VP021 A WAY TO TREAT SPIGELIAN HERNIA

Abstract Aim “Spigelian hernia is uncommon and accounts for only 0.12–2% of all abdominal hernias. It is mandatory to perform surgical correction and in recent years the laparoscopic approach is gaining ground. The authors pretend to demonstrate a video of an outpatient laparoscopic repair of Spigelian hernia.” Material and Methods “53-year-old woman with a left Spigelian hernia referred to laparoscopic repair via intraperitoneal approach.” Results “The patient was submitted to laparoscopic correction with a Ventralex® mesh. The surgery went without any complication and under 30 minutes. A few hours after the surgery, the patient was discharged. In the follow-up appointment, the patient had no complaints or evidence of recurrence.” Conclusions “Spigelian hernias are rare and have a mandatory surgical indication. Traditionally, open surgical repair is most commonly used. However, laparoscopic approach is becoming increasingly popular since it allows faster recovery, shorter hospital stay, and less pain, with no commitment to recurrence. Currently, there are no studies that demonstrate the superiority of a laparoscopic technique (intraperitoneal, TAPP or TEP). The intraperitoneal route is a simple, faster, and easily reproducible approach.”

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State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽

10.1024/0301-1526/a000324 ◽

2014 ◽

Vol 43 (1) ◽

pp. 6-26 ◽

Cited By ~ 12

Author(s):

Fabian Rengier ◽

Philipp Geisbüsch ◽

Paul Schoenhagen ◽

Matthias Müller-Eschner ◽

Rolf Vosshenrich ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Replacement ◽

Surgical Repair ◽

Imaging Modality ◽

Open Surgical Repair ◽

Cross Sectional ◽

Transcatheter Aortic Valve ◽

Cross Sectional Imaging ◽

Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

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Laparoscopic versus Open Liver Resection: Differences in Intraoperative and Early Postoperative Outcome among Cirrhotic Patients with Hepatocellular Carcinoma—A Retrospective Observational Study

HPB Surgery ◽

10.1155/2014/871251 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 14

Author(s):

Antonio Siniscalchi ◽

Giorgio Ercolani ◽

Giulia Tarozzi ◽

Lorenzo Gamberini ◽

Lucia Cipolat ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Liver Function ◽

Hospital Stay ◽

Perioperative Complications ◽

Laparoscopic Approach ◽

Postoperative Outcome ◽

Laparoscopic Technique ◽

Surgical Trauma ◽

Cirrhotic Patients

Introduction. Laparoscopic liver resection is considered risky in cirrhotic patients, even if minor surgical trauma of laparoscopy could be useful to prevent deterioration of a compromised liver function. This study aimed to identify the differences in terms of perioperative complications and early outcome in cirrhotic patients undergoing minor hepatic resection for hepatocellular carcinoma with open or laparoscopic technique. Methods. In this retrospective study, 156 cirrhotic patients undergoing liver resection for hepatocellular carcinoma were divided into two groups according to type of surgical approach: laparoscopy (LS group: 23 patients) or laparotomy (LT group: 133 patients). Perioperative data, mortality, and length of hospital stay were recorded. Results. Groups were matched for type of resection, median number of nodules, and median diameter of largest lesions. Groups were also homogeneous for preoperative liver and renal function tests. Intraoperative haemoglobin decrease and transfusions of red blood cells and fresh frozen plasma were significantly lower in LS group. MELD score lasted stable after laparoscopic resection, while it increased in laparotomic group. Postoperative liver and renal failure and mortality were all lower in LS group. Conclusions. Lower morbidity and mortality, maintenance of liver function, and shorter hospital stay suggest the safety and benefit of laparoscopic approach.

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Laparoscopic Spigelian Hernia Repair: The Scroll Technique

The American Surgeon ◽

10.1177/000313480807400203 ◽

2008 ◽

Vol 74 (2) ◽

pp. 108-112 ◽

Cited By ~ 2

Author(s):

Alan A. Saber ◽

Mohamed H. Elgamal ◽

Arun J. Rao ◽

Robert L. Osmer ◽

Ed A. Itawi

Keyword(s):

Hernia Repair ◽

Laparoscopic Repair ◽

Operative Time ◽

Simple Technique ◽

Mesh Fixation ◽

Case Series ◽

Spigelian Hernia ◽

Mesh Placement ◽

Vague Abdominal Pain

Spigelian hernia is a rare clinical entity. It has a subtle clinical presentation with vague abdominal pain that may warrant laparoscopy. Even though laparoscopic ventral hernia repair is increasingly popular, laparoscopic repair of spigelian hernia has not been adequately studied. Eight patients who underwent laparoscopic spigelian hernia repair are presented herein, along with a description of our simple technique for mesh placement. In addition, literature review of laparoscopic repair of spigelian hernia is also presented. Our case series included six females and two males; two patients presented acutely whereas the others presented with chronic pain. Laparoscopic repair was successfully performed in all of our patients with a mean operative time of 92.5 minutes. There were no postoperative complications or recurrence with a mean follow up of 36 months. Our scroll technique for laparoscopic repair is simple and feasible. It minimizes intra-corporeal mesh manipulation, facilitates mesh fixation to the anterior abdominal wall, and maintains a precise orientation of the mesh in relation to the defect.

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Treatment of subacute/chronic ECU tendinopathy using wrist arthroscopy and open surgical repair

Journal of Orthopaedic Surgery ◽

10.1177/23094990211067009 ◽

2022 ◽

Vol 30 (1) ◽

pp. 230949902110670

Author(s):

Young-Keun Lee

Keyword(s):

Surgical Repair ◽

Clinical Findings ◽

Wrist Arthroscopy ◽

Dash Score ◽

Open Surgical Repair ◽

Mri Findings ◽

Open Procedure ◽

Mayo Wrist Score ◽

Quick Dash

Purpose To report the arthroscopic and clinical findings of patients with extensor carpi ulnaris (ECU) tendinopathy treated with wrist arthroscopy and open surgical repair. Methods We retrospectively reviewed the medical records of seven patients with chronic ECU tendinopathy who were treated with diagnostic wrist arthroscopy and open surgical repair between 2010 and 2017. Seven cases diagnosed with ECU tendinopathy had undergone open procedure for the ECU tendinopathy, as well as wrist arthroscopy in the same session. Any pathology of the triangular fibrocartilage complex (TFCC) diagnosed by wrist arthroscopy were treated simultaneously with open procedure for the ECU tendinopathy. The functional outcome was evaluated by comparing the preoperative and final follow-up values of range of motion (ROM), grip strength, visual analog scale (VAS) for pain, modified Mayo wrist score and quick disabilities of the arm, shoulder, and hand (DASH) score. Results TFCC tears were identified in four patients of which repair was performed concomitantly. The average follow-up period was 39 months (range, 25–49 months). At the final follow-up, all the outcomes including average VAS score (6.4→1), the ROM (173→192°), quick DASH score (42.5→18.2), and modified Mayo wrist score (48.6→79.3) improved significantly. Conclusion When treating patients with ECU tendinopathy, the possibility of TFCC combined injury should always be considered. If surgical treatment is planned, we suggest a wrist arthroscopy for more accurate diagnosis an intra-articular pathology, particularly for patients whose MRI findings suggest a degenerative tear or degeneration at the periphery of the TFCC. Additionally, if ECU and DRUJ stability is obtained by repair or reconstruction of the concurrent pathologies in the ECU subsheath, TFCC and other intra-articular structures, the results will be favorable.

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Long-term computed tomography follow-up after open surgical repair of abdominal aortic aneurysms

Acta Radiologica ◽

10.1080/02841850600690397 ◽

2006 ◽

Vol 47 (6) ◽

pp. 549-553 ◽

Cited By ~ 9

Author(s):

M. Mantoni ◽

K. Neergaard ◽

J. K. Christoffersen ◽

T. L. Lambine ◽

N. BÆkgaard

Keyword(s):

Computed Tomography ◽

Surgical Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Open Surgical Repair ◽

Abdominal Aortic

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Laparoscopic Rectopexy without Resection: A Worthwhile Treatment for Rectal Prolapse in Patients without Prior Constipation

The American Surgeon ◽

10.1177/000313480707300905 ◽

2007 ◽

Vol 73 (9) ◽

pp. 858-861 ◽

Cited By ~ 6

Author(s):

Allen Hsu ◽

Marc I. Brand ◽

Theodore J. Saclarides

Keyword(s):

Irritable Bowel Syndrome ◽

Rectal Prolapse ◽

Hospital Stay ◽

Colonic Motility ◽

Laparoscopic Approach ◽

Levator Hiatus ◽

Mesenteric Vessels ◽

Rectal Mobilization ◽

Irritable Bowel

Anterior resection with rectopexy is considered by many to be the best operation for rectal prolapse. It is feared that if sigmoid redundancy created by rectal mobilization is not resected, colonic motility (specifically constipation) could be disabling. We contend that resection is not necessary in patients without preexisting constipation. We tested this hypothesis using a laparoscopic approach to minimize hospital stay. Twelve patients were treated (eight women); mean age was 45 years (range, 25–82 years). No patient had preexisting constipation; one had irritable bowel syndrome. Three patients had prior prolapse operations. Full rectal mobilization was undertaken down to the levator hiatus; neither the mesenteric vessels nor the lateral ligaments were divided. Rectopexy to the presacral fascia was done with one to two Nurolon sutures on either side of the rectum. There were no complications; mean hospital stay was 4 days. Mean follow up was 32 months (range; 3–75 months); there have been no recurrences. Only the patient with irritable bowel syndrome developed significant constipation. We conclude: 1) rectopexy can be safely done laparoscopically, 2) resection is not required in the absence of prior constipation, and 3) rectal mobilization and rectopexy does not predispose to future constipation in these selected patients.

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Long-Term Results After Elective Open Surgical Repair of Abdominal Aortic Aneurysm: A 14-Year Follow-Up Study

Journal of Vascular Surgery ◽

10.1016/j.jvs.2015.04.172 ◽

2015 ◽

Vol 61 (6) ◽

pp. 88S-89S

Author(s):

Daniela Mazzaccaro ◽

Alberto Settembrini ◽

Michele Carmo ◽

Alessandro Fossati ◽

Simone Salvati ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Surgical Repair ◽

Long Term Results ◽

Open Surgical Repair ◽

Follow Up Study ◽

Abdominal Aortic

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Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?

Minimally Invasive Surgery ◽

10.1155/2021/8828091 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

André Pereira ◽

Hugo Santos Sousa ◽

Diana Gonçalves ◽

Eduardo Lima da Costa ◽

André Costa Pinho ◽

...

Keyword(s):

Peptic Ulcer ◽

Hospital Stay ◽

Laparoscopic Repair ◽

Laparoscopic Approach ◽

Oral Intake ◽

Length Of Hospital Stay ◽

Perforated Peptic Ulcer ◽

Open Group ◽

New Paradigm ◽

Female Ratio

Introduction. Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the treatment of PPU. Methods. Single-institutional, retrospective study of all patients submitted to surgical repair of PPU between 2012 and 2019. Results. During the study period, 169 patients underwent emergent surgery for PPU. A laparoscopic approach was tried in 60 patients and completely performed in 49 of them (conversion rate 18.3%). The open group was composed of 120 patients (included 11 conversions). Comparing the laparoscopic with the open group, there were significant differences in gender (male/female ratio 7.2/1 versus 2.2/1, respectively; p = 0.009 ) and in the presence of sepsis criteria (12.2% versus 38.3%, respectively; p = 0.001 ), while the Boey score showed no differences between the two groups. The operative time was longer in the laparoscopic group (median 100’ versus 80’, p = 0.01 ). Laparoscopy was associated with few early postoperative complications (18.4% versus 41.7%, p = 0.004 ), mortality (2.0% versus 14.2%; p = 0.02 ), shorter hospital stay (median 6 versus 7 days, p = 0.001 ), and earlier oral intake (median 3 versus 4 days, p = 0.021 ). Conclusion. Laparoscopic repair of PPU may be considered the procedure of choice in patients without sepsis criteria if expertise and resources are available. This kind of approach is associated with a shorter length of hospital stay and earlier oral intake. In patients with sepsis criteria, more data are required to access the safety of laparoscopy in the treatment of PPU.

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First application of the ‘lasso technique’ on an endograft with suprarenal fixation stent

Vascular ◽

10.1177/1708538113478733 ◽

2013 ◽

Vol 21 (3) ◽

pp. 177-181 ◽

Cited By ~ 2

Author(s):

Stavros Spiliopoulos ◽

Kevin Mani ◽

Tarun Sabharwal ◽

Miltiadis Krokidis ◽

Panagiotis Gkoutzios

Keyword(s):

Endovascular Repair ◽

Surgical Repair ◽

Renal Arteries ◽

Main Body ◽

Infected Aneurysm ◽

Open Surgical Repair ◽

Proximal Migration ◽

Abdominal Aortic ◽

Bilateral Renal Artery

The authors report the use of the ‘lasso technique’ for the preservation of bilateral renal artery patency, following the intraoperative proximal migration of an aortic endograft with suprarenal bare metal fixation and anchoring barbs, due to device delivery failure. During an emergency endovascular repair of a ruptured mycotic abdominal aortic aneurysm using the Zenith Flex device, the main body of the graft migrated proximally to cover both renal arteries. Attempts to pull down the graft using balloons were not effective. Finally, the ‘lasso technique’ using a guidewire over the aortic bifurcation was employed and successfully adjusted the graft below the level of the renal arteries. No procedure-related complications were noted. The endovascular repair was used as a bridging procedure and two months following the primary endovascular procedure, open surgical repair of the infected aneurysm with excision of the stent graft was performed. The patient is alive after eight months follow-up.

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A Method for Combined Percutaneous and Open Surgical Repair of Achilles Tendon Ruptures: A Report of Three Cases

Foot & Ankle International ◽

10.1177/107110079601700406 ◽

1996 ◽

Vol 17 (4) ◽

pp. 217-220 ◽

Cited By ~ 4

Author(s):

Behiç Tanil Esemenli ◽

Hakan Gündeş ◽

Mete Mecikoğlu

Keyword(s):

Surgical Treatment ◽

Achilles Tendon ◽

Surgical Repair ◽

Functional Results ◽

Wound Complication ◽

Wound Complications ◽

Distal Stump ◽

Open Surgical Repair ◽

Tendon Ruptures

Surgical treatment of Achilles tendon ruptures provides excellent functional results in active individuals, although it carries an incidence of wound complications. After experiencing a 25% wound complication rate with the traditional techniques in Achilles tendon ruptures, we modified the Bosworth technique by passing the gastrocsoleus flap percutaneously through the distal stump. This modification eliminated one third of the distal incision, which appears to be the most vulnerable part. We performed the operation in three consecutive cases. At 2-year follow-up there were no wound complications and no reruptures.

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