scholarly journals Comparative Study of Snodgrass and Mathieu’s Procedure for Primary Hypospadias Repair

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Raashid Hamid ◽  
Aejaz A. Baba ◽  
Altaf H. Shera
Keyword(s):  
Operative Time ◽  
Stricture Formation ◽  
Urethrocutaneous Fistula ◽  
Cutaneous Fistula ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Urinary Stream ◽  
The Mean ◽  
Local Examination

Objective. Present study was undertaken to compare the results of two single stage hypospadias repairs, namely, Tubularized Incised Plate (TIP) repair and Mathieu’s repair. Methods. The study included 100 patients of distal penile hypospadias, from January, 2008 to January, 2013. After a detailed history, local examination was performed with reference to the site of meatus, shape of glans, and presence of chordee. TIP repair was performed in 52 patients and Mathieu’s repair in 48 patients. On follow-up, the patients were examined for the position of meatus, shape of meatus, urinary stream, urethrocutaneous fistula, and stricture formation. Results. The mean age of presentation was 6.2 ± 3.2 years (range 1.5–15years). The mean operative time was 63.7 ± 14.3 (45–90) minutes and 95.0 ± 19.1 (70–125) minutes in TIP and Mathieu’s repair, respectively.Complications after surgery were urethero cutaneous fistula in 3(5.76%) and 7 (14.5%), meatal stenosis in 3(5.33%) and 4(8.33%), wound infection in 19.2% and 8.3% cases in TIP repair and Mathieu repair, respectively. The shape of meatus was slit-like and vertically oriented in 48(92.3%) patients who had undergone TIP repair. Conclusion. The Snodgrass repair is significantly faster, with more natural cosmetic appearance of the meatus than the Mathieu’s repair.

scholarly journals Comparative study of two different procedures for primary hypospadias repair

2017 ◽  
Vol 4 (8) ◽  
pp. 2475
Author(s):  
Naser R. Tawfiq ◽  
Mahmood J. Saood ◽  
Mohanad Hamed Abdulla
Keyword(s):  
Operative Time ◽  
Wound Dehiscence ◽  
Cutaneous Fistula ◽  
Tubularized Incised Plate ◽  
Urinary Stream ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Local Examination

Background: Different modalities of procedures for hypospadial repair have been described in the literature. Data about the outcome of two main different procedure of repair are scares from Iraq. The aim of this study is to compare the results of these two methods of hypospadias repairs. The present study compared two single stage hypospadias repairs, namely, tubularized incised plate (Snodgrass) repair and Mathieu’s repair.Methods: It involved 50 patients diagnosed with penile hypospadias, from March 2011 to April 2015 at the Department of Surgery, Al-Karama Teaching Hospital. After a detailed history, local examination was performed with reference to the site of meatus, shape of glans, and presence of chordee, patients were randomly assigned as Group A of 26 patients in whom Snodgrass repair was accomplished and Group B having 24 patients in whom Mathieu’s repair was performed. On follow-up, the patients were examined for the position of meatus, shape of meatus, urinary stream, urethra-cutaneous fistula, and stricture formation.Results: The results showed that the mean age of presentation was 7±6 years (range 1-13years). The mean operative time was 90±15 (75-105) minutes and 60±15 (45-75) minutes in Snodgrass and Mathieu’s repair respectively. Complications after surgery were urethero-cutaneous fistula in 2(7.69%) and 4 (16.67%), meatal stenosis in 1(3.84%) and 2(8.33%), wound infection in 4(15.38%) and 3(12.5%) cases in Snodgrass repair and Mathieu repair, respectively, wound dehiscence was equal in Snodgrass repair and Mathieu repair.Conclusions: It can be concluded that the cosmetic results were excellent with Snodgrass repair with a normal looking slit like meatus.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

scholarly journals Surgical and Postoperative Evaluations of Rectal Adenomas Ecised With a Novel Proctoscope.

2020 ◽  
Author(s):  
Roberta Denise Alkmin Lopes Lima ◽  
Rogerio Serafim Parra ◽  
Marley Ribeiro Feitosa ◽  
Omar Féres ◽  
José Joaquim Ribeiro Rocha
Keyword(s):  
Operative Time ◽  
Average Distance ◽  
Economic Feasibility ◽  
Surgeon Experience ◽  
Average Operative Time ◽  
The Mean ◽  
Average Size ◽  
High Level ◽  
Complex Methods

Abstract Purpose Many transanal endoscopic surgeries require a high level of technical expertise and surgeon experience. Considering the economic feasibility of material acquisition and the technical feasibility of training and experience with complex methods, a simpler technique with available resources is relevant for the excision of rectal adenomas. This study presents the surgical and postoperative results achieved with a novel proctoscope using the transanal endoscopic technique to excise rectal adenomas. The results are compared to the results obtained with other currently employed transanal techniques. Methods We retrospectively investigated the medical records of patients who underwent transanal endoscopic operations from April 2000 to June 2018 at two tertiary referral centers for colorectal cancer. Results This study included 99 patients. The mean age was 65.3 ± 13.3 years. The average size of the adenomas was 4.6 ± 2.3 cm, and their average distance to the anal border was 5.6 ± 3.3 cm. The average operative time was 65.3 ± 41.7 min. In 48.5% of the operations, the specimen was fragmented, and in 59.6% of the cases, the microscopic margins were free. The rates of postoperative complications and relapse were 5% and 19%, respectively. The mean follow-up was 80 ± 61.5 months. Conclusions The described proctoscope proved to be a viable technique with results similar to other techniques, with the advantage that it allowed greater accessibility for surgeons. Therefore, its use could be implemented and become widespread in surgical practice.

scholarly journals Using prepucial mucous to cover neourethra in TIP urethroplasty: 4 years experience in a tertiary paediatric hospital of Bangladesh

2020 ◽  
pp. 37-40
Author(s):  
Sabbir Karim ◽  
◽  
Monoarul Islam Talukder ◽  
Sultana Parvin ◽  
◽  
...  
Keyword(s):  
Conflict Of Interest ◽  
Wide Spectrum ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Paediatric Hospital ◽  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Key Words Hypospadias ◽  
The Mean ◽  
Different Tissues

Background. Hypospadias has a wide spectrum of penile abnormality requiring surgical correction. Most of the cases are of anterior variety and the surgical technique depends on constructing a neo urethra. Snodgrass or Tubularized Incised Plate (TIP) urethroplasty is one of the most popular techniques of urethroplasty which depends on the existing healthy, adequate and intact urethral plate. Different tissues have been described to cover the neourethra as second layer in literature. In this study we modified the TIP urethroplasty by covering the neourethra with 2 layers of pedicled prepucial mucosa or Dartos flap. Objective. To see the outcome of modified Snodgrass or TIP urethroplasty in anterior mid and proximal penile hypospadias. Materials and method. Total 88 patients were operated by modified Snodgrass technique or modified TIP urethroplasty from January 2012 to July 2016. Coronal, subcoronal, distal penile, mid penile and proximal penile hypospadias were included in the study. Every patient underwent modified TIP urethroplasty and outcomes were assessed. Results. The mean age of the patients were 28.34±14.98 months, ranges from 6.5 to 65 months. 9 (10.2%) patients of our series develop urethrocutaneous fistula, 5 (5.68%) patients develop meatal stenosis and 1 (1.1%) patient developed neourethral stricture. Conclusion. TIP urethroplasty is a versatile method to correct penile hypospadias. Covering of the neourethra with prepucial mucosa secure the neourethral anastomosis. The author declares that there is no conflict of interest. Key words: Hypospadias, TIP urethroplasty, Prepucial mucosa.

scholarly journals LigaSure Haemorrhoidectomy versus Conventional Diathermy for IV-Degree Haemorrhoids: Is It the Treatment of Choice? A Randomized, Clinical Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Maurizio Gentile ◽  
Michele De Rosa ◽  
Gabriele Carbone ◽  
Vincenzo Pilone ◽  
Francesca Mosella ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Operative Time ◽  
Randomized Study ◽  
Late Complications ◽  
The Third ◽  
Effective Instrument ◽  
The Mean ◽  
Complications Rate

Introduction. Milligan-Morgan haemorrhoidectomy performed with LigaSure system (LS) seems to be mainly effective where a large tissue demolition is required. This randomized study is designed to compare LigaSure haemorrohidectomy with conventional diathermy (CD) for treatment of IV-degree haemorrhoids. Methods. 52 patients with IV-degree haemorrhoids were randomized to two groups (conventional diathermy versus LigaSure haemorrhoidectomy). They were evaluated on the basis of the following main outcomes: mean operative time, postoperative pain, day of discharge, early and late complications. The time of recovery of work was also assessed. All patients had a minimum follow-up of twelve months (range 12–24). All data were statistically evaluated. Results. 27 patients were treated by conventional diathermy, 25 by LigaSure. The mean operative time was significantly shorter in LS, such as postoperative pain, mainly lower on the third and fourth postoperative day: moreover pain disappeared earlier in LS than CD. The time off-work was shorter in LS, while there was no difference in hospital stay and overall complications rate. Conclusions. LigaSure is an effective instrument when a large tissue demolition is required. This study supports its use as treatment of choice for IV degree haemorrhoids, even if the procedure is more expansive than conventional operation.

scholarly journals Laryngoceles: Concepts of Diagnosis and Management

2017 ◽  
Vol 96 (3) ◽  
pp. 133-138 ◽  
Author(s):  
Mohammad Kamal Mobashir ◽  
Waleed M. Basha ◽  
Abd ElRaof Said Mohamed ◽  
Mostafa Hassaan ◽  
Ahmed M. Anany
Keyword(s):  
Operative Time ◽  
Benign Lesion ◽  
Direct Visualization ◽  
Neck Swelling ◽  
Treatment Results ◽  
Endoscopic Laser ◽  
The Mean ◽  
Laryngeal Saccule ◽  
Single Approach

A laryngocele is an abnormal dilatation of the laryngeal saccule. It is a rare benign lesion of the larynx. Various modalities of treatment have been advocated for its management. We present our treatment results and outcomes of a series of cases of laryngoceles and discuss the concepts of their management. This study included patients with different laryngocele types. Patients with an internal laryngocele underwent endoscopic CO2 laser resection, while those with a combined laryngocele underwent resection via a V-shaped lateral thyrotomy approach. Seven patients had an internal laryngocele, and 4 patients had a combined laryngocele. Hoarseness and neck swelling were the most common symptoms. The mean follow-up period was 8.5 months. None of the patients needed a tracheostomy either preoperatively or postoperatively, or had recurrence of laryngocele. We advocate the lateral thyrotomy approach for combined laryngoceles as it provides safe, precise, and complete resection under direct visualization via a single approach, while we favor the endoscopic laser approach for the internal ones as it allows resection of the entire lesion with minimal laryngeal trauma, less operative time, and a shorter hospital stay.

Incisional Hernia Risk after Hand-Assisted Laparoscopic Surgery

2012 ◽  
Vol 78 (8) ◽  
pp. 864-869 ◽  
Author(s):  
William S. Cobb ◽  
Alfredo M. Carbonell ◽  
Garrett M. Snipes ◽  
Brianna Knott ◽  
Viet Le ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Incisional Hernia ◽  
Operative Time ◽  
Group Versus ◽  
True Incidence ◽  
Hernia Formation ◽  
The Mean ◽  
Laparoscopic Techniques ◽  
Mean Time

Hand-assisted laparoscopic surgery (HALS) bridges traditional open surgery and pure laparoscopy. The HALS technique provides the necessary site for organ retrieval, reduces operative time, and realizes the postoperative benefits of laparoscopic techniques. Although the reported rates of incisional hernia should be theoretically low, we sought to determine our incidence of hernia after HALS procedures. A retrospective review of all HALS procedures was performed from July 2006 to June 2011. All patients who developed postoperative incisional hernias at the hand port site were confirmed by imaging or examination findings. Patient factors were reviewed to determine any predictors of hernia formation. Over the 5 years, 405 patients undergoing HALS procedures were evaluated: colectomy (264), nephrectomy (107), splenectomy/pancreatectomy (18), and ostomy reversal (10). The overall incidence of incisional hernia was 10.6 per cent. There were three perioperative wound dehiscences. The mean body mass index was significantly higher in the hernia group versus the no hernia cohort (32.1 vs 29.2 kg/m2; P = 0.001). The hernia group also had a higher incidence of renal disease (18.6 vs 7.2%; P = 0.018). Mean time to hernia formation was 11.4 months (range, 1 to 57 months). Follow-up was greater than 12 months in 188 (46%) of patients, in which the rate of incisional hernia was 17 per cent. The rate of incisional hernia formation after hand-assisted laparoscopic procedures is higher than the reported literature. Because the mean time to hernia development is approximately 1 year, it is important to follow these patients to this end point to determine the true incidence of incisional hernia after hand-assisted laparoscopy.

scholarly journals Nonstented tubularized incised plate urethroplasty with Y-to-I spongioplasty in non–toilet trained children

2013 ◽  
Vol 2 (2) ◽  
pp. 110 ◽  
Author(s):  
Fayez Almodhen ◽  
Ahmed Alzahrani ◽  
Roman Jednak ◽  
Jean Paul Capolicchio ◽  
Mohamed T. El Sherbiny
Keyword(s):  
Standard Deviation ◽  
Urethral Catheter ◽  
Cosmetic Appearance ◽  
Supportive Role ◽  
Tubularized Incised Plate ◽  
Urinary Extravasation ◽  
Tubularized Incised Plate Urethroplasty ◽  
Urethral Stent

Introduction: This study was designed to evaluate the supportive role of spongioplastyduring tubularized incised plate (TIP) urethroplasty repair of hypospadias.Methods: All non–toilet trained children who underwent TIP repair for primaryhypospadias by 1 surgeon over a 30-month period were included inour study. The divergent spongiosa was mobilized off the corpora cavernosaand was rotated toward the midline to wrap the neourethra. A dartos flapwas used to cover the neourethra. The neourethra was calibrated immediatelyafter surgery in all patients. A urethral stent was left in place only when difficultcalibration was encountered. Complications and cosmetic appearance weredocumented at last follow-up.Results: Thirty-two consecutive patients with a mean age of 18 (standard deviation[SD] 6) months were included in the study. The defects were distal andmid-shaft in 26 patients (81.3%) and proximal-shaft in 6 (18.8%). No intraoperativecatheterization difficulties were encountered and all repairs were nonstented.Antibiotics and anticholinergics were not required. Mean follow-up was9 (SD 6) months. Urinary extravasation developed in 1 patient (3.1%) on the secondpostoperative day. A urethral catheter was easily inserted and left indwellingfor 5 days. One patient presented 6 days postoperatively with suspected voidingdifficulty. Urethral calibration was easily performed excluding any mechanicalobstruction. There were no urinary fistulae and reoperation was not required.An excellent cosmetic appearance was achieved in all patients.Conclusion: TIP urethroplasty is a versatile operation that can be performed inalmost all cases of penile hypospadias. A nonstented technique for hypospadiasrepair simplifies postoperative care and obviates the need for antibioticsand anticholinergics. We believe that spongioplasty provides good supportto the neourethra and the hypoplastic distal urethra that may facilitate catheterizationin the immediate and early postoperative periods, if required. Futurecontrolled study is warranted to further evaluate the role of spongioplasty.

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