Lichtenstein, y en 50, la técnica libre de tensión. Se realizaron 93 herniorrafias primarias, y 57 en hernias recidivadas, 10 de ellas iteradas. El tipo de hernia más frecuentemente operado según la clasificación de Gilbert modificada, fue la tipo III; 8 pacientes presentaban hernia en pantalón (tipo VI. La anestesia más frecuentemente usada fue la regional, y le siguió en frecuencia la anestesia general, local y analgesia acupuntural. Las complicaciones se comportaron de manera similar a las técnicas tradicionales, donde 26 pacientes presentaron complicaciones inmediatas menores. Ocurrió sepsis de la herida en un caso (0,6 %, y hasta la fecha no se han verificado recidivas, con un seguimiento promedio de 39 meses (12-66 del 100 % de los casos. Se sustenta la enseñanza del reforzamiento protésico para el cirujano en formaciónThe results of a prospective study dealing with the placement of prostheses by anterior route in the repair of inguinal hernias by using the technical variants proposed by Lichtenstein were presented. 150 patients who were operated on from September, 1996, to February, 2001, were included. The prosthetic reinforcement technique initially described by Lichtenstein was performed in 100, whereas the free-tension technique was used in 50 patients. 93 primary herniorraphies were performed. 57 were carried out in recurrent hernias, 10 of them iterated. Type III was the type of hernia most commonly operated on, according to Gilbert classification. 8 patients presented type VI hernia

Etiology of Inguinal Hernias

DEFF Research Database (Denmark)

Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

2017-01-01

BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral...... and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared...... mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor....

Sutureless vascular anastomoses by N-butyl-2 cyanoacrylate adhesive: an experimental animal study.

Science.gov (United States)

Saba, D; Yilmaz, M; Yavuz, H; Noyan, S; Avci, B; Ercan, A; Ozkan, H; Cengiz, M

2007-01-01

The purpose of this animal study was to find out whether sutureless anastomoses using N-butyl-2-cyanoacrylate were effective in the suppression of neointimal hyperplasia or not. Ten male adult mongrel dogs were used in this animal study. The animals were randomly divided into a control group (n = 5) and a study group (n = 5). The study group underwent sutureless anastomoses using N-buthyl-2-cyanoacrylate adhesive. Infrarenal aortoaortic graft was interposed using polytetrafluoroethylene. In the study group, the mean intimal thickness at the proximal anastomosis was 27.4 +/- 1.94 microm and 27.4 +/- 1.51 microm at the distal anastomosis. In the control group, the mean intimal thickness was 138.4 +/- 5.02 mum at the proximal anastomosis and 67.6 +/- 6.42 microm at the distal anastomosis. Intimal thickness at the proximal and distal anastomoses in the control group was significantly (p anastomoses using with N-butyl-2-cyanoacrylate adhesive might be a good alternative to conventional suture technique. Copyright 2007 S. Karger AG, Basel.

An Evaluation of Parastomal Hernia Repair Using the Americas Hernia Society Quality Collaborative.

Science.gov (United States)

Fox, Sarah S; Janczyk, Randy; Warren, Jeremy A; Carbonell, Alfredo M; Poulose, Benjamin K; Rosen, Michael J; Hope, William W

2017-08-01

The purpose of this review was to evaluate outcomes relating to parastomal hernia repair. Data from the Americas Hernia Society Quality Collaborative were used to identify patients undergoing parastomal hernia repair from 2013 to 2016. Parastomal hernia repairs were compared with other repairs using Pearson's test and Wilcoxon test with a P value Ostomy disposition included ostomy left in situ (47%), moved to a new site (18%), taken down (22%), and rematured in same location in (13%). Outcomes related to parastomal hernia repair included 10 per cent surgical site infection, 24 per cent surgical site occurrence, and 12 per cent surgical site occurrences requiring procedural interventions with a 13 per cent readmission rate and 6 per cent reoperation rate. When comparing parastomal hernias with other ventral hernia repairs, parastomal hernias had a significantly higher surgical site infection, surgical site occurrence, surgical site occurrences requiring procedural intervention, readmission, reoperation rate, and length of stay, and were less commonly performed laparoscopically (P < 0.05). Most parastomal hernias are being repaired open with synthetic mesh in the sublay position. Less favorable outcomes of parastomal hernia repair when compared with other ventral hernia repairs are likely related to the complexity of parastomal hernia repair.

Lichtenstein Mesh Repair (LMR) v/s Modified Bassini’s Repair (MBR) + Lichtenstein Mesh Repair of Direct Inguinal Hernias in Rural Population – A Comparative Study

Science.gov (United States)

Patil, Santosh M; Kumar, Ashok; Kumar, Kuthadi Sravan; Mithun, Gorre

2016-01-01

Introduction Lichtenstein’s tension free mesh hernioplasty is the commonly done open technique for inguinal hernias. As our hospital is in rural area, majority of patients are labourers, open hernias are commonly done. The present study was done by comparing Lichtenstein Mesh Repair (LMR) v/s Modified Bassini’s repair (MBR) + Lichtenstein mesh repair (LMR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate. Materials and Methods A comparative randomized study was conducted on patients reporting to MNR hospital, sangareddy with direct inguinal hernias. A total of fifty consecutive patients were included in this study of which, 25 patients were operated by LMR and 25 patients were operated by MBR+LMR and followed up for a period of two years. The outcomes of the both techniques were compared. Results Study involved 25 each of Lichtenstein’s mesh repair (LMR) and modified bassini’s repair (MBR) + LMR, over a period of 2 years. The duration of surgery for lichtenstein mesh repair is around 34.56 min compared to LMR+MBR, which is 47.56 min which was statistically significant (p-value is MBR group in POD 1, but not statistically significant (p-value is 0.0949) and from POD 7 the pain was almost similar in both groups. The recurrence rate is 2% for LMR and 0% for MBR+LMR. Conclusion LMR+MBR was comparatively better than only LMR in all direct inguinal hernias because of low recurrence rate (0%) and low postoperative complications, which showed in our present study. PMID:27042517

Traumatic lung hernia; Hernia pulmonar traumatica

Energy Technology Data Exchange (ETDEWEB)

Rabaza, M. J.; Alcazar, P. P.; Touma, C. [Hospital Universitario Virgen de las Nieves. Granada (Spain)

2001-07-01

Lung hernia is an uncommon entity that is defined as the protrusion of the lung parenchyma through a defect in the thoracic cavity. It is classified on the basis of its location (cervical, intercostal and diaphragmatic) and etiology (congenital and acquired). Acquired lung hernias can be further grouped as spontaneous, traumatic or pathological, depending on the responsible mechanism. Nearly half of them are secondary to chest trauma, whether penetrating or blunt. We present a case of lung hernia in a patient with penetrating chest trauma. The diagnosis was suspected from the radiographic images and was confirmed by computed tomography. We also review the literature concerning its classification and incidence, diagnostic methods used and treatment. (Author) 9 refs.

The impact of tension-free vaginal tape on the urethral closure function

DEFF Research Database (Denmark)

Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar

2015-01-01

AIM: To investigate if the tension-free vaginal tape (TVT) works by increasing the abdominal to urethral pressure impact ratio (APIR). METHODS: Twenty one women with urodynamically proven stress urinary incontinence (SUI) were assessed by ICIQ-SF, pad-weighing test, incontinence diary and Urethral...

Reparación de hernias inguinoescrotales gigantes bilaterales con realización preoperatoria de neumoperitoneo Repair of bilateral giant inguinoscrotal hernias with preoperative pneumoperitoneum

Directory of Open Access Journals (Sweden)

Eugenio Vicario Benito del Valle

2004-06-01

Full Text Available Se describe el manejo preoperatorio y quirúrgico de un paciente con hernia inguinoescrotal gigante “con pérdida del derecho de asilo” mediante neumoperitoneo preoperatorio, con el fin de facilitar su reducción y evitar la tensión y la insuficiencia respiratoria que conllevaría. Para realizar el neumoperitoneo se utilizó el aparato de laparoscopia a través de un drenaje peritoneal colocado percutaneamente con ayuda del radiólogo intervencionistaThe preoperative and surgical management of a patient with giant inguinoscrotal hernia with “loss of the asylum right” by preoperative pneumoperitoneum in order to facilitate its reduction and prevent the tension and respiratory failure it would lead to, is described. The pneumoperitoneum was performed by using the laparoscopy apparatus through a peritoneal drainage percutaneously placed with the help of the interventionist radiologist

Intraoperative and early postoperative complications of manual sutureless cataract extraction.

Science.gov (United States)

Iqbal, Yasir; Zia, Sohail; Baig Mirza, Aneeq Ullah

2014-04-01

To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. Case series. Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery (MSCS) by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences (SPSS) version 13.0 and the results were calculated in frequencies. Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases (3%) underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema.

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...

Etiology of Inguinal Hernias

DEFF Research Database (Denmark)

Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

2017-01-01

BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral a...

Large Ventral Hernia

Directory of Open Access Journals (Sweden)

Meryl Abrams, MD

2018-04-01

Full Text Available History of present illness: A 46-year-old female presented to the emergency department (ED with diffuse abdominal pain and three days of poor oral intake associated with non-bilious, non-bloody vomiting. Initial vital signs consisted of a mild resting tachycardia of 111 with a temperature of 38.0 degrees Celsius (°C. On examination, the patient had a large pannus extending to the knees, which contained a hernia. She was tender in this region on examination. Laboratory values included normal serum chemistries and mild leukocytosis of 12.2. The patient reports that her abdomen had been enlarging over the previous 8 years but had not been painful until 3 days prior to presentation. The patient had no associated fever, chills, diarrhea, constipation, chest pain or shortness of breath. Significant findings: Computed tomography (CT scan with intravenous (IV contrast of the abdomen and pelvis demonstrated a large pannus containing a ventral hernia with abdominal contents extending below the knees (white circle, elongation of mesenteric vessels to accommodate abdominal contents outside of the abdomen (white arrow and air fluid levels (white arrow indicating a small bowel obstruction. Discussion: Hernias are a common chief complaint seen in the emergency department. The estimated lifetime risk of a spontaneous abdominal hernia is 5%.1 The most common type of hernia is inguinal while the next most common type of hernia is femoral, which are more common in women.1 Ventral hernias can be epigastric, incisional, or primary abdominal. An asymptomatic, reducible hernia can be followed up as outpatient with a general surgeon for elective repair.2 Hernias become problematic when they are either incarcerated or strangulated. A hernia is incarcerated when the hernia is irreducible and strangulated when its blood supply is compromised. A complicated hernia, especially strangulated, can have a mortality of greater than 50%.1 It is key to perform a thorough history

Perineal hernia repair using an autologous tunica vaginalis communis in nine intact male dogs.

Science.gov (United States)

Pratummintra, Kittiya; Chuthatep, Suwicha; Banlunara, Wijit; Kalpravidh, Marissak

2013-01-01

Perineal hernia in dogs is very problematic and mostly requires surgical reconstruction of the weak pelvic diaphragm. Tissue or synthetic grafts have been used for the correction after failure of the conventional herniorrhaphy. Aim of this clinical trial was to assess the possible use of the autologous tunica vaginalis communis as a free graft for perineal hernia repair in intact male dogs. Seven unilateral and 2 bilateral perineal hernias in nine intact male dogs free from testicular and scrotal neoplasms were included in this study. The median surgical time for unilateral herniorrhaphy was 75 min. The median follow-up time was 13 months. The success of the autografting, based on no recurrence and comfort of the animals during urination and defecation, was found in ten of 11 hernias; giving a success rate of 90.91%. One hernia (9.09%) recurred 10 days after surgery. Histopathological examination of the apposing area between the graft and the adjacent tissue, taken during the repair of the recurred case at day 20, revealed neovascularization and connective tissue ingrowth. In conclusion, the tunica vaginalis autograft can be used for perineal herniorrhaphy in intact male dogs.

Free energies of stable and metastable pores in lipid membranes under tension

NARCIS (Netherlands)

den Otter, Wouter K.

2009-01-01

The free energy profile of pore formation in a lipid membrane, covering the entire range from a density fluctuation in an intact bilayer to a large tension-stabilized pore, has been calculated by molecular dynamics simulations with a coarse-grained lipid model. Several fixed elongations are used to

Morgagni's Hernia

International Nuclear Information System (INIS)

Khalid, M.M.

2004-01-01

Congenital diaphragmatic hernias, including Morgagni's hernia, usually present in early childhood and are treated by surgical repair. This case report is about an unusual Morgagni's hernia, presenting with dyspepsia and chest pain, at the age 45 years. For many years the diagnosis remained a dilemma because patient's chest x-ray was not done and she was treated for 'ngina' and 'dyspepsia' Diagnosis was obvious once a chest x-ray was done, however, barium studies were performed for further confirmation. (author)

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

Bullhorn Hernia: A Rare Traumatic Abdominal Wall Hernia

African Journals Online (AJOL)

Department of Surgery, Government Medical College and Rajindra. Hospital, Patiala ‑ 147 001, Punjab, India. E‑mail: drbimal.undefined@gmail.com. INTRODUCTION. Traumatic abdominal wall hernia (TAWH) is uncommonly encountered despite the high prevalence of blunt abdominal trauma.[1] Bullhorn hernia is a rare, ...

European Hernia Society guidelines on prevention and treatment of parastomal hernias.

Science.gov (United States)

Antoniou, S A; Agresta, F; Garcia Alamino, J M; Berger, D; Berrevoet, F; Brandsma, H-T; Bury, K; Conze, J; Cuccurullo, D; Dietz, U A; Fortelny, R H; Frei-Lanter, C; Hansson, B; Helgstrand, F; Hotouras, A; Jänes, A; Kroese, L F; Lambrecht, J R; Kyle-Leinhase, I; López-Cano, M; Maggiori, L; Mandalà, V; Miserez, M; Montgomery, A; Morales-Conde, S; Prudhomme, M; Rautio, T; Smart, N; Śmietański, M; Szczepkowski, M; Stabilini, C; Muysoms, F E

2018-02-01

International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched. Quality assessment was performed using Scottish Intercollegiate Guidelines Network checklists. The guidelines were presented at the 38th European Hernia Society Congress and each key question was evaluated in a consensus voting of congress participants. End colostomy is associated with a higher incidence of parastomal hernia, compared to other types of stomas. Clinical examination is necessary for the diagnosis of parastomal hernia, whereas computed tomography scan or ultrasonography may be performed in cases of diagnostic uncertainty. Currently available classifications are not validated; however, we suggest the use of the European Hernia Society classification for uniform research reporting. There is insufficient evidence on the policy of watchful waiting, the route and location of stoma construction, and the size of the aperture. The use of a prophylactic synthetic non-absorbable mesh upon construction of an end colostomy is strongly recommended. No such recommendation can be made for other types of stomas at present. It is strongly recommended to avoid performing a suture repair for elective parastomal hernia. So far, there is no sufficient comparative evidence on specific techniques, open or laparoscopic surgery and specific mesh types. However, a mesh without a hole is suggested in preference to a keyhole mesh when laparoscopic repair is performed. An evidence-based approach to the diagnosis and management of parastomal hernias reveals the lack of

Perforated gastric corpus in a strangulated paraesophageal hernia: a case report

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Shafii Alexis E

2009-05-01

Full Text Available Abstract Introduction Patients with paraesophageal hernias often present secondary to chronic symptomatology. Infrequently, acute intestinal ischemia and perforation can occur as a consequence of paraesophageal hernias with potentially dire consequences. Case presentation An 86-year-old obtunded male presented to the emergency department with hypotension and severe back and abdominal pain. An emergency abdominal CT scan was ordered with a presumptive diagnosis of ruptured abdominal aortic aneurysm. CT topograms revealed extensive free intra-abdominal air and herniated abdominal viscera into the right hemithorax. Prior to completion of the CT study, the patient sustained a cardiopulmonary arrest. Surgery was consulted, but the patient was unable to be revived. Post-mortem examination revealed gross contamination within the abdomen and a giant, incarcerated, hiatal hernia with organoaxial volvulus and ischemic perforation. Conclusion Current recommendations call for prompt repair of giant hiatal hernias before they become symptomatic due to the increased risk of strangulation. Torsion of the stomach in large hiatal hernias frequently leads to a fatal complication such as this warranting elective repair as soon as possible.

Cervical lung hernia

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Lightwood, Robin G.; Cleland, W. P.

1974-01-01

Lightwood, R. G., and Cleland, W. P. (1974).Thorax, 29, 349-351. Cervical lung hernia. Lung hernias occur in the cervical position in about one third of cases. The remainder appear through the chest wall. Some lung hernias are congenital, but trauma is the most common cause. The indications for surgery depend upon the severity of symptoms. Repair by direct suture can be used for small tears in Sibson's (costovertebral) fascia while larger defects have been closed using prosthetic materials. Four patients with cervical lung hernia are described together with an account of their operations. PMID:4850946

Intraoperative and Early Postoperative Complications of Manual Sutureless Cataract Extraction

International Nuclear Information System (INIS)

Iqbal, Y.; Zia, S.; Mirza, A. B.

2014-01-01

Objective: To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. Study Design: Case series. Place and Duration of Study: Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. Methodology: Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery (MSCS) by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences (SPSS) version 13.0 and the results were calculated in frequencies. Results: Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases (3%) underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. Conclusion: Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema. (author)

Groin hernia subtypes are associated in patients with bilateral hernias

DEFF Research Database (Denmark)

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

2015-01-01

repair (89.9% males) were registered, and of those were 12,041 persons operated bilaterally (94.9% males). Females and males operated for a unilaterally direct inguinal hernia (DIH) had increased Hazard Ratios (HR) of 3.85 (CI 95% 2.14-6.19) and 4.46 (CI 95% 2.57-7.88) of being contralaterally operated...... for a DIH. Females and males operated for a unilaterally indirect inguinal hernia (IIH) had HRs of 6.93 (CI 95% 3.66-13.11) and 1.89 (CI95% 1.24-2.88) for being contralaterally operated for an IIH. The same tendency was seen for femoral hernias. CONCLUSIONS: All hernia subtypes were bilaterally associated...

[Amyand's hernia--a clinical case].

Science.gov (United States)

Savlovschi, C; Brănescu, C; Serban, D; Tudor, C; Găvan, C; Shanabli, A; Comandaşu, M; Vasilescu, L; Borcan, R; Dumitrescu, D; Sandolache, B; Sajin, M; Grădinaru, S; Munteanu, R; Kraft, A; Oprescu, S

2010-01-01

Amyand's hernia, a rare entity in the surgical pathology, presupposes the presence of the vermiform appendix inside a inguinal hernia sac (1). The hernia sac peritonitis by appendix swelling is even more rare, very few cases being presented in the surgical literature (1). The preoperatory diagnosis of Amyand's hernia is therefore very difficult. We herein present the case of a 71-year old male patient, operated on an emergency basis for hernia, which eventually turned out to be Amyand's hernia, a case which determined us to research the literature dedicated to this topic.

THREE PORTS LAPAROSCOPIC REPAIR OF ADULT MORGAGNI HERNIA AND RARE SIMULTANEOUS PRESENTATION OF PARA-ESOPHAGEAL HERNIA WITH MORGAGNI HERNIA

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Salman Assad

2018-05-01

Full Text Available We report two case reports of Morgagni hernia repair. Our first case was on 65 year old white male who presented with abdominal pain in right upper quadrant and right side of chest for last 3 days. He was having 3 episodes of dark appearing vomiting associated with pain. He also had two episodes of hematemesis. Patient had gastric outlet obstruction with severe distension of stomach because of incarcerated small bowel and colon in the right sided anterior diaphragmatic Morgagni hernia. Laparoscopic repair of incarcerated Morgagni hernia under general anesthesia was planned. We report our second case on rare simultaneous presentation of Morgagni Hernia with type 3 Para esophageal hernia. 60 years old female patient presented in clinic with a follow up of chest discomfort which was progressively increasing with shortness of breath and a chronic gastric reflux. Her vitals were within normal limits and had body mass index (BMI= 29.52kg/m2 (overweight category. Previous past medical history included multiple episodes of gastric regurgitation and cardiovascular intervention for coronary stenting. CT scan showed type 3 paraesophageal hernia (gastro esophageal junction with fundus of stomach displaced above diaphragm. The patient had more than 30% of her stomach incarcerated in the chest as a paraesophageal hernia. The gastro esophageal junction was intra-abdominal after lysis of adhesion. Mesh was placed after posterior crural repair, followed by Nissen fundoplication over a 54 French bougie patient also had an incidental finding of a reducible Morgagni hernia through an anterior defect, followed by a repair without mesh. Esophago-gastro-duodenoscopy showed there was no evidence of any air leak with good valve creation on retroflexion through a fundoplication.

A waveless free surface flow past a submerged triangular obstacle in presence of surface tension

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Hakima Sekhri

2016-07-01

Full Text Available We consider the Free surface flows passing a submerged triangular obstacle at the bottom of a channel. The problem is characterized by a nonlinear boundary condition on the surface of unknown configuration. The analytical exact solutions for these problems are not known. Following Dias and Vanden Broeck [6], we computed numerically the solutions via a series truncation method. These solutions depend on two parameters: the Weber number $\\alpha$ characterizing the strength of the surface tension and the angle $\\beta$ at the base characterizing the shape of the apex. Although free surface flows with surface tension admit capillary waves, it is found that solution exist only for values of the Weber number greater than $\\alpha_0$ for different configurations of the triangular obstacle.

Abdominal wall hernias: computed tomography findings; Hernias da parede abdomino-pelvica: aspectos tomograficos

Energy Technology Data Exchange (ETDEWEB)

D' Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo[Hospital e Maternidade Sao Luiz, Sao Paulo, SP (Brazil). Setor de US/TC/RMN]. E-mail: giuseppe_dr@uol.com.br

2005-07-15

Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand’s Hernia with Non-Inflamed Appendices

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Emin Kose

2017-01-01

Full Text Available Amyand’s hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand’s hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand’s hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months, there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand’s hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy.

Intrathoracic drainage of a perforated prepyloric gastric ulcer with a type II paraoesophageal hernia

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Zonneveld Bas JGL

2008-12-01

Full Text Available Abstract Background With an incidence of less than 5%, type II paraesophageal hernias are one of the less common types of hiatal hernias. We report a case of a perforated prepyloric gastric ulcer which, due to a type II hiatus hernia, drained into the mediastinum. Case presentation A 61-year old Caucasian man presented with acute abdominal pain. On a conventional x-ray of the chest a large mediastinal air-fluid collection and free intra-abdominal air was seen. Additional computed tomography revealed a large intra-thoracic air-fluid collection with a type II paraesophageal hernia. An emergency upper midline laparotomy was performed and a perforated pre-pyloric gastric ulcer was treated with an omental patch repair. The patient fully recovered after 10 days and continues to do well. Conclusion Type II paraesophageal hernia is an uncommon diagnosis. The main risk is gastric volvulus and possible gastric torsion. Intrathoracic perforation of gastric ulcers due to a type II hiatus hernia is extremely rare and can be a diagnostic and treatment challenge.

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery.

Science.gov (United States)

Wu, Jian-Guo; Wei, Rui-Hua; Liu, Ai-Hua; Zhou, Xiao-Xu; Sun, Guo-Ling; Li, Xiao-Rong

2011-01-01

The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery. We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit. Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05). This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.

Hernias (For Parents)

Science.gov (United States)

... look like inguinal hernias, but are not: A communicating hydrocele is similar to a hernia, except that ... reviewed: September 2016 More on this topic for: Parents Kids Teens Medical Care and Your Newborn Undescended ...

Laparoscopic inguinal hernia repair by the hook method in emergency setting in children presenting with incarcerated inguinal hernia.

Science.gov (United States)

Chan, Kin Wai Edwin; Lee, Kim Hung; Tam, Yuk Him; Sihoe, Jennifer Dart Yin; Cheung, Sing Tak; Mou, Jennifer Wai Cheung

2011-10-01

The development of laparoscopic hernia repair has provided an alternative approach to the management of incarcerated inguinal hernia in children. Different laparoscopic techniques for hernia repair have been described. However, we hereby review the role of laparoscopic hernia repair using the hook method in the emergency setting for incarcerated inguinal hernias in children. A retrospective review was conducted of all children who presented with incarcerated inguinal hernia and underwent laparoscopic hernia repair using the hook method in emergency setting between 2004 and 2010. There were a total of 15 boys and 1 girl with a mean age of 30 ± 36 months (range, 4 months to 12 years). The hernia was successfully reduced after sedation in 7 children and after general anesthesia in 4 children. In 5 children, the hernia was reduced by a combined manual and laparoscopic-assisted approach. Emergency laparoscopic inguinal hernia repair using the hook method was performed after reduction of the hernia. The presence of preperitoneal fluid secondary to recent incarceration facilitated the dissection of the preperitoneal space by the hernia hook. All children underwent successful reduction and hernia repair. The median operative time was 37 minutes. There was no postoperative complication. The median hospital stay was 3 days. At a median follow-up of 40 months, there was no recurrence of the hernia or testicular atrophy. Emergency laparoscopic inguinal hernia repair by the hook method is safe and feasible. Easier preperitoneal dissection was experienced, and repair of the contralateral patent processus vaginalis can be performed in the same setting. Copyright © 2011 Elsevier Inc. All rights reserved.

Ventral hernia repair

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... incarcerated) in the hernia and become impossible to push back in. This is usually painful. The blood supply ... you are lying down or that you cannot push back in. Risks The risks of ventral hernia repair ...

Amyand’s Hernia – Vermiform Appendix in an Inguinal Hernia: A Rare Finding

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Prakash Kumar Sahoo

2017-10-01

Full Text Available A variety of surprises may spring up when the sac is opened in an inguinal hernia. Omentum, bowel diverticulum, ovary, fallopian tube, urinary bladder, large bowel, Meckel’s diverticulum or foreign bodies being the varied contents of a hernia sac. The presence of vermiform appendix in the hernia sac in an inguinal hernia is a rare finding. This condition has been named as “Amyand’s Hernia” in the honour of an English surgeon, Claudius Amyand. A diagnosis preoperatively is difficult and is most often made intraoperatively. We report here a 52-year-old patient who presented with acute intestinal obstruction due to an obstructed right sided inguinal hernia. A diagnosis of Amyand’s hernia was confirmed when on exploration appendix along with a part of ascending colon was found to be content of the sac along with a few loops of small bowel. The contents were reduced after checking the viability and Bassini’s repair was done. The patient had an uneventful postoperative period.

Treating and Preventing Sports Hernias

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... Close ‹ Back to Healthy Living Treating and Preventing Sports Hernias If you play ice hockey, tennis or ... for the most commonly misdiagnosed groin pain—a sports hernia. A sports hernia often results from overuse ...

Etiology of Inguinal Hernias: A Comprehensive Review

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Stina Öberg

2017-09-01

Full Text Available BackgroundThe etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias.ResultsLateral and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared with patients with lateral hernias. However, connective tissue alteration may play a role in development of both subtypes. Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue homeostasis.ConclusionThe etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas. Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias. The precise mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor.

The Danish Inguinal Hernia Database

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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

Abdominal wall hernia and pregnancy

DEFF Research Database (Denmark)

Jensen, K K; Henriksen, N A; Jorgensen, L N

2015-01-01

PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

Outcome of 20-gauge transconjunctival cannulated sutureless vitrectomy using silicone oil or air tamponade

OpenAIRE

Mohamed, Ahmed Abdel Alim; Abdrabbo, Mohamed

2013-01-01

Ahmed Abdel Alim Mohamed,1 Mohamed Abdrabbo21Ain Shams University, Faculty of Medicine, Ophthalmology Department, Cairo; 2Faculty of Medicine, Ophthalmology Department, Benha University, Benha, EgyptBackground: The purpose of this study was to assess the outcome of pars plana vitrectomy using a 20-gauge transconjunctival cannulated sutureless system with air or silicone oil tamponade in cases of retinal detachment of different etiologies.Methods: A prospective study was performed in 60 eyes f...

Left Paraduodenal Hernia: An Autopsy Case

DEFF Research Database (Denmark)

Omland, Silje Haukali; Hougen, Hans Petter

2011-01-01

We present a case of a left paraduodenal hernia diagnosed at autopsy. A left paraduodenal hernia is an internal hernia of congenital origin due to the abnormal rotation of the midgut during embryonic development. Internal hernias are a rare cause of intestinal obstruction, with the paraduodenal...

Systemic and local collagen turnover in hernia patients

DEFF Research Database (Denmark)

Henriksen, Nadia A

2016-01-01

composition appears altered in fascial tissue but also in skin biopsies, suggesting that the collagen alterations are systemic. More pronounced collagen alterations are found in patients with hernia recurrences. Hypothetically, primary inguinal hernias are formed due to a systemic predisposition to altered...... connective tissue, whereas impaired healing influences on the development of incisional hernias and hernia recurrences. The overall objective of this thesis was to investigate the collagen turnover systemically and locally in patients with primary inguinal hernia, multiple hernias and incisional hernia...... repair after adjustment for gender, age and surgical approach. In a multivariable subgroup analysis, direct and recurrent inguinal hernia repair were associated with primary ventral hernia surgery, whereas only recurrent inguinal hernia repair was associated with secondary ventral hernia surgery...

Incarcerated umbilical hernia in children.

Science.gov (United States)

Chirdan, L B; Uba, A F; Kidmas, A T

2006-02-01

Umbilical hernia is common in children. Complications from umbilical hernias are thought to be rare and the natural history is spontaneous closure within 5 years. A retrospective analysis was performed of the medical records of a series of 23 children who presented with incarcerated umbilical hernias at our institution over an 8-year period. Fifty-two children with umbilical hernias were seen in the hospital over the period. Twenty-three (44.2%) had incarceration. Seventeen (32.7%) had acute incarceration while 6 (11.5%) had recurrent incarceration. There were 16 girls and 7 boys. The ages of the children with acute incarceration ranged from 3 weeks to 12 years (median 4 years), while the ages of those with recurrent incarceration ranged from 3-15 years (median 8.5 years). Incarceration occurred in hernias of more than 1.5 cm in diameter (in those whose defect size was measured). Twenty-one children (15 with acute and all six with recurrent incarceration) underwent repair of the umbilical hernia using standard methods. The parents of two children with acute incarceration declined surgery after spontaneous reduction of the hernia in one and taxis in the other. One boy had gangrenous bowel containing Meckel's diverticulum inside the sac, for which bowel resection with end-to-end anastomosis was done. Operation led to disappearance of pain in all 6 children with recurrent incarceration. Superficial wound infection occurred in one child. There was no mortality. Incarcerated umbilical hernia is not as uncommon as thought. Active observation of children with umbilical hernia is necessary to prevent morbidity from incarceration.

The Danish Inguinal Hernia database.

Science.gov (United States)

Friis-Andersen, Hans; Bisgaard, Thue

2016-01-01

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. Patients ≥18 years operated for groin hernia. Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. 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. 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). 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.

The inheritance of groin hernia

DEFF Research Database (Denmark)

Burcharth, J; Pommergaard, H C; Rosenberg, Jacob

2013-01-01

Groin hernia has been proposed to be hereditary; however, a clear hereditary pattern has not been established yet. The purpose of this review was to analyze studies evaluating family history and inheritance patterns and to investigate the possible heredity of groin hernias.......Groin hernia has been proposed to be hereditary; however, a clear hereditary pattern has not been established yet. The purpose of this review was to analyze studies evaluating family history and inheritance patterns and to investigate the possible heredity of groin hernias....

Asymptotic stability of shear-flow solutions to incompressible viscous free boundary problems with and without surface tension

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Tice, Ian

2018-04-01

This paper concerns the dynamics of a layer of incompressible viscous fluid lying above a rigid plane and with an upper boundary given by a free surface. The fluid is subject to a constant external force with a horizontal component, which arises in modeling the motion of such a fluid down an inclined plane, after a coordinate change. We consider the problem both with and without surface tension for horizontally periodic flows. This problem gives rise to shear-flow equilibrium solutions, and the main thrust of this paper is to study the asymptotic stability of the equilibria in certain parameter regimes. We prove that there exists a parameter regime in which sufficiently small perturbations of the equilibrium at time t=0 give rise to global-in-time solutions that return to equilibrium exponentially in the case with surface tension and almost exponentially in the case without surface tension. We also establish a vanishing surface tension limit, which connects the solutions with and without surface tension.

Tension free monofilament macropore polypropylene mesh (Gynemesh PS in female genital prolapse repair

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Vicente Sola

2006-08-01

Full Text Available OBJECTIVES: To review intraoperative and postoperative complications associated to the correction of cystocele and rectocele with polypropylene mesh macropore monofilament (Gynemesh PS using transvaginal free tension technique. MATERIALS AND METHODS: Prospective study of patients that have been submitted to correction of cystocele and/or rectocele between November 2004 and August 2005 in the Urogynecology and Vaginal Surgery Unit of Gynecology and Obstetrics Department, Las Condes Clinic. Mesh was used in 31 patients: 9 for cystocele, 11 for rectocele, and 11 for concomitant meshes. Total mesh used 42. Media age 55 years old, weight 64 kilograms. In 7 patients we used a third mesh for correction of urinary incontinence by TVT-O technique. RESULTS: They did not present intraoperative complications, neither in immediate or delayed postoperative time. We did not observe hematoma, infection, erosion or exposition mesh. Healing of cystocele and rectocele was obtained in 100% of patients, with a pursuit between 1 and 8 months. DISCUSSION: The use of prosthetic polypropylene monofilament macropore mesh in the correction of cystocele and/or rectocele, by transvaginal route with tension free technique seems to be a safe and effective surgery procedure.

[Hernia surgery in urology. Part 2: parastomal, trocar and incisional hernias - fundamentals of clinical diagnostics and treatment].

Science.gov (United States)

Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

2013-06-01

Hernias are a common occurrence with a correspondingly huge clinical and economic impact on the healthcare system. Parastomal and trocar hernias are rare in routine urological work. The therapy of parastomal hernias remains problematic but basically the surgeon is able to use conventional techniques with suture repair or procedures with mesh implantation. The conventional parastomal hernia repair with mesh can be classified into sublay, onlay and intraperitoneal techniques. Furthermore, a relocation of the stoma is possible. Trocar hernias represent a rare but hazardous complication. Due to the increase in keyhole surgery there is also the danger of a rise in their occurrence. Incisional hernias occur frequently in patients who have undergone laparotomy and for repair different surgical techniques and types of meshes are available. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostic and therapy of parastomal, trocar and incisional hernias.

Inguinal hernia recurrence: Classification and approach

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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.

Made in Italy for hernia: the Italian history of groin hernia repair.

Science.gov (United States)

Negro, Paolo; Gossetti, Francesco; Ceci, Francesca; D'Amore, Linda

2016-01-01

The history of groin hernia surgery is as long as the history of surgery. For many centuries doctors, anatomists and surgeons have been devoted to this pathology, afflicting the mankind throughout its evolution. Since ancient times the Italian contribution has been very important with many representative personalities. Authors, investigators and pioneers are really well represented. Every period (the classic period, the Middle Age, the Renaissance and the post-Renaissance) opened new perspectives for a better understanding. During the 18th century, more information about groin anatomy, mainly due to Antonio Scarpa, prepared the Bassini revolution. Edoardo Bassini developed the first modern anatomically based hernia repair. This procedure spread worldwide becoming the most performed surgical technique. After World War II synthetic meshes were introduced and a new era has begun for hernia repair, once again with the support of Italian surgeons, first of all Ermanno Trabucco. But Italian contribution extends also to educational, with the first national school for abdominal wall surgery starting in Rome, and to Italian participation and support in international scientific societies. Authors hereby wish to resume this long history highlighting the "made in Italy" for groin hernia surgery. Bassini, Groin hernia, History, Prosthetic repair.

Laparoscopic repair of large suprapubic hernias.

Science.gov (United States)

Sikar, Hasan Ediz; Çetin, Kenan; Eyvaz, Kemal; Kaptanoglu, Levent; Küçük, Hasan Fehmi

2017-09-01

Suprapubic hernia is the term to describe ventral hernias located less than 4 cm above the pubic arch in the midline. Hernias with an upper margin above the arcuate line encounter technical difficulties, and the differences in repair methods forced us to define them as large suprapubic hernias. To present our experience with laparoscopic repair of large suprapubic hernias that allows adequate mesh overlap. Nineteen patients with suprapubic incisional hernias who underwent laparoscopic repair between May 2013 and January 2015 were included in the study. Patients with laparoscopic extraperitoneal repair who had a suprapubic hernia with an upper margin below the arcuate line were excluded. Two men and 17 women, with a mean age of 58.2, underwent laparoscopic repair. Most of the incisions were midline vertical (13/68.4%). Twelve (63.1%) of the patients had previous incisional hernia repair (PIHR group); the mean number of previous incisional hernia repair was 1.4. Mean defect size of the PIHR group was higher than in patients without previous repair - 107.3 cm 2 vs. 50.9 cm 2 (p < 0.05). Mean operating time of the PIHR group was higher than in patients without repair - 126 min vs. 77.9 min (p < 0.05). Although all complications occurred in the PIHR group, there was no statistically significant difference. Laparoscopic repair of large suprapubic hernias can be considered as the first option in treatment. The low recurrence rates reported in the literature and the lack of recurrence, as observed in our study, support this view.

[Some complications of tension-free midurethral tapes for the treatment of stress incontinence in women

NARCIS (Netherlands)

Heesakkers, J.P.F.A.; Vierhout, M.E.

2007-01-01

Complications occurred in two women of 45 and 54 years of age who were treated with tension-free midurethral sling procedures. The first woman was treated with transobturator tape due to stress incontinence and an overactive bladder. The procedure resulted in a worsening of the overactive bladder.

Treatment and Controversies in Paraesophageal Hernia Repair

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P. Marco eFisichella

2015-04-01

Full Text Available Background: Historically all paraesophageal hernias were repaired surgically, today intervention is reserved for symptomatic paraesophageal hernias. In this review, we describe the indications for repair and explore the controversies in paraesophageal hernia repair, which include a comparison of open to laparoscopic paraesophageal hernia repair, the necessity of complete sac excision, the routine performance of fundoplication, and the use of mesh for hernia repair.Methods: We searched Pubmed for papers published between 1980 and 2015 using the following keywords: hiatal hernias, paraesophageal hernias, regurgitation, dysphagia, gastroesophageal reflux disease, aspiration, GERD, endoscopy, manometry, pH monitoring, proton pump inhibitors, anemia, iron deficiency anemia, Nissen fundoplication, sac excision, mesh, mesh repair. Results: Indications for paraesophageal hernia repair have changed, and currently symptomatic paraesophageal hernias are recommended for repair. In addition, it is important not to overlook iron-deficiency anemia and pulmonary complaints, which tend to improve with repair. Current practice favors a laparoscopic approach, complete sac excision, primary crural repair with or without use of mesh, and a routine fundoplication.

Modern diagnosis and treatment of hiatal hernias.

Science.gov (United States)

Siegal, Steve R; Dolan, James P; Hunter, John G

2017-12-01

Hiatal hernias are a common finding on radiographic or endoscopic studies. Hiatal hernias may become symptomatic or, less frequently, can incarcerate or become a volvulus leading to organ ischemia. This review examines latest evidence on the diagnostic workup and management of hiatal hernias. A literature review of contemporary and latest studies with highest quality of evidence was completed. This information was examined and compiled in review format. Asymptomatic hiatal and paraesophageal hernias become symptomatic and necessitate repair at a rate of 1% per year. Watchful waiting is appropriate for asymptomatic hernias. Symptomatic hiatal hernias and those with confirmed reflux disease require operative repair with an anti-reflux procedure. Key operative steps include the following: reduction and excision of hernia sac, 3 cm of intraabdominal esophageal length, crural closure with mesh reinforcement, and an anti-reflux procedure. Repairs not amenable to key steps may undergo gastropexy and gastrostomy placement as an alternative procedure. Hiatal hernias are commonly incidental findings. When hernias become symptomatic or have reflux disease, an operative repair is required. A minimally invasive approach is safe and has improved outcomes.

Herniography off femoral, obturator and perineal hernias

International Nuclear Information System (INIS)

Ekberg, O.; Nordblom, I.; Fork, F.T.; Gullmo, A.

1985-01-01

Positive contrast herniography was used in the workup of 550 patients with unclear groin pain. The majority of these patients had rather characteristic hernias of indirect, direct or femoral type. However, now and then diagnostic problems arose. A femoral hernia may look like a direct or even obturator hernia. There is also a variety of multilocular femoral hernias and other types. A femoral hernia may be present together with other hernias in the ipsilateral or contralateral groin. Obturator hernias are usually small but are always confined to the obturator canal laterally in the obturator foramen. Abnormalities in the pouch of Douglas may include a deep rectogenital pouch, diverticula and true herniations. These uncommon herniographic findings are described and discussed. (orig.) [de

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery

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Li X-R

2011-06-01

Full Text Available Jian-Guo Wu, Rui-Hua Wei, Ai-Hua Liu, Xiao-Xu Zhou, Guo-Ling Sun, Xiao-Rong LiTianjin Medical University Eye Center, Tianjin, ChinaBackground: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.Methods: We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15. In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15. The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit.Results: Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01, and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05.Conclusion: This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.Keywords: pars plana vitrectomy, contact lens, silicone ring, cataract surgery

Traumatic lung hernia

International Nuclear Information System (INIS)

Rabaza, M. J.; Alcazar, P. P.; Touma, C.

2001-01-01

Lung hernia is an uncommon entity that is defined as the protrusion of the lung parenchyma through a defect in the thoracic cavity. It is classified on the basis of its location (cervical, intercostal and diaphragmatic) and etiology (congenital and acquired). Acquired lung hernias can be further grouped as spontaneous, traumatic or pathological, depending on the responsible mechanism. Nearly half of them are secondary to chest trauma, whether penetrating or blunt. We present a case of lung hernia in a patient with penetrating chest trauma. The diagnosis was suspected from the radiographic images and was confirmed by computed tomography. We also review the literature concerning its classification and incidence, diagnostic methods used and treatment. (Author) 9 refs

Medical image of the week: Bochdalek hernia

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Omar M

2016-06-01

Full Text Available No abstract available. Article truncated at 150 words. A 61 year-old man presented for an evaluation of a nonproductive cough. He has a history of well-controlled asthma, allergic rhinitis and nasal polyposis, hypertension, gastro-esophageal reflux and obstructive sleep apnea. The ACE inhibitor used to treat hypertension was discontinued. The physical exam was unremarkable. Pulmonary function testing was normal. A PA and lateral chest radiograph was performed and revealed an abnormal contour of the left hemidiaphragm with a large lobulated opacity (Figure 1- blue arrows. Computed chest tomography revealed the lobulated opacity in the left lower lobe contained fat and was consistent with a Bochdalek hernia (Figure 2. Congenital diaphragmatic hernia is a major malformation in newborns and in the perinatal period. The diagnosis of congenital diaphragmatic hernia in adults is rare. There are three types of congenital diaphragmatic hernias: posterolateral (Bochdalek diaphragmatic hernia, subcostosternal (Morgagni hernia and esophageal hiatal hernia. The Bochdalek diaphragmatic hernia is the result of ...

Unusual Presentation of Maydl's Hernia

African Journals Online (AJOL)

Nikhil NBA, Natarajan K, Mohanty A, et al. An. Unusual Case of Maydl's Hernia. Int J Cur Res Rev. 2013;5(6):22-5. 11. Ganesaratnam M. Maydl's hernia: Report of a Series of Seven Cases and Review of Literature. Brit J Surg. 1985;72:737-8. 12. Weledji EP, Mokake M, Ngowe MN. A Rare. Presentation of Maydl's Hernia.

[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.

The MRI findings of a de Garengeot hernia.

LENUS (Irish Health Repository)

Halpenny, D

2012-03-01

The presence of the appendix within a femoral hernia is rare. It was first described by the French surgeon Jacques Croissant de Garengeot in 1731. This phenomenon accounts for 0.8-1% of all femoral hernias. Acute appendicitis occurring within a femoral hernia is even rarer and is difficult to diagnose pre-operatively. This type of hernia is termed a de Garengeot hernia. The ultrasonographic and CT imaging features of de Garengeot hernias have been described previously. We report a case of a 57-year-old female who presented with a painful right-sided groin mass. She underwent MRI of the inguinal region, which successfully diagnosed this rare hernia pre-operatively. To our knowledge, this is the first description of a de Garengeot hernia diagnosed using MRI.

Abdominal wall hernias

DEFF Research Database (Denmark)

Henriksen, Nadia A; Mortensen, Joachim H; Lorentzen, Lea

2016-01-01

) with a history of more than 3 hernia repairs and 86, age-matched men without hernias. Biomarkers for synthesis of collagen type IV (P4NP) and type V (P5CP) as well as breakdown (C4M and C5M) were measured in serum by validated, solid-phase, competitive assays. Collagen turnover was indicated by the ratio between...

Laparoscopic inguinal hernia repair: gold standard in bilateral hernia repair? Results of more than 2800 patients in comparison to literature.

Science.gov (United States)

Wauschkuhn, Constantin Aurel; Schwarz, Jochen; Boekeler, Ulf; Bittner, Reinhard

2010-12-01

Advantages and disadvantages of open and endoscopic hernia surgery are still being discussed. Until now there has been no study that evaluated the advantages and disadvantages of bilateral hernia repair in a large number of patients. Our prospectively collected database was analyzed to compare the results of laparoscopic bilateral with laparoscopic unilateral hernia repair. We then compared these results with the results of a literature review regarding open and laparoscopic bilateral hernia repair. From April 1993 to December 2007 there were 7240 patients with unilateral primary hernia (PH) and 2880 patients with bilateral hernia (5760 hernias) who underwent laparoscopic transabdominal preperitoneal patch plastic (TAPP). Of the 10,120 patients, 28.5% had bilateral hernias. Adjusted for the number of patients operated on, the mean duration of surgery for unilateral hernia repair was shorter than that for bilateral repair (45 vs. 70 min), but period of disability (14 vs. 14 days) was the same. Adjusted for the number of hernias repaired, morbidity (1.9 vs. 1.4%), reoperation (0.5 vs. 0.43%), and recurrence rate (0.63 vs. 0.42%) were similar for unilateral versus bilateral repair, respectively. The review of the literature shows a significantly shorter time out of work after laparoscopic bilateral repair than after the bilateral open approach. Simultaneous laparoscopic repair of bilateral inguinal hernias does not increase the risk for the patient and has an equal length of down time compared with unilateral repair. According to literature, recovery after laparoscopic repair is faster than after open simultaneous repair. Laparoscopic/endoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

Abdominal wall hernias: computed tomography findings

International Nuclear Information System (INIS)

D'Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo.

2005-01-01

Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

An Unusual Trocar Site Hernia after Prostatectomy

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Ryan K. Schmocker

2016-01-01

Full Text Available Trocar site hernias are rare complications after laparoscopic surgery but most commonly occur at larger trocar sites placed at the umbilicus. With increased utilization of the laparoscopic approach the incidence of trocar site hernia is increasing. We report a case of a trocar site hernia following an otherwise uncomplicated robotic prostatectomy at a 12 mm right lower quadrant port. The vermiform appendix was incarcerated within the trocar site hernia. Subsequent appendectomy and primary repair of the hernia were performed without complication.

Study of modified two incisions silicone oil removal with a 23G transconjunctival sutureless vitrectomy system

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Hai-Jun Yang

2015-01-01

Full Text Available AIM:To evaluate the efficacy and safety of silicone oil removal with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip. METHODS: The suction tip was made with a 23G infusion tube be cut from the end of the 5mm. It was used to connect the disposable transfusion tube and 23G puncture cannula. The disposable transfusion tube which was cut from the end of the MaiFei's pipe was connected with the effusion box of the vitreous cutter. Intraocular silicone oil was proactive suction and removed through two incisions on pars plana ciliaris with the vitreous cutter suction system. RESULTS: Only 13 cases(9.8%need suture puncture ports in 132 cases in the operation. Operation time was 7-28min. The average operation time was 15.1± 6.2min. In early postoperative, there were 107 cases(81.1%appeared lower intraocular pressure(CONCLUSION: The surgery that silicone oil is removed through two incisions with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip has the advantages of safe, effective, fast, economic, and it is worthy of popularization and application in clinical.

Hernia Following Blunt Abdominal Trauma

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N Aghaie

2009-10-01

Full Text Available Traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed. Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.

The operation of giant incisional hernia

DEFF Research Database (Denmark)

Eriksson, Axelina; Krag, Christen; Jørgensen, Lars Nannestad

2014-01-01

Incisional hernia is a common complication to laparotomy impacting negatively on quality of life, risk of emergency surgery and cosmesis. The operation of giant incisional hernia (cross diameter of hernia defect > 20 cm) is a high risk procedure and the surgical techniques are not based on high...

Congenital transmesenteric hernia presenting as neonatal ascites

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Andreia Felizes

2018-01-01

Full Text Available Transmesenteric hernia is an internal hernia without sac, which forms through a congenital mesentery defect. Mostly diagnosed intraoperatively, it as a variable prognosis, which can lead to high morbidity and mortality.The authors describe a case of transmesenteric hernia that presented as isolated fetal ascites. A 34 week preterm baby was delivered by forceps, with respiratory compromise due to abdominal distension. Orotracheal intubation and evacuation paracentesis were performed. After excluding major causes of neonatal ascites and persistent bowel loop distension, the newborn underwent an exploratory laparotomy, where a transmesenteric hernia and pellets of meconium were identified. Hernia reduction, enterectomy and enterostomies were performed, with good outcome. Cystic fibrosis was diagnosed during post-operatory period.This is the first reported case of transmesenteric hernia presenting as fetal ascites, without associated morbidity or mortality due to an early intervention. Keywords: Transmesenteric hernia, Fetal ascites, Cystic fibrosis

An Elderly Male with Amyand’s Hernia

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Saema Said

2017-09-01

Full Text Available History of present illness: A 67-year-old male, with a history of diabetes, coronary artery disease, and chronic kidney disease, presented with two weeks of a new right inguinal bulge and right lower quadrant abdominal pain extending to the groin. He denied nausea, vomiting, fever, and changes in bowel movement. His initial vital signs were: temperature 37.4°C, blood pressure 142/100, heart rate 62, and respiratory rate 18. Physical examination revealed mild right lower quadrant abdominal tenderness, right inguinal and testicular tenderness and swelling, and a non-reducible bulging inguinal mass with no overlying skin changes. Lab results showed a leukocytosis of 13.6. Significant findings: Ultrasound of the right scrotum shows a right inguinal hernia with an air-containing loop of bowel (white arrow and a non-compressible appendix (yellow arrow. Coronal and axial views of abdomen-pelvis CT show a right inguinal hernia containing a loop of small bowel (white arrow and appendix (yellow arrow. Discussion: In the case presented above, ultrasound and abdomen and pelvis computed tomography (CT showed an Amyand’s hernia. The patient was taken emergently to surgery, which revealed an incarcerated right inguinal hernia with perforated appendicitis in the hernia sac. The patient underwent an appendectomy and hernia repair, and had no post-surgical complications. Amyand’s hernia is a form of inguinal hernia characterized by the presence of the appendix in the hernia sac. The hernia may be reducible, incarcerated, or strangulated; and the appendix may be normal, inflamed, or perforated.1 The patient presented above had an incarcerated hernia with no overlying skin changes suggestive of strangulation. Amyand’s hernia accounts for 0.4-1% of all inguinal hernias and 0.1% of all cases of appendicitis.2 It is thought to be due to patency of the processus vaginalis, and as such occurs more frequently in young children.1,2,3 Clinical diagnosis of Amyand�

Rare Case of Large Bowel Injury due to Direct Blunt Trauma to a Preexisting Femoral Hernia

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C. Tinner

2017-01-01

Full Text Available We report a case of an 85-year-old man with a known asymptomatic left femoral hernia who was admitted to the emergency ward a few hours after falling from a bicycle and suffering from blunt trauma of the handlebar to the left inguinal region. The clinical findings and a computed tomography (CT scan detecting free air in the femoral hernia sac suggested bowel perforation. Emergency laparotomy 6 hours after the incident confirmed a tear of the sigmoid colon accompanied by free blood and faeces in the left inguinal region of the abdomen. A segmental sigmoid resection and a primary end-to-end colorectal anastomosis were performed. The postoperative course was complicated by delayed oral feeding, a local infection, and a partial left testicle necrosis that led to secondary resection. The patient was discharged after 32 days of in-hospital care. Three months post trauma, we recorded a restitutio ad integrum. The case exemplifies that blunt trauma to preexisting femoral hernias may cause potentially lethal bowel perforation and that the time interval between time of injury and surgical treatment may be a prognostic factor. CT scans seem most suitable for ruling out bowel perforation. The scarce literature for blunt trauma to hernias is reviewed.

Colon Perforations Causing Morgagni Hernia Case

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Mustafa Ugur

2014-08-01

Full Text Available Herniation of the intraabdominal organs through a diaphragmatic defect that occurs due to the joining anomaly of the sternal and costal segments of diaphragm is known as Morgagni Hernia. Although most of the patients with Morgagni Hernia are asymptomatic, intestinal obstruction, incarceration and strangulation can rarely occur. An 83 years old female patient admitted with acute abdomen to our clinic. Morgagni hernia was detected with preoperative thoracic and abdominal computed tomography. We aimed to present our management in Morgagni Hernia in this study.

Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

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Huang Zhang

2014-09-01

Full Text Available AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.METHODS:Totally 22 cases(22 eyeswith superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope. RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea

Athletic pubalgia (sports hernia).

Science.gov (United States)

Litwin, Demetrius E M; Sneider, Erica B; McEnaney, Patrick M; Busconi, Brian D

2011-04-01

Athletic pubalgia or sports hernia is a syndrome of chronic lower abdomen and groin pain that may occur in athletes and nonathletes. Because the differential diagnosis of chronic lower abdomen and groin pain is so broad, only a small number of patients with chronic lower abdomen and groin pain fulfill the diagnostic criteria of athletic pubalgia (sports hernia). The literature published to date regarding the cause, pathogenesis, diagnosis, and treatment of sports hernias is confusing. This article summarizes the current information and our present approach to this chronic lower abdomen and groin pain syndrome. Copyright © 2011 Elsevier Inc. All rights reserved.

Laparoscopic Repair of Inguinal Hernias

OpenAIRE

Carter, Jonathan; Duh, Quan-Yang

2011-01-01

For patients with recurrent inguinal hernia, or bilateral inguinal hernia, or for women, laparoscopic repair offers significant advantages over open techniques with regard to recurrence risk, pain, and recovery. For unilateral first-time hernias, either laparoscopic or open repair with mesh can offer excellent results. The major drawback of laparoscopy is that the technique requires a significant number of cases to master. For surgeons in group practice, it makes sense to have one surgeon in ...

The clinical effects of closure of the hernia gap after laparoscopic ventral hernia repair:

DEFF Research Database (Denmark)

Christoffersen, Mette W; Westen, Mikkel; Assadzadeh, Sami

2014-01-01

randomised controlled trials. The primary purpose of this paper is to compare early post-operative activity-related pain in patients undergoing laparoscopic ventral hernia repair with closure of the gap with patients undergoing standard laparoscopic ventral hernia repair (non-closure of the gap). Secondary...... outcomes are patient-rated cosmesis and hernia-specific quality of life. METHODS: A randomised, controlled, double-blinded study is planned. Based on power calculation, we will include 40 patients in each arm. Patients undergoing elective laparoscopic umbilical, epigastric or umbilical trocar-site hernia...... repair at Hvidovre Hospital and Herlev Hospital, Denmark, are invited to participate. CONCLUSION: The gap closure technique may induce more post-operative pain than the non-closure repair, but it may also be superior with regard to other important surgical outcomes. No studies have previously...

Sutureless, Glueless, Scleral Fixation of Single-Piece and Toric Intraocular Lens: A Novel Technique

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Aditya Kelkar

2015-07-01

Full Text Available Sutureless, glueless, scleral fixation of an intraocular lens is a known technique of fixing a lens in the scleral pockets. However, this technique is applied to single-piece and toric lenses instead of 3-piece lenses, allowing the advantage of the use of premium lenses in patients with poor capsular support. Favourable results without complications of pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage and cystoid macular edema with a well-centered, stable intraocular lens have been observed in the 3-month postoperative period in both cases.

Congenital posterolateral diaphragmatic hernia : pathophysiological studies and clinical picture

NARCIS (Netherlands)

A.P. Bos (Albert)

1993-01-01

textabstractCongenital diaphragmatic hernias are classified according to the location of the defect: posterolateral hernia with or without a sac (Bochdalek-type), parasternal hernia through the foramen of Morgagni, central hernia, and diaphragmatic eventration. The so-called hiatal hernia has a

A rare case report of Morgagni Hernia with Organo-Axial Gastric Volvulus and concomitant Para-esophageal hernia, repaired laparoscopically in a Septuagenarian

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Amol Mittal

Full Text Available Introduction: Simultaneous occurrence of Morgagni and the Para-esophageal hernia is a rare clinical condition with eight case reports in the English-language literature and only four managed laparoscopically. We describe a case of a Septuagenarian patient with Morgagni and concomitant Para-esophageal hernia treated laparoscopically. Presentation of a case: A 71-year-old male patient, presented with a one-month history of regurgitation of acid, retrosternal burning and vomiting after eating. Computed tomography (CT imaging demonstrated a large anterior diaphragmatic hernia, with herniation of bowel loops and anterosuperior displacement of the gastric antrum along with a grade III Para-esophageal hernia. The patient underwent simultaneous laparoscopic repair of Morgagni and Para-esophageal hernia with mesh reinforcement with Nissen’s total anti-reflux fundoplication. The patient’s postoperative recovery was uneventful. Discussion: A Morgagni Hernia is a rare congenital condition consisting of a Subcosto-sternal defect in the diaphragm. A Para-esophageal hernia is a rare variant of a hiatus hernia. Morgagni and Para-esophageal hernia may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The laparoscopic operation can provide excellent exposure and repair the hernia defect easily with minimal invasiveness and fewer complications. Conclusion: This case report highlights the co-existence of Morgagni and Para-esophageal hernias and validates the feasibility of laparoscopic repair of both hernias simultaneously. Keywords: Diaphragmatic hernia, Morgagni, Para-esophageal hernia, Minimally invasive surgery, Fundoplication, Case report

Sliding hiatal hernia in dogs

OpenAIRE

JOLANTA SPUŻAK; KRZYSZTOF KUBIAK; MARCIN JANKOWSKI; MACIEJ GRZEGORY; KAMILA GLIŃSKA-SUCHOCKA; JÓZEF NICPOŃ; VASYL VLIZLO; IGOR MAKSYMOVYCH

2010-01-01

Introduction Sliding hiatal hernia is a disorder resulting from a displacement of the abdominal part of the oesophagus and/or a part of the stomach into the thoracic cavity through the oesophageal hiatus of the diaphragm. The disorder may be congenital or acquired. Congenital hernia follows disturbances in the embryonic development. In the literature the predisposition to congenital sliding hiatal hernia is observed in the dogs of shar-pei and chow-chow breeds. Pathogenesis of acquired slidin...

Sigmoid Volvulus Through a Transmesenteric Hernia.

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Brandão, Pedro Nuno; Martins, Vilma; Silva, Cristina; Davide, José

2017-06-01

Internal hernias are a rare pathology with very low incidence. Transmesenteric hernias represent less than 10% of all cases and may occur at any age. They involve more often the small bowel and, more rarely, the colon. We present a case of a sigmoid volvulus through a transmesenteric hernia in a 19-year-old patient.

Tension-free vaginal taping in pakistani women with stress urinary incontinence

International Nuclear Information System (INIS)

Saleem, A.

2017-01-01

To evaluate the effectiveness and determine the peroperative and postoperative complications of tension-free vaginal tape (TVT) sling for urinary stress incontinence (USI) and contributing factors to complications. Study Design: Descriptive study. Place and Duration of Study: Kidney Centre Postgraduate Institute, Karachi, from January 2009 to December 2010. Methodology: One hundred consecutive patients underwent TVT as per Ulmsten Technique for urinary stress incontinence and patients were followed for 3 years. The subjective cure rate and improvement rate was based on the international consultation on incontinence questionnaire for evaluating female lower urinary tract symptoms (ICIQ - FLUS). The subjective cure was defined as the statement of the woman not experiencing any loss of urine upon physical stress and improvement rate was defined as occasional leakage during stress. Results: Patients at 1- and 3-year up follow-up showed subjective cure rate and improvement rate of 98% and 2%, and 95% and 5%, respectively. Mean operative time was 32 minutes. UTI was the commonest complication observed in 7 (7%) patients. Women with voiding dysfunction preoperatively had 9-fold odds of difficulty postoperatively (0<0.001). There was a significant association of preoperative symptoms of overactive bladder (OAB) with the same postoperative symptoms (p<0.0001). Preoperative hysterectomy had a significant (p< 0.005) 15.63 fold odds of intraoperative bladder perforation. Conclusion: Tension-free vaginal tape sling is an efficacious and secure surgical procedure for the treatment of urinary stress incontinence. Bladder perforation, voiding dysfunction, supra-pubic discomfort and UTI are the commonest complications. Risk factors for perforation include preoperative hysterectomy. Pre-existing voiding dysfunction and UTI lead to persistent similar postoperative problems. (author)

Umbilical hernia repair - series (image)

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... treatment. The indications for umbilical hernia repair include: incarcerated (strangulated) umbilical hernia defects not spontaneously closed by 4 to 5 years of age children under 2 with very large defects unacceptable to ...

Inguinal Hernia in Athletes: Role of Dynamic Ultrasound.

Science.gov (United States)

Vasileff, William Kelton; Nekhline, Mikhail; Kolowich, Patricia A; Talpos, Gary B; Eyler, Willam R; van Holsbeeck, Marnix

Inguinal hernia is a commonly encountered cause of pain in athletes. Because of the anatomic complexity, lack of standard imaging, and the dynamic condition, there is no unified opinion explaining its underlying pathology. Athletes with persistent groin pain would have a high prevalence of inguinal hernia with dynamic ultrasound, and herniorrhaphy would successfully return athletes to activity. Case-control study. Level 3. Forty-seven amateur and professional athletes with sports-related groin pain who underwent ultrasound were selected based on history and examination. Patients with prior groin surgery or hip pathology were excluded. Clinical and surgical documentation were correlated with imaging. The study group was compared with 41 age-matched asymptomatic athletes. Ultrasound was positive for hernia with movement of bowel, bladder, or omental tissue anterior to the inferior epigastric vessels during Valsalva maneuver. The 47-patient symptomatic study group included 41 patients with direct inguinal hernias, 1 with indirect inguinal hernia, and 5 with negative ultrasound. Of 42 patients with hernia, 39 significantly improved with herniorrhaphy, 2 failed to improve after surgery and were diagnosed with adductor longus tears, and 1 improved with physical therapy. Five patients with negative ultrasound underwent magnetic resonance imaging and were diagnosed with hip labral tear or osteitis pubis. The 41-patient asymptomatic control group included 3 patients with direct inguinal hernias, 2 with indirect inguinal hernias, and 3 with femoral hernias. Inguinal hernias are a major component of groin pain in athletes. Prevalence of direct inguinal hernia in symptomatic athletes was greater than that for controls ( P < 0.001). Surgery was successful in returning these athletes to sport: 39 of 42 (93%) athletes with groin pain and inguinal hernia became asymptomatic. Persistent groin pain in the athlete may relate to inguinal hernia, which can be diagnosed with dynamic

Effect of mitomycin-c-assisted sutureless trabeculectomy on keratometry and axial length

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Anant Sharma

2017-01-01

Full Text Available Aim: Glaucoma is defined as chronic, progressive optic neuropathy caused by a group of ocular conditions, which leads to damage of the optic nerve with loss of visual function. This study was conducted to find out the changes in corneal curvature, axial length and intraocular pressure. Materials and Methods: The present study was conducted in the Department of Ophthalmology, S P Medical College and Associated Group of Hospitals, Bikaner. A total of fifty cases of either age- and sex-matched controls were selected for this study. These cases were divided into two groups: Group A (sutureless trabeculectomy with mitomycin-C [MMC] and Group B (sutureless trabeculectomy without MMC. Results: The mean post-operative intraocular pressure (IOP was lowered in MMC-treated eyes when compared to control at 1½ months. The IOP reduction was greater in the MMC-treated eyes (13.25 mmHg at 1½ months as compared to control Group B (16.9 mmHg at 1½ months. Comparing results with the present study, it was found that success rate in MMC-treated eyes was noted in 23 (92% individuals, in which complete success was in 22 (88% while qualified success in 1 (4% and qualified failure in 2 (8% with mean IOP of 13.2 mmHg at 1½ months, whereas in control group, success rate was noted in 19 (76% individuals, in which complete success was in 18 (72% and qualified success in 1 (4%, while qualified failure in 6 (24% with mean IOP of 16.9 mmHg at 1½ months after operation. Conclusion: Results of this study are in favour of intraoperative application of MMC during filtration surgery, especially in cases with high-risk failure.

Bochdalek Hernia with Adult Diaphragmatic Agenesis

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Erkan Akar

2013-10-01

Full Text Available    Diaphragmatic hernia arises from pleuro-peritoneal membranes inability to close pericardioperitoneal membranes. Diaphragmatic defect may be located in esophageal hiatus (hiatal hernia, nearby the hiatus (paraesophageal, retrosternal (Morgagni or posterolateral (Bochdalek. Congenital diaphragmatic hernias (CDH diagnosed after neonatal period are defined as late presenting CDH. This group of patients consist 5-31% of CDHs and lead to diagnostic difficulties. A case of adult type Bochdalek hernia who was admitted to our clinic with respiratory problems and recognized late with the absence of left diaphragm was discussed in the light of clinical and surgical methods.

Laparoscopic repair of postoperative perineal hernia.

LENUS (Irish Health Repository)

Ryan, Stephen

2010-01-01

Perineal hernias are infrequent complications following abdominoperineal operations. Various approaches have been described for repair of perineal hernias including open transabdominal, transperineal or combined abdominoperineal repairs. The use of laparoscopic transabdominal repair of perineal hernias is not well-described. We present a case report demonstrating the benefits of laparoscopic repair of perineal hernia following previous laparoscopic abdominoperineal resection (APR) using a nonabsorbable mesh to repair the defect. We have demonstrated that the use of laparoscopy with repair of the pelvic floor defect using a non absorbable synthetic mesh offers an excellent alternative with many potential advantages over open transabdominal and transperineal repairs.

The Danish Inguinal Hernia database

DEFF Research Database (Denmark)

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...... 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...

Two Ports Laparoscopic Inguinal Hernia Repair in Children

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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.

Comparing effectiveness of combined transobturator tension-free vaginal mesh (Perigee) and transobturator tension-free vaginal tape (TVT-O) versus anterior colporrhaphy and TVT-O for associated cystocele and urodynamic stress incontinence.

Science.gov (United States)

Lau, Hei-Yu; Twu, Nae-Fang; Chen, Yi-Jen; Horng, Huann-Cheng; Juang, Chi-Mou; Chao, Kuan-Chong

2011-06-01

To evaluate the efficacy and safety of transobturator tension-free vaginal mesh (Perigee) and concomitant transobturator tension-free vaginal tape (TVT-O) for treating cystocele with urodynamic stress incontinence (UDSI). A retrospective study of 115 patients with symptomatic stages 2-3 cystocele and UDSI who were treated with a Perigee system (Group I, n=68) plus TVT-O procedure or traditional anterior colporrhaphy (Group II, n=47) plus TVT-O procedure. All patients were followed up for more than one year. Objective and subjective symptoms were evaluated at one year postoperatively. Statistical analysis was performed using SPSS software. The objective cure rates for cystocele at one year were significantly higher in Group I than in Group II (98.5% and 86.9%, P=0.018), respectively. The cure rates for UDSI in the two groups were 91.0% vs. 91.3% (P=1.000). Symptomatic improvement of frequency was better in Group I than Group II (87.7% vs. 70.0%, P=0.030). There were no significant differences with regard to intraoperative and postoperative complications between the two groups. The combination of the Perigee system and TVT-O offers a safe and effective treatment for cystocele with UDSI and may be performed as first-line treatment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Laparoscopic Inguinal Hernia Repair in a Developing Nation: Short ...

African Journals Online (AJOL)

bilateral hernias, and recurrent hernias), there are data demonstrating an ... no reports of laparoscopic inguinal hernia repair from the. Anglophone ... MATERIALS AND METHODS .... inguinal hernia repair has advantages over open repair for.

Inguinal hernia vs. arthritis of the hip in sporting adolescents--case report and review of the literature.

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Holzheimer, R G; Gresser, U

2007-07-26

Chronic pain in the hip, groin or thigh can be caused by a wide spectrum of diseases posing extended diagnostic problems. We describe the case of a 10-years old child with chronic pain in the groin with gait restriction for more than six months without successful classification and treatment. The girl suffered from heavy pain in the groin after a sporting contest which forced her to walk with walking sticks and to avoid climbing stairs. Within six months she was examined by pediatric, orthopedic, pediatric surgery, pediatric orthopedic, radiology, pediatric rheumatology specialists. Working diagnoses were transient synovitis (coxitis fugax), arthritis, streptococcal arthritis, Morbus Perthes, rheumatic fever, rheumatoid arthritis. She was treated with antibiotics and ibuprofen in high dosage. Repeated laboratory tests and imaging studies (ultrasound, x-rays, magnetic resonance imaging) of the hip and pelvis did not support any of these diagnoses. Six months after beginning of the complaints the girl was presented by her mother to our institution. The physical examination showed a sharp localized pain in the groin, just in the region of the inguinal ligament with otherwise free hip movement. There was no visible inguinal hernia. The family history for hernia was positive. After infiltration of the ilioinguinal nerve the girl had a complete long-lasting disappearance of pain and gait disturbance. This led to the diagnosis of inguinal hernia with nerve entrapment. After hernia repair and neurolysis/neurectomy there was a continuous state of disappearance of pain and gait disturbances. To avoid such a diagnostic dilemma one should always discuss all possible causes. Non-visible inguinal hernia may be more common in females than previously thought. Nerve entrapment as a cause of groin pain has been well described. The relationship of the start of complaints with sporting activity, a positive family history for inguinal hernia, a lack of signs of inflammation and bone

Stomal Closure: Strategies to Prevent Incisional Hernia

Science.gov (United States)

Harries, Rhiannon L.; Torkington, Jared

2018-01-01

Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias. PMID:29670882

Stomal Closure: Strategies to Prevent Incisional Hernia

Directory of Open Access Journals (Sweden)

Rhiannon L. Harries

2018-04-01

Full Text Available Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias.

Initial experience of laparoscopic incisional hernia repair.

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Razman, J; Shaharin, S; Lukman, M R; Sukumar, N; Jasmi, A Y

2006-06-01

Laparoscopic repair of ventral and incisional hernia has become increasingly popular as compared to open repair. The procedure has the advantages of minimal access surgery, reduction of post operative pain and the recurrence rate. A prospective study of laparoscopic incisional hernia repair was performed in our center from August 2002 to April 2004. Eighteen cases (n: 18) were performed during the study period. Fifteen cases (n: 15) had open hernia repair previously. Sixteen patients (n: 16) had successful repair of the hernia with the laparoscopic approach and two cases were converted to open repair. The mean hernia defect size was 156cm2. There was no intraoperative or immediate postoperative complication. The mean operating time was 100 +/- 34 minutes (75 - 180 minutes). The postoperative pain was graded as mild to moderate according to visual analogue score. The mean day of discharge after surgery was two days (1 - 3 days). During follow up, three patients (16.7%) developed seroma at the hernia sac which was resolved with conservative management after three weeks. One (5.6%) patient developed recurrence six months after surgery. In conclusion, laparoscopic repair of incisional hernia particularly recurrent hernia has been shown to be safe and effective in our centre. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.

Paraduodenal hernia. A case report

International Nuclear Information System (INIS)

Irion, K.L.

1989-01-01

The authors present a case of right paraduodenal hernia and a brief review of the embriology and anatomy of the paraduodenal fossae as well as of the clinical signs, symptoms and radiologic aspects of paraduodenal hernias. (author) [pt

Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device

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Tetsuro Uchida, MD, PhD

2017-12-01

Full Text Available Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif to create the proximal anastomosis, eliminating the need for aortic clamping. This system is thought to make direct proximal aortic anastomosis safe and easy in patients requiring surgical reconstruction of celiac artery aneurysms.

Comparison of three mid-urethral tension-free tapes (TVT, TVT-O, and TVT-Secur) in the treatment of female stress urinary incontinence: 1-year follow-up.

Science.gov (United States)

Wang, Yi-jun; Li, Fei-ping; Wang, Qian; Yang, Sen; Cai, Xian-guo; Chen, Ying-he

2011-11-01

The purpose of the study was to evaluate and compare the clinical values of tension-free vaginal tape (TVT), tension-free vaginal tape-transobturator (TVT-O), or tension-free vaginal tape-Secur (TVT-Secur) as treatment for female stress urinary incontinence. The pre-operative and 1-year post-operative follow-up protocols for patients who were treated with serial mid-urethral tension-free tape procedures in two hospitals from October 2008 to December 2009 were prospectively studied. These patients were randomly allocated to TVT, TVT-O, or TVT-Secur. A total of 102 women participated. At the 1-year follow-up, complications were not statistically different across the three groups except for pain in the thigh, which was more common in the TVT-O group. The overall efficacy and cure rate were similar between the TVT and TVT-O groups, but were significantly lower in the TVT-Secur group. A comparison of the three procedures shows that TVT-O is easy to operate and is as safe as TVT-Secur, and it has similar long-term efficacy to TVT, though, as one of the third-generation mid-urethral tension-free tapes, TVT-Secur is still being evaluated. Basing on the outcome of our study, it had rare complications but unsatisfactory efficacy, and we suggest that TVT-Secur is not fit for severe cases. However, observation and comparison of these groups in a larger sample size on a longer term are needed.

Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres?

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Cheong, Kai Xiong; Lo, Hong Yee; Neo, Jun Xiang Andy; Appasamy, Vijayan; Chiu, Ming Terk

2014-04-01

We aimed to report the outcomes of inguinal hernia repair performed at Tan Tock Seng Hospital and compare them with those performed at dedicated hernia centres. We retrospectively analysed the medical records and telephone interviews of 520 patients who underwent inguinal hernia repair in 2010. The majority of the patients were male (498 [95.8%] men vs. 22 [4.2%] women). The mean age was 59.9 ± 15.7 years. Most patients (n = 445, 85.6%) had unilateral hernias (25.8% direct, 64.3% indirect, 9.9% pantaloon). The overall recurrence rate was 3.8%, with a mean time to recurrence of 12.0 ± 8.6 months. Risk factors for recurrence included contaminated wounds (odds ratio [OR] 50.325; p = 0.004), female gender (OR 8.757; p = 0.003) and pantaloon hernias (OR 5.059; p = 0.013). Complication rates were as follows: chronic pain syndrome (1.2%), hypoaesthesia (5.2%), wound dehiscence (0.4%), infection (0.6%), haematoma/seroma (4.8%), urinary retention (1.3%) and intraoperative visceral injury (0.6%). Most procedures were open repairs (67.7%), and laparoscopic repair constituted 32.3% of all the inguinal hernia repairs. Open repairs resulted in longer operating times than laparoscopic repairs (86.6 mins vs. 71.6 mins; p hospital stays (2.7 days vs. 0.7 days; p = 0.020) and a higher incidence of post-repair hypoaesthesia (6.8% vs. 1.8%; p = 0.018). However, there were no significant differences in recurrence or other complications between open and laparoscopic repair. A general hospital with strict protocols and teaching methodologies can achieve inguinal hernia repair outcomes comparable to those of dedicated hernia centres.

Obturator Neuralgia: A Rare Complication of Tension-free Vaginal Tape Sling-Complete Resolution After Laparoscopic Tension-free Vaginal Tape Removal.

Science.gov (United States)

Miklos, John R; Moore, Robert D; Chinthakanan, Orawee

2015-01-01

To show a technique of retropubic tension-free vaginal tape (TVT) removal using both a transvaginal and laparoscopic approach in the treatment of a rare condition, obturator neuralgia. A step-by-step explanation of the patient's condition, diagnosis, surgical technique, and postoperative results using video, pictures, and medical illustrations (education video). TVT retropubic slings have become the gold standard for the treatment of stress urine incontinence over the last decade. Despite high cure rates, the TVT is not without potential complications. Typical complications include urine retention, incomplete bladder emptying, frequency, urgency, urethral erosion, vaginal extrusion, vaginal pain, and dyspareunia. The most common complication for sling removal/revision is chronic pain. The TVT obturator neuralgia is a rare and specific type of chronic pain that is normally associated with transobturator tape slings. The purpose of this video is to present an extremely rare complication of TVT retropubic slings, present symptoms and signs of obturator nerve compression, show the normal and the actual position of this patient's TVT sling, describe the laparoscopic removal of the TVT sling, and present the postoperative course and resolution of the patient's pain. The patient signed a release for her video to be used for educational and teaching purposes. A combined transvaginal and laparoscopic approach in a patient with lower abdominal, levator, and obturator-type pain after a TVT retropubic procedure. In patients suffering from obturator neuralgia after a retropubic sling, surgeons should include the sling as a potential causative factor in the differential diagnosis. Surgeons should consider removing the sling based on the patient's symptoms. If the patient suffers from only vaginal pain and dyspareunia, then the surgeon should consider only the removal of the vaginal portion of the sling. In patients with obturator neuralgia, retropubic, and/or lower abdominal

Low Spigelian hernia in a 6-year-old boy presenting as an incarcerated inguinal hernia: a case report

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Christianakis Efstratios

2009-01-01

Full Text Available Abstract Introduction Lower Spigelian hernia is a very rare entity. The clinical findings are similar to those of inguinal hernias and in many cases may be misdiagnosed. In the literature, only a few references to this entity have been reported in children. To the best of our knowledge, this is the first case report of a lower Spigelian hernia in a child who presented with an acute painful scrotum. Case presentation We discuss the case of a 6-year-old Greek boy who presented to our emergency department complaining of severe pain in the left inguinal area and scrotum. The acute painful swelling started suddenly, without any obvious cause. The initial diagnosis was incarcerated inguinal hernia which was reduced with difficulty. Five days later, the patient still experienced mild pain during palpation and he was operated on. During the operation, a large lower Spigelian hernia was revealed and reconstructed. Conclusion Although Spigelian hernias are rare in children and difficult to diagnose, physicians should be aware of them and include them in the differential diagnosis.

Male Fertility After Inguinal Hernia Mesh Repair

DEFF Research Database (Denmark)

Kohl, Andreas Pagh; Andresen, Kristoffer; Rosenberg, Jacob

2017-01-01

OBJECTIVE:: To determine whether patients who receive an inguinal hernia repair father the same number of children as the background population. BACKGROUND:: Although the effect of inguinal hernia repair on male fertility has previously been investigated through indirect measures, no previous...... studies have evaluated the final measure of male fertility, which is the number of children fathered by patients. METHODS:: Prospectively collected data on 32,621 male patients between the ages of 18 and 55 years who received 1 or more inguinal hernia repairs during the years 1998 to 2012 were found in 5...... hernia repair using Lichtenstein technique or laparoscopic approach did not father fewer children than expected. Thus, inguinal hernia repair using Lichtenstein or laparoscopic approach did not impair male fertility....

Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography

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Husam Vehbi

2016-06-01

Full Text Available Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far.In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan. Keywords: Amyand's hernia, Appendicitis

Posterolateral diaphragmatic hernia with small-bowel incarceration ...

African Journals Online (AJOL)

Bochdalek hernia (BH), a closing defect of the peripheral posterior aspect of the diaphragm, is the most common of the congenital diaphragmatic hernias and is usually diagnosed in neonates. Symptomatic presentation of a right-sided diaphragmatic hernia in an adult is unusual. Owing to their rarity and varied presentation, ...

Radiographic observation of congenital diaphragmatic hernia

International Nuclear Information System (INIS)

Rhee, Chung Sik

1973-01-01

Five cases of congenital diaphragmatic hernia. Case 1: A female infant, birth weight 2.25 kg, Apgar score 10, normal delivery at 11:33 P.M. on Feb.8, 1972. Lt side congenital diaphragmatic hernia. Case 2: A female infant, birth weight 1.48 kg, Apgar score 5, normal delivery at 11:20 A.M. on Oct.14, 1972. Lt. side congenital diaphragmatic hernia. This infant was twin. this infant's mother was toxemia. Case 3; A 33 years old women was admitted to the our hospital because of Lt.hip joint pain without other symptoms. Date of admission: Jan. 8, 1973. Rt side congenital diaphragmentic hernia. Case 4: A 4 month infant male was admitted to the our hospital because of vomiting, dyspnea and abdominal pain. He had cyanosis intermittently after one month ago. This infant was normal delivered. The family history was not contributory. Date of admission: This infant was normal delivered. The family history was not contributory. Date of admission: Aug. 30, 1971. Rt side congenital diaphragmatic hernia. Case 5: A 13 years old girl was admitted to our hospital because of general weakness without other symptoms. This patient was normal delivered. The family history was not contributory. Date of admission: March. 15, 1973. Lt. side congenital diaphragmentic hernia

Radiographic observation of congenital diaphragmatic hernia

Energy Technology Data Exchange (ETDEWEB)

Rhee, Chung Sik [Ewha Women' s University College of Medicine, Seoul (Korea, Republic of)

1973-12-15

Five cases of congenital diaphragmatic hernia. Case 1: A female infant, birth weight 2.25 kg, Apgar score 10, normal delivery at 11:33 P.M. on Feb.8, 1972. Lt side congenital diaphragmatic hernia. Case 2: A female infant, birth weight 1.48 kg, Apgar score 5, normal delivery at 11:20 A.M. on Oct.14, 1972. Lt. side congenital diaphragmatic hernia. This infant was twin. this infant's mother was toxemia. Case 3; A 33 years old women was admitted to the our hospital because of Lt.hip joint pain without other symptoms. Date of admission: Jan. 8, 1973. Rt side congenital diaphragmentic hernia. Case 4: A 4 month infant male was admitted to the our hospital because of vomiting, dyspnea and abdominal pain. He had cyanosis intermittently after one month ago. This infant was normal delivered. The family history was not contributory. Date of admission: This infant was normal delivered. The family history was not contributory. Date of admission: Aug. 30, 1971. Rt side congenital diaphragmatic hernia. Case 5: A 13 years old girl was admitted to our hospital because of general weakness without other symptoms. This patient was normal delivered. The family history was not contributory. Date of admission: March. 15, 1973. Lt. side congenital diaphragmentic hernia.

One-stop endoscopic hernia surgery: efficient and satisfactory.

Science.gov (United States)

Voorbrood, C E H; Burgmans, J P J; Clevers, G J; Davids, P H P; Verleisdonk, E J M M; Schouten, N; van Dalen, T

2015-06-01

One-stop surgery offers patients diagnostic work-up and subsequent surgical treatment on the same day. In the present study, patient satisfaction and efficiency from an institutional perspective were evaluated in patients who were referred for one-stop endoscopic inguinal hernia repair. In a high-volume inguinal hernia clinic, all consecutive patients referred for one-stop surgical treatment, were registered prospectively. An instructed secretary screened patients for eligibility for the one-stop option when the appointment was made. Totally extraperitoneal hernia repair under general anaesthesia was the preferred operative technique. Patient's satisfaction, successful day surgery and institutional efficiency were evaluated. Between January 2010 and January 2012 a total of 349 patients (17 % of all patients in the hernia clinic) were referred for one-stop hernia repair. Mean age was 47.5 years and 96.3 % were males. Three hundred thirty-six patients underwent hernia surgery on the same day (96.3 %). In thirteen patients (3.7 %) no operative repair was done on the day of presentation due to an incorrect diagnosis (n = 7), a watchful waiting policy for asymptomatic hernia (n = 3), rescheduling due to a large scrotal hernia, and there were two "no shows". Following hernia repair 97 % of the patients were discharged on the same day, while ten patients required hospitalization. Based on the questionnaires the main satisfaction score among patients was 9.0 (8.89-9.17 95 % CI) on a scale ranging from 0 to 10. One-stop hernia surgery is feasible and satisfactory from an institutional as well as from a patient's perspective.

Assessment of Pain and Quality of Life in Lichtenstein Hernia Repair Using a New Monofilament PTFE Mesh: Comparison of Suture vs. Fibrin-Sealant Mesh Fixation.

Science.gov (United States)

Fortelny, René H; Petter-Puchner, Alexander H; Redl, Heinz; May, Christopher; Pospischil, Wolfgang; Glaser, Karl

2014-01-01

Inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become the gold standard in open inguinal hernia repair. Despite the low recurrence rates, pain and discomfort remain a problem for a large number of patients. The aim of this study was to compare suture fixation vs. fibrin sealing by using a new monofilament PTFE mesh, i.e., the Infinit(®) mesh by W. L. Gore & Associates. This study was designed as a controlled prospective single-center two-cohort study. A total of 38 patients were enrolled and operated in Lichtenstein technique either standard suture mesh fixation or fibrin-sealant mesh fixation were used as described in the TIMELI trial. Primary outcome parameters were postoperative complications with the new mesh (i.e., seroma, infection), pain, and quality of life evaluated by the VAS and the SF-36 questionnaire. Secondary outcome was recurrence assessed by ultrasound and physical examination. Follow-up time was 1 year. Significantly, less postoperative pain was reported in the fibrin-sealant group compared to the suture group at 6 weeks (P = 0.035), 6 months (P = 0.023), and 1 year (P = 0.011) postoperatively. Additionally, trends toward a higher postoperative quality of life, a faster surgical procedure, and a shorter hospital stay were seen in the fibrin-sealant group. Fibrin-sealant mesh fixation in Lichtenstein hernioplasty effectively reduces acute and chronic postoperative pain. Monofilament, macro-porous, knitted PTFE meshes seem to be a practicable alternative to commonly used polypropylene meshes in open inguinal hernia repair.

Assessment of pain and quality of life in Lichtenstein hernia repair using a new monofilament PTFE mesh: comparison of suture vs. fibrin sealant mesh fixation

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René H Fortelny

2014-11-01

Full Text Available Background: Inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become the gold standard in open inguinal hernia repair. Despite the low recurrence rates, pain and discomfort remain a problem for a large number of patients. The aim of this study was to compare suture fixation vs. fibrin sealing by using a new monofilament PTFE mesh, i.e. the Infinit® mesh by W. L. Gore & Associates. Methods: This study was designed as a controlled prospective single-centre two cohort study. A total of 38 patients were enrolled and operated in Lichtenstein technique either standard suture mesh fixation or fibrin sealant mesh fixation were used as described in the TIMELI trial. Primary outcome parameters were postoperative complications with the new mesh (i.e. seroma, infection, pain and quality of life evaluated by the VAS and the SF-36 questionnaire. Secondary outcome was recurrence assessed by ultrasound and physical examination. Follow-up time was 1 year.Results: Significantly less postoperative pain was reported in the fibrin sealant group compared to the suture group at 6 weeks (P=0.035, 6 months (P=0.023 and 1 year (P=0.011 postoperatively. Additionally trends towards a higher postoperative quality of life, a faster surgical procedure and a shorter hospital stay were seen in the fibrin sealant group.Conclusion: Fibrin sealant mesh fixation in Lichtenstein hernioplasty effectively reduces acute and chronic postoperative pain. Monofilament, macro-porous, knitted PTFE meshes seem to be a practicable alternative to commonly used polypropylene meshes in open inguinal hernia repair.

CT discography for cervical soft disc hernia

Energy Technology Data Exchange (ETDEWEB)

Iwasa, Kenichi; Mizutani, Shigeru; Morimoto, Hiroyuki; Yamada, Hidehito; Iwasa, Satoru

1985-03-01

In this study the effectiveness of computed tomographic discography (CTD) in diagnosing cervical soft disc hernia was evaluated. Twenty-five intervertebral discs of 15 cases with cervical soft disc hernia were examined with a discography and then a CT scan. Results of the CT scan were as follows: three discs were protruded, 12 discs were prolapsed, 6 discs were extruded, and 4 discs were sequestrated. The findings were helpful in determining the location of soft disc hernias between the median and posterolateral discs. They were also valuable in classifying types of hernias and surgical approaches.

Which factors influenced the result of a tension free vaginal tape operation in a single teaching hospital?

NARCIS (Netherlands)

Withagen, M.I.J.; Milani, A.L.

2007-01-01

BACKGROUND: Tension free vaginal tape (TVT) has proven to be successful. Nevertheless, complications of the TVT have been reported. The aim of this study was to describe factors that might influence the efficacy and safety of the TVT procedure in our clinic. METHODS: Medical records of all patients

De Garengeot’s Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia

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Zhaosheng Jin

2016-01-01

Full Text Available We present two cases of incarcerated de Garengeot’s hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT. Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot’s hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot’s hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

The Danish ventral hernia database

DEFF Research Database (Denmark)

Helgstrand, Frederik; Jorgensen, Lars Nannestad

2016-01-01

Aim: The Danish Ventral Hernia Database (DVHD) provides national surveillance of current surgical practice and clinical postoperative outcomes. The intention is to reduce postoperative morbidity and hernia recurrence, evaluate new treatment strategies, and facilitate nationwide implementation of ...... of operations and is an excellent tool for observing changes over time, including adjustment of several confounders. This national database registry has impacted on clinical practice in Denmark and led to a high number of scientific publications in recent years.......Aim: The Danish Ventral Hernia Database (DVHD) provides national surveillance of current surgical practice and clinical postoperative outcomes. The intention is to reduce postoperative morbidity and hernia recurrence, evaluate new treatment strategies, and facilitate nationwide implementation...... to the surgical repair are recorded. Data registration is mandatory. Data may be merged with other Danish health registries and information from patient questionnaires or clinical examinations. Descriptive data: More than 37,000 operations have been registered. Data have demonstrated high agreement with patient...

Association between thoracic aortic disease and inguinal hernia.

Science.gov (United States)

Olsson, Christian; Eriksson, Per; Franco-Cereceda, Anders

2014-08-21

The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher-than-expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population-based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance. The prevalence of inguinal hernia in subjects with TAD was determined from nation-wide register data and compared to a non-TAD group (patients with isolated aortic stenosis). Groups were balanced using propensity score matching. Multivariable statistical analysis (logistic regression) was performed to identify variables independently associated with hernia. Hernia prevalence was 110 of 750 (15%) in subjects with TAD versus 29 of 301 (9.6%) in non-TAD, P=0.03. This statistically significant difference remained after propensity score matching: 21 of 159 (13%) in TAD versus 14 of 159 (8.9%) in non-TAD, PTAD, OR 1.8 (1.1 to 2.8), P=0.015. The prevalence of inguinal hernia (15%) in TAD is higher than expected in a general population and higher in TAD, compared to non-TAD. TAD is independently associated with hernia in multivariable analysis. Presence or history of hernia may be of importance in detecting TAD, and the association warrants further study. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Clinical study on 44 cases of femoral hernia

International Nuclear Information System (INIS)

Yamamoto, Ryo; Shinozaki, Hiroharu; Kase, Kenichi; Kobayashi, Kenji; Sasaki, Junichi

2012-01-01

Femoral hernia is a surgical disease that is frequently associated with incarceration and necessitates emergency surgery. However, there are only a few studies referred which have compared emergency and elective surgery for femoral hernias. We retrospectively reviewed the clinical characteristics of patients diagnosed as having femoral hernia between 2005 and 2009 in our institution. The clinical features of emergency repairs were compared with those of elective ones, and diagnostic values of preoperative diagnostic modalities were studied. The mean age of the patients was 73±12 years. Females comprised 68% of the cases, and right femoral hernias comprised 70% of the cases. Incarceration was associated with 66% of the cases (29 patients), and emergency surgery was performed in 52% of the patients (23 patients). Bowel resection was performed in 32% of the cases (14 patients). The mean age, body temperature, white blood cell (WBC) count, and LDH value were higher in the emergency repairs than in the elective one, and most of the hernias were repaired with McVay's procedure. CT scans had a high diagnostic value in detecting femoral hernias (44%) and incarceration (88%). It was confirmed that femoral hernias were frequently associated with incarceration and CT scan has a high diagnostic value in femoral hernias. (author)

Rectal duplication with sciatic hernia.

Science.gov (United States)

Nosek, Marzena; Golonka, Anna; Kalińska-Lipert, Anita; Nachulewicz, Paweł

2015-07-01

Rectal duplications represent 5% of all duplications in the alimentary tract, and they are very rarely diagnosed during the neonatal period. The authors present the method of investigation and the results of surgical treatment of a full-term neonate with a sciatic hernia containing a rectal duplication. The procedure started with three-port laparoscopy, but excision of the tubular duplication of the rectum was possible only by a transanal endorectal pull-through approach. The sciatic hernia was closed, and plastic sutures on the buttock finished the procedure. The coincidence of sciatic hernia with rectal duplication is extremely rare, and the method of treatment depends exclusively on the anatomical conditions.

The epidemiology and risk factors for recurrence after inguinal hernia surgery.

Science.gov (United States)

Burcharth, Jakob

2014-05-01

Recurrence after inguinal hernia surgery is a considerable clinical problem, and several risk factors of recurrence such as surgical technique, re-recurrence, and family history have been identified. Non-technical patient related factors that influence the risk of recurrence after inguinal hernia surgery are sparsely studied. The purpose of the studies included in this PhD thesis, was to describe the epidemiologic characteristics of inguinal hernia occurrence and recurrence, as well as investigating the patient related risk factors leading to recurrence after inguinal hernia surgery. Four studies were included in this thesis. Study 1: The study was a nationwide register-based study combining the Civil Registration System and the Danish National Hospital Register during a five-year period. We included a total of 46,717 persons operated for a groin hernia from the population of 5,639,885 people (2,799,105 males, 2,008,780 females). We found that 97% of all groin hernia repairs were inguinal hernias and 3% femoral hernias. Data showed that inguinal hernia surgery peaked during childhood and old age, whereas femoral hernia surgery increased throughout life. Study 2: Using data from the Danish Hernia Database (DHDB), we included all male patients operated for elective primary inguinal hernia during a 15-year period (n = 85,314). The overall inguinal hernia reoperation rate was 3.8%, and subdivided into indirect inguinal hernias and direct inguinal hernias, the reoperation rates were 2.7% and 5.2%, respectively (p thesis have studies the natural history of groin hernias on a nationwide basis; have identified the epidemiologic distribution of groin hernias and the non-technical risk factors associated with recurrence. Data showed that non-technical patient-related risk factors have great impact on the risk of recurrence after inguinal hernia surgery. The reason to why inguinal hernias recur is most likely multifactorial and lies in the span of technical and non

An inguinal hernia sac tumor of extrahepatic cholangiocarcinoma origin

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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.

Evaluation of optical data gained by ARAMIS-measurement of abdominal wall movements for an anisotropic pattern design of stress-adapted hernia meshes produced by embroidery technology

Science.gov (United States)

Breier, A.; Bittrich, L.; Hahn, J.; Spickenheuer, A.

2017-10-01

For the sustainable repair of abdominal wall hernia the application of hernia meshes is required. One reason for the relapse of hernia after surgery is seen in an inadequate adaption of the mechanical properties of the mesh to the movements of the abdominal wall. Differences in the stiffness of the mesh and the abdominal tissue cause tension, friction and stress resulting in a deficient tissue response and subsequently in a recurrence of a hernia, preferentially in the marginal area of the mesh. Embroidery technology enables a targeted influence on the mechanical properties of the generated textile structure by a directed thread deposition. Textile parameters like stitch density, alignment and angle can be changed easily and locally in the embroidery pattern to generate a space-resolved mesh with mechanical properties adapted to the requirement of the surrounding tissue. To determine those requirements the movements of the abdominal wall and the resulting distortions need to be known. This study was conducted to gain optical data of the abdominal wall movements by non-invasive ARAMIS-measurement on 39 test persons to estimate direction and value of the major strains.

Umbilical Hernia Repair and Pregnancy: Before, during, after…

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Hakan Kulacoglu

2018-01-01

Full Text Available Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section. Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation.

Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

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Avinash Chennamsetty

2015-01-01

Full Text Available Introduction. To explore the long term incidence and predictors of incisional hernia in patients that had RARP. Methods. All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair. Results. Of 577 patients, 48 (8.3% had a hernia at an incisional site (35 men had umbilical, diagnosed at (median 1.2 years after RARP (mean follow-up of 5.05 years. No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams; P=0.001 and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48 versus 4.6% (22/480; P=0.033. Overall, 4% (23/577 of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias. Conclusion. Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

Robotic Inguinal Hernia Repair: Technique and Early Experience.

Science.gov (United States)

Arcerito, Massimo; Changchien, Eric; Bernal, Oscar; Konkoly-Thege, Adam; Moon, John

2016-10-01

Laparoscopic inguinal hernia repair has been shown to have multiple advantages compared with open repair such as less postoperative pain and earlier resume of daily activities with a comparable recurrence rate. We speculate robotic inguinal hernia repair may yield equivalent benefits, while providing the surgeon added dexterity. One hundred consecutive robotic inguinal hernia repairs with mesh were performed with a mean age of 56 years (25-96). Fifty-six unilateral hernias and 22 bilateral hernias were repaired amongst 62 males and 16 females. Polypropylene mesh was used for reconstruction. All but, two patients were completed robotically. Mean operative time was 52 minutes per hernia repair (45-67). Five patients were admitted overnight based on their advanced age. Regular diet was resumed immediately. Postoperative pain was minimal and regular activity was achieved after an average of four days. One patient recurred after three months in our earlier experience and he was repaired robotically. Mean follow-up time was 12 months. These data, compared with laparoscopic approach, suggest similar recurrence rates and postoperative pain. We believe comparative studies with laparoscopic approach need to be performed to assess the role robotic surgery has in the treatment of inguinal hernia repair.

Hiatus Hernia as a Cause of Dysphagia.

Science.gov (United States)

Philpott, Hamish; Sweis, Rami

2017-08-01

This review aims to discuss the putative relationship between hiatus hernia and dysphagia. Proposed mechanisms of dysphagia in patients with hiatus hernia are usually difficult to identify, but recent advances in technology (high-resolution manometry with or without concomitant impedance, ambulatory pH with impedance, videofluoroscopy, and the endoluminal functional lumen imaging probe (EndoFLIP)) and methodology (inclusion of swallows of various consistencies and volumes or shifting position during the manometry protocol) can help induce symptoms and identify the underlying disorder. Chronic reflux disease is often associated with hiatus hernia and is the most common underlying etiology. Dysmotility because of impaired contractility and vigor can occur as a consequence of repeated acid exposure from the acid pocket within the hernia, and the resultant poor clearance subsequently worsens this insult. As such, dysphagia appears to be more common with increasing hiatus hernia size. Furthermore, mucosal inflammation can lead to fibrotic stricture formation and in turn obstruction. On the other hand, there appears to be a difference in the pathophysiology of smaller sliding hernias, in that those with dysphagia are more likely to have extrinsic compression at the crural diaphragm as compared to those with reflux symptoms only. Sliding hiatus hernia, especially when small, does not commonly lead to dysmotility and dysphagia; however, in those patients with symptoms, the underlying etiology can be sought with new technologies and, in particular, the reproduction of normal eating and drinking during testing.

Left-Sided Congenital Diaphragmatic Hernia with Multiple Congenital Cardiac Anomalies, Hernia Sac, and Microscopic Hepatic Heterotopia: A Case Report

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Maria Arafah

2011-01-01

Full Text Available Congenital diaphragmatic hernia is a common congenital anomaly of uncertain etiology. Its association with multiple congenital anomalies in various organs is well recognized and antenatal radiological evidence of congenital diaphragmatic hernia warrants thorough evaluation to detect other anomalies, some of which can be life threatening. Rarely, heterotopic hepatic tissue is identified in the hernia, a rare pathological finding, exhibiting more than one macroscopic and microscopic characteristics, and always associated with cardiac congenital anomalies. Herein, we report a case of left-sided microscopic heterotopic hepatic tissue in a congenital diaphragmatic hernia in an infant with multiple cardiac congenital anomalies, but with preserved pericardium.

High temperature expansions for the free energy of vortices respectively the string tension in lattice gauge theories

International Nuclear Information System (INIS)

Muenster, G.

1980-05-01

We derive high temperature cluster expansions for the free energy of vortices in SU(2) and Z 2 lattice gauge theories in 3 and 4 dimensions. The expected behaviour of the vortex free energy is verified. It obeys an area law behaviour. The coefficient of the area is shown to be equal to the string tension between static quarks. We calculate its expansion up to 12th order. For SU(2) in 4 dimensions the result is compared with Monte Carlo calculations of Creutz and is in good agreement at strong and intermediate coupling. (orig.)

The Use of Nontreated Mosquito‑Net Mesh Cloth for a Tension Free ...

African Journals Online (AJOL)

Wideochir Inne Tech Malo. Inwazyjne 2013;8:36‑42. 15. Taylor EW, Duffy K, Lee K, Hill R, Noone A, Macintyre I, et al. Surgical site infection after groin hernia repair. Br J Surg. 2004;91:105‑11. 16. Tongaonkar RR, Sandra DL, Kingsnorth AN. Ten year personal experience of using Low Density Polyethylene (LDPE) mesh for.

Factors associated with lumbar disc hernia recurrence after microdiscectomy.

Science.gov (United States)

Camino Willhuber, G; Kido, G; Mereles, M; Bassani, J; Petracchi, M; Elizondo, C; Gruenberg, M; Sola, C

Lumbar disc hernias are a common cause of spinal surgery. Hernia recurrence is a prevalent complication. To analyse the risk factors associated with hernia recurrence in patients undergoing surgery in our institution. Lumbar microdiscectomies between 2010 and 2014 were analysed, patients with previous surgeries, extraforaminales and foraminal hernias were excluded. Patients with recurrent hernia were the case group and those who showed no recurrence were the control group. 177 patients with lumbar microdiscectomy, of whom 30 experienced recurrence (16%), and of these 27 were reoperated. Among the risk factors associated with recurrence, we observed a higher rate of disc height, higher percentage of spinal canal occupied by the hernia and presence of degenerative facet joint changes; we observed no differences in sex, body mass index or age. Previous studies show increased disc height and young patients as possible factors associated with recurrence. In our series we found that the higher rate of disc height, the percentage of spinal canal occupied by the hernia and degenerative facet joint changes were associated with hernia recurrence. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Complicated childhood inguinal hernias in UITH, Ilorin

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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.

Imaging diagnosis--positive contrast peritoneographic features of true diaphragmatic hernia.

Science.gov (United States)

Choi, Jihye; Kim, Hyunwook; Kim, Mieun; Yoon, Junghee

2009-01-01

A true diaphragmatic hernia is a congenital diaphragmatic malformation that can appear identical to a peritoneopericardial diaphragmatic hernia (PPDH). True diaphragmatic hernias are rare in dogs. Herein we describe the use of positive contrast peritoneography for diagnosis of a true diaphragmatic hernia in two dogs.

An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

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Fenglin Song

2014-01-01

Full Text Available To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV were less than those in the control group (using Gore-Tex. The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility.

Studies on surface tension effect for free surface flow around floating models; Futai mokei mawari no jiyu hyomenryu ni oyobosu hyomen choryoku no eikyo ni kansuru kenkyu

Energy Technology Data Exchange (ETDEWEB)

Suzuki, K [Yokohama National Univ., Yokohama (Japan). Faculty of Engineering; Akiba, H [Toyo Construction Co. Ltd., Tokyo (Japan)

1997-12-31

The effect of surface tension on free surface flow around floating models is discussed experimentally and numerically. Three-dimensional free surface flow around vertical circular cylinders floating in a circulating water channel was visually observed, where a surface-active agent was added to water. The results are analyzed using Weber number. The numerical analysis was done for vertical cylinder and CY100 models using the Rankine source method. Weber number of at least around 120 is necessary to eliminate the effect of surface tension from free surface flow around the CY100 model. The numerical analysis for the cylinder model needs simulation with wavelength shorter than that of free surface wave used by the Rankine source method. The model for the resistance test should be at least around 7m long to eliminate the effect of surface tension at Froude number of 0.1 or higher. 15 refs., 12 figs., 2 tabs.

Studies on surface tension effect for free surface flow around floating models; Futai mokei mawari no jiyu hyomenryu ni oyobosu hyomen choryoku no eikyo ni kansuru kenkyu

Energy Technology Data Exchange (ETDEWEB)

Suzuki, K. [Yokohama National Univ., Yokohama (Japan). Faculty of Engineering; Akiba, H. [Toyo Construction Co. Ltd., Tokyo (Japan)

1996-12-31

The effect of surface tension on free surface flow around floating models is discussed experimentally and numerically. Three-dimensional free surface flow around vertical circular cylinders floating in a circulating water channel was visually observed, where a surface-active agent was added to water. The results are analyzed using Weber number. The numerical analysis was done for vertical cylinder and CY100 models using the Rankine source method. Weber number of at least around 120 is necessary to eliminate the effect of surface tension from free surface flow around the CY100 model. The numerical analysis for the cylinder model needs simulation with wavelength shorter than that of free surface wave used by the Rankine source method. The model for the resistance test should be at least around 7m long to eliminate the effect of surface tension at Froude number of 0.1 or higher. 15 refs., 12 figs., 2 tabs.

Pain following the repair of an abdominal hernia

DEFF Research Database (Denmark)

Hansen, Mark Berner; Andersen, Kenneth Geving; Crawford, Michael Edward

2010-01-01

Pain and other types of discomfort are frequent symptoms following the repair of an abdominal hernia. After 1 year, the incidence of light to moderate pain following inguinal hernia repair is as high as 10% and 2% for severe disabling chronic pain. Postoperative chronic pain not only affects......, psychosocial characteristics, and surgical procedures) related to the postoperative pain conditions. Furthermore, the mechanisms for both acute and chronic pain are presented. We focus on inguinal hernia repair, which is the most frequent type of abdominal hernia surgery that leads to chronic pain. Finally...

Prognostic factors of congenital diaphragmatic hernia accompanied by cardiovascular malformation.

Science.gov (United States)

Takahashi, Shigehiro; Sago, Haruhiko; Kanamori, Yutaka; Hayakawa, Masahiro; Okuyama, Hiroomi; Inamura, Noboru; Fujino, Yuji; Usui, Noriaki; Taguchi, Tomoaki

2013-08-01

Congenital diaphragmatic hernia is associated with cardiovascular malformation. Many prognostic factors have been identified for isolated congenital diaphragmatic hernia; however, reports of concurrent congenital diaphragmatic hernia and cardiovascular malformation in infants are limited. This study evaluated congenital diaphragmatic hernia associated with cardiovascular malformation in infants. Factors associated with prognosis for patients were also identified. This retrospective cohort study was based on a Japanese survey of congenital diaphragmatic hernia patients between 2006 and 2010. Frequency and outcome of cardiovascular malformation among infants with congenital diaphragmatic hernia were examined. Severity of congenital diaphragmatic hernia and cardiovascular malformation were compared as predictors of mortality and morbidity. Cardiovascular malformation was identified in 76 (12.3%) of 614 infants with congenital diaphragmatic hernia. Mild cardiovascular malformation was detected in 19 (33.9%) and severe cardiovascular malformation in 37 (66.1%). Their overall survival rate at discharge was 46.4%, and the survival rate without morbidity was 23.2%. Mortality and morbidity at discharge were more strongly associated with severity of cardiovascular malformation (adjusted OR 7.69, 95%CI 1.96-30.27; adjusted OR 7.93, 95%CI 1.76-35.79, respectively) than with severity of congenital diaphragmatic hernia. The prognosis for infants with both congenital diaphragmatic hernia and cardiovascular malformation remains poor. Severity of cardiovascular malformation is a more important predictive factor for mortality and morbidity than severity of congenital diaphragmatic hernia. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Diagnosis of lumbar disc hernia with computed tomography

Energy Technology Data Exchange (ETDEWEB)

Yoshizumi, Atsuro; Ohira, Nobuhiro; Ojima, Tadashi; Oshida, Midori; Horaguchi, Mitsuru (Tohoku Rosai Hospital, Sendai (Japan))

1982-07-01

Results of computed tomography performed on patients with clinically diagnosed hernia were compared with those of myelography and operative findings. This comparative study suggested that computed tomography is quite different from other methods and very useful in diagnosis of hernia. Some cases of hernia were shown, and the characteristics of CT were reviewed.

Incisional hernia: new approaches and aspects

NARCIS (Netherlands)

D. den Hartog (Dennis)

2010-01-01

textabstractThis thesis is about the anatomy, diagnosis, treatment and outcome of incisional hernia. New approaches and aspects are discussed in the following chapters. The following definitions were derived from Butterworth’s medical dictionary 1. A hernia is the protrusion of an internal

Amyand's hernia with appendicitis in the children: A delayed diagnosis

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Asma Jabloun

2016-10-01

Full Text Available The presence of a vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. It is an uncommon and rare condition estimated to be found in approximately 1 % of hernia. However, in just 0.08 %, the condition is complicated by an acute appendicitis. The clinical presentation varies, depending on the extent of inflammation of the appendix, and is most often misdiagnosed as an incarcerated inguinal hernia. As such, it is rarely recognized prior to surgical exploration. We report a case of Amyand’s hernia in a 2-month-old male, who presented as a right-sided congenital hernia with pain in the right groin. He underwent herniotomy, which revealed that the hernia sac containing elongated inflamed appendix appeared with some adhesions to sac, lying in the inguinal canal.

Efficacy and Safety of Tension-Free Vaginal Tape-Secur Mini-Sling Versus Standard Midurethral Slings for Female Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

OpenAIRE

Wei Huang; Tao Wang; Huantao Zong; Yong Zhang

2015-01-01

Purpose: To assess the efficacy and safety of tension-free vaginal tape (TVT)-Secur for stress urinary incontinence (SUI). Methods: A literature review was performed to identify all published trials of TVT-Secur. The search included the following databases: MEDLINE, Embase, and the Cochrane Controlled Trial Register. Results: Seventeen publications involving a total of 1,879 patients were used to compare TVT-Secur with tension-free obturator tape (TVT-O) and TVT. We found that TVT-Secur had s...

Multidetector-Row CT Findings of an Internal Supravesical Hernia: A Case Report

International Nuclear Information System (INIS)

Kim, Sang Won; Shin, Hyeong Cheol; Kim, Hyung Hwan; Kim, Young Tong; Kim, Il Young; Kang, Kil Ho

2010-01-01

A supravesical hernia occurs in the supravesical fossa and is either classified as an external or internal supravesical hernia. Most patients with internal supravesical hernias present with small bowel obstruction. Internal supravesical hernias are less common than external supravesical hernia. To date, there are few reports describing the radiological findings of supravesical hernias. To our knowledge, this is the first reported multidetector row CT (MDCT) depiction of this type of hernia. We report here on the MDCT findings of a patient with an internal supravesical hernia presenting with small bowel obstruction

Post-tensioned Discrete Concrete Elements Developed For Free-form Construction

DEFF Research Database (Denmark)

Egholm Pedersen, Ole; Larsen, Niels Martin; Pigram, Dave

2015-01-01

This paper presents a method for the construction of non-uniform precast concrete shell structures from unique parts. A novel method of discontinuous post-tensioning is introduced which allows tension to be taken through the connections. This increases the formal possibilities of the system beyon...

Diagnosis of lumbar disc hernia with computed tomography

International Nuclear Information System (INIS)

Yoshizumi, Atsuro; Ohira, Nobuhiro; Ojima, Tadashi; Oshida, Midori; Horaguchi, Mitsuru

1982-01-01

Results of computed tomography performed on patients with clinically diagnosed hernia were compared with those of myelography and operative findings. This comparative study suggested that computed tomography is quite different from other methods and very useful in diagnosis of hernia. Some cases of hernia were shown, and the characteristics of CT were reviewed. (Ueda, J.)

Anterior perineal hernia after anterior exenteration

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Ka Wing Wong

2017-10-01

Full Text Available Perineal hernia is a rare complication of anterior exenteration. We reported this complication after an anterior exenteration for bladder cancer with bleeding complication requiring packing and second-look laparotomy. Perineal approach is a simple and effective method for repair of perineal hernia.

On relation between the quark-gluon bag surface tension and the colour tube string tension

International Nuclear Information System (INIS)

Bugaev, K.A.; Zinovjev, G.M.

2010-01-01

We revisit the bag phenomenology of deconfining phase transition aiming to replenish it by introducing systematically the bag surface tension. Comparing the free energies of such bags and the strings confining the static quark-antiquark pair, we express the string tension in terms of the bag surface tension and the bulk pressure in order to estimate the bag characteristics using the lattice QCD (LQCD) data. Our analysis of the bag entropy density demonstrates that the surface tension coefficient is amazingly negative at the cross-over (continuous transition). The approach developed allows us to naturally account for an origin of a pronounced maximum (observed in the LQCD studies) in the behaviour of heavy quark-antiquark pair entropy. The vicinity of the (tri-)critical endpoint is also analyzed to clarify the meaning of vanishing surface tension coefficient.

A Short-Term Follow-Up Of Tension-Free Vaginal Tape For Surgical Treatment Of Stress Urinary Incontinence

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A.S. Moosavi

2006-05-01

Full Text Available Background and Aim: This study was conducted to evaluate the safety and efficacy of Tension-free Tape for the surgical treatment of female stress urinary incontinence. Materials and Methods: In a prospective open study for pre and post operative, we followed 36 patients at least 1.5 years after surgery (18-28 months; all patients underwent the operation under local anesthesia, allowing the surgeon to check intra-operatively that continence has been obtained. Results: Mean operation time was 36 minutes (range 20-45 minutes. 32(89% of the patients was cured according to the protocol, another 3(8.3% were significantly improved and there was 1(2.7% failure. Mast of patients (about 91% were operated on a one day-care basis, which implies that they were released from the hospital the day after the procedure, and no post operative catheterization, defect healing and tape rejection occurred. Pain free recovery time without any analgesic was another benefit. Five patients needed an indwelling catheter for 3 days and two uncomplicated hematoma occurred. Conclusion: Based on the results, we conclude that Tension-free Vaginal Tape is a safe and effective ambulatory procedure for surgical treatment of genuine stress urinary incontinence, which allows the majority of the women to be discharged from the clinic the day after the procedure and start their works in the second week.

Analgesia and sedation practices for incarcerated inguinal hernias in children.

Science.gov (United States)

Al-Ansari, Khalid; Sulowski, Christopher; Ratnapalan, Savithiri

2008-10-01

In this study, the use of medications for analgesia and/or sedation for incarcerated inguinal hernia reductions in the emergency department was analyzed. A retrospective chart review was conducted for all patients presenting to a pediatric emergency department with incarcerated inguinal hernia from 2002 to 2005. A total of 99 children presented with incarcerated hernias during the study period. The median age was 11 months. Forty-four percent of children received medication for the procedure, of them 75% received parenteral and 25% oral or intranasal medications. Forty-five percent of children who received medication went through at least 1 hernia reduction attempt initially without medications. More than half the children with incarcerated inguinal hernias did not receive any medication for pain and/or sedation prior to hernia reduction. Guidelines for medication use for children with incarcerated inguinal hernias need to be developed.

Ventral incisional hernia (VIH) repair after liver transplantation (OLT) with a biological mesh: experience in 3 cases.

Science.gov (United States)

Schaffellner, S; Sereinigg, M; Wagner, D; Jakoby, E; Kniepeiss, D; Stiegler, P; Haybäck, J; Müller, H

2016-05-01

Hernias after orthotopic liver transplant (OLT) occur in about 30 % of cases. Predisposing factors in liver cirrhotic patients of cases are ascites, low abdominal muscle mass and cachexia before and immunosuppression after OLT. Standard operative transplant-technique even in small hernias is to implant a mesh. For patients after liver transplantation a porcine non-cross linked biological patch being less immunogenic than synthetic and cross-linked meshes is chosen for ventral incisional hernia repair. 3 patients (1 female, 2 male), OLT indications Hepatitis C, exogenous- toxic cirrhosis, median-age 53 (51 - 56) and median time to hernia occurrence after OLT were 10 month (6 - 18 m) are documented. 2 patients suffered from diabetes, 2 from chronic-obstructive lung disease. Maintenance immunosuppressions were Everolimus in 1 patient, Everolimus + MMF in the second and Everolimus +Tacrolimus in the third patient. The biological was chosen for hernia repair due to the preexisting risk- factors. Meshes, 10 × 16 cm were placed, in IPOM (Intra-Peritonel-Onlay-Mesh) -position by relaparatomy. Insolvable, monofile, interrupted sutures were used. All patients recovered primarily, and were dismissed within 10 d post OP. No wound healing disorders or signs of postoperative infections occurred. All are free of hernia recurrence in a mean observation time of 22 month (10 - 36). The usage of porcine non-cross-linked biological patches seems feasible for incisional hernia repair after OLT. Wound infections in these patients have been observed with other meshes. Further investigation is needed to prove potential superiority of this biological to the other meshes. © Georg Thieme Verlag KG Stuttgart · New York.

Algunas hernias abdominales anteriores

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Augusto Salazar Sánchez

1947-09-01

Full Text Available Las hernias epigástricas se presentan en dos tipos de individuos: los atléticos y los asténicos. Son casi una exclusividad del sexo masculino. En los atléticos aparecen durante la juventud y son la consecuencia de esfuerzos durante los cuales la resistencia de la línea alba cede a la presión intraabdominal, produciendose una ruptura de esa línea, generalmente de tamaño muy pequeño pero suficiente para que por allí pase una porción de la grasa pre-peritoneal, quedando constituida la hernia. Más tarde, la grasa arrastra consigo al peritoneo parietal y este contrae adherencia con el anillo hernario, siendo esta la fase en la cual el enfermo se da cuenta de su afección, porque es entonces cuando sobrevienen los dolores y demás sintomatología clínica que es propia de este tipo de hernias.

A STUDY ON INCISIONAL HERNIA FOLLOWING OBSTETRICS AND GYNAECOLOGICAL SURGERIES

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Sumathi Ravikumar

2016-12-01

Full Text Available BACKGROUND The term ventral hernia encompasses incisional, epigastric, paraumbilical, spigelian and traumatic hernias. This is a hernia that protrudes through defect in an abdominal wound. With evolution of modern surgery and rapid increase in the number of abdominal operations performed, incisional hernias have risen in frequency and this hernia seems to be more common in females following obstetric and gynaecological surgeries. This study undertaken to stress the problem of incisional hernias in females occurring after obstetric and gynaecological surgeries. The aim of the study is to- 1. Study the incidence and prevalence of incisional hernias following obstetrics and gynaecological surgeries in KAPV Government Medical College, Tiruchirappalli. 2. Study aetiological factors for incisional hernia following obstetric and gynaecological surgeries. 3. Analyse preventive measures. 4. Analyse the problems in females, which led to incisional hernia. MATERIALS AND METHODS 178 cases of incisional hernia admitted in KAPV Government Medical College, Tiruchirappalli, during the period of 2 years from June 2014 to May 2016. The cases analysed according to age, previous history, type of incision, suture material used and associated comorbidities. RESULTS Maximum age affected is between 50 to 59 years and with 10 years of surgery. Incidence more following LSCS with midline incision. Incidence more with the usage of absorbable suture material. Postoperative wound infection and anaemia were leading associated factors for incisional hernia. CONCLUSION The incidence of incisional hernia is more common in females especially in obese and multiparous woman. The incidence is more after LSCS and puerperal sterilisation. Onlay reinforced mesh repair using Prolene mesh have given good results. Prolene mesh appears to be best tolerated by body tissues. The use of closed suction drain have significantly reduced the postoperative wound infection.

Internal obturator muscle transposition for treatment of perineal hernia in dogs: 34 cases (1998-2012).

Science.gov (United States)

Shaughnessy, Magen; Monnet, Eric

2015-02-01

To evaluate the outcome of dogs with perineal hernia treated with transposition of the internal obturator muscle. Retrospective case series. 34 dogs. Medical records of dogs with perineal hernia surgically treated from 1998 to 2012 were reviewed. Diagnostic methods and surgical techniques were recorded. Dogs were assigned preoperative and postoperative clinical sign scores. Complication and recurrence rates were evaluated over time. Risk factors were determined. Median follow-up time was 345 days (range, 22 to 1,423 days). Complications were observed in 10 dogs. Tenesmus (n = 9), dyschezia (7), fecal impaction (3), stranguria (4), hematochezia (2), urinary incontinence (2), diarrhea (1), urinary tract infection (1), and megacolon (1) occurred following surgery. Bladder retroflexion at the time of initial evaluation or surgery was not a risk factor for complication (hazard ratio, 1.72). One year after surgery, 51.2% dogs were free of complications. Three dogs developed a perineal hernia on the contralateral side between 35 and 95 days after surgery. The 1-year recurrence rate was 27.4%. Median time for recurrence was 28 days after surgery (range, 2 to 364 days). Postoperative tenesmus was a risk factor for the development of recurrence (hazard ratio, 2.29). Internal obturator muscle transposition was used for primary repair of perineal hernia in dogs. Recurrence was recorded as long as 1 year after surgery. Tenesmus was a risk factor for the development of recurrence after treatment of perineal hernia with internal obturator muscle transposition.

The Amyand's Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography.

Science.gov (United States)

Keskin, Suat; Simşek, Cihan; Keskin, Zeynep

2013-01-01

Amyand's hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand's hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT) scans. CT of the abdomen may help in guiding the diagnosis.

An Incarcerated Colon Inguinal Hernia That Perforated into the Scrotum and Exhibited an Air-Fluid Level

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Seisuke Ota

2015-01-01

Full Text Available There are few reports of a transverse colon inguinal hernia; furthermore, an inguinal hernia perforating the scrotum is rare. Here we report the case of a 79-year-old man who died after developing an incarcerated colon inguinal hernia that perforated the scrotum and exhibited an air-fluid level. The patient was referred to our hospital in November 2011 with a complaint of inability to move. Physical examination revealed an abnormally enlarged left scrotum and cold extremities. He reported a history of gastric cancer that was surgically treated more than 30 years ago. His white blood cell count and C-reactive protein level were elevated. Abdominal and inguinal computed tomography revealed that his transverse colon was incarcerated in the left inguinal canal. Free air and air-fluid level were observed around the transverse colon, suggestive of a perforation. The patient and his family refused any surgical intervention; therefore, he was treated with sultamicillin tosilate hydrate and cefotiam hydrochloride. However, he succumbed to panperitonitis 19 days after admission. The findings from this case indicate that the transverse colon can perforate into an inguinal hernia sac.

Arterial Injury Associated with Tension-Free Vaginal Tapes-SECUR Procedure Successfully Treated by Radiological Embolization

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Yun Seok Jung

2010-12-01

Full Text Available Various postoperative complications have been reported after the use of tension-free vaginal tapes (TVT. The transobturator approach was introduced to minimize the potential complications. The next generation of recently introduced TVT-SECUR is intended to minimize the incidence of complications. Herein we report a case of internal pudendal artery injury sustained during this procedure that was successfully treated by radiological embolization. Angiography with vessel embolization, when available, should be considered when the arterial injury is suspected.

High resolution computed tomography evaluation of cervical disk hernia

International Nuclear Information System (INIS)

Halversen, G.L.; Thoen, D.D.; Satovick, R.M.; Goldstein, M.L.

1986-01-01

Previous difficulties in the diagnosis of cervical disk hernia were related to lack of non-invasive imaging techniques, but the gap has now been filled by CT scan imaging. A total of 442 patients with pains in neck, shoulder or arm were referred for a CT scan to exclude a cervical disk hernia. Of the group studied, 2% were found to have a herniated disk, 16% a lateral hernia and 9% combined lateral hernia-narrow cervical canal due to concomitant arthrotic changes. Assessment of correlation between CT scan images and myelographic and surgical findings indicated that CT scan imaging is a very precise, non-invasive method for investigation of cervical disk hernia [fr

High resolution computed tomography evaluation of cervical disk hernia

Energy Technology Data Exchange (ETDEWEB)

Halversen, G.L.; Thoen, D.D.; Satovick, R.M.; Goldstein, M.L.

1986-05-01

Previous difficulties in the diagnosis of cervical disk hernia were related to lack of non-invasive imaging techniques, but the gap has now been filled by CT scan imaging. A total of 442 patients with pains in neck, shoulder or arm were referred for a CT scan to exclude a cervical disk hernia. Of the group studied, 2% were found to have a herniated disk, 16% a lateral hernia and 9% combined lateral hernia-narrow cervical canal due to concomitant arthrotic changes. Assessment of correlation between CT scan images and myelographic and surgical findings indicated that CT scan imaging is a very precise, non-invasive method for investigation of cervical disk hernia.

Incarcerated umbilical cord hernia containing the gallbladder

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Ann M. Kulungowski

2017-06-01

Full Text Available A 16 day-old boy infant with an umbilical mass underwent operative exploration of the umbilicus. The mass proved to be a gallbladder incarcerated in a hernia of the umbilical cord. Distinguishing an omphalocele from an umbilical cord hernia is not obvious and can be arbitrary. Morphologically, the two terms both describe congenital abdominal wall defects covered by a membrane, typically containing abdominal organs. Subtle differences and clinical features between omphalocele and umbilical cord hernia are highlighted in this report.

Intermediate term evaluation of tension-free vaginal tape outcome: Patient's perspective

International Nuclear Information System (INIS)

Farrukh, A.; Doyle, P.M.

2006-01-01

Various new sling techniques for surgical treatment of female urinary stress incontinence have evolved over the last decade and several reports indicate high objective cure rates and fewer complications compared to traditional major procedures. We conducted a study to determine the subjective outcome and satisfaction from a patient's perspective, based on their own responses to a symptom-specific health related postal questionnaire after five year five years of having Tension-free vaginal tape surgery (TVT, Gynecare, UK). Data were collected from 70 women. The end-point was improvement or cure from stress incontinence and its affect on their disease related quality of life. A significant improvement in continence was reported by 80 percent of treated women. The responses also allowed these women to appreciate the difference TVT had made on their daily activities with a definite positive impact on quality of life. (author)

Amyand\\'s Hernia - A Case Report | Nimako | African Journal of ...

African Journals Online (AJOL)

The finding of a vermiform appendix as the content of an inguinal hernia sac is rare. Even rarer is the finding of an inflamed appendix in the hernia sac, referred to asAmyand\\'s hernia.We report a case of a 5-year-old boy who presented with an inflamed appendix as the content of an incarcerated right inguinal hernia.

Gastric necrosis secondary to strangulated giant paraesophic hiatal hernia.

Science.gov (United States)

Díez Ares, José Ángel; Peris Tomás, Nuria; Estellés Vidagany, Nuria; Periáñez Gómez, Dolores

2016-08-01

Asymptomatic giant hiatal hernia comprises a relatively common disease, mostly presented in women with 50 years onwards. The therapeutic approach remains controversial in recent years. Under the latest SAGES`revision, all the symptomatic hernias must be repaired, but the symptomatic hiatal hernia definition isn`t even now established. We present the case os a A 67 - year old woman with an asymptomatic hiatal hernia, that is admitted to our hospital owing to toracic and abdominal pain. This pain was related with food intake for 6 months. The patient presents a clear worsening in the last 24 hours, with no other asociated symptomatology. Suspecting an incarcerated hiatal hernia with stomach perforation, the patient is taken to theatre for a laparotomy during the early hours. An atypic gastrectomy of the greater curvature with a gastropexy is performed with fixation to the anterior abdominal wall. The surgery is completed with a feeding jejunostomy. The Manegement of giant paraesophagic hernias, still remains as one of the challenge of the esophageal surgeons.

Reoperation Rates for Laparoscopic vs Open Repair of Femoral Hernias in Denmark

DEFF Research Database (Denmark)

Andresen, Kristoffer; Bisgaard, Thue; Kehlet, Henrik

2014-01-01

IMPORTANCE: In Denmark approximately 10 000 groin hernias are repaired annually, of which 2% to 4% are femoral hernias. Several methods for repair of femoral hernias are used including sutured repair and different types of mesh repair with either open or laparoscopic techniques. The use of many...... laparoscopic vs open femoral hernia repair, analyzing data from a nationwide database. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted. Data on femoral hernia repairs registered in the Danish Hernia Database from January 1998 until February 2012 were extracted and analyzed. All...... repairs were followed in the database and analyzed for reports of reoperation, which were used as a proxy for recurrence. Femoral hernia recurrence and inguinal hernia occurrence after the index repair were analyzed. EXPOSURE: Repair of a femoral hernia. MAIN OUTCOMES AND MEASURES: Reoperation...

Neurological Findings in Relation to the Level of Lumbar Disc Hernia

OpenAIRE

谷代, 弘三; Yashiro, Kouzou

1989-01-01

Real neurological findings in 177 cases of lumbar disc hernia, the levels of which were operatively proved were compared with those described as corresponding to a certain level of hernia in books hitherto published. Sensory change in Keegan's L5 dermatome was accordant with L4-5 hernia only in 41%, that in S1 dermatome with L5-S1 hernia in 44%, and that in L4 dermatome with L3-4 hernia in 67%. Weakness of an entire lower limb or of lliopsoas was proved in accordance with L1-2 or L2-3 hernia....

Umbilical Hernia

Science.gov (United States)

... Prompt diagnosis and treatment can help prevent complications. Causes During pregnancy, the umbilical cord passes through a small opening ... abdominal pressure can cause an umbilical hernia. Possible causes in adults include: ... pregnancies Fluid in the abdominal cavity (ascites) Previous abdominal ...

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

African Journals Online (AJOL)

BACKGROUND: An inguinal hernia is said to be irreducible when the content fails to return into the peritoneal cavity without surgical intervention. Irreducibility is an ever present risk in untreated inguinal hernias and its management remains an important part of pediatric surgery practice. When a hernia is irreducible ...

Open tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions.

Science.gov (United States)

Pedano, Nicolás; Pastor, Carlos; Arredondo, Jorge; Poveda, Ignacio; Ruiz, Jaime; Montón, Soledad; Molina, María; Hernández-Lizoain, José Luis

2012-02-01

The process of mesh fixation and the potential risk of associated chronic pain are always surgeon's main concerns in hernia surgery. A wide variety of lightweight mesh models are currently available on the market to overcome some of these problems showing good preliminary results, but no data representing the medium- or long-term results. The present study aims to report the clinical outcomes of two institutional series of patients who underwent hernia repair using a partially absorbable auto adherent mesh (Parietene™ Progrip™--PP). A prospective analysis was performed including unselected patients with primary groin hernia who underwent a standardized Lichtenstein procedure using the PP mesh at two tertiary institutions. During the 2-year study period, 181 patients (167 males; 14 females) with a median age of 63 years (19-85 years) were operated on at both centers. Short-term complications occurred in 27 patients (15%), the most commonly seen being urinary retention (6%) followed by hematoma (5%) and acute orchitis (2%). With a median follow-up of 17 months (12-29 months), 4 patients (2%) had a feeling of a foreign body in the groin, and 7 (4%) developed chronic pain. A total of four patients (2%) developed recurrence. In our experience, the use of the PP mesh for hernioplasties offers a potential benefit not only in the short-term period but also in a medium-term follow-up with low recurrence and late chronic pain rates. However, this particular mesh does not fully prevent all complications and chronic pain and recurrent hernias have been reported for the first time.

Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia.

Science.gov (United States)

Rodriguez-Acevedo, Omar; Elstner, Kristen E; Jacombs, Anita S W; Read, John W; Martins, Rodrigo Tomazini; Arduini, Fernando; Wehrhahm, Michael; Craft, Colette; Cosman, Peter H; Dardano, Anthony N; Ibrahim, Nabeel

2018-02-01

Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair. This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017. Serial non-contrast abdominal CT imaging was performed to evaluate changes in lateral oblique muscle length and thickness. All hernias were repaired laparoscopically, or laparoscopic-open-laparoscopic (LOL) using intraperitoneal onlay mesh. 56 patients received BTA injections at predetermined sites to the lateral oblique muscles, which were well tolerated. Mean patient age was 59.7 years, and mean BMI was 30.9 kg/m 2 (range 21.8-54.0). Maximum defect size was 24 × 27 cm. A subset of 18 patients underwent preoperative pneumoperitoneum as an adjunct procedure. A comparison of pre-BTA to post-BTA imaging demonstrated an increase in mean lateral abdominal wall length from 16.1 cm to 20.1 cm per side, a mean gain of 4.0 cm/side (range 1.0-11.7 cm/side) (p LOL primary closure was achieved in all cases, with no clinical evidence of raised intra-abdominal pressures. One patient presented with a new fascial defect 26 months post-operative. Preoperative BTA to the lateral abdominal wall muscles is a safe and effective technique for the preparation of patients prior to operative management of complex ventral hernias. BTA temporary flaccid paralysis relaxes, elongates and thins the chronically contracted abdominal musculature. This in turn reduces lateral traction forces facilitating laparoscopic repair and fascial closure of large

Sports hernia and femoroacetabular impingement in athletes: A systematic review.

Science.gov (United States)

Munegato, Daniele; Bigoni, Marco; Gridavilla, Giulia; Olmi, Stefano; Cesana, Giovanni; Zatti, Giovanni

2015-09-16

To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes. PubMed, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism. FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone (89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries. The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy.

Posterolateral Bochdalek diaphragmatic hernia in adults Hernia diafragmática posterolateral de Bochdalek en el adulto

Directory of Open Access Journals (Sweden)

José Maximiliano Garófano-Jerez

2011-09-01

Full Text Available Bochdalek hernias (BHs are produced in the posterolateral area of the diaphragm. They are generally congenital, appearing in childhood, but are also detected in asymptomatic adult patients seeking medical attention for other reasons. Computed tomography (CT or magnetic resonance imaging (MRI is used for the correct diagnosis of the hernia type and for its localization, facilitating its management and the choice of treatment. We describe three cases of Bochdalek hernia, two on the right side and one bilateral, which was larger on the right than left side. All of these hernias contained only omental fat. In one patient, the right kidney was adjacent to the diaphragmatic defect but remained within the abdomen. The patients showed no symptoms and were not surgically treated. Examination by multi-slice CT with the possibility of coronal and sagittal reconstruction should be considered the standard method for diagnosing this entity. MRI in T1 is highly valuable to evaluate fat-containing chest lesions. The incidental finding of BH in asymptomatic adults is increasing, thanks to the wider application of new imaging techniques.Las hernias de Bochdalek se producen a través de la zona posterolateral del diafragma. Generalmente son congénitas y se presentan en la infancia, pero pueden verse también en la edad adulta en pacientes asintomáticos, que consultan por patologías diversas. El uso de tomografía computarizada o resonancia magnética permite el diagnóstico correcto del tipo y localización de la hernia, lo cual facilitará su manejo y la elección del tratamiento. Presentamos 3 casos clínicos, dos tenían una hernia de Bochdalek derecha, y, el otro caso es bilateral, siendo mayor la situada en el lado derecho. En todos nuestros casos, el contenido ha sido únicamente grasa omental. No obstante, en uno de ellos, el riñón derecho se situaba adyacente al defecto diafragmático, pero dentro del abdomen. Debido a la ausencia de sintomatolog

Sports Hernia: Diagnosis, Management and Operative Treatment

Science.gov (United States)

Emblom, Benton A.

2017-01-01

Objectives: Athletic Pubalgia, also known as sports hernia or core muscle injury, causes significant dysfunction in athletes. Increased recognition of this specific injury distinct from inguinal hernia pathology has led to better management of this debilitating condition. We hypothesize that patients who undergo our technique of athletic pubalgia repair will recover and return to high-level athletics. Methods: Using our billing and clinical database, patients who underwent sports hernia repair by single surgeon at a single institution were contacted for Harris hip score, functional outcome, and return to play data. Results: Of 101 patients who met criteria, 43 were contacted. 93% of patients were able to return to play at an average of 4.38 mo. Normal activities were rated at 95.5% and athletic function was rated at 88.9%. Negative predictors were female sex, multiple operations, and prior inguinal hernia repair. Overall complication rate was 4.6%, and reoperation rate was 4.6%. Conclusion: Our method of adductor to rectus abdominis turn up flap is a safe procedure with high return to play success. Patients who had previously undergone inguinal hernia repair or other hip/pelvic related surgery had a worse outcome.

Management of chronic pain after hernia repair

Directory of Open Access Journals (Sweden)

Andresen K

2018-04-01

Full Text Available Kristoffer Andresen, Jacob Rosenberg Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark Abstract: Chronic pain following inguinal hernia repair is a common problem and feared complication. Up to 16% of people experience chronic pain following the repair of a groin hernia. The aim of this review was to provide an overview of treatment strategies for patients with chronic pain following inguinal hernia repair based on best practice guidelines and current clinical routines. The optimal management of chronic pain following inguinal hernia surgery should begin with a thorough clinical examination to rule out other causes of chronic pain and to rule out a recurrence. A scaled approach to treatment is recommended. Initially, watchful waiting can be tried if it can be tolerated by the patient and then systemic painkillers, escalating to blocks, and surgery as the final option. Surgery should include mesh removal and triple neurectomy following anterior approaches or mesh and tack removal following a posterior approach. The diagnosis and treatment strategies should be performed by or discussed with experts in the field. Keywords: inguinal hernia, chronic pain, management, surgery, pharmacology, radio frequency

Primary ventral or groin hernia in pregnancy

DEFF Research Database (Denmark)

Oma, E; Bay-Nielsen, M; Jensen, K K

2017-01-01

BACKGROUND: Prevalence, management, and risk of emergency operation for primary ventral or groin hernia in pregnancy are unknown. The objective of this study was to estimate the prevalences of primary ventral or groin hernia in pregnancy and the potential risks for elective and emergency repair...... was conducted to identify patients registered with a primary ventral or groin hernia in pregnancy. Follow-up was conducted by review of medical record notes within the Capital Region of Denmark supplemented with structured telephone interviews on indication. RESULTS: In total, 20,714 pregnant women were...... included in the study cohort. Seventeen (0.08%) and 25 (0.12%) women were registered with a primary ventral and groin hernia, respectively. None underwent elective or emergency repair in pregnancy, and all had uncomplicated childbirth. In 10 women, the groin bulge disappeared spontaneously after delivery...

Postoperative interstitial hernia as a cause of obscure incisional wound site pain

OpenAIRE

Modrzejewski, Andrzej; Śmietański, Maciej

2011-01-01

An interstitial hernia is one in which the hernia sac is located between the layers of the abdominal wall. The analysis of contemporary literature shows that interstitial hernias are most often seen in children as a type of inguinal hernia and often accompany undescended testis. The hernia sac is usually located between the external-oblique and internal-oblique muscles in a lateral-cephalic direction. The authors present 3 cases of interstitial hernia found during laparoscopic exploration of ...

Nationwide quality improvement of groin hernia repair from the Danish Hernia Database of 87,840 patients from 1998 to 2005

DEFF Research Database (Denmark)

Kehlet, H.; Bay-Nielsen, M.

2008-01-01

BACKGROUND: Increased focus and research on surgical technique and anaesthesia in groin hernia repair have improved outcomes from centres of interest in hernia surgery, but little information is available from nationwide data to document the incorporation of scientific evidence into general...... rates, increased use of the Lichtenstein hernia technique, higher rate of outpatient surgery, near elimination of regional anaesthesia, and documentation and focus on incidence and mechanisms of chronic pain. CONCLUSION: Establishment of nationwide groin hernia databases leads to general improvement...... in outcomes and, due to the large number of patients, allows analyses of specific sub-groups or complications which otherwise could not be obtained from single centres. Nationwide collaboration is important for multi-centre research and further improvement of outcomes, especially in chronic pain...

Severe, recurrent hiatal hernia in schwartz syndrome

International Nuclear Information System (INIS)

Badshah, S.; Ghafoor, T.; Muhammad, S.

2003-01-01

An 18 months old boy presented with marked failure to thrive, abnormal facial grimacing and troublesome vomiting. The patient was diagnosed as having schwartz syndrome with hiatal hernia. Medical and surgical treatment was carried out and with supportive care the patient gained weight and his symptoms subsided. In 8 months, however, the patient developed hernia on the other side necessitating repeat surgery. The case is being reported to highlight the accompaniment of hiatal hernia not previously reported as part of the syndrome and to report the experience of using muscle relaxants in the condition. (author)

Video-assisted repair of cervical lung hernia.

Science.gov (United States)

Zhang, P; Jiang, G; Xie, B; Ding, J

2010-04-01

Lung hernia is an extremely rare condition and the treatments vary. We report a case of cervical lung hernia without any trauma. The patient underwent video-assisted repair with a satisfactory result. Georg Thieme Verlag KG Stuttgart New York.

Comparison of two surgical techniques in large incisional hernias

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Mustafa Sit

2014-03-01

Full Text Available Objectives: Incisional hernias occur from incisions of previous abdominal operations. It is an often complication of abdominal interventions. Prevalence of incisional hernias is approximately 2.9% and 3.6% in vertical midline incisions and transverse incisions, respectively. Incisional hernias cause morbidity and loss of manpower. The only treatment option is surgery. We aimed to compare surgical methods of incisional hernias and discuss the postoperative data in this retrospective report. Methods: We retrospectively analyzed the data of 54 patients with large incisional hernias operated between 2007 and 2011. Results: We compared age, chronic diseases (e.g. Chronic obstructive pulmonary disease, diabetes mellitus,which may cause postoperative recurrence, gender, personal factors, such as patients undergoing incisional hernia repair mesh over solid fascia less or over than 5 cm with the placement of decolation; recurrence, the development of postoperative seroma, receiving postoperative drainage and postoperative length of hospital stay were compared. While the recurrence rate of less than 5 cm above the decolation; seroma development, no significant difference in length of hospital stay and drain times to get. Conclusion: In conclusion, we think that recurrence rate should be reduced by dissection of 5 cm intact fascia and grafting in incisional hernias of anterior abdominal wall. J Clin Exp Invest 2014; 5 (1: 36-39

Day case inguinal hernia surgery in Nigerian children: Prospective ...

African Journals Online (AJOL)

required readmission into the hospital. Conclusion: Day case inguinal hernia surgery in children is safe and well accepted by patients and parents alike. Health institutions in which children with inguinal hernias still queue for long periods for space on the operation list need to adopt day case surgery for inguinal hernia in ...

[Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique].

Science.gov (United States)

El Harrech, Y; Ameur, A; Janane, A; Moufide, K; Ghadouane, M; Abbar, M

2010-01-01

To evaluate the long term efficacy and safety of transvaginal implantation of a non-resorbable synthetic prosthesis (Gynemesh) for the treatment of cystocele using transvaginal free tension technique. Prospective study of patients that have been submitted to correction of cystocele between April 2004 and July 2007. A prolene mesh was cut to an appropriate size to cover the whole cystocele leaving two tabs on each side. The two tabs of the mesh were then placed in paravaginal spaces, tension free, without stitches. Mesh was used in 31 patients. All patients had a symptomatic cystocele >or= 2 according to Baden-Walker halfway classification. Patients were reviewed initially at 1 and 3 month and then every 6 months. The mean age of the patients was 58 years (range: 47-70 years). Mean parity was 5.8 (range 1-11), and mean weight was 75 kg (range 60-82Kg). All women were postmenopausal. The operation was combined with vaginal hysterectomy in 2 patients, Posterior colporraphy in 2 patients, Perineorrhaphy in 1 patient, Sacrospinous fixation in 2 patients, transobturator tape for stress urinary incontinence in 7 women. Average time of surgery was 23 minutes for cystocele. There were no major complications, such as trauma to the bladder, urethra, bowels, or large vessels in the patient group treated. There was no immediate postoperative complications (up to 7 days) recorded. No hematoma or infection was observed in the operative area. Mesh erosion was detected in one patient. It was treated by excision of the eroded part of the mesh. Mean follow-up was 36.4 months (18 to 52 months). Using our definition of success based on both anatomic and functional outcomes, the overall cure rate was 74.19% (asymptomatic with no or grade 1 cystocele). The improvement rate (asymptomatic with a grade 2 cystocele) was 19.35% and the overall failure rate (symptomatic or with a grade 3 or 4 cystocele) was only 6.4% (2 women). The interposition of a sub-vesical transversal tension-free

Acute testicular ischemia caused by incarcerated inguinal hernia.

Science.gov (United States)

Orth, Robert C; Towbin, Alexander J

2012-02-01

Acute testicular ischemia caused by an incarcerated inguinal hernia usually affects infants. There are few reports of diagnosis using US, and the effect of long-standing reducible hernias on testicular growth in infants and children is unknown. The objectives of this study were to determine the incidence of testicular ischemia secondary to an incarcerated inguinal hernia at scrotal sonography and to determine the effect on testicular size at diagnosis. A hospital database was used to locate scrotal sonography examinations documenting an inguinal hernia, and images were reviewed for signs of testicular ischemia. Testicular volumes were compared using the Wilcoxon signed rank test. A total of 147 patients were identified with an inguinal hernia (age 1 day to 23 years, average 6 years). Ten patients (6.8%) had associated testicular ischemia (age 3 weeks to 6 months, average 9 weeks) and showed a statistically significant increase in ipsilateral testicular size compared to the contralateral testicle (P = 0.012). Patients without testicular ischemia did not show a significant difference in testicular size, regardless of patient age. An incarcerated inguinal hernia should be considered as a cause of acute testicular ischemia in infants younger than 6 months of age.

A very simple technique to repair Grynfeltt-Lesshaft hernia.

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Solaini, Leonardo; di Francesco, F; Gourgiotis, S; Solaini, Luciano

2010-08-01

A very simple technique to repair a superior lumbar hernia is described. The location of this type of hernia, also known as the Grynfeltt-Lesshaft hernia, is defined by a triangle placed in the lumbar region. An unusual case of a 67-year-old woman with a superior lumbar hernia is reported. The diagnosis was made by physical examination. The defect of the posterior abdominal wall was repaired with a polypropylene dart mesh. The patient had no evidence of recurrence at 11 months follow up. The surgical approach described in this paper is simple and easy to perform, and its result is comparable with other techniques that are much more sophisticated. No cases on the use of dart mesh to repair Grynfeltt-Lesshaft hernia have been reported by surgical journals indexed in PubMed.

Free-Energy Barrier of Filling a Spherical Cavity in the Presence of Line Tension: Implication to the Energy Barrier between the Cassie and Wenzel States on a Superhydrophobic Surface with Spherical Cavities.

Science.gov (United States)

Iwamatsu, Masao

2016-09-20

The free-energy barrier of filling a spherical cavity having an inner wall of various wettabilities is studied. The morphology and free energy of a lens-shaped droplet are determined from the minimum of the free energy. The effect of line tension on the free energy is also studied. Then, the equilibrium contact angle of the droplet is determined from the generalized Young's equation. By increasing the droplet volume within the spherical cavity, the droplet morphology changes from spherical with an equilibrium contact angle of 180° to a lens with a convex meniscus, where the morphological complete drying transition occurs. By further increasing the droplet volume, the meniscus changes from convex to concave. Then, the lens-shaped droplet with concave meniscus spreads over the whole inner wall, resulting in an equilibrium contact angle of 0° to leave a spherical bubble, where the morphological complete wetting transition occurs. Finally, the whole cavity is filled with liquid. The free energy shows a barrier from complete drying to complete wetting as a function of droplet volume, which corresponds to the energy barrier between the Cassie and Wenzel states of the superhydrophobic surface with spherical cavities. The free-energy maximum occurs when the meniscus of the droplet becomes flat, and it is given by an analytic formula. The effect of line tension is expressed by the scaled line tension, and this effect is largest at the free-energy maximum. The positive line tension increases the free-energy maximum, which thus increases the stability of the Cassie superhydrophobic state, whereas the negative line tension destabilizes the superhydrophobic state.

Ureteral sciatic hernia: a case report

Energy Technology Data Exchange (ETDEWEB)

Choi, So Young; Han, Hyun Young; Park, Suk Jin; Choe, Hyoung Shim; Kim, Eun Tak [Eulji University Hospital, Daejeon (Korea, Republic of)

2008-09-15

A ureteral hernia that occurs through the sciatic foramen is very rare. We present a case of a ureteral sciatic hernia with hydronephrosis. Intravenous urography (IVU) showed the presence of a curved, laterally displaced ureter, and computed tomography (CT) clearly depicted the herniated ureter through the sciatic foramen. The patient was treated transiently with a double J catheter.

Congenital Morgagni's hernia in infants and children: a national review

African Journals Online (AJOL)

assisted repair, and in five (4.7%) patients the hernia was repaired .... 24 (23%) and inguinal hernia in 13 (12.6%) patients. Thirteen ... bilateral Morgagni's hernia (Fig. 4). ... repair using the open approach and one following a laparoscopic-.

Association Between Thoracic Aortic Disease and Inguinal Hernia

OpenAIRE

Olsson, Christian; Eriksson, Per; Franco?Cereceda, Anders

2014-01-01

Background The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher?than?expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population?based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance. Methods and ...

Presence of Inguinal Hernia in Soccer Players with Osteitis Pubis

Directory of Open Access Journals (Sweden)

Ali Eraslan

2017-11-01

Conclusion: The study revealed that soccer players with osteitis pubis may have concomitant inguinal hernia, and that osteitis pubis may develop in soccer players who have undergone hernia repair. In addition, more severe osteitis pubis findings on the same side with hernia indicate that the two pathologies occur with common mechanisms. It should not be forgotten that inguinal hernia be considered in the differential diagnosis of osteitis pubis, which it may accompany. Conservative methods are mostly used in the treatment of osteitis pubis, whereas the treatment of inguinal hernia is surgery. If only one entity is diagnosed when both are present, the success of treatment will decrease.

Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients.

Science.gov (United States)

Garg, Harshit; Vigneshwaran, Balasubiramaniyan; Aggarwal, Sandeep; Ahuja, Vineet

2017-01-01

The aim of this study was to analyse the impact of hiatal hernia repair (HHR) on gastro-oesophageal reflux disease (GERD) in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG). It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS) questionnaire and anti-reflux medications. Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80%) showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH) during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

Patient-Related Risk Factors for Recurrence After Inguinal Hernia Repair

DEFF Research Database (Denmark)

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

2015-01-01

patient demographics, hernia characteristics, connective tissue composition and degradation, habits and social relations, and conditions related to inguinal hernia recurrence. Results. From a total of 5061 records screened, we included 40 observational studies enrolling 720 651 inguinal hernia procedures...

Current practices of laparoscopic inguinal hernia repair: a population-based analysis.

Science.gov (United States)

Trevisonno, M; Kaneva, P; Watanabe, Y; Fried, G M; Feldman, L S; Andalib, A; Vassiliou, M C

2015-10-01

The selection of a laparoscopic approach for inguinal hernias varies among surgeons. It is unclear what is being done in actual practice. The purpose of this study was to report practice patterns for treatment of inguinal hernias among Quebec surgeons, and to identify factors that may be associated with the choice of operative approach. We studied a population-based cohort of patients who underwent an inguinal hernia repair between 2007 and 2011 in Quebec, Canada. A generalized linear model was used to identify predictors associated with the selection of a laparoscopic approach. 49,657 inguinal hernias were repaired by 478 surgeons. Laparoscopic inguinal hernia repair (LIHR) was used in 8 % of all cases. LIHR was used to repair 28 % of bilateral hernias, 10 % of recurrent hernias, 6 % of unilateral hernias, and 4 % of incarcerated hernias. 268 (56 %) surgeons did not perform any laparoscopic repairs, and 11 (2 %) surgeons performed more than 100 repairs. These 11 surgeons performed 61 % of all laparoscopic cases. Patient factors significantly associated with having LIHR included younger age, fewer comorbidities, bilateral hernias, and recurrent hernias. An open approach is favored for all clinical scenarios, even for situations where published guidelines recommend a laparoscopic approach. Surgeons remain divided on the best technique for inguinal hernia repair: while more than half never perform LIHR, the small proportion who perform many use the technique for a large proportion of their cases. There appears to be a gap between the best practices put forth in guidelines and what surgeons are doing in actual practice. Identification of barriers to the broader uptake of LIHR may help inform the design of educational programs to train those who have the desire to offer this technique for certain cases, and have the volume to overcome the learning curve.

Perineal hernias in children: Case report and review of the literature ...

African Journals Online (AJOL)

Perineal hernias (pelvic floor hernias) are extremely rare occurring through defects in musculature of the pelvic floor. This report presents a successfully treated case of primary perineal hernia and takes a review of the existing literature. The case of a 14-month-old girl with a great perineal hernia is presented. Diagnosis was ...

Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana.

Science.gov (United States)

Ohene-Yeboah, Michael; Beard, Jessica H; Frimpong-Twumasi, Benjamin; Koranteng, Adofo; Mensah, Samuel

2016-04-01

Inguinal hernia is thought to be common in rural Ghana, though no recent data exist on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings. Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia. Men with hernia completed a survey on demographics, knowledge of the disease, and barriers to surgical treatment. A total of 803 participants were examined, while 105 participants completed the survey. The prevalence of inguinal hernia was 10.8 % (95 % CI 8.0, 13.6 %), and 2.2 % (95 % CI 0, 5.4 %) of participants had scars indicative of previous repair, making the overall prevalence of treated and untreated inguinal hernia 13.0 % (95 % CI 10.2, 15.7 %). Prevalence of inguinal hernia increased with age; 35.4 % (95 % CI 23.6, 47.2 %) of men aged 65 and older had inguinal hernia. Untreated inguinal hernia was associated with lower socio-economic status. Of those with inguinal hernia, 52.4 % did not know the cause of hernia. The most common reason cited for failing to seek medical care was cost (48.2 %). Although inguinal hernia is common among adult men living in rural Ghana, surgical repair rates are low. We propose a multi-faceted public health campaign aimed at increasing access to safe hernia repair in Ghana. This approach includes a training program of non-surgeons in inguinal hernia repair headed by the Ghana Hernia Society and could be adapted for use in other low-resource settings.

Lumbar hernia - a case report and review of the literature

International Nuclear Information System (INIS)

D'Ippolito, Giuseppe; Yonamine, Claudia

1999-01-01

The authors present a case of lumbar hernia of inferior right space (Petit's triangle), classified as acquired hernia and diagnosed by clinical history and computed tomography. Lumbar hernia are quite rare. Authors have done a literature review of this disease. (author)

Lumbar hernia: A commonly misevaluated condition of the bilateral costoiliac spaces

Directory of Open Access Journals (Sweden)

Yiji Suh

2017-09-01

Full Text Available Lumbar hernias develop through the weakening of the posterolateral abdominal wall associated with the Petit's triangle or the Grynfeltt-Lesshaft triangle. Clinicians are generally unfamiliar with the presentation of lumbar hernias, which frequently leads to misdiagnosis and delay of treatment. Prompt failure to diagnose and surgically correct lumbar hernias have resulted in increased morbidity. This review addresses the anatomical and clinical concepts associated with the bilateral costoiliac spaces, which may be implicated in the increased prevalence of left-sided hernias. Knowledge of the contents and boundaries of this enclosure can aid the physician in diagnosis. We explore the intraperitoneal and retroperitoneal diseases that present at the lumbocostal space, including lumbar hernias, which can be classified as congenital, acquired, traumatic, or iatrogenic in origin. In an evaluation, imaging is crucial for assessing musculofascial layer disruptions and hernia contents. Open and laparoscopic surgery, as well retromuscular lumbar hernia repair, are options to explore in surgical intervention, particularly if there are challenges in preliminary pain management. Keywords: Lumbar hernia, Costoiliac spaces, Petit's triangle, Grvnfeltt-lesshaft triangle, Lumbocostovertebral syndrome

Connective tissue alteration in abdominal wall hernia

DEFF Research Database (Denmark)

Henriksen, N A; Yadete, D H; Sørensen, Lars Tue

2011-01-01

The aetiology and pathogenesis of abdominal wall hernia formation is complex. Optimal treatment of hernias depends on a full understanding of the pathophysiological mechanisms involved in their formation. The aim of this study was to review the literature on specific collagen alterations in abdom...

Hiatal hernia | Samkari | Pan African Medical Journal

African Journals Online (AJOL)

Initial evaluation revealed paraesophageal hernia. EGD finding is grade II esophagitis with nodular mucosa and superficial ulceration, Distal part of the funds, body and the Antrum were rolled back into thoracic cavity. Abdominal computed tomography (CT) showed undulating diaphragm and large complex hiatal hernia.

Financial implications of ventral hernia repair: a hospital cost analysis.

Science.gov (United States)

Reynolds, Drew; Davenport, Daniel L; Korosec, Ryan L; Roth, J Scott

2013-01-01

Complicated ventral hernias are often referred to tertiary care centers. Hospital costs associated with these repairs include direct costs (mesh materials, supplies, and nonsurgeon labor costs) and indirect costs (facility fees, equipment depreciation, and unallocated labor). Operative supplies represent a significant component of direct costs, especially in an era of proprietary synthetic meshes and biologic grafts. We aim to evaluate the cost-effectiveness of complex abdominal wall hernia repair at a tertiary care referral facility. Cost data on all consecutive open ventral hernia repairs (CPT codes 49560, 49561, 49565, and 49566) performed between 1 July 2008 and 31 May 2011 were analyzed. Cases were analyzed based upon hospital status (inpatient vs. outpatient) and whether the hernia repair was a primary or secondary procedure. We examined median net revenue, direct costs, contribution margin, indirect costs, and net profit/loss. Among primary hernia repairs, cost data were further analyzed based upon mesh utilization (no mesh, synthetic, or biologic). Four-hundred and fifteen patients underwent ventral hernia repair (353 inpatients and 62 outpatients); 173 inpatients underwent ventral hernia repair as the primary procedure; 180 inpatients underwent hernia repair as a secondary procedure. Median net revenue ($17,310 vs. 10,360, p costs for cases performed without mesh were $5,432; median direct costs for those using synthetic and biologic mesh were $7,590 and 16,970, respectively (p financial loss was $8,370. Outpatient ventral hernia repairs, with and without synthetic mesh, resulted in median net losses of $1,560 and 230, respectively. Ventral hernia repair is associated with overall financial losses. Inpatient synthetic mesh repairs are essentially budget neutral. Outpatient and inpatient repairs without mesh result in net financial losses. Inpatient biologic mesh repairs result in a negative contribution margin and striking net financial losses. Cost

Incidence of Incisional Hernia after Cesarean Delivery

DEFF Research Database (Denmark)

Aabakke, Anna J M; Krebs, Lone; Ladelund, Steen

2014-01-01

OBJECTIVE: To estimate the incidence of incisional hernias requiring surgical repair after cesarean delivery over a 10-year period. METHODS: This population- and register-based cohort study identified all women in Denmark with no history of previous abdominal surgery who had a cesarean delivery...... the inclusion period. The cumulated incidence of a hernia repair within 10 years after a cesarean delivery was 0.197% (95% CI 0.164-0.234%). The risk of a hernia repair was higher during the first 3 years after a cesarean delivery, with an incidence after 3 years of 0.157% (95% CI 0.127-0.187%). CONCLUSIONS...

Recurrence and complications of pediatric inguinal hernia repair ...

African Journals Online (AJOL)

complications of inguinal hernia repair in pediatric patients ... surgery. Patients and methods This retrospective study was ... Bilateral inguinal hernia was observed ..... single-blind comparison of laparoscopic versus open repair of pediatric.

The experience of surgical treatment of hiatal hernia with laparoscopic access

Directory of Open Access Journals (Sweden)

V.M. Ratchik

2017-09-01

Full Text Available Background. Diagnosis and treatment of hiatal hernia — one of the most pressing problems of modern medicine. The objective of the study is to present the experience of surgical treatment of hiatal hernia with laparoscopic access. Materials and methods. 67 patients with hiatal hernia underwent surgical treatment with laparoscopic access in the department of digestive of SI “Institute of Gastroenterology of the NAMS of Ukraine” for the period of 2013–2017. Results. Hiatal hernia type I was diagnosed in 60 (88.2 % patients, hiatal hernia type II — in 7 (10.4 % patients, mixed hiatal hernia with short esophagus — in 1 (1.5 % patient. Hernia cruroplasty was performed in 100 % patients with hiatal hernia: posterior cruroplasty — in 60 (89.6 % patients, anterior cruroplasty — in 2 (2.9 % patients, сombined cruroplasty — in 5 (7.5 % patients, alloplasty with cruroplasty — in 6 (8.9 % patients. We used the following options of laparoscopic fundoplication in patients with hiatal hernia: Nissen fundoplication — in 46 (68.7 %, Dor fundoplication — in 7 (10.4 % patients, Toupet fundoplication — in 14 (20.9 % patients. Fixing the cuff to the diaphragm crus were performed in 61 (91.0 % patients. Deaths after surgery were not registered. Conclusions. The results of the study indicate the high efficacy of laparoscopic access in the surgical treatment of patients with hiatal hernia.

Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension.

LENUS (Irish Health Repository)

Lyons, Mathew

2014-06-03

Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace׳s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development.

Hiatal Hernia

Science.gov (United States)

... happens. But a hiatal hernia might be caused by: Age-related changes in your diaphragm Injury to the area, for example, after trauma or certain types of surgery Being born with an unusually large hiatus Persistent and intense pressure on the surrounding muscles, such as while coughing , ...

External Validation of the European Hernia Society Classification for Postoperative Complications after Incisional Hernia Repair: A Cohort Study of 2,191 Patients.

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Kroese, Leonard F; Kleinrensink, Gert-Jan; Lange, Johan F; Gillion, Jean-Francois

2018-03-01

Incisional hernia is a frequent complication after midline laparotomy. Surgical hernia repair is associated with complications, but no clear predictive risk factors have been identified. The European Hernia Society (EHS) classification offers a structured framework to describe hernias and to analyze postoperative complications. Because of its structured nature, it might prove to be useful for preoperative patient or treatment classification. The objective of this study was to investigate the EHS classification as a predictor for postoperative complications after incisional hernia surgery. An analysis was performed using a registry-based, large-scale, prospective cohort study, including all patients undergoing incisional hernia surgery between September 1, 2011 and February 29, 2016. Univariate analyses and multivariable logistic regression analysis were performed to identify risk factors for postoperative complications. A total of 2,191 patients were included, of whom 323 (15%) had 1 or more complications. Factors associated with complications in univariate analyses (p < 0.20) and clinically relevant factors were included in the multivariable analysis. In the multivariable analysis, EHS width class, incarceration, open surgery, duration of surgery, Altemeier wound class, and therapeutic antibiotic treatment were independent risk factors for postoperative complications. Third recurrence and emergency surgery were associated with fewer complications. Incisional hernia repair is associated with a 15% complication rate. The EHS width classification is associated with postoperative complications. To identify patients at risk for complications, the EHS classification is useful. Copyright © 2017. Published by Elsevier Inc.

Intrathoracic Hernia after Total Gastrectomy

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Yoshihiko Tashiro

2016-05-01

Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

The Amyand’s Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography

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Suat Keskin

2013-01-01

Full Text Available Amyand’s hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand’s hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT scans. CT of the abdomen may help in guiding the diagnosis.

Celiac artery compression syndrome with bilateral Bochdalek hernia

International Nuclear Information System (INIS)

Kara, K.; Verim, S.; Bozkurt, Y.; Tasar, M.

2012-01-01

Full text: Introduction: Celiac artery compression syndrome or median arcuate ligament syndrome is rare and controversial condition. The definition of the syndrome relies on a combination of both clinical and radiographic features. It typically occurs in young patients, who may present with epigastric pain and weight loss. Bochdalek hernia is the most common congenital diaphragmatic hernia in adults. Bilaterality of this pathology is rare. There are not many reports about the associated pathologies to Bochdalek hernia. Objectives and tasks: We aimed to demonstrate the computed tomography (CT) angiography findings of celiac artery compression syndrome with Bochdalek hernia that has detected incidentally. Materials and methods: A CT angiography was performed to 32-year-old patient having postphelebitic syndrome for the possible diagnosis as pulmonary embolus. Results: At the imaging pulmonary arteries and the branches were normal. Celiac artery compression syndrome with Bochdalek Hernia was detected incidentally. A %75 stenosis at the origin of celiac artery and post stenotic dilatation after the stenosis was seen due to the compression. A poster medial defect at the diaphragm was seen as an additional finding for the cause of Bochdalek hernia. Conclusion: Many incidental finding can be detected at vascular and non vascular area in the routine CT angiography imaging. The pathologies like celiac artery compression syndrome and congenital diaphragm pathologies can be detected easily at CT angiography method

Laparoscopic repair of Morgagni diaphragmatic hernia in infants ...

African Journals Online (AJOL)

risk accruing from leaving the hernia sac intact. .... adenomatoid malformation of the lung, pneumohe- mothorax, anterior mediastinal mass, or lung abscess .... factor in the diagnosis, management and outcome in patients of Morgagni hernia.

Femoral hernia repair

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Dunbar KB, Jeyarajah DR. Abdominal hernias and gastric volvulus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap ...

CT and US findings of ovarian torsion within an incarcerated inguinal hernia.

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Hyun, Park Mee; Jung, Ah Young; Lee, Yul; Yang, Ik; Yang, Dae Hyun; Hwang, Ji-Young

2015-02-01

Inguinal hernia is relatively common in children. Although inguinal hernia is not frequently encountered in girls in comparison to boys, there are occasional cases of uterine or ovarian herniation in female indirect inguinal hernia. Incarcerated ovary in hernia sac has the risk of torsion and strangulation. We present an 8-year-old girl with painful mass in her left groin. With computed tomography (CT) and ultrasonography (US), we made the diagnosis of ovarian strangulation within an incarcerated inguinal hernia. Since ultrasound is primarily used for evaluation of groin mass, CT findings of an incarcerated inguinal hernia is rarely reported.

Obturator hernia: a rare case of acute mechanical intestinal obstruction.

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Aydin, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali

2013-01-01

Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.

Update on Bioactive Prosthetic Material for the Treatment of Hernias.

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Edelman, David S; Hodde, Jason P

2011-12-01

The use of mesh in the repair of hernias is commonplace. Synthetic mesh, like polypropylene, has been the workhorse for hernia repairs since the 1980s. Surgisis® mesh (Cook Surgical, Bloomington, IN), a biologic hernia graft material composed of purified porcine small intestinal submucosa (SIS), was first introduced to the United States in 1998 as an alternative to synthetic mesh materials. This mesh, composed of extracellular matrix collagen, fibronectin and associated glycosaminoglycans and growth factors, has been extensively investigated in animal models and used clinically in many types of surgical procedures. SIS acts as a scaffold for natural growth and strength. We reported our initial results in this publication in July 2006. Since then, there have been many more reports and numerous other bioactive prosthetic materials (BPMs) released. The object of this article is to briefly review some of the current literature on the use of BPM for inguinal hernias, sports hernias, and umbilical hernias.

Ventral hernia with uterine rupture after vaginal delivery

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Jung Mi Byun

2014-09-01

Conclusion: If a patient has hernia-related symptoms or complications, the diagnosis and management of the hernia should be performed as soon as possible, regardless of the onset, to decrease maternal and fetal mortality.

[Non-incarcerated inguinal hernia in children: operation within 7 days not necessary].

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Timmers, L; Hamming, J F; Oostvogel, H J M

2005-01-29

To assess the necessity to operate on non-incarcerated inguinal hernia in children within 7 days of diagnosis. Retrospective. Data on 360 children, 0-10 years old (104 girls and 256 boys) who were operated on for inguinal hernia between 1 January 1993-31 December 2001 at the St. Elisabeth Hospital in Tilburg, the Netherlands, were collected from the medical records. These data included sex, age, interval between diagnosis and repair, recurrence, incarceration, length of hospitalisation and complications. In the group of 113 children 0-1 years old, 137 inguinal hernias were repaired, ofwhich 16 were incarcerated on presentation. The interval between diagnosis and repair was known in 93 of 121 cases: 37 hernias were repaired within 7 days and 56 at a later stage. In the latter group, there was one case of secondary incarceration (1.8%; 95% CI: 0-5.4). The number needed to treat was 56. In the group of 247 children 1-10 years old, 269 inguinal hernias were repaired, of which 8 were primarily incarcerated. The interval between diagnosis and repair was known in 208 of 261 cases: 34 hernias were repaired within 7 days and 174 at a later stage. In the latter group, 3 hernias incarcerated secondarily (1.7%; 95% CI: 0-3.7). The number needed to treat was 58. In the group of non-incarcerated hernias 1 complication occurred, in the group of incarcerated hernias none. The mean length of hospitalisation of children with non-incarcerated hernia was 0.85 days, and of children with incarcerated hernia 2.4 days. In children with a non-incarcerated inguinal hernia who are waiting for an operation, the risk of secondary incarceration and complications is 2% which we do not think is enough reason to carry out an elective hernia-repair procedure within 7 days.

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 o...

Pre-operative pain and sensory function in groin hernia

DEFF Research Database (Denmark)

Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

2009-01-01

BACKGROUND: Although persistent postherniotomy occurs in 5-10% of patients, pathogenic mechanisms remain debatable. Since pre-operative pain has been demonstrated to be a risk factor for persistent postherniotomy pain, pre-operative alterations in nociceptive function may be a potential pathogenic...... mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... (7%), all whom experienced no pain or pain less than weekly. Only cool detection thresholds were significantly lower between the hernia vs. contralateral side (poperative groin hernia...

Correlation between early surgical complications and readmission rate after ventral hernia repair.

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Kokotovic, D; Sjølander, H; Gögenur, I; Helgstrand, F

2017-08-01

Postoperative surgical complications arising from ventral hernia repair have been assessed by a variety of outcome measures. The objective of this study was to correlate the Clavien Dindo Classification (CDC) graded complications with the 30-day readmission rate as early outcome measures in ventral hernia repair. Secondarily, we wanted to investigate whether the risk factors for Clavien Dindo class ≥1 and 30-day readmission were comparable. Single-centre retrospective study including all patients (≥18 years) who underwent ventral hernia repair between January 1, 2009 and September 1, 2014 at Zealand University Hospital. Data were obtained from hospital files and the Danish National Patient Registry. A 100% follow-up was obtained. In total, the study included 700 patients (261 patients with incisional hernia repair and 439 patients with umbilical or epigastric hernia repair). There was a significant association between a complication graded by the CDC ≥1 and 30-day readmission for both incisional and umbilical/epigastric hernia repair (p readmission. Recurrent (vs. primary) hernia repair was an independent risk factors for both CDC ≥1 and 30-day readmission in umbilical/epigastric hernia repair. Furthermore, hernia size 2-7 cm (vs. >2 cm) was a risk factor for CDC ≥1 but not for 30-day readmission in umbilical/epigastric hernia repair. Reports on 30-day readmission can be used as a general outcome measure in ventral hernia repair, however CDC provides a more precise and detailed registration of postoperative complications.

Pattern of abdominal wall herniae in females: a retrospective analysis

African Journals Online (AJOL)

Background: Gender differences are expected to influence the pattern and outcome of management of abdominal wall hernias. Some of these are left to speculations with few published articles on hernias in females. Objectives: To describe the clinical pattern of abdominal wall hernias in females. Method: A 5 year ...

Long-term follow-up results of umbilical hernia repair.

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Venclauskas, Linas; Jokubauskas, Mantas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

2017-12-01

Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias ( 30 kg/m 2 , diabetes and wound infection were independent risk factors for umbilical hernia recurrence. The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m 2 , diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

Hernia Surgery in Nyeri Provincial General Hospital, Kenya: Our 6 ...

African Journals Online (AJOL)

Introduction: Hernia is a common surgical condition world over. Much of hernia surgery in Africa is carried out as an emergency while elective procedures are few. Knowledge of the burden of hernia disease would facilitate optimal resource allocation. Methods: A retrospective audit between 2007 and 2012 was carried out ...

Obturator Hernia: A Rare Case of Acute Mechanical Intestinal Obstruction

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Ibrahim Aydin

2013-01-01

Full Text Available Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.

Aortic valve surgery of the 21st century: sutureless AVR versus TAVI.

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Costache, Victor S; Moldovan, Horatiu; Arsenescu, Catalina; Costache, Andreea

2018-04-01

Surgical aortic valve replacement (sAVR) has been a safe, effective and time-proven technique and is still the standard of care all over the world for aortic valve treatment. The vast majority of centers perform this procedure by doing a median sternotomy with several disadvantages. While many others specialties went minimally invasive decades ago, in cardiovascular field transcatheter valve implantation was the first minimally invasive valvular procedure that gained rapid worldwide acceptance. Transcatheter valve replacement (TAVR) is now marketed as a procedure that should be performed under local anesthesia, by an interventional cardiologist via trans femoral route with no other healthcare professional invited to the patient selection or case planning. An increasing number of surgeons are promoting minimally invasive aortic valve replacement, which is gaining grounds, especially with the help of the new sutureless valve technology. With these two new technologies emerging, legitimate questions arise and need to be answered - which has the longest durability, lower complication rate and lower overall mortality.

Laparoscopic inguinal hernia repair: review of 6 years experience.

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Vanclooster, P; Smet, B; de Gheldere, C; Segers, K

2001-01-01

Since 6 years, the totally extraperitoneal laparoscopic hernia repair has become our procedure of choice to manage inguinal hernia in adult patients, especially for bilateral hernias and recurrences after classical anterior repair. Between March 1993 and March 1999, 976 patients underwent 1259 hernia repairs by an endoscopic total extraperitoneal approach. A large polypropylene prosthesis (15 x 15 cm) is placed and covers all potential defects. Follow-up on patients ranged from 6 to 79 months (mean, 39 months). Per- and postoperative morbidity and complications were acceptable (8.4%) and included conversion to open surgery (0.4%), bleedings (0.3%), urinary retention (4.2%), seromas (2.7%), neuralgias (0.2%), vague persistent groin discomfort (0.4%), orchitis (0.08%) and sigmoido-cutaneous fistula (0.08%). Recurrence rate so far is 0.1%. This retrospective study shows that the totally extraperitoneal repair for inguinal hernia should have a promising future because of low morbidity and low recurrence rate.

[Laparoscopic approach in large hiatal hernia--particular considerations].

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Munteanu, R; Copăescu, C; Iosifescu, R; Timişescu, Lucia; Dragomirescu, C

2003-01-01

Large hiatal hernia are associated with permanent or intermittent protrusion of more than 1/3 of the stomach into the chest, single or in associated with other organs, a hiatal defect greater than 5 cm and various complications related to the morphological and physiological modifications. While the laparoscopic approach in small hiatal hernia and gastro-esophageal reflux disease is a standard procedure in large hiatal hernia persists a number of questions and controversies. Between 1995 and 2002 a number of 23 patients with large hiatal hernia (9 men, 14 women), mean age 65.8 years (range 49 to 77) underwent laparoscopic surgery. The majority of the patients had complications of the disease (dysphagia, severe esophagitis, anemia, respiratory and cardiac failure). In 16 cases was a sliding hernia (one recurrent after open procedure), in 2 paraesophageal and in 5 a mixed hernia (two "upside-down" type). In 7 cases we perform, in the same operation, cholecystectomy for gallbladder stones and in one cases Heller myotomy for achalasia. In all cases the repairs was performed by using interrupted stitches to approximate the crurae, but in three of them (recurrent and upside down hernia) we consider necessary to repair with a polypropylene mesh (10 x 5 cm) with a "keyhole" for the esophagus. In these particular cases we do not perform a antireflux procedure, in others 20 cases a short floppy Nissen was done. During the operation one patient developed a left pneumothorax and required pleural drainage. Postoperatively one patient had dysphagia treated by pneumatic dilatation and another die 3 weeks after the surgery because severe respiratory and cardiac failure. Laparoscopic approach is a feasible and effective procedure with good postoperatively results, but required good skills in mininvasive technique.

Laparoscopic approach to incarcerated inguinal hernia in children.

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Kaya, Mete; Hückstedt, Thomas; Schier, Felix

2006-03-01

The purpose of this study was to describe the laparoscopic approach to incarcerated inguinal hernia in children. After unsuccessful manual reduction, 29 patients (aged 3 weeks to 7 years; median, 10 weeks; 44 boys, 15 girls) with incarcerated inguinal hernia underwent immediate laparoscopy. The hernial content was reduced in a combined technique of external manual pressure and internal pulling by forceps. The bowel was inspected, and the hernia was repaired. In all patients, the procedure was successful. No conversion to the open approach was required. Immediate laparoscopic herniorrhaphy in the same session was added. No complications occurred. Laparoscopy allowed for simultaneous reduction under direct visual control, inspection of the incarcerated organ, and definitive repair of the hernia. Technically, it appears easier than the conventional approach because of the internal inguinal ring being widened by intraabdominal carbon dioxide insufflation. The hospital stay is shorter.

Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients

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Harshit Garg

2017-01-01

Full Text Available Background: The aim of this study was to analyse the impact of hiatal hernia repair (HHR on gastro-oesophageal reflux disease (GERD in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG. Materials and Methods: It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS questionnaire and anti-reflux medications. Results: Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80% showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. Conclusion: In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

Chronic diaphragmatic hernia in 34 dogs and 16 cats.

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Minihan, Anne C; Berg, John; Evans, Krista L

2004-01-01

Medical records of 34 dogs and 16 cats undergoing surgical repair of diaphragmatic hernia of >2 weeks' duration were reviewed, and long-term follow-up information was obtained. The most common clinical signs were dyspnea and vomiting; however, many of the animals were presented for nonspecific signs such as anorexia, lethargy, and weight loss. Thoracic radiographs revealed evidence of diaphragmatic hernia in only 66% of the animals, and additional imaging tests were often needed to confirm the diagnosis. Thirty-six hernias were repaired through a midline laparotomy; 14 required a median sternotomy combined with a laparotomy. In 14 animals, division of mature adhesions of the lungs or diaphragm to the herniated organs was necessary to permit reduction of the hernia. Fourteen animals required resection of portions of the lungs, liver, or intestine. All hernias were sutured primarily without the use of tissue flaps or mesh implants. Twenty-one of the animals developed transient complications in the postoperative period; the most common of these was pneumothorax. The mortality rate was 14%. Thirty-four (79%) of the animals that were discharged from the hospital had complete resolution of clinical signs, and none developed evidence of recurrent diaphragmatic hernia during the follow-up period. Nine were lost to follow-up.

Obturator Hernia: diagnosis and management under conditions of ...

African Journals Online (AJOL)

85.7%) underwent full resection and anastomosis, and one (14.3%) had partial resection. Hernia defect was closed in four (57.1%). Wound infection was common (71.4%) and three (43%) died. Conclusion: Obturator hernia is mainly a disease ...

Acquired secondary Grynfeltt's hernia: a case report

International Nuclear Information System (INIS)

Renck, Decio Valente; Lopes Junior, Joao Ivan

2009-01-01

Lumbar hernia is a rare condition whose diagnosis is hardly achieved. The prevalence is higher in elderly men. The present case report describes the case of a male, 78-year-old patient who underwent pleural effusion drainage 17 years before presenting with clinical manifestations and tomographic findings compatible with acquired secondary Grynfeltt's hernia. (author)

Congenital paraesophageal hiatus hernia with gastric volvulus

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Kshirsagar Ashok

2008-01-01

Full Text Available Paraesophageal hiatus hernia is rarely seen in the neonatal period. An intrathoracic gastric volvulus complicating such a hernia is rarer. The upper gastrointestinal tract contrast study is diagnostic. Rapid diagnosis and treatment is essential. It avoids lethal complications as gastric dilatation, gangrene and perforation, which in turn may lead to cardiopulmonary arrest.

Abdominal wall hernias: imaging with spiral CT

International Nuclear Information System (INIS)

Stabile Ianora, A.A.; Midiri, M.; Vinci, R.; Rotondo, A.; Angelelli, G.

2000-01-01

Computed tomography is an accurate method of identifying the various types of abdominal wall hernias, especially if they are clinically occult, and of distinguishing them from other diseases such as hematomas, abscesses and neoplasia. In this study we examined the CT images of 94 patients affected by abdominal wall hernias observed over a period of 6 years. Computed tomography clearly demonstrates the anatomical site of the hernial sac, the content and any occlusive bowel complications due to incarceration or strangulation. Clinical diagnosis of external hernias is particularly difficult in obese patients or in those with laparotic scars. In these cases abdominal imaging is essential for a correct preoperative diagnosis and to determine the most effective treatment. (orig.)

Bilateral Morgagni Hernia: A Unique Presentation of a Rare Pathology

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Michael Leshen

2016-01-01

Full Text Available Morgagni hernia is an unusual congenital herniation of abdominal content through the triangular parasternal gaps of the anterior diaphragm. They are commonly asymptomatic and right-sided. We present a case of a bilateral Morgagni hernia resulting in delayed growth in a 10-month-old boy. The presentation was unique due to its bilateral nature and its symptomatic compression of the mediastinum. Diagnosis was made by 3D reconstructed CT angiogram. The patient underwent medical optimization until he was safely able to tolerate laparoscopic surgical repair of his hernia. Upon laparoscopy, the CT findings were confirmed and the hernia was repaired.

Factors Influencing Choice of Inguinal Hernia Repair Technique ...

African Journals Online (AJOL)

Background: Inguinal hernia repair surgery is one of the most frequently performed surgical procedures worldwide. This study sought to highlight factors that may influence decisions concerning inguinal hernia repair techniques. Methods: This descriptive crosssectional study was carried out in September 2014 among ...

Konsensus zur Anwendung der "Tension-free Vaginal Tape" (TVT Operation bei der weiblichen Belastungsinkontinenz

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Hanzal E

2003-01-01

Full Text Available Unter der Patronanz der Medizinischen Gesellschaft für Inkontinenzhilfe Österreich wurde im Juni 2002 in Wien die 2. Auflage eines Österreichischen Tension-free Vaginal Tape (TVT Konsensus-Meetings abgehalten. TVT ist eine neue Operationstechnik zur Behandlung der weiblichen Stressharninkontinenz, die seit 1998 in Österreich eingesetzt wird. Im Rahmen des Treffens, an dem Experten aus den Fachbereichen Urologie und Gynäkologie teilnahmen, wurde die vorhandene Fachliteratur analysiert und ein Konsensus für die präoperative Abklärung, Durchführung und postoperative Verlaufskontrolle als Basis für eine laufende Qualitätsverbesserung des Verfahrens erarbeitet, dessen Ergebnis in dem vorliegenden Papier als Leitlinie zusammengefaßt ist.

Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria ...

African Journals Online (AJOL)

Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria. ... wall hernia who had operative intervention and other postoperative management. ... elective in 23 patients (21%) who had spontaneous reduction while awaiting surgery.

Inguinal hernia repair in the Amsterdam region 1994-1996.

Science.gov (United States)

Schoots, I G; van Dijkman, B; Butzelaar, R M; van Geldere, D; Simons, M P

2001-03-01

In the Netherlands, approximately 30,000 inguinal hernia repairs are performed yearly. At least 15% are for recurrence. New procedures are being introduced creating discussion on which technique is the best. Currently it is not possible to choose on evidence alone because of the long follow-up that is needed. In 1996 an inventory was taken of all inguinal hernia repairs that were performed in the Amsterdam region (9 hospitals). These results were compared with the results from a similar study performed in 1994. Major changes in treatment strategy were noted. The Bassini repair was replaced by Shouldice and Lichtenstein techniques. There was a significant increase in the use of prostheses for both primary and recurrent inguinal hernias. There was no significant decrease in the percentage of operations performed for recurrent hernia from 19.5% to 16.8%. However, there was a significant decrease in operations performed for early recurrences (5.1%-3.4%) (p = 0.05). These results suggest that the Shouldice and Lichtenstein repairs may be superior to the Bassini repair in terms of early hernia recurrence.

Androgen receptors in the pelvic diaphragm muscles of dogs with and without perineal hernia.

Science.gov (United States)

Mann, F A; Nonneman, D J; Pope, E R; Boothe, H W; Welshons, W V; Ganjam, V K

1995-01-01

Levator ani and coccygeus muscle estrogen and androgen receptors were measured in 6, healthy, > or = 5-year-old, noncastrated, male Beagles (controls) and in 24 dogs with perineal hernia. Estrogen and androgen receptor analyses were performed on levator ani and coccygeus muscle specimens obtained from control dogs at the time of castration; contralateral levator ani and coccygeus muscle specimens were assayed 2 months after castration. During herniorrhaphy of dogs with perineal hernia, levator ani (non-castrated, n = 12; castrated, n = 7) and/or coccygeus (noncastrated, n = 5; castrated, n = 4) muscle biopsy specimens were obtained for estrogen and androgen receptor analyses. For estrogen and androgen receptor assays, each muscle biopsy specimen was homogenized in Tris-EDTA-glycerol buffer, and centrifuged at 30,000 x g; extracts were used for binding with ligands: [3H]methyltrienolone (3HR1881) for androgen receptors, and [3H]estradiol-17 beta for estrogen receptors. Extracts were incubated overnight at 0 to 4 C. Nonspecific binding was estimated, using 100-fold concentration of cold ligands. Bound and free hormones were separated, using hydroxylapatite batch assay. Receptor numbers for each tissue were calculated as femtomoles (fmol) per milligram of protein. Quantified data were compared between precastration and postcastration controls, using a paired t-test. One-way ANOVA and Bonferroni post-hoc test were used to compare values for precastration controls, postcastration controls, castrated dogs with perineal hernia, and noncastrated dogs with perineal hernia. Significance was set at P < 0.05.(ABSTRACT TRUNCATED AT 250 WORDS)

Bowel obstruction in obturator hernia: A challenging diagnosis

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L. Conti

2018-01-01

Conclusion: Obturator hernia is a rare type of hernia due to his diagnosis, which is often unclear; a prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.

Transdiaphragmatic intercostal hernia: imaging aspects in three cases

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Ana Carolina Sandoval Macedo

2013-06-01

Full Text Available Transdiaphragmatic intercostal hernia is uncommon and mostly related to blunt or penetrating trauma. We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance in each of the cases.

Laparoscopic repair of Morgagni diaphragmatic hernia in children ...

African Journals Online (AJOL)

Minimal invasive surgery allows for excellent visualisation of the diaphragm, and is increasingly used for the repair of diaphragmatic hernias in children. This report describes laparoscopic repairs between 2001 and 2007 of four Morgagni hernias in children. All defects were treated successfully using the laparoscopic ...

The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia.

Science.gov (United States)

Lee, S R; Choi, S B

2017-06-01

Pediatric laparoscopic herniorrhaphy has rare complications, but recurrence might occur. The purpose of this manuscript is to evaluate the efficacy of linear suture technique of laparoscopic pediatric herniorrhaphy in reducing recurrences. Laparoscopic surgery was performed on 2223 pediatric patients (under 10 years old) from September 2012 to December 2014 in Damsoyu Hospital, Seoul, Republic of Korea. The causes of recurrence were investigated case by case. The patients were categorized into two groups according to the suture method used in closing the hernia orifice: Group 1 (purse-string suture, 1009 patients) and Group 2 (linear suture, 1214 patients). There were 1413 (63.6%) male and 810 (36.4%) female patients. Mean age was 30.5 ± 29.2 months. A significantly higher proportion of male patients, contralateral patent processus vaginalis, and less proportion of recurrence were observed in Group 2. There were ten cases of recurrence in Group 1 because the internal ring suture could not endure the tension. One recurrence occurred in Group 2. The suture technique and age were found to be a significant risk factor for recurrence. Linear suture technique had a lower recurrence rate (odds ratio = 0.07, with 95% confidence interval 0.01-0.53, and p = 0.004). Purse-string suture technique causes significantly higher occurrence of hernia recurrences than linear suture technique. Linear suture technique can reduce recurrence by increasing the endurance to tension around the internal ring by distributing pressure to a wider area along the linear suture line. Linear suture technique can effectively reduce recurrence in pediatric inguinal herniorrhaphy.

Incidental De Garengeot's hernia: A case report of dual pathology to remember.

Science.gov (United States)

Whitehead-Clarke, Thomas; Parampalli, Umesh; Bhardwaj, Rakesh

2015-01-01

A De Garengeot's hernia is the very rare dual pathology of a vermiform appendix within a femoral hernia. We discuss the rare case of a 62 year old female who presented as an emergency with a strangulated femoral hernia. Within the hernia sac a partly necrotic vermiform appendix was discovered. The patient successfully underwent an appendicectomy and repair of her femoral hernia. The post-operative period was uneventful, with no further issues at follow-up. Our case report displays the successful treatment of a De Garengeot's hernia as an emergency admission, with a shorter than average admission time, and no post-operative complications. This is a rare case of dual pathology, of which we believe there are few published cases. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

An incarcerated Amyand’s hernia: Shall we apply appendectomy routinely?

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Gökhan Demiral

2018-03-01

Full Text Available Amyand’s hernia is a very rare clinical condition characterized by the presence of a normal or inflammed appendix within the inguinal hernia sac. It may be present as an acute apendicitis inside the sac or incarcerated hernia. Sometimes it may be asymptomatic. We report a case of 70-year-old male patient that was presented to our emergency service with a huge right inguinal mass that was diagnosed as an incarcerated inguinal hernia and underwent operation. The intraoperative findings included small intestinal segment, large omental tissue and mobile cecum with healthy appendix inside the sac. There was no sign of strangulation. Lichtenstein herniorhaphy was done without appendectomy.

Congenital hernia of cord: an often misdiagnosed entity

Science.gov (United States)

Raju, Rubin; Satti, Mohamed; Lee, Quoc; Vettraino, Ivana

2015-01-01

Congenital hernia of the cord, also known as umbilical cord hernia, is an often misdiagnosed and under-reported entity, easily confused with a small omphalocele. It is different from postnatally diagnosed umbilical hernias and is believed to arise from persistent physiological mid-gut herniation. Its incidence is estimated to be 1 in 5000. Unlike an omphalocele, it is considered benign and is not linked with chromosomal anomalies. It has been loosely associated with intestinal anomalies, suggesting the need for a complete fetal anatomical ultrasound evaluation. We present a case of a fetal umbilical cord hernia diagnosed in a 28-year-old woman at 21 weeks gestation. The antenatal and intrapartum courses were uncomplicated. It was misdiagnosed postnatally as a small omphalocele, causing unwarranted anxiety in the parents. Increased awareness and knowledge of such an entity among health professionals is important to prevent unwarranted anxiety from misdiagnosis, and inadvertent bowel injury during cord clamping at delivery. PMID:25899514

Internal hernia through the pouch of douglas after hysterectomy: A case report

International Nuclear Information System (INIS)

Yang, Dong Jin; Cho, Seung Hyun; Shin, Hyun Woong; Kim, Tae Eun; Kim, Byung Young; Kim, Hee Jin

2012-01-01

Internal hernia is a rare cause of small bowel obstruction. Among the different types of internal hernias, the pelvic hernia is extremely rare. We report the radiographic findings of a patient with a Douglas pouch hernia presenting with closed loop obstruction at the anterior aspect of the distal rectum. The patient was a 60 year old female, who had undergone a hysterectomy 20 years prior, for treatment of a uterine myoma

Recurrence and Pain after Mesh Repair of Inguinal Hernias

African Journals Online (AJOL)

Abstract. Background: Surgery for inguinal hernias has ... repair. Methods: The study was conducted on all inguinal hernia patients operated between 1st. October ... bilateral (1.6%). Only 101 .... Open Mesh Versus Laparoscopic Mesh. Repair ...

Incidental De Garengeot?s hernia: A case report of dual pathology to remember

OpenAIRE

Whitehead-Clarke, Thomas; Parampalli, Umesh; Bhardwaj, Rakesh

2015-01-01

Introduction: A De Garengeot’s hernia is the very rare dual pathology of a vermiform appendix within a femoral hernia. Presentation of case: We discuss the rare case of a 62 year old female who presented as an emergency with a strangulated femoral hernia. Within the hernia sac a partly necrotic vermiform appendix was discovered. The patient successfully underwent an appendicectomy and repair of her femoral hernia. The post-operative period was uneventful, with no further issues at follow-u...

The tension of framed membranes from computer simulations

DEFF Research Database (Denmark)

Hamkens, Daniel; Jeppesen, Claus; Ipsen, John H.

2018-01-01

the membranes display power-law characteristics for the equation of state, while higher tension levels includes both an extended linear (elastic) as well as a highly non-linear stretching regime. For semi-flexible membranes a transition from extended to buckled conformations takes place at negative frame......Abstract.: We have analyzed the behavior of a randomly triangulated, self-avoiding surface model of a flexible, fluid membrane subject to a circular boundary by Wang-Landau Monte Carlo computer simulation techniques. The dependence of the canonical free energy and frame tension on the frame area...... is obtained for flexible membranes. It is shown that for low bending rigidities the framed membrane is only stable above a threshold tension, suggesting a discontinuous transition from the collapsed (branched polymer) state to a finite tension extended state. In a tension range above this threshold tension...

Retrospective Study (2009-2014): Perineal Hernias and Related Comorbidities in Bitches.

Science.gov (United States)

Hayashi, Ayne Murata; Rosner, Sandra Aparecida; de Assumpção, Thais Cristine Alves; Stopiglia, Angelo João; Matera, Julia Maria

2016-12-01

Retrospective study based on data extracted from medical records of dogs diagnosed with perineal hernia between 2009 and 2014; medical records of bitches were selected for further analysis to determine the prevalence of perineal hernias in bitches and to investigate potential comorbidities. Perineal hernia was diagnosed in 182 dogs (174 males and 8 females; 96% and 4%, respectively). Surgical correction was performed in 6 bitches. Surgical procedures corresponded to internal obturator muscle transposition with or without polypropylene mesh reinforcement (n = 5) and semitendinosus muscle transposition flap (n = 1). Major comorbidities associated with perineal hernias in adult bitches were trauma (n = 3; 7.3 ± 1.5 years; 7.1 ± 8.5kg) and persistent cough secondary to conditions such as bronchitis, tracheal collapse, and cardiopathy in aged, small-sized patients (n = 3; 13.6 ± 2.0 years; 2.3 ± 0.1kg). Perineal hernias are uncommon in bitches and tend to be associated with comorbidities in these patients. Aged female dogs suffering from uncontrolled chronic cough secondary to cardiopathy or bronchitis are at risk of developing perineal hernia. Previous trauma to the pelvis is another potential risk factor for perineal hernia development in female dogs. Copyright © 2016. Published by Elsevier Inc.

Modified semitendinosus muscle transposition to repair ventral perineal hernia in 14 dogs.

Science.gov (United States)

Morello, E; Martano, M; Zabarino, S; Piras, L A; Nicoli, S; Bussadori, R; Buracco, P

2015-06-01

To describe a modified technique of semitendinosus muscle transposition for the repair of ventral perineal hernia. Retrospective review of case records of dogs with ventral perineal hernia that were treated by transposing the medial half of the longitudinally split semitendinosus muscle of one limb. The transposition of the internal obturator muscle was used when uni- or bilateral rectal sacculation was also present in addition to ventral perineal hernia; colopexy and vas deferens pexy were also performed. Fourteen dogs were included. In addition to ventral perineal hernia, unilateral and bilateral perineal hernia was also present in five and six of the dogs, respectively. The mean follow-up time was 890 days. Ventral perineal hernia was successfully managed by the modified semitendinosus muscle transposition with minor complications in all the dogs included in the study. Despite the small number of dogs included, the unilateral transposition of the medial half of the longitudinally split semitendinosus muscle consistently supported the ventral rectal enlargement in perineal hernia without obvious adverse effects. © 2015 British Small Animal Veterinary Association.

Amyand’s Hernia, State of the Art and New Points of View

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Guido Mantovani

2017-01-01

Full Text Available Background. Amyand’s hernia (AH is an inguinal hernia containing the vermiform appendix, with an incidence between 0.4% and 1% of all inguinal hernias. Acute or perforated appendicitis can complicate AH. Case Presentation. A 75-year-old Caucasian man presented with incarceration of vermiform appendix in inguinal hernia sac. Diagnosis was posed preoperatively with computed tomography (CT scan. Patient underwent urgent surgery and simultaneous appendectomy and hernia repair by Bassini’s technique were performed. Conclusions. Preoperative diagnosis of AH is rare; however it could be useful for surgeon to choose operative approach. Treatment of AH depends on grade of appendix inflammation and/or perforation. The technique utilized to repair hernia depends largely on surgeon’s preferences; the presence of inflamed or perforated appendix is not an absolute contraindication for using a prosthetic mesh.

Conventional X-ray examination of hiatus hernia in aged people (31 cases report)

International Nuclear Information System (INIS)

Xu Xiaoyuan; Xie Zirong; Liao Chengyang; Xiong Bo

2008-01-01

Objective: To evaluate methods and features of X-ray examination in aged people with hiatus hernia. Methods: Imaging features of chest film, fluoroscopy and barium meal examination of 31 cases with hiatus hernia diagnosed by barium meal examination were retrospectively analyzed. Results Sac shadows behind the heart were showed in all 23 cases, including chest film (14/23 cases) and fluoroscopy (9/23 cases), 20 cases of which were irreducible hiatus hernia diagnosed by barium meal immediately. 3 cases were misdiagnosed by the chest film, with occupying lesions of the left lower lung (2/3 cases) or aneurysm of descending aorta (1/3 cases). Gastric mucosa was showed in thorax above the left hemidiaphragm in another 8 cases with hiatus hernia evaluated by barium meal, including 5 cases irreducible hiatus hernia and 3 cases sliding hiatus hernia. Conclusion: Chest film, fluoroscopy and barium meal play different roles in the diagnosis of hiatus hernia. Though chest film and fluoroscopy could detect easily, barium meal is of the most importance in evaluation of hiatus hernia due to its characteristics. (authors)

The value of fetal ultrasonography and magnetic resonance imaging in the assessment of diaphragmatic hernias

International Nuclear Information System (INIS)

Amim, Bruno; Guerra, Fernando; Marchiori, Edson; Gasparetto, Emerson Leandro

2008-01-01

To demonstrate the relevance of ultrasonography and magnetic resonance imaging findings in the prenatal characterization and prognostic evaluation in cases of congenital diaphragmatic hernia. Materials And Methods: Fourteen pregnant women (mean gestational age = 28.7 weeks) who had undergone ultrasonography for suspicion of fetuses with congenital diaphragmatic hernia were assessed by means of magnetic resonance imaging on a 1.5 tesla equipment, following the standard protocol. Two radiologists evaluated the images and the findings were defined by consensus. Results: Twelve fetuses had left diaphragmatic hernia and two, right diaphragmatic hernia. Ultrasonography showed the fetal liver inside the thorax of five fetuses (three with left diaphragmatic hernia, and two with right diaphragmatic hernia) and magnetic resonance imaging in eight fetuses (six with left diaphragmatic hernia, and two with right diaphragmatic hernia). Stomach and small bowel loop herniation was observed in all of the fetuses with left diaphragmatic hernia (n = 12) at both magnetic resonance imaging and ultrasonography. Eight fetuses (seven with left diaphragmatic hernia and one with right diaphragmatic hernia) survived after surgical treatment. Conclusion: Ultrasonography and magnetic resonance imaging are complementary imaging methods in the evaluation of congenital diaphragmatic hernia. Magnetic resonance imaging is a helpful diagnostic method complementary to ultrasonography for evaluation of the fetal liver positioning, considering its relevance as a prognostic factor in cases of congenital diaphragmatic hernia. (author)

The prevalence of umbilical and epigastric hernia repair

DEFF Research Database (Denmark)

Burcharth, J; Pedersen, M S; Pommergaard, H-C

2015-01-01

in Denmark on December 31st, 2010 was performed. Within this population all umbilical and epigastric hernia repairs from January 1st, 2006 to December 31st, 2010 were identified using data from the Danish National Hospital Register, and 5-year prevalence estimates were calculated. RESULTS: The study...... hernia repairs was seen in males aged 60-70 years with a 5-year prevalence of 0.53 % (95 % CI 0.51-0.56 %) and the highest age-specific 5-year prevalence of epigastric hernia repair was seen in 40-50 year females with a 5-year prevalence of 0.086 % (95 % CI 0.077-0.095 %). CONCLUSION: The gender and age...

Comparison of Midterm Efficiency and Complications of Tension-Free Vaginal Tape Alone and Tension-Free Vaginal Tape Performed with Vaginal Hysterectomy

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Emre Sinan Güngör

2017-09-01

Full Text Available Aim: To evaluate and compare the results and complications of tension-free vaginal tape (TVT when performed alone or with vaginal hysterectomy (VH and to evaluate the mid-term success rates of TVT for both groups. Methods: A retrospective study was performed on 179 patients who had TVT alone for stress urinary incontinance (SUI or TVT with VH for SUI and vaginal prolapse. Demographic, outcome and complication data were obtained from medical records. The main outcome measures were postoperative SUI and voiding dysfunction. Results: The mean age of the patients who underwent TVT and TVT+VH were 50.2±6.8 and 52.2±8.1, respectively (p>0.05 and the mean parity was 4±2.07 and 4.15±2.02, respectively (p>0.05. The success rate was significantly higher in TVT alone group than in TVT+VH group (93.6% vs. 84.5%, p0.05. Overall complication rate was higher in TVT+VH group (4.2% vs. 9.5%, p<0.05. Postoperative residuel urine volumes were significantly higher than preoperative residuel urine volumes in both groups (p=0.001. Due to mesh rejection, second surgery was performed in one patient from both groups to reomove the mesh. Conclusion: Midterm success rates were significantly higher in TVT group than in TVT+VH group, but success rates in TVT+VH were acceptable. Overall complication rates were higher in TVT+VH group; requirement for a second surgery was similar for both groups.

The use of sterilized mosquito nets for hernioplasty

DEFF Research Database (Denmark)

Sørensen, C G; Rosenberg, J

2012-01-01

Hernia repair is among the most frequent surgeries performed. Surgeons prefer the tension-free mesh repair, but in large parts of the world, commercial meshes are unavailable or unaffordable. Consequently, surgeons have been experimenting with insertion of inexpensive non-commercial meshes, the m......, the most common being a non-impregnated, sterilized mosquito net....

Post Operative Pain Control in Inguinal Hernia Repair: Comparison ...

African Journals Online (AJOL)

ADMIN

drug to be used for local wound infiltrations following inguinal hernia repair. Results: A total of 52 ... intramuscularly or via intravenously 2,3. The local ..... suppository and local marcaine injection on inguinal hernia surgery. Arch crit care.

Vasitis mimicking an Amyand’s hernia: A case report

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Juan Manuel Romero Marcos

2017-01-01

Conclusion: Presently, Amyand’s hernia is more frequently diagnosed preoperatively than intraoperatively. However when an Amyand’s hernia is preoperatively suspected, the possibility of a vasitis should always be ruled out in order to avoid unnecessary operations.

Two-trocar needlescopic approach to incarcerated inguinal hernia in children.

Science.gov (United States)

Shalaby, Rafik; Shams, Abdul Moniem; Mohamed, Soliman; el-Leathy, Mohamed; Ibrahem, Medhat; Alsaed, Gamal

2007-07-01

Many studies described the safety and effectiveness of laparoscopy in the treatment of inguinal hernia in children. Needlescopic techniques have been recently used in repairing inguinal hernias, which made this type of surgery more cosmetic and less invasive. However, few reports have described its role in the treatment of incarcerated inguinal hernia. The aim of this study was to assess the feasibility and outcome of needlescopy in the treatment of incarcerated inguinal hernia in children. A total of 250 children, comprising 190 boys and 60 girls, who presented with incarcerated inguinal hernia were analyzed. Their ages ranged from 6 months to 6 years (mean age, 2 years). In 170 (68%) cases, manual reduction was successful. One hundred of these patients were subjected to definitive surgery in the same day, whereas the remaining 70 patients were subjected to needlescopy 1 to 3 days later. In 80 (32%) cases, external manual reduction was unsuccessful. These children were subjected to urgent needlescopic reduction and herniorrhaphy. The incarcerated herniae were easily reduced and the contents thoroughly inspected under direct vision. Then the hernia was repaired in the same setting. In all patients, there was no need to convert the procedure to an open approach. Immediate needlescopic herniorrhaphy in the same session was added without significant increase in operative time. The mean operative time is 10 minutes. There were no intraoperative complications. The study showed that needlescopic approach to incarcerated inguinal hernia in children is feasible, safe, easy, and preferable to the open surgery. In addition to reduction of incarcerated hernial contents under direct vision, it allows definitive treatment of hernial defect at the same time without significant increase in operative time and hospital stay.

Surgical treatment of the giant hiatal hernia - A single-center experience

DEFF Research Database (Denmark)

Jensen, Jonas Sanberg

Introduction All symptomatic giant hiatal hernias, defined as any hiatal hernia where more than 30% of the stomach is placed intrathoracically, should be addressed with elective surgery, significantly reducing the risk of complications. Symptoms of incarceration require immediate emergency surgery...... and occur in less than 2% per year. The purpose of this study was to evaluate perioperative data, outcome and patient satisfaction in patients undergoing emergency or planned surgery for giant hiatal hernia in a Danish centre. Methods and Procedures This retrospective study was performed using patient...... records of all patients undergoing emergency (E) or planned (P) primary laparoscopic repair for giant hiatal hernia at a single center over a six-year period. Demographics and characteristics of hiatal hernia and surgery were registered. Admission length, complications and readmission within 30 days were...

Alternative wavelengths for sutureless laser microvascular anastomosis: a preliminary study on acute samples.

Science.gov (United States)

Bass, L S; Oz, M C; Libutti, S K; Treat, M R

1992-06-01

Attempts to improve the speed and patency of microvascular anastomosis with laser-assisted techniques have provided a modest reduction in operative time and comparable success rates. Using sutureless microvascular anastomoses, 30 end-to-end anastomoses were created in the rat carotid artery using the gallium-aluminum-arsenide diode laser (808 nm). Indocyanine green and fibrinogen were applied to enhance tissue absorption of the laser energy and strengthen the bond created. These were compared with previously reported welds using the THC:YAG laser (2150 nm). Mean welding times were 140 and 288 s, and mean bursting pressures immediately after welding were 515 and 400 mmHg for the diode and THC:YAG laser groups, respectively. Histologically, both lateral and vertical spread of thermal damage was limited. Since both lasers create welds of adequate initial strength without stay sutures and are faster and easier to use than existing systems, evaluation of long-term patency would be worthwhile.

Sonography in the postoperative evaluation of laparoscopic inguinal hernia repair.

Science.gov (United States)

Furtschegger, A; Sandbichler, P; Judmaier, W; Gstir, H; Steiner, E; Egender, G

1995-09-01

We evaluated the use of sonography as a means of assessing hernial occlusion and possible postoperative changes such as hematomas or seromas in the inguinal and scrotal regions after 1139 laparoscopic repairs of hernias between August 1992 and November 1994. Changes after laparoscopic hernia repair were found in 307 patients (27%). Hematomas or seromas were seen in 132 patients, protrusion of the prosthetic mesh in 17, mesh infection in two, and small bowel entrapment in an insufficient peritoneal suture in two. Recurrences were diagnosed correctly in six patients, mobile preperitoneal lipomas in five. Sonography is useful in the evaluation of complications after laparoscopic hernia repair, including recurrent hernia. In the absence of symptoms, sonography is not indicated.

Outcome of laproscopic totally extraperitoneal hernioplasty for inguinal hernia

International Nuclear Information System (INIS)

Hanif, H.; Memon, S.H.

2015-01-01

Background: Hernioplasty for Inguinal hernia is one of the commonest operations performed in general surgical wards. More recently, interest has waxed and waned regarding the minimally invasive approach to hernioplasty. This study was carried out to assess the management outcome of minimally invasive hernioplasty (Totally extra-peritoneal approach) as the treatment of choice for uncomplicated (incomplete and reducible) inguinal hernia. Method: In this quasi experimental study patients aged between 14-83 years who were otherwise fit and willing for total extra-peritoneal laparoscopic repair were recruited prospectively over a 10 month period. Thirty-seven such patients were operated and followed up in the hernia clinics. Six cases were later excluded for lack of proper follow-up. Results: The typical patient was middle-aged male with right-sided inguinal hernia. Mean operating time was 53.3 minutes. No conversion was undertaken; however, there was one case of small bowel injury that went unrecognized on-table but necessitated subsequent laparotomy. Overall morbidity was 13.5 percentage. Mean length of hospitalization was 2.89 days. Mean duration to normal routine life was 9.25 days. Overall, 70.9 percentage of patients expressed satisfaction with the surgery. Conclusion: Totally extra-peritoneal mesh repair is a new and safe technique for hernioplasty with acceptable rates of morbidity and it is procedure of choice for recurrent and bilateral inguinal hernias and also used as alternate to open hernioplasty for uncomplicated (incomplete and reducible) inguinal hernia. (author)

Bilateral cervical lung hernia with T1 nerve compression.

Science.gov (United States)

Rahman, Mesbah; Buchan, Keith G; Mandana, Kyapanda M; Butchart, Eric G

2006-02-01

Lung hernia is a rare condition. Approximately one third of cases occur in the cervical position. We report a case of bilateral cervical lung hernia associated with neuralgic pain that was repaired using bovine pericardium and biological glue.

Clinical And Surgical Anatomy Of Lumbar Hernia: A Review

Directory of Open Access Journals (Sweden)

João Victor Souza Sanders

2017-10-01

Full Text Available Lumbar hernia is defined as the presence of failure in the transverse fascia or in the aponeurosis of the transverse abdominal muscle that results in the extrusion of intra or extra peritoneal organs through the discontinuity of the postero lateral abdominal wall. The aim of this study was to conduct a methodical review of the anatomy of the hernia form grynfelt dated from 2006 to 2017. For this, we performed a bibliographic review by means of electronic databases like SciELO, PubMed, Science Direct, LILACS and Bireme to get better approach to the subject. It has been found that the lumbar hernia is a disease little known by doctors whose diagnostics are often performed in the wrong way and for surgical correction needs a good anatomical knowledge. Lumbar hernias, although rare, must be taken into account, since ischemia of herniated intestinal segments can lead to the death of the patient, especially in the elderly. Knowledge about the anatomy of the lumbar region is of vital importance because it makes surgery safe and reduces risks of complications and recidivating of the hernia.

[Hiatal hernias: why and how should they be surgically treated].

Science.gov (United States)

Braghetto, Italo; Csendes, Attila; Korn, Owen; Musleh, Maher; Lanzarini, Enrique; Saure, Alex; Hananias, Baydir; Valladares, Héctor

2013-01-01

There is controversy in the literature about the choice of expectant medical treatment versus surgical treatment of hiatal hernias, depending on the presence or absence of symptoms. This study presents the results obtained by our group, considering disease duration and postoperative results. A total of 121 patients were included and divided by age, disease duration, type of hiatal hernia and postoperative outcome. In 32% of the patients younger than 70 years, symptom duration was longer than 11 years and 68% of those aged more than 71 years had long-term symptoms (p<.05). Type iv hernias (complex) and those with diameters measuring more than 16 cm were observed in the group with longer symptom duration. Complications were more frequent in the older age group, in those with longer symptom duration and in those with type iv complex hernias. There was no postoperative mortality and only one patient (0.8%) with a type iii hernia and severe oesophagitis required reoperation. We recommend that patients with hiatal hernia undergo surgery at diagnosis to avoid complications and risks. Older patients should not be excluded from surgical indication but should undergo a complete multidisciplinary evaluation to avoid complications and postoperative mortality. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

An animal model to train Lichtenstein inguinal hernia repair

DEFF Research Database (Denmark)

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

2013-01-01

, thus complicating the procedure if operation should be done in the inguinal canal. The chain of lymph nodes resembles the human spermatic cord and can be used to perform Lichtenstein's hernia repair. RESULTS: This experimental surgical model has been tested on two adult male pigs and three adult female...... 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...

Congenital diaphramatic hernia

Energy Technology Data Exchange (ETDEWEB)

Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Fetal Care Center of Cincinnati, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States)

2012-01-15

Congenital diaphragmatic hernia, despite advances in therapy, remains a complex condition with significant morbidity and mortality. The etiology of the disorder is still incompletely understood, though the pulmonary hypoplasia and pulmonary hypertension that develop secondarily must be overcome to improve survival. Prenatal US and fetal MRI have helped in the development of a greater understanding of this disease. Also with these modalities, measurement techniques have been developed in an attempt to provide prognosticators for the development of pulmonary hypoplasia and pulmonary hypertension. There is a broad range of approaches for performing these measurements, and variability among imaging centers is noted. Despite inconsistent approaches, these techniques have become the foundation for counseling and prenatal and postnatal therapy. It is hoped that with further research with prenatal US and fetal MRI and the development of innovative medical and surgical therapies that the morbidity and mortality of children with congenital diaphragmatic hernias can be significantly reduced. (orig.)

Congenital diaphramatic hernia

International Nuclear Information System (INIS)

Kline-Fath, Beth M.

2012-01-01

Congenital diaphragmatic hernia, despite advances in therapy, remains a complex condition with significant morbidity and mortality. The etiology of the disorder is still incompletely understood, though the pulmonary hypoplasia and pulmonary hypertension that develop secondarily must be overcome to improve survival. Prenatal US and fetal MRI have helped in the development of a greater understanding of this disease. Also with these modalities, measurement techniques have been developed in an attempt to provide prognosticators for the development of pulmonary hypoplasia and pulmonary hypertension. There is a broad range of approaches for performing these measurements, and variability among imaging centers is noted. Despite inconsistent approaches, these techniques have become the foundation for counseling and prenatal and postnatal therapy. It is hoped that with further research with prenatal US and fetal MRI and the development of innovative medical and surgical therapies that the morbidity and mortality of children with congenital diaphragmatic hernias can be significantly reduced. (orig.)

Silver microparticles plus fibrin tissue sealant prevents incisional hernias in rats.

Science.gov (United States)

Primus, Frank E; Young, David M; Grenert, James P; Harris, Hobart W

2018-07-01

Open abdominal surgery is frequently complicated by the subsequent development of an incisional hernia. Consequently, more than 400,000 incisional hernia repairs are performed each year, adding over $15 billion per year to U.S. health-care expenditures. While the vast majority of studies have focused on improved surgical techniques or prosthetic materials, we examined the use of metallic silver microparticles to prevent incisional hernia formation through enhanced wound healing. A rodent incisional hernia model was used. Eighty-two rats were randomly placed into two control groups (saline alone and silver microparticles alone), and three experimental groups (0 mg/cm, 2.5 mg/cm, and 25 mg/cm of silver microparticles applied with a fibrin sealant). Incisional hernia incidence and size, tensile strength, and tissue histology were assessed after 28 days. A significant reduction of both incisional hernia incidence and hernia size was observed between the control groups and 2.5 mg/cm group, and between the control and 25 mg/cm group by nearly 60% and 90%, respectively (P < 0.05). Histological samples showed a noticeable increase in new fibrosis in the treated animals as compared with the controls, whereas the tensile strength between the groups did not differ. The novel approach of using silver microparticles to enhance wound healing appears to be a safe and effective method to prevent incisional hernias from developing and could herald a new era of medicinal silver use. Copyright © 2018 Elsevier Inc. All rights reserved.

LAPAROSCOPIC MANAGEMENT OF GIANT PARAESOPHAGEAL HERNIA WITH A SILICONE-COATED BIFACIAL MESH

Directory of Open Access Journals (Sweden)

S. Unguryanu

2016-01-01

Full Text Available BACKGROUND. Paraesophageal hernias are relatively uncommon. The incidence of this disease has increased recently, and esophageal hernias now account for 5–10% of all hiatus hernias. Surgical treatment is recommended for all patients with this disease because of high risk of complications: strangulation or perforation.CASE REPORT. A 44-year-old male patient with a giant and symptomatic paraesophageal hernia. The diagnosis was confirmed by instrumental examination. We performed laparoscopic repair using silicone-coated polypropylene bifacial mesh. The postoperative period was uneventful.CONCLUSION. The laparoscopic approach may be successfully used as a therapeutic option in the treatment for hiatal hernias. Our clinical experience showed, that the technique appeared to be valid and safe. In cases of large hiatal hernia with a defect greater than 5 cm, it is recommended to apply the mesh in order to minimize the recurrence rate.

Incisional abdominal hernia repair with concomitant abdominoplasty: Maintaining umbilical viability

OpenAIRE

Robert Phan; Elan Kaplan; Jemma K. Porrett; Yik-Hong Ho; Warren M. Rozen

2018-01-01

Introduction: Abdominoplasty and abdominal hernia repair are often carried out in two-stage procedures, and those describing single-stage surgery require careful dissection to preserve often only partial blood supply to the umbilicus to maintain its viability. This paper aims to describe the surgical method of laparoscopic umbilical hernia repair in association with abdominoplasty. Case presentation: A patient presents with an incisional hernia at a previous periumbilical port site of size 14...

Laparoendoscopic single-site extraperitoneal inguinal hernia repair: initial experience in 10 patients.

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Do, Minh; Liatsikos, Evangelos; Beatty, John; Haefner, Tim; Dunn, Ian; Kallidonis, Panagiotis; Stolzenburg, Jens-Uwe

2011-06-01

Recent technical advances and a trend toward laparoscopic single incision surgery have led us to explore the feasibility of laparoendoscopic single-site (LESS) hernia repair. We present our technique and initial experience with LESS extraperitoneal inguinal hernia repair in 10 consecutive men with unilateral inguinal hernias. Age range was 43.7 (28-64) years. Mean body mass index was 28 (range 24-30). Six were left inguinal hernias. There were six indirect and four direct hernias. Three patients had undergone previous open appendectomy. Incarcerated or bilateral hernias were excluded from our initial series. All cases were performed by three surgeons who were experienced in conventional totally extraperitoneal laparoscopic hernia repair as well as experienced in LESS. A literature review of current single-port inguinal hernia repair data is also presented. The mean operative time was 53 minutes (range 45-65  min). The average length of skin incision was 2.8  cm (range 2.3-3.2  cm). No drain was necessary in any of the patients, while no recordable bleeding was observed. There were no intraoperative or immediate postoperative complications. Hospitalization period was 2 days for all patients. After a limited follow-up of 1 month, there have been no recurrences and no complaints of testicular pain. The results of the current series compare favorably with those found in a literature review. LESS extraperitoneal inguinal hernia repair is both feasible and safe, although more technically demanding than its conventional laparoscopic counterpart. Although the cosmetic result with the former approach may prove superior, there are standing questions regarding the complications and long-term outcome. Randomized and if possible blinded trials that compare conventional and single-incision laparoscopic hernia repair may help to distinguish the most advantageous technique.

Laparoscopic repair of hiatal hernias: Experience after 200 consecutive cases

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Bjelović Miloš

2014-01-01

Full Text Available Introduction. Repair of hiatal hernias has been performed traditionally via open laparotomy or thoracotomy. Since first laparoscopic hiatal hernia repair in 1992, this method had a growing popularity and today it is the standard approach in experienced centers specialized for minimally invasive surgery. Objective. In the current study we present our experience after 200 consecutive laparoscopic hiatal hernia repairs. Methods. A retrospective cohort study included 200 patients who underwent elective laparoscopic hiatal hernia repair at the Department for Minimally Invasive Upper Digestive Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2004 to December 2013. Results. Hiatal hernia types included 108 (54% patients with type I, 30 (15% with type III, 62 (31% with giant paraesophageal hernia, while 27 (13.5% patients presented with a chronic gastric volvulus. There were a total of 154 (77% Nissen fundoplications. In 26 (13% cases Nissen procedure was combined with esophageal lengthening procedure (Collis-Nissen, and in 17 (8.5% Toupet fundoplications was performed. Primary retroesophageal crural repair was performed in 164 (82% cases, Cleveland Clinic Foundation suture modification in 27 (13.5%, 4 (2% patients underwent synthetic mesh hiatoplasty, 1 (0.5% primary repair reinforced with pledgets, and 4 (2% autologous fascia lata graft reinforcement. Poor result with anatomic and symptomatic recurrence (indication for revisional surgery was detected in 5 patients (2.7%. Conclusion. Based on the result analysis, we found that laparoscopic hiatal hernia repair was a technically challenging but feasible technique, associated with good to excellent postoperative outcomes comparable to the best open surgery series.

Mesh hernia repair and male infertility: a retrospective register study.

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Hallén, Magnus; Westerdahl, Johan; Nordin, Pär; Gunnarsson, Ulf; Sandblom, Gabriel

2012-01-01

Previous studies have suggested that the use of mesh in groin hernia repair may be associated with an increased risk for male infertility as a result of inflammatory obliteration of structures in the spermatic cord. In a recent study, we could not find an increased incidence of involuntary childlessness. The aim of this study was to evaluate this issue further. Men born between 1950 and 1989, with a hernia repair registered in the Swedish Hernia Register between 1992 and 2007 were cross-linked with all men in the same age group with the diagnosis of male infertility according to the Swedish National Patient Register. The cumulative and expected incidences of infertility were analyzed. Separate multivariate logistic analyses, adjusted for age and years elapsed since the first repair, were performed for men with unilateral and bilateral repair, respectively. Overall, 34,267 men were identified with a history of at least 1 inguinal hernia repair. A total of 233 (0.7%) of these had been given the diagnosis of male infertility after their first operation. We did not find any differences between expected and observed cumulative incidences of infertility in men operated with hernia repair. Men with bilateral hernia repair had a slightly increased risk for infertility when mesh was used on either side. However, the cumulative incidence was less than 1%. Inguinal hernia repair with mesh is not associated with an increased incidence of, or clinically important risk for, male infertility. Copyright © 2012 Mosby, Inc. All rights reserved.

A new classification of parastomal hernias--from the experience at Bielański Hospital in Warsaw.

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Gil, Grzegorz; Szczepkowski, Marek

2011-08-01

Parastomal hernia is the most common local stoma complication. The incidence of parastomal hernia reaches 48%, and in a certain proportion of patients it is considered to be an inevitable consequence of stoma formation. The current classifications of parastomal hernias (Rubin, Devlin) are of little clinical value, which is supported by the fact that they have not been used in any publication presenting surgical treatment results in parastomal hernia. Moreover, these classifications do not include recommendations regarding surgical approach selection in those cases where surgical treatment is indicated. These disadvantages clearly indicate a need for developing a new classification of a greater practical value. was to present a suggested new parastomal hernia classification, based on structural criteria, and its use in surgical approach selection. The authors presented a group of 52 patients registered in Outpatient Stoma Clinic at Bielański Hospital in Warsaw, who had been diagnosed with parastomal hernia, defined as a type of hernia associated with postoperative artificial external intestinal fistula, who also had indications for surgical treatment of this stomal complication. These patients underwent a reconstructive procedure of their parastomal hernia with a surgical technique involving the placement of a monofilament polypropylene mesh in the preperitoneal space and repair of co-existing stomal complications using the variants of surgical techniques adequate for a given parastomal hernia type. Based on our studies and clinical experience, we propose a new classification of parastomal hernias, based on structural criteria. All hernias were divided into four groups (type I-IV) depending on hernia size and the presence of hernia in the postoperative scar. Qualification of a given hernia to a specific type was achieved based on physical examination, which makes the suggested classification a simple tool, useful in everyday practice. Each parastomal hernia type

Pain during sexual activity before and after laparoscopic inguinal hernia repair

DEFF Research Database (Denmark)

Tolver, Mette A; Rosenberg, Jacob

2015-01-01

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......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...

Prevention of Incisional Hernias after Open Abdomen Treatment

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Frederik Berrevoet

2018-02-01

Full Text Available Management of a patient with an open abdomen is difficult, and the primary closure of the fascial edges is essential to obtain the best patient outcome, regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh-mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%. As shown for other high-risk patient subgroups, such as obese patients, patients with an abdominal aneurysm, and patients with former -ostomy sites, the prevention of incisional hernias might be key to further optimize patient outcomes after open abdomen treatment. In this overview, current available modalities to decrease the incidence of incisional hernia are discussed. Most of these preventive options have been shown effective in giant ventral hernia repair and might work effectively in this patient cohort with open abdomen as well.

Proceedings of the colloquium: The response of liquids to dynamic tension

International Nuclear Information System (INIS)

Jones, A.V.

1978-01-01

The contributed papers are: - Tension pulses in a liquid column; - A generalized cavitationn model for liquids; - Transmission of a tension pulse through water; - Current status of the equation of state in Lagrangian codes; - The effects of the reflection of an underwater shock at a free surface; - The calculation of the propagation of tension and recompaction waves

Bilateral giant inguinoscrotal Hernia: psychosocial issues and a new ...

African Journals Online (AJOL)

Background: Bilateral giant inguinoscrotal hernias pose challenging psychosocial problems to the patient. The engulfed phallus and hernia size are socially embarrassing and may make penetration during coitus increasingly difficult and uncomfortable. This paper presents a classification and the psychosocial aspects of ...

Incisional hernia prevention and use of mesh. A narrative review.

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Hernández-Granados, Pilar; López-Cano, Manuel; Morales-Conde, Salvador; Muysoms, Filip; García-Alamino, Josep; Pereira-Rodríguez, José Antonio

2018-02-01

Incisional hernias are a very common problem, with an estimated incidence around 15-20% of all laparotomies. Evisceration is another important problem, with a lower rate (2.5-3%) but severe consequences for patients. Prevention of both complications is an essential objective of correct patient treatment due to the improved quality of life and cost savings. This narrative review intends to provide an update on incisional hernia and evisceration prevention. We analyze the current criteria for proper abdominal wall closure and the possibility to add prosthetic reinforcement in certain cases requiring it. Parastomal, trocar-site hernias and hernias developed after stoma closure are included in this review. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Ovarian Spigelian hernia: A radiological diagnosis

International Nuclear Information System (INIS)

Hill, Ciaran Scott; Chahil, Balvinder; Marlow, Benjamin

2012-01-01

We describe that case of a 54 year old lady with achondroplasia who presented with ongoing left sided abdominal pain. Ultrasound and abdominal computerized tomography images demonstrated an enlarged left ovary and Fallopian tube trapped between the rectus abdominus and the lateral semilunar line under cover of the external oblique aponeurosis. A left sided salpingoophrectomy with mesh herniorrhaphy was performed and histological analysis confirmed the hernia contents were a hydrosalpinx and normal ovary. This case report presents the unusual radiographic images and intraoperative photographs of an ovarian Speglian hernia.

Mesh versus non-mesh repair of ventral abdominal hernias

International Nuclear Information System (INIS)

Jawaid, M.A.; Talpur, A.H.

2008-01-01

To investigate the relative effectiveness of mesh and suture repair of ventral abdominal hernias in terms of clinical outcome, quality of life and rate of recurrence in both the techniques. This is a retrospective descriptive analysis of 236 patients with mesh and non-mesh repair of primary ventral hernias performed between January 2000 to December 2004 at Surgery Department, Liaquat University of Medical and Health Sciences, Jamshoro. The record sheets of the patients were analyzed and data retrieved to compare the results of both techniques for short-term and long-term results. The data retrieved is statistically analyzed on SPSS version 11. There were 43 (18.22%) males and 193 (81.77%) females with a mean age of 51.79 years and a range of 59 (81-22). Para-umbilical hernia was the commonest of ventral hernia and accounted for 49.8% (n=118) of the total study population followed by incisional hernia comprising 24% (n=57) of the total number. There was a significant difference in the recurrent rate at 3 years interval with 23/101 (22.77%) recurrences in suture-repaired subjects compared to 10/135 (7.40%) in mesh repair group. Chronic pain lasting up to 1-2 years was noted in 14 patients with suture repair. Wound infection is comparatively more common (8.14%) in mesh group. The other variables such as operative and postoperative complications, total hospital stay and quality of life is also discussed. Mesh repair of ventral hernia is much superior to non-mesh suture repair in terms of recurrence and overall outcome. (author)

Diaphragmatic hernia: diagnostic approaches with review of the literature

Energy Technology Data Exchange (ETDEWEB)

Eren, Suat [Department of Radiology, Faculty of Medicine, Atatuerk University, 25240 Erzurum (Turkey)]. E-mail: suateren@atauni.edu.tr; Ciris, Fahri [Department of Radiology, Faculty of Medicine, Atatuerk University, 25240 Erzurum (Turkey)

2005-06-01

Because surgical repair is indicated for the treatment of diaphragmatic hernia (DH), preoperative imaging of the diaphragmatic defect, hernia content, and associated complications with other organ's pathologies is important. While various techniques can be used on imaging of DHs, selection of the most effective but the least invasive technique will present the most accurate findings about DH, and will facilitate the management of DH. We reviewed the diaphragmatic hernia types associated with our cases, and we discussed the preferred imaging modalities for different DHs with review of the literature. We evaluated the imaging findings of 21 DH cases. They were Morgagni's hernia (n = 4), Bochdalek hernia (n = 2), iatrogenic DH (n = 4), traumatic DH (n = 6), and hiatal hernia (n = 5). Although its limited findings on DH and indirect findings about the diaphragmatic rupture, plain radiography is firstly preferred technique on DH. We found that ultrasound (US) is a useful tool on DH, on traumatic DH cases especially. Not only it shows diaphragmatic continuity and herniated organs, but also it reveals associated abdominal organ's pathologies. Computed tomography (CT) scan is most effective in many DH cases. It shows the herniated abdominal organs together with complications, such as intestinal strangulation, haemothorax, and rib fractures. We stressed that Multislice CT scan with coronal and sagittal reformatted images is the most effective and useful imaging technique on DH. With high sensitivity for soft tissue, MR imaging may be performed in the selected patients, on the late presenting DH cases or on the cases of the diagnosis still in doubt especially.

Incidental De Garengeot’s hernia: A case report of dual pathology to remember

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Whitehead-Clarke, Thomas; Parampalli, Umesh; Bhardwaj, Rakesh

2015-01-01

Introduction A De Garengeot’s hernia is the very rare dual pathology of a vermiform appendix within a femoral hernia. Presentation of case We discuss the rare case of a 62 year old female who presented as an emergency with a strangulated femoral hernia. Within the hernia sac a partly necrotic vermiform appendix was discovered. The patient successfully underwent an appendicectomy and repair of her femoral hernia. The post-operative period was uneventful, with no further issues at follow-up. Discussion Our case report displays the successful treatment of a De Garengeot's hernia as an emergency admission, with a shorter than average admission time, and no post-operative complications. Conclusion This is a rare case of dual pathology, of which we believe there are few published cases. PMID:26520035

Quality of Life after Ventral Hernia Repair with Endoscopic Component Separation Technique

DEFF Research Database (Denmark)

Thomsen, C Ø; Brøndum, T L; Jørgensen, Lars Nannestad

2016-01-01

of the hernia size. Demographic data, operative information, and postoperative complications were recorded. All patients completed two similar questionnaires regarding their function level, cosmetic satisfaction, analgesic medication, alcohol consumption, and self-estimated physical and mental health before...... center operated on with endoscopic components separation. MATERIAL AND METHODS: A total of 19 consecutive patients scheduled for open hernia repair with endoscopic components separation from October 2010 to June 2012 were included. All procedures included endoscopic components separation because...... and after the hernia repair. Patients were assessed as outpatient median 2 months and 16 months after operation for exclusion of hernia recurrence and completion of the postoperative questionnaire. RESULTS AND CONCLUSIONS: Operating room time was median 204 min and correlated significantly with the hernia...

Clinical anatomy and surgical repair of prepubic hernia in dogs and cats.

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Beittenmiller, Menolly R; Mann, F A; Constantinescu, Gheorghe M; Luther, Jill K

2009-01-01

Prepubic hernia is a traumatic hernia in small animals, most often associated with severe trauma to the caudal abdomen. Common causes include vehicular trauma, dog fights, and kicks by large animals. Rupture of the prepubic tendon in dogs and of its equivalent in cats results in a ventral abdominal hernia. Due to the traumatic nature of the injury, concurrent injuries are frequently seen. Clinical signs of herniation are often nonspecific, and the resultant hernia may not be readily apparent during routine physical examination. This being so, diagnosis is often based on a thorough physical examination in conjunction with abdominal radiography and, possibly, abdominal ultrasonography. Multiple methods of repair of prepubic hernia have been reported, and survival rates are quite good if concurrent injuries are not severe.

[Sciatic hernia as a cause of chronic pelvic pain].

Science.gov (United States)

De los Ríos, José F; Calle, Gustavo; Castañeda, Juan D; Serna, Eduardo A; Vásquez, Ricardo A; Arango, Adriana M; López, Claudia C

2013-04-01

Sciatic hernia constitutes the scarcest group of hernias of pelvic floor; however, they should be considered in the origin of chronic pelvic pain. The proper diagnosis of sciatic hernias has allowed to surgeons treating successfully patients with acute or chronic pelvic pain, with intestinal or ureteral obstruction and with urinary or gluteus sepsis. It has to be considered as differential diagnosis before the finding of a congenital or acquired gluteus mass. Laparoscopist gynecologist should know the existence of this defect, to be familiar with its aspect in laparoscopic view and to know the laparoscopic treatment of this disease.

Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

International Nuclear Information System (INIS)

Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang

2009-01-01

Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

2009-12-15

Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

Sigmoid colon cancer in an incarcerated left inguinal hernia

OpenAIRE

González González, Daniel Alfredo; Tarigo, Nicolás

2017-01-01

Resumen: El cáncer de colon como contenido de una hernia inguinal es una situación infrecuente. Pocos casos se han reportado en la literatura. Habitualmente ocurre en hernias inguinales izquierdas y es el colon sigmoides su contenido. La palpación de una tumoración en una hernia que previamente no existía y la aparición de sintomatología intestinal orientan el diagnóstico. El colon por enema constituye el examen paraclínico por excelencia para su confirmación. El tratamiento quirúrgico se imp...

Laparoscopic repair of congenital pleuroperitoneal hernia using a polypropylene mesh in a dog

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H.F. Hartmann

2015-12-01

Full Text Available ABSTRACT Pleuroperitoneal hernias are the most uncommon type of diaphragmatic hernias in dogs and cats. The treatment of choice is surgery and may involve the use of prosthetic implant through celiotomy. In the current report, laparoscopic repair of a congenital pleuroperitoneal hernia using polypropylene mesh in a dog is described. The surgery was feasible. Appropriate reduction of the hernia was carried out and no complications were noted.

Tension-induced binding of semiflexible biopolymers

Science.gov (United States)

Benetatos, Panayotis; von der Heydt, Alice; Zippelius, Annette

2015-03-01

We investigate theoretically the effect of polymer tension on the collective behaviour of reversible cross-links. We use a model of two parallel-aligned, weakly-bending wormlike chains with a regularly spaced sequence of binding sites subjected to a tensile force. Reversible cross-links attach and detach at the binding sites with an affinity controlled by a chemical potential. In a mean-field approach, we calculate the free energy of the system and we show the emergence of a free energy barrier which controls the reversible (un)binding. The tension affects the conformational entropy of the chains which competes with the binding energy of the cross-links. This competition gives rise to a sudden increase in the fraction of bound sites as the polymer tension increases. The force-induced first-order transition in the number of cross-links implies a sudden force-induced stiffening of the effective stretching modulus of the polymers. This mechanism may be relevant to the formation and stress-induced strengthening of stress fibers in the cytoskeleton. We acknowledge support by the Deutsche Forschungsgemeinschaft (DFG) via grant SFB-937/A1.

Tension-induced binding of semiflexible biopolymers

International Nuclear Information System (INIS)

Benetatos, Panayotis; Heydt, Alice von der; Zippelius, Annette

2014-01-01

We investigate theoretically the effect of polymer tension on the collective behavior of reversibly binding cross-links. For this purpose, we employ a model of two weakly bending wormlike chains aligned in parallel by a tensile force, with a sequence of inter-chain binding sites regularly spaced along the contours. Reversible cross-links attach and detach at the sites with an affinity controlled by a chemical potential. In a mean-field approach, we calculate the free energy of the system and find the emergence of a free-energy barrier which controls the reversible (un)binding. The tension affects the conformational entropy of the chains which competes with the binding energy of the cross-links. This competition gives rise to a sudden increase in the fraction of bound sites as the tension increases. We show that this transition is related to the cross-over between weak and strong localization of a directed polymer in a pinning potential. The cross-over to the strongly bound state can be interpreted as a mechanism for force-stiffening which exceeds the capabilities of single-chain elasticity and thus available only to reversibly cross-linked polymers. (paper)

Internal Hernia in a Liver Transplant Recipien: A Case Report

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Hironori Hayashi

2013-01-01

Full Text Available Biliary complications have great importance for liver transplant recipients because of affecting long-term prognosis. In rare situations, an internal hernia of the Roux-en-Y loop cause graft injury. A 42-year-old woman with a history of living donor liver transplantation 6 years ago presented with prolonged graft injury during the past 6 months. She suddenly developed ileus of the small bowel with internal hernia through the defect of the mesentery around the Roux-en-Y limb of the hepaticojejunostomy. Emergent surgery was performed to reduce the hernia and volvulus; also the mesenteric rent was closed with interrupted suture of silk. Internal hernia of the small bowel after liver transplantation is rare but causes graft injury due to associated biliary complications and rapid deterioration of patient’s condition.

Abdominal Wall Reconstruction with Concomitant Ostomy-Associated Hernia Repair: Outcomes and Propensity Score Analysis.

Science.gov (United States)

Mericli, Alexander F; Garvey, Patrick B; Giordano, Salvatore; Liu, Jun; Baumann, Donald P; Butler, Charles E

2017-03-01

The optimal strategy for abdominal wall reconstruction in the presence of a stomal-site hernia is unclear. We hypothesized that the rate of ventral hernia recurrence in patients undergoing a combined ventral hernia repair and stomal-site herniorraphy would not differ clinically from the ventral hernia recurrence rate in patients undergoing an isolated ventral hernia repair. We also hypothesized that bridged ventral hernia repairs result in worse outcomes compared with reinforced repairs, regardless of stomal hernia. We retrospectively reviewed prospectively collected data from consecutive abdominal wall reconstructions performed with acellular dermal matrix (ADM) at a single center between 2000 and 2015. We compared patients who underwent a ventral hernia repair alone (AWR) and those who underwent both a ventral hernia repair and ostomy-associated herniorraphy (AWR+O). We conducted a propensity score matched analysis to compare the outcomes between the 2 groups. Multivariable Cox proportional hazards and logistic regression models were used to study associations between potential predictive or protective reconstructive strategies and surgical outcomes. We included 499 patients (median follow-up 27.2 months; interquartile range [IQR] 12.4 to 46.6 months), 118 AWR+O and 381 AWR. After propensity score matching, 91 pairs were obtained. Ventral hernia recurrence was not statistically associated with ostomy-associated herniorraphy (adjusted hazard ratio [HR] 0.7; 95% CI 0.3 to 1.5; p = 0.34). However, the AWR+O group experienced a significantly higher percentage of surgical site occurrences (34.1%) than the AWR group (18.7%; adjusted odds ratio 2.3; 95% CI 1.4 to 3.7; p < 0.001). In the AWR group, there were significantly fewer ventral hernia recurrences when the repair was reinforced compared with bridged (5.3% vs 38.5%; p < 0.001). There was no statistically significant difference in ventral hernia recurrence between the AWR and AWR+O groups. Bridging was associated

Efficacy of local anaesthesia in repair of inguinal hernia

International Nuclear Information System (INIS)

Rafiq, M.K.; Sultan, B.; Malik, M.A.; Khan, K.; Abbasi, M.A.

2017-01-01

Local anaesthesia has been identified as the most favourable anaesthesia for elective inguinal hernia repair with respect to complication rate, cost effectiveness and overall patients' satisfaction. This study was conducted to determine the efficacy of local anaesthesia in inguinal hernia in terms of pain relief, wound infection and hospital stay. Methods: In this randomized controlled trial (RCT), 60 patients with inguinal hernia were included at the General Surgical 'B' Unit, Ayub Teaching Hospital Abbottabad. Results: The day-case rates were significantly higher when patients underwent surgery under LA compared to GA (82.6 percent versus 42.6 percent). The incidence of urinary retention was higher in the GA group (p<0.05). There were 17 (2.9 percent) re-admissions overall. The reasons for re-admission included haematoma (n=6), severe pain (n=4), infection (n=3), fainting (n=2) and urinary retention (n=2). Conclusion: This study demonstrates that local anaesthesia for inguinal hernia repair has better efficacy as compared to general anaesthesia. (author)

Sports hernia repair with adductor tenotomy.

Science.gov (United States)

Harr, J N; Brody, F

2017-02-01

Sports hernias, or athletic pubalgia, is common in athletes, and primarily involves injury to the fascia, muscles, and tendons of the inguinal region near their insertion onto the pubic bone. However, management varies widely, and rectus and adductor tenotomies have not been adequately described. The purpose of this manuscript is to demonstrate a suture repair and a rectus and adductor longus tenotomy technique for sports hernias. After magnetic-resonance-imaging confirmation of sports hernias with rectus and adductor tendonitis, 22 patients underwent a suture herniorrhaphy with adductor tenotomy. The procedure is performed through a 4-cm incision, and a fascial release of the rectus abdominis and adductor tenotomy is performed to relieve the opposing vector forces on the pubic bone. All 22 patients returned to their respective sports and regained their ability to perform at a high level, including professional status. No further surgery was required. In athletes with MRI confirmation of rectus and adductor longus injuries, tenotomies along with a herniorraphy may improve outcomes. A suture repair to reinforce the inguinal floor prevents mesh-related complications, especially in young athletes.

Hernia inguinal laparoscopic surgery

International Nuclear Information System (INIS)

Morelli Brum, R. . E mail: raulmorelli@hotmail.com

2005-01-01

The purpose of this paper is to enhance treatment of inguinal hernia through a bibliographic study of its main complications and the analysis of a retrospective series of laparoscopic restorations performed by the author in the same private medical care center. From December 1994 through July 2003, ninety-nine patients were operated in 108 procedures.The technique employed was trans-abdominal peritoneal (TAPP)Follow-up covered over 2 years in 80% of patients with a relapse of 2.8%. Main morbidity was neuralgia due to a nerve being trapped, which fact required re-intervention.There was no mortality.The conclusion arrived at is that it is and excellent technique which requires a long learning curve and its main indication would be relapse of conventional surgery, bilateralism, coexistence with another laparoscopic abdominal pathology and doubts concerning contra lateral hernia

Thoracoscopic approach in management of congenital diaphragmatic hernia.

Science.gov (United States)

Liem, Nguyen Thanh

2013-10-01

Thoracoscopic repair is feasible and safe for congenital diaphragmatic hernia (CDH). The operation can be performed with three trocars using carbon dioxide insufflations at a pressure of 4-6 mmHG. From January 2001 to July 2012, we performed thoracoscopic repair for 311 children with CDH including 152 newborns and 159 infants and toddlers. Mean operative time was 75 ± 27 min. HFOV was used in 24 patients. Direct closure of two rims of diaphragmatic hernia was carried out in 175 patients. Closure of two rims of diaphragmatic hernia with the thoracic wall was performed in 136 patients. Prosthetic patches were required in 54 patients. Conversion to open surgery was required in 38 patients (12.2%). There were no intraoperative deaths. 38 patients died postoperatively (13.5%).

Pulmonary Hernia in a Two-Year-Old Child

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Jenna Fine

2014-01-01

Full Text Available Pulmonary hernia, also known as lung herniation or intercostal herniation, is best explained as the lung parenchyma protruding beyond the confines of the thoracic wall. This rare finding can be classified as congenital or acquired. Acquired pulmonary herniations are often the complication of blunt or penetrating trauma to the chest wall. This report describes a two-year-old male who fell onto a rigid post, striking his left lower chest. Imaging studies demonstrated a small pneumothorax as well as pulmonary herniation. The patient underwent a diagnostic thoracoscopy and repair of a pulmonary hernia within the 7th intercostal space without complication. In this case report, we aim to add to the limited body of existing literature on the surgical management of pulmonary hernias.

CT-guided percutaneous laser disk decompression for cervical and lumbar disk hernia

International Nuclear Information System (INIS)

Shimizu, Kanichiro; Koyama, Tutomu; Harada, Junta; Abe, Toshiaki

2008-01-01

Percutaneous laser disk decompression under X-ray fluoroscopy was first reported in 1987 for minimally invasive therapy of lumbar disk hernia. In patients with disk hernia, laser vaporizes a small portion of the intervertebral disk thereby reducing the volume and pressure of the affected disk. We present the efficacy and safety of this procedure, and analysis of fair or poor response cases. In our study, 226 cases of lumbar disk hernia and 7 cases of cervical disk hernia were treated under CT guided PLDD. Japan Orthopedic Association (JOA) score and Mac-Nab criteria were investigated to evaluate the response to treatment. Improvement ratio based on the JOA score was calculated as follows. Overall success rate was 91.6% in cases lumber disk hernia, and 100% in cases of cervical disk hernia. We experienced two cases with two cases with postoperative complication. Both cases were treated conservatively. The majority of acute cases and post operative cases were reported to be 'good' on Mac-Nab criteria. Cases of fair or poor response on Mac-Nab criteria were lateral type, foraminal stenosis or large disk hernia. CT-guided PLDD is a safe and accurate procedure. The overall success rate can be increased by carefully selecting patients. (author)

A técnica de Lichtenstein nas hérnias inguinais primárias e recidivadas - cirurgia ambulatorial em hospital universitário Lichtenstein hernia repair in primary and recurrent inguinal hernias - ambulatory surgery in a university hospital

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Marco Antonio de Oliveira Peres

2007-12-01

üente nos ambulatórios.BACKGROUND: Lichtenstein hernia repair is gold standard in inguinal hernia surgeries, allowing a tension-free polypropylene mesh, low recurrence, wide applicability, easy teaching to young surgeons, early discharge and lower costs. AIM: A retrospective analysis was made using the results in the ambulatory surgery of primary inguinal hernias and recurrences, performing the Lichtenstein technique in a University Hospital. METHODS: From August of 1994 to December of 2001, 343 inguinal hemioplasties were performed in 326 patients with primary and recurrent inguinal hernias. Three hundred and four (88.6% were male, with ages ranging between 19 to 85 years. Concomitant diseases were observed in 196 cases (60.1%, were hypertension, smoking and cardiopathy were predominant. Regarding the side of the hernias, 232 were on the right and 94 on the left side; seventeen male patients (7.3% showed bilateral presentation. Among the 38 (11.1% recurrent hernias, 27 were on the right side. The classic Lichtenstein technique was indicated in all, using polypropylene mesh, of 15 x 7.5 cm. RESULTS: Local anesthesia was the first choice in 55.9% of cases. Anesthetist intervention and the conversion of the local anesthesia for general was necessary in only one case (0.3%. Four patients needed single day hospital admissions. Early local complications were of seroma: 15 cases; superficial infection of operative wound: 11 (3.3%; hematoma: 5 cases and venous thrombosis of the spermatic cord : 2 cases. After a five year follow-up, hernia recurrences were observed in three cases (0.87%. CONCLUSION: The technique revealed to be of easy application, could be performed under local anesthesia and as an outpatient, with low rates of complications and recurrences. It also allowed students and residents to learn the technique, as well as to attend to such demanding and frequent disease in daily clinics.

Use of biologic mesh at ostomy takedown to prevent incisional hernia: A case series

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Sepehr Lalezari

Full Text Available Introduction: Incisional hernias are a relatively common occurrence after ostomy takedown with a incidence of 30–35%. The use of biologic mesh offers a means to bolster the stoma incision site with a lower risk of infection than synthetic mesh. Methods: This study represents a retrospective chart review of six patients who underwent stoma takedown and had biologic mesh placed in the retrorectus position during repair from March 2015 until March 2016. Results: There has been a zero-rate of hernia occurrence for the six patients who underwent stoma takedown. No incisional hernias were noted on physical exam with follow up ranging from 11 to 25 months. Conclusion: We conclude that placement of biologic mesh is a safe and effective way of preventing incisional hernias at stoma sites. Keywords: Biologic mesh, Ostomy takedown, Stoma reversal, Incisional hernia, Parastomal hernia, Hernia prophylaxis

Chronic pain after childhood groin hernia repair

DEFF Research Database (Denmark)

Aasvang, Eske Kvanner; Kehlet, Henrik

2007-01-01

BACKGROUND: In contrast to the well-described 10% risk of chronic pain affecting daily activities after adult groin hernia repair, chronic pain after childhood groin hernia repair has never been investigated. Studies of other childhood surgery before the age of 3 months suggest a risk of increased...... pain responsiveness later in life, but its potential relationship to chronic pain in adult life is unknown. METHODS: This was a nationwide detailed questionnaire study of chronic groin pain in adults having surgery for a groin hernia repair before the age of 5 years (n = 1075). RESULTS: The response...... rate was 63.3%. In the 651 patients available for analysis, pain from the operated groin was reported by 88 (13.5%) patients whereof 13 (2.0%) patients reported frequent and moderate or severe pain. Pain occurred primarily when exercising sports or other leisure activities. Patients operated on before...

[Type IV paraesophageal hernia with 60% of gastric necrosis. Case report].

Science.gov (United States)

Navarro-Tovar, Fernando; Juárez-de La Torre, Juan Carlos; Pérez-Ayala, Luis Carlos; Quintero-Cabrera, Eduardo

2014-01-01

Paraesophageal hernias are rare and, when associated with symptoms, the risk of complications increases, becoming a surgical emergency. We report a case of a 53 year-old female with 3 weeks of clinical evolution including abdominal pain, nausea and occasional vomiting; 24 h prior to admission she presented intestinal occlusion. Radiographic and tomographic findings showed a paraesophageal hernia, requiring exploratory laparotomy, which demonstrated a 9 cm paraesophageal diaphragmatic defect with a hernia sac containing transverse colon, omentum, fundus and body of the stomach (this last one presented ~60% of necrosis), performing nonanatomic gastrectomy and simple diaphragmatic reconstruction. The patient had a complicated postoperative period requiring two additional surgeries attempting to correct gastrectomy dehiscence and ending with a third procedure for cervical esophagostomy and Witzel jejunostomy. Elective repair is recommended in all patients with asymptomatic paraesophageal hernia in order to avoid possible complications. The approach method is dependent on the surgeon's experience and the conditions of the hernia and involved structures at the time of diagnosis.

Laparoscopic-assisted repair of Morgagni–Larrey hernia by anterior ...

African Journals Online (AJOL)

Various techniques have been described to repair Morgagni–Larrey hernia. There is still concerns on the sufficiency of a simple laparoscopic anterior abdominal wall fixation. We aim to report of two children undergoingthe laparoscopic-assisted anterior abdominal wall repair for Morgagni–Larrey hernia, and to discuss this ...

Y-to-V umbilicoplasty for proboscoid umbilical hernia | Almetaher ...

African Journals Online (AJOL)

Background/purpose Several techniques are proposed for reconstruction of proboscoid umbilical hernia in the pediatric patients. In this work, we reported our experience with Y-to-V umbilicoplasty in the surgical repair of proboscoid umbilical hernia in infants and children. Patients and methods A 3-year prospective study ...

Sportsman hernia; the review of current diagnosis and treatment modalities.

Science.gov (United States)

Paksoy, Melih; Sekmen, Ümit

2016-01-01

Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature.

Garengeot’s hernia: two case reports with CT diagnosis and literature review

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Garcia-Amador Cristina

2016-01-01

Full Text Available Garengeot’s hernia (GH is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review the diagnostic methods and surgical considerations.

Congenital asymptomatic diaphragmatic hernias in adults: a case series.

Science.gov (United States)

Bianchi, Enrica; Mancini, Paola; De Vito, Stefania; Pompili, Elena; Taurone, Samanta; Guerrisi, Isabella; Guerrisi, Antonino; D'Andrea, Vito; Cantisani, Vito; Artico, Marco

2013-05-13

Congenital diaphragmatic hernia is a major malformation occasionally found in newborns and babies. Congenital diaphragmatic hernia is defined by the presence of an orifice in the diaphragm, more often to the left and posterolateral, that permits the herniation of abdominal contents into the thorax. The aim of this case series is to provide information on the presentation, diagnosis and outcome of three patients with late-presenting congenital diaphragmatic hernias. The diagnosis of congenital diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray films and computed tomography scans. In the present report three cases of asymptomatic abdominal viscera herniation within the thorax are described. The first case concerns herniation of some loops of the large intestine into the left hemi-thorax in a 75-year-old Caucasian Italian woman. The second case concerns a rare type of herniation in the right side of the thorax of the right kidney with a part of the liver parenchyma in a 57-year-old Caucasian Italian woman. The third case concerns herniation of the stomach and bowel into the left side of the chest with compression of the left lung in a 32-year-old Caucasian Italian man. This type of hernia may appear later in life, because of concomitant respiratory or gastrointestinal disease, or it may be an incidental finding in asymptomatic adults, such as in the three cases featured here. Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms, and diagnosis may be difficult. Additional investigation and research appear necessary to better explain the development and progression of this type of disease.

Hernia diafragmática paraesternal de Morgagni-Larrey en adulto Morgagni-Larrey parasternal diaphragmatic hernia in the adult

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L. A. Arráez-Aybar

2009-05-01

Full Text Available Con una prevalencia de 0,3-0,5/1.000 nacimientos, la hernia diafragmática congénita (HDC sigue siendo una anomalía grave, no bien entendida, alta mortalidad y tratamiento no siempre efectivo. En España se ha informado de una frecuencia del 0,69%oo con una tendencia decreciente en el periodo 1980-2006 del 0,10%oo por año. No obstante, hasta un 5% se diagnostican en adultos durante la realización de un reconocimiento por otra causa. Presentamos un cuadro de vómitos de tres meses de evolución en una mujer de 74 años por hernia diafragmática paraesternal de Morgagni-Larrey (retrocondroesternal, retrocostoxifoidea, retroesternal, subcostal, subesternal o subcostoesternal, que nos ha permitido realizar una actualización de esta patología en adultos y de la morfogénesis del diafragma toracoabdominal. Es en la embriología del diafragma donde encontramos explicación de algunas de sus alteraciones morfológicas y características clínicas, si bien persisten aspectos confusos de la misma. También analizamos el grado de controversia que persiste en algunos aspectos de su tratamiento quirúrgico (vías de acceso, uso o no de mallas y reducción o no del saco herniario. Por lo general priman las técnicas mínimamente invasivas. Consideramos el abordaje laparoscópico como de elección en pacientes adultos con hernia paraesternal candidatos a la cirugía.With a prevalence of 0.3-0.5/1000 births, congenital diaphragmatic hernia (CDH remains a serious, poorly understood abnormality with a high mortality rate that cannot always be effectively managed. Its reported frequency in Spain is 0.69%oo with a yearly decreasing trend of 0.10%oo during the period 1980-2006. Up to 5% of cases are incidentally identified in adults undergoing studies for other reasons. We report the case of a 74-year-old woman with vomiting for three months due to parasternal diaphragmatic hernia of Morgagni-Larrey (retrochondrosternal, retrocostoxyphoid, retrosternal

Surgical treatment of an umbilical hernia in a free-ranging sub-adult African elephant in Samburu National Reserve, Kenya

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Mijele D

2015-05-01

Full Text Available Domnic Mijele, Michael Njoroge, Titus Kaitho Veterinary Services Department, Species Conservation and Management Division, Kenya Wildlife Service, Nairobi, Kenya Abstract: A 10-year-old male African elephant (Loxodonta africana at Samburu National Reserve in Northern Kenya, weighing approximately 1,600 kg, presented with an umbilical hernia in October 2013. Umbilical herniorrhaphy was carried out under field conditions. Anesthesia was induced and maintained using etorphine hydrochloride for 3 hours during the surgery. This case report details both the surgical and anesthetic procedure carried out to correct the hernia, and the eventual successful recovery of the elephant from anesthesia. However, the elephant died weeks after the surgery and a postmortem could not reveal the cause of death because predators had scavenged the carcass. The challenges of the surgical procedure and outcome including possible causes of death are highlighted in this report. Keywords: African elephant, general anesthesia, etorphine hydrochloride, local anesthesia Lignocaine + adrenaline, umbilical herniorrhaphy

Parastomal hernia: an exploration of the risk factors and the implications.

Science.gov (United States)

McGrath, Anthony; Porrett, Theresa; Heyman, Bob

Risk may be defined as 'the chance that something may happen to cause loss or an adverse effect' (Concise Oxford Medical Dictionary, 2003). Patients undergoing stoma formation are at risk of developing a wide range of complications following surgery. A parastomal hernia is an adverse effect that can contribute to postoperative morbidity. The risk of developing a parastomal hernia is dependent upon a number of variables, and stoma care nurses need to be aware of these to plan the appropriate care for patients undergoing stoma formation. This article discusses the issues surrounding the development of parastomal hernias and also looks at ways in which the risk factors associated with the development of a parastomal hernia may be minimized.

Hernia diagfragmática congénita derecha en el Hospital Universitario de Santander Right congenital diaphragmatic hernia at the Hospital Universitario de Santander

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Julio César Mantilla

2010-08-01

Full Text Available Introducción: La hernia diafragmática del lado derecho es una variable poco frecuente de los defectos congénitos diafragmáticos que permiten el paso del contenido abdominal a la cavidad torácica, causando graves trastornos en el desarrollo pulmonar fetal. Objetivo: Describir las características patológicas encontradas en la autopsia perinatal de un paciente con Hernia diafragmática congénita derecha en el Hospital Universitario de Santander. Caso clínico: Neonato de 35 semanas de gestación con diagnóstico prenatal de Hernia Diafragmática Congénita, quien fallece minutos después de su nacimiento debido a insuficiencia respiratoria aguda. En los hallazgos de autopsia se encuentra ausencia de la mayor parte del hemidiafragma derecho, herniación del contenido abdominal al tórax y una severa hipoplasia pulmonar. Conclusion: La Hernia diafragmática congénita del lado derecho se asocia con alta mortalidad neonatal y los hallazgos encontrados en el presente caso se correlacionan con los graves defectos estructurales pulmonares que se describen en otros casos reportados en la literatura. Salud UIS 2010; 42: 133-138Introduction: The congenital diaphragmatic hernia of the right side is the least common type of the congenital diaphragmatic defects which allows the passage of abdominal contents to the thoracic cavity, causing serious disorders on lung development. Objective: To describe the pathological features found in perinatal autopsy of a patient with Congenital Diaphragmatic Hernia of the right side at the Hospital Universitario de Santander. Case report: 35 weeks gestation neonate with prenatal diagnosis of congenital diaphragmatic hernia, who died due to acute respiratory failure. In the autopsy be found a severe pulmonary hypoplasia and in the microscopic examination, the pulmonary alveoli collapsed. Conclusion: The congenital diaphragmatic hernia of the right side is associated with high neonatal mortality and the findings in

A case report of a de Garengeot hernia in a nonagenarian veteran

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Luis R. Taveras

Full Text Available Introduction: A hernia containing the vermiform appendix [de Garengeot hernia (DGH] is an exceedingly rare event. Appendicitis occurring in this setting if further unusual. Most cases of DGH are made during inguinal exploration. In the present report, we discuss a patient who underwent an operation which revealed a DGH with appendicitis. Presentation of a case: A 94-year-old man with a past medical history significant for hypertension and Parkinson’s disease was admitted to the hospital for the management of an event of CHF exacerbation. He developed acute onset of a painful right inguinal bulge. He had no prior hernia history. On physical exam, he had a 3-cm, tender, non-reducible right inguinal bulge without skin changes. Laboratory analyses were normal without leukocytosis. An acute abdominal series was obtained and demonstrated no obstruction. A groin exploration was performed under local anesthetic. An abscess was found associated with a femoral hernia containing the vermiform appendix. An appendectomy was performed through the hernia sac. The hernia was repaired via a McVay technique. At thirty days after his procedure, he had no complications and no signs of recurrence. Conclusion: Most cases of DGH are diagnosed intraoperatively. Limited work up might be sufficient for adequate management. Several surgical strategies are acceptable. Groin exploration, plus and minus an appendectomy, and tissue repair versus mesh placement are acceptable surgical strategies. Laparoscopic approach for the management of DGH has been reported. Keywords: Femoral hernia, Groin hernia, Appendicitis, Case report

Ventral hernia repair with poly-4-hydroxybutyrate mesh.

Science.gov (United States)

Plymale, Margaret A; Davenport, Daniel L; Dugan, Adam; Zachem, Amanda; Roth, John Scott

2018-04-01

Biomaterial research has made available a biologically derived fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for use in ventral and incisional hernia repair (VIHR). This study evaluates outcomes of patients undergoing VIHR with P4HB mesh. An IRB-approved prospective pilot study was conducted to assess clinical and quality of life (QOL) outcomes for patients undergoing VIHR with P4HB mesh. Perioperative characteristics were defined. Clinical outcomes, employment status, QOL using 12-item short form survey (SF-12), and pain assessments were followed for 24 months postoperatively. 31 patients underwent VIHR with bioresorbable mesh via a Rives-Stoppa approach with retrorectus mesh placement. The median patient age was 52 years, median body mass index was 33 kg/m 2 , and just over half of the patients were female. Surgical site occurrences occurred in 19% of patients, most of which were seroma. Hernia recurrence rate was 0% (median follow-up = 414 days). Patients had significantly improved QOL at 24 months compared to baseline for SF-12 physical component summary and role emotional (p < 0.05). Ventral hernia repair with P4HB bioresorbable mesh results in favorable outcomes. Early hernia recurrence was not identified among the patient cohort. Quality of life improvements were noted at 24 months versus baseline for this cohort of patients with bioresorbable mesh. Use of P4HB mesh for ventral hernia repair was found to be feasible in this patient population. (ClinicalTrials.gov Identifier: NCT01863030).

Amyand’s Hernia: Rare Presentation of a Common Ailment

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Sanjeev Singhal

2015-01-01

Full Text Available Inguinal hernia with vermiform appendix as content is known as Amyand’s hernia. It is a rare entity but we encountered four cases within six months. A 52-year-old female had high grade fever and evidence of inflammatory pathology involving the ileocaecal region. She was initially managed conservatively and subsequently underwent exploratory laparatomy. The appendix was perforated and herniating in the inguinal canal. Appendectomy was done with herniorrhaphy without mesh placement. A 74-year-old male with bilateral inguinal hernia, of which, the right side was more symptomatic, underwent open exploration. Operative findings revealed a lipoma of the sac and a normal appearing appendix as content. Contents were reduced without appendectomy and mesh hernioplasty was performed. A 63-year-old male with an obstructed right sided hernia underwent emergency inguinal exploration which revealed edematous caecum and appendix as content without any inflammation. Contents were reduced without any resection. Herniorrhaphy was performed without mesh placement. A 66-year-old male with an uncomplicated right inguinal hernia underwent elective surgery. The sac revealed an appendix with adhesions at the neck. Contents were reduced after adhesiolysis and hernioplasty was performed with mesh placement. Emphasis is made to the rarity of disease, variation in presentation, and difference in treatment modalities depending upon the state of appendix.

Poorly understood and often miscategorized congenital umbilical cord hernia: an alternative repair method.

Science.gov (United States)

İnce, E; Temiz, A; Ezer, S S; Gezer, H Ö; Hiçsönmez, A

2017-06-01

Umbilical cord hernia is poorly understood and often miscategorized as "omphalocele minor". Careless clamping of the cord leads to iatrogenic gut injury in the situation of umbilical cord hernia. This study aimed to determine the characteristics and outcomes of umbilical cord hernias. We also highlight an alternative repair method for umbilical cord hernias. We recorded 15 cases of umbilical cord hernias over 10 years. The patients' data were retrospectively reviewed, and preoperative preparation of the newborn, gestational age, birth weight, other associated malformations, surgical technique used, enteral nutrition, and length of hospitalization were recorded. This study included 15 neonates with umbilical cord hernias. The mean gestational age at the time of referral was 38.2 ± 2.1 hernia, the body folds develop normally and form the umbilical ring. The double purse-string technique is easy to apply and produces satisfactory cosmetic results in neonates with umbilical cord hernias.

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 a...... 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...

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

Ultrasound assessment of tension-free vaginal tape (TVT).

Science.gov (United States)

Flock, F; Kohorst, F; Kreienberg, R; Reich, A

2011-01-01

To date, no standardization for the visualization of tension-free vaginal tape (TVT) has been established in clinical practice. The aim of this prospective observational study was to evaluate the shape and position of the tape using ultrasound and to compare this data with clinical postoperative results. In a three-year period, 296 patients with clinically and urodynamically proven stress urinary incontinence (SUI) were treated with TVT and received follow-up in our department. An additional 12 patients, who were initially treated in other hospitals and had postoperative problems, were included in this study. Depending on the outcome after 3 months, the patients were divided into groups with and without specific disorders. The TVT was evaluated by introital ultrasound. The position of the tape was established by its location in relation to the urethral length and the distance to the hypoechoic center of the urethra (HCU). A suitable TVT position was determined in patients without any postoperative disorders. The mean value for the TVT position at rest in relation to the urethral length was 61 %. The distance to the HCU was 4.6 ± 1.5 mm. In patients with persistent SUI, the tape was more often located under the inner (3 % vs. 0 %) or outer quarter (29 % vs. 13 %, p = 0.004). In patients with residual volume, the distance to the urethra was significantly lower (2.7 vs. 4.6, p TVT may be regularly investigated using ultrasound. In combination with the clinical outcome, it represents an important method of evaluating the tape and assists in the planning of a future therapeutic course of action in cases of postoperative problems. © Georg Thieme Verlag KG Stuttgart · New York.

Parastomal hernia and physical activity. Are patients getting the right advice?

Science.gov (United States)

Russell, Sarah

2017-09-28

This article draws on a large nationwide survey (2631 respondents) that investigated the physical health and wellbeing of people living with stomas in the UK. It specifically considers the findings relating to parastomal hernia (where additional loops of bowel protrude through the abdominal wall around the stoma, creating a bulge). In this survey, 26% of respondents reported that they had a medically diagnosed parastomal hernia, which is below average when compared with other estimates. The impact of parastomal hernia on physical activity levels was the most significant finding: 32% of those with a medically diagnosed hernia reported being 'much less active' than they were prior to their surgery (compared with 19% without a hernia). This creates a more serious problem for general health-significantly increasing their risk of co-morbidities such as cancer, stroke, diabetes and other chronic conditions related to physical inactivity. Clinical guidelines clearly state that patients should be informed of exercises to strengthen core muscles, as part of hernia prevention, but 88% of patients did not engage in any sort of abdominal or core exercises. When asked, 69% of patients did not realise it was important and 82% of patients could not recall being given advice to do abdominal exercises as part of their recovery. There is a significant gap in the patient care pathway regarding advice on physical activity, core/abdominal exercises and hernia prevention and management after stoma surgery. This is an area that urgently needs more research and education for patients and all health professionals.

Case Report: De Garengeot’s hernia. Appendicitis within femoral hernia. Diagnosis and surgical management

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Agustin Sibona, MD

2016-01-01

Conclusion: Although rare, the finding of a strangulated appendix within a femoral hernia represents a challenge. Here we present a case that may guide the surgeon who faces a similar case in the future.

Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair.

Science.gov (United States)

Nishihara, Yuichi; Isobe, Yoh; Kitagawa, Yuko

2017-12-01

A realistic simulator for transabdominal preperitoneal (TAPP) inguinal hernia repair would enhance surgeons' training experience before they enter the operating theater. The purpose of this study was to create a novel physical simulator for TAPP inguinal hernia repair and obtain surgeons' opinions regarding its efficacy. Our novel TAPP inguinal hernia repair simulator consists of a physical laparoscopy simulator and a handmade organ replica model. The physical laparoscopy simulator was created by three-dimensional (3D) printing technology, and it represents the trunk of the human body and the bendability of the abdominal wall under pneumoperitoneal pressure. The organ replica model was manually created by assembling materials. The TAPP inguinal hernia repair simulator allows for the performance of all procedures required in TAPP inguinal hernia repair. Fifteen general surgeons performed TAPP inguinal hernia repair using our simulator. Their opinions were scored on a 5-point Likert scale. All participants strongly agreed that the 3D-printed physical simulator and organ replica model were highly useful for TAPP inguinal hernia repair training (median, 5 points) and TAPP inguinal hernia repair education (median, 5 points). They felt that the simulator would be effective for TAPP inguinal hernia repair training before entering the operating theater. All surgeons considered that this simulator should be introduced in the residency curriculum. We successfully created a physical simulator for TAPP inguinal hernia repair training using 3D printing technology and a handmade organ replica model created with inexpensive, readily accessible materials. Preoperative TAPP inguinal hernia repair training using this simulator and organ replica model may be of benefit in the training of all surgeons. All general surgeons involved in the present study felt that this simulator and organ replica model should be used in their residency curriculum.

Mucinous ovarian tumour presenting as a ruptured incisional hernia.

LENUS (Irish Health Repository)

Toomey, D

2012-10-01

We describe an ovarian borderline tumour that presented as an acute deterioration in an incisional hernia secondary to intraperitoneal mucin accumulation. The differential diagnosis associated with hernial sac contents and options for opportunistic diagnosis are discussed. This case raises awareness of potential serious diagnoses that may be overlooked during emergent hernia repair.

Pattern of abdominal wall herniae in females: a retrospective analysis.

African Journals Online (AJOL)

Result: There were 181 female patients with 184 hernias representing 27.9% of the total ... It is not unexpected to find variations in the pattern of hernia presentation and outcome of man- .... with majority typically found in elderly females with a.

Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

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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.

Full - Term Pregnancy In An Incisional Hernia - A Case Report ...

African Journals Online (AJOL)

... made and the fascia should be closed with non-absorbable sutures (mass closure) in order to avoid occurrence of incisional hernias. Emergency operations in the abdomen including caesarian section, surgical principles should always be observed. Keywords: Full-term pregnancy, Abdominal incision, hernia, prevention.

Vaginocutaneous fistula and inguinal abcess presented 6 years after tension-free vaginal tape sling

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Ali Feyzullah Sahin

2013-06-01

Full Text Available Surgical treatment of female stress urinary incontinence (SUI has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF plus inguinal abcess after tension-free vaginal tape (TVT. A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT.

Concomitant inguinal endometriosis and groin hernia – Case report

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Daniel Ion

2017-12-01

Full Text Available Endometriosis is a condition which affects women during their reproductive age. We present the case of a 42 years old Caucasian nulliparous woman accusing in the last three months a painful bulging mass in the right groin. The patient reported that the mass increases in size during prolonged standing and lifting of heavyweights. In addition, the inguinal pain was exacerbated during ovulation. The patient underwent surgery, during which wide excision of the nodule was performed. Furthermore, both direct and indirect hernia sacs were found and dissected, the content was reduced and the sacs were excised. Four months after the surgery, the patient was free of symptoms and had no signs of recurrence.

Warfarin-Associated Diaphragmatic Hernia: An Unusual Diagnosis

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Cristina Vilhena

2015-01-01

Full Text Available Fetal warfarin syndrome is a consequence of maternal intake of warfarin during pregnancy and comprises a wide range of manifestations, including some typical facial dysmorphologic features. The authors report a case of prenatal ultrasonographic diagnosis of warfarin embryopathy in an obese woman on unsupervised warfarin prophylaxis at the 16th week of gestation. The fetus presented with facial dysmorphism, pectus excavatum, diaphragmatic hernia, and pulmonary hypoplasia. To the best of our knowledge, this is the second reported case of warfarin-associated diaphragmatic hernia.

Establishment and initial experiences from the Danish Ventral Hernia Database

DEFF Research Database (Denmark)

Helgstrand, F; Rosenberg, J; Bay-Nielsen, M

2010-01-01

, use of mesh or no mesh, type of suture material, and placement of the mesh. A total of 5,629 elective and 661 acute ventral hernia repairs were registered. After the first 2 years the registration rate was 70%. CONCLUSION: The first national ventral hernia database has been established. Preliminary...... of the Danish Ventral Hernia Database (DVHD). Furthermore, the first 2-year data from 2007 to 2008 are presented. METHODS: Registrations were based on surgeons' web registrations and validated by cross checking with data from the Danish National Patient Register. RESULTS: The DVHD was established in June 2006...... and is based on prospective online web-registration of perioperative data, and individualised tracking of follow up data. During the first 2 years (2007-2008) data showed a large variation in almost all aspects of ventral hernia repair regarding surgical technique, use of open versus laparoscopic technique...

Substantial variation among hernia experts in the decision for treatment of patients with incisional hernia

DEFF Research Database (Denmark)

Kokotovic, D; Gögenur, I; Helgstrand, F

2017-01-01

PURPOSE: Benign elective procedures give rise to heterogeneity in indication for surgery and surgical technique among specialized surgeons in a variety of surgical fields. The objective was to analyze the extent of agreement in surgical management among expert hernia surgeons when evaluating the ...... of treatment strategy for patients with incisional hernias was very low among experienced surgeons. A standardization of surgical decision making is desirable to develop new interventions and improve clinical outcomes....... was present in 14 cases (56%). The most common reason for not performing surgery was due to comorbidities. Agreement in operation type (open vs. laparoscopic) was present in 10 cases (40%). Agreement in mesh fixation (absorbable tacks/non-absorbable tacks/suture/other) method was also present in 10 cases (40...

Amyand′s hernia masquerading as a strangulated inguinal hernia: A case report and literature review

Directory of Open Access Journals (Sweden)

Shahbaz Habib Faridi

2014-01-01

Full Text Available We report a rare case of a 62-year-old male who presented to surgical emergency department with the complaints of sudden onset pain and swelled in the right inguinal region with nausea, vomiting and abdominal distension. There was a history of a reducible swelling in the right inguino-scrotal region for the last 1 year. Based on history, clinical examination and investigations a provisional diagnosis of right-sided strangulated inguinal hernia was made and patient was planned for an emergency surgery. On the exploration, the hernial sac revealed a gangrenous vermiform appendix and the diagnosis of Amyand′s hernia was made. Appendectomy was performed through the same incision, and hernial repair was done using a polypropylene mesh.

Gross hematuria as the presentation of an inguinoscrotal hernia: a case report

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Ansari Kayvan

2011-12-01

Full Text Available Abstract Introduction Several complications have been reported with inguinal hernias. Although hematuria and flank pain, either as the presentation or as a complication of inguinal hernia, are infrequent, this condition may lead to the development of obstructive uropathy, which can have diverse manifestations. Case presentation A 71-year-old Iranian man with Persian ethnicity presented with new onset episodes of gross hematuria and left-sided flank pain. A physical examination revealed a large and non-tender inguinal hernia on his left side. An initial workup included an abdominal ultrasound, an intravenous pyelogram and cystoscopy, which showed left hydronephrosis and a bulging on the left-side of his bladder wall. On further evaluation, computed tomography confirmed that his sigmoid colon was the source of the pressure effect on his bladder, resulting in hydroureteronephrosis and hematuria. No tumoral lesion was evident. Herniorrhaphy led to the resolution of his signs and symptoms. Conclusion Our case illustrates a rare presentation of inguinal hernia responsible for gross hematuria and unilateral hydronephrosis. Urologic signs and symptoms can be caused by the content of inguinal hernias. They can also present as complications of inguinal hernias.

Comparison of Radiography and Ultrasonography for Diagnosis of Diaphragmatic Hernia in Bovines

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Hakim Athar

2010-01-01

Full Text Available The present study was conducted on 101 animals suffering from thoracoabdominal disorders; out of which twenty seven animals (twenty six buffaloes and one cow were diagnosed with diaphragmatic hernia based on clinical signs, radiography, ultrasonography, and left flank laparorumenotomy. Radiography alone confirmed diaphragmatic hernia in 18 cases (66.67% with a sac-like structure cranial to the diaphragm. In 15 animals the sac contained metallic densities while in three cases a sac-like structure with no metallic densities was present. Ultrasonography was helpful in confirming diaphragmatic hernia in 23 cases (85.18% and ultrasonographically reticular motility was evident at the level of 4th/5th intercostal space in all the animals. B+M mode ultrasonography was used for the first time for diagnosis of diaphragmatic hernia in bovines and the results suggested that ultrasonography was a reliable diagnostic modality for diaphragmatic hernia in bovines.

Laparoscopic hernia repair and bladder injury.

Science.gov (United States)

Dalessandri, K M; Bhoyrul, S; Mulvihill, S J

2001-01-01

Bladder injury is a complication of laparoscopic surgery with a reported incidence in the general surgery literature of 0.5% and in the gynecology literature of 2%. We describe how to recognize and treat the injury and how to avoid the problem. We report two cases of bladder injury repaired with a General Surgical Interventions (GSI) trocar and a balloon device used for laparoscopic extraperitoneal inguinal hernia repair. One patient had a prior appendectomy; the other had a prior midline incision from a suprapubic prostatectomy. We repaired the bladder injury, and the patients made a good recovery. When using the obturator and balloon device, it is important to stay anterior to the preperitoneal space and bladder. Prior lower abdominal surgery can be considered a relative contraindication to extraperitoneal laparoscopic hernia repair. Signs of gas in the Foley bag or hematuria should alert the surgeon to a bladder injury. A one- or two-layer repair of the bladder injury can be performed either laparoscopically or openly and is recommended for a visible injury. Mesh repair of the hernia can be completed provided no evidence exists of urinary tract infection. A Foley catheter is placed until healing occurs.

Risk factors for parastomal hernia in Japanese patients with permanent colostomy.

Science.gov (United States)

Funahashi, Kimihiko; Suzuki, Takayuki; Nagashima, Yasuo; Matsuda, Satoshi; Koike, Junichi; Shiokawa, Hiroyuki; Ushigome, Mitsunori; Arai, Kenichiro; Kaneko, Tomoaki; Kurihara, Akiharu; Kaneko, Hironori

2014-08-01

Although the definitive risk factors for parastomal hernia development remain unclear, potential contributing factors have been reported from Western countries. The aim of this study was to identify the risk factors for parastomal hernia in Japanese patients with permanent colostomies. All patients who received abdominoperineal resection or total pelvic exenteration at our institution between December 2004 and December 2011 were reviewed. Patient-related, operation-related and postoperative variables were evaluated, in both univariate and multivariate analyses, to identify the risk factors for parastomal hernia formation. Of the 80 patients who underwent colostomy, 22 (27.5 %) developed a parastomal hernia during a median follow-up period of 953 days (range 15-2792 days). Hernia development was significantly associated with increasing patient age and body mass index, a laparoscopic surgical approach and the transperitoneal route of colostomy formation. In the multivariate analysis, the body mass index (p = 0.022), the laparoscopic approach (p = 0.043) and transperitoneal stoma creation (p = 0.021) retained statistical significance. Our findings in Japanese ostomates match those from Western countries: a higher body mass index, the use of a laparoscopic approach and a transperitoneal colostomy are significant independent risk factors for parastomal hernia formation. The precise role of the stoma creation route remains unclear.

Accuracy of hiatal hernia detection with esophageal high-resolution manometry

NARCIS (Netherlands)

Weijenborg, P. W.; van Hoeij, F. B.; Smout, A. J. P. M.; Bredenoord, A. J.

2015-01-01

The diagnosis of a sliding hiatal hernia is classically made with endoscopy or barium esophagogram. Spatial separation of the lower esophageal sphincter (LES) and diaphragm, the hallmark of hiatal hernia, can also be observed on high-resolution manometry (HRM), but the diagnostic accuracy of this

PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

African Journals Online (AJOL)

GB

BACKGROUND: Literature is scarce about spontaneous rupture of hernia because spontaneous rupture of here is uncommon (1). Reported cases are complications of incisional hernias, recurrent inguinal hernia, and umbilical hernias. It is potentially life threatening (1) because the ensuing entrapment and tension on ...

Hernia diafragmática congénita atascada

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Miurkis Endis Miranda

Full Text Available La hernia diafragmática congénita constituye uno de los retos pendientes dentro de las enfermedades quirúrgicas del recién nacido. Se presenta un caso muy inusual, en el cual se diagnosticó una hernia diafragmática derecha atascada, con compromiso de gran parte del intestino. Se describen los medios diagnósticos utilizados, el procedimiento quirúrgico realizado y las complicaciones presentadas. La hernia diafragmática congénita atascada es una complicación potencialmente letal, por el amplio compromiso vascular que produce en los órganos abdominales y que conlleva a la necrosis de estos si no se diagnostica precozmente. Por ello, debe ser considerada en el diagnóstico diferencial de la insuficiencia respiratoria en los recién nacidos y lactantes pequeños.

Polyester composite versus PTFE in laparoscopic ventral hernia repair.

Science.gov (United States)

Colon, Modesto J; Telem, Dana A; Chin, Edward; Weber, Kaare; Divino, Celia M; Nguyen, Scott Q

2011-01-01

Both polyester composite (POC) and polytetrafluoroethylene (PTFE) mesh are commonly used for laparoscopic ventral hernia repair. However, sparse information exists comparing perioperative and long-term outcome by mesh repair. A prospective database was utilized to identify 116 consecutive patients who underwent laparoscopic ventral hernia repair at The Mount Sinai Hospital from 2004-2009. Patients were grouped by type of mesh used, PTFE versus POC, and retrospectively compared. Follow-up at a mean of 12 months was achieved by telephone interview and office visit. Of the 116 patients, 66 underwent ventral hernia repair with PTFE and 50 with POC mesh. Patients were well matched by patient demographics. No difference in mean body mass index (BMI) was demonstrated between the PTFE and POC group (31.8 vs. 32.5, respectively; P=NS). Operative time was significantly longer in the PTFE group (136 vs.106 minutes, PPTFE group and none in the POC group (P NS). No other major complications occurred in the immediate postoperative period (30 days). At a mean follow-up of 12 months, no significant difference was demonstrated between the PTFE and POC groups in hernia recurrence (3% vs. 2%), wound complications (1% vs. 0%), mesh infection, requiring removal (3% vs. 0%), bowel obstruction (3% vs. 2%), or persistent pain or discomfort (28% vs. 32%), respectively (P=NS). Our study demonstrated no significant association between types of mesh used and postoperative complications. In the 12-month follow-up, no differences were noted in hernia recurrence.

The impact of incisional hernia on mortality after colonic cancer resection

DEFF Research Database (Denmark)

Jensen, Kristian Kiim; Erichsen, Rune; Krarup, Peter Martin

2016-01-01

intended colonic resection for cancer with primary anastomosis between 2001 and 2008 were included. The exposure of interest was incisional hernia, as registered in the NPR, and the outcome was long-term overall mortality. Extended cox regression analysis was used to adjust for confounding variables...... the impact of incisional hernia on mortality after colonic cancer resection. METHOD: This was a nationwide cohort study comprising data from the Danish Colorectal Cancer Group's database, the Danish National Patient Registry (NPR), and the Danish Central Person Registry. Patients who underwent curatively...... with increased mortality (adjusted hazard ratio 2.35, 95 % confidence interval 1.39-3.98), while incisional hernia repair did not increase mortality (adjusted hazard ratio 0.81, 95 % confidence interval 0.68-0.97). CONCLUSIONS: Incisional hernia diagnosis or repair subsequent to colonic cancer resection did...

Incarcerated umbilical hernia leading to small bowel ischemia.

Science.gov (United States)

Lutwak, Nancy; Dill, Curt

2011-09-19

A 59-year-old male with history of hepatitis C, refractory ascites requiring multiple paracentesis and transjugular intrahepatic portosystemic shunt placement presented to the emergency department with 2 days of abdominal pain. Physical examination revealed blood pressure of 104/66 and pulse of 94. The abdomen was remarkable for distention and a tender incarcerated umbilical hernia. The skin overlying the hernia was pale with areas of necrosis. The patient immediately underwent laparotomy which was successful.

Two Ports Laparoscopic Inguinal Hernia Repair in Children

OpenAIRE

Ibrahim, Medhat M.

2015-01-01

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...

Diaphragmatic hernia in the Coffin-Siris syndrome.

Science.gov (United States)

Delvaux, V; Moerman, P; Fryns, J P

1998-01-01

At 32 weeks of gestation, delivery of a female fetus was induced because of severe malformations seen on ultrasonogram: congenital diaphragmatic hernia and cerebellar hypoplasia. The diagnosis of Coffin-Siris syndrome was based on the physical examination: coarse face with low-set ears, low nuchal hairline, scalp hypotrichosis and hypoplasia of the nails of fingers and toes with absence of the right fifth fingernail. Autopsy confirmed the prenatally diagnosed major associated abnormalities: hypoplasia of the cerebellum and congenital diaphragmatic hernia. Various clinical entities are included in the differential diagnosis.

Handlebar Hernia With Jejunal and Duodenal Injuries: A Case Report

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Ching-Wen Huang

2004-09-01

Full Text Available Traumatic abdominal wall hernia is an uncommon complication of abdominal blunt trauma. Handlebar hernia is even more infrequent. To the best of our knowledge, there are fewer than 30 cases of handlebar hernia reported in the English literature. Associated intra-abdominal injuries are infrequent. We present a case of handlebar hernia with jejunal and duodenal injuries. Emergency surgical intervention included primary repair of the disrupted musculofascial defect and injuries of the duodenum and jejunum. Bile- stained discharge from the drain tube was noted, so a second operation was performed about 7 days after the first. Leakage from the sutured jejunal perforation and another irregular perforation in the posterior wall of the fourth portion of the duodenum were noted. The two perforations were debrided and repaired. The muscular and fascial defects were debrided and closed with interrupted sutures. The patient recovered smoothly and was discharged 30 days after the blunt injury. No other major complication was noted 11 months after surgery.

Epigastric hernia contiguous with the laparoscopic port site after endoscopic robotic total prostatectomy.

Science.gov (United States)

Moriwaki, Yoshihiro; Otani, Jun; Okuda, Junzo; Maemoto, Ryo

2018-03-23

Both laparoscopic and endoscopic robotic surgery are widely accepted for many abdominal surgeries. However, the port site for the laparoscope cannot be easily sutured without defect, particularly in the cranial end; this can result in a port-site incisional hernia and trigger the progressive thinning and stretching of the linea alba, leading to epigastric hernia. In the present case, we encountered an epigastric hernia contiguous with an incisional scar at the port site from a previous endoscopic robotic total prostatectomy. Abdominal ultrasound and CT revealed that the width of the linea alba was 30-48 mm. Previous CT images prepared before endoscopic robotic prostatectomy had shown a thinning of the linea alba. We should be aware of the possibility of epigastric hernia after laparoscopic and endoscopic robotic surgery. In laparoscopic and endoscopic robotic surgery for a high-risk patient for epigastric hernia, we should consider additional sutures cranial to the port-site incision to prevent of an epigastric hernia. © 2018 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

Late Recurrence of Benign Multicystic Peritoneal Mesothelioma Complicated with an Incisional Hernia

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Emel Canbay

2013-01-01

Full Text Available Benign multicystic peritoneal mesothelioma (BMPM is a rare disease arising from the peritoneal mesothelium. Here, we report a 57-year-old woman admitted to our unit with an incisional hernia fifteen years later following her first operation due to BMPM. Computerized tomography demonstrated a cystic appearing mass with intraabdominal extension in hernia sac. The patient underwent en bloc resection of the mass and hernia repair. An immunohistochemical analysis of the mass confirmed the recurrence of BMPM. Our case supports that BMPM has slowly progressive nature and can recur with complicated incisional hernia long time after primary resection. Diagnosis and long-term followup are crucial for clarifying the characteristics of this disease.

Long-term results of incisional hernia repair with retromuscular mesh

Directory of Open Access Journals (Sweden)

Miran Rems

2011-04-01

Conclusions: The retromuscular mesh placement for postoperative hernia repair results in a low rate of recurrences and postoperative complications. Complications are more common in patients admitted due to incarceration and in patients having suffered from stoma. Pain inflicted by postoperative hernia repair is an underrated with treatment results.

Risk of incisional hernia after minimally invasive and open radical prostatectomy.

Science.gov (United States)

Carlsson, Sigrid V; Ehdaie, Behfar; Atoria, Coral L; Elkin, Elena B; Eastham, James A

2013-11-01

The number of radical prostatectomies has increased. Many urologists have shifted from the open surgical approach to minimally invasive techniques. It is not clear whether the risk of post-prostatectomy incisional hernia varies by surgical approach. In the linked Surveillance, Epidemiology and End Results (SEER)-Medicare data set we identified men 66 years old or older who were treated with minimally invasive or open radical prostatectomy for prostate cancer diagnosed from 2003 to 2007. The main study outcome was incisional hernia repair, as identified in Medicare claims after prostatectomy. We also examined the frequency of umbilical, inguinal and other hernia repairs. We identified 3,199 and 6,795 patients who underwent minimally invasive and open radical prostatectomy, respectively. The frequency of incisional hernia repair was 5.3% at a median 3.1-year followup in the minimally invasive group and 1.9% at a 4.4-year median followup in the open group, corresponding to an incidence rate of 16.1 and 4.5/1,000 person-years, respectively. Compared to the open technique, the minimally invasive procedure was associated with more than a threefold increased risk of incisional hernia repair when controlling for patient and disease characteristics (adjusted HR 3.39, 95% CI 2.63-4.38, p<0.0001). Minimally invasive radical prostatectomy was associated with an attenuated but increased risk of any hernia repair compared with open radical prostatectomy (adjusted HR 1.48, 95% CI 1.29-1.70, p<0.0001). Minimally invasive radical prostatectomy was associated with a significantly increased risk of incisional hernia compared with open radical prostatectomy. This is a potentially remediable complication of prostate cancer surgery that warrants increased vigilance with respect to surgical technique. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Laparoscopic Repair of Sportman's Hernia - The Trinidad Experience.

Science.gov (United States)

Gopeesingh, Anyl; Dan, Dilip; Naraynsingh, Vijay; Hariharan, Seetharaman; Seetahal, Shiva

2014-01-01

Sportman's hernia: (Athletic pubalgia) is an uncommon and poorly understood condition afflicting athletic individuals. Sufferers complain of chronic groin pain and often present diagnostic dilemmas to physicians and physiotherapists. We present a series of cases illustrating the varying presentations of sportman's hernia and diagnostic approaches that can be utilized to exclude common differentials. We also describe laparoscopic mesh repair as an effective treatment option for this condition. © 2013 National Medical Association. Published by Elsevier Inc. All rights reserved.

Relaxin of prostatic origin might be linked to perineal hernia formation in dogs.

Science.gov (United States)

Niebauer, Gert W; Shibly, Sarina; Seltenhammer, Monika; Pirker, Armin; Brandt, Sabine

2005-05-01

Perineal hernia occurs spontaneously in older male dogs after idiopathic weakening of the pelvic diaphragm. Hernias invariably contain cystic paraprostatic tissues. Castration reduces incidence and recurrence after surgical repair. Although cystic prostatic hypertrophy is a consistent feature in patients with perineal hernia, an endocrine link of the disease to steroid sex hormones has not been demonstrated. Employing immunohistochemistry, we found intense relaxin immunoreactivity in dogs with perineal hernia within the epithelia of hypertrophic prostates and in periprostatic tissues. The prostate of normal dogs exhibited similar but less intense relaxin staining. In neutered dogs with prostatic atrophy, relaxin immunostaining was weak or absent. Periprostatic cysts highly expressed relaxin precursors in the fluid phase as shown by SDS-gel electrophoresis. Relaxin of prostatic origin, therefore, is possibly a local factor in connective tissue weakening and subsequently in perineal hernia formation.

A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea

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Cem Sahin

2015-01-01

Full Text Available Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea.

A Data Mining and Survey Study on Diseases Associated with Paraesophageal Hernia

OpenAIRE

Yang, Jianji; Logan, Judith

2006-01-01

Paraesophageal hernia is a severe form of hiatal hernia, characterized by the upward dislocation of the gastric fundus into the thoracic cavity. In this study, the 1999 National Inpatient Sample dataset of the Healthcare Cost and Utilization Project was analyzed using data mining techniques to explore disorders associated with paraesophageal hernia. The result of this data mining process was compared with a subsequent expert knowledge survey of 97 gastrointestinal tract surgeons. This two-ste...

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.

Usefulness of ultrasonographic examination of diagnosis of muscle hernia

International Nuclear Information System (INIS)

Choi, Jin Soo; Lee, Sung Moon

2003-01-01

To evaluate the usefulness of ultrasonography in diagnosis of muscle hernia. Ultrasonographic findings of seven patients with muscle hernia were retrospectively reviewed. The subjects consisted of 6 males and 1 female, age ranged from 17 to 66 years (mean=45 years). Ultrasonographic examination was performed using a high-frequency (7-15 MHz) linear probe during rest and stress states of the affected muscle, and both tranverse and longitudinal views were obtained. Six muscle herniations were located in the lower extremity in six cases while only one muscle herniation, in the upper extremity. Four cases showed a focal defect of the fascia with a localized bulging out of the muscle substance through the defect. Herniated muscle in stress state was larger and harder than in rest state. In 3 cases, defect of the fascia was not noted on ultrasonography. However, the affected muscle showed an abnormal contraction with a focal bulging out appearance during stress state. Ultrasonographically, the herniated muscle substance was less echogenic than the normal muscle without any evidence of muscle tear or associated mass in all cases. Ultrasonography is a simple and useful dynamic study of muscle hernia in diagnosis and differentiation of muscle hernia.

Primary lumbar hernia in an elderly woman: case report | Ouma ...

African Journals Online (AJOL)

Surgical dissection revealed a large hernial sac, which contained retro peritoneal fat, protruding through a 3-4 centimetres defect in the transversalis fascia lining the floor of the superior lumbar triangle. The hernia sac was reduced and the defect closed. There was no recurrence four months post-operative. Lumber hernias ...

Correlation between early surgical complications and readmission rate after ventral hernia repair

DEFF Research Database (Denmark)

Kokotovic, D; Sjølander, H; Gögenur, I

2017-01-01

PURPOSE: Postoperative surgical complications arising from ventral hernia repair have been assessed by a variety of outcome measures. The objective of this study was to correlate the Clavien Dindo Classification (CDC) graded complications with the 30-day readmission rate as early outcome measures...... in ventral hernia repair. Secondarily, we wanted to investigate whether the risk factors for Clavien Dindo class ≥1 and 30-day readmission were comparable. METHODS: Single-centre retrospective study including all patients (≥18 years) who underwent ventral hernia repair between January 1, 2009 and September 1......). There was a significant association between a complication graded by the CDC ≥1 and 30-day readmission for both incisional and umbilical/epigastric hernia repair (p readmission. Recurrent...

Neonatal perforated Amyand's hernia presenting as an enterocutaneous scrotal fistula

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Antonios Panagidis

2015-07-01

Full Text Available Perforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

Primary 25-gauge transconjunctival sutureless vitrectomy in pseudophakic retinal detachment

Directory of Open Access Journals (Sweden)

Horozoglu Fatih

2007-01-01

Full Text Available Aims: There are few reports on 25-gauge transconjunctival sutureless vitrectomy (TSV in cases of pseudophakic retinal detachment. We conducted this study to report the anatomic and functional outcomes of 25-gauge TSV in the treatment of primary pseudophakic retinal detachment (RD. Design: Prospective, interventional case series. Materials and Methods: Fifteen eyes of 15 patients with RD after cataract surgery with phacoemulsification were evaluated. Primary pseudophakic RDs with macular detachment and proliferative vitreoretinopathy Stage B or less were included in the study. Pars plana vitrectomy with the 25-gauge TSV system, perfluorocarbon liquid injection followed by air exchange, endolaser photocoagulation and sulfur hexafluoride gas (20% injection were applied to all eyes. Results: Mean follow-up time was 9.2 months (range, six to 12 months. Retinal reattachment with a single operation was achieved in 93% of eyes and with additional surgery, the retina was reattached in 100% of eyes. Preoperative visual acuity was less than 20/200 in all eyes (range, hand motions to 20/400. Postoperative visual acuity was 20/40 or better in eight eyes (53% and between 20/50 and 20/200 in seven eyes (47%. No severe hypotony was encountered and no sutures were required to close the scleral and conjunctival openings. Postoperative complications were macular pucker in one eye (7% and cystoid macular edema in another eye (7%. Conclusions: Primary 25-gauge TSV system appears to be an effective and safe procedure in the treatment of uncomplicated pseudophakic RD.

CT discography for cervical soft disc hernia

International Nuclear Information System (INIS)

Iwasa, Kenichi; Mizutani, Shigeru; Morimoto, Hiroyuki; Yamada, Hidehito; Iwasa, Satoru

1985-01-01

In this study the effectiveness of computed tomographic discography (CTD) in diagnosing cervical soft disc hernia was evaluated. Twenty-five interververtebral discs of 15 cases with cervical soft disc hernia were examined with a discography and then a CT scan. Results of the CT scan were as follows: three discs were protruded, 12 discs were prolapsed, 6 discs were extruded, and 4 discs were sequestrated. The findings were helpful in determining the location of soft disc hernians between the median and posterolateral discs. They were also valuable in classifying types of hernians and surgical aproaches. (author)

Laparoscopic Pediatric Inguinal Hernia Repair: Overview of "True Herniotomy" Technique and Review of Current Evidence.

Science.gov (United States)

Feehan, Brendan P; Fromm, David S

2017-05-01

Inguinal hernia repair is one of the most commonly performed operations in the pediatric population. While the majority of pediatric surgeons routinely use laparoscopy in their practices, a relatively small number prefer a laparoscopic inguinal hernia repair over the traditional open repair. This article provides an overview of the three port laparoscopic technique for inguinal hernia repair, as well as a review of the current evidence with respect to visualization and identification of hernias, recurrence rates, operative times, complication rates, postoperative pain, and cosmesis. The laparoscopic repair presents a viable alternative to open repair and offers a number of benefits over the traditional approach. These include superior visualization of the relevant anatomy, ability to assess and repair a contralateral hernia, lower rates of metachronous hernia, shorter operative times in bilateral hernia, and the potential for lower complication rates and improved cosmesis. This is accomplished without increasing recurrence rates or postoperative pain. Further research comparing the different approaches, including standardization of techniques and large randomized controlled trials, will be needed to definitively determine which is superior. Copyright© South Dakota State Medical Association.

Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

LENUS (Irish Health Repository)

Good, Daniel W

2011-05-03

Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.

Late presentation of a right Bochdalek hernia with a right intrathoracic stomach and organoaxial torsion

International Nuclear Information System (INIS)

Al-Shehri, Mohammed A.; Al-Binali, Ali M.; Eid, Waleed A.; Osinowo, Olu A.; Mohammed, Nabil E.

2005-01-01

A postero-lateral hernia through the foramen of Bochdalek is a rare type of congenital diaphragmatic hernia CDH. The incidence of Bochdalek hernia on the right side is 10-20% compared to the left side, and herniation of the stomach into the right pleural cavity is extremely rare. We report a case of right-sided Bochdalek hernia with a right intrathoracic stomach and organo-axial torsion misdiagnosed initially, and treated as a case of hyperactive airway disease. The child had a right thoracotomy, excision of the hernia sac that contained the stomach, greater omentum and part of the liver, reduction of the viscera into the abdominal cavity and simple closure of the diaphragmatic defect. Recovery was uneventful. This case highlights the consequences of late diagnosis and the effectiveness of surgical relief. A new clinico-anatomical classification of Bochdalek hernia is presented. (author)

Reliable and valid assessment of Lichtenstein hernia repair skills

DEFF Research Database (Denmark)

Carlsen, C G; Lindorff Larsen, Karen; Funch-Jensen, P

2014-01-01

PURPOSE: Lichtenstein hernia repair is a common surgical procedure and one of the first procedures performed by a surgical trainee. However, formal assessment tools developed for this procedure are few and sparsely validated. The aim of this study was to determine the reliability and validity...... of an assessment tool designed to measure surgical skills in Lichtenstein hernia repair. METHODS: Key issues were identified through a focus group interview. On this basis, an assessment tool with eight items was designed. Ten surgeons and surgical trainees were video recorded while performing Lichtenstein hernia...... a significant difference between the three groups which indicates construct validity, p skills can be assessed blindly by a single rater in a reliable and valid fashion with the new procedure-specific assessment tool. We recommend this tool for future assessment...

Amyand’s hernia with acute gangrenous appendicitis and cecal perforation: A case report and review of the literature

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William Kromka

Full Text Available Introduction: An Amyand's hernia is a heterogeneous clinical condition defined by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not contain other abdominal contents or pathologic inflammatory changes. Herein we present an exceptionally rare case of an Amyand's hernia containing acute appendicitis and a perforated cecum. Presentation of case: A 46-year-old male with a right inguinal hernia of 2–3 year duration presented to our Emergency Department complaining of acute onset abdominal and groin pain. The patient was diagnosed with an incarcerated right inguinal hernia and underwent emergent surgical repair. Intraoperatively a reactive fluid was found within the hernia sac that prompted an exploratory laparotomy for suspected bowel perforation. The hernia was then found to contain an inflamed gangrenous appendix with an inflamed and perforated cecum. An ileocecectomy and enteroenterostomy was performed and the hernia defect was repaired without mesh. Discussion: With an estimated incidence of only 1%, Amyand's hernias are rare and lack a clear evidence-based management scheme. Moreover, they can contain a diverse range of pathologic features and presentations that can complicate diagnosis and treatment. To avoid potential morbidity and mortality, the surgeon must consider an Amyand's hernia on his or her differential when operating on inguinal hernias and be aware of the associated presentations, complications, and management schemes. Conclusion: There is a paucity of reports describing simultaneous appendicitis and cecal perforation within an Amyand's hernia. In our case, ileocecectomy and Bassini hernia repair with close follow-up led to a favorable outcome. Keywords: Amyand, Hernia, Appendicitis, Surgery, Case report, Ileocecectomy

The diagnostic utility of resistive MRI for lumbar disc hernias

International Nuclear Information System (INIS)

Sakaida, Hiroshi; Hanakita, Junya; Suwa, Hideyuki; Nishihara, Kiyoshi; Nishi, Shogo; Ohta, Fumito; Iihara, Kouji

1990-01-01

The diagnostic utility of the 0.1 tesla resistive magnetic resonance imaging (MRI) system was studied for 78 lumbar disc hernias in surgically treated 70 patients. Myelographic appearance of the lumbar disc hernias fell into the following three categories: (1) medial type, compressing the thecal sac; (2) mediolateral type, compressing both the nerve root and thecal sac; and (3) lateral type, compressing the nerve root. MRI was performed in low-flip angle (LF) and saturation-recovery (SR) radiofrequency-pulse sequences for the midline and paramedian sagittal sections, respectively. A transverse section was found positive when the laterality of the disc hermia was obtained. A coronal section was found positive when high-intensity disc material compresisng the nerve root was recognized. Diagnostic capability of MRI was graded in three scores: Excellent- the optimal information was provided; Fair- some pieces of information was obtained, but not enough for diagnosis; Poor- the information was not helpful for diagnosis in deciding the operative procedure. Of 13 medial disc hernias, 84.6% was positive in the sagittal plane and 88.9% in the transverse plane. MRI was superior to myelography in 9 lesions. Of 38 mediolateral disc hernias, 84.2% were positive in the sagittal plane, 74.2% in the transverse plane, and 26.7% in the coronal plane. MRI was judged as excellent for 17 lesions, fair for 15 lesions, and poor for 6 lesions. Of 27 lateral disc hernias, 55.6% were positive in the sagittal plane, 50.0% in the transverse plane, and 30.0% in the coronal plane. MRI was judged as excellent for 4 lesions, fair for 11 lesions, and poor for 12 lesions. Resistive MRI system was of limited value in diagnosing surgical indication of lateral lumbar disc hernias, especially for small but painful lesions. (N.K.)

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...

Recurrent Congenital Diaphragmatic Hernia in Ehlers-Danlos Syndrome

International Nuclear Information System (INIS)

Lin, I.C.; Ko, S.F.; Shieh, C.S.; Huang, C.F.; Chien, S.J.; Liang, C.D.

2006-01-01

Ehlers-Danlos syndrome (EDS) includes a group of connective tissue disorders with abnormal collagen metabolism and a diverse clinical spectrum. We report two siblings with EDS who both presented with congenital diaphragmatic hernia (CDH). The elder sister suffered from recurrent diaphragmatic hernia twice and EDS was overlooked initially. Echocardiography as well as contrast-enhanced magnetic resonance angiography (MRA) showed dilatation of the pulmonary artery, and marked elongation and tortuosity of the aorta and its branches. A diagnosis of EDS was eventually established when these findings were coupled with the clinical features of hyperelastic skin. Her younger brother also had similar features. This report emphasizes that EDS may present as CDH in a small child which could easily be overlooked. Without appropriate surgery, diaphragmatic hernia might occur. Echocardiographic screening is recommended in patients with CDH. Contrast-enhanced MRA can be helpful in delineation of abnormally tortuous aortic great vessels that are an important clue to the early diagnosis of EDS

Repair of an inguinoscrotal hernia in a patient with Becker muscular dystrophy.

Science.gov (United States)

Tatulli, F; Caraglia, A; Delcuratolo, A; Cassano, S; Chetta, G S

2017-01-01

Inguinal hernia repairs are routinely performed as outpatient procedures in most patients, whereas a few require admission due to clinical or social peculiarities. Muscular dystrophies are inherited disorders characterized by progressive muscle wasting and weakness. In case of surgery there is no definite recommendation for either general or regional anesthesia. This contribution regards a 48 y. o. male patient diagnosed with Becker Muscular Dystrophy by muscle biopsy 10 years earlier. He had a left-sided sizable inguinoscrotal hernia with repeat episodes of incarceration. An elective mesh repair with suction drainage was accomplished under selective spinal anesthesia. The post-operative course was uneventful. A few inguinal hernia repairs require admission due to peculiarities such as extensive scrotal hernias requiring suction drainage. Muscular dystrophies are inherited disorders with no cure and no two dystrophy patients are exactly alike, therefore the health issues will be different for each individual. In case of surgery there is no definite recommendation for either general or regional anesthesia. This contribution regards the successful elective mesh repair with suction drainage of a large left-sided inguino-scrotal hernia in a 48 y. o. male patient affected by Becker muscular dystrophy by selective spinal anesthesia obtained by 10 milligrams of hyperbaric bupivacaine. Effective mesh repair with suction drainage of large inguinal hernias under spinal anesthesia can be achieved in patients affected by muscular dystrophy.

Hernia surgery, South Africa 2015

African Journals Online (AJOL)

in the US.[1,2] More than one million hernia repairs are performed each year in the US. No published ... preoperative planning, but it is unclear if this approach is cost- effective. ... of compliance and outcomes data and adequate training. The.

Amyand's hernia masquerading inguinal abscess complicated with appendico-cutaeneous fistula in an infant with Hirschsprung's disease

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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.

Comparative Study of Inguinal Hernia Repair Rates After Radical Prostatectomy or External Beam Radiotherapy

International Nuclear Information System (INIS)

Lughezzani, Giovanni; Sun, Maxine; Perrotte, Paul; Alasker, Ahmed; Jeldres, Claudio; Isbarn, Hendrik; Budaeus, Lars; Lattouf, Jean-Baptiste; Valiquette, Luc; Benard, Francois; Saad, Fred; Graefen, Markus; Montorsi, Francesco; Karakiewicz, Pierre I.

2010-01-01

Purpose: We tested the hypothesis that patients treated for localized prostate cancer with radical prostatectomy (RP) have a higher risk of requiring an inguinal hernia (IH) repair than their counterparts treated with external beam radiotherapy (EBRT). Methods and Materials: Within the Quebec Health Plan database, we identified 6,422 men treated with RP and 4,685 men treated with EBRT for localized prostate cancer between 1990 and 2000, in addition to 6,933 control patients who underwent a prostate biopsy. From among that population, we identified patients who underwent a unilateral or bilateral hernia repair after either RP or EBRT. Kaplan-Meier plots showed IH repair-free survival rates. Univariable and multivariable Cox regression models tested the predictors of IH repair after RP or EBRT. Covariates consisted of age, year of surgery, and Charlson Comorbidity Index. Results: IH repair-free survival rates at 1, 2, 5, and 10 years were 96.8, 94.3, 90.5, and 86.2% vs. 98.9, 98.0, 95.4, and 92.2%, respectively, in RP vs. EBRT patients (log-rank test, p < 0.001). IH repair-free survival rates in the biopsy population were 98.3, 97.1, 94.9, and 90.2% at the same four time points. In multivariable Cox regression models, RP predisposed to a 2.3-fold higher risk of IH repair than EBRT (p < 0.001). Besides therapy type, patient age (p < 0.001) represented the only other independent predictor of IH repair. Conclusions: RP predisposes to a higher rate of IH repair relative to EBRT. This observation should be considered at informed consent.

Obturator hernia should be considered in the differential diagnosis of hip and knee pain.

Science.gov (United States)

Belli, Ahmet Korkut; Memiş, Gündüz; Dere, Özcan; Koşan, Ulaş; Nazlı, Okay

2016-11-01

Obturator hernia is a rare disease usually occurring in debilitated elderly women. Pain radiating down the medial thigh and knee (Howship-Romberg sign) is a specific sign of the disease. Presently described is a case of obturator hernia in a 73-year-old female patient who presented with severe left hip pain radiating down the medial thigh and knee, nausea, and loss of appetite. Initially, vertebral disc herniation was thought to be cause, but abdomino-pelvic computed tomography scan revealed left strangulated obturator hernia. Diagnosis of obturator hernia can be challenging. Physicians should consider obturator hernia in the differential diagnosis of knee and hip pain, and investigate for Howship-Romberg sign. Early diagnosis of the disease not only decreases morbidity and mortality, but also presents opportunity to treat with minimally invasive methods.

Struggling with a Gastric Volvulus Secondary to a Type IV Hiatal Hernia

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Dafnomilis George

2010-01-01

Full Text Available Type IV hiatal hernias are characterized by herniation of the stomach along with associated viscera such as the spleen, colon, small bowel, and pancreas through the esophageal hiatus. They are relatively rare, representing only about 5%–7% of all hernias, and can be associated with severe complications. We report a 71-year-old veteran wrestler who presented to our department with a type IV paraesophageal hernia containing a gastric volvulus and treated successfully with emergency operation.

Surgical removal of a large vaginal calculus formed after a tension-free vaginal tape procedure.

Science.gov (United States)

Zilberlicht, Ariel; Feiner, Benjamin; Haya, Nir; Auslender, Ron; Abramov, Yoram

2016-11-01

Vaginal calculus is a rare disorder which has been reported in association with urethral diverticulum, urogenital sinus anomaly, bladder exstrophy and the tension-free vaginal tape (TVT) procedure. We report a 42-year-old woman who presented with persistent, intractable urinary tract infection (UTI) following a TVT procedure. Cystoscopy demonstrated an eroded tape with the formation of a bladder calculus, and the patient underwent laser cystolithotripsy and cystoscopic resection of the tape. Following this procedure, her UTI completely resolved and she remained asymptomatic for several years. Seven years later she presented with a solid vaginal mass. Pelvic examination followed by transvaginal ultrasonography and magnetic resonance imaging demonstrated a large vaginal calculus located at the lower third of the anterior vaginal wall adjacent to the bladder neck. This video presents the transvaginal excision and removal of the vaginal calculus.

Acute appendicitis in an incarcerated crural hernia: analysis of our experience Apendicitis aguda en una hernia crural incarcerada: análisis de nuestra experiencia

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P. Priego

2005-10-01

Full Text Available Introduction: the finding of the vermiform appendix within a crural hernia (Amyand's hernia is a rare entity whose incidence is not described in the literature. Objective: the aim of this study was to report our hospital's experience in this kind of pathology. Material and methods: between 1993 and 2004, 4,572 acute appendicitis and 372 incarcerated crural hernia cases have been operated on in our hospital. We studied 6 cases of incarcerated crural hernia with vermiform appendix inside. We analyzed in retrospect the following parameters: age, sex, personal history, clinical manifestations, preoperative diagnosis, surgical technique, mean hospital stay, and outcome. Results: all patients were women with a mean age of 78.8 years. Most frequent clinical manifestations included pain and a mass in the right inguinocrural region, of variable intensity and duration. No clinical, laboratory, or radiographic signs help in reaching a correct preoperative diagnosis. General anesthesia and a crural approach are used in most surgical operations. In all cases an appendectomy was performed via the hernia sac, thus proving the presence of acute appendicitis in four of them (66.67%. A prosthetic mesh was used in 3 cases, and one case of wound infection was found. In the other cases we sutured the hernia ring using prolene. Conclusion: the finding of the appendix in an incarcerated crural hernia is a rare entity in old women that is difficult to diagnose preoperatively. Treatment includes appendectomy and herniorraphy. The use of prosthetic mesh is controversial.Introducción: la presencia del apéndice vermiforme en el interior de un saco herniario crural (hernia de Amyand constituye una entidad poco frecuente y cuya incidencia no está descrita en la literatura. Objetivo: el objetivo del trabajo es presentar la experiencia de nuestro hospital en este tipo de patología. Material y métodos: entre 1993 y 2004 se han intervenido en nuestro centro 4.572 pacientes

Occult Radiographically Evident Port-Site Hernia After Robot-Assisted Urologic Surgery: Incidence and Risk Factors.

Science.gov (United States)

Christie, Matthew C; Manger, Jules P; Khiyami, Abdulaziz M; Ornan, Afshan A; Wheeler, Karen M; Schenkman, Noah S

2016-01-01

Laparoscopic trocar-site hernias (TSH) are rare, with a reported incidence of 1% or less. The incidence of occult radiographically evident hernias has not been described after robot-assisted urologic surgery. We evaluated the incidence and risk factors of this problem. A single-institution retrospective review of robot-assisted urologic surgery was performed from April 2009 to December 2012. Patients with preoperative and postoperative CT were included for analysis. Imaging was reviewed by two radiologists and one urologist. One hundred four cases were identified, including 60 partial nephrectomy, 38 prostatectomy, and 6 cystectomy. Mean age was 58 years and mean body mass index (BMI) was 29 kg/m(2). The cohort was 77% male. Ten total hernias were identified by CT in 8 patients, 2 of which were clinically evident hernias. Excluding these two hernias, occult port-site hernias were identified radiographically in seven patients. Per-patient incidence of occult TSH was 6.7% (7/104), and per-port incidence was 1.4% (8/564). All hernias were midline and 30% contained bowel. Eight of the 10 occurred at 12 mm sites (p = 0.0065) and 3 of the 10 occurred at extended incisions. Age, gender, BMI, smoking status, diabetes mellitus, immunosuppressive drug therapy, ASA score, procedure, blood loss, prior abdominal surgery, and history of hernia were not significant risk factors. Specimen size >40 g (p = 0.024) and wound infection (p = 0.0052) were significant risk factors. While the incidence of clinically evident port-site hernia remains low in robot-assisted urologic surgery, the incidence of CT-detected occult hernia was 6.7% in this series. These occurred most often in sites extended for specimen extraction and at larger port sites. This suggests more attention should be paid to fascial closure at these sites.

Risk factors for inguinal hernia in women: a case-control study. The Coala Trial Group.

Science.gov (United States)

Liem, M S; van der Graaf, Y; Zwart, R C; Geurts, I; van Vroonhoven, T J

1997-11-01

Potential risk factors for inguinal hernia in women were investigated and the relative importance of these factors was quantified. In women, symptomatic but nonpalpable hernias often remain undiagnosed. However, knowledge on this subject only concerns hernia and operation characteristics, which have been obtained by review of case series. Virtually nothing is known about risk factors for inguinal hernia. The authors performed a hospital-based case-control study of 89 female patients with an incident inguinal hernia and 176 age-matched female controls. Activity since birth with two validated questionnaires was measured and smoking habits, medical and operation history, Quetelet index (kg/m2), and history of pregnancies and deliveries were recorded. Response for cases was 81% and for controls 73%. Total physical activity was not associated with inguinal hernia (univariate odds ratio (OR) = 0.8, 95% confidence interval (CI) 0.6-1.1), but high present sports activities was associated with less inguinal hernia (multivariate OR = 0.2, 95% CI 0.1-0.7). Obesity (Quetelet index > 30) was also protective for inguinal hernia (OR = 0.2, 95% CI 0.04-1.0). Independent risk factors were positive family history (OR = 4.3, 95% CI 1.9-9.7) and obstipation (OR = 2.5, 95% CI 1.0-6.7). In particular, smoking, appendectomy, other abdominal operations, and multiple deliveries were not associated with inguinal hernia in females. The protective effect of present sports activity may be explained by optimizing the resistance of the abdominal musculature protecting the relatively small inguinal weak spot in the female. The individual predisposition for inguinal hernia may be quantified by these risk factors, and, with this in mind, the authors advise that further evaluation might be needed for the patient with unexplained inguinal pain.

Management of vaginal extrusion after tension-free vaginal tape procedure for urodynamic stress incontinence.

Science.gov (United States)

Giri, Subhasis K; Sil, Debasri; Narasimhulu, Girish; Flood, Hugh D; Skehan, Mark; Drumm, John

2007-06-01

To report our experience in the management of vaginal extrusion after the tension-free vaginal tape (TVT) procedure for urodynamic stress incontinence. Five patients diagnosed with vaginal extrusion after a TVT procedure performed at our institution were identified. We reviewed the patients' records retrospectively. The interval from TVT placement to diagnosis, presenting symptoms and signs, duration of symptoms, diagnostic test findings, treatment, and postoperative results were recorded. Patients were followed up for at least 12 months. From January 2001 to June 2004, a total of 166 patients underwent the TVT procedure. Of these, 5 patients (3%) were diagnosed with isolated vaginal extrusion 4 to 40 months postoperatively. No cases of urethral or bladder erosion occurred in this series. The symptoms included vaginal discharge, pain, bleeding, and dyspareunia. The eroded margin of the vaginal mucosa was trimmed, mobilized, and closed over the tape with interrupted vertical mattress sutures in a single layer using 2-0 polyglactin 910 to avoid mucosal inversion. All patients remained symptom free without any evidence of defective healing or additional extrusion at a minimal follow-up of 12 months. Primary reclosure of the vaginal mucosa over the TVT tape is an effective first-line treatment option for vaginal extrusion without compromising continence. Patients undergoing the TVT procedure should be adequately counseled about the possibility of this complication and the available treatment options.

Mortality following emergency groin hernia surgery in Denmark

DEFF Research Database (Denmark)

Kjærgaard, Jesper; Bay-Nielsen, M; Kehlet, H

2010-01-01

The mortality following emergency groin hernia repair in Denmark is more than twice as high (7%) as in comparable countries. This article describes in detail the population that died following emergency herniotomy in order to identify aspects of care that may improve outcome.......The mortality following emergency groin hernia repair in Denmark is more than twice as high (7%) as in comparable countries. This article describes in detail the population that died following emergency herniotomy in order to identify aspects of care that may improve outcome....

Sports Hernia/Athletic Pubalgia

Science.gov (United States)

Larson, Christopher M.

2014-01-01

Context: Sports hernia/athletic pubalgia has received increasing attention as a source of disability and time lost from athletics. Studies are limited, however, lacking consistent objective criteria for making the diagnosis and assessing outcomes. Evidence Acquisition: PubMed database through January 2013 and hand searches of the reference lists of pertinent articles. Study Design: Review article. Level of Evidence: Level 5. Results: Nonsurgical outcomes have not been well reported. Various surgical approaches have return-to–athletic activity rates of >80% regardless of the approach. The variety of procedures and lack of outcomes measures in these studies make it difficult to compare one surgical approach to another. There is increasing evidence that there is an association between range of motion–limiting hip disorders (femoroacetabular impingement) and sports hernia/athletic pubalgia in a subset of athletes. This has added increased complexity to the decision-making process regarding treatment. Conclusion: An association between femoroacetabular impingement and athletic pubalgia has been recognized, with better outcomes reported when both are managed concurrently or in a staged manner. PMID:24587864

COMPLICATIONS OF THE TENSION-FREE VAGINAL TAPE OPERATION IN WOMEN WITH STRESS URINARY INCONTINENCE

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Ismail Mete Itil

2006-03-01

Full Text Available AMAÇ: Bu çalismada klinigimizde uyguladigimiz Tension-free Tape operasyonunun stres üriner inkontinasli vakalardaki etkinligini ve komplikasyon oranlarini belirtmeyi amaçladik.\tMETOD: Retrospektif olarak 4 yillik süre içerinde klinigimizde 153 hastaya uyguladigimiz TVT operasyonun intraoperatif ve postoperatif komplikasyonlarini ve basari oraninini inceledik.\tSONUÇLAR: Intraoperatif dönemde sadece 11 mesane perforasyonu gözlenmistir (%7.20. Postoperatif dönemde 16 hastada kisa süreli iseme sorunlari (%10,46 ve 14 hastada overaktif mesane (%9,15 izlenmistir. Mesane perforasyon orani daha önceden baska bir inkontinans cerrahisi geçirenlerde (%13,4; 7/52 geçirmeyenlere göre anlamli olarak yüksek bulunmustur (%4,0; 4/101 (p0,05. Tüm hastalarda sübjektif kür orani %90,85 bulunmustur\tYORUM: TVT stres üriner inkontinansli hastalarda etkili ve kabul edilebilir komplikasyon oranlariyla beraber güvenli bir operasyondur.

The feasibility, safety and cost of infiltration anaesthesia for hernia repair. Hvidovre Hospital Hernia Group

DEFF Research Database (Denmark)

Callesen, T; Bech, K; Kehlet, H

1998-01-01

Data from 400 consecutive elective ambulatory operations for inguinal hernia under unmonitored local anaesthesia with limited pre-operative testing were prospectively obtained by the use of standardised files and questionnaires to assess the feasibility, patient satisfaction and potential cost re...

Nationwide analysis of prolonged hospital stay and readmission after elective ventral hernia repair

DEFF Research Database (Denmark)

Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

2011-01-01

Early outcome after elective ventral hernia repair is unsatisfactory, but detailed analyses are lacking. The aim of this study was to describe the aetiology of prolonged hospital stay (LOS), readmission and death <30 days after elective ventral hernia repair.......Early outcome after elective ventral hernia repair is unsatisfactory, but detailed analyses are lacking. The aim of this study was to describe the aetiology of prolonged hospital stay (LOS), readmission and death

Laparoscopic diaphragmatic hernia repair using expanded polytetrafluoroethylene (ePTFE) for delayed traumatic diaphragmatic hernia.

Science.gov (United States)

Jee, Yeseob

2017-06-01

Traumatic diaphragmatic hernia (TDH) is an uncommon surgical problem, and diagnosis is often delayed. However, the mortality from bowel necrosis can reach 80%. Therefore, suspicion is needed and surgery is required to prevent complications. A 50-year-old man was transferred due to abdominal pain and vomiting. Chest X-ray and computed tomography (CT) scan showed herniation of the stomach through the left diaphragm. The patient had fallen down 15 months ago and CT scan at that time revealed a small defect of the diaphragm without herniation. We diagnosed delayed herniation of TDH and the patient underwent laparoscopic repair using an expanded polytetrafluoroethylene (ePTFE) mesh. Recovery was uneventful and the CT scan at 3 months after the operation showed no recurrence. We reported a delayed presenting TDH and considered a laparoscopic approach to be safe and feasible during elective surgery. Moreover, use of an ePTFE mesh for repair of large diaphragmatic hernia was also feasible.

Prevalence of Hiatal Hernia and Related Risk Factors to Laparoscopic Cholecystectomy Using the Hasson Technique

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AA Darzi

2016-09-01

Full Text Available BACKGROUND AND OBJECTIVE: One of the complications of laparoscopic cholecystectomy is trocar incision hernia (TSIH: Trocar Site Incisional Hernia, which occurs almost exclusively in the navel area and could cause significant problems. The aim of this study was to evaluate the prevalence of hiatal hernia in laparoscopic cholecystectomy and identify the associated risk factors. METHODS: This cross sectional study was done on patients who underwent laparoscopic cholecystectomy during one year in different hospitals of Babol. Information including age, gender, BMI, diagnosis prior to surgery, duration of hospitalization, duration of surgery, the thickness of the lining of the gallbladder, surgical site infection and umbilical hernia during 12 months follow-up for patients were confirmed and examined. FINDINGS: Among 270 studied patients, there were 236 women (87.4% and 34 men (12.59 %. Eleven patients (4.07% during the 12-month follow-up; they had a hiatal hernia surgical site infection in the navel area (223.82-4.33: CI-95%, OR: 31.14 and BMI (60.18-1.72 CI-95%; OR: 10.21 were associated with increased incidence of inguinal hernias. There was no relationship between other variables and umbilical hernia. CONCLUSION: According to the results of this study obesity and surgical site infections have been linked with an increased incidence of inguinal hernias.

Contemporary engagement with social media amongst hernia surgery specialists.

Science.gov (United States)

Lui, D H; McDonald, J J; de Beaux, A; Tulloh, B; Brady, R R W

2017-08-01

Healthcare professional engagement is increasing. This study aims to identify levels of adoption and engagement of several social media platforms by a large international cohort of hernia surgery specialists. Hernia specialists attending the 38th International Congress of the European Hernia Society were identified. A manual search was then performed on Twitter, ResearchGate, and LinkedIn to identify those who had named accounts. Where accounts were identified, data on markers of utilisation were assessed. 759 surgeons (88.5% male) from 57 countries were identified. 334 surgeons (44%) engaged with a social media platform. 39 (5.1%) had Twitter accounts, 189 (24.9%) had ResearchGate accounts and 265 (34.9%) had LinkedIn accounts. 137 surgeons (18.1%) had accounts on 2 or more social media platforms. There was no gender association with social media account ownership (p > 0.05). Engagement in one social media platform was associated with increased engagement and utilisation on other platforms; LinkedIn users were more likely to have Twitter accounts (p social media amongst Hernia surgeons is similar to other surgical specialities. Geographical variation in SM engagement is seen. Engagement with one SM platform is associated with presence on multiple platforms.

Bochdalek hernia and repetitive pancreatitis in a 33 year old woman.

Science.gov (United States)

Angel, Medina Andrade Luis; David, Coot Polanco Reyes; Laura, Medina Andrade; Abraham, Medina Andrade; Stephanie, Serrano Collazos; Grecia, Ortiz Ramirez

2014-01-01

Bochdalek hernia presentation in adulthood is rare. The presentation in newborns is the most common, manifesting with data from respiratory failure secondary to pulmonary hypoplasia, requiring urgent surgical intervention with high morbidity and mortality. We present the case of a 33 year old woman admitted in the emergency room with severe abdominal pain in the left upper quadrant and disnea. After physical examination and laboratory test we diagnose mild acute pancreatitis. The patient haven't colelitiasis by ulstrasound or any risk factor for pancreatitis. Initially she received medical treatment and was discharged after one week. After four weeks she presented the same symptoms in two different occasions, with severe and mild pancreatitis respectively. A computed tomography report a left posterolateral diafragmatic hernia. In spite of the rare association of pancreatitis and Bochdalek hernia, we realized it as the etiology until the second event and planned his surgery. We made a posterolateral torachotomy and diafragmatic plasty with a politetrafluoroetileno mesh and after a 6 months follow up she has coursed asymptomatic. The high rate of complications in this type of hernia requires us to perform surgical treatment as the hernia is detected. In this case it is prudent medical treatment prior to surgical correction despite this being the origin of the pancreatitis, because the systemic inflammatory response added by the surgical act could result in a higher rate of complications if not performed at the appropriate time. There is no precise rule to determine the type of approach of choice in this type of hernia which thoracotomy or laparotomy may be used. Bochdalek hernia is a rare find in adults who require treatment immediately after diagnosis because of the high risk of complications. When presented with data from pancreatitis is recommended to complete the medical treatment of pancreatitis before surgery to obtain the best results, unless it exist another

Inguinal/inguinoscrotal hernias are the com

African Journals Online (AJOL)

hi-tech

with obstructed abdominal wall hernias between 1991 - 1996. ... Request for reprints to: Dr. A.R.K. Adesunkanmi, Department of Surgery, College of Health Sciences, Obafemi ... had operative intervention and other postoperative management.

Incarcerated giant uterine leiomyoma within an incisional hernia: a case report.

Science.gov (United States)

Exarchos, Georgios; Vlahos, Nikolaos; Dellaportas, Dionysios; Metaxa, Linda; Theodosopoulos, Theodosios

2017-11-01

Uterine leiomyomas presenting as incarcerated or strangulated hernias in surgical emergencies are extremely rare and should be considered in the differential diagnosis in patients with known uterine fibroids and an irreducible ventral abdominal wall hernia. Detailed history and multidisciplinary approach optimize the diagnosis and decision making toward surgical treatment.

Surgical treatment of an umbilical hernia in a free-ranging sub-adult African elephant in Samburu National Reserve, Kenya

OpenAIRE

Kaitho, Titus; Mijele,Dominic; Njoroge,Michael

2015-01-01

Domnic Mijele, Michael Njoroge, Titus Kaitho Veterinary Services Department, Species Conservation and Management Division, Kenya Wildlife Service, Nairobi, Kenya Abstract: A 10-year-old male African elephant (Loxodonta africana) at Samburu National Reserve in Northern Kenya, weighing approximately 1,600 kg, presented with an umbilical hernia in October 2013. Umbilical herniorrhaphy was carried out under field conditions. Anesthesia was induced and maintained using etorphine hydrochloride for...

Surgical management of a De Garengeot’s hernia using a biologic mesh: A case report and review of literature

Directory of Open Access Journals (Sweden)

Amandine Klipfel

2017-01-01

Conclusion: The De Garengeot hernia is an uncommon differential diagnosis for patients presenting with clinical signs of strangled femoral hernia. Although hernia repairs with a synthetic mesh in the presence of appendicitis have been reported, we describe a case of femoral hernia repair using a biologic mesh, in a patient with a De Garengot hernia.