scholarly journals A new fixation-free 3D multilamellar preperitoneal implant for open inguinal hernia repair

2017 ◽  
pp. 66-68
Author(s):  
Antonio Brescia ◽  
Federico Tomassini ◽  
Giammauro Berardi ◽  
Massimo Pezzatini ◽  
Umile Michele Cosenza ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Analogue Scale ◽  
Postoperative Morbidity ◽  
Control Group ◽  
Mesh Group ◽  
3D Mesh ◽  
Duration Of Surgery ◽  
Lichtenstein Procedure ◽  
Open Inguinal Hernia Repair ◽  
The Mean

Between September 2014 and December 2015, 32 patients with inguinal hernia were treated using a new 3D mesh in our department. This mesh is characterized by a multilamellar flower-shaped central core with a flat, large-pore polypropylene ovoid disk that has to be implanted preperitoneally. Compared with the traditional Lichtenstein procedure, we observed a shorter mean duration of surgery and a significantly lower mean visual analogue scale (VAS) postoperative pain score recorded immediately after the procedure in the 3D mesh group. The mean VAS score recoded after 4 and 8 postoperative days showed better results in the 3D mesh group than the control group. Moreover, there was reduced postoperative morbidity in the 3D mesh group than the control group, even if no patients experienced severe complications.

scholarly journals Application of platysma muscle suture after thyroidectomy

2020 ◽  
pp. 147-150
Keyword(s):  
Postoperative Pain ◽  
Wound Infection ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Platysma Muscle ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean ◽  
Length Of Hospitalization

Introduction: Thyroidectomy is a common surgery in the neck area, in which the application of platysma muscle suture after thyroidectomy is still being discussed. This study was conducted to compare the application (currently common) or non-application of suture for platysma muscle. Methods: In this retrospective cross-sectional study, 117 patients underwent thyroidectomy, among which 63 cases without suturing platysma (control group) and 54 subjects with suturing platysma (Intervention group ) were examined in terms of postoperative pain based on visual analogue scale score measured 24 h post-operation. The samples were also investigated regarding hematoma and seroma, wound infection, length of hospitalization, scarring (1 year after surgery), duration of surgery, and the number of cases using opioids during the hospitalization. Patients with diabetes, previous neck surgery, coagulopathy, and radiation history were excluded from the study. The gathered data were analyzed statistically in SPSS software (version 18) using the Chi-square test and the Mann–Whitney U test. A p-value of less than (0.05) was considered significant. Results: Based on the findings, the mean age of the patients in the Intervention group was calculated at 51 years, of which 41 and 13 cases were females and males, respectively. In the Intervention group, 34 patients underwent complete thyroidectomy and 20 patients had hemithyroidectomy. The mean age score of subjects in the control group was calculated at 50 years, of which 44 and 19 patients were respectively female and male. No significant difference was revealed considering wound infection, length of hospitalization, created scarring, the amount of opioid use (opioids), and postoperative pain. However, only the length of surgery was different between the groups (P-value<0.05). Conclusions: There was no difference between wound and surgical complications and cosmetic results between both groups; nevertheless, due to the duration of the surgery and other benefits, such as consuming less thread, not suturing the platysma is recommended.

Uterine Isthmus Tourniquet during Abdominal Myomectomy: Support or Hazard? A Randomized Double-Blind Trial

2020 ◽  
Vol 85 (5) ◽  
pp. 396-404
Author(s):  
Abolfazl Mehdizadehkashi ◽  
Kobra Tahermanesh ◽  
Samaneh Rokhgireh ◽  
Vahideh Astaraei ◽  
Zahra Najmi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Ovarian Reserve ◽  
Operating Time ◽  
Serum Levels ◽  
Massive Hemorrhage ◽  
Control Group ◽  
Double Blind ◽  
Abdominal Myomectomy ◽  
Duration Of Surgery ◽  
The Mean

<b><i>Background and Objectives:</i></b> A tourniquet has been suggested as a useful means of reducing massive hemorrhage during myomectomy. However, it is not clear whether the restricted perfusion affects the ovaries. In the present study, we examined the effect of a tourniquet on ovarian reserve and blood loss during myomectomy. <b><i>Materials and Methods:</i></b> In a randomized double-blind clinical trial, fertile nonobese patients scheduled for abdominal myomectomy at Rasool-e-Akram Hospital from February 2018 to June 2019 were randomized to a tourniquet (<i>n</i> = 46) or a non-tourniquet group (<i>n</i> = 35). Serum levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) were measured before and 3 months after surgery, blood loss was recorded during surgery, and serum levels of hemoglobin (Hb) were recorded before surgery, 6 h and 3 days after surgery. SPSS version 21 was used for statistical analysis. <b><i>Results:</i></b> Demographic, obstetric, and myoma characteristics were similar in the 2 groups (<i>p</i> &#x3e; 0.05). The mean baseline values of AMH and FSH did not differ between groups (<i>p</i> &#x3e; 0.05). After surgery, only FSH was higher in the control group (<i>p</i> = 0.043). Despite the time taken to fasten and open the tourniquet, the mean operating time was shorter in the tourniquet group (<i>p</i> &#x3c; 0.001). Blood loss was higher in the control group (<i>p</i> = 0.005). The drop in Hb levels at 6 h after surgery was higher in the non-tourniquet group (<i>p</i> = 0.002). Blood loss was significantly associated with the duration of surgery (<i>r</i> = 0.523, <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The use of a tourniquet during abdominal myomectomy significantly reduced the mean volume of blood loss compared to the non-tourniquet group, while it did not prolong the duration of surgery, nor reduced the ovarian reserve. A tourniquet is a safe and efficient measure during abdominal myomectomy.

scholarly journals Improving postoperative pain management in subpectoral tissue expander implant reconstruction of the breast using an elastomeric pump

2015 ◽  
Vol 97 (5) ◽  
pp. 364-368 ◽  
Author(s):  
A Chaudhry ◽  
S Hallam ◽  
A Chambers ◽  
AK Sahu ◽  
S Govindarajulu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Local Anaesthetic ◽  
Analogue Scale ◽  
Breast Surgery ◽  
Infusion Pump ◽  
Intervention Group ◽  
Tissue Expander ◽  
Control Group ◽  
The Mean

Introduction Postoperative pain after breast surgery is one of the major factors contributing to delay in mobilisation and prolonged hospital stay. A retrospective analysis was performed of patients undergoing skin sparing mastectomy and insertion of a subpectoral implant. The aim was to determine whether the use of an elastomeric local anaesthetic pump improved pain control and length of stay. Methods Twenty-five consecutive patients undergoing the above procedure were sited with an elastomeric local anaesthetic infusion pump intraoperatively, in addition to standard regular and pro re nata analgesia. The control group comprised 25 patients undergoing the same procedure in the same year who received standard analgesia alone. Visual analogue scale scores were recorded for the duration of inpatient stay, as was any further analgesic requirement. Results The median age was 51 years (range: 26–75 years) in the intervention group and 50 years (range: 28–70 years) in the control group. The mean visual analogue scale score was 0.28 (standard deviation [SD]: 0.61) at 24 hours for the intervention group and 1.84 (SD: 0.37) for the control group (p<0.0001). The mean length of stay was 1.8 days (SD: 0.71 days) for the intervention group and 2.28 days (SD: 0.94 days) for the control group (p=0.15). There were no complications involving catheter placement, leakage or toxicity relating to use of the local anaesthetic. Conclusions There was significantly reduced pain with the use of the local anaesthetic infusion pump. The elastomeric pump is a step towards enhanced patient recovery after breast surgery in the case of skin sparing mastectomy and subpectoral tissue expander reconstruction.

scholarly journals Desarda’s versus Lichtenstein technique of inguinal hernia repair

2017 ◽  
Vol 5 (1) ◽  
pp. 92
Author(s):  
Obaid Syed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Complication Rate ◽  
Mesh Repair ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

scholarly journals Desarda Repair No Mesh and Lichtenstein Repair for Inguinal Hernia a Study of 2793 Patients

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
Duration Of Surgery ◽  
The Mean ◽  
Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair

scholarly journals P080 ROUTINE ELECTIVE ILIOHYPOGASTRIC NEURECTOMY IN LICHTENSTEIN INGUINAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Kryspin Mitura
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Hernia ◽  
Mesh Fixation ◽  
Synthetic Mesh ◽  
Control Group ◽  
Effective Technique ◽  
Open Inguinal Hernia Repair

Abstract Aim Chronic postherniorraphy pain occurs in 8-25% of patients undergoing groin hernioplasty with mesh insertion. The most common cause for inguinodynia is neuropathy resulting from nerve damage or entrapment during mesh fixation. With wide mesh insertion there is often a conflict between upper prosthesis margin and an iliohypogastric nerve. The aim of this study is to present a routine elective iliohypogastric neurectomy in Lichtenstein groin hernia repair for prevention of chronic inguinodynia. Material and Methods Between 2018 and 2020, 398 patients were admitted for open inguinal hernia repair. 218 patients underwent a Lichtenstein repair with transection of iliohypogastric nerve before implantation of 10x14 polypropylene mesh (IH group). In the control group of 180 patients all nerves were spared (C group). Follow-up was conducted on 1 POD,1 month, and 1 year after surgery. Results 1 month after a surgery a pain was reported in 24 (11%) patients in IH group (2.9% severe; 8.1% moderate; 89% no pain), and 48 (26.7%) patients in C group (3.9% severe; 22.8% moderate; 73.3% no pain). 1 year after a surgery a persistent pain was reported in 1 (0.4%) patient in IH group, and in 5 (2.8%) patients in C group. An incidence of inguinodynia was significantly lower after iliohypogastric neurectomy (0.5% vs. 2.8%; p &lt; 0.001). Conclusions Routine neurectomy of iliohypogastric nerve appears to be an effective technique in chronic inguinodynia after open mech repair for inguinal hernias. Iliohypogastric nerve resection allows to place a flat synthetic mesh with wide coverage of myopectineal orifice with no need for additional mesh trimming.

scholarly journals Desarda repair no Mesh and Lichtenstein repair for inguinal hernia (A study of 2793 patients)

2021 ◽  
Vol 3 (9) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
Duration Of Surgery ◽  
The Mean ◽  
Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair.

scholarly journals Long-Term Follow-Up of Lichtenstein Repair of Inguinal Hernia in the Morbid Patients With Self-Gripping Mesh (ProgripTM)

2021 ◽  
Vol 8 ◽  
Author(s):  
Weiyu Zhang ◽  
Yixin Zhao ◽  
Xiangyu Shao ◽  
Tao Cheng ◽  
Zhenling Ji ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
The Self ◽  
Long Term Follow Up ◽  
Lichtenstein Procedure ◽  
The Mean

Objective: This study aimed to demonstrate the safety and the efficacy of the self-gripping mesh (ProgripTM) for inguinal hernia repair in morbid patients of the higher American Society of Anesthesiologists (ASA) classification (ASA III and IV). The incidence of chronic pain, postoperative complications, and hernia recurrence was evaluated.Methods: Data were collected retrospectively from the files of the patient and were analyzed for 198 hernias in 147 patients. All the patients included in this study had undergone inguinal hernia repair by Lichtenstein approach with the self-gripping mesh (ProgripTM) in the same clinical center. Preoperative, perioperative, and postoperative data were collected and a long-term follow-up of 31.8 ± 19.5 m (5–60 m) was performed. Complications, pain scored on a 0–10 numeric rating scale (NRS), and hernia recurrence were assessed.Results: During the past 5 years, 198 hernias in 147 patients were repaired with the Lichtenstein procedure with the self-gripping mesh (ProgripTM). The majority of the patients were high level of the ASA classification (ASA III and IV) (95.9%), with ASA III (10.2%) and IV (85.7%). The mean operation time was 71.2 ± 23.8 min. The mean length of postoperative stay was 2.5 ± 2.1 days. There were no intraoperative complications. About 14 cases (7.1%) suffered from postoperative surgical wound complications, which were limited to the skin and subcutaneous tissue and were cured with the conservative methods successfully; there was no mesh infection, the acute postoperative pain was low or mild [visual analog scale (VAS) score ≤ 4] and the chronic postoperative pain was reported in three patients (1.5%) and tolerable, hernia recurrence (femoral hernia recurrence) occurred in one patient half a year after during the follow-up period.Conclusion: This study demonstrated the advantages of the self-gripping mesh in hernia repair of the high-risk patients with inguinal hernia (ASA III and IV) by Lichtenstein procedure under local anesthesia.

scholarly journals ROLE OF CHEWING GUM ON EARLY RECOVERY OF FEMALES AFTER CAESAREAN SECTION

2016 ◽  
Vol 21 (4) ◽  
pp. 280
Author(s):  
Rabia Wajid ◽  
Ghazala Huma ◽  
Iram Mobusher
Keyword(s):  
Caesarean Section ◽  
Digestive System ◽  
Total Duration ◽  
The Body ◽  
Chewing Gum ◽  
Control Group ◽  
Bowel Sound ◽  
Early Recovery ◽  
Duration Of Surgery ◽  
The Mean

AbstractBackground:The incidence of Caesarean section is increasing day by day, which is usually conducted under spinal anesthesia. It is done on lower abdominal region and for this reason; the working of digestive system can slow down in the coming period. This is known as ileus, and is distressing for the patient but the way to prevent this problem, is there. One possible way of avoiding this consequence is chewing gum which tricks the body into thinking it is eating making the bowel start its function again.Objective:To compare the effect of chewing gum as compared to no intervention for early recovery of bowel system after lower segment caesarean section at term.Methodology:This randomized controlled trial was conducted on 100 females who were planned to undergo caesarean section. Informed consent was obtained and demographic details were noted. In group A, females were suggested to take chewing gum after 6 hours of surgery to chew for 60 minutes while in group B, females were not subjected to chewing gum. They were followedup in wards and time required for first bowel sound and first fecal discharge was noted and compared in both groups by using t-test.Results:The mean age of females was 24.48 1.99 years. The females presented at mean gestational age of 38.76 0.87 weeks. The mean BMI of females was 25.49 2.29 kg/m2. Total duration of surgery required for c-section including anesthesia time was 42.28 2.38 minutes. After surgery, the mean duration bet-ween c-section and first onset of feeling of hunger was 11.38 3.14 hours in chewing gum group and 16.84 0.49 hours in control group. The mean duration bet-ween c-section and first bowel sound was 21.39 0.68 hours in chewing gum group and in control group were 28.27 0.60 hours. The mean duration between c-section and first passage of flatus was 25.94 0.71 hours in chewing gum group and 32.00 0.77 hours in control group. The mean duration between c-section and first defecation was 31.56 0.81 hours in chewing gum group and 41.28 0.80 hours in control group. The difference was significant and chewing gum group required less duration for feel of hunger, first bowel sound, passage of flatus and defecation than control group (p < 0.05).Conclusion:In conclusion, use of chewing is effec-tive and beneficial in early recovery of females after caesarean section in terms of early return of bowel activities.Key words:Bowel Sound, Caesarean Section, Chew-ing Gum, Digestive System, Fecal Discharge, Ileus.

scholarly journals A COMPARATIVE STUDY ON OUTCOMES OF OPEN & LAPAROSCOPIC REPAIR IN INGUINAL HERNIA IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 23-25
Author(s):  
Konkena Janardhana Rao ◽  
K. Meghana ◽  
N. Prahalada Reddy ◽  
J. Ramanaiah ◽  
Mamatha. V ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Female Ratio ◽  
Duration Of Surgery ◽  
The Mean ◽  
Operative Recovery ◽  
Lichtenstein Operation

Background: Over the last decade, the field of hernia surgery got a new transformation, with exponential growth in mesh technology. Laparoscopic hernia repair has remained a contentious issue since its inception. Though a variety of procedures performed; none can be termed as an ideal procedure as each one is accompanied by varied early and late complications. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we have conducted a study in our institute, to compare Lichtenstein tension-free open hernioplasty with Transabdominal pre-peritoneal repair (TAPP) comparing the intraoperative and early postoperative complications. Methods: Our study was a single-centre, prospective comparative study conducted on sixty-one patients, over a period of 2 years from August 2018 to August 2020. All the cases included in the study were uncomplicated inguinal hernias. A detailed history of the symptoms, thorough clinical examination and investigations were done, which were analysed. Results: Most of the patients presented in the 5th decade. Male to female ratio of incidence of inguinal hernia was 11.2:1. Majority of the patients presented with unilateral hernia with right inguinal hernia being the most frequent presentation. The mean duration of surgery for TAPP is more when compared to Lichtenstein operation. The mean duration of hospital stay for open hernioplasty is more when compared to the laparoscopic hernia repair. TAPP is associated with lesser complications when compared to Lichtenstein's hernioplasty. Seroma, hematoma, and wound infection were the common complications noted. Conclusion: TAPP repair is a better procedure when compared to Lichtenstein operation in terms of hospital stay, post- operative recovery, intra-operative and post-operative complications.

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